THE RIO STATEMENT OF
"REPRODUCTIVE HEALTH AND JUSTICE"
INTERNATIONAL WOMEN'S HEALTH CONFERENCE
FOR CAIRO 1994"


During the period from January 24 through 28, 1994, 215 women from 79 countries participated in "Reproductive Health and Justice: International Women's Health Conference for Cairo '94" held in Rio de Janeiro. The conference brought together representatives of women's and other non-governmental organizations and networks active in the fields of health, human rights, development, environment, and population. The main objective of the conference was for women to prepare to participate in the International Conference on Population and Development to be held in Cairo in September 1994, and to provide a forum where women could search for and identify commonalities on reproductive health and justice, while recognizing the diversities emanating from different economic, social, political, and cultural backgrounds. The conference also aimed at developing tools and strategies to be used before, during, and after the Cairo conference.

The participants strongly voiced their opposition to population policies intended to control the fertility of women and that do not address their basic right to a secure livelihood, freedom from poverty and oppression; or do not respect their rights to free, informed choice or to adequate health care; that whether such policies are pro- or anti-natalist, they are often coercive, treat women as objects, not subjects, and that in the context of such policies, low fertility does not result in alleviation of poverty. In fact, a significant number of the participants opposed population policies as being inherently coercive. There was unanimous opposition to designing fertility control measures or population policies specifically targeted at Southern countries, indigenous peoples, or marginalized groups within both Southern and Northern countries, whether by race, class, ethnicity, religion, or other basis.

There was also significant criticism of pressure by donors and efforts to link development aid or structural adjustment programs to the institution and/or implementation of population control policies, and a suggestion that donor countries should not promote in other countries what they do not support for the majority of their own people.

It was agreed that:

1. Inequitable development models and strategies constitute the underlying basis of growing poverty and marginalization of women, environmental degradation, growing numbers of migrants and refugees, and the rise of fundamentalism everywhere. For women, these problems (and their presumed solutions through economic programs for structural adjustment that promote export production at the expense of local needs) have particularly severe consequences:

2. External debt, structural adjustment programs, and international terms of trade sustain Northern domination, increase inequalities between rich and poor in all countries, aggravate civil strife, encourage the corruption of government leaders, and erode the already meager resources for basic services.

3. Environmental degradation was seen to be closely related to inequality in resources and consumption, profit-driven production systems, and the role of the military as a major polluter and user of resources; hence, there is a close relationship between the violence and poverty that bedevil people's, particularly women's, lives, and environmental problems. Focusing on women's fertility as a major cause of the current environmental crisis diverts attention from root causes, including exploitative economic systems, unsustainable elite consumption patterns, and militarism. Women in the conference urged governments to diminish military expenditures in favor of social programs. The participants also urged the Northern governments and donors to stop supporting and financing military and undemocratic regimes in the South.

4. There was particular concern about the situation of women migrants who are heads of households, domestic servants, migrant workers, entertainers, and other service workers. It was agreed that while the movement of people should not be constrained by discriminatory and restrictive immigration policies that operate in contexts where migration is often forced by economic hardship, civil strife, war, and political persecution, efforts should be made to address the brutality and violence faced by women and children who are victims of trafficking and sexual exploitation.

5. Alternative development strategies must be identified. In doing so, there is no single blue-print for development strategies but a multiplicity of approaches within a basic framework of food security, adequate employment and in comes, and good-quality basic services, which can be guaranteed through democratic people centered and participatory processes.

6. The "sustainable and human development models" that are currently being proposed in the official documents of governments and international organizations need to be based on investments and social policies that guarantee the quality of life and well-being of all people.

7. There was general agreement on the need to design social development policies starting from the concerns and priorities of women.

These include:

8. The discussion of fundamentalism brought strong agreement that, whatever its origins or religious claims, its aim is political. Central to fundamentalist attempts to gain political power is the control of women's lives and in particular of female sexuality, including the right to self determination and reproductive decisions. There was criticism of the role of major Northern countries in supporting fundamentalist groups for their own political ends. Fundamentalists use religion, culture, and ethnicity in their pursuit of power; such movements represent a new form of war against women and an aggressive attempt to mutilate their human rights.

9. A major site of the fundamentalist war against women is over the meaning of "families." The participants at the conference agreed that a definition of "family" that is limited to a model with a male "head" of household, wife and children, does not reflect the life situation of all of the world's people. Instead it was agreed that all those who voluntarily come together and define themselves as a family, accepting a commitment to each other's well-being, should be respected, supported, and affirmed as such.

10. All members of the family have rights, especially to justice and human dignity. Physical, emotional, psychological, or sexual abuse of women, young girls, and children within families constitute a serious violation of basic human rights under the Universal Declaration of Human Rights. Women's rights within the family include access to resources, participation in decision making, bodily integrity, and security. Women have a right to participate in public life, to social benefits and social insurance, and to have their unpaid work inside and outside the home recognized and shared by all members of the family.

11. Comprehensive and high-quality health services for women, including for reproductive health, are a primary responsibility of governments. They should be available, accessible, and affordable to women in order to reduce maternal mortality, morbidity, child mortality, and unsafe abortion, within a broad women's health approach that addresses women's needs across the life cycle. Qualitative (as well as quantitative) indicators need to be developed to assess services, and users need to be involved in this.

12. There was clear agreement that quality reproductive health services are a key right for women. However, existing family planning programs cannot simply be redefined as programs of reproductive health. Reproductive health services should include prenatal, child birth, and postpartum care including nutritional and lactation programs; safe contraception and safe non-compulsory abortion; prevention, early diagnosis, and treatment of sexually transmitted diseases, and breast, cervical, and other women's cancers, as well as the prevention and treatment of HIV/AIDS, and treatment of infertility; all with the informed consent of women. These services should be women-centered and wornen-controlled, and every effort should be made to prevent the maltreatment and abuse of women users by the medical staff. The UN and other donors and governments should recognize the right to safe and legal abortion as an intrinsic part of women's rights, and governments should change legislation and implement policies to reflect such a recognition.

13. In the area of contraceptive technology, resources should be redirected from provider controlled and potentially high-risk methods, like the vaccine, to barrier methods. A significant proportion of the participants also felt strongly that Norplant or other long-term hormonal contraceptives should be explicitly mentioned as high-risk methods from which resources should be redirected. Female controlled methods that provide both contraception and protection from sexually transmitted diseases, including HIV, as well as male methods, should receive the highest priority in contraceptive research and development. Women's organizations are entitled to independently monitor contraceptive trials and ensure women's free, informed consent to enter the trial. Trial results must be available for women's organizations at the different stages of such trials, including the very early stages.

14. Better health services are one element of women's human rights. In addition, sexuality and gender power relationships must be addressed as a central aspect of reproductive rights. Reproductive rights are inalienable human rights that are inseparable from other basic rights, such as the right to food, shelter, health, security, livelihood, education, and political empowerment. Therefore, the design and implementation of policies affecting reproductive rights and health should conform to international human rights standards.

15. Women are entitled to bodily integrity. Within this principle, violence against women; forced early marriage; and harmful practices, especially female genital mutilation, must be recognized as major reproductive rights, health, and development issues. Governments should take measures to combat such practices and should be held accountable for failure to do so.

16. Women have a right to express their sexuality with pleasure and without fear of abuse and risk of diseases or discrimination on the basis of their sexual orientation or disability. Social and economic powerlessness; oppressive cultural, traditional and religious norms and practices; inequitable laws; fundamentalism, and fear of male violence are impediments to women's own sense of entitlement and should be challenged.

17. Women, especially girls, must have equal access to education in general. Such education should not be gender-discriminatory in its objectives, methods, and content. Quality sex education with a gender perspective should be made available to women and men of all ages, in order to create the conditions for equity in social roles and empowerment of women in order to enable them to control their own fertility.

18. For women to be able to empower themselves and fully exercise their rights of citizenship, the underlying inequities in gender relationships must be elilllinated. In particular, policies and programs should educate and encourage men to share family responsibilities, including the responsibility for their reproductive behavior and for the prevention of sexually transmitted diseases.

19. Participants at the conference were concerned that women and women's organizations should be involved in the decision-making process locally, nationally, and internationally where any laws or policies affecting their rights and health are designed and implemented. Governments, the UN, and other international institutions should be held accountable for the design and implementation of social and development policies that guarantee women's reproductive rights and health. Mechanisms for monitoring and regular evaluation should be established, and should provide for participation of women's organizations.

20. Donors and governments should also be held accountable, and their concern for women's health and development should be reflected in their resource allocation and priorities. Donors and governments should revise their funding categories to promote comprehensive women's health programs, rather than narrowly defined programs for family planning. A major requirement is that women-centered programs must have access to a fair share of the financial resources available for reproductive health.

21. The participants recommended a UN commission on women's reproductive rights whose composition should be gender-balanced, and should take account of geographic, ethnic, racial, social class, and other balances. Said commission should be interdisciplinary and should include NGOs, especially women's human rights organizations. Each government should be held responsible for establishing a similar commission at the national level.


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