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PLATFORM FOR ACTION
C. Women and health*
89. Women have the right to the enjoyment of the highest attainable standard of physical and mental health. The enjoyment of this right is vital to their life and well-being and their ability to participate in all areas of public and private life. Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Women's health involves their emotional, social and physical well-being and is determined by the social, political and economic context of their lives, as well as by biology. However, health and well-being elude the majority of women. A major barrier for women to the achievement of the highest attainable standard of health is inequality, both between men and women and among women in different geographical regions, social classes and indigenous and ethnic groups. In national and international forums, women have emphasized that to attain optimal health throughout the life cycle, equality, including the sharing of family responsibilities, development and peace are necessary conditions.
90. Women have different and unequal access to and use of basic health resources, including primary health services for the prevention and treatment of childhood diseases, malnutrition, anaemia, diarrhoeal diseases, communicable diseases, malaria and other tropical diseases and tuberculosis, among others. Women also have different and unequal opportunities for the protection, promotion and maintenance of their health. In many developing countries, the lack of emergency obstetric services is also of particular concern. Health policies and programmes often perpetuate gender stereotypes and fail to consider socio-economic disparities and other differences among women and may not fully take account of the lack of autonomy of women regarding their health. Women's health is also affected by gender bias in the health system and by the provision of inadequate and inappropriate medical services to women.
91. In many countries, especially developing countries, in particular the least developed countries, a decrease in public health spending and, in some cases, structural adjustment, contribute to the deterioration of public health systems. In addition, privatization of health-care systems without appropriate guarantees of universal access to affordable health care further reduces health-care availability. This situation not only directly affects the health of girls and women, but also places disproportionate responsibilities on women, whose multiple roles, including their roles within the family and the community, are often not acknowledged; hence they do not receive the necessary social, psychological and economic support.
92. Women's right to the enjoyment of the highest standard of health must be secured throughout the whole life cycle in equality with men. Women are affected by many of the same health conditions as men, but women experience them differently. The prevalence among women of poverty and economic dependence, their experience of violence, negative attitudes towards women and girls, racial and other forms of discrimination, the limited power many women have over their sexual and reproductive lives and lack of influence in decision-making are social realities which have an adverse impact on their health. Lack of food and inequitable distribution of food for girls and women in the household, inadequate access to safe water, sanitation facilities and fuel supplies, particularly in rural and poor urban areas, and deficient housing conditions, all overburden women and their families and have a negative effect on their health. Good health is essential to leading a productive and fulfilling life, and the right of all women to control all aspects of their health, in particular their own fertility, is basic to their empowerment.
93. Discrimination against girls, often resulting from son preference, in access to nutrition and health-care services endangers their current and future health and well-being. Conditions that force girls into early marriage, pregnancy and child-bearing and subject them to harmful practices, such as female genital mutilation, pose grave health risks. Adolescent girls need, but too often do not have, access to necessary health and nutrition services as they mature. Counselling and access to sexual and reproductive health information and services for adolescents are still inadequate or lacking completely, and a young woman's right to privacy, confidentiality, respect and informed consent is often not considered. Adolescent girls are both biologically and psychosocially more vulnerable than boys to sexual abuse, violence and prostitution, and to the consequences of unprotected and premature sexual relations. The trend towards early sexual experience, combined with a lack of information and services, increases the risk of unwanted and too early pregnancy, HIV infection and other sexually transmitted diseases, as well as unsafe abortions. Early child-bearing continues to be an impediment to improvements in the educational, economic and social status of women in all parts of the world. Overall, for young women early marriage and early motherhood can severely curtail educational and employment opportunities and are likely to have a long-term, adverse impact on the quality of their lives and the lives of their children. Young men are often not educated to respect women's self-determination and to share responsibility with women in matters of sexuality and reproduction.
94. Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility which are not against the law, and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. In line with the above definition of reproductive health, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. It also includes sexual health, the purpose of which is the enhancement of life and personal relations, and not merely counselling and care related to reproduction and sexually transmitted diseases.
95. Bearing in mind the above definition, reproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other consensus documents. These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes their right to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights documents. In the exercise of this right, they should take into account the needs of their living and future children and their responsibilities towards the community. The promotion of the responsible exercise of these rights for all people should be the fundamental basis for government- and community-supported policies and programmes in the area of reproductive health, including family planning. As part of their commitment, full attention should be given to the promotion of mutually respectful and equitable gender relations and particularly to meeting the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality. Reproductive health eludes many of the world's people because of such factors as: inadequate levels of knowledge about human sexuality and inappropriate or poor-quality reproductive health information and services; the prevalence of high-risk sexual behaviour; discriminatory social practices; negative attitudes towards women and girls; and the limited power many women and girls have over their sexual and reproductive lives. Adolescents are particularly vulnerable because of their lack of information and access to relevant services in most countries. Older women and men have distinct reproductive and sexual health issues which are often inadequately addressed.
96. The human rights of women include their right to have control over and
decide freely and responsibly on matters related to their sexuality,
including sexual and reproductive health, free of coercion, discrimination and
violence.
Equal relationships between women and men in matters of sexual relations and
reproduction, including full respect for the integrity of the person, require
mutual respect, consent and shared responsibility for sexual behaviour and its
consequences.
97. Further, women are subject to particular health risks due to inadequate responsiveness and lack of services to meet health needs related to sexuality and reproduction. Complications related to pregnancy and childbirth are among the leading causes of mortality and morbidity of women of reproductive age in many parts of the developing world. Similar problems exist to a certain degree in some countries with economies in transition. Unsafe abortions threaten the lives of a large number of women, representing a grave public health problem as it is primarily the poorest and youngest who take the highest risk. Most of these deaths, health problems and injuries are preventable through improved access to adequate health-care services, including safe and effective family planning methods and emergency obstetric care, recognizing the right of women and men to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility which are not against the law, and the right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. These problems and means should be addressed on the basis of the report of the International Conference on Population and Development, with particular reference to relevant paragraphs of the Programme of Action of the Conference. 14/ In most countries, the neglect of women's reproductive rights severely limits their opportunities in public and private life, including opportunities for education and economic and political empowerment. The ability of women to control their own fertility forms an important basis for the enjoyment of other rights. Shared responsibility between women and men in matters related to sexual and reproductive behaviour is also essential to improving women's health.
98. HIV/AIDS and other sexually transmitted diseases, the transmission of which is sometimes a consequence of sexual violence, are having a devas- tating effect on women's health, particularly the health of adolescent girls and young women. They often do not have the power to insist on safe and responsible sex practices and have little access to information and services for prevention and treatment. Women, who represent half of all adults newly infected with HIV/AIDS and other sexually transmitted diseases, have emphasized that social vulnerability and the unequal power relationships between women and men are obstacles to safe sex, in their efforts to control the spread of sexually transmitted diseases. The consequences of HIV/AIDS reach beyond women's health to their role as mothers and caregivers and their contribution to the economic support of their families. The social, developmental and health consequences of HIV/AIDS and other sexually transmitted diseases need to be seen from a gender perspective.
99. Sexual and gender-based violence, including physical and psychological abuse, trafficking in women and girls, and other forms of abuse and sexual exploitation place girls and women at high risk of physical and mental trauma, disease and unwanted pregnancy. Such situations often deter women from using health and other services.
100. Mental disorders related to marginalization, powerlessness and poverty, along with overwork and stress and the growing incidence of domestic violence as well as substance abuse, are among other health issues of growing concern to women. Women throughout the world, especially young women, are increasing their use of tobacco with serious effects on their health and that of their children. Occupational health issues are also growing in importance, as a large number of women work in low-paid jobs in either the formal or the informal labour market under tedious and unhealthy conditions, and the number is rising. Cancers of the breast and cervix and other cancers of the reproductive system, as well as infertility affect growing numbers of women and may be preventable, or curable, if detected early.
101. With the increase in life expectancy and the growing number of older women, their health concerns require particular attention. The long-term health prospects of women are influenced by changes at menopause, which, in combination with life-long conditions and other factors, such as poor nutrition and lack of physical activity, may increase the risk of cardiovascular disease and osteoporosis. Other diseases of ageing and the interrelationships of ageing and disability among women also need particular attention.
102. Women, like men, particularly in rural areas and poor urban areas, are increasingly exposed to environmental health hazards owing to environmental catastrophes and degradation. Women have a different susceptibility to various environmental hazards, contaminants and substances and they suffer different consequences from exposure to them.
103. The quality of women's health care is often deficient in various ways, depending on local circumstances. Women are frequently not treated with respect, nor are they guaranteed privacy and confidentiality, nor do they always receive full information about the options and services available. Furthermore, in some countries, over-medicating of women's life events is common, leading to unnecessary surgical intervention and inappropriate medication.
104. Statistical data on health are often not systematically collected, disaggregated and analysed by age, sex and socio-economic status and by established demographic criteria used to serve the interests and solve the problems of subgroups, with particular emphasis on the vulnerable and marginalized and other relevant variables. Recent and reliable data on the mortality and morbidity of women and conditions and diseases particularly affecting women are not available in many countries. Relatively little is known about how social and economic factors affect the health of girls and women of all ages, about the provision of health services to girls and women and the patterns of their use of such services, and about the value of disease prevention and health promotion programmes for women. Subjects of importance to women's health have not been adequately researched and women's health research often lacks funding. Medical research, on heart disease, for example, and epidemiological studies in many countries are often based solely on men; they are not gender specific. Clinical trials involving women to establish basic information about dosage, side-effects and effectiveness of drugs, including contraceptives, are noticeably absent and do not always conform to ethical standards for research and testing. Many drug therapy protocols and other medical treatments and interventions administered to women are based on research on men without any investigation and adjustment for gender differences.
105. In addressing inequalities in health status and unequal access to and inadequate health-care services between women and men, Governments and other actors should promote an active and visible policy of mainstreaming a gender perspective in all policies and programmes, so that, before decisions are taken, an analysis is made of the effects for women and men, respectively.
Strategic objective C.1. Increase women's access throughout the life cycle to appropriate, affordable and quality health care, information and related services
Actions to be taken
106. By Governments, in collaboration with non-governmental organizations and employers' and workers' organizations and with the support of international institutions:
(a) Support and implement the commitments made in the Programme of
Action of the International Conference on Population and
Development, as established in the report of that Conference and the
Copenhagen Declaration on Social Development and Programme of Action
of the World Summit for Social Development 15/ and the obligations
of States parties under the Convention on the Elimination of All
Forms of Discrimination against Women and other relevant
international agreements, to meet the health needs of girls and
women of all ages;
(b) Reaffirm the right to the enjoyment of the highest attainable
standards of physical and mental health, protect and promote the
attainment of this right for women and girls and incorporate it in
national legislation, for example; review existing legislation,
including health legislation, as well as policies, where necessary,
to reflect a commitment to women's health and to ensure that they
meet the changing roles and responsibilities of women wherever they
reside;
(c) Design and implement, in cooperation with women and com-
munity-based organizations, gender-sensitive health programmes, including
decentralized health services, that address the needs of women
throughout their lives and take into account their multiple roles
and responsibilities, the demands on their time, the special needs
of rural women and women with disabilities and the diversity of
women's needs arising from age and socio-economic and cultural
differences, among others; include women, especially local and
indigenous women, in the identification and planning of health-care
priorities and programmes; remove all barriers to women's health
services and provide a broad range of health-care services;
(d) Allow women access to social security systems in equality with men
throughout the whole life cycle;
(e) Provide more accessible, available and affordable primary health-
care services of high quality, including sexual and reproductive
health care, which includes family planning information and
services, and giving particular attention to maternal and emergency
obstetric care, as agreed to in the Programme of Action of the
International Conference on Population and Development;
(f) Redesign health information, services and training for health
workers so that they are gender-sensitive and reflect the user's
perspectives with regard to interpersonal and communications
skills and the user's right to privacy and confidentiality; these services,
information and training should be based on a holistic approach;
(g) Ensure that all health services and workers conform to human
rights and to ethical, professional and gender-sensitive standards in the
delivery of women's health services aimed at ensuring responsible,
voluntary and informed consent; encourage the development,
implementation and dissemination of codes of ethics guided by
existing international codes of medical ethics as well as ethical
principles that govern other health professionals;
(h) Take all appropriate measures to eliminate harmful, medically
unnecessary or coercive medical interventions, as well as
inappropriate medication and over-medication of women, and ensure
that all women are fully informed of their options, including likely
benefits and potential side-effects, by properly trained personnel;
(i) Strengthen and reorient health services, particularly primary health
care, in order to ensure universal access to quality health
services for women and girls; reduce ill health and maternal morbidity and
achieve world wide the agreed-upon goal of reducing maternal
mortality by at least 50 per cent of the 1990 levels by the year
2000 and a further one half by the year 2015; ensure that the
necessary services are available at each level of the health system
and make reproductive health care accessible, through the primary
health-care system, to all individuals of appropriate ages as soon
as possible and no later than the year 2015;
(j) Recognize and deal with the health impact of unsafe abortion as a
major public health concern, as agreed in paragraph 8.25 of the
Programme of Action of the International Conference on Population
and Development; 14/
(k) In the light of paragraph 8.25 of the Programme of Action of the
International Conference on Population and Development, which
states: "In no case should abortion be promoted as a method of
family planning. All Governments and relevant intergovernmental
and non-governmental organizations are urged to strengthen their
commitment to women's health, to deal with the health impact of
unsafe abortion 16/ as a major public health concern and to reduce
the recourse to abortion through expanded and improved
family-planning services. Prevention of unwanted pregnancies must
always be given the highest priority and every attempt should be
made to eliminate the need for abortion. Women who have unwanted
pregnancies should have ready access to reliable information and
compassionate counselling. Any measures or changes related to
abortion within the health system can only be determined at the
national or local level according to the national legislative
process. In circumstances where abortion is not against the law,
such abortion should be safe. In all cases, women should have
access to quality services for the management of complications
arising from abortion. Post-abortion counselling, education and
family-planning services should be offered promptly, which will also
help to avoid repeat abortions", consider reviewing laws containing
punitive measures against women who have undergone illegal
abortions;
(l) Give particular attention to the needs of girls, especially the
promotion of healthy behaviour, including physical activities; take
specific measures for closing the gender gaps in morbidity and
mortality where girls are disadvantaged, while achieving
internationally approved goals for the reduction of infant and child
mortality - specifically, by the year 2000, the reduction of
mortality rates of infants and children under five years of age by
one third of the 1990 level, or 50 to 70 per 1,000 live births,
whichever is less; by the year 2015 an infant mortality rate below
35 per 1,000 live births and an under-five mortality rate below 45
per 1,000;
(m) Ensure that girls have continuing access to necessary health and
nutrition information and services as they mature, to facilitate a
healthful transition from childhood to adulthood;
(n) Develop information, programmes and services to assist women to
understand and adapt to changes associated with ageing and to
address and treat the health needs of older women, paying
particular
attention to those who are physically or psychologically dependent;
(o) Ensure that girls and women of all ages with any form of disability
receive supportive services;
(p) Formulate special policies, design programmes and enact the
legislation necessary to alleviate and eliminate environmental and
occupational health hazards associated with work in the home, in the
workplace and elsewhere with attention to pregnant and lactating
women;
(q) Integrate mental health services into primary health-care systems or
other appropriate levels, develop supportive programmes and train
primary health workers to recognize and care for girls and women of
all ages who have experienced any form of violence especially
domestic violence, sexual abuse or other abuse resulting from armed
and non-armed conflict;
(r) Promote public information on the benefits of breast-feeding;
examine ways and means of implementing fully the WHO/UNICEF
International Code of Marketing of Breast-milk Substitutes, and
enable mothers to breast-feed their infants by providing legal,
economic, practical and emotional support;
(s) Establish mechanisms to support and involve non-governmental
organizations, particularly women's organizations, professional
groups and other bodies working to improve the health of girls and
women, in government policy-making, programme design, as
appropriate, and implementation within the health sector and
related
sectors at all levels;
(t) Support non-governmental organizations working on women's health and
help develop networks aimed at improving coordination and
collaboration between all sectors that affect health;
(u) Rationalize drug procurement and ensure a reliable, continuous
supply of high-quality pharmaceutical, contraceptive and other
supplies and equipment, using the WHO Model List of Essential Drugs
as a guide, and ensure the safety of drugs and devices through
national regulatory drug approval processes;
(v) Provide improved access to appropriate treatment and rehabilitation
services for women substance abusers and their families;
(w) Promote and ensure household and national food security, as
appropriate, and implement programmes aimed at improving the
nutritional status of all girls and women by implementing the
commitments made in the Plan of Action on Nutrition of the
International Conference on Nutrition, 17/ including a reduction
world wide of severe and moderate malnutrition among children under
the age of five by one half of 1990 levels by the year 2000, giving
special attention to the gender gap in nutrition, and a reduction in
iron deficiency anaemia in girls and women by one third of the 1990
levels by the year 2000;
(x) Ensure the availability of and universal access to safe drinking
water and sanitation and put in place effective public distribution
systems as soon as possible;
(y) Ensure full and equal access to health-care infrastructure and
services for indigenous women.
Strategic objective C.2. Strengthen preventive programmes that promote women's health
Actions to be taken
107. By Governments, in cooperation with non-governmental organizations, the mass media, the private sector and relevant international organizations, including United Nations bodies, as appropriate:
(a) Give priority to both formal and informal educational programmes
that support and enable women to develop self-esteem, acquire
knowledge, make decisions on and take responsibility for their own
health, achieve mutual respect in matters concerning sexuality and
fertility and educate men regarding the importance of women's health
and well-being, placing special focus on programmes for both men and
women that emphasize the elimination of harmful attitudes and
practices, including female genital mutilation, son preference
(which results in female infanticide and prenatal sex selection),
early marriage, including child marriage, violence against women,
sexual exploitation, sexual abuse, which at times is conducive to
infection with HIV/AIDS and other sexually transmitted diseases,
drug abuse, discrimination against girls and women in food
allocation and other harmful attitudes and practices related to the
life, health and well-being of women, and recognizing that some of
these practices can be violations of human rights and ethical
medical principles;
(b) Pursue social, human development, education and employment policies
to eliminate poverty among women in order to reduce their
susceptibility to ill health and to improve their health;
(c) Encourage men to share equally in child care and household work and
to provide their share of financial support for their families, even
if they do not live with them;
(d) Reinforce laws, reform institutions and promote norms and practices
that eliminate discrimination against women and encourage both women
and men to take responsibility for their sexual and reproductive
behaviour; ensure full respect for the integrity of the person, take
action to ensure the conditions necessary for women to exercise
their reproductive rights and eliminate coercive laws and practices;
(e) Prepare and disseminate accessible information, through public
health campaigns, the media, reliable counselling and the education
system, designed to ensure that women and men, particularly young
people, can acquire knowledge about their health, especially
information on sexuality and reproduction, taking into account the
rights of the child to access to information, privacy,
confidentiality, respect and informed consent, as well as the
responsibilities, rights and duties of parents and legal guardians
to provide, in a manner consistent with the evolving capacities of
the child, appropriate direction and guidance in the exercise by the
child of the rights recognized in the Convention on the Rights of
the Child, and in conformity with the Convention on the Elimination
of All Forms of Discrimination against Women; ensure that in all
actions concerning children, the best interests of the child are a
primary consideration;
(f) Create and support programmes in the educational system, in the
workplace and in the community to make opportunities to participate
in sport, physical activity and recreation available to girls and
women of all ages on the same basis as they are made available to
men and boys;
(g) Recognize the specific needs of adolescents and implement specific
appropriate programmes, such as education and information on sexual
and reproductive health issues and on sexually transmitted diseases,
including HIV/AIDS, taking into account the rights of the child and
the responsibilities, rights and duties of parents as stated in
paragraph 107 (e) above;
(h) Develop policies that reduce the disproportionate and increasing
burden on women who have multiple roles within the family and the
community by providing them with adequate support and programmes
from health and social services;
(i) Adopt regulations to ensure that the working conditions, including
remuneration and promotion of women at all levels of the health
system, are non-discriminatory and meet fair and professional
standards to enable them to work effectively;
(j) Ensure that health and nutritional information and training form an
integral part of all adult literacy programmes and school curricula
from the primary level;
(k) Develop and undertake media campaigns and information and
educational programmes that inform women and girls of the health and
related risks of substance abuse and addiction and pursue strategies
and programmes that discourage substance abuse and addiction and
promote rehabilitation and recovery;
(l) Devise and implement comprehensive and coherent programmes for the
prevention, diagnosis and treatment of osteoporosis, a condition
that predominantly affects women;
(m) Establish and/or strengthen programmes and services, including media
campaigns, that address the prevention, early detection and
treatment of breast, cervical and other cancers of the reproductive
system;
(n) Reduce environmental hazards that pose a growing threat to health,
especially in poor regions and communities; apply a precautionary
approach, as agreed to in the Rio Declaration on Environment and
Development, adopted by the United Nations Conference on Environment
and Development, 18/ and include reporting on women's health risks
related to the environment in monitoring the implementation of
Agenda 21; 19/
(o) Create awareness among women, health professionals, policy makers
and the general public about the serious but preventable health
hazards stemming from tobacco consumption and the need for
regulatory and education measures to reduce smoking as important
health promotion and disease prevention activities;
(p) Ensure that medical school curricula and other health-care training
include gender-sensitive, comprehensive and mandatory courses on
women's health;
(q) Adopt specific preventive measures to protect women, youth and
children from any abuse - sexual abuse, exploitation, trafficking
and violence, for example - including the formulation and
enforcement of laws, and provide legal protection and medical and
other assistance.
Strategic objective C.3. Undertake gender-sensitive initiatives that address sexually transmitted diseases, HIV/AIDS, and sexual and reproductive health issues
Actions to be taken
108. By Governments, international bodies including relevant United Nations organizations, bilateral and multilateral donors and non-governmental organizations:
(a) Ensure the involvement of women, especially those infected with
HIV/AIDS or other sexually transmitted diseases or affected by the
HIV/AIDS pandemic, in all decision-making relating to the
development, implementation, monitoring and evaluation of policies
and programmes on HIV/AIDS and other sexually transmitted diseases;
(b) Review and amend laws and combat practices, as appropriate, that may
contribute to women's susceptibility to HIV infection and other
sexually transmitted diseases, including enacting legislation
against those socio-cultural practices that contribute to it, and
implement legislation, policies and practices to protect women,
adolescents and young girls from discrimination related to HIV/AIDS;
(c) Encourage all sectors of society, including the public sector, as
well as international organizations, to develop compassionate and
supportive, non-discriminatory HIV/AIDS-related policies and
practices that protect the rights of infected individuals;
(d) Recognize the extent of the HIV/AIDS pandemic in their countries,
taking particularly into account its impact on women, with a view to
ensuring that infected women do not suffer stigmatization and
discrimination, including during travel;
(e) Develop gender-sensitive multisectoral programmes and strategies to
end social subordination of women and girls and to ensure their
social and economic empowerment and equality; facilitate promotion
of programmes to educate and enable men to assume their
responsibilities to prevent HIV/AIDS and other sexually transmitted
diseases;
(f) Facilitate the development of community strategies that will protect
women of all ages from HIV and other sexually transmitted diseases;
provide care and support to infected girls, women and theirfamilies
and mobilize all parts of the community in response to the HIV/AIDS
pandemic to exert pressure on all responsible authorities to respond
in a timely, effective, sustainable and gender-sensitive manner;
(g) Support and strengthen national capacity to create and improve
gender-sensitive policies and programmes on HIV/AIDS and other
sexually transmitted diseases, including the provision of resources
and facilities to women who find themselves the principal caregivers
or economic support for those infected with HIV/AIDS or affected by
the pandemic, and the survivors, particularly children and older
persons;
(h) Provide workshops and specialized education and training to parents,
decision makers and opinion leaders at all levels of the community,
including religious and traditional authorities, on prevention of
HIV/AIDS and other sexually transmitted diseases and on their
repercussions on both women and men of all ages;
(i) Give all women and health workers all relevant information and
education about sexually transmitted diseases including HIV/AIDS and
pregnancy and the implications for the baby, including breast-
feeding;
(j) Assist women and their formal and informal organizations to
establish and expand effective peer education and outreach
programmes and to participate in the design, implementation and
monitoring of these programmes;
(k) Give full attention to the promotion of mutually respectful and
equitable gender relations and, in particular, to meeting the
educational and service needs of adolescents to enable them to deal
in a positive and responsible way with their sexuality;
(l) Design specific programmes for men of all ages and male adolescents,
recognizing the parental roles referred to in paragraph 107 (e)
above, aimed at providing complete and accurate information on safe
and responsible sexual and reproductive behaviour, including
voluntary, appropriate and effective male methods for the prevention
of HIV/AIDS and other sexually transmitted diseases through,
inter alia, abstinence and condom use;
(m) Ensure the provision, through the primary health-care system, of
universal access of couples and individuals to appropriate and
affordable preventive services with respect to sexually transmitted
diseases, including HIV/AIDS, and expand the provision of
counselling and voluntary and confidential diagnostic and treatment
services for women; ensure that high-quality condoms as well as
drugs for the treatment of sexually transmitted diseases are where
possible, supplied and distributed to health services;
(n) Support programmes which acknowledge that the higher risk among women of contracting HIV is linked to high-risk behaviour, including ntravenous substance use and substance-influenced unprotected
and irresponsible sexual behaviour, and take appropriate preventive
measures;
(o) Support and expedite action-oriented research on affordable methods,
controlled by women, to prevent HIV and other sexually transmitted
diseases, on strategies empowering women to protect themselves from
sexually transmitted diseases, including HIV/AIDS, and on methods of
care, support and treatment of women, ensuring their involvement in
all aspects of such research;
(p) Support and initiate research which addresses women's needs and
situations, including research on HIV infection and other sexually
transmitted diseases in women, on women-controlled methods of
protection, such as non-spermicidal microbicides, and on male and
female risk-taking attitudes and practices.
Strategic objective C.4. Promote research and disseminate information on women's health
Actions to be taken
109. By Governments, the United Nations system, health professions, research institutions, non-governmental organizations, donors, pharmaceutical industries and the mass media, as appropriate:
(a) Train researchers and introduce systems that allow for the use of
data collected, analysed and disaggregated by, among other factors,
sex and age, other established demographic criteria and
socio-economic variables, in policy-making, as appropriate,
planning, monitoring and evaluation;
(b) Promote gender-sensitive and women-centred health research,
treatment and technology and link traditional and indigenous
knowledge with modern medicine, making information available to
women to enable them to make informed and responsible decisions;
(c) Increase the number of women in leadership positions in the health
professions, including researchers and scientists, to achieve
equality at the earliest possible date;
(d) Increase financial and other support from all sources for
preventive, appropriate biomedical, behavioural, epidemiological and
health service research on women's health issues and for research on
the social, economic and political causes of women's health
problems, and their consequences, including the impact of gender and
age inequalities, especially with respect to chronic and
non-communicable diseases, particularly cardiovascular diseases and
conditions, cancers, reproductive tract infections and injuries,
HIV/AIDS and other sexually transmitted diseases, domestic violence,
occupational health, disabilities, environmentally related health
problems, tropical diseases and health aspects of ageing;
(e) Inform women about the factors which increase the risks of
developing cancers and infections of the reproductive tract, so that
they can make informed decisions about their health;
(f) Support and fund social, economic, political and cultural research
on how gender-based inequalities affect women's health, including
etiology, epidemiology, provision and utilization of services and
eventual outcome of treatment;
(g) Support health service systems and operations research to strengthen
access and improve the quality of service delivery, to ensure
appropriate support for women as health-care providers and to
examine patterns with respect to the provision of health services to
women and use of such services by women;
(h) Provide financial and institutional support for research on safe,
effective, affordable and acceptable methods and technologies for
the reproductive and sexual health of women and men, including more
safe, effective, affordable and acceptable methods for the
regulation of fertility, including natural family planning for both
sexes, methods to protect against HIV/AIDS and other sexually
transmitted diseases and simple and inexpensive methods of
diagnosing such diseases, among others; this research needs to be
guided at all stages by users and from the perspective of gender,
particularly the perspective of women, and should be carried out in
strict conformity with internationally accepted legal, ethical,
medical and scientific standards for biomedical research;
(i) Since unsafe abortion 16/ is a major threat to the health and life
of women, research to understand and better address the determinants
and consequences of induced abortion, including its effects on
subsequent fertility, reproductive and mental health and
contraceptive practice, should be promoted, as well as research on
treatment of complications of abortions and post-abortion care;
(j) Acknowledge and encourage beneficial traditional health care,
especially that practised by indigenous women, with a view to
preserving and incorporating the value of traditional health care in
the provision of health services, and support research directed
towards achieving this aim;
(k) Develop mechanisms to evaluate and disseminate available data and
research findings to researchers, policy makers, health
professionals and women's groups, among others;
(l) Monitor human genome and related genetic research from the
perspective of women's health and disseminate information and
results of studies conducted in accordance with accepted ethical
standards.
Strategic objective C.5. Increase resources and monitor follow-up for women's health
Actions to be taken
110. By Governments at all levels and, where appropriate, in cooperation with non-governmental organizations, especially women's and youth organizations:
(a) Increase budgetary allocations for primary health care and social
services, with adequate support for secondary and tertiary levels,
and give special attention to the reproductive and sexual health of
girls and women and give priority to health programmes in rural and
poor urban areas;
(b) Develop innovative approaches to funding health services through
promoting community participation and local financing; increase,
where necessary, budgetary allocations for community health centres
and community-based programmes and services that address women's
specific health needs;
(c) Develop local health services, promoting the incorporation of
gender-sensitive community-based participation and self-care and
specially designed preventive health programmes;
(d) Develop goals and time-frames, where appropriate, for improving
women's health and for planning, implementing, monitoring and
evaluating programmes, based on gender-impact assessments using
qualitative and quantitative data disaggregated by sex, age, other
established demographic criteria and socio-economic variables;
(e) Establish, as appropriate, ministerial and inter-ministerial
mechanisms for monitoring the implementation of women's health
policy and programme reforms and establish, as appropriate, high-
level focal points in national planning authorities responsible for
monitoring to ensure that women's health concerns are mainstreamed
in all relevant government agencies and programmes.
111. By Governments, the United Nations and its specialized agencies, international financial institutions, bilateral donors and the private sector, as appropriate:
(a) Formulate policies favourable to investment in women's health and,
where appropriate, increase allocations for such investment;
(b) Provide appropriate material, financial and logistical assistance to
youth non-governmental organizations in order to strengthen them to
address youth concerns in the area of health, including sexual and
reproductive health;
(c) Give higher priority to women's health and develop mechanisms for coordinating and implementing the health objectives of the Platform
for Action and relevant international agreements to ensure
progress.
* The Holy See expressed a general reservation on this section. The reservation is to be interpreted in terms of the statement made by the representative of the Holy See at the 4th meeting of the Main Committee, on 14 September 1995 (see chap. V of the present report, para. 11).
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