and men

Women´s Issues After Beijing
Platform for Action of the Fourth World Conference on Women
Positions - Networks - Results

Chapter III

The Twelve Critical Areas of Concern of the Beijing Platform for Action: A Women´s Agenda for the Twenty-first Century

3 Women and health: a threat to an increasing number of women

"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. ... However, health and well-being elude the majority of women". This gap has widened in the last ten years.

The gap in health services widens world-wide

Structural adjustment programmes, which are implemented in a number of developing countries on request of the World Bank, force these countries to decrease public spending, frequently at the expense of public health systems. This decline has an adverse effect on women. Privatization of health-care systems further reduces the availability of affordable health-care.

Structural adjustments threaten health systems

The Platform mentions complications related to pregnancy and child-birth as the leading causes of mortality and morbidity of women of reproductive age. Similar problems exist in countries with economies in transition. Abortions are also a high risk for a large number of women, in particular the poorest and youngest of them. "Most of these deaths, health problems and injuries are preventable through improved access to adequate health-care services".

Special risks: pregnancy and child-birth

The Platform for Action considers women´s health to be under increasing pressure in many parts of the world: increasing poverty, economic dependence, use of force, discriminatory practices, restricted freedom of decision of many women on matters of sexuality and reproduction and also lack of influence over decision-making are the essential gender-based factors that have an adverse impact on the health of women. Lack of food and inequitable distribution of food in the household, unsafe drinking water, inadequate sanitation facilities, lack of fuel supplies, deficient housing conditions all have a negative effect on their health. It starts in very early childhood: "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".

Increasing pressure on women and girls

Adolescent girls are both biologically and psychologically more vulnerable than boys to violence, sexual abuse and prostitution. Girls are also more exposed to the possibly fatal consequences of unprotected and early sexual experience. Combined with lack of sex information and of basic health services and inadequate nutrition, this significantly increases their risks. Early pregnancies, unsafe abortions which put their lives at risk, HIV/Aids and other sexually transmitted diseases, the transmission of which is sometimes a consequence of sexual violence, all have a devastating effect on the health of women and girls. "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".

Higher health risks through violence

Psychological stress resulting from poverty, overwork, stress and domestic violence are growing health risks for women. Occupational health issues also grow in importance as a large number of women work in low-paid jobs in either the formal or the informal sector under monotonous and unhealthy conditions. "Cancers of the breast and the 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". Illness, ill health or early motherhood in turn limit social opportunities, including opportunities in education and at work.
The gap between social and economic life realities of women and their human right to physical integrity widens, in particular when regarded from a gender perspective. The right of women "to control all aspects of their health, in particular their own fertility", as reaffirmed at the Vienna Human Rights Conference, is of less consequence in their daily lives. However, the Platform emphasizes that this right is "basic to their empowerment".

Poverty makes women ill, ill health excludes them socially

The World Health Organization defines health as "a state of complete physical, mental and social well-being", while the Platform applies this definition specifically to reproductive health. Reproductive health includes "all matters related to the reproductive system and to its functions and processes". As in the case of general health, it means more than the absence of disease or infirmity: "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".

Sexuality and reproduction are autonomous rights

The right to reproductive and sexual health, "the purpose of which is the enhancement of life and personal relations", is recognized as an autonomous feature of human rights. The Platform for Action is the first international document to make this clear distinction.
The human rights of women include the 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". Catholic moral teaching on sexuality still insists on relating sexuality to reproduction only.

Breaking the taboo regarding women´s sexual self-determination

In various contexts, the Platform explicitly mentions abortion as one possible choice for controlling fertility in the responsibility of women, if it is not against the law. Current Catholic teaching regards abortions as unacceptable even if they do not violate the law. Because of this, the Holy See subjected the complex "Women and Health" to a general reservation, which is included in the annex to the Platform.

Strategies and actions to be taken

The Platform defines women´s sexual and reproductive health both as a human right and an essential condition for social development and peace. On this basis, the Governments commit themselves to create primary health care world-wide with concrete targets: By the year 2000 maternal mortality is to be reduced in all countries by at least 50 percent of the 1990 levels and a further half by the year 2015. In line with the Programme of Action of the World Population Conference of Cairo, the Governments declare in Beijing that high-risk pregnancies are "a major public health concern" and commit themselves to consider reviewing laws containing punitive measures against women.

Lifelong access to affordable health care

In cooperation with national and international organizations, priority should be given to education and information programmes that encourage women to take responsibility for their own reproductive and sexual health and that achieve mutual respect between men and women in matters of sexuality and fertility. Governments must further pursue policies to eliminate poverty among women; they must reduce environmental health hazards, which constitute a growing health risk for women, and take concrete preventive measures to protect women, young people and children from any abuse.

Concrete action towards prevention

To address the problems of sexually transmitted diseases and reproductive health, the Governments and international organizations are called upon to develop multisectoral strategies with which to end the social subordination of women and girls and to ensure their social and economic empowerment. This involves efforts to protect women from sexually transmitted diseases and to give them information about how to prevent them. Governments regard full attention to the promotion of mutually respectful and equitable gender relations as a fundamental aim of health policy and commit themselves to this principle in providing education on the matter to adolescents.

Health requires education

Governments and research institutions should promote gender-sensitive and women-centred health research that establishes disaggregated data for policy-making. The number of women in leadership positions in the health professions should be increased.

Health requires research and investment

To ensure primary health care, Governments must make the necessary budgetary allocations. In cooperation with other agencies, including non-governmental organizations, they should develop innovative approaches to funding health services that address women´s specific health needs. Apart from Governments, the UN-organizations are called upon in particular to give priority to women´s health and to implement the health objectives of the Platform for Action and other international agreements.


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© Friedrich Ebert Stiftung | technical support | Net Edition mv&ola | Oktober 1997