REPRODUCTIVE RIGHTS AND REPRODUCTIVE HEALTH

The State of the World Population 1997 Report of the United Nations Population Fund (UNFPA), titled "The Right to Choose: Reproductive Rights and Reproductive Health", highlights a topic that touches the lives of everyone on the planet. This Report was launched worldwide, simultaneously in a number of cities by senior UNFPA officials, on 28 May.

'Reproductive and sexual health is a right for both men and women', the report begins. At issue are the rights of all people to enjoy the best possible sexual and reproductive health, and to be free to make their own decisions about sexuality, marriage and childbearing. Thus, 'a key aim of this year's report is to increase global awareness that reproductive rights are an integral part of human rights, and that laws and policies must be strengthened and better enforced so all people can enjoy sexual and reproductive health and free choice'.

In the Pacific, we are justifiably proud of achievements in social development. By some standard measures, well-being is relatively high compared to many developing countries in other regions. Absolute poverty and deprivation are comparatively unknown. Social indicators of human development have attained respectable levels in many countries of the Pacific sub-region due to the commendable efforts of Governments, non-governmental organizations (NGOs), and the donor community. But is there reason for complacency?

There are threats to the prevailing levels of real welfare. High natural rates of population growth are exerting intense pressure on the social services and economic institutions of the sub-region. Many countries are finding it extremely difficult to maintain, let alone expand, the quality and quantity of social services, including reproductive health services. This will surely endanger prospects for further improving the education and health status of women and children, a prerequisite for inducing greater demographic behavioural change and promoting sustainable development.

A central theme of the 1997 UNFPA report is that reproductive choice, gender equality and sustainable development are closely connected -- a linkage the international community has recognized repeatedly at the 1990s series of conferences on social development issues. Pacific Island Countries (PICs) had actively participated in the International Conference on Population and Development (ICPD) in Cairo in 1994 and the Fourth World Conference on Women in Beijing in 1995. Therefore, the principles and programmes of action adopted at these conferences carry special relevance to the prospects and potentials for improvement of reproductive rights and reproductive health in these countries.

Despite expressed commitment to these concepts, however, broad- based reproductive health strategies are yet to be developed. Reproductive health services are still narrowly focused on maternal and child health and family planning. Full perspectives of ICPD principles on reproductive rights and reproductive health are also yet to be fully realized. One reason is that the present programmes and donor support were designed before the various international conferences. As other stories in this newsletter show, there clearly is a movement towards more comprehensive reproductive health programmes in the sub-region.

There will be much to do. Although family planning services are generally available in all Pacific Island countries, accessibility to a broader range of contraceptive methods, as well as level of practice, vary widely. Knowledge of reproductive health and human sexuality, especially among the young population, is low, undoubtedly due to inadequate information, education and communication activities. Family planning integrated with Maternal and Child Health (MCH) has focused on married women, leaving sexually active young people and men outside the purview of reproductive health programmes. Women's perspectives, despite this MCH/FP integration, are inadequately taken into account in the design of programmes. It is quite paradoxical that, in the PICs, despite fairly good health services, maternal mortality and morbidity rates are also high.

The growing incidence of sexually transmitted diseases (STDs) and HIV/AIDS, especially among the young population, must be a matter of grave concern. The incidence of teenage pregnancy is clearly an indication of rising adolescent sexual activity. In most of the PICs, access to reproductive health services by young people is severely constrained, even where it is not prohibited.

The Report states that "the most practical and effective population and development policy is to create an environment in which people can freely make reproductive choices and decisions. This implies a priority for investment in basic social services such as education and health care. Especially, it means investing in women and redressing the gender imbalance, so that women can make choices on an equal basis with men".

Thus, to make the right to choose meaningful, action is especially needed in two areas: first, to establish the broad human rights which enable sexual and reproductive rights, and create the conditions for their exercise; and, second, to put in place information and services that meet the full range of requirements for sexual and reproductive health.