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The United Nations
Fourth World Conference on Women
Beijing, China - September 1995
Action for Equality, Development and Peace
PLATFORM FOR ACTION
 Women and Health Diagnosis
 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.
Strategic objective C.2. Strengthen preventive programmes that promote women's heath. Actions to be taken.
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.
Strategic objective C.4. Promote research and disseminate information on women's health. Actions to be taken
Strategic objective C.5. Increase resources and monitor follow-up for women's health. Actions to be taken.
Women and Health follow-up (Under construction)
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C. Women and Health
- Women have the right to the enjoyment of the highest attainable
standardof
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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- HIV/AIDS and other sexually transmitted diseases, the
transmission of
which is sometimes a consequence of sexual violence, are having a
devastating
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.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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
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