Transcript Sexual and Reproductive Health: Malta

Sexual and Reproductive
Health and Rights in Malta
Dr. Frances Camilleri-Cassar
[email protected]
Solidarity Overseas Services Malta
Commonwealth People’s Forum
21 November 2005
Key Millennium Development Goal
The Millennium
particularly:
Development
Goals,
the eradication of extreme poverty and
hunger,
…cannot be achieved if sexual and
reproductive health and rights are not
addressed.
Human Rights
Reproductive and sexual rights
embrace human rights that are
already recognised in national
laws, international human
rights documents and other
consensus documents.
National Policy
Yet, Malta still awaits a national sexual
and reproductive health policy,
(although this has been on Government’s
agenda for a long number of years.)
Women’s Right to Choose
• Access to quality basic education reduces
poverty and empowers women and girls to make
their own choices. Control over one’s body is
perhaps the central feminist credo.
• Safe reproductive control has been central to the
improvement of women’s health in Western
countries.
• Such control is also central to other choices
such as paid work and participation in public
politics.
Problematic?
• However, neither the technology nor the
choice are problem free.
• The recipients are rarely fully informed.
• Encounters with the male-dominated
medical profession have made this area
highly contested.
Reproductive Technology
• Reproductive technology is a product of the
male reality and buttresses male power over
women
– It takes reproductive control away from women and
gives it to (mostly male) physicians
– It is physically and emotionally harmful to women
– It reinforces the importance of motherhood in
women’s lives
– It carries with it the potential for eugenic uses
Taboos
• Political and religious impediments to access the
necessary range of reproductive options present one
of the most serious health problems facing women
(and men) in Malta today.
• The 2001/2002 WHO international report on young
people’s health states that data for Malta on the
incidence of sexual intercourse, mean age and use of
contraception are unavailable.
• Indeed, the survey on the sexual health of people
aged 11, 13 and 15 proved problematic in Malta.
Quality Education
Although the national minimum curriculum
for secondary schools includes education
on sex, sexuality and health
…data which draws on the responses of
school-aged children suggest that sex
information is sporadic and largely given
informally by parents or friends.
Age of First Sexual Intercourse
• Mean age
21.3 years
• Median age 20 years
(The First National Health Interview Survey – Summary Statistics, 2003 H.I.S. Malta)
Sexual Partner/s
•
•
No
Yes
•
Not applicable/No information 24%
71%
5%
(The First National Health Interview Survey – Summary Statistics, 2003 H.I.S. Malta)
Young People and Contraception
• Casual sex among young people has increased
from 28 % in 2000 to 42% in 2004 (Carabot, 2004:15)
• Despite the high rate of casual sex, the use of
condoms remains poor, with 63% indulging in
unprotected sex (Carabot, 2004:16)
• Only 25% of young women use any form of
consistent contraception – the OCP in 85% of
cases (Carabot, 2004:17)
Use of Contraceptives
•
•
•
•
•
Never
Sometimes
Rarely
Frequently
Always
34.23%
13.3%
5%
10%
7%
• Not been sexually active
• Not applicable/No information
15.4%
16%
(The First National Health Interview Survey – Summary Statistics, 2003 H.I.S. Malta)
Contraceptive Methods
•
•
•
•
•
•
•
•
•
Withdrawal
14%
Condom
13.3%
Safe period
12%
Contraceptive pill
2%
Coil
0.4%
Cap/Diaphragm
0.05%
Spermicides
0.02%
Other
3.5%
N/A; No information 55%
(The First National Health Interview Survey – Summary Statistics, 2003 H.I.S. Malta)
Prevention of unwanted
pregnancies and abortion
• Abortion is punishable at law under section 241243A of the Criminal Code and should not be
promoted as a family planning method.
• Not only women but men too must bear
responsibility
for
preventing
unwanted
pregnancies.
Adolescent Pregnancies
• Few young women seem to worry about
unplanned pregnancies. (Carabot, 2004:17)
• An increased rate of adolescent pregnancies
runs parallel to the trend in unprotected sex and
the lack of quality sexuality education and
specific sexual and reproductive health
counseling and services. (National Obstetric Information System Malta –
Annual Report, 2004, Dept Health Information)
• In 2004, 18% of all deliveries occurred to lone
mothers…the percentage rose to 21% in the first
quarter of 2005. (National Obstetric Information System Malta – First Quarterly
Report: January – March 2005, Dept Health Information)
Women and Poverty
• The ‘feminisation of poverty’ is intrinsically
linked with female headed households as a
vulnerable and residualised group.
• 76% of lone parent households in Malta are
headed by women.
47% are under 20
44% live below the poverty
on social benefits (HBS, 2003)
line
are
dependent
AIDS
• There were 10 notified cases of AIDS and
7 deaths in Malta between 2000 and the
first quarter of 2004.
• Most AIDS cases seen in Malta since 1985
were homo/bisexual men. Amongst these
persons, casual sex is high and the use of
condoms is low (Carabot, 2004:19)
TIME FOR ACTION
Nothing just happens,
it has to be planned!
TIME FOR ACTION
• A key challenge to sexual and reproductive
health rights is Malta’s tradition of involving
religious conservative views in its national
reproductive health agenda.
• Young people have a right to information and
prevention, and outreach services need to
target ‘high risk’ groups
TIME FOR ACTION
• Good access to all forms of contraception
would reduce unwanted pregnancies and
sexually transmitted diseases.
• Malta needs to emphasis condoms as the
proven best-practice preventive method for
HIV/AIDS (European Policy Framework, 2004).
• Reproductive control is central to women’s
health and autonomy, and where services are
inadequate, costs in health, life and personal
freedom are enormous.
Time for Action
Malta is bound to draw up a:
Development Aid Policy (by 2007)
…and it urgently needs to understand the state of
sexual and reproductive health and rights and best
practices
for
effective
implementation
of
reproductive health policies.
Time for Action
For example:
• Malta lacks reliable data on sexual behaviour
and harmonised reproductive health indicators.
• Key data on the true prevalence of all STIs
including HIV is unknown (Carabot, 2004).
• Malta is still unsure of the prevalence of and
correlation between HIV cases and drug
users.
Time for Action
• Sexual violence has a devastating impact on
the sexuality and the reproductive health of
women and teenage girls.
• Yet, the Domestic Violence Act has, for years,
hung in the pipeline.
Time for Action
Malta urgently awaits a clear and separate
policy on sexual and reproductive health.
It is high time for action !
there are those…
who make things happen.
there are those…
who watch things happen.
there are those…
who wondered what happened.
Which way
are Maltese policy makers looking now
when it matters most
?
References
• Annual NOIS Report (2004) Department of Health Information,
Malta.
• Carabot, P. (2004) The GU Clinic Report, Department of
Dermatology, Sir Paul Boffa Hospital, Malta.
• Currie, C. et al. (eds) (2004) Young people’s health in context:
Health Behaviour in School-Aged Children (HBSC) study:
international report from the 2001/2002 survey, World Health
Organization Europe.
• Disease Surveillance Branch (2004) Department of Public Health,
Malta.
• First Quarterly NOIS Report (2005) Department of Health
Information, Malta.
• The First National Health Interview Survey – Summary Statistics
(2003) Department of Health Information, Malta.