Transcript Achieving Reproductive Rights in Brazil

Achieving Reproductive Rights
in Brazil
Magaly Marques
Pacific Institute for Women’s Health
Background
• Political Scenario
• Demographic Trend
• Social/Economic Situation
• Civil Society Mobilization
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Health
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Political Scenario 1970s and 1980s
• Dictatorship & military regime
• Development goals with no policies
• Top-down population programs
• Women excluded from decision making
• Mobilization for democracy
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Health
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Demographics in the 1970s and 1980s
• Programs with excessive focus on fertility reduction
• High maternal mortality rates - 240 per 100,000
• FP policies (or lack of) led to - sterilization and
C-Section abuse, limited contraceptive options, scarce
access to services
• High abortion rates /severe legal restrictions on
abortion
• Decline of fertility rates - demographic transition
completed in the 1980s, a trend that continued into the
1990s
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Health
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Social/Economic Situation
vis-à-vis population in the 1970s/1980s
• International funding for FP from
USAID, World Bank was attached to
development policies and population control
agreements
• Foundations and European agencies funding
small women’s groups
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Civil Society Mobilization
• Activism, organized left, women’s groups
• Women leaders detach from left parties to
re-define priorities
• Women’s movement organize around
violence, abortion, and discrimination
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Goal:
• Political will
• Democratic environment
• Public recognition of health problems
• Policies directed at accepted problems
• Mechanisms to ensure policy enforcement
• Civil society surveillance systems
• Government accountability
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The Reproductive Health
Movement in the 1980s
• Women’s Groups organize as NGOs
• Women’s Health Advocates launch national
initiative for Women’s Comprehensive Health
(PAISM)
• The new Constitution calls for attention to
reproductive health matters
• International support make possible for local
NGOs to develop
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From Activism to Public Policy
Change - the 1990s’ events
• Feminists in Women’s Health Movement join in
government agencies
• National advocacy efforts increase public interest and
awareness
• Women in parliament become aware of reproductive
rights issues
• National Feminist Reproductive Health Network is
founded
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“As opposed to the dictatorship years, the recent
Henrique Cardoso administration produced
economic, political and institutional stability. The
development of sound national policies, development
of mechanisms to ensure enforcement of these
policies, and the constant dialogue and collaboration
with civil society allowed for an increased sense of
accountability and recognition of human rights as
universal.” Sonia Correia
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Health
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“The 2000 survey tells us that the national fertility
rates are 2.3 children per woman. But in São Paulo,
Rio and the South fertility is already below
replacement level. This is not surprising as women
have expanded their participation in the labor
market, they are investing in their own education
and professional lives and they have decided to
provide good care to just one or two children. This
trend is here to stay”.
Elza Berquo, PhD
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Health
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Institutionalizing
Women’s Rights
• Aftermath of U.N. Conferences enhanced creation of
mechanisms to monitor policy implementation locally
• PAISM re-defined in 1997 (compromise and focus)
• Maternal Mortality Committees to monitor city level
implementation of PAISM
• ICPD/Cairo language incorporated at all levels (from
FP to RH)
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Health
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U.N. Conferences
Absorbing the International Process
• 1993 Human Rights Conference led to National Human
Rights Program in 1995, re-defined in 2002 as state
policy including gender, racial, sexual, and HIV/AIDS
related discrimination/violence; access to abortion.
• 1994 ICPD led to National Commission on Population
and Development in 1995
• 2000 Beijing+5 led to National Secretary for Women's
Rights; ratification of the CEDAW Protocol (Convention
on the Elimination of Discrimination against Women)
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Health
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Achievements
• 1985 - National Council on Women’s Rights
• 1988 Constitution spells out a national FP
legislation
• Creation of 387 city-level maternal mortality
committees
• Reduction in hospital-based mortality from
34 to 24 in 100.000 women
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• Policy enforcement for epidemiological
investigation of all maternal deaths
• Increased coverage of pre-natal care from
5.4 million women in 1997 to 10.1
million in 2001
• Approval of health system protocol
mandating and establishing guidelines for
services to be offered to women who
undergo sexual violence (1998)
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Health
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• Protocol mandating routine registration
into the health system of all cases of
gender-based violence attended
• Increase from none to 165 health services
providing legal, safe abortions in case of
rape
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Health
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Lessons Learned
• Combination of activism and negotiation
• Alliances, partnerships were needed
• Networking of various types of organizations
(grassroots, research, advocacy)
• International liaising and local focus
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Health
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Unfinished Tasks, and
Challenges Ahead
• Full access to legal abortion
• Increased understanding about the links
among health, development and human
rights issues.
• Paradigm shift in the way sexuality is
conceived and promoted at all levels.
• Full incorporation of women as leaders and
decision makers into the democratic process
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