REPRODUCTIVE RIGHTS AND REPRODUCTIVE HEALTH: A CONCISE REPORT
Press Release
POP/623
REPRODUCTIVE RIGHTS AND REPRODUCTIVE HEALTH: A CONCISE REPORT
19960925 NEW YORK, 23 September (DESIPA) -- The Population Division of the Department for Economic and Social Information and Policy Analysis (DESIPA) has recently issued a report entitled Reproductive Rights and Reproductive Health: A Concise Report. It is the first in a series of annual reports monitoring selected themes of the Programme of Action adopted by the 1994 International Conference on Population and Development.The report provides a global overview of selected aspects of reproductive rights and reproductive health, including entry into reproductive life; reproductive behaviour; the use of contraception; abortion; the incidence of maternal mortality and morbidity; the impact of sexually transmitted diseases, including infection by the human immunodeficiency virus (HIV) and the acquired immunodeficiency syndrome (AIDS); policy issues related to reproductive rights; and the development and use of population information, education and communication relative to reproductive rights and reproductive health.
According to the Programme of Action, 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 thus encompasses problems that may arise all through life and not just during the reproductive years. Reproductive rights are central to the achievement of reproductive health. They include the basic right of 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, as well as the right to make decisions concerning reproduction, free of discrimination, coercion and violence.
The report focuses on two important determinants of both fertility and reproductive health -- the events that define entry into reproductive life, and their timing. In a number of societies, menarche is taken as a sign of maturity and the readiness to marry or commence sexual activity. Studies documenting the age at menarche show that it can vary by up to five years between different population groups, that it tends to be lower in developed than in developing countries and that it has been declining. Although a declining age at menarche implies an earlier potential to reproduce, that biological factor has been offset by increases in the age at first marriage.
Traditionally, age at marriage has been regarded as marking the initiation of sexual activity and therefore the beginning of exposure to reproduction. The report shows that age at marriage among women has risen dramatically in many countries.
The delays in the timing of first marriage have played a key role in the fertility decline that have occurred in many countries. At the world level, the average number of children per women declined from 3.6 in 1980-1985 to 3.1 in 19890-1995. In the more developed regions, there has been only a slight decline, whereas in the less developed regions fertility declined from 4.2 to 3.5 children per woman.
Child-bearing during adolescence has emerged as an issue of increasing concern throughout the developing and the developed world. It is currently estimated that worldwide about 15 million women aged from 15 to 19 give birth each year and that about 11 per cent of all babies are born to adolescents.
Family planning is an integral part of reproductive health. In developing countries during the early 1960s, when women had, on average, 6.1 children over their reproductive lives, probably less than 10 per cent of all couples where the woman was of reproductive age used contraception. In 1991, an estimated 53 per cent of couples did. In developed countries, it was 71 per cent, and for the world as a whole the average was 57 per cent. The transformation in contraceptive practice reflects the growing desire of couples and individuals to have smaller families and to choose when to have their children. However, despite the substantial recent increase in contraceptive use in many developing countries, various indicators suggest that the level of unmet need remains high.
Partly as a result of the unmet need for contraception, in 1990 an estimated 25 million legal abortions were reported worldwide, or one legal abortion for every six births. In addition, the World Health Organization (WHO) estimates that some 20 million unsafe abortions are performed each year, or one unsafe abortion for every seven births.
Among the various indicators commonly used to compare levels of development between countries and regions, levels of maternal mortality reflect striking disparities. Maternal mortality is also a sensitive indicator of the status of women in society, their access to health care and the adequacy of the health-care system in responding to their needs. The WHO has estimated that approximately 585,000 maternal deaths occur annually, the majority in developing countries.
Until recently, the prevention and control of sexually transmitted diseases was accorded low priority by most countries and development agencies but the prevention of transmission of infection is currently receiving
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increased attention because of the global epidemic of infection due to HIV/AIDS, and the identification of several sexually transmitted diseases as risk factors for the spread of HIV. The WHO estimates that about 333 million curable cases of sexually transmitted diseases occur globally every year, most of which are occurring in developing countries. As its second decade elapses, the HIV epidemic continues to grow. It is estimated that a cumulative total of 18.5 million adults and 1.5 million children have been infected with HIV. Of all the persons infected, from 7 to 8 million are women, about 70 per cent of whom are of child-bearing age.
According to the WHO, between 13 million and 15 million infected adolescents and adults, in addition to about half a million infected children, are alive at present, says the report. Over the past 10 years, the response to HIV/AIDS has focused on prevention and care. Governments, non-governmental organizations, communities, associations and networks of people living with HIV/AIDS, international organizations, the health, education and other sectors, as well as the public and private sectors have worked in partnership to develop a response to the epidemic.
In population policy, the issue of reproductive rights is a relatively new subject, and a controversial one, because it touches on the most intimate and personal areas of life -- sexuality, sexual relations and reproduction. Although the concept of reproductive rights is of relatively recent origin, there is ample support for those rights in existing international documents and human rights treaties. The final documents adopted at all the past three international conferences on population, as well as at the Fourth World Conference on Women (Beijing, 1995), strongly assert reproductive rights. Yet, the general public is often not aware of the meaning and scope of those rights. An important strategy to improve the effective recognition of reproductive rights is to increase the provision of information and education on them. In that respect, information, education and communication activities can play a crucial role, especially by motivating policy makers, programme managers, service providers and communities to translate into action the concept of reproductive rights and reproductive health, including family planning.
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Note: Reproductive Rights and Reproductive Health: A Concise Report is a United Nations publication, Sales No. E.96.XIII.11.