HIGH MATERNAL MORTALITY RATES, PRIVATIZATION OF HEALTH-CARE SECTOR AMONG ISSUES ADDRESSED BY EXPERTS ON AZERBAIJAN REPORT

20 January 1998

Press Release
WOM/1006

HIGH MATERNAL MORTALITY RATES, PRIVATIZATION OF HEALTH-CARE SECTOR AMONG ISSUES ADDRESSED BY EXPERTS ON AZERBAIJAN REPORT

19980120 As Committee on Elimination of Discrimination Against Women Continues Consideration of Azerbaijan's Report

The increase in maternal mortality in Azerbaijan was alarming and violated women's right to life, an expert told the Committee on the Elimination of Discrimination against Women this afternoon as it continued its consideration of that country's initial report.

Calling for urgent attention to that situation, the expert said that "there is no reason that women should be dying from childbirth". She asked a series of questions concerning the negative impact of an informal fee for health services in the public health sector, specifically whether that fee might be discouraging women from giving birth in hospitals.

As the 23-member expert Committee continued to review Azerbaijan's compliance with the Convention on the Elimination of All Forms of Discrimination against Women, another expert expressed concern that the imposition of health-care fees was a very dangerous trend in a country already experiencing such difficult times. Even in highly developed, stabilized countries, problems of privatization in the health-care sector adversely affected the poor, she noted.

Affirmative action and other temporary measures were needed to "help put the stick to the downslide", another expert said, referring to the tendency to solve problems at the expense of women's interests in times of economic and social crises. Another expert said that "the economic power of women is the key to the problem" facing women overall. While no legislation in Azerbaijan specifically forbids women from seeking credit, she questioned whether they actually receive it. The impact of the economic crisis on the access of young girls, including refugees, to education was also the focus of concern by experts.

The Committee will meet again at 10:15 a.m. tomorrow, 21 January, to begin consideration of the initial report of Croatia.

Committee Work Programme

The Committee on the Elimination of Discrimination against Women met this afternoon to continue its consideration of the initial report of Azerbaijan on its implementation of the Convention on the Elimination of All Forms of Discrimination against Women. (For background on the report, see Press Release WOM/1005 issued today.)

Comments on Specific Articles

Beginning this afternoon's meeting with article 6, concerning the traffic in and exploitation of the prostitution of women, one expert, noting the increasing scourge of trafficking in women in many countries, including in Azerbaijan, particularly in times of economic stress, asked what kinds of laws had been passed to protect women, and whether there were any educational programmes alerting young people to the dangers of such activities.

Another expert, noting reference in the report of the initiation of 26 court proceedings in 1995 and 1996 concerning houses of prostitution, asked about the Court's imposition of sentences, including whether the victims had received any kind of compensation for moral damage. In what way did the Government make it possible for women to have access to employment in order to discourage the turn to prostitution? She requested more information regarding the trafficking in women and children, particularly for the purpose of prostitution, and whether there was any preventive action in those areas? Another expert asked for more explicit information concerning national legislation establishing criminal liability for the violation of the rights of women, and the criminal charges faced by individuals who involved minors in criminal activities.

Turning to article 7, concerning discrimination against women in political and public life, another expert reiterated her request that the delegation provide information on women in decision-making positions.

Another expert said that the 12 per cent representation of women in the Parliament was an impressive figure, particularly given that it was a common occurrence in former Soviet republics for women's participation to decline at first, and then increase later. The same pattern seemed to be emerging in Azerbaijan. However, she asked whether there was any change in the nature of the representation, such as women in positions of leadership, and whether there were any efforts by them to legislate women's rights and address discrimination issues. Were the women in Parliament organized in any way to join their efforts across party lines to promote such rights and legislate gender-sensitive policies? How were non-governmental organizations, particularly women's rights groups, allowed to participate in discussions of political issues in the country, and were they free to do so? another expert asked.

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Concerning the provision of equal rights to acquire, change or retain nationality, outlined in article 9, the same expert drew attention to the effects of divorce in the case of different nationalities. She sought clarification on the status of children when parents of different nationalities divorced.

An expert noted that, according to the report, information concerning equality was provided at all levels of education, the subject of article 10 of the Convention. Were there special courses offered on the subject, or was the Convention itself taught in schools? Also, were physically mature, mentally retarded students physically separated from the rest? She also asked about the education budget, and whether there were private schools in the country. Another expert requested statistics on the trends in the rates of school enrolment for both girls and boys since the country's independence, and for gender-specific statistics for university students. Were any efforts under way to institutionalize courses of study in women's issues? she asked.

What had been the impact of the economic crisis on access of young girls to education, especially by those below the poverty line? another expert asked. How had privatization of the economy impacted on girls' access to education? With women accounting for 45 per cent of pupils in higher education, had that figure increased or decreased in the past five-year period? She also asked why there was a lower figure of females remaining in higher education, when they aspired to teach at that level, and whether professors were trained in gender-related issues.

To the report's note that equality issues were taken up in textbooks, and included no discriminatory ideas, another expert asked how that was being achieved. She also asked whether there were programmes to actively change attitudes via the textbooks, and at what level the Government was actively looking at the school system, including gender-tracking. She expressed an interest in the comparative profile of the professions of women in the last 10 years during the transition period, particularly whether there was any regression of women in that time. Although much had been said about the problems of refugees, nothing had been said about the education of women and children in such difficult situations. Since education was being examined, not just in terms of raising literacy but also in elevating values of dignity, in what way was the Government ensuring the integration of that goal? she also asked.

One expert said the section of the report on discrimination in the field of employment had been more in accordance with the Committee's guidelines. The Committee was very interested in the de facto situation and not only the de jure situation of women in the labour force. She asked about the provisions of the Azerbaijani labour code regarding rates of pay by gender. What were the rates of unemployment, disaggregated by sex? Were the country's social benefits the same in the private and public sectors? More information

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was needed on part-time work and on the effect of the conflict on employment of women. She also asked about provision of pension to women with various lengths of service and with children. Was it possible to ensure the rights to pension at a time of economic crisis?

Commending Azerbaijan for its accession to the International Labour Organization (ILO) conventions governing the rights of working women in the area of employment, an expert asked whether employers respected the provisions of such conventions and whether mechanisms were well established to monitor their implementation? She also asked about the existence of paternity leave in the public and private sectors; whether stability of work was guaranteed to men and women; and whether similar practices governed the employment of men and women? Questions were also raised about the equality of training as well as retraining for women re-entering the labour force? In addition, were there laws to protect women against sexual harassment? What were the rights of unemployed women to unemployment benefits?

She went on to raise questions on article 16, including the influence of tradition and customs on marriage and the family; the rate of divorce requested by men as compared with women; and the payment of child support in cases of divorce.

Another expert asked if programmes existed for facilitating access to jobs by women who were heads of households, single mothers or women who were the sole supporters of their families. What programmes existed to help refugees to obtain employment? She asked for an update of the percentage of women in the workforce and what groups were taken into account in the statistics on the workforce. What was the percentage of women working in all sectors of the economy and at management levels? She also asked about child- care centres; how many were funded by the State; and what requirement existed for pre-school children to attend those centres.

Another expert asked what proportion of women held managerial positions in such fields as health care, social welfare and education. What were the retirement practices and wages in those sectors? How many unemployed women received social benefits from the State, and were those benefits the same as those of men? Were there any statistics on women who were entitled to receive old age pension at age 65 with 25 years service. Were there any discrepancies in the application of the pension act.

Taking up article 12, on the elimination of discrimination against women in health, one expert expressed concern about the increase in maternal mortality in Azerbaijan as "alarming information". Such a situation violated the right to life of women and should be urgently addressed so that women's lives were not endangered. "There was no reason that women should be dying from childbirth", she said. She asked for clarification on the decrease in the number of maternal health-care services since Azerbaijan's independence.

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She also sought information about the existence of an illegal fee for health services that pervaded the health service.

Referring to information she had received from non-governmental organizations, the expert also asked about the decrease in the number of births taking place in hospitals since 1991. Was that decrease one of the causes of the increase in maternal mortality? Were there two different systems of health care? Referring to a bill on public health, she asked about its status and if it had been passed. She also asked about the percentage of the private facilities as opposed to public and what percentage of the population had access to the health facilities. Did the public health bill provide for free immunization for young children?

The expert also asked for information on contraception -- the methods and rates of use, the cost and to what extent did women have a choice of methods. Was there reproductive health provided for adolescents? Were contraceptives available and accessible to women of all socio-economic groups? Were there bureaucratic hurdles to supplying condoms to refugee women? Regarding abortion, what was the rate and what facilities existed, at what cost, who paid for abortion and what were the health consequences of abortion. Questions were also raised on the availability of sterilization; about contagious diseases, such as sexually transmitted diseases, including HIV/AIDS and tuberculosis; statistics on drug and alcohol abuse by women; and on health facilities for women victims of domestic and sexual violence. All those concerns were heightened in the context of the privatization of the health services in the country, she added.

Another expert, welcoming the intention to set up a government unit to monitor women's problems, asked what would be its priority concern and would there be efforts to retain the gains women enjoyed during the Soviet period. In times of economic and social crises, problems tended to be solved at the expense of women's interests. Therefore, there was need to push for the implementation of article 4 to ensure the application of affirmative and temporary measures to "help put the stick to the downslide". She asked for more information on the effect of economic reform on education, employment and health. Regarding article 11, she asked for clarification on Azerbaijan's demographic policy of encouraging women to have many children.

Another expert asked about the major causes of the high mortality rate, particularly given the large presence of women in the health-care sector. She also noted the failure of the report to provide detailed statistical data. Concerning fees for health services, a very dangerous trend was emerging in a country that was going through such difficult times. Even in highly developed, stabilized countries, problems of privatization in the health sector adversely affected the poor.

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The report contained little about diseases such as HIV/AIDS, and gender- based violence, which risked women's health, she said. She sought information about programmes to combat sexually transmitted diseases, and asked a series of questions about the availability of pre-natal fetal testing and the related incidences of abortion.

Concerning article 13, on discrimination against women in other areas of economic and social life, another expert asserted that the mere presence of "texts" did not limit women's rights to financial credit and mortgages. Moreover, the report did not elaborate on the level of loans available to women. Given the globalization of the economy and financial crises, the question of women's economic power was key. While nothing forbids them from seeking credit, it seemed that they might not have enough guarantees to do so. She noted that there were countries that had established special banks for women, and others which had opened specific windows for women to have access to credit, which allowed them to carry on many activities to improve their revenue and improve their lot.

She asked if there were enough infant day-care facilities enabling women to benefit from sports and cultural activities. Also, given the traditional division of tasks, did men participate in activities at home so that women could enjoy a few moments of freedom?

Concerning discrimination against women within marriage and the family, as addressed in article 16, an expert asked what happened when the wife's choices of occupation, place of residence or family name did not conform with those of the husband. She also asked a number of questions concerning adoption, including whether orphan boys were favoured over girls, and whether only illegitimate children were adopted. Concerning the division of property, did the property acquired prior to a marriage remain property of the individual, and following divorce, how was such property divided? She also posed a series of questions concerning the registration of marriages versus the trend towards living together, and whether that arrangement further burdened the woman. Also, did that practice lead to polygamy?

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