WOMEN SHOULD RECEIVE EXPANDED HEALTH CARE, COMMISSION ON POPULATION AND DEVELOPMENT TOLD

Press Release
POP/762

WOMEN SHOULD RECEIVE EXPANDED HEALTH CARE, COMMISSION ON POPULATION AND DEVELOPMENT TOLD

Women should receive expanded health care as they often died prematurely due to poor health delivery systems, the Commission on Population and Development was told this afternoon, as it continued its general debate on national experiences in population matters.

The observer for the Holy See said reproductive health care should include nutrition, prenatal education and care, obstetrical and gynaecological services, support for breast feeding and protection and sustenance of the unborn child from conception on. Efforts should also be intensified to overcome HIV/AIDS, with special emphasis on "absolute avoidance" of irresponsible or exploitative sexual behaviour -- particular threats to women and girls.

In the coming years, South Africa would face a generation of AIDS orphans and unattended elderly persons, the country’s representative said. The international community must recognize the AIDS pandemic as a global concern beyond humanitarian consideration; there was also an economic component to consider, namely, that the traders in the developed world might not find an African market for their goods.

The Malaysian representative said that HIV/AIDS and its effects on women and children had prompted the Government to realize that reproductive health was a "life-cycle concept" with inter-generational consequences. The promotion of healthy lifestyles and responsible sexual behaviour had stepped-up efforts towards greater parental and male responsibility. A module on fatherhood, aimed at removing gender biases in parenting, had been developed, along with modular training packages on family life and development, which emphasized parenting, adolescent development and reproductive health.

In Thailand, victims of trafficking had been decriminalized under revised laws addressing prostitution and the trafficking of women and children, that country's representative said. Investigations had also become "child- and woman- friendly". At the regional level, a memorandum of understanding between the countries in the Mekong subregion had marked a new chapter of regional cooperation to counteract that transboundary crime of trafficking. In addition, a "one-stop" service for women victims of violence had been established in several hospitals, with multi-disciplinary teams comprised of health, social and community development experts.

Population & Development Commission - 1a - Press Release POP/762 4th Meeting (PM) 28 March 2000

Also today, the Commission held a panel discussion on the theme, population, gender and development. Representatives from India, Iran, Hungary, Mexico, Netherlands and South Africa provided a regional perspective to the issue of gender and development.

Statements were also made by the representatives of Burkina Faso, Algeria, El Salvador, Ukraine and Turkey.

The Commission on Population and Development will meet again at 10 a.m. on Wednesday, 29 March, to continue its general debate on national experience in population matters.

Commission Work Programme

The Commission on Population and Development met this afternoon to continue its general debate on national experience in population matters: population, gender and development. Following the conclusion of the debate, a panel discussion was scheduled to be held on that topic.

Statements

SERAPHINE TOE (Burkina Faso) said that new communications technology had made it possible to overcome the slowness of traditional media, but there was a great risk of marginalization and isolation unless the developing countries adapted the new technology. Efforts to facilitate access to the new media and update the facilities of developing countries should be applauded, as such activities would ensure their participation in the broad discussions on development. The Population Division had taken a first step in that direction by proposing a model of cooperation among the institutions of the South through the use of the Internet as a vehicle of collaboration.

She said she was pleased that the first training workshop for demographic research on the Internet had taken place last year in her country. That had born witness to its commitment to the new communications technology. Indeed, her country had been updating its telecommunications sector and taking every measure to encourage Internet use throughout the country. There was a long road to travel, but the organization of that regional training workshop had shown that "we are on the right path".

GEORGES BUIELLA, demographic researcher at the University of Ouagadougou, said the training workshop had sought to provide basic training on the way in which researchers could use the new technology. The workshop had been designed to evolve a regional Web site to enable the countries of the region to master the new communications technology. In the course of the workshop, State progress on the use of the Internet in institutions had been examined. Through practical demonstration, participants observed the ways in which other research institutions had used the Internet in their work.

He said that participants learned to build Web sites, and they established a regional network site. Questions about the effect of Internet use on methods of work and relations with other countries had been debated, and a functional structure, objectives and timetable for the network had been adopted. The second workshop would be held next week.

RACHIDA BENKHELIL (Algeria) said her Government had maintained the objective of integrating demographic variables into effective development policies. The transition phase that had begun more than a decade ago had allowed for a reduction in the population growth rate, due to a reduction in the birth and fertility rates. The results of a general population survey in 1998 had confirmed that tendency; demographic evolution, within an economic and social framework, had undergone profound changes. That, in turn, had given the national policy for development renewed impetus in the fight against inequality. A solution to unemployment had also found full expression.

She said that the coming decade would revolve around three major axes: the development of family planning, including improvements in the country's health and reproductive services; strengthened information, communication and education; and the consolidation of action to advance women and integrate them in the development process. Women's improved status through the reduction and ultimate elimination of the gender gap in all spheres of development would be a major challenge in the coming decade. In the last decade, achievements had been made for women in numerous areas, including education.

Women now represented 46.4 per cent of primary school students, 54 per cent of secondary enrolment, and 49 per cent of university students, she said. Parity had also been attained in the professional arena. Despite such improvements, however, illiteracy among women was still a subject for concern: the illiteracy rates among women aged 10 and above had been 40 per cent in 1998, compared to approximately 23 per cent for men the same age. Thus, the fight against that scourge was a priority of the decade. Poverty had also threatened the education of women and girls. Nonetheless, many sectors, such as health, education and judiciary, had been broadly feminized in Algeria.

In the health sector, she said, there had been a tangible improvement in life expectancy, which stood at age 70 for women, and 68 for men. The improvement had been the result of a reduction in the mortality rates for children under the age of five; however, the fight against infant mortality still remained a difficult issue. Reproductive health had been a prime aspect of the population policy: there was an increase in family planning and in the age of marriage. In addition to strengthened family-planning services, programmes had been established to detect genital infections and sexually transmitted diseases. Maternal mortality remained a serious concern.

ASNA HAZEL ESCRICH (El Salvador) said that today's subject had become especially important to her Government, which had envisaged it in a programme called "The New Alliance". The country's main achievements in that regard had been the result of an inter-institutional effort on a broad level, coordinated by an institute for women's development, founded in 1996. Recently, the Government had been updating its action plan, which now incorporated such topics as women with disabilities, adolescent girls, women deprived of freedom, and a gender approach to statistical data.

She said she wished to highlight the activities carried out by the Ministry of Education, especially the training of teachers, aimed at an improved status of women. Furthermore, sexual and reproductive education had been incorporated at all educational levels, including in technical and higher education. In the workplace, businesses had been encouraged to render more flexible schedules for working mothers. Intensive educational programmes had also been established to provide basic education on the prevention of HIV/AIDS and the elimination of discrimination against infected persons. In addition, approximately half of all middle-level schools, public and private, no longer considered that pregnant adolescents should be expelled.

The Health Minister had been driving a health sector reform, she said. Among its strategies had been institutional reorganization, as well as the creation of an adolescent health administration. Such new programmes interacted directly with families in communities and in the workplace. In the framework of health sector reform, strong support had been provided in the area of sexual reproductive health, and the following main actions had been emphasized: start-up of a national reproductive health plan and national plan for the prevention and control of sexually transmitted diseases and HIV/AIDS.

She said her country had passed a law in 1996 on intra-family violence, and, since 1998, a new penal code had criminalized that phenomenon and reduced delays in the judiciary process. Victims now had better access to the courts and could receive psychotherapeutic treatment for themselves and their families. Gender training had addressed such groups as judges and staff of all psycho-social care centres. Safety committees had been set up to ensure compliance with recommended measures in that regard. Women had also received job training, in order to facilitate their inclusion in the labour market. An amended labour code, to harmonize it with the recommendations of the International Labour Organization (ILO), had also been proposed.

JAMES T. McHUGH, observer for the Holy See, said international cooperation and universal solidarity were crucial for improving quality of life and assuring increased opportunity for people around the world. Development strategies were immensely important in efforts to alleviate poverty in the poorest nations, but those strategies required the cooperation and collaboration of developed nations and international agencies.

He said that the Cairo Plan of Action stressed that the right to development was a universal and inalienable right, and that the people were the centre of development. In that regard, the welfare of women and children and their capacity to realize their basic human potential required socio-economic stability and security. In order to achieve economic stability, continued efforts must be made to reduce international debt. That might require a new development model that was firmly imbedded in a mix of social investment, democracy building, and just economic opportunity. An end to violence and war and an end to continued expenditures for arms were also indicated.

Special efforts must be made in developmental policies to sustain the family unit, he said. As the basic unit of society, it was entitled to society's protection and support. That included assurance of a family wage and adequate housing opportunities for families and children. The participation of women in development still depended greatly on adequate education of women and girls. Inadequate educational opportunities had prevented women from reaching their potential and deprived society of their contributions. Through its worldwide network of schools and educational agencies, the Holy See would continue to offer education to young women.

He said that health care for women must be expanded. In many cases, women and girls had suffered debilitating illness and died prematurely because of poor or inefficient health delivery systems. Reproductive health care should include, among other things, nutrition, prenatal education and care, obstetrical and gynaecological services, support for breast feeding and protection and sustenance of the unborn child from conception on. The world population was ageing and women tended to outlive men. Pensions and systems of care must be adapted to meet the needs of those women.

Migration was an international challenge, he went on. Developed nations had increasingly depended on migrants to fill gaps in the work force, but, too often, women and children were the victims of virtual abandonment. Greater efforts must be made to protect the dignity and security of the workers and to ensure health care and education for their families. Similarly, efforts to reduce morbidity and mortality, including maternal and infant mortality, should be expanded and made more effective. Greater efforts must also be made to overcome HIV/AIDS, with special emphasis on "absolute avoidance" of irresponsible or exploitative sexual behaviour, which were particular threats to women and girls.

Mr. ZUYDAM (South Africa) said that about 150,000 people in his country had died of AIDS. A large percentage of those people had been women between the ages of 25 and 49. Nearly 12 per cent of the population was HIV positive. In the coming years, South Africa would surely be faced by a generation of AIDS orphans and elderly persons without care. It was time for the international community to recognize the AIDS pandemic as a global concern beyond humanitarian considerations. There was also an economic component to consider: there might soon be the demise of a market for traders in the developed world.

He said the Government had instituted a three-tiered plan to prepare South Africa to face the socio-economic devastation of the spread of the disease by: preparing society for dealing with the impact of the disease; assessing the reviewing intervention programmes; and intensifying population advocacy and publicity about the spread of the disease. He said that this plan should be complemented by improved reproductive health policies, which would include information for males, as well as females.

Mr. RESHETNYAK (Ukraine) said his country had enacted a National Plan of Action for 1999-2000 for the advancement of women. Other measures had focused on gender as it related to health issues such as reproduction and access to modern medical technologies.

He said that, despite these positive changes, the social and economic situation of women in Ukraine remained unstable. The death rate of women due to abortion and its complications had risen. This could be due in part to the fact that women as a whole, but particularly rural women, lacked access to modern medical facilities. HIV infection was also spreading with alarming speed. He stressed that the international community must cooperate to counter the devastating effects of this pandemic.

Despite these and other hardships, he was pleased to inform the Commission that his country had made many strides in the area of education. Universal access to primary and secondary education had been achieved and, throughout the country, student enrolment had increased.

Y. MEHMET KONTAS (Turkey) said that, despite the legal and structural adjustments to his country’s Civil Code, the social and economic status of Turkish women required further improvement. Illiteracy was still high, and there had only been moderate attempts to increase the proportion of females in learning institutions. There were also considerable urban-rural differences in literacy and educational attainment, which contributed to the problem.

He said Turkey was traditionally known to have excessive infant and child mortality rates that were incompatible with the country’s level of development. There had been significant improvement in these rates over the last 50 years that was a direct result of, among other things, successful immunization campaigns.

There had also been considerable focus on HIV/AIDS and other sexually transmitted diseases in Turkey. According to that country’s Ministry of Health, the spread of the virus had been steadily increasing since the first case was reported in 1985. Routine screenings were now conducted among certified sex workers and during blood transfusions. The Primary Health Care Division of the Ministry of Health monitored infection control programmes.

FATIMAH SAAD (Malaysia) said that gender concerns had always been integrated into Malaysia’s socio-economic plans in order to ensure that women participated more fully and effectively in development programmes and activities. In order to strengthen the national machinery for the advancement of women, the country’s Women’s Affairs Division had been upgraded to a full-fledged department in 1997.

She said that in order to promote greater understanding of gender concerns and to eliminate discriminatory perceptions, gender sensitization programmes were being implemented to effect perceptual changes. Those changes would, in turn, promote the idea of equitable family life and household responsibilities through information dissemination, education and training activities. To protect the girl child, the Child Protection Act had recently been passed to protect children and adolescents from sexual abuse, incest and violence. It was important to note that Act also included a provision that ensured greater parental responsibility.

The increasing incidence of HIV/AIDS and its effects on women and children had made the Government realize that reproductive health was a life-cycle concept that had intergenerational consequences. She said that to promote healthy lifestyles and responsible sexual behaviour, efforts had been intensified to promote greater parental and male responsibility. Modular training programmes on family life had been developed, which had an emphasis on parenting, adolescent development and reproductive health. Those programme packages also included an emphasis on fatherhood aimed at removing gender biases in parenting.

SUWANNA WARAKAMIN (Thailand) said that while her country had routinely addressed issues of gender equality and violence against women, it had also given specific attention to women’s economic empowerment and their right to equitable access to health and education. The Thai Constitution of 1997 had clearly stipulated gender equality and within its tenets were laws that would ensure equal opportunities for women and men, as well as addressing women’s rights.

She went on to say that the laws to address prostitution and trafficking of women and children had been revised to decriminalize the victims of trafficking. Investigation procedures and techniques had also been improved to become more child- and woman-friendly. At the regional level, a memorandum of understanding between countries in the Mekong subregion marked a new chapter in cooperation by identifying policies aimed at counteracting this transboundary crime.

She said that there was a National Policy and Plan of Action to Eradicate Violence against Women and Children in the drafting process. That plan would establish “one-stop” service for victims of violence at several hospitals in Bangkok with multidisciplinary teams comprising health, social and community development experts.

Panel Discussion

The Commission then began a panel discussion on population, gender and development.

The representative of Iran reported on the policy progress made in the area of gender equality. Women and men must have equal access to health-care services, and his country had attached great importance to the formation and protection of the family. Great progress had been made in the educational field; last year, 70 per cent of the students taking university entrance exams had been women. Improved health care in Iran had led to improved health conditions among women and the elderly. That progress had been the result of the decentralization of the health-care system, which had enabled services to reach isolated individuals in remote, rural areas. Nevertheless, the capacity of local governments should be strengthened to cope with health-care needs, and financing for health-care programmes should be increased.

The representative of Hungary said the population decline in her country for the last 20 years had reached levels that had raised the concerns of the Government and society. The population now was just over 10 million and was projected to drop to approximately 8 million by 2050, due to a steady decline in fertility, accelerated after 1994, and a high mortality rate. The life expectancy at birth was 66 years for men and 74 years for women. The current migration balance was around zero, but immigration figures were very crude.

She said that the demographic behaviour of the population had experienced a marked change after 1990, due to major societal shifts. A big shock had been the emergence of unemployment, accompanied by a decline in social and family services. That had contributed to a dramatic decrease in fertility rates in the mid-1990s. In response, the Government had recently adopted a family policy aimed at consolidating women's role as mothers and workers and the creation of a larger inter-generational solidarity.

There was no real gender policy in Hungary, she said. A recent Council on Gender Issues had been established within the Ministry and Welfare Council, which was charged with advising the Government on proposed legislation from a gender perspective.

The representative of Mexico highlighted the varying degrees of progress among countries and subregions, particularly in areas of education, health, and labour. For example, in his region, real progress had been made in universalizing primary education, and there had been a systematic reduction in the gender approach to schooling at all levels. In addition, a broad variety of measures had been introduced to deal with gender inequalities, including: equal access to education; the promotion of an effective and timely system for women's full health care; a reduction of poverty, particularly as it affected women; broadened access to labour and the defence of female workers; and the strengthening of the family.

Efforts had also been made to combat intra-family violence and evolve a balanced and non-discriminatory image of women, he said. Despite such progress, however, inequality between men and women had not been overcome. That was a long- term process. Moreover, the persistence of such inequities and unequal structures was deeply rooted in the cultural realities and institutions of the different countries of the region. Such traditions had inhibited women's ability to fully exercise their potential. In all Latin American and Caribbean countries, there was a "horizon of possibilities" to implement the Cairo outcome. The road was long, but a look backwards would show that progress had indeed been made.

The representative of the Netherlands said she had been disappointed that real disaggregation of data by gender and age was missing in the majority of tables in the Population Division's report, with the exception of internal and international migration. In most of the tables, women, subdivided by age, did not exist. Policy-makers and researchers in the field had underlined the importance of data disaggregated according to gender and age categories. The research done to date had not yet included all of the details needed to address, in depth, the gender, population and development scene. For example, the situation of migrant women, old and young, required more details about their needs, but first that required the data. At present, the data was incomplete and insufficient.

The representative of South Africa said that everyone was well aware that poverty was both a population and a gender issue. In South Africa, poverty had undermined development; it had been feminized, and the majority of the burden was being carried by the rural population, of which women and children comprised 70 per cent. With a new Government, many issues had been addressed to correct gender imbalances, including the formulation of gender-sensitive laws and policies, which had opened up avenues for women to purchase property and own land. Challenges remained in the area of poverty, namely, the inequalities defined along gender, educational and geographic lines.

The number of women infected with HIV/AIDS had also undermined population development, she said. Currently, in South Africa, 20 per cent of the "economically available" population had been affected. The issue of patriarchy had hindered women's autonomy and control over their reproductive health, further compromising their decisions about their lives. The Government's response had been positive, and sexual reproductive health was enshrined as a human rights issue in South Africa's Constitution.

The representative of Belgium wondered whether there was a coincidence between the great recent United Nations Conferences –- Beijing and Cairo -- and the arrival of a new government in South Africa.

The representative of South Africa said that the timing of the conferences had indeed had an impact on the new South African regime, particularly in light of its stance on women’s rights and reproductive health issues.

The representative of India asked the representative of Hungary for clarification of her statements about population decline in her native Hungary due to low fertility rates. He was concerned that the idea of setting a macro-level policy to increase or decrease fertility might interfere with reproductive rights concerns expressed at Cairo. The representative of Hungary said that the decrease was indeed alarming. In fact, it was much below replacement level fertility and her country might never be able to reach replacement level. There was no conflict between her country’s policies and the reproductive rights concerns expressed at Cairo. A majority of the surveys in family and reproductive matters in Hungary had shown that the society was “family friendly”. Perhaps, those policies geared towards increasing fertility were actually enabling women to exercise their reproductive rights.

The representative of Brazil asked the representative of South Africa to elaborate on her comments about South Africa’s pregnancy termination laws. He wondered if there was a minimum age.

The representative of South Africa said that termination of pregnancy was open to whoever needed the service. The minimum age was 14.

The representative of the United States said that her country was impressed with Iran’s progress and policies on reproductive health. She wondered if there been any outreach programmes from the Iranian Government to other countries in the region to share and learn from those successes.

She asked the representative of the Netherlands what were the implications of reporting census data on deaths in a specific age range, but not others.

The representative of Iran said that the United Nations Population Fund (UNFPA) had convened many workshops in his country dealing with reproductive health. Those workshops had been attended by representatives from neighbouring countries.

The representative of the Netherlands said that the problem of census-taking was that the questions were concentrated on a small number of demographic variables.

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