PUTRAJAYA DECLARATION +5WOMEN, DISASTER SITUATIONS AND HEALTH:

MALAYSIA’S SITUATIONby

RashidahShuibWomen’s Development Research Centre

(KANITA)

OUTLINE:* Background

* Substantive issues relating to the sections* External/internal factors influencing issues in the past five years

* Emerging trends

* Actions to be prioritised in the next 5 years

Background for discussions:I. Various international conferences ratified:> ICPD 1994 >> benchmark for SRH >> paradigm shift from demography to

SRH as central to development> Beijing 1995> CEDAW> UN Human Rights Charter> Millenium Development Goals (MDGs)

Background for discussions:II. Inter-linkages of health and development,

social, political and economic contexts.> linked with other sections of the Putrajaya

Declaration.

III. Gender and Rights Framework> Gender equality is the goal> Rights framework: Government has to respect,

protect and fulfill rights.

"Everyone has the right to the enjoyment of the highest attainable standard of physical and mental health. States should take all appropriate measures to ensure, on a basis of equality of men and women, universal access to health-care services, including those related to reproductive health care.... The role of women as primary custodians of family health should be recognized and supported. Access to basic health care, expanded health education, the availability of simple cost-effective remedies ... should be provided...."

--Cairo Programme of Action, Principle 8 and para. 8.6

"The explicit recognition ... of the right of all women to control all aspects of their health, in particular their own fertility, is basic to their empowerment.... We are determined to ... ensure equal access to and equal treatment of women and men in ... health care and enhance women's sexual and reproductive health as well as Health."

--Beijing Declaration, paras. 17 and 30

"Women have the right to the enjoyment of the highest attainable standard of physical and mental health. The enjoyment of this right is vital to their life and well-being and their ability to participate in all areas of public and private life.... Women's health involves their emotional, social and physical well-being and is determined by the social, political and economic context of their lives, as well as by biology.... To attain optimal health, ... equality, including the sharing of family responsibilities, development and peace are necessary conditions."

--Beijing Platform for Action, para. 89

Rights frameworkThe Human Rights at Issue Human Rights relating to health are set out in basic

human rights treaties and include: • Right to life and survival• The human right to the highest attainable standard

of physical and mental health, including reproductive and sexual health.

• The human right to equal access to adequate health care and health-related services, regardless of sex, race, or other status.

• The human right to equitable distribution of food.

Rights frameworkThe Human Rights at Issue • The human right to access to safe drinking water

and sanitation. • The human right to an adequate standard of living

and adequate housing. • The human right to a safe and healthy environment. • The human right to a safe and healthy workplace,

and to adequate protection for pregnant women in work proven to be harmful to them.

• The human right to freedom from discrimination and discriminatory social practices, including female genital mutilation, prenatal gender selection, and female infanticide.

• The human right to education and access to information relating to health, including reproductive health and family planning to enable couples and individuals to decide freely and responsibly all matters of reproduction and sexuality.

• The human right of the child to an environment appropriate for physical and mental development.

Substantive Issues• Rights framework : “…right to the highest attainable

standard of physical and mental health.”>> not sure whether this framework has been applied consciously in the design and implementation of programmes and services.

BUT it does provide quality of care through its primary health care programmes.

• Gender mainstreaming in health?> gender sensitive health services> gender indicators

Substantive Issues• Steady increase of HIV/AIDS among women

• Care of HIV/AIDS and other infectious and chronic diseases

• Social, developmental and health consequences of health

Substantive Issues• Sexuality education

> teenage pregnancies

• Emerging new types of violence > gang rape> violence leading to deaths

• Gender perspective in disaster situations• Men and boys as responsible partners• Steady increase of HIV/AIDS among women

PROGRESS• Conventional health indicators showed progress:> MMR: 30/100,000> IMR: > Life-expectancy (Male): 71 yrs.> Life expectancy (Female): 76 yrs• Violence Against Women:> Domestic Violence Act (1994 but gazetted in 1996)> OSCC in major hospitals though services varied> Widespread campaign by women NGOs• Creation of national machineries e.g Ministry of Women,

Gender Equality Cabinet Committee (now defunct)

PROGRESS• Special attention to adolescent SRH, particularly by

NGOs e.g FRHAM produced RHAM and REHAK Kelantan had a regular school programme

EXTERNAL/INTERNAL FACTORSINFLUENCING ISSUES IN THE

PAST 5 YEARS

EXTERNAL FACTORS• Increasing conservatism>political & religious> collusion of the Bush Admin+

OIC & the Vatican

• Neoliberal financial crisis

• Migrants legal and illegal, refugees (?)

INTERNAL FACTORS

• Neoliberal economic policy

• Increasing privatisation• Health seen as a money

making service sector > medical/health

tourism

• Increasing conservatism• Lack of political

commitment, • CEDAW committee to

remove family ….

ACTIONS TO BE PRIORITISED

EMERGING TRENDS• Increasing aged

population• Feminisation of the aged• Increasing chronic

diseases• Feminisation of HIV/AIDS• Increasing home based

care• Growth and expansion

of cities

• Emerging and re-emerging infections

• MMR 60/100,000 WHO current

• Contraceptive prevalence rate is still low

• Spousal consent• Teenage pregnancies• Teenage marriages

PRIORITY ACTIONS• Clear agenda of gender mainstreaming and

integration of the rights framework

• Review of policies and practices which are barriers e.g spousal consent

• Planned programmes targeting men as responsible partners

• Call for all medical curricular to be gender mainstreamed.

• Teenage pregnancies > do a research

PRIORITY ACTIONS• Develop capacity to cope with feminisation of

the aged.• Revisit home based care; paid and unpaid care