While the deliberations and final negotiations of the process known as Cairo + 10
at CEPAL were focused on language to affirm and
re-commit to the original Program of Action of ICPD
(UN International Conference on Population &
Development), the women´s NGOs (non-governmental
organizations) continued work on the original agenda
of Cairo +10 with the 10-year evaluation of progress
on the Platform of Action itself
Results of the Project ATENEA were presented at
CEPAL by the Latin-American & Caribbean Women´s
Health Network, which focused on monitoring progress
on the original Plan of Action from Cairo in 1994 in
seven Latin American countries. The countries
included Brazil, Chile, Colombia, Mexico, Nicaragua, Peru and Surinam.
Monitoring in Project ATENEA was based on 147 quantitative and qualitative indicators.
One of the participants in the monitoring project, Ana María Pizarro of the
Health Network and SIMUJER in Nicaragua, explained
that "ATENEA enables us to know the relative global context
of fulfilling the international commitments of Cairo
from 1994, and at the same time to see these
agreements incorporated into national
legislation. Also if the conventions and treaties that the international community has signed have been ratified
by these countries, we can help ensure that the new
laws reflect these commitments."
Project ATENEA is comprised of seven thematic areas
or axes that are each comprised of various
categories used to analyze progress toward the Plan
of Action of ICPD from 1994 through 2002. The
areas include: sexual violence against girls, male responsibility in sexuality and reproduction, participation of
women´s organizations of women in decisionmaking, quality of attention in reproductive and sexual
health services, access of adolescents and youth to
information and reproductive and sexual health services,
more humane attention to unsafe abortions, and the prevention and attention to persons affected by
HIV/AIDS.
Ana María added that "although the results of
ATENEA are mixed, in general the legislative advances in the region
are one of the most important points to emphasize.
For the majority of the thematic areas, with the exception of male responsibility in sexuality and reproduction, laws have been
passed that reflect the most important agreements of the Program of Action of the
ICPD."
An example of such laws are those that were passed
in Latin America against violence against women and
girls, although the emphasis in these statutes
is on violence labeled as ¨domestic¨, or intrafamiliar,
with less emphasis on sexual violence and
incest. As part of these changes, many
countries have also begun to develop programs for
violence prevention and treatment of victims and
survivors of violence, although many health
professionals are not yet fully trained to offer
these services.
The ATENEA report indicates that "the system of registration
is gradually incorporating a focus with indicators
of progress that go beyond traditional
demographics. These indicators show, for
example, a large increase in sexual abuse and
violations of girls by family members and close
relatives. It shows that although charges are
brought against many perpetrators of these abuses,
often they are freed a short time later.
Thus male responsibility for abuse is not well
incorporated in most laws, and reproduction is still
regarded as primarily the responsibility of
women."
Another problem is that the statistics do not
include general figures on male fertility. Men´s use of contraceptive methods is extremely low and in the best
case scenario a maximum of 20% of men are
sterilized. At the same time, female sterilizations
range from 90% to almost 100% of sterilizations. Although
in every country there exist specialized services for men,
few address male sexually transmitted diseases
(STDs) or prostate cancer.
On another important issue in the 1994 Cairo Program of
Action, the participation of women´s organizations
in decisionmaking, the ATENEA study shows that even
if there has not been formal legal progress toward
this goal in some countries, many mixed commissions
and advisory councils have been created that include
these women´s groups. However, they do not
necessarily outline formal rules or desired levels
of participation for women, which is needed to
ensure that women have a formalized role or
guaranteed participation in decisionmaking. The proportion of women
candidates in popular elections is generally less
than 30% in all the countries, and there is even
greater competition at the local level where mayors,
registrars and local representatives compete with
political parties in inequitable conditions for
women.
The
quality of attention in reproductive and health
services is another criticall theme evaluated in the
Cairo monitoring project, which although it is a general
concern for many governments, in many countries is
not legally standardized. The Health
Network concluded that "the resources assigned
to this area are not clearly defined, although
training of medical personnel in this area consumes
important resources and time in many
institutions."
Ana María indicated that although some attention to
gender has been incorporated in training of public
health personnel in many countries, representatives
of women´s organizations who have greater
experience in this area have not been included as
trainers. She noted for example, that although
"violence as a public health problem has been
included in the training, even with specific
programs and procedures assigned to this area,
neither the legal or health personnel have received
sufficient training specifically related to gender.
Another critical theme is that of the reproductive and sexual health of adolescents. The study verifies that access of adolescents and
youth to information and reproductive and sexual health services is mentioned in almost all the
legislation, although no institutional or formal capacity exists to establish
special programs or to assign resources that incorporate the
specific needs of youths and adolescents.
There are no legal obstacles to access to
information in any Latin American countries, although the curricula of
university, secondary, and primary education
generally fail to incorporate this focus.
Fertility
rates among adolescents are in some cases very high,
above 150
births per 1.000 adolescents, whereas maternal mortality
among teenaged mothers may reach 30% of
births. The use of contraceptive measures is
much lower among adolescents, including among
adolescent males who are less likely to use condoms.
More
humane attention to problems related to unsafe
abortion is one area where legal progress has not
occurred, and the illegal status of abortion in most
countries is used to justify the poor quality of
attention that women receive in many public
facilities. As
a result, the amount of financial resources used to
deal with complications of unsafe abortions
cannot be determined. Maternal mortality rates
due to unsafe abortions are the second highest cause
of hospital deaths, and amount to 30% of the total
in some cases. Numerous women´s organizations
conduct ongoing campaigns to raise awareness about
such serious health problems caused by legal
restrictions against abortion in their
countries.
Legislation
to provide services for the prevention and attention
to persons affected by HIV/AIDS has been
passed in many countires. In addition to
efforts to control and prevent this pandemic, laws
have addressed the human rights of persons with
HIV/AIDS, particularly in terms of discrimination
against them as well as against the sexual practices
or lifestyles. Budgets assigned to HIV/AIDS
services are vastly unequal among the different
countries, and only two countries offer 100%
health coverage of persons infected with the virus.
The
feminization of HIV/AIDS pandemic is evident in all the countries,
particularly given the fact that more and more
younger women are becoming infected without
preventative measures being implemented, especially
in the adolescent population Religious pressures continue
to be an obstacle for the dissemination of information and of condoms in almost all the countries.
With this
unique citizen monitoring project, the women´s
health movement has provided a valuable instrument to demand the fulfillment of the Program of Action of the
ICPD. In the meantime ATENEA constitutes a
unified monitoring effort by women´s organizations of the
Latin American and Caribbean region.
The Health Network has proposed expanding
distribution of the ATENEA monitoring project and
making it accessible on the web.
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