Developing Developing Arguments and Arguments and Strategies Strategies

Presentation delivered to Presentation delivered to Improving Sexual Health Improving Sexual Health Seminar, Seminar, organised by the Irish Family Planning organised by the Irish Family Planning Association (IFPA), Clarion Hotel, Liffey Valley, County Association (IFPA), Clarion Hotel, Liffey Valley, County Dublin Dublin

Tanya WardTanya WardIrish Council for Civil LibertiesIrish Council for Civil Liberties

31 May 2006 31 May 2006

Presentation OutlinePresentation Outline

1.1. Introduction Introduction

2.2. Understanding your rights Understanding your rights

3.3. CEDAW and the role of civil society CEDAW and the role of civil society

4.4. Developing arguments Developing arguments

5.5. Strategies (making complaints and lobbying)Strategies (making complaints and lobbying)

1. Introduction1. Introduction

Human rights standards on reproductive health Human rights standards on reproductive health from the Convention on the Elimination of All from the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) Forms of Discrimination Against Women (CEDAW)

Article 12 and Article 16 are most relevant Article 12 and Article 16 are most relevant

I will show how it can be used to develop I will show how it can be used to develop arguments leading to strategiesarguments leading to strategies

1. Introduction1. Introduction

Human rights law presents activists, community Human rights law presents activists, community workers and NGO representatives with a range of workers and NGO representatives with a range of opportunities to address inequalities in healthcare opportunities to address inequalities in healthcare provision provision

In Ireland, rights have played a significant role in In Ireland, rights have played a significant role in improving sexual health services improving sexual health services

Magee v. the Attorney GeneralMagee v. the Attorney General (1974) (1974)

The case involved a married woman with four children The case involved a married woman with four children who was advised by her doctor against further who was advised by her doctor against further pregnancy. She was prevented by customs officers pregnancy. She was prevented by customs officers from importing contraceptives and the Supreme Court from importing contraceptives and the Supreme Court ruled that this was an invasion of her right to privacy ruled that this was an invasion of her right to privacy

1. Introduction1. Introduction

Rights have been used by campaigners during Rights have been used by campaigners during referendareferenda

In the main, most groups do not use rights to In the main, most groups do not use rights to

address sexual health services address sexual health services

This is new territory for many groupsThis is new territory for many groups

2. Understanding your rights2. Understanding your rights

Find out what your rights are and understand Find out what your rights are and understand

how different rights mechanisms work how different rights mechanisms work

Attend training and seminars Attend training and seminars

Contact national non-governmental organisations Contact national non-governmental organisations (NGOs) for information: Amnesty International, (NGOs) for information: Amnesty International, the Irish Family Planning Association (IFPA), the the Irish Family Planning Association (IFPA), the Irish Council for Civil Liberties (ICCL) and the Irish Council for Civil Liberties (ICCL) and the Women’s Human Rights Alliance Women’s Human Rights Alliance

2. Understanding your rights2. Understanding your rights

Get on newsletter mailing listsGet on newsletter mailing lists

Become a member of a human rights Become a member of a human rights organisation organisation

Purchase key publicationsPurchase key publications

Visit United Nations (UN) websites and key Visit United Nations (UN) websites and key human rights resources human rights resources

Organise staff development days on rights Organise staff development days on rights

3. CEDAW3. CEDAW

CEDAW provides the strongest legal support for CEDAW provides the strongest legal support for the right to reproductive health and choice than the right to reproductive health and choice than any other human rights treatyany other human rights treaty

You can also use standards from other human You can also use standards from other human rights conventions in your workrights conventions in your work

The International Conference on Population and The International Conference on Population and Development provides useful benchmarks Development provides useful benchmarks

3. CEDAW3. CEDAW

State parties shall take all appropriate measures State parties shall take all appropriate measures to eliminate discrimination against women in the to eliminate discrimination against women in the field of healthcare in order to ensure, on a basis field of healthcare in order to ensure, on a basis of equality of men and women, access to of equality of men and women, access to healthcare services, including those related to healthcare services, including those related to family planningfamily planning (Article 12.1) (Article 12.1)

Article 16(e) also provides that women should Article 16(e) also provides that women should have the same rights to decide freely on the have the same rights to decide freely on the number and spacing of their children, together number and spacing of their children, together with access to information to enable them to with access to information to enable them to exercise their rights exercise their rights

3. CEDAW – Article 123. CEDAW – Article 12

UN Human Rights Committees explain what UN Human Rights Committees explain what human rights articles/standards mean through human rights articles/standards mean through General CommentsGeneral Comments

The UN CEDAW Committee has further explained The UN CEDAW Committee has further explained what Article 12 means through General what Article 12 means through General Recommendation No. 24 Recommendation No. 24

3. CEDAW – Article 123. CEDAW – Article 12

Implement measures to eliminate discrimination Implement measures to eliminate discrimination against women in the field of healthcare (Article against women in the field of healthcare (Article 12.1)12.1)

Equality between men and women in access to Equality between men and women in access to healthcare services, including family planning healthcare services, including family planning (Article 12.1) (Article 12.1)

The State shall ensure appropriate services in The State shall ensure appropriate services in connection with pregnancy, confinement and connection with pregnancy, confinement and post-natal period (Article 12.2)post-natal period (Article 12.2)

Free services and vulnerable Free services and vulnerable womenwomen

Granting free services where necessary (Article 12.2) Granting free services where necessary (Article 12.2)

Free contraception for low income, free Free contraception for low income, free testing testing for sexual diseases, free medical for sexual diseases, free medical treatment treatment

Special attention should be given to the health needs Special attention should be given to the health needs

and rights of women belonging to vulnerable and and rights of women belonging to vulnerable and disadvantaged groups (General Comment 24, para 6)disadvantaged groups (General Comment 24, para 6)

Are there special measures targeting Are there special measures targeting vulnerable vulnerable

groups of women?groups of women?

Conscientious objection and Conscientious objection and alternative health providersalternative health providers

It is discriminatory for the Government to refuse to It is discriminatory for the Government to refuse to legally provide certain reproductive health services for legally provide certain reproductive health services for women i.e. conscientious objectionwomen i.e. conscientious objection

Measures should be introduced to ensure that women Measures should be introduced to ensure that women are referred to alternative health providers (General are referred to alternative health providers (General Comment 24, para 11)Comment 24, para 11)

Doctors who will not prescribe contraceptives Doctors who will not prescribe contraceptives

Women who are unable to get information on Women who are unable to get information on abortion servicesabortion services Rural women are particularly affected by this Rural women are particularly affected by this

Gender proofing and Gender proofing and participation participation

Place a gender perspective at the centre of all Place a gender perspective at the centre of all policiespolicies

All policies affecting women’s health should All policies affecting women’s health should involve women in the planning, implementation involve women in the planning, implementation of such policies (General Comment 24, 31(a))of such policies (General Comment 24, 31(a))

Local women’s groups and providers Local women’s groups and providers should be should be consulted and involved in decision-consulted and involved in decision-making making processes processes

Prioritize unwanted pregnancy Prioritize unwanted pregnancy

Government agencies should prioritize the Government agencies should prioritize the prevention of unwanted pregnancies through prevention of unwanted pregnancies through family planning and sex education (General family planning and sex education (General Comment 24, 31(c))Comment 24, 31(c))

Are local areas being targeted by special Are local areas being targeted by special programmes? programmes?

Are sexual education programmes Are sexual education programmes delivered to delivered to young people and members of the young people and members of the local local community?community?

Abortion Abortion

Legislation criminalizing abortion should be Legislation criminalizing abortion should be amended to remove punitive provisions against amended to remove punitive provisions against women (General Comment 24, see 31(c)) women (General Comment 24, see 31(c))

CEDAW pays attention to maternal deaths, the CEDAW pays attention to maternal deaths, the number of women having illegal abortions and number of women having illegal abortions and discrimination in relation to services discrimination in relation to services

For CEDAW, this is a violation of their right to For CEDAW, this is a violation of their right to health and right to life health and right to life

AbortionAbortion

Women should not be prosecuted for having an Women should not be prosecuted for having an abortion in the country abortion in the country

Women on low income and asylum seekers face Women on low income and asylum seekers face barriersbarriers

Rural women Rural women

HIV/Aids and other diseasesHIV/Aids and other diseases

The issues of HIV/Aids and other sexually The issues of HIV/Aids and other sexually transmitted disease are central to the rights of transmitted disease are central to the rights of women and adolescent girls to sexual healthwomen and adolescent girls to sexual health

Due to unequal power relations, girls are often Due to unequal power relations, girls are often unable to refuse sex or insist on safe sex unable to refuse sex or insist on safe sex

Harmful traditional practices (FGM) can expose Harmful traditional practices (FGM) can expose women to disease women to disease

Women in prostitution are vulnerable (General Women in prostitution are vulnerable (General Comment 24, para 18)Comment 24, para 18)

HIV/Aids and other diseasesHIV/Aids and other diseases

Without prejudice, government agencies, should Without prejudice, government agencies, should ensure the right to sexual health information, ensure the right to sexual health information, education and services for all women and girls education and services for all women and girls

This includes trafficked women This includes trafficked women

Staff must be properly trained in specially Staff must be properly trained in specially designed programmes that respect their rights to designed programmes that respect their rights to privacy and confidentialityprivacy and confidentiality

This area is seriously underfunded in This area is seriously underfunded in

Ireland Ireland NGOs and the Crisis Pregnancy Agency NGOs and the Crisis Pregnancy Agency

Monitoring sexual health Monitoring sexual health

services services Monitor the provision of health services to women Monitor the provision of health services to women

by public, NGO and private organisations to by public, NGO and private organisations to ensure equal access and quality of care (General ensure equal access and quality of care (General Comment 24, 31(d))Comment 24, 31(d))

The Irish Government is required to provide The Irish Government is required to provide information to the CEDAW Committee on positive information to the CEDAW Committee on positive measures to curb violations of women’s rights by measures to curb violations of women’s rights by third parties (General Comment 24, para 19)third parties (General Comment 24, para 19)

Quality of service in rural areas or Quality of service in rural areas or disadvantaged disadvantaged areasareas

Rogue counsellors giving advice to Rogue counsellors giving advice to women facing women facing a crisis pregnancy a crisis pregnancy

Autonomy, confidentiality, Autonomy, confidentiality, privacy…privacy…

Require all health services to be consistent with Require all health services to be consistent with the human rights of women, including the rights the human rights of women, including the rights to autonomy, privacy, confidentiality, informed to autonomy, privacy, confidentiality, informed consent and choice (General Comment 24, 31(e))consent and choice (General Comment 24, 31(e))

Do services in your local area protect Do services in your local area protect your rights your rights to autonomy and privacy?to autonomy and privacy?

Is confidentiality guaranteed? Is confidentiality guaranteed? Are you informed before you make a Are you informed before you make a

decision? decision? Do you have choices?Do you have choices?

Training for health workers Training for health workers

Ensure that the training curricula for health Ensure that the training curricula for health workers includes comprehensive, mandatory, workers includes comprehensive, mandatory, gender-sensitive courses on women’s health and gender-sensitive courses on women’s health and human rights, in particular, gender-based human rights, in particular, gender-based violence (General Comment, 32(f)) violence (General Comment, 32(f))

Are service providers in your local area Are service providers in your local area properly properly trained?trained?

3. CEDAW3. CEDAW

CEDAW works on the principle of ‘constructive CEDAW works on the principle of ‘constructive dialogue’ and relies on the goodwill of dialogue’ and relies on the goodwill of government agencies to respect its government agencies to respect its recommendations recommendations

It is up to us to make the Government embrace It is up to us to make the Government embrace rights and make them accountable rights and make them accountable

4. Developing arguments 4. Developing arguments

Understand your rights and apply them to your Understand your rights and apply them to your local community. Examine whether local local community. Examine whether local providers fulfil their obligations providers fulfil their obligations

Look for gaps in provisionLook for gaps in provision

Find out who is responsible and what decision-Find out who is responsible and what decision-makers are expected to provide makers are expected to provide

4. Developing arguments4. Developing arguments

Set up a system which monitors gaps/inequalities Set up a system which monitors gaps/inequalities – conduct a survey or consult with service users, – conduct a survey or consult with service users, maintain a database or record book of complaints maintain a database or record book of complaints

Change stories into hard facts and numbers that Change stories into hard facts and numbers that can be used to can be used to hold local government hold local government accountable for their actionsaccountable for their actions

5. Strategies – Complain 5. Strategies – Complain constructivelyconstructively

The information can be used to form the basis of a The information can be used to form the basis of a complaint complaint

Find out if there is a complaints procedure Find out if there is a complaints procedure

Give all the facts and only the facts Give all the facts and only the facts

State what you want to happen State what you want to happen

Keep a copy/record of all communications Keep a copy/record of all communications

Follow-up Follow-up

5. Strategies – Lobbying5. Strategies – Lobbying

Using rights as a political tool Using rights as a political tool

Write up the information highlighting where Write up the information highlighting where service providers are not meeting their service providers are not meeting their obligations – use rights language, examples and obligations – use rights language, examples and case histories case histories

Be accurateBe accurate

Use the information to lobby service providers, Use the information to lobby service providers, health board officials, local politicians health board officials, local politicians

5. Strategies – Lobbying5. Strategies – Lobbying

Publicise your findings – local newsletters, Publicise your findings – local newsletters, newspapers, notice boards newspapers, notice boards

Organise a public meeting Organise a public meeting

Publicise successes and evaluate your activities Publicise successes and evaluate your activities

Contact national NGOs and tell them about your Contact national NGOs and tell them about your findings. This information can be used at an findings. This information can be used at an international level international level