Gender, health and human rights Hilary Homans 15 th March 2011

1. Gender, health and human rights Hilary Homans 15th March 2011 www.abdn.ac.uk/sustainable-international-development

2. Vision The Centre’s vision is to make a significant contribution to the sustainable achievement of the Millennium Development Goals (MDGs) and other international development targets.

3. Overview • Definitions of sex and gender • Gender differences in health • Definitions of human rights • Key issues for Gender, Health and Human Rights • Gender and health human rights violations • Examples of progress good practice • Way forward

4. Discussion • What is the difference between sex and gender?

5. Understanding Gender • Gender framework: • Biological • Social Construction • Needs/Rights

6. Sex Male Female SEX refers to an individual’s identity from the physiological or biological characteristics of male and female

7. Gender • Gender has to do with: • how we think • how we feel we should behaviour • what we believe we can and cannot do • Social construction- socially defined concepts of masculinity and femininity • Men as hunters, risk takers • Women as gathers, care givers

8. Gender equality Gender Equality means equal treatment of women and men in laws and policies, and in access to resources and services within families, communities and society at large.

9. Gender equity • Gender Equityis about fairness and justice in the distribution of benefits and responsibilities between women and men, and often requires women-specific programmes and projects to end existing inequalities. • Equity should be built on a real-life status and experience, an understanding of gender-related expectations, needs, and rights and may need to challenge adverse norms.

10. Empowerment When women and men have an unequal status within a community and unequal access to and control over resources, women need preferential treatment and affirmative action before their starting point could be considered as equal with men.

11. Gender issues in health • Working groups x 4 • Flash card question – 10 minutes to discuss based on evidence from your country • Feedback

12. Definition of human rights

13. What are human rights? • Human rights are universal - the birth right of all human beings. • Human rights focus on the inherent dignity and equal worth of all human beings. • All human rights are equal, indivisible and interdependent. Universal Declaration of Human Rights, 1948 http://www.un.org/en/documents/udhr/index.shtml

14. Human rights law • A set of performance standards for duty-bearers at all levels of society, but especially organs of the state. • It serves as a basis for accountability. • It grants justiciable legal guarantees to every individual as a rights-holder. • It is codified in international, regional and national legal systems.

15. International human rights law • Serves as: • A beacon - pulling states towards accepting human rights. • A safety net - to supplement the national legal system. • A basis - to ‘mobilise shame’ of the international community. • The application of international human rights frameworks means that governments are held accountable for their actions.

16. Human rights obligations of State Four categories of obligations: • Respecting a right means that a state must not violate a particular right. • Protecting a right means that a state has to prevent violations of that right by non-state actors. • Fulfilling a right means that a state has to take all appropriate measures, like allotting budgetary resources, to the realisation of that right. • Promoting a right means that a state must educate the public and raise awareness about that right.

17. What is a human rights-based approach? • It is one that focuses on empowering people (especially the most vulnerable & marginalised) with the knowledge and resources to understand and assert their rights. • Simultaneously, it focuses on capacity building of duty-holders (government) to be able to protect and promote human rights.

18. Human rights include gender • The universal system for the protection of human rights, in Articles 1 and 2 of the Universal Declaration, proclaims that “all human beings are born free and equal in dignity and rights" and thus anyone may invoke all the rights and freedoms established in the Declaration "without distinction," including gender.

19. The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) 1979 “discrimination against women” : • any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women, irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, civil or any other field. http://www.un.org/womenwatch/daw/cedaw/cedaw.htm

20. CEDAW (2) This definition covers any difference in treatment based on gender that: • intentionally or unintentionally disadvantages women; • prevents recognition by society as a whole of the rights of women in the public and private spheres; or • prevents women from exercising their rights

21. CEDAW (3) In Article 5(a), the CEDAW establishes the obligation of the States to “modify the social and cultural patterns of men and women, with a view to achieving the elimination of prejudices and customary and all other practices which are based on the idea of the inferiority or superiority of either of the sexes or on stereotyped roles for men and women.”

22. CEDAW (4) • Right to equality and non-discrimination based on sex (Articles 2 & 3). • States must modify and abolish laws, customs and practices that discriminate against women (Article 2(f)). • Protection of women against trafficking and sexual exploitation (Article 6). • Right to appropriate health care services including during pregnancy and postnatal period (Article 12). • Non-discrimination in matters of marriage (Article 16).

23. Convention on the Rights of the Child (CRC) 1989/90 Children have the right to health services: • full range of accessible and affordable services • privacy • confidentiality • be treated with dignity and respect • be treated by people who are trained and knowledgeable • continuity of care • non discrimination http://www2.ohchr.org/english/law/crc.htm

24. Convention on the Rights of the Child (CRC) Children have the right to participation, information, self-expression: • Information - to seek, receive impart information (13) • Express views on services received and to complain about unsatisfactory services (12, 13) • Make free informed choices in matters relating to sexual experience, pleasure and sexual orientation • Freedom of association • Participation and involvement in decisions that affect them

25. Convention on the Rights of the Child (CRC) Children have the right to special protection: • from deprivation of parental care (9, 10, 11) • from abuse and violence, or neglect (19) • from exploitation (32, 34, 35, 36) • when in conflict with the law (37, 40)

26. Domestication of a treaty • Signature (state not bound to treaty provisions). • Ratification / Accession (state becomes bound). • Legislative conversion (‘enabling legislation’). • Implementation in practice.

27. Questions • Has your country ratified CEDAW? • Has your country ratified CRC? • Do you know of any countries that have not?

28. Countries and dates ratified CEDAW and CRC

29. Mechanisms for monitoring • Fulfillment of commitments to treaties is monitored by independent expert committees called treaty bodies. • Also Shadow reports produced by civil society organisations.

30. The right to health The Universal Declaration of Human Rights : • Article 25 - Everyone has the right to a standard of living adequate for the health and well-being of himself and his family, including food, clothing, housing and medical care and necessary social services and the right to security in the event of unemployment , sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

31. The right to health Health is considered a fundamental human right in the WHO Constitution: • The right to health applies to all human beings regardless of their race, colour, sex, language, religion, political or other opinion, their social origin, property, birth or other status.

32. Reproductive rights Rights of couples and individuals to: • Decide freely and responsibly the number, spacing and timing of their children and have the information, education and means to do so • Attain the highest standard of sexual and reproductive health • Make decisions about reproduction free from discrimination, coercion and violence (ICPD, 1994) Photoshare,K4Health

33. Protocol on the rights of women in Africa • Prohibition of discrimination against women (Article 2). • Right to dignity (Article 3). • Elimination of harmful practices (Article 5). • Equal rights in marriage (Article 6). • Health and reproductive rights (Article 14). • Right to inheritance (Article 21).

34. Protocol on the rights of women in Africa Health and reproductive rights (Article 14). • States parties shall ensure that the right to health of women, including sexual and reproductive health is respected and promoted. This includes: • the right to control their fertility; • the right to decide whether to have children; • the number of children and the spacing of the children; • the right to choose any method of contraception; • the right to self-protection and to be protected against sexually transmitted infections, including HIV/AIDS.

35. Key issues in implementing human rights legislation on gender and health

36. Do women and men want the same number of children?

37. Ideal no. of children amongst women and men in Kenya

38. Are women’s voices heard in decision making about family size and other household decisions?

39. Household decisions made by husbands alone

40. Human rights violations Human rights violations due to societal conditions such as • violence against women • lack of education • harmful cultural practices • restrictions on property and inheritance exacerbate gender inequalities. Kyrgyz girl computing class, Homans

41. Gender-based violence • Gender-based violence causes more deaths and disabilities against women than cancer, malaria, traffic accidents and war • 60 million girls a year are sexually assaulted at or en route to school • ¼ women have been victims of domestic violence • 1/5 women have been victims of rape

42. Violence against women

44. BUT • 29% governments lack laws or policies to prevent violence against women

45. MDGs

46. MDGs and gender • MDG 1 Poverty Gender discrimination, or the denial of women’s basic human rights, is a major cause of poverty. • MDG 2 Universal primary education – two thirds children denied schooling are girls (41 million) • MDG 3 Gender equality and women’s empowerment - 64% world’s illiterate are women. Only 19% women in Parliament are women globally (? country with highest representation of women, your country?)

48. MDGs and gender (2) • MDG 4 Child health • is likely to be better in countries characterized by more gender equity, where women have more reproductive autonomy, education, and political influence. • Equalising women's status would decrease child malnutrition by 13%.

49. MDGs and gender (3) • MDG 5 Maternal health – most “off track” MDG, reflects status of women in many countries • MDG 6 HIV & Malaria • pregnant women more vulnerable to malaria • where HIV is transmitted sexually women are more vulnerable • Injecting drug use young men more vulnerable..but overlap of sex and drugs

50. Examples of good practice Elimination of female genital cutting through community based participatory communication - Senegal