Developing Arguments and Strategies

1. Developing Arguments and Strategies Presentation delivered to Improving Sexual Health Seminar, organised by the Irish Family Planning Association (IFPA), Clarion Hotel, Liffey Valley, County Dublin Tanya Ward Irish Council for Civil Liberties 31 May 2006

2. Presentation Outline • Introduction • Understanding your rights • CEDAW and the role of civil society • Developing arguments • Strategies (making complaints and lobbying)

3. 1. Introduction • Human rights standards on reproductive health from the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) • Article 12 and Article 16 are most relevant • I will show how it can be used to develop arguments leading to strategies

4. 1. Introduction • Human rights law presents activists, community workers and NGO representatives with a range of opportunities to address inequalities in healthcare provision • In Ireland, rights have played a significant role in improving sexual health services • Magee v. the Attorney General (1974) • The case involved a married woman with four children who was advised by her doctor against further pregnancy. She was prevented by customs officers from importing contraceptives and the Supreme Court ruled that this was an invasion of her right to privacy

5. 1. Introduction • Rights have been used by campaigners during referenda • In the main, most groups do not use rights to address sexual health services • This is new territory for many groups

6. 2. Understanding your rights • Find out what your rights are and understand how different rights mechanisms work • Attend training and seminars • Contact national non-governmental organisations (NGOs) for information: Amnesty International, the Irish Family Planning Association (IFPA), the Irish Council for Civil Liberties (ICCL) and the Women’s Human Rights Alliance

7. 2. Understanding your rights • Get on newsletter mailing lists • Become a member of a human rights organisation • Purchase key publications • Visit United Nations (UN) websites and key human rights resources • Organise staff development days on rights

8. 3. CEDAW • CEDAW provides the strongest legal support for the right to reproductive health and choice than any other human rights treaty • You can also use standards from other human rights conventions in your work • The International Conference on Population and Development provides useful benchmarks

9. 3. CEDAW • State parties shall take all appropriate measures to eliminate discrimination against women in the field of healthcare in order to ensure, on a basis of equality of men and women, access to healthcare services, including those related to family planning (Article 12.1) • Article 16(e) also provides that women should have the same rights to decide freely on the number and spacing of their children, together with access to information to enable them to exercise their rights

10. 3. CEDAW – Article 12 • UN Human Rights Committees explain what human rights articles/standards mean through General Comments • The UN CEDAW Committee has further explained what Article 12 means through General Recommendation No. 24

11. 3. CEDAW – Article 12 • Implement measures to eliminate discrimination against women in the field of healthcare (Article 12.1) • Equality between men and women in access to healthcare services, including family planning (Article 12.1) • The State shall ensure appropriate services in connection with pregnancy, confinement and post-natal period (Article 12.2)

12. Free services and vulnerable women • Granting free services where necessary (Article 12.2)  Free contraception for low income, free testing for sexual diseases, free medical treatment • Special attention should be given to the health needs and rights of women belonging to vulnerable and disadvantaged groups (General Comment 24, para 6)  Are there special measures targeting vulnerable groups of women?

13. Conscientious objection and alternative health providers • It is discriminatory for the Government to refuse to legally provide certain reproductive health services for women i.e. conscientious objection • Measures should be introduced to ensure that women are referred to alternative health providers (General Comment 24, para 11)  Doctors who will not prescribe contraceptives  Women who are unable to get information on abortion services  Rural women are particularly affected by this

14. Gender proofing and participation • Place a gender perspective at the centre of all policies • All policies affecting women’s health should involve women in the planning, implementation of such policies (General Comment 24, 31(a))  Local women’s groups and providers should be consulted and involved in decision-making processes

15. Prioritize unwanted pregnancy • Government agencies should prioritize the prevention of unwanted pregnancies through family planning and sex education (General Comment 24, 31(c))  Are local areas being targeted by special programmes?  Are sexual education programmes delivered to young people and members of the local community?

16. Abortion • Legislation criminalizing abortion should be amended to remove punitive provisions against women (General Comment 24, see 31(c)) • CEDAW pays attention to maternal deaths, the number of women having illegal abortions and discrimination in relation to services • For CEDAW, this is a violation of their right to health and right to life

17. Abortion • Women should not be prosecuted for having an abortion in the country • Women on low income and asylum seekers face barriers • Rural women

18. HIV/Aids and other diseases • The issues of HIV/Aids and other sexually transmitted disease are central to the rights of women and adolescent girls to sexual health • Due to unequal power relations, girls are often unable to refuse sex or insist on safe sex • Harmful traditional practices (FGM) can expose women to disease • Women in prostitution are vulnerable (General Comment 24, para 18)

19. HIV/Aids and other diseases • Without prejudice, government agencies, should ensure the right to sexual health information, education and services for all women and girls • This includes trafficked women • Staff must be properly trained in specially designed programmes that respect their rights to privacy and confidentiality  This area is seriously underfunded in Ireland  NGOs and the Crisis Pregnancy Agency

20. Monitoring sexual health services • Monitor the provision of health services to women by public, NGO and private organisations to ensure equal access and quality of care (General Comment 24, 31(d)) • The Irish Government is required to provide information to the CEDAW Committee on positive measures to curb violations of women’s rights by third parties (General Comment 24, para 19)  Quality of service in rural areas or disadvantaged areas  Rogue counsellors giving advice to women facing a crisis pregnancy

21. Autonomy, confidentiality, privacy… • Require all health services to be consistent with the human rights of women, including the rights to autonomy, privacy, confidentiality, informed consent and choice (General Comment 24, 31(e))  Do services in your local area protect your rights to autonomy and privacy?  Is confidentiality guaranteed?  Are you informed before you make a decision?  Do you have choices?

22. Training for health workers • Ensure that the training curricula for health workers includes comprehensive, mandatory, gender-sensitive courses on women’s health and human rights, in particular, gender-based violence (General Comment, 32(f))  Are service providers in your local area properly trained?

23. 3. CEDAW • CEDAW works on the principle of ‘constructive dialogue’ and relies on the goodwill of government agencies to respect its recommendations • It is up to us to make the Government embrace rights and make them accountable

24. 4. Developing arguments • Understand your rights and apply them to your local community. Examine whether local providers fulfil their obligations • Look for gaps in provision • Find out who is responsible and what decision-makers are expected to provide

25. 4. Developing arguments • Set up a system which monitors gaps/inequalities – conduct a survey or consult with service users, maintain a database or record book of complaints • Change stories into hard facts and numbers that can be used to hold local government accountable for their actions

26. 5. Strategies – Complain constructively • The information can be used to form the basis of a complaint • Find out if there is a complaints procedure • Give all the facts and only the facts • State what you want to happen • Keep a copy/record of all communications • Follow-up

27. 5. Strategies – Lobbying • Using rights as a political tool • Write up the information highlighting where service providers are not meeting their obligations – use rights language, examples and case histories • Be accurate • Use the information to lobby service providers, health board officials, local politicians

28. 5. Strategies – Lobbying • Publicise your findings – local newsletters, newspapers, notice boards • Organise a public meeting • Publicise successes and evaluate your activities • Contact national NGOs and tell them about your findings. This information can be used at an international level