Access to Quality Health Care – A Woman’s Right

Since 1987, women’s groups from around the globe have celebrated the International Day of Action for Women’s Health on May 28, by campaigning for the prevention of maternal mortality and morbidity. Last year, the campaign in Latin America and the Caribbean shifted its focus to the exercise of sexual and reproductive rights.

Why sexual and reproductive rights? Because these concepts involve basic principles that must be recognized respected and practiced in women’s daily lives in all societies; because these rights permit the full enjoyment of comprehensive health. The emphasis on rights is also very timely. Next month marks the fifty anniversary of the Vienna World Conference on Human Rights and its historic recognition of women’s rights as human rights. And in December, the world celebrates the 50th anniversary of the Universal Declaration of Human Rights.

What are sexual and reproductive rights? Sexual rights include:

• the basic right to decide, freely and responsibly, the number and spacing of children, or to decide not to have children, and to have access to the information, education and means needed to make this decision;

• the right to make reproductive decisions free from discrimination, coercion, domination or violence;

• The right to enjoy the highest level of sexual and reproductive health.

Recognized in the agreements of the International Conference on Population and Development (Cairo, 1994) and the Fourth World Conference of Women (Beijing, 1995), these concepts are one of the most important political gains of the international health movement. Since they are recognized as human rights, women, as well as men, should be able to exercise these rights freely, without obstacles. These agreements also reinforce health as a basic human right, essential for the comprehensive development of each individual, and as a basic civil right.

However, even though sexual and reproductive rights are increasingly being made known, included in national women’s health programmes and in daily discourse, they have not been translated into real improvements of women’s lives and health. On the contrary, in recent years there has been a marked decline in women’s health and quality of life due to current public policies and renewed attacks by conservative sectors.

A recent review of women’s health in the Caribbean, revealed the following key facts:

Most of the leading causes of death in Latin America and the Caribbean, with the exception of accidents and violence, are exacting a heavier toll on women and than on men.

Death rates from diabetes, hypertension and cervical cancer are all significantly higher among Caribbean women than among women in any other parts of the Western Hemisphere.

• Cancer of the breast causes the greatest percentage of female cancer deaths in the English-speaking Caribbean.

• Cervical cancer constitutes an even greater public health problem than breast cancer because of its high prevalence, the preventability of its fatal consequences and the fact that those most affected are the women of the lowest socioeconomic strata who have the least access to health care.

• The persistence of maternal mortality constitutes indisputable evidence of gender inequity in the region.

• According to World Bank/WHO estimates for Latin America and the Caribbean, for each year lost to premature death and disability by a male from sexually transmitted diseases, nine years were lost by a female.

Without a doubt, the worldwide decline in women’s health and quality of life is directly linked to the processes of globalization and the economic and social models imposed throughout the world. The structural adjustment policies adopted by many Caribbean governments to alleviate the debt crisis of the 1980s have been associated with, inter-alia, cuts in health services and food subsidies; increases in the price of drugs, transportation, housing, water and electricity; privatization of public industry and services; and trade liberalization.

In the area of health, system reforms are being implemented, regardless of the detriment to the general population and particularly to women, the primary users of state health services. Thus, the privatization of these services reduces the access of most of the population. Health is not considered a right, but another good on the market. This new health model has a disproportionate effect on women, especially those in the poorest sectors, and strengthens the inequities of gender. At the same time, the quality of health services is declining and the model of medical hegemony is reinforced, a model that neither supports nor respects women’s dignity as clients or human beings, but imposes a form of care which is authoritarian, patriarchal and even abusive. All these characteristics combine to limit women’s access to health services and to discourage women from continuing treatment or seeking much needed information on contraceptives, care in childbirth, care for chronic diseases, etc.

The Campaign for the Exercise of Sexual and Reproductive Rights promotes the recognition of these rights, but above all, urges the governments to guarantee the conditions needed to freely exercise them.

The Caribbean Association for Feminist Research and Action joins with sister organizations around the world in demanding that all women have equal access to health services. We also demand that women receive quality care, respecting their requests and needs, without discrimination due to age, race, religion, marital status, socioeconomic status or sexual orientation.