RECLAIMING	
  &	
  REDEFINING	
  
RIGHTS	
  ICPD	
  +	
  20
Status	
  of	
  Sexual	
  and	
  Reproduc2ve	
  
Health	
  and...
Content	
  of	
  the	
  presentaNon	
  
•  IntroducNon	
  to	
  ARROW	
  
•  IntroducNon	
  to	
  the	
  Global	
  South	
...
1.	
  About	
  ARROW:
•  ARROW	
  is	
  a	
  regional	
  non-­‐profit	
  women’s	
  NGO	
  based	
  in	
  Kuala	
  
Lumpur,...
Monitoring	
  the	
  InternaNonal	
  Conference	
  on	
  
PopulaNon	
  and	
  Development
•  Monitoring	
  government	
  c...
2.	
  The	
  Global	
  South	
  ICPD+20	
  Monitoring	
  IniNaNve	
  	
  
•  In	
  2014	
  and	
  2015	
  as	
  the	
  tar...
The	
  Global	
  South	
  ICPD+20	
  Monitoring	
  
IniNaNve	
  	
  
•  “RECLAIMING	
  &	
  REDEFINING	
  RIGHTS	
  ICPD	
...
The	
  Global	
  South	
  ICPD+20	
  Monitoring	
  IniNaNve	
  	
  
•  Asia	
  Pacific	
  monitoring	
  in	
  21	
  countri...
3.	
  Overall	
  context	
  of	
  the	
  region	
  
 
i.	
  Signatories	
  to	
  major	
  human	
  rights	
  instruments	
  	
  
	
  Name	
  of	
  the	
  
Country	
  	
  
Int...
 
ii.	
  Gender	
  Inequality	
  Index	
  
	
  Name	
  of	
  the	
  
Country	
  	
  
Gender	
  Inequality	
  
Index	
  	
 ...
iii.	
  Health	
  Financing	
  
Name	
  of	
  the	
  
Country	
  	
  
Total	
  expenditure	
  	
  
on	
  health	
  as	
  
...
4.	
  Key	
  Findings	
  on	
  Reproduc2ve	
  
Health	
  and	
  Rights	
  Indicators	
  
 
	
  
i.	
  Total	
  and	
  Wanted	
  FerNlity	
  Rates	
  
	
  Name	
  of	
  the	
  Country	
  	
   Total	
  Fer2lity	
 ...
ii.	
  ContracepNve	
  Prevalence	
  Rates	
  (CPR)	
  
•  CPR	
  for	
  the	
  countries	
  under	
  review	
  takes	
  o...
CPR-­‐	
  Male	
  ContracepNon	
  
•  Male	
  contracepNon	
  as	
  percentage	
  of	
  total	
  contracepNon	
  is	
  
ve...
 
	
  
iii.	
  Unmet	
  Need	
  for	
  ContracepNon	
  
	
  Name	
  of	
  the	
  
Country	
  	
  
Spacing	
   Limi2ng	
   ...
iv.	
  Pregnancy	
  &	
  Childbirth	
  Related	
  Mortality	
  &	
  Morbidity	
  
	
  
	
  
Name	
  of	
  the	
  
Country	...
Pregnancy	
  &	
  Childbirth	
  Related	
  Mortality	
  &	
  Morbidity	
  
•  Despite	
  progress	
  in	
  the	
  reducNon...
 
IntervenNons	
  to	
  prevent	
  maternal	
  deaths-­‐	
  EmOC	
  and…	
  
	
  Name	
  of	
  the	
  
Country	
  	
  
Ski...
v.	
  Adolescent	
  Birth	
  	
  Rates	
  
Name	
  of	
  the	
  Country	
  	
   Adolescent	
  Birth	
  Rates	
  
Afghanist...
vi.	
  Status	
  of	
  AborNon	
  Laws	
  in	
  the	
  countries	
  under	
  review	
  
Name	
  of	
  the	
  
Country	
  	...
AborNon	
  
•  Different	
  extremes	
  with	
  regards	
  to	
  women’s	
  
access	
  to	
  safe	
  aborNon	
  services	
 ...
AborNon	
  
•  In	
  Bangladesh,	
  although	
  ‘aborNon’	
  is	
  only	
  
available	
  to	
  save	
  the	
  life	
  of	
...
AborNon	
  
•  Women	
  also	
  face	
  policy	
  barriers	
  such	
  as	
  mandatory	
  
spousal	
  authorisaNon	
  for	
...
vii.	
  ReproducNve	
  Cancers	
  
•  Most	
  of	
  the	
  countries	
  under	
  review	
  in	
  the	
  ARROW	
  ICPD+20	
...
6.	
  Key	
  Conclusions	
  -­‐ReproducNve	
  
Health	
  and	
  Rights	
  in	
  the	
  Region	
  
•  Progress	
  across	
 ...
7.	
  Key	
  Findings	
  on	
  Sexual	
  Health	
  
and	
  Rights	
  Indicators	
  
i.	
  Sexual	
  rights	
  of	
  adolescents	
  to	
  highest	
  
atainable	
  	
  standard	
  of	
  health	
  in	
  relaNo...
ii.	
  Sexually	
  Transmited	
  InfecNons	
  
•  The	
  prevenNon	
  and	
  treatment	
  of	
  STI	
  in	
  the	
  
count...
iii.	
  HIV	
  AND	
  AIDS	
  
•  The	
  epidemic	
  in	
  the	
  region	
  is	
  largely	
  
concentrated	
  among	
  hig...
HIV	
  AND	
  AIDS	
  
•  Coverage	
  of	
  ART	
  remains	
  a	
  challenge	
  in	
  many	
  
countries	
  in	
  the	
  r...
iv.	
  Legal	
  Age	
  and	
  Median	
  Age	
  at	
  Marriage	
  
Name	
  of	
  the	
  
Country	
  	
  
Women	
   Men	
   ...
v.	
  Marriages:	
  Arranged	
  and	
  Forced	
  
•  In	
  Bhutan,Maldives,	
  Nepal	
  and	
  Sri	
  Lanka	
  –	
  the	
 ...
vi.	
  Sexual	
  Violence	
  Against	
  Women	
  
•  Rape:	
  Out	
  of	
  the	
  countries	
  examined	
  here,	
  with	
...
Sexual	
  Violence	
  Against	
  Women	
  
•  Sexual	
  Harassment:	
  Provisions	
  for	
  anN-­‐sexual	
  
harassment	
 ...
vii.	
  Trafficking	
  
•  Afghanistan	
  is	
  a	
  source,	
  transit,	
  and	
  desNnaNon	
  
country	
  for	
  men,	
  w...
viii.	
  Sex	
  work	
  
•  All	
  21	
  countries	
  in	
  Asia	
  Pacific	
  	
  under	
  review	
  criminalise	
  
sex	
...
ix.	
  Status	
  of	
  diverse	
  sexual	
  and	
  gender	
  idenNNes	
  
•  In	
  most	
  of	
  the	
  countries	
  in	
 ...
x.	
  Transgenderism	
  	
  
•  Nepal	
  seems	
  to	
  be	
  the	
  most	
  progressive	
  country	
  
in	
  the	
  regio...
9.	
  Key	
  Conclusions-­‐	
  Sexual	
  Health	
  &	
  
Rights	
  
•  Sexual	
  health	
  is	
  sNll	
  being	
  framed	
...
10.	
  Key	
  recommendaNons	
  
•  There	
  is	
  need	
  for	
  policy	
  change	
  underpinned	
  by	
  
commitment	
  ...
Reference:	
  
	
  
	
  RECLAIMING	
  &	
  REDEFINING	
  RIGHTS	
  ICPD	
  +	
  20:	
  Status	
  of	
  
Sexual	
  and	
  R...
Thank You
Reclaiming & Redefining Rights ICPD+20: Status of Sexual and Reproductive Health and Rights in Asia Pacific.
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Reclaiming & Redefining Rights ICPD+20: Status of Sexual and Reproductive Health and Rights in Asia Pacific.

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Reclaiming & Redefining Rights ICPD+20: Status of Sexual and Reproductive Health and Rights in Asia Pacific (2013)

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Reclaiming & Redefining Rights ICPD+20: Status of Sexual and Reproductive Health and Rights in Asia Pacific.

  1. 1. RECLAIMING  &  REDEFINING   RIGHTS  ICPD  +  20 Status  of  Sexual  and  Reproduc2ve   Health  and  Rights  in  Asia  Pacific    Nalini  Singh     Programme  Manager  –  Advocacy  &  Capacity  Building   Email:  nalini@arrow.org.my  
  2. 2. Content  of  the  presentaNon   •  IntroducNon  to  ARROW   •  IntroducNon  to  the  Global  South  monitoring  iniNaNve   •  Overall  context  of  the  region   •  Key  findings  pertaining  to  ReproducNve  Health  and   Rights   •  Key  conclusions-­‐  ReproducNve  Health  and  Rights   •  Key  Findings  pertaining  to  Sexual  Health  and  Rights   •  Key    conclusions  –Sexual  Health  and  Rights   •  RecommendaNons  
  3. 3. 1.  About  ARROW: •  ARROW  is  a  regional  non-­‐profit  women’s  NGO  based  in  Kuala   Lumpur,  Malaysia.    We  work  to  advance  women’s  health,   affirmaNve  sexuality  and  rights,  and  empower  women   through  informaNon  and  knowledge,  engagement,  advocacy   and  mobilisaNon. •  Established in 1993, ARROW works with NGO partners in 15 Asia-Pacific countries (and expanding) and across the five regions in the Global South. •  Areas of work: ü  Evidence generation through research and monitoring for advocacy. ü  Advocacy, capacity building and movement building through partnerships. ü  Strategic information sharing and communication.
  4. 4. Monitoring  the  InternaNonal  Conference  on   PopulaNon  and  Development •  Monitoring  government  commitments  to  women’s  health   especially  their  sexual  and  reproducNve  health  and  rights   using  the  framework  of  the  ICPD  Programme  of  AcNon  (PoA),   which  Nll  today  remains  the  most    comprehensive  outline  and   approach  to  women’s  health  and  equality,  has  been  an   important  strategy  at  ARROW.       •  ARROW  along  with    our  partners  have  been  consistently   monitoring  the  ICPD  PoA.  (+5,  +10,  +15  and  +20  now-­‐  in  the   Global  South).    
  5. 5. 2.  The  Global  South  ICPD+20  Monitoring  IniNaNve     •  In  2014  and  2015  as  the  target  dates  for  the  ICPD  PoA  as  well  as  the   MDGs  reach  their  respecNve  Nme  bound  goals,  ARROW  realised  the   importance  of  bringing  together  not  only  the  voices  and  realiNes  of     Asia-­‐Pacific  ,  but  also  the  other  regions  from  the  Global  South  to   arNculate  southern  voices  and  southern  agenda  in  the  lead  up  to   2014-­‐2015  development  agenda.       •  Thus  the  Global  South  ICPD+20  monitoring  iniNaNve  was   conceptualised  and  brings  together  five  regions  (49  countries)  -­‐     –  Asia  Pacific   –  Africa   –  Eastern  Europe   –  LaNn  America  and  the  Caribbean   –  Middle  East  and  Northern  Africa  regions    
  6. 6. The  Global  South  ICPD+20  Monitoring   IniNaNve     •  “RECLAIMING  &  REDEFINING  RIGHTS  ICPD  +  20:   Status  of  Sexual  and  ReproducNve  Health  and  Rights   in  Asia  Pacific”  is  one  of  the  five  Global  South   reports.   •  The  scope  of  monitoring  includes  issues  of:   –  reproducNve  health   –  reproducNve  rights   –  sexual  health   –   sexual  rights   –  women’s  empowerment   –  health  financing  
  7. 7. The  Global  South  ICPD+20  Monitoring  IniNaNve     •  Asia  Pacific  monitoring  in  21  countries  :   –   East  Asia-­‐  China   –   South  Asia-­‐  Afghanistan,  Bangladesh,  Bhutan,  Sri   Lanka,  Maldives,  Nepal,  Pakistan,  India   –  Southeast  Asia-­‐Cambodia,  Myanmar,  Lao  PDR,   Malaysia,  Philippines,  Indonesia,  Thailand,  Vietnam   –  Pacific  countries  of  Fiji,  KiribaN,  Papua  New  Guinea,   and  Samoa.     •  In  the  next  slides  we  present  to  you  key  findings   pertaining  to  Afghanistan,  Bhutan,  Bangladesh,   India,  Nepal,  Maldives,  Pakistan  and  Sri  Lanka.  
  8. 8. 3.  Overall  context  of  the  region  
  9. 9.   i.  Signatories  to  major  human  rights  instruments      Name  of  the   Country     Interna2onal   Covenant   on  Civil  and   Poli2cal   Rights  (1966)   Interna2onal   Covenant  on   Economic,   Social  and   Cultural   Rights(1966)   Conven2on  on   Elimina2on  of   All  Forms  of   Discrimina2on   Against   Women  (1979)   Conven2on  on   the  Rights  of   the  Child   (1989)   Afghanistan   1983   1983   2003   1994   Bhutan   1981   1990   Bangladesh   2000   1998   1984   1990   India   1979   1979   1993   1992   Nepal   1991   1991   1991   1990   Maldives   2006   2006   1993   1991   Pakistan   2010   2008   1996   1990   Sri  Lanka   1980   1980   1981   1991  
  10. 10.   ii.  Gender  Inequality  Index    Name  of  the   Country     Gender  Inequality   Index    (Rank  and   Value)   MMR   Adolescent  Fer2lity   Rate     %  of  women  in   na2onal   parliament   Afghanistan   147  (0.712)   460   99.6   27.6   Bhutan   92  (0.464)   180   44.9   13.9   Bangladesh   111(0.518)   240   68.2   19.7   India   132  (0.610)   200   74.7   10.9   Nepal   102  (0.485)   170   86.2   33.2   Maldives   64  (0.357)   60   10.2   6.5   Pakistan   123  (0.567)   260   28.1   21.1   Sri  Lanka   75  (0.402)   35   22.1   5.8   Source:  Human  Development  Report  2013-­‐  The  rise  of    the  South:  Human  Progress  in    a    Diverse  World    
  11. 11. iii.  Health  Financing   Name  of  the   Country     Total  expenditure     on  health  as   percentage  of  GDP   General   Government   Expenditure  on   Health  as   Percentage  of  GDP   Out  of  Pocket   Expenditure  on   Health  as   percentage  of    Total   Health  Expenditure   Afghanistan   10.4   22.5   83.0   Bhutan   4.3   84.6   11.9   Bangladesh   3.7   36.5   63.4   India   3.7   28.2   61.1   Nepal   5.1   37.4   54.4   Maldives   6.2   60.8   28.2   Pakistan   2.8   28.2   50.4   Srilanka   3.5   45.6   44.9  
  12. 12. 4.  Key  Findings  on  Reproduc2ve   Health  and  Rights  Indicators  
  13. 13.     i.  Total  and  Wanted  FerNlity  Rates    Name  of  the  Country     Total  Fer2lity  Rate     Wanted  Fer2lity  Rate   Afghanistan   -­‐   -­‐   Bhutan   -­‐   -­‐   Bangladesh   2.3   1.6   India   2.7   1.9   Nepal   2.6   1.8   Maldives   2.5   2.2   Pakistan   4.1   3.1   Sri    Lanka   -­‐   -­‐   Source:  RespecNve  Country  latest  Demographic  and  Health  Surveys  
  14. 14. ii.  ContracepNve  Prevalence  Rates  (CPR)   •  CPR  for  the  countries  under  review  takes  only  married   women  into  account.   •  Women’s  access  to  range  of  contracepNves  is  sNpulated  in   the  ICPD  PoA,  however  an  examinaNon  of  CPR  in  the   countries  under  review    shows  CPR  is  considerably  high  in   Sri  Lanka  (68%)  and  Bhutan  (65.6%),  while  it  is  very  low  in   Pakistan  (29.6%)  and  Afghanistan  (21.8%).   •  Access  to  range  of  services  is  limited  to  few  opNons  eg:   –  oral  contracepNve  pills  being  the  predominant  method  in   Bangladesh   –  injectables  in  Afghanistan   –  female  steralisaNon  in  India  leaving  fewer  contracepNve  opNons   for  women  to  choose  from    
  15. 15. CPR-­‐  Male  ContracepNon   •  Male  contracepNon  as  percentage  of  total  contracepNon  is   very  low  in  all  the  countries  under  review  indicaNng  the   extent    of  (UNEQUAL)  shared  reproducNve  burden.   •  Condom  usage  and  male  steralisaNon  are  key  male   contracepNon  methods.   •  Condom  usage  is  highest  in  Maldives  (26.8%)  and  Pakistan   (23%).  It  needs  to  be  noted  the  overall  CPR  in  these   countries  is  quite  low.   •  Among  the  countries,  male  steralisaNon  is  highest  in   Bhutan  and  Nepal.   •  Male  involvement,  as  equal  partners,  in  decision-­‐making  on   reproducNon  as  sNpulated  in  the  ICPD  PoA  seems  to  have   had  limited  headway  
  16. 16.     iii.  Unmet  Need  for  ContracepNon    Name  of  the   Country     Spacing   Limi2ng   Unmet  need   Afghanistan   -­‐   -­‐   -­‐   Bhutan   -­‐   -­‐   -­‐   Bangladesh  (2011)   4.4   7.3   11.7   India(2005-­‐06)   6.1   7.8   13.9   Nepal  (2011)   9.6   17.4   27   Maldives(2009)   15.0   13.6   28.6   Pakistan  (2007)   10.8   14.1   25.2   Sri  Lanka  (2007)   3.5   3.8   7.3   Source:  RespecNve  Country  latest  Demographic  and  Health  Surveys  
  17. 17. iv.  Pregnancy  &  Childbirth  Related  Mortality  &  Morbidity       Name  of  the   Country     MMR  in  2010   Life2me  risk  of   maternal  death:  1  in     ICPD  Target  met?   Afghanistan   460   32   No   Bhutan   180   210   No   Bangladesh   240   170   No   India   200   170   No   Nepal   170   190   No   Maldives   60   870   Yes   Pakistan   260   110   No   Sri  Lanka   35   1200   Yes   World  Health  OrganizaNon.  (2012).  Trends  in  Maternal  Mortality:  1990  to  2010.  WHO,   UNICEF,  UNFPA  and  the  World  Bank  esNmates  
  18. 18. Pregnancy  &  Childbirth  Related  Mortality  &  Morbidity   •  Despite  progress  in  the  reducNon  in  maternal   deaths,  many  countries  such  as  India,   Pakistan,  Bangladesh,  Afghanistan  conNnue   have  high  maternal  deaths.   •  The  causes  of  maternal  deaths  in  the  region  is   mostly:   –   Haemorrhage  (35%)   – Hypertension(17%)   – AborNon  (10%)  
  19. 19.   IntervenNons  to  prevent  maternal  deaths-­‐  EmOC  and…    Name  of  the   Country     Skilled  a_endance   at  birth   ICPD  target  is    90%   by  end  of  2010   Post  partum  care   (post  natal  visit   within  2  days  of   childbirth)   Antenatal  Care  (4   visits)   Afghanistan   34%   23%   16%   Bhutan   64.5%   -­‐   77%   Bangladesh   26.5%   23%   23%   India   52.7%  (2007)   48%   50%   Nepal   36%   31%   29%   Maldives   94.8%  (2009)   67%   85%   Pakistan   38.8  (2006)   39%   28%   Srilanka   98.6%  (2006)     71%   93%  
  20. 20. v.  Adolescent  Birth    Rates   Name  of  the  Country     Adolescent  Birth  Rates   Afghanistan   90.0   Bhutan   59.0   Bangladesh   133.4   India   38.5   Nepal   81.0   Maldives   15   Pakistan   16.1   Sri  Lanka   24.3   Source:  Latest  UN  staNsNcs,  Millenium  Development  Goals  Indicators  ,  the  official   UN  site  for  MDG  indicators  Adolescent  Birth  Rate  
  21. 21. vi.  Status  of  AborNon  Laws  in  the  countries  under  review   Name  of  the   Country     To  save   woman’s   life   Preserve   physical   health   Preserve   mental   health   Rape  or   incest   Foetal   Impairment   Economic   and  social   reasons   On   request   Afghanistan   x   -­‐   -­‐   -­‐   -­‐   -­‐   -­‐   Bhutan   x   x   x   x   -­‐   -­‐   -­‐   Bangladesh   x   -­‐   -­‐   -­‐   -­‐   -­‐   -­‐   India   x   x   x   x   x   x   -­‐   Nepal   x   x   x   x   x   x   x   Maldives   x   x   -­‐   -­‐   -­‐   -­‐   -­‐   Pakistan   x   x   x   -­‐   -­‐   -­‐   -­‐   Srilanka   x   -­‐   -­‐   -­‐   -­‐   -­‐   -­‐   Source:  World  AborNon  Policies  2012  
  22. 22. AborNon   •  Different  extremes  with  regards  to  women’s   access  to  safe  aborNon  services  –Nepal  has   legalised  aborNon  while  Afghanistan  and  Sri   Lanka  are  most  restricNve.   •  Unplanned  and  unwanted  pregnancies  lead  to   unsafe  aborNons  which  are  either  self-­‐ induced,  or  induced  by  untrained   pracNNoners,  leading  to  complicaNons  that   can  lead  to  maternal  deaths.  
  23. 23. AborNon   •  In  Bangladesh,  although  ‘aborNon’  is  only   available  to  save  the  life  of  the  woman,  in  the   mid-­‐70s,  the  government  slowly  started   introducing  menstrual  regulaNon  (MR)  services  as   an  opNon  for  early  terminaNon  of  pregnancy.   During  the  last  20  years,  menstrual  regulaNon   services  have  been  extended  throughout   Bangladesh  and  the  government  has  trained  over   10,000  physicians  and  other  health  care   providers,  primarily  family  welfare  visitors,  to   provide  menstrual  regulaNon  services.  
  24. 24. AborNon   •  Women  also  face  policy  barriers  such  as  mandatory   spousal  authorisaNon  for  aborNon  services  in     Maldives.   •  In  Pakistan,  although  the  law  allows  aborNon  on  a   number  of  grounds,  it  is  usually  perceived  as  illegal.   •  In  2002,  India  adopted  legislaNon  aimed  at  improving   access  to  safe  aborNon  faciliNes  by  moving  authoriNes   to  approve  faciliNes  from  the  state  level  to  the  district   level.  The  law,  which  is  intended  to  simplify  the     approval  process  for  new  faciliNes,  also  increases   criminal  penalNes  for  providers  and  facility  owners   who  operate  without  approval  
  25. 25. vii.  ReproducNve  Cancers   •  Most  of  the  countries  under  review  in  the  ARROW  ICPD+20   monitoring,  are  countries  in  low  resource  serngs.   •  Early  screening  for  cancers  can  go  a  long  way  in  reducing   the  incidence  and  mortality  from  cervical  and  breast   cancers     •  Health  systems  in  respecNve  countries  in  the  region  have  to   be  geared  to  put  in  place  effecNve  prevenNon  strategies,   early  detecNon,  which  comprises  of  diagnosis,  screening   including  cervical  cancer  screening,  HPV  tesNng,   mammography  screening,  treatment  and  palliaNve  care.   •  Therefore,  populaNon-­‐based  data  on  cancer    incidence  and   mortality  become  the  starNng  point  for  any  intervenNon   and  countries  need  to  start  collecNng  this  informaNon.  
  26. 26. 6.  Key  Conclusions  -­‐ReproducNve   Health  and  Rights  in  the  Region   •  Progress  across  the  region  is  uneven  and  slow  with   regards  to  reproducNve  health  and  reproducNve  rights   indicators  with  no  one  country  having  made  progress   in  every  single  indicator  of  RH  and  RR.   •  PoliNcal  will  of  governments  is  crucial  in  making  laws,   allocaNng  resources,  and  deploying  trained  staff   •  Access  for  marginalised  groups  is  a  concern  across  all   countries,  with  women  who  are  poor,  less  educated,   live  in  remote  areas  and/or  rural  areas  and  hard  to   reach  areas  facing    greater  difficulNes  in  accessing   services  and  realising  the  autonomy  of  their  bodies  
  27. 27. 7.  Key  Findings  on  Sexual  Health   and  Rights  Indicators  
  28. 28. i.  Sexual  rights  of  adolescents  to  highest   atainable    standard  of  health  in  relaNon  to   sexuality     •    Progress  on  imparNng  sex  educaNon  and  sexuality   educaNon  to  adolescents  is  staggered  and  uneven.     •  In  all  countries,  unmarried  young  people  sNll  face   many  barriers,  some  legal  and  some  socially   discriminatory,  to  accessing  SRH  services.     •  It  is  clear  from  the  lack  of  provision  of  educaNon,   informaNon,  and  services  to  young  people  who  are  in   dire  need  of  these,  that  governments  in  the  region  are   hesitant  to  recognise  the  role  of  sexuality  beyond  its   funcNon  in  reproducNon.  
  29. 29. ii.  Sexually  Transmited  InfecNons   •  The  prevenNon  and  treatment  of  STI  in  the   countries  under  review  have  largely  been   driven  by  the  HIV  intervenNon  efforts.     •  HIV  intervenNon  focuses  on  high-­‐risk   behaviour  groups.  As  a  result,  the  larger   populaNon,  who  are  at  risk  of  STI  but  do  not   fall  under  the  high  risk  categories,  are  not   prioriNsed  for    prevenNon  and  treatment   programmes  
  30. 30. iii.  HIV  AND  AIDS   •  The  epidemic  in  the  region  is  largely   concentrated  among  higher  risk  groups  such   as  men  who  have  sex  with  men,  sex  workers   and  injectable  drug  users.   •  Few  governments  in  the  region  have   addressed  sNgma  and  discriminaNon  through   laws,  policies  and  programme.  SNgma,   especially  for  the  vulnerable  populaNons,   hinders  access  to  HIV  treatment  and  care.  
  31. 31. HIV  AND  AIDS   •  Coverage  of  ART  remains  a  challenge  in  many   countries  in  the  region.   •  In  designing  future  programmes  on  HIV  and   AIDS  it  is  imperaNve  to  note  that  not  all  sex  is     heterosexual  and  vaginal.   •   Gender  analysis  also  needs  to  take  into   account  the  role  of  sexuality  and  diversity  as   well  as  meanings  of  and  within  sexual   relaNons.  
  32. 32. iv.  Legal  Age  and  Median  Age  at  Marriage   Name  of  the   Country     Women   Men   Median  age  at   marriage  for   women     Remarks   Afghanistan   16   18   17.7   Bhutan   18   18   Bangladesh   18   21   15   India   18   21   17.4   Nepal   20   20   17   Maldives   18   18   19.0   Government  policy  strictly   discourages  marriages  under   16   Pakistan   16   18   19.1   Sri  Lanka   18   18   22.4   Does  not  apply  to  Muslim   PopulaNon  
  33. 33. v.  Marriages:  Arranged  and  Forced   •  In  Bhutan,Maldives,  Nepal  and  Sri  Lanka  –  the  legal  age   of  marriage  is  the  same  for  both  men  and  women.  In   other  countries,  the  legal  age  of  marriage  of  women   tends  to  be  lower  than  that  of  men.   •  Afghanistan,  and  Pakistan  in  the  region  have  a  legal   age  of  marriage  under  18.   •  Arranged  and  forced  marriages  are  both  quite   common  and  deeply  embedded  in  the  cultures  and   tradiNons  of  South  Asia.     •   Afghanistan  Independent  Human  Rights  Commission   esNmates  that  over  38%  of  women  have  been  vicNms   of  forced  marriage  
  34. 34. vi.  Sexual  Violence  Against  Women   •  Rape:  Out  of  the  countries  examined  here,  with   the  excepNon  of  Maldives,  all  countries  have  laws   against  rape  and  these  usually  exist  within  the   penal  code  or  the  criminal  code.  However,    any   barriers  remain  prevenNng  jusNce  for  vicNm-­‐ survivors  of  rape.   •  Marital  rape:  Marital  rape  is  a  contested  issue  in   almost  all  the  countries  in  the  region.  In  India   marital  rape  legislaNon  is  part  of  the  overall   domesNc  violence  laws,  however  counteracNng     laws  exist  that  counter  marital  rape.  
  35. 35. Sexual  Violence  Against  Women   •  Sexual  Harassment:  Provisions  for  anN-­‐sexual   harassment  in  the  workplace  exist  in  Afghanistan,   Bangladesh,  Bhutan,  Maldives,  Nepal,  and  Sri   Lanka,  and  these  provisions  are  part  of  the  labour   law  in  Bangladesh,  and  Pakistan.   •  Trafficking:  Trafficking  laws  seem  to  be  in  place  in   most  countries  seem  to  be  in  place,  the   implementaNon  and  enforcement  of  such  laws  is   quesNonable  in  the  region  
  36. 36. vii.  Trafficking   •  Afghanistan  is  a  source,  transit,  and  desNnaNon   country  for  men,  women,  and  children  subjected  to   forced  labour  and  sex  trafficking.  According  to  the   Ministry  of  the  Interior,  trafficking  within    Afghanistan   is  more  prevalent  than  transnaNonal  trafficking.     •  In  India,  evidence  shows  that  trafficking  of  girls  and   young  women  for  sexual  exploitaNon  and  other   abusive  purposes  is  rampant.  According  to  the  2006   CEDAW  Shadow  Report,  intra-­‐country  trafficking  is   very  high,  and  it  was  also  noted  that  94%  of  trafficked   women  are  from  rural  India  and  from  the  lower   socioeconomic  levels.  
  37. 37. viii.  Sex  work   •  All  21  countries  in  Asia  Pacific    under  review  criminalise   sex  work  or  certain  acNviNes  related  to  sex  work.   •  All  forms  of  sex  work  including  sex  work  in  private,   soliciNng  sex  and  brothel  keeping  are  illegal  in   Afghanistan,  Bhutan,  Maldives,  and  Pakistan  in  South   Asia.   •  CriminalisaNon  of  sex  work  or  of  some  forms  of  sex   work  legiNmises  violence  and  discriminaNon.  Incidents   of  sexual  assaults  by  police  and  military  personnel   against  sex    workers  has  been  reported  in  Bangladesh,   India,Nepal,  and  Sri  Lanka.  
  38. 38. ix.  Status  of  diverse  sexual  and  gender  idenNNes   •  In  most  of  the  countries  in  the  region,  the  laws   are  silent  on  same-­‐sex  sexual  preference,  and   hence,  it  is  not  criminalised.       •  Among  the  countries  monitored,  same-­‐sex  sexual   relaNons  (both  male  to  male  and  female  to   female)  is  illegal  in  Afghanistan,  Bhutan,  Maldives   and  Sri  Lanka.  Female  to  female  relaNons  are  not   illegal  in  Bangladesh,  India,  Pakistan.  Same-­‐sex   sexual  relaNons  are  not  illegal  in  Nepal.  
  39. 39. x.  Transgenderism     •  Nepal  seems  to  be  the  most  progressive  country   in  the  region,  having  decriminalised  laws  which   control  sexuality  and  having  recognised  sexual   minoriNes  as  ciNzens  with  equal  rights  regardless   of  sexual  orientaNon  and  gender  idenNty.   •  Transgendered  people  are  now  able,  through  a   Supreme  Court  ruling  to  amend  the  ConsNtuNon,   to  obtain  ciNzenship  with  the  idenNty  of  the  third   gender.  A  government  commitee  had  also  been   set  up  to  review  the  marriage  system  to  amend  it   accordingly  with  this  new  ruling.  
  40. 40. 9.  Key  Conclusions-­‐  Sexual  Health  &   Rights   •  Sexual  health  is  sNll  being  framed  in  limited   paradigms  across  the  region.   •  PoliNcal  will  of  governments  is  crucial  in   recognising  the  sexual  health  and  sexual  rights   of  ciNzens   •  Sexual  rights  are  not  as  contenNous  as   perceived  with  many  aspects  of  sexual  rights   have  been  accepted  and  legislated  by  the   governments.  
  41. 41. 10.  Key  recommendaNons   •  There  is  need  for  policy  change  underpinned  by   commitment  to  the  ICPD  POA,  with  respect  to  reproducNve   rights  and  sexual  rights.   •  Ensure  universal  access  to  comprehensive,  affordable,   quality,  gender-­‐sensiNve  services  to  enable  the  realisaNon   of  the  highest  standard  of  sexual  and  reproducNve  health.   •  Ensure  conNnued,  commited  and  sustained  investments  in   women’s  SRHR  by  governments  and  donors.   •  Ensure  SRHR  of  all  are  fully  realised  and  exercised,   especially  those  of  young  people  and  adolescents  ,  those   with  diverse  sexual  orientaNon  and  marginalised  groups  
  42. 42. Reference:      RECLAIMING  &  REDEFINING  RIGHTS  ICPD  +  20:  Status  of   Sexual  and  ReproducNve  Health  and  Rights  in  Asia  Pacific   (2013)       htp://www.arrow.org.my/publicaNons/ICPD+20/ICPD +20_ARROW_AP.pdf        
  43. 43. Thank You

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