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Achieving Reproductive Rights in Brazil
- 1. Achieving Reproductive Rights in Brazil Magaly Marques Pacific Institute for Women’s Health
- 2. February 2003 Pacific Institute for Women's Health2 Background • Political Scenario • Demographic Trend • Social/Economic Situation • Civil Society Mobilization
- 3. February 2003 Pacific Institute for Women's Health3 Political Scenario 1970s and 1980s • Dictatorship & military regime • Development goals with no policies • Top-down population programs • Women excluded from decision making • Mobilization for democracy
- 4. February 2003 Pacific Institute for Women's Health4 Demographics in the 1970s and 1980s • Programs with excessive focus on fertility reduction • High maternal mortality rates - 240 per 100,000 • FP policies (or lack of) led to - sterilization and C-Section abuse, limited contraceptive options, scarce access to services • High abortion rates /severe legal restrictions on abortion • Decline of fertility rates - demographic transition completed in the 1980s, a trend that continued into the 1990s
- 5. February 2003 Pacific Institute for Women's Health5 Social/Economic Situation vis-à-vis population in the 1970s/1980s • International funding for FP from USAID, World Bank was attached to development policies and population control agreements • Foundations and European agencies funding small women’s groups
- 6. February 2003 Pacific Institute for Women's Health6 Civil Society Mobilization • Activism, organized left, women’s groups • Women leaders detach from left parties to re-define priorities • Women’s movement organize around violence, abortion, and discrimination
- 7. February 2003 Pacific Institute for Women's Health7 Goal: • Political will • Democratic environment • Public recognition of health problems • Policies directed at accepted problems • Mechanisms to ensure policy enforcement • Civil society surveillance systems • Government accountability
- 8. February 2003 Pacific Institute for Women's Health8 The Reproductive Health Movement in the 1980s • Women’s Groups organize as NGOs • Women’s Health Advocates launch national initiative for Women’s Comprehensive Health (PAISM) • The new Constitution calls for attention to reproductive health matters • International support make possible for local NGOs to develop
- 9. February 2003 Pacific Institute for Women's Health9 From Activism to Public Policy Change - the 1990s’ events • Feminists in Women’s Health Movement join in government agencies • National advocacy efforts increase public interest and awareness • Women in parliament become aware of reproductive rights issues • National Feminist Reproductive Health Network is founded
- 10. February 2003 Pacific Institute for Women's Health10 “As opposed to the dictatorship years, the recent Henrique Cardoso administration produced economic, political and institutional stability. The development of sound national policies, development of mechanisms to ensure enforcement of these policies, and the constant dialogue and collaboration with civil society allowed for an increased sense of accountability and recognition of human rights as universal.” Sonia Correia
- 11. February 2003 Pacific Institute for Women's Health11 “The 2000 survey tells us that the national fertility rates are 2.3 children per woman. But in São Paulo, Rio and the South fertility is already below replacement level. This is not surprising as women have expanded their participation in the labor market, they are investing in their own education and professional lives and they have decided to provide good care to just one or two children. This trend is here to stay”. Elza Berquo, PhD
- 12. February 2003 Pacific Institute for Women's Health12 Institutionalizing Women’s Rights • Aftermath of U.N. Conferences enhanced creation of mechanisms to monitor policy implementation locally • PAISM re-defined in 1997 (compromise and focus) • Maternal Mortality Committees to monitor city level implementation of PAISM • ICPD/Cairo language incorporated at all levels (from FP to RH)
- 13. February 2003 Pacific Institute for Women's Health13 U.N. Conferences Absorbing the International Process • 1993 Human Rights Conference led to National Human Rights Program in 1995, re-defined in 2002 as state policy including gender, racial, sexual, and HIV/AIDS related discrimination/violence; access to abortion. • 1994 ICPD led to National Commission on Population and Development in 1995 • 2000 Beijing+5 led to National Secretary for Women's Rights; ratification of the CEDAW Protocol (Convention on the Elimination of Discrimination against Women)
- 14. February 2003 Pacific Institute for Women's Health14 Achievements • 1985 - National Council on Women’s Rights • 1988 Constitution spells out a national FP legislation • Creation of 387 city-level maternal mortality committees • Reduction in hospital-based mortality from 34 to 24 in 100.000 women
- 15. February 2003 Pacific Institute for Women's Health15 • Policy enforcement for epidemiological investigation of all maternal deaths • Increased coverage of pre-natal care from 5.4 million women in 1997 to 10.1 million in 2001 • Approval of health system protocol mandating and establishing guidelines for services to be offered to women who undergo sexual violence (1998)
- 16. February 2003 Pacific Institute for Women's Health16 • Protocol mandating routine registration into the health system of all cases of gender-based violence attended • Increase from none to 165 health services providing legal, safe abortions in case of rape
- 17. February 2003 Pacific Institute for Women's Health17 Lessons Learned • Combination of activism and negotiation • Alliances, partnerships were needed • Networking of various types of organizations (grassroots, research, advocacy) • International liaising and local focus
- 18. February 2003 Pacific Institute for Women's Health18 Unfinished Tasks, and Challenges Ahead • Full access to legal abortion • Increased understanding about the links among health, development and human rights issues. • Paradigm shift in the way sexuality is conceived and promoted at all levels. • Full incorporation of women as leaders and decision makers into the democratic process
Editor's Notes
- READ 1-8 CARDS
- These are variables that affected the unfolding of the reproductive rights history in Brazil. These are also the problems that the reproductive rights field and actors addresses over the years.
- I am limiting my focus to only those aspects affecting reproductive health directly
- Sometimes viewd as a problem by the conservatitive forces, activism was crucial to leading the country back to democracy, and crucial to nurturing of a culture of individual rights, and later human rights. At first women spoke about their condition, situation, and status, to then be able to conceptualize the problem in terms of rights.
- Going back to our initial question: How do you know you achieved your goal? What was the goal? How do you engage in a dynamic, dialectic process of revisiting your problem and the present conditions to assess how much you advanced, and where to redirect efforts? The goal seems to be….
- In the 1980s, women's groups began to raise above a spontenous collective gathering and gained the status of NGOs. This caused the movement to shake, there were crisis, conflicts, separations. New actors came into play, the agenda's were redefined Funds made NGOs grow, but also led them to work in more restrictly defined agendas The narrow focus hurt the activism, but also gave a allowed for pressing issues such as health to be institutionalized \
- The 1990s were marked by greater coalitions, networking and dialogue with government and main stream organizations. The accomplishments and the obstacles of the 1980s led feminists to engage in even more focused battles, learn to coordinate and partner with different constituencies, and be able to engage in international fora in a pro-active way. As opposed to the earlier phases protest and re action to to laws and constraints, discrimination and lack of attention to women's needs, feminists in the 1990s, took the lead in proposing new policies, norms, and type of services women needed nationwide.
- The strengthening of democracy was a condition for advancing reproductive and sexual health and rights. The HIV preventaion and AIDS treatment program at the national level is an example.
- And the demographic transition that Brazil went through in the 1980s, confirmed what the women’s movement knew. Women do not want to only have children, to have many children, or to be left with no choice. Quite the opposite, women want to be involved in all aspects of the social and political mesh of the country, have access to information, and make their own decisions.
- The way women's health advocates managed to achieve a few land marks in institutionalizing a political attention to women's health can be observed in the following examples;