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CEE Bulletin on Sexual and Reproductive Rights

No 05 (84) 2010

Table of contents:

burning issue

Update on SRHR services in Central and Eastern Europe (CEE) and the Commonwealth of the Independent States (CIS). The countries of the CEE and CIS share common characteristics that led to inadequate policies in the area of SRHR. Since the 1990s when Romania’s and Albania’s restrictive abortion legislation have been liberalized, in many countries of the region, abortion and other SRHR services have increasingly become hot political issues, influenced by the growing political role of religious institutions. Similarly, access to contraception and sexuality education has also become politicized, controversial and ignored by policy-makers. Although in theory abortion is available on request during the first trimester in CEE countries (except Poland), there are various restrictions in law and in practice, which make abortion services hardly accessible. The anti-choice movement is on the rise in Lithuania, where the parliament debates the criminalization of abortion. In Georgia, abortion is inaccessible in clinics belonging to the Greek Orthodox Church. Slovakia faces abuse of conscientious objections: multiple clinics refuse to provide abortion to women entitled to received according to the law. Poland has the most restrictive anti-abortion law in the region. Polish physicians can refuse to perform abortion on the grounds of conscientious objection even to women who are entitled to abortion according to the law. Political, cultural, and medical barriers obstruct full access to SRHR services in CEE and CIS countries. Political transformation resulted in strengthening conservative trends and challenging the gains of the past. The general feature of SRHR policy in the region is criticism towards liberal abortion legislation and growing influence of religious powers. These combined with the rise of anti-choice movements provide to generalization of anti-choice strategies region-wide. Further, lack of access to SRHR services is the outcome of poor condition of national health care systems. D&C method predominates for termination of pregnancy, vacuum aspiration is more difficult to access. Medical abortion remains unregistered in a number of the countries in the region (Bulgaria, Croatia, Czech Republic, Lithuania, Poland, Slovenia, Slovakia). The abortion rate remains high in the CEE and CIS: it is on the level of 44 (per 1000 women 15-44 years). Both unsafe abortion rate and proportion of abortion causing maternal death are strikingly high. The modern contraceptives prevalence is growing, but still quite low when compared with developed countries: in Georgia, Kyrgyzstan, Lithuania, Poland it is below 50% for women aged 15-49 (WHO). ASTRA Network’s members from Albania, Bulgaria, Georgia, Macedonia, Poland, Russia, and Ukraine report the lack of comprehensive sexuality education programs in schools.

Source: ASTRA Network

regional updates

EU accession to the European Convention on Human Rights.The Lisbon Treaty establishes the legal basis for EU accession to the European Convention on Human Rights (ECHR). The ECHR was signed in Rome under the aegis of the Council of Europe in November 1950. It offers protection of fundamental civil and political rights and establishes an enforcement machinery through the European Court of Human Rights, based in Strasbourg. Individuals who deem their rights have been violated in one country can bring their case to the Strasbourg court after exhaustion of national remedies. The EU has developed a separate legal order, with the European Court of Justice in Luxembourg as its highest court. The ECHR and its judicial mechanism do not apply to EU acts, although all member states of the Union, as parties to the convention, have an obligation to respect the ECHR even when they are applying or implementing EU law. This can only be corrected by the EU, as such, becoming a Party to the Convention. The EU's accession strengthens therefore the protection of human rights in Europe, by submitting the Union’s legal system to independent external control. It also closes gaps in legal protection by giving European citizens the same protection vis-à-vis acts of the Union as they presently enjoy from member states. All States Parties to the ECHR as well as the EU as such, will also have to express their consent to be bound by the key accession modalities, which will require formal consent by national Parliaments as well as the European Parliament.

Source: The True Guide to Lisbon Treaty

Women's rights activists rallied in St. Petersburg to protest the dismissals of pregnant women and mothers with small children from their jobs.In the wake of the economic crisis many Russian companies have laid off female workers and in some cases failed to pay them their severance and other social allowances to which they are entitled, other women have not received maternity leave payments. The St. Petersburg-based organization Peterburgskaya Egida (St. Petersburg Aegis) is currently investigating the number of instances of pregnant women or those with children under three years of age being fired by their employers and denied social allowances has increased in recent years. Peterburgskaya Egida advocates for changing the law to make the State Social Insurance Fund responsible for the payment of allowances to dismissed women who are pregnant or who have children under the age of three.

Source: RFE/RL's Russian Service

Illegal abortions worsening Russia's demographic problems.Experts say the low birth rate in Russia is reaching a critical point. It began to decline in 1992 as a result of poor medical services, social problems and high alcoholism. The government recognizes the problem and is working to reverse the trend. Earlier this year it heralded statistics showing the country's population had increased for the first time in 15 years. Every year 1.2 million Russian women deliberately terminate pregnancy and 30,000 of them become sterile, many from the estimated 180,000 illegal abortions. According to the Russian law abortion is permitted up to the 12th week of pregnancy. Further it is possible to terminate the pregnancy later than 12 weeks in order to preserve physical and mental health. There is also a variety of social factors, which permit abortion up to the 22nd week of pregnancy, including rape, imprisonment and poverty, and death or severe disability of the husband. Nonetheless, illegal abortion is widespread in Russia - unofficial estimates say 10-15% of the total, or up to 180,000 terminations. A quarter of deaths among pregnant women are the result of illegal abortions, but according to investigators, there were just 28 cases opened into illegal abortions in 2009. The figure was 27 in 2008, and over those two years less than 10 cases made it to court. According to data provided by the Russian Health Ministry, in 2008 there were 1.7 million births in Russia and 1.2 million abortions.

More: RIA Novosti

Kyrgyzstan joins UN campaign to stop violence against women.Kyrgyzstan has joined the United Nation's campaign entitled "UNiTE to End Violence Against Women". Kyrgyz President Kurmanbek Bakiyev signed a document to this effect at a meeting with UN Secretary-General Ban Ki-moon. Ban Ki-moon said that this decision confirmed Kyrgyzstan adherence to the observance of women's rights. A global campaign “Unite to End Violence against Women” has been initiated in 2008 by the Secretary General of the United Nations Ban Ki-moon. The initiative has received broad support all over the world, heads of the states, members of parliament, politicians, leaders of non-governmental organizations and journalists have joined it so far.

Source:Kyrgyz news agency

Georgia Combating Domestic Violence. According to the report released this March by the Violence Policy Center (VCP) Georgia ranks as the 15th in the world for most instances of men killing women in single-victim homicides. These instances of single-victim homicides are typically cases of domestic violence. Georgia’s parliament is currently debating a new law on sexual equality, but experts say it will do little to combat the domestic violence that is rife in the country. Non-governmental organizations in Georgia have long campaigned for action against domestic violence. Interior ministry figures show that since 2006, when a law was adopted recognizing domestic violence as a specific crime, 757 cases had been recorded. In all but 71 of these, the violence had come from the man. Experts say that this is only the tip of the iceberg. Rusudan Kervalishvili, the vice-speaker of parliament, is pushing the new law on gender equality to help fight domestic violence. Parliament has already passed the bill, which contains measures to prevent and detect such attacks, in a second reading. Kervalishvili said the law would broaden the definition of family members who could be accused of violence, and would make it easier for people to be recognized as a victim of violence. It would also set up a crisis centre which would serve as a short-term refuge and provide counseling. Women’s activists, although they welcomed such measures, said they would not be enough to solve the problem in the long term. Lawyers specializing in domestic violence cases say that social attitudes are the main obstacle to change.

Source:Emory University

Azerbaijan Begins Pregnancy Planning Campaign.The pharmacy network Leader Pharma launched the "Reproductive Health and Family Planning " campaign in Azerbaijan. The campaign is organized by USAID and implemented via the "NAR" national project under the slogan "Pregnancy Planning - Choose the Right Time." The aim of the project is to inform the public about safe and reliable methods of planning a healthy pregnancy with the use of modern contraceptives and to attract buyers to a wide choice of quality contraceptives. The campaign began in March and will last until late May in about 100 pharmacies in Baku, Absheron, Agsu, Kurdemir, Goychay, Shamakhi and Ismayilli. The campaign is held together with the Health Ministry and the U.N. Population Fund, as well as the Support Younger Generation public association and several pharmaceutical companies.

Source:Trend Daily News (Azerbaijan)

Italian Regional Governments Try to Stop RU-486 Distribution. Following March regional elections, several newly elected regional heads around Italy have moved to block the sale of the abortion drug, RU-486. Three regional presidents have said that the use of the drug violates the standing abortion law, Law 194, that allows only surgical abortions, carried out in hospitals. The Italian Ministry of Health and the Pharmaceuticals Agency (AIFA) approved the drug, sold under the brand name Mifegyne, for use in Italy in 2009. According to the permission of the AIFA, the drug may only be administered in a hospital and, for the moment, is prohibited for sale in pharmacies. There are no national guidelines on its distribution and to date only six regions have legislated on it: Emilia Romagna, Lombardy, Piedmont, Tuscany, Veneto and the Autonomous Province of Trento. Last November, the Italian Senate attempted to block the sale of the drug, citing safety issues.

More:Corriere Della Serra

Girls Lose Out On Schooling in Tajikistan. Financial pressures add to commonly-held view that girls need education less than boys. Accordingly with the rising trend girls are taken out of school early either due to financial pressures or because educating them is not felt to be worth the investment. The drop-out rate for girls is much higher than for boys, especially in rural areas. The United Nations children’s agency UNICEF reports that as of 2008, 25 per cent of girls left before reaching ninth grade. Although child labour is formally outlawed, girls who drop out of school are expected to work in the home, in the fields if they live in farming communities, or in other jobs if they are in a town. Under Tajik law, it is a criminal offence to prevent children going to school within the required nine-year period, and a number of parents have been prosecuted over the last couple of years, facing fines of several thousands of US dollars. State education is free in Tajikistan, but many families cannot afford the uniform and equipment a child needs to go to school. It costs about 50 dollars to kit out a first grade schoolchild with the basics, but the average monthly wage in Tajikistan is 60 dollars. More than half the population lives below the poverty line as defined by the World Bank. The high drop-out rate means few girls make it into higher education. Their representation at college or university has been falling steadily from 34 per cent in 1991, when the Soviet Union came to an end and Tajikistan became a separate state, to 29 per cent in the current academic year.

More information can be found at:WLUML


Lancet Study: Maternal Mortality Remains a Major Challenge to Health Systems Worldwide. The number of women dying from pregnancy-related causes has dropped by more than 35% in the past 30 years – from more than a half-million deaths annually in 1980 to about 343,000 in 2008, according to a new study by the Institute for Health Metrics and Evaluation (IHME). IHME’s research shows that deaths have been declining at an annual rate of about 1.4% since 1990. Contrary to previous reports that have shown very little change in the maternal mortality ratio (MMR), the global MMR – the number of women dying for every 100,000 live births – declined from 422 in 1980 to 320 in 1990. It reached 251 in 2008 and is on pace for further declines. Reliable information about the rates and trends in maternal mortality is essential for resource mobilisation, and for planning and assessment of progress towards Millennium Development Goal 5 (MDG 5), the target for which is a 75% reduction in the maternal mortality ratio (MMR) from 1990 to 2015. The authors of the study assessed levels and trends in maternal mortality for 181 countries. Nearly 80% of all maternal deaths are concentrated in 21 countries, and six countries (India, Nigeria, Pakistan, Afghanistan, Ethiopia, and the Democratic Republic of the Congo) account for more than half of all maternal deaths. Researchers found that progress in reducing maternal mortality has been slowed by the ongoing HIV epidemic. Nearly one out of every five maternal deaths – a total of 61,400 in 2008 – can be linked to HIV, and many of the countries with large populations affected by HIV have had the most difficulty reducing their maternal mortality ratio. The safest country in the world in which to give birth appears to be Italy, with a death rate of 3.9 women for every 100,000 births - down from 7.4 in 1990. Next come Sweden, Luxembourg and Australia. All have brought their death rates down by more than 1% over the same period.

The study, Maternal mortality for 181 countries, 1980-2008: a systematic analysis of progress towards Millennium Development Goal 5 was published by:The Lancet.

47 European Countries Unanimously Agree on Historic Human Rights Recommendations for LGBT people.On the 31st of March the Committee of Ministers of the Council of Europe, representing the national governments of its 47 Member States, unanimously adopted historic Recommendations on measures to combat discrimination on grounds of sexual orientation or gender identity. This is the world’s first intergovernmental agreement codifying the application of human rights standards to LGBT people. The Recommendations establish how international human rights standards should be applied to LGBT people and contain specific measures for Member States on how they should improve their legislation, policies and practices to address discrimination against LGBT people in such areas as hate crime and hate speech; freedom of association, expression and peaceful assembly; right to respect for private and family life; employment; education; health; housing; sports; right to seek asylum. Additionally, the Recommendations prescribe that Member States should ensure that national human rights structures are clearly mandated to address discrimination on grounds of sexual orientation and gender identity. They also encourage Member States to address multiple discrimination experienced by LGBT people.

Source:ILGA Europe.

The full text of the Recommendations is available on the Committee of Minister’s website:Council of Europe.

European Commission’s 2010 work plan includes ensuring access to health care in developing countries. The European Commission published a 2010 work programme containing its objectives and concrete policy measures. The Communication entitled ‘Time to act’ highlights four main sections which are to be concentrated on over the next few years. Tackling the economic crisis and its social impact are the European Commission's top priorities but pursuing the international development agenda will also be a key priority for the Commission. Further the Commission affirms its continued support for the Paris Declaration and highlights that ‘specific work has been launched to ensure access to health care.’.

For the full work plan, visit:European Commission.

European Commission adopts Communication on the EU’s role in Global Health.The Communication on “The EU Role in Global Health" and its three Staff Working Documents have been adopted by the European Commission. The Communication welcomed both northern and southern civil society input through a consultation process and establishes the Commission’s commitment to unite with civil society in contributing towards the universal protection of the right to health, coverage of health services and progress towards the health Millennium Development Goals. The Communication was discussed in the Working Party on Development Cooperation (CODEV) on 8 April and will be adopted at the Foreign Affairs Council on 10 and 11 May.

The Communication can be retrieved at:European Commission.

World Bank (WB) launches Reproductive Health Action Plan.The WB proposed to establish a Consultative Group on Health, Nutrition and Population (HNP), which would be consulted on a regular basis with regard to the formulation, implementation and monitoring of WB policies on HNP. The WB suggests launching this initiative by July 2010. Further the WB announced the launching of a Reproductive Health Action Plan by the end of May 2010. The plan will focus on high burden countries and specifically aims at strengthening multi-sector interventions, technical assistance for improved access to reproductive health services, as well as health worker capacity building in family planning.

For further information on HNP :World Bank.

OECD released figures showing a continuing growth in development aid in 2009, despite the financial crisis.To total net ODA from donors the OECD’s Development Assistance Committee (DAC) rose slightly in real terms (0.7%) to 119.6 Billion USD representing 0.31% of DAC members’ combined gross national income. Excluding debt relief, the rise in ODA in real terms was +6.8%. In 2009, the largest donors by volume were the United States, France, Germany, the United Kingdom and Japan. Five countries exceeded the United Nations ODA target of 0.7% of GNI: Denmark, Luxembourg, the Netherlands, Norway and Sweden. The largest percentage increases in net ODA in real terms were from Norway, France, the United Kingdom, Korea (which joined the DAC with effect from 1 January 2010), Finland, Belgium and Switzerland. The continued growth in ODA has shown that aid pledges are effective when backed up with adequate resources, political will and firm multi-year spending plans even in the face of the global economic crisis.

For further information visit:OECD.


Information Package on Medical Abortion. The International Consortium for Medical Abortion’s information package on medical abortion is available on the ICMA’s website. The publication is available in Arabic, English, French, Hindi, Portuguese, Russian, and Spanish.


Medical Abortion Initiative brochure published by IPAS. This brochure provides an introduction to medical abortion as a safe and effective abortion option for policymakers, health care providers, advocates, and researchers.

It can be downloaded from the IPAS website at:IPAS

upcoming events

An EU position for the Millennium Development Goals (MDGs) review. With the forthcoming MDG summit in September it is essential that the EU has a clear, strong and unified EU voice. The event organized by the European Parliamentary Working Group on Reproductive Health, HIV/AIDS and Development(EPWG) will include speakers such as Michael Cashman (MEP), Françoise Moreau from DG Development of the European Commission and Nicola Harington from the United Nations. The different actors will present on the MDG Summit, what the EU position should be and how can the MDG targets be met, notably MDG 5 which is the most off-track.

For more information on the EPWG, visit:EPWG

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Link: ASTRA Network on Facebook