As elaborated by the Committee on Economic, Social and Cultural Rights (CESCR), the right to health under the International Covenant on Economic, Social and Cultural Rights (United Nations, 1966b), encompasses an entitlement to the information, education, and means necessary to realize the highest attainable standard of sexual and reproductive health. This includes:
access to family planning, pre-and post-natal care, emergency obstetric services and access to information, as well as to resources necessary to act on that information. (CESCR, 2000, Paragraph 14)
The right to health obligates governments to ensure that health facilities, goods, and services related to sexual and reproductive health are available in sufficient quantity, accessible to everyone without discrimination, acceptable (respectful of medical ethics and culturally appropriate), and of good scientific and medical quality (CESCR, 2000, Paragraph 12).
Rights to sexual and reproductive health services may thus require increased expenditure or the redistribution of public resources to improve efficient access to and quality of services. Pursuant to the right to life under the Political Covenant, the Human Rights Committee has required governments to adopt ‘‘positive measures’’ necessary to preserve life, including the provision of essential obstetric care to reduce high rates of avoidable maternal death. Under the country’s constitutional rights to life and health, the Supreme Court of Venezuela required the government to reallocate budgets to provide access to antiretroviral therapy within the public system (Cruz Bermudez et al. v. Ministerio de Sanidady Asistencia Social, 1999). The Constitutional Court of South Africa similarly required the reasonable provision of treatment to pregnant women with HIV/AIDS under the constitutional right to health (Minister of Health v. Treatment Action Campaign, 2002). Rights to health services further encompasses the right to effective participation in all political processes, including the setting of spending priorities and the evaluation of government budgets, which affect sexual and reproductive health.
In addition to timely and appropriate health care, the right to health extends:
to the underlying determinants of health, such as … access to health-related education and information, including on sexual and reproductive health. (CESCR, 2000, Art. 11)
The Women’s Convention explicitly recognizes a right of:
[a]ccess to specific educational information to help to ensure the health and well-being of families, including information and advice on family planning. (Art. 10(h))
Rights To Equality And Nondiscrimination
Reproductive rights are guaranteed to everyone without discrimination on the basis of marginalized status, including, for example, poverty, age, sex, race, ethnicity, disability, health or marital status, geography, and sexual orientation. CESCR recognizes that, where services are not provided on principles of substantive equality, states are in violation of the right to health (CESCR, 2000, Art. 12).
Substantive equality requires that governments do not impose burdens or withhold benefits on the basis of presumed group characteristics unrelated to an individual’s health needs. CERD regards targeting for mandatory HIV testing on the basis of national origin or race as a form of discrimination.
Substantive equality further requires governments to recognize and address particular health needs of population subgroups. The CEDAW Committee recognizes that societal factors determinative of health status vary between women and men and among women themselves (CEDAW, 1999, Art. 6). Governments are obligated to address these differences. Under the International Convention on the Elimination of All Forms of Racial Discrimination, a woman’s inability to access appropriate reproductive health-care services because of her race, color, descent, national, or ethnic origin violates the right of nondiscrimination.
Conclusion
Reproductive rights refer to a composite of human rights guaranteed in national laws, constitutions, and regional and international treaties that can be applied to protect against the causes of ill health and promote sexual and reproductive well-being. These rights may be broadly divided into three categories: (1) rights to reproductive self-determination, (2) rights to sexual and reproductive health services, information, and education, and (3) rights to equality and nondiscrimination. Rights to reproductive self-determination recognize women as autonomous agents with the authority to make sexual and reproductive decisions free from interference, coercion, and violence. Reproductive rights also encompass entitlements to the means necessary, including health facilities, goods, services, information, and education, to realize the highest attainable standards of sexual and reproductive health. Reproductive rights further guarantee that all couples and individuals have the right to decide freely on matters related to their sexual and reproductive health, and the means to do so, without discrimination and on the basis of substantive equality. While reproductive rights are instrumental to achieving population, health, and development goals, they are important in themselves. Reproductive rights, as all human rights, are intended to protect the inherent dignity of the individual.
Bibliography:
- Benin (2003) Law No. 2003–04 on Reproductive and Sexual Health. Geneva, Switzerland: WHO.
- Brazil Ministry of Health (1998) Norma Te´cnica de Prevenc¸ a˜o e Tratamento dos Agravos Resultantes da Violeˆncia Sexual Contra Mulheres e Adolescentes. Brasili´a DF: Ministe´ rio da Sau´ de.
- CEDAW (1994) General Recommendation 21: Equality in Marriage and Family Relations. A/49/38. New York: United Nations.