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WOMEN'S LINKAGE CAUCUS

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C (continued)

Actions to be taken

107. By governments, [retain: in collaboration with non-governmental organizations and employers and with the support of international institutions]:

(a) Support and implement [delete: their commitments] [retain: the commitments made] [delete: to the report of the International Conference on Population and Development] [amend & retain: in the Programme of Action of the International Conference on Population and Development, (delete: taking into account the reservations and declarations made in that document)] and the Copenhagen Declaration on Social Development and Programme of Action of the World Summit for Social Development14/ and relevant international agreements, to meet the health needs of girls and women of all ages;

(c) Design and implement, in cooperation with women and community-based organizations, gender-sensitive health programmes, including decentralized health services that address the needs of women throughout their lives and that take into account their multiple roles and responsibilities, and the demands on their time, the special needs of rural women and women with disabilities, and the diversity of women's needs arising from age, socio- economic, and cultural differences among others, and include women, especially local and indigenous women, in the identification and planning of health-care priorities and programmes; [retain: and remove all barriers to women's health services] [retain: and provide the widest possible access to a broad range of health-care services;]

(d) [retain: Allow women access to social security systems in equality with men throughout the whole life-cycle;]

(e) Provide more accessible, available, and affordable primary health-care services of high quality, including [amend & retain: universal access to sexual and reproductive health-care (delete: as well as family planning) information and services by the year 2015], and giving particular attention to maternal and emergency obstetric care [delete: as contained in the Report of the International Conference on Population and Development] [retain: as agreed in the Programme of Action of the International Conference on Population and Development];

(f) Redesign health information, services and training for health workers, so they are [retain: gender] sensitive and reflect the user's perspectives with regard to interpersonal and communications skills and the user's right to privacy and confidentiality. [delete: recognizing the rights, duties and responsibilities of parents and other persons legally responsible for children, and consistent with the Convention on the Rights of the Child] These services, information and training should adopt a holistic approach [retain: as defined by WHO;]

(g) [amend & retain: Ensure that all health services and workers conform to human rights and to ethical, professional and gender-sensitive standards in the delivery of women's health services, including to (delete: aimed at ensuring) ensure responsible, voluntary and informed consent.] [retain: Develop, implement and disseminate widely codes of ethics in this regard.] [delete: Nothing, however, in the present Platform for Action is intended to require any health professional or health facility to provide (or refer for) services to which they have objections on the basis of religious belief or moral conviction as a violation of conscience;]

(h) [retain: Take all appropriate measures to eliminate harmful, medically unnecessary or coercive medical interventions, as well as inappropriate medication and over medication of women. All women should be fully informed of their options, including likely benefits and potential side effects;]

(first Alternative)

[delete: Ensure that women are fully informed by properly trained personnel orally, and in writing where appropriate, of the potential dangers, side effects and contraindications as well as the likely benefits of their health-care options, including medication and any surgical interventions, among others; all appropriate measures should be taken to eliminate harmful, medically unnecessary or coercive medical interventions, as well as inappropriate medication and over-medication of women; ensure that immunization is provided to women and girls according to established ethical medical standards;]

(second Alternative)

[delete: Ensure that before medication is prescribed, mechanical devices inserted, or sterilization performed, women are medically examined by a physician who must give them full information, orally and in writing, on the potential dangers, side effects and contraindications of all the available methods of family planning; Ensure that immunization of women and girls does not include experimental drugs, vaccines, or abortifacients;]

(i) Strengthen and reorient health services, particularly primary health-care, in order to ensure universal access to quality health services for women and girls, [delete: recognizing the rights, duties and responsibilities of parents and other persons legally responsible for children, and consistent with the Convention on the Rights of the Child] to reduce ill health and maternal morbidity, and to achieve world-wide the agreed-upon goal of reducing maternal mortality by at least 50 percent of the 1990 levels by the year 2000 and a further one half by the year 2015; ensure that the necessary services are available at each level of the health system; and make reproductive health-care accessible through the primary health-care system to all individuals of appropriate ages as soon as possible and no later than the year 2015;

(j) [retain: Recognize and deal with the health impact of unsafe abortion as a major public health concern as agreed in the Programme of Action of the International Conference on Population and Development;] [retain: para. 8.25 of the Programme of Action of the International Conference on Population and Development states: "In no case should abortion be promoted as a method of family planning. All Governments and relevant intergovernmental and non-governmental organizations are urged to strengthen their commitment to women's health, to deal with the health impact of unsafe abortion15 as a major public health concern and to reduce the recourse to abortion through expanded and improved family-planning services. Prevention of unwanted pregnancies must always be given the highest priority and every attempt should be made to eliminate the need for abortion. Women who have unwanted pregnancies should have ready access to reliable information and compassionate counselling. Any measures or changes related to abortion within the health system can only be determined at the national or local level according to the national legislative process. In circumstances where abortion is not against the law, such abortion should be safe. In all cases, women should have access to quality services for the management of complications arising from abortion. Post-abortion counselling, education and family-planning services should be offered promptly, which will also help to avoid repeat abortions."]

(k) [amend & retain: In view of the high incidence of morbidity and mortality due to unsafe abortion (delete: consider) review(delete:ing) and reform laws and policies to reflect a commitment to women's health and well-being, including those containing punitive measures against women who have undergone illegal abortions;]

(l) Give particular attention to the needs of girls [delete: taking into account the rights, duties and responsibilities of parents and other persons legally responsible for children and consistent with the Convention on the Rights of the Child;] especially the promotion of healthy behaviors, including physical activities; take specific measures for closing the gender gaps in morbidity and mortality where girls are disadvantaged, while achieving internationally approved goals for the reduction of infant and child mortality - specifically, by the year 2000, the reduction of mortality rates of infants and children under five years of age by one third of the 1990 level, or 50 to 70 per 1,000 live births, whichever is less; by the year 2015 an infant mortality rate below 35 per 1,000 live births and an underfive mortality rate below 45 per 1,000;

(m) Ensure that girls [delete: taking into account the rights, duties and responsibilities of parents and other persons legally responsible for children and consistent with the Convention on the Rights of the Child;] have continuing access to necessary health, including reproductive and sexual health, and nutrition information and services as they mature, to facilitate a healthful transition from childhood to adulthood; (p) Formulate special policies, design programmes and enact the legislation necessary to alleviate and eliminate environmental and occupational health hazards associated with work in the home, in the work place and elsewhere [retain: with special attention to pregnant and lactating women]; (u) Rationalize drug procurement and ensure a reliable, continuous supply of high-quality pharmaceutical, [retain: contraceptive] and other supplies and equipment, [retain: using the WHO Model List of Essential Drugs as a guideline;] and ensure the safety of drugs and devices through national regulatory drug approval processes;

108. By governments, in cooperation with nongovernmental organizations, the mass media, the private sector and relevant international organizations, including United Nations bodies, as appropriate:

(a) [amend & retain: Give priority to both formal and informal educational programmes that support and enable women to develop self-esteem, acquire knowledge, make decisions on and take responsibility for their own health, [delete: achieve mutual respect in matters concerning] sexuality and fertility, and educate men regarding the importance of women's health and well-being, placing special focus on programmes for both men and women that emphasize the elimination of harmful attitudes and practices, including female genital mutilation, son preference (which results in female infanticide and prenatal sex selection), early marriage, widow inheritance, violence against women, [retain: prostitution], sexual abuse, which at times is conducive to infection with HIV/AIDS and other sexually transmitted diseases infections, drug abuse, discrimination against girls and women in food allocation and other harmful attitudes and practices related to the life, health and well being of women and recognizing that some of these practices can be violations of human rights and ethical medical principles;]

(d) [retain: Reinforce laws, reform institutions and promote norms and practices that eliminate discrimination against women and encourage both women and men to take responsibility for their sexual and reproductive behaviour; [amend & retain: ensure full respect for the physical integrity of the human body, whether that of woman or man]; [retain: and take action to ensure the conditions necessary for women to exercise their reproductive rights] [amend & retain: and eliminate (delete: ,where possible,) coercive laws and practices];]

(e) [amend & retain: Prepare and disseminate accessible information, through public health campaigns, the media, reliable counselling and the education system, designed to ensure that women and men, particularly young people, can acquire knowledge about their health, especially information on sexuality and reproduction. [delete: taking into account the rights, duties and responsibilities of parents and other persons legally responsible for children and consistent with the Convention on the Rights of the Child] [delete: as agreed in the Programme of Action of the International Conference on Population and Development] (delete: and) [delete: as contained in the Report of the International Conference on Population and Development];]

(g) [retain: Recognize the specific needs of adolescents, [retain: boys and girls], and implement specific appropriate programmes, such as [retain: information on sexual and reproductive health issues and] on sexually transmitted diseases including HIV/AIDS, and recognize their rights to privacy, confidentiality, respect and informed consent; [amend & retain: (delete: taking into account the rights and duties and responsibilities of parents and other persons legally responsible for children) with the support and guidance of their parents and consistent with Article 5 of the Convention on the Rights of the Child];]

(h) Develop policies that reduce the disproportionate and increasing burden on [delete: mothers] women [retain: who have multiple roles within the family and the community] by providing women with adequate support and programmes from health and social services;

(m) Establish and/or strengthen programmes and services, including media campaigns that address the prevention, early detection and [retain: treatment of breast, cervical and other cancers of the reproductive system];

(p) [retain: Ensure that medical school curricula and other health-care training include gender-sensitive, comprehensive and mandatory courses on women's health (delete: as defined in para 91 above];

(q) Adopt specific preventive measures to protect women, youth and [amend & retain: (delete: children) girls] from any abuse - sexual abuse, exploitation, trafficking and violence, for example, - including formulation and enforcement of laws and provide legal protection, medical and other assistance.

Strategic objective C.3. Undertake [retain: gender-sensitive] multisectoral initiatives that address sexually transmitted diseases, the HIV/AIDS pandemic and other [retain: sexual and reproductive health] issues

109. By governments, international bodies including relevant United Nations organizations, bilateral and multilateral donors and non-governmental organizations:

(b) [retain: Review and amend laws and practices, as appropriate, that may contribute to women's susceptibility to HIV infection and other sexually transmitted diseases, including enacting legislation against [retain: those socio-cultural practices] that contribute to it], and implement legislation, policies and practices to protect women, adolescents and young girls from discrimination related to HIV/AIDS;

(d) Recognize the extent of the HIV/AIDS pandemic in their countries taking particularly into account its impact on women, with a view that infected women should not suffer stigmatization and discrimination, [retain: including during travel];

(e) Develop [retain: gender-sensitive] multisectoral programmes and strategies to end social subordination of women and girls and to ensure their social and economic empowerment and equality; and facilitate promotion of programmes to educate and enable men to assume their responsibilities to prevent HIV/AIDS and other sexually transmitted diseases;

(f) Facilitate the development of community strategies that will protect women of all ages from HIV and other sexually transmitted diseases, provide care and support to infected girls, women and their families and mobilize all parts of the community in response to the HIV/AIDS pandemic to exert pressure on all responsible authorities to respond in a timely, effective, sustainable and [retain: gender-sensitive] manner;

(g) Support and strengthen national capacity to create and improve [retain: on HIV/AIDS and other sexually transmitted diseases [retain: gender-sensitive] policies and programmes] including the provision of resources and facilities to women who find themselves the principal caregivers or economic support for those infected with HIV/AIDS and affected by the pandemic, and the survivors, particularly children and older persons;

(h) Provide workshops and specialized education and training to parents, decision makers and opinion leaders at all levels of the community, including religious and traditional authorities, on prevention of HIV/AIDS and other sexually transmitted diseases, and their repercussions on both women and men of all ages; [delete: parental language]

(i) [amend & retain: Give all women and health workers all relevant information about sexually transmitted diseases, including HIV/AIDS and pregnancy and the implications for the baby, including breast-feeding;]

(j) Assist women [retain: of all ages] [delete: recognizing the rights, duties and responsibilities of parents and other persons legally responsible for children and consistent with the Convention on the Rights of the Child] and their formal and informal organizations to establish and expand effective peer education and outreach programmes and to participate in the design, implementation and monitoring of these programmes; [delete: recognizing the rights, duties and responsibilities of parents and other persons legally responsible for children and consistent with the Convention on the Rights of the Child];

(k) Give full attention to the promotion of mutually respectful and equitable [retain: gender relations] and in particular to meeting the educational and service needs of adolescents to enable them to deal in a positive and responsible way with their sexuality, [retain: as agreed in the Programme of Action of the International Conference on Population and Development] [delete: as contained in the Report of the International Conference on Population and Development];

(l) [amend & retain: Design specific programmes for boys, adolescents, with the support and guidance of their parents, and in line with the Convention on the Rights of the Child] [delete: recognizing the rights, duties and responsibilities of parents and other persons legally responsible for children and consistent with the Convention on the Rights of the Child], and men of all ages, aimed at providing [delete: reliable] [retain: complete and accurate] information and encouraging [delete: abstinence until marriage as responsible sexual behaviour.] safe and responsible sexual and reproductive behaviour, including voluntary, appropriate and effective male methods for the prevention of HIV/AIDS and other sexually transmitted diseases, and][retain: training in the promotion of safe and responsible sexual behaviour, including voluntary abstinence and [retain: condom use];]

(m) Ensure the provision, through the primary health-care system, of [retain: universal access of individuals and couples] to appropriate and affordable preventive services with respect to sexually transmitted diseases, including HIV/AIDS, and expand the provision of counselling and voluntary and confidential diagnostic and treatment services for women; [retain: and ensure that high quality condoms as well as] drugs for the treatment of sexually transmitted diseases are, where possible, supplied and distributed to and by health services;

(n) Support programmes which acknowledge that the higher risk among women of contracting HIV is linked to high-risk behaviour, including intravenous substance use and substance-influenced, [retain: unprotected] [delete: irresponsible] sexual behaviour, and take appropriate preventive measures;

(p) [retain: Support and initiate research that addresses women's needs and situations, including research on HIV infection and other sexually transmitted diseases in women; on womencontrolled methods of protection, such as non-spermicidal microbicides; and on male and female risk-taking attitudes and practices].

Strategic objective C.4. Promote research and information dissemination on women's health

Actions to be taken

110. By governments, the United Nations system, health professions, research institutions, non-governmental organizations, donors, pharmaceutical industries and the mass media, as appropriate:

(a) Train researchers and introduce systems that allow for the use of data collected, analyzed and disaggregated by, among other factors, sex and age, [retain: race and ethnicity] and socio-economic variables, in policymaking as appropriate, planning, monitoring and evaluation;

(d) Increase financial and other support from all sources for preventive, appropriate biomedical, behavioural, epidemiological and health service research on women's health issues and for research on the social, economic and political causes of women's health problems, and their consequences, including the impact of [retain: gender and] age inequalities, especially with respect to chronic and noncommunicable diseases, particularly cardio-vascular diseases and conditions, cancers, reproductive tract infections and injuries, HIV/AIDS and other sexually transmitted diseases, domestic violence, occupational health, disabilities, environmentally related health problems, tropical diseases and health aspects of ageing;

(e) [delete: Inform women about data which shows that hormonal contraception, abortion and promiscuity increase risks of developing cancers and infections of the reproductive tract, so that they can make informed decisions about their health]

(h) Provide financial and institutional support for research on safe, effective, affordable and acceptable [retain: drugs and] technologies for [retain: reproductive and sexual health] of women and men, including more safe, effective, affordable and acceptable methods [delete: such as natural family planning] [retain: for the regulation of fertility] for both sexes, methods to protect against HIV/AIDS and other sexually transmitted diseases, and simple and inexpensive methods of diagnosing such diseases, among others. This research needs to be guided at all stages by users and from the perspective of gender, particularly the perspective of women, and should be carried out in strict conformity with internationally accepted legal, ethical, medical and scientific standards for biomedical research;

(i) Since [retain: unsafe abortion]15/ is a major threat to the health and lives of women, research to understand and better address the determinants and consequences of induced abortion, including its effects on subsequent fertility, reproductive and mental health and [retain: contraceptive] practice, should be promoted, as well as research on treatment of complications of abortions and post-abortion care. (l) [retain: Report on all genome and genetic engineering research;]

Strategic objective C.5. Increase resources and monitor follow up for women's health

Actions to be taken

111. By governments at all levels, and where appropriate, in cooperation with non-governmental organizations, especially women's and youth organizations:

(a) Increase, [delete: where necessary], budgetary allocations for [delete: basic] [retain: primary] health-care and social services, with adequate support for secondary and tertiary levels, and give special attention to the [retain: reproductive and sexual] health of girls and women; priority should be given to health programmes in rural and poor urban areas;

(c) Develop [delete: where appropriate] local health services, promoting the incorporation of a gender-sensitive community-based participation and self-care, and specially designed preventive health programmes;

(d) Develop goals and time-frames, where appropriate, for improving women's health and for planning, implementing, monitoring and evaluating programmes, based on gender-impact assessments using qualitative and quantitative data disaggregated by sex, age, [retain: race and ethnicity] and socio-economic variables;

112. By governments, the United Nations and its specialized agencies, international financial institutions, bilateral donors, and the private sector, as appropriate:

(b) [Retain: Provide appropriate material, financial and logistical assistance to youth organizations in order to strengthen them to address youth concerns in the area of health, [retain: including sexual and reproductive health];]