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Assessment of Laws and Policies for Strengthening Adolescent Sexual and Reproductive Health in Bangladesh. Experience of implementing human rights related activities at country level. Anna Häggblom - Child & Adolescent Health Unit - WHO Country Office for Bangladesh.

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Assessment of Laws and Policies for Strengthening Adolescent Sexual and Reproductive Health in Bangladesh

Experience of implementing human rights related activities at country level

Anna Häggblom - Child & Adolescent Health Unit - WHO Country Office for Bangladesh

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  • All the international human rights treaties has been ratified (except CMV)

  • Bangladesh has participated in almost all major international conferences related to human rights

  • The right to life, food, health, shelter, basic necessities of life, speech, education are enshrined in the Bangladesh Constitution

“The Republic shall be a democracy in which fundamental human rights and freedom, and respect for the dignity and worth of the human person shall be guaranteed”

Constitution of Bangladesh, article 11

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  • Legal age of marriage: 18 years

  • Mean age at first marriage:

15.7 years

14.9 years

13 years

Source: Bangladesh DHS 1993-2007

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  • Contraceptives are only provided to married adolescents through public facilities

  • Abortion is illegal, but menstrual regulation allowed (within 6-10 weeks)

  • Mean age at first birth:



Source: Bangladesh DHS 1999-2007

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  • General fertility rate: 105 births/1000 women

  • Adolescent specific fertility rate: 126 births/1000 women

  • Poor, non-educated, rural adolescents most vulnerable

Source: Bangladesh DHS 1993-2007

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  • Developed by WHO HQ and Harvard School of Public Health

  • Aim: improve awareness and understanding of States’ human rights obligations

  • Method: systematic examination of the SRH status of vulnerable groups, involving non-health sectors, fostering civil society participation and developing recommendations to address regulatory and policy barriers to SRH with clear assignment of responsibility

  • Goal: Strengthen the links between human rights and SRH, and contribute to national achievement of the highest attainable standard of health

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  • Entry point: adolescent pregnancy

  • Advocacy efforts with Government of Bangladesh + other stakeholders

  • Formation of Technical Advisory Group

  • Formation of Core Group (respondents)

  • Conduction of workshop for national adaptation of generic tool

  • Objectives:

    • To examine the status and implications of human rights approach for adolescent health in Bangladesh

    • To study the national laws and policies related to core aspects of adolescents’ SRH

    • Review health data together with laws, policies and regulations related to adolescent SRH, in the context of human rights

    • Review and document government efforts to respect, protect and fulfill adolescents’ right in the context of SRH

    • Identify possible discrepancies in laws and policies that might be barriers to adolescent SRH

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  • Data collection

  • Workshop with policy makers and programme managers

    • Interviews with legal and public health experts

    • Document review

  • Analysis using SWOT (Strengths, Weaknesses, Opportunities, Threats) framework

  • Report writing

  • Decision after feedback from HQ and regional level: further analysis needed

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  • Incomplete data on national laws and regulations

  • Non-systematic analysis of health issues

  • Unclear barriers and recommendations

  • No clear linking with relevant human rights instruments

  • Example of existing barriers:

    • Inadequate protection of girls/women from early marriage

    • Discrepancy between the Health Law/ Religious Law and the Criminal Code with regards to family planning information

    • Inadequate legal provisions for unmarried adolescent women to access reproductive health services

    • Inadequate provision of privacy, confidentiality and informed consent

  • Senior legal expert and public health expert to work for 2 months to fill data gaps, more thoroughly conduct analysis  identify barriers and formulate recommendations/suggestions

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  • Culturally sensitive topics related to adolescent SRH

  • Reluctance in GoB to discuss human rights

    • Lack of knowledge?

    • Fear of criticism?

  • Difficult to talk about human rights “in isolation”

  • Formulation of specific recommendations on how to overcome barriers without “pointing fingers”

  • Finding persons with experience of both legal analysis and sexual and reproductive health

  • Extensive tool

    • Limited country capacity

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  • Sensitization and de-mystification needed on human rights and the added value for the field of health

    • Government

    • WHO staff

  • National adaptation of tool crucial for:

    • Understanding

    • Ownership

    • Future use of the report

  • Countries need to find their own purpose for conducting the assessment:

    • Bangladesh: door opener, stimulate dialogue, advocacy for AH

  • Takes time…