Assessment of Laws and Policies for Strengthening Adolescent Sexual and Reproductive Health in Bangladesh - PowerPoint PPT Presentation

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

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

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  1. 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

  2. HUMAN RIGHTS IN BANGLADESH • 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

  3. BANGLADESH CONTEXT • Legal age of marriage: 18 years • Mean age at first marriage: 15.7 years 14.9 years 13 years Source: Bangladesh DHS 1993-2007

  4. BANGLADESH CONTEXT (contd.) • 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: 19 Age Source: Bangladesh DHS 1999-2007

  5. BANGLADESH CONTEXT (contd.) • 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

  6. THE WHO GENERIC TOOL • 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

  7. THE BANGLADESH PROCESS • 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

  8. THE BANGLADESH PROCESS (contd.) • 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

  9. CURRENT SITUATION • 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

  10. CHALLENGES • 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

  11. LESSONS LEARNT • 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…