Ensuring the Accessibility of Standard Health Care System and Reproductive

Rights for Pregnant Women and Children amid Covid-19 Pandemic.

Overview:

Sexual and reproductive health and rights

Women's sexual and reproductive health is linked to several human rights, including the right to life, the
right to freedom from torture, the right to health, the right to privacy, the right to education and the
prohibition of discrimination. The Committee on Economic, Social and Cultural Rights and the
Committee on the Elimination of Discrimination against Women (CEDAW) have both clearly indicated
that women’s right to health includes their sexual and reproductive health. This means that states have an
obligation to respect, protect and fulfill rights related to women's sexual and reproductive health. The
Special Rapporteur on the Right of All to the highest achievable standard of physical and mental health
believes that women are entitled to reproductive health services, goods and facilities that:
(a) Available in a reasonable number;
(b) are physically and economically accessible;
(c) are accessible without discrimination; and
(d) good quality
Despite these commitments, violations of women's sexual and reproductive health rights are common.
These take many forms, including denying access to services that only women need or poor quality
services that require women to access third-party services, and performing reproductive and sexual health
procedures by women without women's consent, including forced sterilization, forced virginity tests and
forced abortion. Women's sexual and reproductive health rights are also at risk if they are subject to
female genital mutilation (FGM) and early marriage.
Violations of women's sexual and reproductive health rights are often deeply rooted in the social values of
women's sexuality. Patriarchal concepts of the role of women within the family mean that women are
often valued for their reproductive ability. Early marriage and pregnancy, or repeated pregnancies that are
too close together, often due to efforts to produce male offspring because sons are preferred, have
devastating health effects for women, sometimes with fatal consequences. Women are also often held
responsible for infertility, marginalization and various human rights violations.
CEDAW (article 16) guarantees women equal rights in deciding “freely and responsibly on the number
and spacing of their children and to have access to the information, education and means to enable them
to exercise these rights.” CEDAW (article 10) also specifies that women’s right to education includes
“access to specific educational information to help to ensure the health and well-being of families,
including information and advice on family planning.”
The Women’s Convention
Both the ICPD (International Conference on Population and Development) and the FWCW (Fourth
World Conference on Women) acknowledged the intrinsic relation of gender equality to women’s health,
including sexual and reproductive health. Both are consensus documents that express political will. In
contrast, international human rights documents - treaties or conventions - are sources of international law
and are considered legally binding as such. The Women's Convention is the central human rights treaty to
combat discrimination against women and is sometimes referred to as the international Bill of Women's
Rights. In general, States parties to the Convention undertake to pursue a policy of eliminating
discrimination in all its forms and to guarantee women the exercise and enjoyment of human rights and
fundamental freedoms based on equality with men. It covers all areas of women's lives, both public and
private, including discrimination related to the right to health and health services.
The Committee on the Elimination of Discrimination against Women (CEDAW Committee) is
established in accordance with Article 17. It is composed of 23 expert members who are elected by the
contracting states from among themselves and work in their personal capacity. The main task of the
Committee is to monitor the implementation of the Convention by reviewing regular reports by the
Contracting States on the measures they have taken to implement and progress on the provisions of the
Convention. The Committee may also make general recommendations based on the review of reports and
information received from the contracting states. Some of these general recommendations deal with
formal issues such as reporting obligations of the contracting states, while others are explanations on
material matters and are an authoritative interpretation of the rights guaranteed by the Convention.

The Right to Life

Indeed, discrimination against women is a key factor in the high number of deaths and complications
associated with pregnancy and childbirth. Failure to provide health services to mothers often reflects the
low priority given to the special needs of women when allocating resources. Maternal mortality and
morbidity can be largely avoided by providing reproductive health services, including contraception, safe
abortion, and basic and obstetric emergency care. The most obvious human right violated by preventable
deaths during pregnancy or childbirth is the fundamental right of women to life itself. It is questionable
whether the central minimum content of government obligations under international human rights
instruments is to have access to affordable to provide high quality health services that would prevent
maternal mortality.
In Indonesia, the government appeared to violate its core responsibility for providing safe maternal health
services: it attributed the high maternal mortality rate to deliveries by traditional obstetricians, which
accounted for almost 64% of the total. The report stated that many women prefer home births "because of
the convenience, low cost, and flexible payment arrangements, aftercare services offered, and the
convenience of home delivery." However, it is questionable whether "customer preference" should not
release the government from its obligation to respect, protect and fulfill the right of women to life.
While the Azerbaijan case violated the right to affordable services, the Dominican Republic appeared to
have violated the right to quality of care. The actual maternal mortality rate was not known until recently
due to the unreliability of health statistics in general and the lack of gender-disaggregated data in
particular. In later years, however, there was an increase in maternal mortality despite the prevalence of
pregnancy, nursing and hospital births. Non-governmental sources said the high maternal mortality was
due to the low priority given to women's reproductive health.

Reproductive Choice - Abortion

Unsafe abortion is also a major cause of maternal mortality and morbidity. States' reports to the
committee often do not contain official data because abortion is illegal in many countries. However, they
consistently show a correlation between unsafe abortion and high maternal mortality and morbidity rates,
which are presented as bleeding and complications from pregnancy.
Zimbabwe, for example, reported that bleeding and post-abortion infections are the leading cause of
death, although the actual numbers cannot be determined given the illegality of the abortion. The
Dominican Republic also reported that "secret abortions" are the third leading cause of maternal death
(after toxemia and bleeding during childbirth), but found "severe under-reporting".
There are reasons to believe that laws that criminalize health services that only women need - whether
they target the people who provide them or the women who receive them - are discriminatory as such.
Criminalization of abortion is particularly heinous because it affects not only women's right to
reproductive choices - making free and responsible decisions on matters that are vital to controlling their
lives - but also serious health risks exposing them to an unsafe abortion that violates their right to physical
integrity and, in extreme cases, to life itself.
In many countries there are exemptions from the penal code that allow legal abortion in certain
circumstances, e.g. B. In cases where the life of the mother (or fetus) is at risk or where pregnancy was
caused by rape. In Indonesia, however, rape is not a reason for legal abortion, which means that the state
effectively increases sexual violence against women by forcing them to bear the resulting pregnancy.

Reproductive Choice - Family Planning

The right to reproductive choice means that women have the right to choose whether or not to reproduce,
including the right to choose whether to have or terminate an unwanted pregnancy and the right to choose
their preferred method of family planning and to choose contraception. A violation of this right was found
in a non-government report on the widespread discrimination against women in the Mexican export
processing sector (Maquiladora) due to pregnancy. An information mission to investigate the allegations
found that all women who applied to work in the sector routinely had to undergo screening tests for
pregnancy and that women who were employed were forced to resign if they became pregnant. In some
factories, women were required to show sanitary napkins as a condition for continued employment to the
company's nurses. The report concluded that such practices punish women for exercising their
reproductive choices and inherently affect their ability to freely choose the number and spacing of their
children, and that the Mexican government is responsible for such employment practices can be set.
The right to family planning education, information and services is key to reproductive health and is
central to women's sexual and reproductive health, particularly given the risk of maternal mortality and
the illegality of abortion in many countries.
Family planning services are particularly important when abortion is illegal. Abortion is illegal in the
Dominican Republic, but birth control is only offered by non-governmental organizations. If the state
does not allow safe legal abortion, its primary duty is to at least afford family planning services that
guarantee women the right to make reproductive decisions.
Even in countries where abortion is legal, prevention of pregnancy is preferable to termination in terms of
women's health. In many cases, however, the legal option of abortion is not supported by adequate family
planning measures. In the Czech Republic, for example, the government found that the frequency of
abortions is a major public health problem, reflecting the inadequate use of contraceptives. However, the
cost of contraception is only partially covered by general health insurance (which may be due to
discrimination in resource allocation as it is a service that only women need). The government also noted
that health workers sometimes lack adequate contraceptive skills.
Women in Vulnerable Situations
In recent years, the focus of human rights work on vulnerable groups has increased. This is the result of a
new interest in economic and social rights and the associated concept of social justice. While the previous
emphasis on civil and political rights has been largely based on the concept of freedom and has focused
on the individual as such, attention is now being paid to violating the rights of individuals as members of
vulnerable groups within a particular society. Therefore, health practices and policies should be examined
in the light of the needs of the most disadvantaged groups in society. These include rural and urban fringe
groups, women in armed conflict situations and women in prostitution.
Mexico noted in its report the unmet contraceptive needs of rural women and the poor in the city, while in
Zimbabwe, according to a non-governmental source, 20 percent of the population in rural areas has no
political will despite access to family planning or health services for mothers the government to deliver
such.
Women in armed conflict situations are particularly vulnerable to sexual violence and torture, with the
health consequences of psychological damage, susceptibility to sexually transmitted diseases, and related
reproductive health problems, including unwanted pregnancies. Such abuse can isolate, stigmatize and
reject women from their families and communities. Women are often reluctant to report these violations
because they feel shameful, according to a non-government report on women in East Timor.
Women who are internally displaced as a result of armed conflict may have limited access to reproductive
health services. For example, a study by a United Nations High Commissioner for Refugees for
Reproductive Health on women in five IDP settlements in Azerbaijan found that women consider family
planning primarily as a primary health problem, but that there are bureaucratic hurdles to delivering
condoms. Similarly, it did not appear lawful in Croatia that refugee women were entitled to all the
services provided under the comprehensive publicly funded health system.
Women in prostitution are significantly marginalized in all societies and are at extremely high risk of
suffering from rape and other forms of violence. This is increasingly worrying given the alarming growth
in international trafficking in women and girls. At the same time, they are often selected for
discriminatory treatment through public health programs that do not take into account the more general
concerns and underlying determinants of the problem in question. In Indonesia, for example, the Ministry
of Social Affairs is spreading information about the risk of HIV / AIDS "close to the place of the
prostitute", while reports have shown that women have been detained as suspicious prostitutes as part of
sporadic urban "cleansing programs". That they are forced to have vaginal checkups during interrogation.
It should be noted that health professionals are often able to identify the health consequences of sexual
violence and should be able to respond effectively to survivors' health needs. Bulgaria, for example, has
not included information on gender-based violence in its report, but a non-governmental source has
received first-hand evidence from health professionals who viewed this as a serious problem and
described some cases as brutal.

Women Healthcare:
Women's health refers to women's health, which differs from that of men in many ways. Women's health
is an example of population health, where health is defined by the World Health Organization as "the
state of complete physical, mental and social well-being, not just the absence of illness or ailment". Many
groups, often treated only as women's reproductive health, advocate a broader definition of women's
general health, better expressed as "women's health". These differences are further aggravated in
developing countries, where women whose health includes both their risks and experience are further
disadvantaged.
Although women in developed countries have narrowed the gender gap in life expectancy and now live
longer than men, in many health care areas they suffer from earlier and more serious illnesses with worse
results. Gender remains an important social determinant of health because women's health is influenced
not only by their biology but also by conditions such as poverty, employment and family responsibilities.
Women have long been disadvantaged in many ways, including social and economic power that limits
their access to life needs, including healthcare, and the more disadvantaged, as in developing countries,
the greater the adverse health effects.
The reproductive and sexual health of women differs significantly from that of men. Even in developed
countries, pregnancy and childbirth pose significant risks for women whose maternal mortality causes
more than a quarter of a million deaths a year, with large differences between developing and developed
countries. Comorbidity due to other non-reproductive disorders such as cardiovascular disease contributes
to both mortality and morbidity in pregnancy, including preeclampsia. Sexually transmitted infections
have serious consequences for women and infants. Mother-to-child transmission leads to results such as
stillbirth and death in newborns, and pelvic inflammatory disease leads to infertility. In addition,
infertility due to many other causes, birth control, unplanned pregnancy, consensual sexual activity, and
the struggle for access to abortion cause further strain for women.
While the rates of major causes of death, cardiovascular disease, and cancer and lung disease are similar
in women and men, women have different experiences. Lung cancer has overtaken all other cancers as the
leading cause of death in women, followed by breast, colon, and ovarian, uterine and cervical cancer.
While smoking is the main cause of lung cancer, the risk of developing cancer is three times higher in
women who do not smoke than in men who do not smoke. Even so, breast cancer remains the most
common cancer among women in industrialized countries and one of the most important chronic diseases
in women, while cervical cancer remains one of the most common cancers in developing countries
associated with the human papillomavirus (HPV), an important sexually transmitted disease. HPV
vaccine along with screening offers promise to control these diseases. Other important health problems
for women include cardiovascular disease, depression, dementia, osteoporosis and anemia. A major
obstacle to promoting women's health was their underrepresentation in research studies. Inequality has
been addressed in the United States and other western countries through the establishment of centers of
excellence in women's health research and large-scale clinical trials such as the Women's Health
Initiative.
Women's experiences with health and illness differ from those of men due to unique biological, social and
behavioral conditions. The biological differences vary from phenotypes to cell biology and have unique
risks for the development of diseases. The World Health Organization (WHO) defines health as "a state of
complete physical, mental and social well-being and not just the absence of illnesses or ailments".
Women's health is an example of the health of the population, the health of a certain defined population.
Women's health has been described as a "patchwork quilt with gaps". Although many of the problems
related to women's health relate to their reproductive health, including maternal and child health, genital
and breast health, and endocrine (hormonal) health, including menstruation, birth control, and menopause
wider understanding of women's health all aspects of women's health were called for and "women's
health" replaced by "women's health". The World Health Organization believes that inappropriate
emphasis on reproductive health is a major obstacle to access for all women to quality health care.
Diseases that affect both men and women, such as cardiovascular diseases, osteoporosis, manifest
themselves differently in women. Women's health problems also include medical situations in which
women face problems that are not directly related to their biology, such as: B. Gender-based access to
medical treatment and other socio-economic factors. Women's health is particularly important due to
widespread discrimination against women in the world, which puts them at a disadvantage.
A number of advocates of health and medical research, such as the Society for Women's Health Research
in the United States, support this broader definition, and not just questions specific to the human female
anatomy, to include areas in which biological gender differences between women and men exist. Women
also need more health care and have more access to the health system than men. While part of it is due to
their reproductive and sexual health needs, they also have more chronic non-reproductive health problems
such as cardiovascular disease, cancer, mental illness, diabetes and osteoporosis. Another important
perspective is the realization that events throughout the life cycle (or life course) from the uterus to aging
affect women's growth, development and health. The life course perspective is one of the key strategies of
the World Health Organization.

Reproductive and sexual health

 Maternal health
 Sexual health
 Infertility
 Child marriage
 Menstrual cycle
 Other issues

Non-reproductive health:
 Cardiovascular disease
 Cancer
 Mental health
 Dementia
 Bone health
 Anemia
 Violence

Additional Information:
n addition to combating gender inequality in research, a number of countries have made women's health a
subject of national initiatives. For example, the Department of Health and Human Services set up a
Women's Health Office (OWH) in the United States in 1991 to improve women's health in America by
coordinating the women's health agenda across the Department and other agencies. In the 21st century,
the office has focused on underserved women. In addition, the Centers for Disease Control and
Prevention (CDC) established its own Office for Women's Health (OWH) in 1994, which was officially
approved by the 2010 Affordable Health Care Act (ACA).
Internationally, many United Nations organizations such as the World Health Organization (WHO), the
United Nations Population Fund (UNFPA) and the United Nations Children's Fund (UNICEF) have
specific programs on women's health or maternal health, sexual and reproductive health. In addition, the
United Nations' global goals deal directly and indirectly with many issues related to women's health.
These include the Millennium Development Goals 2000 (MDG) and its successor, the Sustainable
Development Goals, which were adopted in September 2015 following the report on progress towards
MDGs (Report on the 2015 Millennium Development Goals). For example, the eight MDG goals that
eradicate extreme poverty and hunger, achieve universal primary education, promote gender equality and
empower women, reduce child mortality, improve maternal health, fight HIV / AIDS malaria and other
diseases that Ensure environmental sustainability and a global partnership for development, all impacts on
women's health, as well as all seventeen SDG goals, in addition to the specific SDG5: gender equality and
empowerment of all women and girls.

Current Situation:
An estimated 116 million babies are born in the shadow of the COVID-19 pandemic, UNICEF said
before Mother's Day today. These babies are expected to be recognized as a pandemic on March 11, up to
40 weeks after the approval of COVID-19, which is currently affecting health systems and medical
supply chains around the world.
New mothers and newborns are greeted by harsh realities, UNICEF said, including global containment
measures such as curfews and curfews; Health centers overwhelmed with response efforts; Supply and
equipment bottlenecks; and a shortage of adequately qualified obstetricians as health workers, including
midwives, is being used to treat COVID-19 patients.
“Millions of mothers around the world have embarked on a journey of parenting in the world as it was.
They now need to prepare to bring a life into the world as it has become - a world in which expectant
mothers are afraid to go to health centers because of fear of being infected or because of tense health
services and emergency care barriers to be missed, ”he said Henrietta Fore, UNICEF executive director.
"It's hard to imagine how much the coronavirus pandemic has reshaped maternity."
Ahead of Mother’s Day, which was recognized in over 128 countries in May, UNICEF warns that
COVID-19 containment measures can disrupt life-saving health services such as obstetrics and put
millions of pregnant mothers and their babies at high risk.
Countries with the highest number of births expected in the nine months since the pandemic declaration
are: India (20.1 million), China (13.5 million), Nigeria (6.4 million), Pakistan (5 million) and Indonesia (4
million). Most of these countries had high newborn mortality rates prior to the pandemic and can increase
these levels under COVID-19 conditions.
More affluent countries are also affected by this crisis. In the United States, the sixth highest country in
terms of expected number of births, more than 3.3 million babies are expected to be born between March
11 and December 16. In New York, authorities are considering alternative birth centers because many
pregnant women are concerned about hospital birth.
UNICEF warns that while pregnant mothers are proven to be no more affected by COVID-19 than others,
countries must ensure that they continue to have access to prenatal, childbirth and postnatal services. Sick
newborn babies also need emergency services because they are at high risk of death. New families need
support to start breastfeeding and receive medication, vaccines, and nutrition to keep their babies healthy.
On behalf of mothers worldwide, UNICEF is urging governments and healthcare providers to save lives
in the coming months by addressing these issues:
• Issue to support pregnant women with screening, qualified maternity care, aftercare, and care related to
COVID-19 as needed;
• Obstacle to ensure that health workers are provided with the necessary personal protective equipment
and receive priority testing and vaccination as soon as a COVID 19 vaccine is available so that it can
provide high quality care to all pregnant women and newborns during the pandemic;
• Risk to ensure that all infection prevention and control measures in healthcare facilities are carried out
during and immediately after birth;
• Risk to allow healthcare workers to reach pregnant women and young mothers through home visits,
encourage women in remote areas to use maternity homes, and use mobile health strategies for
teleconsultations;
• Lack of training, protecting and equipping healthcare workers with clean birth kits for home births
where healthcare facilities are closed;
• Lack of resources for life saving services and supplies for maternal and child health.
Before the COVID-19 pandemic, an estimated 2.8 million pregnant women and newborns died every
year, or one every 11 seconds, mostly for avoidable reasons.

Risks:
In general, pregnant women do not appear to be more risky than healthy adults to develop a more serious
illness or complication if they are affected by a coronavirus. Most often, only mild to moderate flu-like
symptoms occur, e.g. If you are pregnant and your flu-like symptoms worsen, it may mean that your
breast infection is getting more serious and you may need to be hospitalized. If you develop more severe
symptoms or your recovery is delayed, contact a hospital near you immediately.
As it is a very new virus, we do not have all the information and evidence available yet. There is no
evidence of an increased risk of miscarriage when exposed to COVID-19. There is also no evidence of
vertical transmission that indicates the ability of the virus to pass on to your unborn baby during
pregnancy. In a study of nine pregnant women in China who tested positive for COVID-19, all nine
babies tested negative for the virus and were overall healthy. A pregnant woman in London tested
positive for coronavirus, and later her newborn also tested positive. However, it is unclear whether the
baby was infected with the viral infection in the uterus or shortly after birth. Expert opinion is that the
baby is unlikely to be exposed during pregnancy and, as a result, the baby is unlikely to have
developmental disorders. There is currently no new evidence to suggest otherwise.
It is not yet known whether pregnant women are more susceptible to infection with COVID-19 than the
normal population. Nevertheless, pregnant women are advised to reduce social contact with social
distance. It is an established fact that in some women pregnancy changes the way the body fights some
viral infections. For this reason, although the evidence for coronavirus is still insufficient, pregnant
women are advised to be particularly careful during this pandemic.
The benefits of breastfeeding your child far outweigh the risk of transmission of the coronavirus through
breast milk. The main risk with breastfeeding is the close contact between you and your baby, which
carries the risk of a droplet infection that can spread to the baby when breathing. Discuss the risks and
benefits with your doctor and family before making a decision. Here are a few steps to take to minimize
the risk of transmission:
 Wash your hands before feeding or touching the baby, breast pump or bottles
  Avoid coughing or sneezing while feeding
 Wear a face mask when feeding, if available.
 If you are using a breast pump, follow the instructions for proper cleaning and sterilization.
 Ask one of your healthy family members to feed your baby when expressing milk. 

Questions the resolutions must answer:

 How can we minimize the risk for the mother and child during Covid-19 pandemic?
 Can all government come together to support the world to fight Covid-19 for the future children
of this world?
 What will be the new standards of health care for pregnant woman amid Covid-19 pandemic?
 How to allocate the current resources for life saving services and supplies for maternal and child
health?

External sources:
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https://www.un.org/womenwatch/daw/beijing/fwcw.htm
https://www.unfpa.org/icpd
https://www.ohchr.org/en/issues/women/wrgs/pages/healthrights.aspx
https://www.who.int/topics/womens_health/en/
https://www.tandfonline.com/doi/full/10.3109/00365513.2014.936672
https://pubmed.ncbi.nlm.nih.gov/25083885/
https://unfoundation.org/features/bcun/newsletter/womens-health-post2015.pdf
https://www2.unwomen.org/~/media/headquarters/attachments/sections/csw/57/csw57-
agreedconclusions-a4-en.pdf?v=1&d=20140917T100700
https://www.narayanahealth.org/blog/covid-19-and-pregnancy-what-are-the-risks/
https://www.who.int/reproductivehealth/publications/emergencies/COVID-19-SRH/en/
https://www.unicef.org/press-releases/pregnant-mothers-and-babies-born-during-covid-19-pandemic-
threatened-strained-health