Colombia

The political impetus around the women's human rights agenda that was generated by the 1991 constitutional process continued after the constitution's passage. According to PROFAMILIA, "the new political will, the incorporation of new groups in the Government, and the networking of feminist groups" led to further changes, as women's NGOs successfully lobbied the Government to adopt new programmes with a gender perspective. One of the most important of these was the policy issued by the Ministry of Public Health in 1992, entitled "Health for Women, Women for Health."

The Convention has helped provide the framework for the new health policy through its conceptualisation of health as a human rights issue. Article 12 of CEDAW requires the State to "eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality between men and women, access to health care services, including those related to family planning." The State must also provide appropriate services in relation to pregnancy (CEDAW, article 12.2); provide educational information to women about family health and family planning (CEDAW, article 10); and ensure that women have equal rights with men to determine the number and spacing of their children, as well as having access to information and the means to make these decisions (CEDAW, article 16). In addition, the CEDAW Committee's General Recommendation on violence against women identifies coercion in relation to fertility and reproduction as a violation of women's human rights.

The Colombian constitution includes several key provisions regarding women's health that were modelled after the rights contained in the Women's Convention. The constitution guarantees women the right to found a family, to choose the number of children they will have, to have access to health education and information, to the enjoyment of a healthy environment, and to health care. The Colombian Health Policy elaborates upon and extends these entitlements by setting out a detailed programme of women's health rights. PROFAMILIA has summarised these rights in the following way:

· The right to a joyful maternity, which includes a freely decided, wished, and safe pregnancy,

· The right to humanised medical treatment, meaning that a woman's body, her fears, intimacy, and privacy needs should be treated with dignity and respect.

· The right to be treated as an integrated person and not as a biological reproducer by the health services.

· The right to have access to integrated health services which respond to women's specific needs, taking into consideration special characteristics such as age, activities, economic needs, race, and place of origin.

· The right to have access to education that fosters self-care and self-knowledge of the body, promoting self-esteem and empowerment.

· The right to receive information and counselling that promotes the exercise of a free, gratifying, and responsible sexuality, not necessarily conditioned to pregnancy.

· The right to have access to sufficient and appropriate information and counselling and to modern and safe contraceptives.

· The right to have working and living conditions and environments that do not affect women's fertility or health.

· The right not to be discriminated against in the work place or in educational institutions on the basis of pregnancy, number of children, or marital status.

· The right that biological processes such as menstruation, pregnancy, birth, menopause, and old age be considered as natural events and not as illness.

· The right to receive value and respect for cultural knowledge and practices related to women's health.

· The right to have an active and protagonist participation in the community and Governmental decision-making levels of the health system.

· The right to have access to public health services that take care of battered women and victims of all forms of violence.

(from: "CEDAW, Colombia and Reproductive Rights," at 5-6)

The overarching principle that informs the Colombian health policy is its recognition of the importance of women's active involvement. The policy stresses that all women have the right to be active participants in decisions that affect their health, lives, bodies, and sexuality. The policy sets out basic measures - that depend on women's agency - for ending discrimination against women in health care. Women must be empowered, so that the exercise of their rights is guaranteed; women must be afforded equal opportunities; pluralism and differences must be respected; health care must emphasise both women's freedom and privacy; and the social participation of women in active roles must be facilitated.