Cambodia, China, India, Indonesia, Malaysia, Nepal, Philippines and Pakistan
Findings from NGO country-monitoring studies in Cambodia, China, India, Indonesia, Malaysia, Nepal, Philippines and Pakistan reveal that despite agreements to achieve the clear objectives and strategies outlined in the ICPD Programme of Action (PoA), governments have not yet been successful in implementing the majority of actions promised at that landmark conference. Preventable deaths from maternal mortality have only slightly declined in these eight countries: two million women are estimated to have died in the past decade from causes related to maternal mortality with some 259,530 of these dying from unsafe abortions. Violence against women is on the rise, as is HIV/AIDS transmission for women and men. Fifty years after family planning programmes began in the region, the expressed unmet need of Asian women for contraception is still high. (From ARROW's publication "Monitoring Ten Years Of ICPD Implementation, The Way Forward To 2015, Asian Country Reports" - see full text)
‘... All Governments and relevant intergovernmental and non-governmental organisations are urged to strengthen their commitment to women’s health, to deal with the health impact of unsafe abortion 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.... In circumstances where abortion is not against the law, such abortions should be safe. In all cases, women should have access to quality services for the management of complications arising from abortion.’ (ICPD PoA 8.25)
No national data were reported on the reduction of unsafe abortion in any of the countries. Neither was the incidence of abortion available, despite the ICPD commitment to urgently addressing this public health concern. This report thus uses WHO estimates. Asian women are known to have 50 percent or 10.5 million of the 20 million unsafe abortions women have annually (Cook and Fathala, 2003). Around 13 to 15 percent of all deaths due to pregnancy and childbirth in Asia are ascribed to unsafe abortions and many more women survive and suffer from complications related to these. Young women aged 15-19 account for at least one fourth of global abortions, but estimates for Asian young women were not available.
In the eight countries, the number of women who die from unsafe abortions annually is estimated at 25,95313 with the highest of 17,680 deaths being in India, followed by Pakistan (3,380), China (1,650) and Indonesia (1,500) (see table 10).
These figures are shockingly high when compared to only 500 annual deaths in the whole of Europe. Progress was made in reviewing abortion laws, which was a Beijing Platform for Action agreement. Cambodia and Nepal now have new abortion laws, which allow abortion on request for any reason. This is tremendous progress for Nepal, which previously did not permit abortion for any reason and imprisoned many poor women who underwent illegal abortions. In Indonesia and Malaysia, there was review and discussion of the law among medical professionals and reproductive health advocates towards improving the law but no definite outcomes have emerged.
At present, current laws in the eight countries show the diversity of conditions under which abortion is legal (see Table 11). The Philippines is the most restrictive, followed by Pakistan, then Malaysia, which is moderately liberal (abortion is allowed for physical and mental health reasons) with Cambodia, China, India and Nepal allowing abortion for any reason. The earlier liberal abortion laws of China and India were based on demographic population reduction objectives but Cambodia’s new law stated the reproductive rights of women as one of the objectives, showing the influence of the ICPD.
Despite a liberal abortion law, India continues to report a high rate of unsafe abortions. This is attributed to the lack of political will to ensure that quality abortion services are available. Clearly liberal abortion laws do not necessarily guarantee that women can exercise their right to obtain safe abortions. Implementation of the new (2002) abortion law in
Nepal has been very slow, reflecting a lack of urgency to address the situation of at least 780 Nepalese women dying annually from unsafe abortions.
Countries with liberal abortion laws such as Cambodia and Malaysia report that many women service providers and members of the public do not know of the legal abortion rights of women. Partly this is due to the general lack of accurate information and partly it is because of the low priority accorded by the government to promoting women’s human and reproductive rights.
In the government ESCAP reports (2002), only China reported on efforts to reduce unsafe abortion incidence and improve the quality of abortion services, as part of its reproductive health package. In the Philippines, Likhaan’s abortion study (2003)14 and Sanchez (2003)15 found that health service providers were biased and abusive in their provision of post-abortion services, directly contravening ICPD agreements to provide humane care to women. Moralistic attitudes are a deterrent to women needing to obtain such services. More qualitative, women-centred evaluations are needed in countries like Indonesia, Pakistan, and Malaysia.
Governments with restrictive abortion laws continue to deny the reality of women’s need to choose to have an abortion if there is contraceptive failure, or if poverty, gender inequality, rape, sexual coercion and socio-economic reasons make it necessary. The Philippines for example, estimates that 400,000 abortions occur annually (of which 73 percent have complications) as a result of poverty and poor access to family planning services. Teenagers represent 17 percent of the Filipino women having abortions.16 In the other countries (India, Nepal and Cambodia), the need for unrestricted abortion services is recognised and legislation exists but the right to access safe services is still not a reality.
Extracted from ARROW's publication "Monitoring Ten Years Of ICPD Implementation, The Way Forward To 2015, Asian Country Reports" - see full text
Contents (Download in PDF format)
Chapter 1 : Pakistan
Chapter 2 : Philippines
Chapter 3 : China
Chapter 4 : Nepal
Chapter 5 : Malaysia
Chapter 6 : India
Chapter 7 : Indonesia
Chapter 8 : Cambodia