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Guatemala.Pdf © 2003 Center for Reproductive Rights www.reproductiverights.org formerly the Center for Reproductive Law and Policy guatemala final 2/28/01 12:35 PM Page 3 Table of Contents Acknowledgements ....................................................5 Glossary of Terms.......................................................6 Introduction ...............................................................7 I. Executive Summary ...............................................13 II. General Background on Guatemala......................23 A. Population and Demographics.................................................................................23 B. Recent History and the Peace Accords...................................................................23 C. Health Conditions and Indicators............................................................................24 D. Poverty and Economic Distribution........................................................................24 E. Current Unmet Need for Family Planning Information and Services..................25 F. Legal and Social Status of Women..........................................................................27 G. Education, Including Sexual Education .................................................................28 H. Role of the Catholic Church and Religion..............................................................28 I. Failed Attempts to Implement a Law or Policy on Family Planning....................29 III. Government Provision of Health Care, including Reproductive Health Care Services ......................35 A. Delivery of Public Health Services ........................................................................35 B. Inadequate Investment in and Quality of Government Health Care Services ............37 C. Recent Health Legislation, Policies, and Programs Impacting Reproductive Health Care Provision....................................................38 1. The Comprehensive Health Care System.................................................39 2. Standards of Care.......................................................................................41 3. National Plan to Reduce Maternal and Perinatal Mortality ...................42 D. Inadequate Integration of a Rights-Based Approach to Existing Reproductive Health Policies and Programs......................................43 IV. Violations of Human Rights Resulting from the Government’s Refusal to Provide Family Planning...47 A. Domestic and International Human Rights Implicated .........................................47 B. International Sources of Law...................................................................................48 1. International Human Rights Instruments .................................................48 (i) United Nations Charter ..............................................................48 (ii)Universal Declaration of Human Rights ...................................48 3 guatemala final 2/28/01 12:35 PM Page 4 (iii) International Human Rights Covenants ..................................49 (iv) Convention on the Elimination of All Forms of Discrimination Against Women ...........................................50 (v) Convention on the Rights of the Child.....................................52 (vi) Convention on the Elimination of All Forms of Racial Discrimination................................................................52 2. Regional Human Rights Instruments .......................................................53 (i) American Declaration of the Rights and Duties of Man........53 (ii) American Convention on Human Rights.................................53 (iii) Protocol of San Salvador ..........................................................54 (iv) The Inter-American Convention on Violence Against Women ....54 3. International Conferences ..........................................................................54 (i) The International Conference on Population and Development.....55 (ii) The Fourth World Conference on Women..............................57 C. Guatemala’s Duty to Implement Human Rights ....................................................57 D. Domestic Sources of Law........................................................................................59 1. Guatemalan Constitution............................................................................59 2. Peace Accords .............................................................................................60 3. Guatemalan Health Code ...........................................................................62 E. Conclusion: Guatemala’s Failure to Provide Access to Family Planning Information and Services Violates its Citizens’ Rights...........................................62 V. Recommendations: Towards Protection of the Human Right to Family Planning in Guatemala ...65 A. Recommendations Regarding National-level Actions ...........................................65 1. Advocating for a Family Planning Law or Policy....................................65 2. Filing Administrative Complaints for Human Rights Violations............67 3. Instituting a Judicial Action......................................................................68 4. Providing Public Education About the Right to Reproductive Health Care..69 5. Seeking MINUGUA’s Support to Ensure Government Action on Family Planning....................................................................................70 B. Recommendations regarding the Inter-American Human Rights System............70 C. Recommendations regarding the International Human Rights System................72 1. United Nations Human Rights Treaty-Monitoring Committees .............72 2. United Nations Human Rights Commission and Rapporteurs................73 VI. Conclusion..........................................................79 Annex I: Summary of Recent Legislative and Policy Developments.........................81 Notes ..............................................................................................................................84 4 guatemala final 2/28/01 12:35 PM Page 5 Acknowledgements This report was written by Katherine Hall Martinez, Deputy Director of the International Program, and Bonnie Scott Jones, Staff Attorney, both of the Center for Reproductive Law and Policy (CRLP) in New York. Carla Rivera-Avni, Fellowship Attorney in CRLP’s Internation- al Program, also contributed significantly by providing research, editing and drafting assistance on portions of the report. The report is based on research undertaken in Guatemala by Ms. Jones in October through December 1998. The authors and CRLP are grateful for the collab- oration of the dozens of individuals who met with Ms. Jones, often on more than one occasion, to contribute their perspectives and knowledge of reproductive health and women’s rights issues in Guatemala. These individuals included officials who work for non-governmental organiza- tions (NGOs), both Guatemalan-based and international, the Guatemalan government, and international agencies and donors, as well as medical doctors and other health professionals, including traditional health practitioners. Although there are too many people to name, those who were particularly generous with their time and in providing invaluable information include: Guatemalan Congresswoman Manuela Alborado; Marianne Burkhart of the Population Council (Guatemala); Dr. Flory Cipriano Ruíz; Gloria Cospín de Hernández of the Asociación Guatemalteca de Educación Sex- ual (AGES); Lic. Hadi Deman and Jackie Rodríguez, Office of the Comprehensive Health Care System, Ministry of Health of Guatemala; Dr. Telma Duarte de Morales of La Asociación Pro Bienestar De La Familia - APROFAM; Edgar Kestler of CIESAR: Centro de Investigación en Salud Reproductiva; María Eugenia Lemus of Tierra Viva; María Eugenia Mijangos Martínez of Centro para la Acción Legal en Derechos Humanos (CALDH); Mirna Montene- gro of the Policy Project; Patricia O’Connor of USAID; Dr. Oscar Palma and Dr. Ernesto Velázquez of the Ministry of Health, Department of Maternity and Infancy; Lic. Patricia Pinto of the Defensoría de los Derechos de la Mujer, Procurador de los Derechos Humanos; and Dr. Karin Slowing Umaña, Programme Office of UNFPA. Despite the contributions of so many, the content of this report, including any inadvertent errors and inaccuracies, remains the sole responsibility of the authors and CRLP. María Eugenia Mijangos Martínez, Director of the Women’s Division of CALDH, acted as a peer reviewer for this report, providing invaluable input on the final draft. Anika Rahman, Director of CRLP’s International Program, Luisa Cabal, Staff Attorney for Latin America and the Caribbean in CRLP’s International Program, and Barbara Becker, Deputy Director of Com- munications at CRLP provided invaluable comments on drafts of this report. Cara Fineman, Janine Shissler and Verónica Fuentes, Legal Interns in CRLP’s International Program, provid- ed research, fact-checking and drafting assistance on portions of this report. Alison-Maria Bar- tolone and Diane Pagen, International Program Assistants, provided research and administra- tive support. Lisa Hibler and Shannon Kowalski-Morton, International Program Assistants, provided invaluable support throughout the production process. 5 guatemala final 2/28/01 12:35 PM Page 6 Glossary of Terms AGES Guatemalan Association for Sexual Education American Convention American Convention on Human Rights American Declaration American Declaration on the Rights
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