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Abstract #160209

Rushna Ravji, MD, MPH, MS, Office of Population and Reproductive Health, USAID, 1300 Pennsylvania Ave., N.W., Washington DC, DC 20523, 202-712-4548, rravji@usaid.gov and Anwer Aqil, MD, MPH, DrPH, John Snow Inc., 1616 N. Fort Mayer Drive, Arlington, VA 22209.

Few years back, a sixteen year old girl in a Pakistani village died due to pelvic infection, using dirty clothes as sanitary napkins. She could not tell her mother of her problem because of shame and fear, reflecting discussion on the reproductive and sexual health as taboo. Many misperceptions about gender relationship perpetuate sexual and domestic violence. Unsafe abortion is common by traditional birth attendants but is illegal for health providers. Women bear the major burden of diseases due to segregation, little autonomy, male preferential behaviors, and limited access to health care. The alternative sexual practices are criminalized. This paper provides evidence that reproductive and sexual practices are the results of the social structures and norms and health providers are not immune to them. The policy makers are reluctant to include sexual health or abortion as part of the reproductive health package and consider the right to choose a marriage partner or practice sexual preference outside the health domain. Conservative forces inhibited the Pakistan Government to sign ICPD 1994 Declaration. Method: The evidence comes from surveys and government records. Policy Implications: The debate on reproductive and sexual health issues and rights involves health professionals, policy makers and other political forces. To create an enabling environment where women and men can enjoy their reproductive rights and health, a broad coalition of progressive political forces, public health advocacy groups, women and community organizations is needed. Without creating supportive social structure, norms and values, the reproductive health services will remain limited and underutilized.

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