PAKISTAN-ABORTION-TBs-CEDAW

Concluding Observations on Report 5 (2020) (Link)

Health

43. The Committee commends the State party for the adoption of the National Vision 2016–2025 for Coordinated Priority Actions to Address Challenges of Reproductive, Maternal, Newborn, Child, Adolescent Health and Nutrition and its action plan. However, it notes that the action plan fails to specify indicators, targets and budgetary commitments for its implementation. Furthermore, the Committee notes with concern:

(a) The high maternal mortality rate in the State party;

(b) Women’s limited access to family planning services, including modern contraceptives;

(c) Restrictive abortion laws and the large number of women resorting to unsafe abortions, as well as the lack of adequate post-abortion care services;

(d) The high incidence of obstetric fistula in the State party, resulting from prolonged obstructed labour in the absence of skilled birth attendance, as well as iatrogenic fistula, resulting from surgical negligence during caesarean section or hysterectomy;

(e) The subjection of women with disabilities, in particular those living in institutions, to forced sterilization, and the performance of gender reassignment surgery on intersex persons for the purpose of legal gender recognition and victims’ limited access to justice.

44. In line with its general recommendation No. 24 (1999) on women and health, the Committee recommends that the State party ensure the implementation of the National Vision 2016–2025 and its action plan, with clear, time-bound targets, and establish a permanent body to coordinate and monitor their achievement. Furthermore, the Committee recommends that the State party:

(a) Improve women’s access to health-care facilities and to medical assistance provided by trained personnel, especially in rural and remote areas, and ensure the adequate allocation of human and financial resources to the health sector in all provinces and the accessibility and safety of all health services for women and girls;

(b) Strengthen its efforts to reduce the high rate of maternal mortality and ensure access to affordable modern contraceptive methods throughout the State party;

(c) Review its abortion legislation with a view to legalizing abortion in cases of rape, incest, threat to the life or health of the pregnant woman or severe fetal impairment, and with a view to decriminalizing it in all other cases, and prepare guidelines to ensure that women and girls have access to safe post- abortion care;

(d) Address the high incidence of obstetric fistula and the physical and economic barriers resulting in women’s limited access to antenatal, delivery and postnatal care;

(e) Ensure that perpetrators of forced sterilizations are prosecuted and adequately punished, prevent unnecessary gender reassignment surgery in law and in practice, identify and eliminate the barriers preventing victims from gaining access to justice and ensure that they have access to effective reparation, including compensation.

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Concluding Observations on Report 4 (2013) (Link)

Health

31. The Committee is concerned about the high maternal mortality rate in the State party, women’s lack of adequate access to family planning services, including contraceptives, restrictive abortion laws and the large number of women resorting to unsafe abortions, as well as the lack of adequate post-abortion care services. It is further concerned at the wide privatization of the health system and the inadequate budget allocated to the health sector, in particular with regard to sexual and reproductive health-care services, especially in rural remote areas.

32. In line with its general recommendation No. 24 (1999) on women and health, the Committee calls upon the State party:

(a) To expedite the adoption of the pending Reproductive Health Care Bill;

(b) To improve women’s access to health-care facilities and medical assistance by trained personnel, especially in rural and remote areas, and ensure adequate allocation of human and financial resources to the health sector in all provinces;

(c) To strengthen its efforts to reduce the high rate of maternal mortality, and ensure access to affordable contraceptive methods throughout the country;

(d) To review its abortion legislation with a view to expanding the grounds under which abortion is permitted, for example, cases of rape and incest, and prepare guidelines on post-abortion care to ensure that women have access to this type of service;

(e) To ensure that the privatization of the health sector and the devolution to the provinces of the main health competence do not reduce further the already limited health services accessible to women.

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Concluding Observations on Report 1-3 (2007) (Link)

40. The Committee is concerned about women’s lack of access to health care, in particular to sexual and reproductive health services, especially in rural areas, and the link between the rate of abortion and low contraceptive use. Clandestine abortions being a major cause of maternal mortality, the Committee is deeply concerned that abortion is a punishable offence under Pakistani law, which may lead women to seek unsafe, illegal abortions, with consequent risks to their life and health.

41. The Committee calls on the State party to take concrete measures to enhance women’s access to health care, in particular to sexual and reproductive health services, in accordance with article 12 of the Convention and the Committee’s general recommendation 24 on women and health. It requests the State party to take measures aimed at the prevention of unwanted pregnancies, including by making a comprehensive range of contraceptives and family planning methods more widely available and affordable, without any restrictions, and by increasing knowledge and awareness about family planning among women and men. The Committee also calls on the State party to reduce maternal mortality rates by identifying and addressing causes of maternal death. It further calls on the State party to take measures to ensure that women do not seek unsafe medical procedures, such as illegal abortion, because of lack of appropriate services in regard to fertility control. The Committee recommends that the State party review the laws relating to abortion with a view to removing punitive provisions imposed on women who undergo abortion, providing them with access to quality services for the management of complications arising from unsafe abortion and reducing maternal mortality rates, in accordance with the Committee’s general recommendation 24 on women and health and the Beijing Declaration and Platform for Action. Noting the improvement in the indicators of women’s health where the Lady Health Worker programme is being implemented, the Committee recommends that steps be taken to expand this programme to the rural and other areas where they are most needed. The Committee encourages the State party to seek international assistance from the specialized agencies of the United Nations system, including the United Nations Development Programme, the United Nations Population Fund and the World Health Organization, in order to implement measures to enhance women’s access to health care.

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