Richardson Emma, Birn Anne-Emanuelle
Health and Behavioural Science, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
Reprod Health Matters. 2011 Nov;19(38):183-96. doi: 10.1016/S0968-8080(11)38597-7.
The Programme of Action of the International Conference on Population and Development (ICPD) in 1994 defined strategies and goals for advancing reproductive health and rights that are still far from being reached in Latin America. This paper will use elements of a framework developed by Gruskin et al(1) that analyses the interconnected factors affecting the sexual and reproductive health of people living with HIV. We use and adapt some of these elements to examine the extent to which sexual and reproductive rights have been realized in Latin America since 1994. Specifically, we consider the rights, needs and aspirations of people; the socioeconomic context; national and international law and policy; health systems, services and programmes; the opposition; the perceived high costs of political support; the role of civil society, NGO networks and coalitions; and development aid, donor policy and government funding. There are a growing number of progressive regional and national bodies, organizations, groups and individuals with a commitment to sexual and reproductive health and rights in the region, and many gains have been made in the realization of these rights. However, these gains are only partial, given the acute inequality across ethnic, socioeconomic and geographic lines, and there is evidence of widening gaps. Given the breadth of the subject and the number of countries involved, this paper can cite only a few of the enormous number of examples from the literature. We hope the paper will stimulate further in-depth, critical reviews of these issues at the country and regional level.
1994年国际人口与发展会议（ICPD）的《行动纲领》确定了促进生殖健康和权利的战略与目标，而拉丁美洲在这些方面仍远未实现。本文将采用格鲁斯金等人（1）制定的一个框架中的要素，该框架分析了影响艾滋病毒感染者性健康和生殖健康的相互关联因素。我们运用并调整其中一些要素，以审视自1994年以来拉丁美洲在性权利和生殖权利方面的实现程度。具体而言，我们考虑人们的权利、需求和愿望；社会经济背景；国家和国际法及政策；卫生系统、服务和项目；反对意见；政治支持的高昂成本；民间社会、非政府组织网络和联盟的作用；以及发展援助、捐助方政策和政府资金。该地区有越来越多致力于性健康和生殖健康及权利的进步的区域和国家机构、组织、团体及个人，在实现这些权利方面也取得了许多成果。然而，鉴于族裔、社会经济和地理层面存在严重不平等，这些成果只是部分的，而且有证据表明差距在不断扩大。鉴于该主题的广度和涉及的国家数量，本文只能从文献中列举大量例子中的少数几个。我们希望本文能激发在国家和区域层面就这些问题进行进一步深入、批判性的审视。
