This is an op-ed by ARROW’s Executive Director, Sivananthi Thanenthiran, published in The Star
MALAYSIA has made impressive signs of progress towards women’s health and rights.
This was one of the achievements we celebrated at the commemoration of the 25th anniversary of International Conference on Population and Development’s Programme of Action (ICPD PoA) in Nairobi, Kenya recently.
But ensuring the health and rights of women, and marginalised groups, in the country is a commitment that needs to be upheld in the years to come.
Malaysia was one of 179 countries which signed onto the programme of action at the ICPD held in Cairo, Egypt in 1994. The ICPD Programme of Action continues to be one of the most comprehensive agendas on sustainable development, human development and the inter-linkages with key global and political trends such as the environment, migration, youth, women, health and education.
The PoA is the springboard for all development agendas such as the Sustainable Development Goals – especially Goal 3 on health and Goal 5 on gender equality, which reaffirm the critical.
The state of women’s health and rights in the world is one of the key points of discussion in Nairobi.
In this, Malaysia is a stellar example of the gains that have been made. The reduction of maternal mortality in the 1980s remains until today a case study for other nations to follow suit.
This was achieved by ensuring access to contraception and family planning, training midwives at community levels, ensuring a consistent and comprehensive approach for screening for pregnancy complications and early referral services for delivery complications.
Malaysia’s maternal mortality ratio is the lowest in the Asia-Pacific region at 29, and women in Malaysia face a 1 in 1600 lifetime risk of maternal death.
Malaysia is also one of the nine countries which have also reached the 90% target of skilled attendance at birth and is ranked third, after China and Fiji, with 99.5%.
Even today, if you belong to social media parenting groups – you will more often than not hear rave reviews from female citizens on the reproductive and maternal health care provided by the government sector for some of the most affordable rates in the world.
Within the sexual and reproductive health services ambit – Malaysia also continues to commit to the health of its citizens – achieving recently zero mother-to-child transmission of HIV, and universal vaccination coverage for girls against cervical cancer.
Universal HPV vaccination has been suggested as a means to reduce up to 420,000 deaths due to cervical cancer worldwide.
Malaysia started a national, school-based vaccination programme in 2010, achieving almost universal uptake for full-dose vaccine coverage, far above the global goal of 80%.
Barriers exist to cervical cancer screening, and to address this a new mode of screening is being pilot-tested under Project ROSE (Removing Obstacles to Cervical Screening) which integrates self-sampling, rapid HPV-DNA testing, and e-health so that women receive their appointment reminders and test results by text messaging. In recent years we have been set back by the rising number of teenage pregnancies and early age marriages.
There are many struggles at community and cultural levels to address these issues.
But as our own history shows us – utilising the public health paradigm and a scientific evidence-based and building laws, policies and programmes in line with these would serve as the best way ahead to resolve these issues.
Malaysia is one of those rare countries which has been able to achieve both universal health coverage and almost universal access to health. This is a commitment that needs to be upheld in the years to come, to ensure the continued health and rights of women and marginalised groups.
This will require from our country a commitment to pursue a model of health care that prioritises citizen’s health rights as enshrined in Article 12 of the International Convention on Economic, Social and Cultural Rights – that enables citizens to enjoy the highest attainable standard of physical and mental health; and also in Article 12 of the Convention on the Elimination of All Forms of Discrimination Against Women which pays particular attention to women’s health and equal and equitable access to health services.
In a world where many governments have made the economic decision to privatise social services, – the right to accessible, available, affordable, quality health services and medicines are protected by human rights frameworks.
These frameworks also ensure that groups who are marginalised due to factors such as income, class, ethnicity (indigenous groups) or disability status are also able to enjoy the same rights as all other citizens.