Since 1992, the Center’s innovative legal work has fundamentally transformed the landscape of reproductive health and rights worldwide, and has already strengthened laws and policies in more than 50 countries. CRR in the Field is a personal look at the various ways Center staff interacts with plaintiffs, policy makers, governing bodies, and supporters at home and abroad to further the fight for reproductive rights.
Name: Adriana Lamačková Position: Legal Adviser for Europe Reporting from: Slovakia and Poland
Q: The Center recently launched a fact-finding report with its partners on access to contraceptives in Slovakia. What were the findings of the report?
A: The report confirmed that many women and adolescent girls in Slovakia face numerous barriers in accessing modern contraceptive methods and contraceptive information. Because contraceptives are not covered by public health insurance, men and women must pay the full price out of pocket. The interviews with women and various other stakeholders showed that the high price of contraceptives is prohibitive for some women and adolescent girls, such as those with low income or in violent relationships, and keeps others from using the method that would be most suitable based on their health, personal circumstances, or preferences.
Other structural barriers, most notably to comprehensive and accurate information—such as inadequate sexuality education, parental consent requirements for minors who want to use contraceptives, and insufficient information provided by some gynecologists—further limit women’s and adolescent girls’ ability to make unconstrained decisions regarding their fertility. Several social barriers, such as community pressure in rural areas and a lack of male involvement, were also consistently raised by our interviewees.
Q: What response did the report receive in Slovakia?
A: The launch of the report was attended by representatives from various governmental and non-governmental organizations across the spectrum as well as by the head of the World Health Organization Country Office in Slovakia and the Dutch Ambassador to Slovakia. In general, the participants supported the findings and recommendations of the report.
We also had individual meetings with the Ministry of Health, the Directorate General of the Deputy Prime Minister for Human Rights and National Minorities, and with the Parliamentary Committee on Health Care. The majority of them acknowledged that steps need to be undertaken to improve access to contraceptives in Slovakia. That does not mean, however, that there is a general political will to do so. Advocates need to continue raising awareness about these issues especially among politicians who often lack knowledge of and interest in reproductive health and women’s human rights, and hold them accountable for not fulfilling their obligations.
Q: What are the next steps for promoting access to contraceptives in Slovakia and in Central and Eastern Europe generally?
A: In the short term, the Center and its partners are continuing to advocate against a bill introduced by the Slovak Ministry of Health this past February. The bill proposes to exclude contraceptives used for pregnancy prevention from any public health insurance coverage. We submitted a written comment supported by other organizations and individuals where we are requesting to remove this proposal. Several state institutions adopted our arguments introduced in the comment and also requested the ministry to take back the proposal.
Our long term goal is to keep advocating for contraceptives to be financially affordable through public health insurance schemes and for improving access to contraceptive information through mandatory sexuality education in schools. This applies to whole Central and Eastern European region.
Q: You recently attended a conference in Poland about advancing sexual and reproductive rights in Central and Eastern Europe. What are some of the key issues that advocates are working on in the region?
A: In general, advocates in CEE are dealing with increasing attacks on abortion laws in their countries. A lack of access to a wide range of affordable contraceptive services and absence of mandatory sexuality education in schools are other key issues. Moreover, unregulated or inadequately regulated practice of conscientious objection is becoming a tool in restricting access to reproductive health services, especially to abortion, contraception and prenatal examinations.
Q: What are some of the challenges to advancing reproductive rights in Central and Eastern Europe?
A: It is primarily the powerful role of the Catholic Church hierarchy that has been playing in politics in many CEE countries as well as a growing opposition coming from the Orthodox Church to reproductive health issues. Lack of financial support is another significant challenge faced by the non-governmental organizations advocating for sexual and reproductive health and rights in the region.
Q: What is the Center doing to address some of these challenges?
A: Over the years we have been providing technical support in strategic litigation and advocacy activities. –For example, the Center, with our partners in Poland and Moldova, recently filed several cases in the European Court of Human Rights regarding access to abortion and medical care. At the UN level, we have just submitted shadow letters on Moldova, Russia, and Slovakia to the upcoming session of the Committee on Economic, Social and Cultural Rights. In these submissions we have addressed the main problems women and adolescent girls experience in the enjoyment of their reproductive rights. In addition, we recently submitted a legal and policy memorandum with our partner in Hungary regarding a provision of the newly adopted Constitution on protection of life from conception.