IV. Pervasive Barriers in Access to Contracepti ves
Human Rights Watch identified three primary barriers to women's access to contraceptives: domestic and sexual violence, the provision of inaccurate and inadequate information by public health officials, and economic constraints, including at times unauthorized fees for contraceptives and related health services that should have been free of charge under the National Law on Sexual Health and Responsible Procreation.
Domestic and Sexual Violence
I was with him for fourteen years.He beat me [and] the mistreatment had become normal. He always told me: "I am going to fill you with children so that you can't leave my side."
-Gladis Morello, age thirty-two, Buenos AiresProvince
Domestic and sexual violence constitute a persistent barrier for women trying to access contraceptives and to control their bodies and reproductive health.Olga Cceres, president of a nongovernmental organization that provides shelter for battered women in Buenos Aires Province, told Human Rights Watch: "The large majority of the women in the shelter live with violence, [including] sexual violence.In those cases, there is no freedom to decide how many children you want to have, or even when you are going to have sex."Cceres explained that a significant number of abusive men deliberately sabotage their wife's or partner's access to contraceptives as part of the control and abuse: "If he gets her pregnant constantly, there is less possibility that she will leave [the abusive relationship]."
The testimony of Romina Casillas, a forty-six-year-old mother of seven, presents one such example.She suffered physical violence at the hands of her husband, who prevented her from using contraceptives: "I didn't want to have that many [children] but he didn't let me [use contraceptives]. ... I would start on the pills when he was away, and he would hide them when he came back. ... I wanted to get an IUD [intrauterine device], but he wouldn't let me. ... I never thought that I would have many children, I thought that I would have four at the most."
In 1999, an estimated 25 percent of all women in Argentina suffered domestic violence on a regular basis, while 50 percent were estimated to suffer some form of gender-related violence at some point in their lives.Of the forty-three women Human Rights Watch interviewed, more than half testified that they had suffered, or were currently suffering, domestic or sexual violence at the hands of their partners.The reasons for pervasive domestic violence are many and complex, not all of which the state is directly responsible for.However, international human rights standards set out specific minimum steps that states must take in order to comply with their obligation to eradicate domestic violence as a form of gender-based discrimination.
The CEDAW Committee, which monitors the implementation of the Convention on the Elimination of All Forms of Discrimination against Women, noted in its General Recommendation No. 19 on Violence against Women that "[g]ender-based violence is a form of discrimination that seriously inhibits women's ability to enjoy rights and freedoms on a basis of equality with men."In the same document, the committee spelled out specific obligations in terms of preventing violence against women, recommending:
States parties should ensure that laws against family violence and abuse, rape, sexual assault and other gender-based violence give adequate protection to all women, and respect their integrity and dignity. Appropriate protective and support services should be provided for victims. Gender-sensitive training of judicial and law enforcement officers and other public officials is essential for the effective implementation of the Convention.
The U.N. Commission on Human Rights, a body of fifty-three states that meets annually to issue recommendations on human rights, has emphasized "that violence against women has an impact on their reproductive and sexual health" and has encouraged states "to ensure that women have access to health care providers who are knowledgeable and trained to recognize signs of violence against women and to meet the needs of patients who have been subjected to violence, in order to minimize the adverse physical and psychological consequences of violence."
Furthermore, the U.N. Committee on Economic, Social and Cultural Rights (CESCR), which monitors the implementation of the International Covenant on Economic, Social and Cultural Rights (ICESCR), has noted that "to eliminate discrimination against women, there is a need to develop and implement a comprehensive national strategy for promoting women's right to health" of which "[a] major goal should be reducing women's health risks, particularly lowering rates of maternal mortality and protecting women from domestic violence."The Committee has further noted that "the realization of women's right to health requires the removal of all barriers interfering with access to health services, education and information, including in the area of sexual and reproductive health."
In Argentina, a 1994 domestic violence law established protective measures for victims of domestic violence, including restraining orders and temporary paternity support.In April 1999, the Argentine congress amended penal code provisions on "crimes against sexual integrity" to bring them more in line with international legal standards, but did not explicitly criminalize marital rape.NGOs have criticized this clear deficiency of the law, and the U.N. Committee on the Elimination of Discrimination against Women has expressed concern that these legal reforms have not prevented the domestic violence problem in Argentina from worsening.Lucila Morn, a twenty-two-year-old woman who was pregnant for the second time when Human Rights Watch interviewed her, was beaten by her husband almost daily.Morn said that she could not leave her abusive relationship, as her husband repeatedly threatened her with keeping their two-year-old daughter:
He beats me for anything.The other day, he almost killed me. I filed a complaint about him one time, but they [the police] told me that they couldn't help me with anything.They gave me a restraining order [but he did not leave]. I don't have help from anyone. [My husband] says: 'If you want to leave, go, but you are leaving my daughter here.'And so he has me.
Morn's situation was further complicated by the local public hospital's refusal to give her a tubal ligation-due to discriminatory hospital regulations-despite a heart condition that her doctor said makes pregnancy a health hazard for her.
A community educator working with low income women affected by violence in Buenos Aires Province told Human Rights Watch that the government's response to domestic violence, in particular that of police officers, was seriously deficient:
With regard to violence, so much needs to happen. If they [the women] don't go to the police with the law in their hands, [the police] doesn't take the complaint. Because they start asking you why he hit you, and let's see if he really hit you. Sometimes they don't even want to take down a testimony, or they take your testimony, but they don't file the complaint.There are many police stations, but none of them file the complaint.
One fundamental deficiency in the state's response to violence is the lack of shelters for women affected by domestic and sexual violence.A community organizer from Santa Fe Province told Human Rights Watch: "There are two state institutions [in Santa Fe City] that deal with this subject [domestic violence], but they don't have anywhere to send the women so that they are not killed.Because they are killed."
The National Program on Sexual Health and Responsible Procreation only addresses violence in passing, and implementing regulations offer no specifics as to how to prevent intimate partner violence from posing an obstacle to women's independent decision-making in the area of reproductive health.The vast majority of the public hospitals and clinics implementing the program that Human Rights Watch visited were not required or encouraged to detect domestic or sexual violence in patients and counsel patients on these issues.
Misleading, Inaccurate, or Incomplete Information
The women Human Rights Watch interviewed had limited access to contraceptives for a host of reasons, some of which had to do with a generalized level of misinformation regarding reproduction and contraception.Mara del Huerto Terceiro, a lawyer from a policy organization working on access to family planning, lamented: "There is no permanent information, and there is no sex education in the schools.The result is that you continue to be uninformed."  In April 2005, Argentina's government started addressing this issue, notably through the launch of a public information campaign in television, radio, and print press, announcing access to contraceptives as a right, and referring individuals and couples to public health centers for further information. 
However, the central government's demonstrated political will does not always overcome fear and opposition from the public officials who are directly responsible for women's enjoyment of their human rights in the reproductive area.We found that public health officials at times contributed to the existing lack of understanding by providing women with misleading, incomplete, or inaccurate information about contraception.Women we interviewed were often badly placed to demand more accurate or complete information, either because they were unaware that they were being misinformed, or because they did not feel in a position to challenge a medical authority.Considering the disadvantaged economic position of most users of public health facilities, and a related disadvantage in access to education and information, public health officials, as detailed below, did not show the kind of commitment necessary to ensure that women receive essential health information. The net result was that women many times were left with severely limited choices with regard to when and if to have children, even within the already limited range of contraceptive methods legally available to them.
Human Rights Watch found that, in many cases, public health officials offered women access to a more limited range of contraceptives than permitted by law or distributed by the government.Some women testified that doctors in the public health system actively discouraged them from using the contraceptives donated by the state, either by telling them that the contraceptives were not of good quality, or by giving misinformation about some methods."I went to a gynecologist [and] I opted for the pill.But then she said that after [taking the pill] I would have to have treatment to become pregnant again, and that it wasn't worth it," recalled Mara Rivara, thirty-seven, who had eight children.  Paola Mndez, thirty-five and mother of ten, wanted to get an intrauterine device (IUD), but the public health doctor told her that it would not prevent pregnancies, and that it might, in fact, damage a future child: "I wanted to get an IUD, but you know they say that many are born with the IUD in their heads.The doctor himself explained to me that the majority, almost all of them, are born with the IUD in their heads." 
In other cases, women were not told about side effects that may render certain contraceptive methods ineffective, such as use of antibiotics while on hormonal contraception.  In the case of Laura Passaglia, thirty-two, a doctor in the public health system prescribed antibiotics to her without informing her that this treatment was likely to interfere with the effectiveness of the hormonal contraception he also prescribed to her on a monthly basis.Passaglia said: "I took the [contraceptive] pill.But I got pregnant all the same. I was always on antibiotics for a urinary tract infection. They never told me anything about that [that antibiotics may interfere with the contraceptive actions of the pills]."  While taking hormonal contraception, Passaglia had five unwanted pregnancies, in addition to her existing three children and one miscarriage.
Human Rights Watch did not interview any medical doctors who admitted to misinforming patients about contraceptive methods.However, the vast majority of the doctors we interviewed expressed some variant of the idea that they were better placed than the women they treat to make decisions about how the women should control their fertility.Lus Robles, head of the maternity program at FormosaProvince health ministry told Human Rights Watch that the hospitals in that province routinely injected women with hormonal contraception without ensuring consent, in a blatant violation of women's right to bodily integrity.Robles noted that this practice was particularly common when the women were hospitalized for post-abortion care, because in those cases it was assumed that the woman had deliberately refused to use contraceptives: "A woman [who is hospitalized for post-abortion care] has used abortion as contraception.[When she] is discharged, we give her contraception. Whether she wants it or not, we inform her, and inject her." 
Though Human Rights Watch did not interview women from FormosaProvince, our interviews from elsewhere in the country suggested that many women with unwanted pregnancies-whether or not they ended in illegal and unsafe abortions-had been prevented from using any type of contraception due to abusive relationships, insufficient information, or lack of financial resources.
Robles' comment illustrates the fact that many competing factors impede women's possibility to make informed and independent decisions about their contraceptive use.Whereas most women Human Rights Watch interviewed were denied information about a full range of contraceptive methods in the public health system, some noted that doctors prescribed contraceptives "as if they were aspirin" to women with more than three children, regardless of the individual woman's desire to have more children. 
The U.N. Committee on Economic, Social and Cultural Rights has interpreted the "right to prevention, treatment and control of diseases" to impose a positive obligation on states parties to take steps necessary for the "prevention, treatment and control of epidemic, occupational and other diseases," including the "establishment of prevention and education programmes for behaviour-related health concerns such as those adversely affecting sexual and reproductive health."  According to the committee, the right to the enjoyment of the highest attainable standard of health includes the right to information and education concerning prevailing health problems, their prevention and their control.  In the context of "specific legal obligations," the committee notes:
States should refrain from limiting access to contraceptives and other means of maintaining sexual and reproductive health, from censoring, withholding or intentionally misrepresenting health-related information, including sexual education and information, as well as from preventing people's participation in health-related matters. . . . States should also ensure that third parties do not limit people's access to health-related information and services. 
Moreover, accurate and full information on contraception and sexual health should be understood as being contained in the right to the highest attainable standard of health protected by article 12 of the International Covenant on Economic, Social and Cultural Rights. 
The U.N. Committee on the Rights of the Child has explained that this right extends to adolescent girls.The Convention on the Rights of the Child, which under Argentine law is incorporated into the constitution, recognizes the right of children to enjoy "the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health."  According to the U.N. Committee on the Rights of the Child which interprets the convention, adolescents "have the right to access adequate information essential for their health and development and for their ability to participate meaningfully in society."  This implies that states parties have an obligation "to ensure that all adolescent girls and boys, both in and out of school, are provided with, and not denied, accurate and appropriate information on how to protect their health and development and practise healthy behaviours [including] information on safe and respectful social and sexual behaviours." 
Accurate information on contraception would seem particularly important in the Argentine context, where 17.5 percent of all infants were born to adolescent mothers in 2003 and 34 percent of adolescents did not use any type of contraception during their first sexual intercourse according to a 2004 poll.  Indeed, Argentina's health minister has acknowledged the importance of sex education on several occasions, always drawing vehement opposition from conservative groups. 
Women Human Rights Watch interviewed identified their poverty as a decisive factor in their inability to access contraceptives and thus to exercise independent decision-making about if and when to have children.The government has recognized some dimensions of this problem.In fact, one of the main stated objectives of the National Program on Sexual Health and Responsible Procreation is to provide all legal contraceptive methods free of charge through the public health system.This policy, however, is not being implemented effectively and many poor women still are made to pay.
A number of the women Human Rights Watch interviewed testified that public health workers charged them for services that should have been free under the National Program on Sexual Health and Responsible Procreation."The state gives you the IUD [intrauterine device] for free, but they charge you for the checkup, 15 pesos [U.S.$5.05]" said Norma Jimnez, thirty-five, who had been pregnant six times.Paola Vsquez, a twenty-seven-year-old mother of three, had the same experience: "There are some places [public health clinics] where they give [contraceptives] for free, and other places [public health clinics] where they don't give it for free."
When the cost of a consultation, a medical analysis, or the transport to the public hospital where the program is implemented is added to the cost of the contraceptive method itself, moreover, women we interviewed were essentially left to choose between food and shelter or paying for contraceptives.
Given this choice, many women chose to feed themselves and their families.Romina Redondo, thirty-two, exclaimed: "One does not have 30 pesos [U.S.$10.10] every month for an injection. Where do we get 30 pesos for an injection, when we are living off the head of household program with 150 pesos [U.S.$50.14] a month?"Marisa Rossi, thirty-six, noted that sometimes the choice was between food and condoms: "[Condoms] cost 2.50 pesos for three.For that money, you can buy a kilo of bread or a couple of liters of milk."
In most cases, public hospitals did not allow women to set up appointments in advance or over the phone, adding to the economic burden that the access to contraceptives represented because further travel was needed or because the women had to take time off work to go to the hospital: "You have to go at four in the morning [and] they give you an appointment at eight, nine, ten, eleven. If you don't get an appointment, sometimes they give you one for another day," said Romina Casillas, forty-six.Yanina Carlotto, forty-six, asked: "If you have to feed your children, how can you spend 2.50 pesos [U.S.$0.84] on the bus [to get to the hospital]?"Ana Snchez, forty-three, said: "People don't have money, even if it is a small ticket.Sometimes you don't have 3 pesos [U.S.$1.01] to come and go [to the health center], and then you have to come and go again."Mariana Porcel, thirty-one, said of going to the public hospital for contraceptives: "You can't work the whole morning, you have to wait twenty appointments.And if you don't go [to work] a full day, you can't feed your children."Women who use hormonal contraceptives based on a monthly cycle have to repeat the ordeal of getting to the public hospital every month: "Every month you have to go get [the pills]. They give you a card, and when you get the pills, they mark it up," Romina Casillas said.
The U.N. Committee on Economic, Social and Cultural Rights has addressed the issue of economic constraints in its interpretative statement on the right to health, noting that "health facilities, goods and services must be affordable for all [ and that] poorer households should not be disproportionately burdened with health expenses as compared to richer households."
Most women Human Rights Watch interviewed felt that they could not afford to have more children without compromising the welfare of their existing family, yet they were also unable to afford contraceptives.The fact that economic constraints played a significant role for the women we interviewed in deciding how many children to have is, of course, not unique to Argentina, nor is it unique to so-called developing countries.However, economic constraints on voluntary motherhood impose a particularly heavy burden on women who are simultaneously denied the right to decide freely on the use and method of contraception, and on access, when needed, to safe abortions.
Jazmin Castaa, a twenty-four-year-old mother of three, explained to Human Rights Watch how her decisions about if and when to have children were constrained by economic concerns.Castaa had first become pregnant at seventeen, unplanned, and had decided to continue the pregnancy "because I don't agree with abortion."However, despite her personal disapproval of abortion, she felt that she would not be able to justify having another child in her current economic circumstances, should her method of contraception fail:
After the last [third] child, I don't want to have any more. I work in the head of household program for 150 pesos a months [U.S.$50.14]. [My husband] drives a cab, and that is bread for today and not for tomorrow. As I am doing, there is not enough [money] to have another one.I think that if I had to do it [have an abortion], it hurts my soul and may God forgive me, but I don't know that I wouldn't do it.And I am telling you that I don't agree with abortion.
The implementation of the National Program on Sexual Health and Responsible Procreation is an essential step in making contraceptive methods affordable to more women.However, the government needs to ensure closer oversight to ensure that public hospitals do not charge women for contraceptives and services that they are required to provide for free of charge. In addition, Human Rights Watch believes that the government should help women overcome other economic obstacles to access by facilitating the implementation of the program through primary health care centers and not-as is the case now-mostly through hospitals.Primary health care centers are generally smaller, more numerous, and geographically more spread out and therefore accessible to many more women.
While the national government has plans to extend the program to primary health care centers, the program is still concentrated in hospitals.There is some evidence that key officials do not see this issue as a priority.Ins Martnez, the implementation coordinator of the National Program on Sexual Health and Responsible Procreation, told Human Rights Watch: "I am not worried about [the program] existing only in hospitals, because the population itself disdains the primary health level: they prefer to go to the hospital and stand in line."The women Human Rights Watch interviewed stated quite clearly that this was not true in their cases.Mariana Porcel, thirty-two, said: "They should have the conditions [to give contraceptives and services] in the health centers, now they send us to the hospitals. You can't work a whole morning. [And] if you don't go [to work] a full day, you can't feed your children.Yanina Carlotto, forty-six, noted: "Information is the basis for everything, but also access.They [the public health system] have to get closer [to their clients]."
 Human Rights Watch interview with Gladis Morello, Buenos AiresProvince, October 2004.Morello moved in with her husband when she was eighteen, and had ten pregnancies during her fourteen-year physically and sexually abusive marriage, including two miscarriages due to the violence.
 Sexual violence may also increase the risk of sexually transmitted infections, including and especially HIV.Forced or coerced sex creates a risk of trauma: when the vagina is dry and force is used, genital injury is more likely, increasing the risk of transmission.Forced oral sex may cause tears in the skin, also increasing the risk of HIV transmission.
 Human Rights Watch interview with Olga Cceres, president, Mara Pueblo, Buenos AiresProvince, October 18, 2004.
 Human Rights Watch interview with Romina Casillas, Santa FeProvince, September 2004.
 M. Buvinic, A Morrison, and M. Shifter, "La violencia en las Amricas: marco de accin" [Violence in the Americas: a Framework for Action], in A. Morrison and M. Loreto Biehl (eds.), El costo del silencio: violencia domstica en las Amricas [The Cost of Silence: Domestic Violence in the Americas], (Washington, D.C.: Inter-American Development Bank, 1999), pp. 3-34.
 The implementation of the main human rights treaties under the United Nations human rights system is supervised by committees-called treaty monitoring bodies-made up of independent experts selected from the states parties to the respective treaties.The treaty monitoring bodies include the Human Rights Committee, the Committee on Economic, Social and Cultural Rights, the Committee on the Rights of the Child, the Committee against Torture, the Committee on the Elimination of Racial Discrimination, and the Committee on the Elimination of Discrimination against Women.These committees receive periodic reports from states parties which they review in dialogue with the states.After such reviews, the committees issue conclusions and recommendations-generally called concluding remarks-regarding the fulfillment of the rights protected by the conventions they monitor in that specific country.The growing body of concluding remarks issued by the committees provides an important guide for the committees' thinking on the concrete status and scope of the rights protected under the United Nations system.The committees also sometimes issue conceptual guidelines on the implementation of a specific human right-called general comments or general recommendations.These general comments or recommendations provide yet another source on the evolving authoritative interpretation of the human rights in question.
 Committee on the Elimination of Discrimination against Women (CEDAW Committee), General Recommendation No. 19: Violence Against Women, para. 1, in "Compilation of General Comments and General Recommendation Adopted by Human Rights Treaty Bodies," May 12, 2004, U.N. Doc. HRI/GEN/1/Rev.7.
 Ibid., para. 24(b).
 Commission on Human Rights, "Elimination of Violence against Women," Resolution 2004/46, April 20, 2004 (adopted without a vote), para. 7.
 Committee on Economic, Social and Cultural Rights, "The right to the highest attainable standard of health (General Comments), General Comment 14," August 11, 2000, U.N. Doc. E/C.12/2000/4, para. 21.
 Ley 24.417/94 [Law 24.417], Proteccin contra la Violencia Familiar [Protection against Domestic Violence], article 4.
 Historically, in Latin America as in the United States the "good" that laws addressing sexual violence most often aimed to protect was the "honor" of the victim and not the victim herself.This notion finds it most explicit form in laws that exonerate the perpetrator of a rape if he marries the victim of the rape, under the reasoning that the honor would be restored.This was the case in Argentina until the reform in 1994 (and is still the case in Bolivia and Brazil, for example).Women's rights activists in Argentina have argued that even though the new law implicitly criminalizes marital rape, the law's silence on this topic contributes to maintain a strong judicial bias toward marriage as an exonerating factor in rape cases.Human Rights Watch interview with Silvia Chejter, sociologist, Centro de Encuentros Cultura y Mujer CECYM [Center for Culture and Women], Buenos Aires, August 13, 2003.
 Centro de Encuentros Cultura y Mujer [Women and Cultural Convergence Center], Violacin marital (Boletn) [Marital Rape (Bulletin)], 2002 [online] http://www.cecym.org.ar/pdfs/violacionmarital.pdf (retrieved December 2, 2004).
 CEDAW Committee, "Report of the Committee on the Elimination of Discrimination against Women, twenty-sixth session, twenty-seventh session, exceptional session," U.N. Doc. A/57/38, May 2, 2002, para. 364.Argentina's fifth periodic report to the CEDAW Committee noted that the number of complaints filed regarding domestic violence had doubled from 1995 to 2000.Committee on the Elimination of Discrimination against Women, "Consideration of reports submitted by States parties under Article 18 of the Convention on the Elimination of All Forms of Discrimination against Women, Fifth Periodic Reports, Argentina," U.N. Doc. CEDAW/C/ARG/5, February 11, 2002, p. 32. Some of the increase may be the result of the new legislative framework which might encourage complaints.
 Human Rights Watch interview with Lucila Morn, Buenos AiresProvince, October 2004.
 For a full description of limitations generally implemented in Argentina on women's access to voluntary tubal ligation and their illegality under international law, see section V below.In the case of Lucila Morn, the procedures that prevented her from accessing voluntary tubal ligation were discriminatory by denying her access based on her young age.According to the World Health Organization, youth is not, healthwise, a contraindication to surgical sterilization.Moreover, in Morn's case, the same public health workers who refuse to sterilize her also warn her against getting pregnant again under any circumstances, due to her heart condition.
 Human Rights Watch interview with Lucia Lucena, community educator, Decidir [Decide], Moreno, Buenos AiresProvince, October 19, 2004.
 Human Rights Watch interview with Mabel Busaniche, community organizer, Santa Fe, Santa FeProvince, September 13, 2004.
 Ley Nacional 25.673 [National Law 25.673], Creacin del Programa Nacional de Salud Sexual y Procreacin Responsable [Creation of the National Program on Sexual Health and Responsible Procreation], October 30, 2002, article 2(a): "Sern objetivos de este programa: (a) Alcanzar para la poblacin el nivel ms elevado de salud sexual y procreacin responsable con el fin de que pueda adoptar decisiones libres de discriminacin, coacciones o violencia" [It will be the objectives of this program [National Program on Sexual Health and Responsible Procreation]: (a) To achieve the highest attainable level of sexual health and responsible procreation for the population with the purpose of enabling it to make decisions free of discrimination, coercion, or violence].
 See Decreto Nacional 1.282/2003 [National Decree 1.282/2003], Reglamentacin de la Ley Nacional 25.673 de Creacin del Programa Nacional de Salud Sexual y Procreacin Responsable [Regulation of National Law 25.673 on the Creation of the National Program on Sexual Health and Responsible Procreation], May 23, 2003.
 Human Rights Watch interview with Mara del Huerto Terceiro, lawyer, Asociacin Argentina de Planificacin Familiar (AAPF) [Argentine Association on Family Planning], Buenos AiresCity, October 14, 2004.
 "El gobierno lanz una campaa de salud reproductiva" [Government launches campaign on reproductive health], La Nacin (Argentina), April 29, 2005.
 Human Rights Watch interview with Mara Rivara, Buenos AiresProvince, October 2004.
 Human Rights Watch interview with Paola Mndez, Buenos AiresProvince, October 2004.According to Human Rights Watch's interviews with public health officials, no such cases have been reported.Moreover, the general failure rate of intrauterine devices-i.e. the percentage of women experiencing unintended pregnancies in the first year of use-is between 0.1 and 2 percent for typical use, depending on the type of device implanted.Robert A. Hatcher et al, Contraceptive Technology (New York: Ardent Media, 1998), p. 514.
 An on-line guide on family medicine warns in an article that reviews the interaction between hormonal contraception and antibiotics: "Most of the availabledata do not indicate any major reduction in the efficacy ofOCPs [oral contraceptive birth contral pills] with concurrent common antibiotic use.However, these studiescannot reliably exclude a small decrease in efficacy especiallyin the "low-dose" (<35 g of estrogen) combinationOCPs. With several well-known resources suggesting alternativecontraception during antibiotic use, pragmatically it is importantto inform all female patients of the possible interaction."Kevin E. Burroughs, MD; M. Lee Chambliss, MD, MSPH Greensboro, NC, "Antibiotics and Oral Contraceptive Failure" (emphasis added) Archives of Family Medicine [online] http://archfami.ama-assn.org/cgi/content/full/9/1/81 (retrieved February 4, 2005).
 Human Rights Watch interview with Laura Passaglia, Buenos AiresProvince, October 2004.
 Human Rights Watch interview with Lus Robles, head, Programa de Maternidad [Maternity Program], Ministerio de Salud de Formosa [Formosa Province Health Ministry], Castelar, Buenos AiresProvince, September 6, 2004.
 Human Rights Watch interview with [name withheld], head of maternity ward at public hospital [province withheld], September 2004; and with Julie Reina, TucumnProvince, September 2004.
 Committee on Economic, Social and Cultural Rights, The right to the highest attainable standard of health (General Comments), General Comment 14, August 11, 2000, U.N. Doc. E/C.12/2000/4, para. 16; and para. 36 (states must promote "health education, as well as information campaigns, in particular with respect to HIV/AIDS").
 Ibid., paras. 12(b), 16 and note 8.
 Ibid., paras. 34-35.
 ICESCR,article 12.
 Convention on the Rights of the Child (CRC), G.A. Res. 44/25, entered into force September 2, 1990 and ratified by Argentina on December 4, 1990, article 24.
 Committee on the Rights of the Child, "General Comment No. 4: Adolescent Health and Development in the Context of the Convention on the Rights of the Child" U.N. Doc. CRC/GC/2003/4, July 1, 2003, para. 26.
 "Ministro argentino preocupado por abortos y embarazo adolescente" [Argentine Minister Worried about Abortion and Adolescent Pregnancies], Associated Press, Diario La Estrella (Madrid), November 13, 2004; and "Polmica por despenalizacin del aborto llega al ms alto nivel argentino" [Polemic about Decriminalization of Abortion Reaches the Highest Level in Argentina], Agence France Presse, November 27, 2004.
 See "Ministro argentino preocupado por abortos y embarazo adolescente" [Argentina Minister Worried about Abortion and Adolescent Pregnancies], Associated Press, Diario La Estrella (Madrid), November 13, 2004; "Para Ministro de Salud, si no se educa sobre sexo en la escuela primaria 'se pierde una oportunidad'" [For Minister, 'We Lose an Opportunity' by Not Educating on Sex in Primary Schools], Agencia Diarios y Noticias, October 1, 2004; and Guillermo Villarreal, "Silenciosa Ofensiva" [Silent Offensive], Agencia Diarios y Noticias, September 24, 2004.
 Ley 25.673 [Law 25.673], National Law on Sexual Health and Responsible Procreation, article 2(f).The full article reads: "Sern objetivos de este programa [Programa Nacional de Salud Sexual y Procreacin Responsable]: a) Alcanzar para la poblacin el nivel ms elevado de salud sexual y procreacin responsable con el fin de que pueda adoptar decisiones libres de discriminacin, coacciones o violencia; b) Disminuir la morbimortalidad materno-infantil; c) Prevenir embarazos no deseados; d) Promover la salud sexual de los adolescentes; e) Contribuir a la prevencin y deteccin precoz de enfermedades de transmisin sexual, de vih/sida y patologas genital y mamarias; f) Garantizar a toda la poblacin el acceso a la informacin, orientacin, mtodos y prestaciones de servicios referidos a la salud sexual y procreacin responsable; g) Potenciar la participacin femenina en la toma de decisiones relativas a su salud sexual y procreacin responsable." [It will be the objectives of this program [National Program on Sexual Health and Responsible Procreation]: a) To achieve the highest attainable level of sexual health and responsible procreation for the population with the purpose of enabling it to make decisions free of discrimination, coertion, or violence; b) To diminish mother-child morbi-mortality; c) to prevent unwanted pregnancies; d) To promote sexual health in adolescents; e) To contribute to the prevention and early detection of sexually transmitted diseases, of HIV/AIDS, and of genital and mammary pathologies; f) To guarantee to the full population access to information, orientation, methods, and the provision of services related to their sexual health and responsible procreation."
 Human Rights Watch interview with Norma Jimnez, Santa FeProvince, September 2004.
 Human Rights Watch interview with Paola Vsquez, Santa FeProvince, September 2004.
 The Head of Household Program [Programa Jefes y Jefas de Hogar] was created in 2002 to provide emergency income for the economically vulnerable population.Those inscribed in the program receive 150 pesos per month in exchange for some community service.It is administered by Decreto Nacional 565/2002 [National Decree 565/2002].
 Human Rights Watch interview with Romina Redondo, Santa FeProvince, September 2004.
 Human Rights Watch interview with Marisa Rossi, Buenos AiresProvince, October 2004.
 Human Rights Watch interview with Romina Casillas, Santa FeProvince, September 2004.
 Human Rights Watch interview with Yanina Carlotto, Buenos AiresProvince, October 2004.
 Human Rights Watch interview with Ana Snchez, Buenos AiresProvince, October 2004.
 Human Rights Watch interview with Mariana Porcel, Santa FeProvince, September 2004.
 Human Rights Watch interview with Romina Casillas, Santa FeProvince, September 2004.
 Committee on Economic, Social and Cultural Rights, "The right to the highest attainable standard of health (General Comments), General Comment 14," August 11, 2000, U.N. Doc. E/C.12/2000/4, para. 12(b).
 The exchange rate used in this report is 2.97 Argentine pesos to one U.S. dollar, the exchange rate on December 3, 2004, unless otherwise indicated.
 Human Rights Watch interview with Jazmn Castaa, TucumnProvince, September 2004.
 Human Rights Watch interview with Ins Martnez, head, National Program on Sexual Health and Responsible Procreation, Ministerio de Salud de la Nacin [National Health Ministry], October 21, 2004.
 Human Rights Watch interview with Mariana Porcel, Santa FeProvince, September 2004.
 Human Rights Watch interview with Yanina Carlotto, Buenos AiresProvince, October 2004.