مسودة الاستراتيجية العالمية بشأن توقي ومكافحة الأمراض المنقولة جنسيا: تقرير من الأمانة

‫ﻤﻨﻅﻤـﺔ ﺍﻟﺼﺤـﺔ ﺍﻟﻌﺎﻟﻤﻴـﺔ‬ ‫ﺝ‪١١/٥٩‬‬ ‫‪ ١٨‬ﺃﻴﺎﺭ‪ /‬ﻤﺎﻴﻭ ‪٢٠٠٦‬‬ ‫‪A59/11‬‬

‫ﺠﻤﻌﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺍﻟﺘﺎﺴﻌﺔ ﻭﺍﻟﺨﻤﺴﻭﻥ‬ ‫ﺍﻟﺒﻨﺩ ‪ ٦-١١‬ﻤﻥ ﺠﺩﻭل ﺍﻷﻋﻤﺎل ﺍﻟﻤﺅﻗﺕ‬

‫‪‬ﺩﺓ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺒﺸﺄﻥ‬ ‫ﻤﺴﻭ‬ ‫ﺎ‬ ‫ﺘﻭﻗﻲ ﻭﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺘﻘﺭﻴﺭ ﻤﻥ ﺍﻷﻤﺎﻨﺔ‬ ‫ﻁﻠﺒﺕ ﺠﻤﻌﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺇﻟﻰ ﺍﻟﻤﺩﻴﺭ ﺍﻟﻌﺎﻡ‪ ،‬ﻓﻲ ﺍﻟﻘﺭﺍﺭ ﺝ ﺹ ﻉ‪ ،١٤-٥٣‬ﻭﻀﻊ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻋﺎﻟﻤﻴﺔ‬ ‫‪-١‬‬ ‫ﺎ‪ .‬ﻭﻓﻲ ﻋﺎﻡ ‪،٢٠٠٣‬‬ ‫ﺨﺎﺼﺔ ﺒﺎﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﻟﻤﻭﺍﺠﻬﺔ ﺃﻭﺒﺌﺔ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﻭﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺒﺎﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺸﺎﻤﻠﺔ ﻟﻘﻁﺎﻉ ﺍﻟـﺼﺤﺔ‬ ‫ﺍﻋﺘﻤﺩﺕ ﺠﻤﻌﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺍﻟﻘﺭﺍﺭ ﺝ ﺹ ﻉ‪ ٣٠-٥٦‬ﺍﻟﺫﻱ ﻴﺤﻴﻁ ﻋﻠﻤﹰ‬ ‫ﻟﻤﻜﺎﻓﺤﺔ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪ ١،‬ﻭﺃﻗﺭﺕ ﻓﻲ ﺍﻟﻌﺎﻡ ﺍﻟﺘﺎﻟﻲ‪ ،‬ﻓﻲ ﺍﻟﻘﺭﺍﺭ ﺝ ﺹ ﻉ‪ ،١٢-٥٧‬ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺘـﺴﺭﻴﻊ‬ ‫‪‬ﺩﺓ ﺍﻻﺴـﺘﺭﺍﺘﻴﺠﻴﺔ‬ ‫ﺍﻟﺘﻘﺩﻡ ﻨﺤﻭ ﺒﻠﻭﻍ ﺍﻷﻫﺩﺍﻑ ﻭﺍﻟﻤﺭﺍﻤﻲ ﺍﻟﺩﻭﻟﻴﺔ ﺍﻟﻤﺘﺼﻠﺔ ﺒﺎﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪ .‬ﻭﻴﺸﻜل ﺘﻘـﺩﻴﻡ ﻤـﺴﻭ‬ ‫ﺍﻟﻌﺎﻟﻤﻴﺔ ﺒﺸﺄﻥ ﺘﻭﻗﻲ ﻭﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻟﻠﺤﻘﺒﺔ ‪ ٢ ٢٠٢٥-٢٠٠٦‬ﺍﻟﺨﻁﻭﺓ ﺍﻟﺘﺎﻟﻴﺔ ﻓﻲ ﺍﻻﺴـﺘﺠﺎﺒﺔ‬ ‫ﻟﻠﻁﻠﺏ ﺍﻟﻭﺍﺭﺩ ﻓﻲ ﺍﻟﻘﺭﺍﺭ ﺝ ﺹ ﻉ‪.١٤-٥٣‬‬ ‫‪‬ﺩﺓ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺒﻌﺩ ﻤﺸﺎﻭﺭﺍﺕ ﻤﺴﺘﻔﻴﻀﺔ ﺸﻤﻠﺕ ﺠﻤﻴﻊ ﺍﻷﻗﺎﻟﻴﻡ ﻭﺸﺎﺭﻙ ﻓﻴﻬـﺎ ﻤﻤﺜﻠـﻭ‬ ‫ﻭﻗﺩ ﺘﻡ ﻭﻀﻊ ﻤﺴﻭ‬ ‫‪-٢‬‬ ‫ﻭﺯﺍﺭﺍﺕ ﺍﻟﺼﺤﺔ ﻭﻤﻨﻅﻤﺎﺕ ﻏﻴﺭ ﺤﻜﻭﻤﻴﺔ ﻭﺸﺭﻜﺎﺀ ﻤﻥ ﻤﻨﻅﻭﻤﺔ ﺍﻷﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ ﻭﺍﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﺍﻟﺨﺎﺹ ﻭﺴـﺎﺌﺭ‬ ‫ﹸﻅﻤﺕ‪،‬‬ ‫ﺃﺼﺤﺎﺏ ﺍﻟﻤﺼﻠﺤﺔ‪ .‬ﻭﺒﺩﺃﺕ ﺘﻠﻙ ﺍﻟﻌﻤﻠﻴﺔ ﻓﻲ ﻋﺎﻡ ‪ ٢٠٠٢‬ﺒﻤﻠﺨﺹ ﻷﻫﻡ ﻋﻨﺎﺼﺭ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺠﺩﻴﺩﺓ‪ .‬ﺜﻡ ﻨ‬ ‫‪‬ﺩﺓ ﺍﻷﻭﻟﻰ ﻓﻲ ﻜل ﺇﻗﻠﻴﻡ‪ ،‬ﺘﻠﺘﻬﺎ ﻤـﺸﺎﻭﺭﺓ ﻋﺎﻟﻤﻴـﺔ‬ ‫ﻓﻲ ﺍﻟﻨﺼﻑ ﺍﻟﺜﺎﻨﻲ ﻤﻥ ﻋﺎﻡ ‪ ،٢٠٠٤‬ﻤﺸﺎﻭﺭﺍﺕ ﻟﻤﻨﺎﻗﺸﺔ ﺍﻟﻤﺴﻭ‬ ‫‪‬ﺩﺓ ﺘﺘـﻀﻤﻥ ﺍﻟﺘﻭﺼـﻴﺎﺕ‬ ‫‪‬ﺩﺓ ﻋﻤل‪ .‬ﻤﻤﺎ ﺃﻓﻀﻰ ﺇﻟﻰ ﻭﻀﻊ ﻤـﺴﻭ‬ ‫ﻟﻠﻨﻅﺭ ﻓﻲ ﺠﻤﻴﻊ ﺍﻟﻤﺩﺨﻼﺕ ﻭﺘﺠﻤﻴﻌﻬﺎ ﻓﻲ ﻤﺴﻭ‬ ‫ﺍﻟﺼﺎﺩﺭﺓ ﻋﻥ ﺠﻤﻴﻊ ﺍﻟﻤﺸﺎﻭﺭﺍﺕ ﻭﺍﻟﺘﻭﺼﻴﺎﺕ ﺍﻟﺘﻲ ﺘﻘﺩﻡ ﺒﻬﺎ ﺃﻋﻀﺎﺀ ﺍﻟﻔﺭﻴﻕ ﺍﻻﺴﺘﺸﺎﺭﻱ ﺍﻟﻤﻌﻨﻲ ﺒﻘﻀﺎﻴﺎ ﺍﻟﺠﻨﺴﻴﻥ‬ ‫ﺎ ﺒﻤﺎ ﻓﻴﻬﺎ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﺍﻟﺘﺎﺒﻌﻴﻥ‬ ‫ﻭﻓﺭﻴﻕ ﺍﻟﺨﺒﺭﺍﺀ ﺍﻻﺴﺘﺸﺎﺭﻱ ﺍﻟﻤﻌﻨﻲ ﺒﺎﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ﺩﺓ ﻋﻠﻰ ﻤﻭﻗﻊ ﺍﻻﻨﺘﺭﻨﺕ ﺍﻟﺘﺎﺒﻊ ﻟﻠﻤﻨﻅﻤﺔ ﻓﻲ ﺸﺒﺎﻁ‪ /‬ﻓﺒﺭﺍﻴﺭ ‪ ٢٠٠٦‬ﻟﻐﺭﺽ ﻤﻨﺎﻗﺸﺘﻬﺎ ﻤﻥ‬ ‫‪‬ﺭﻀﺕ ﺍﻟﻤﺴﻭ‬ ‫ﻟﻠﻤﻨﻅﻤﺔ‪ ،‬ﻭﻋ‬ ‫‪‬ـل‬ ‫‪‬ﺩﺓ ﺍﻷﺨﻴﺭﺓ ﺍﻟﺘﻌﻠﻴﻘﺎﺕ ﺍﻟﺘﻲ ﺘﻡ ﺘﻠﻘﻴﻬـﺎ ﻭﻫـﻲ ﺘﻜﻤ‬ ‫ﻗﺒل ﺍﻟﺩﻭل ﺍﻷﻋﻀﺎﺀ ﻭﺇﺒﺩﺍﺀ ﺘﻌﻠﻴﻘﺎﺘﻬﺎ ﻋﻠﻴﻬﺎ‪ .‬ﻭﺘﺭﺍﻋﻲ ﺍﻟﻤﺴﻭ‬ ‫‪‬ﺩﺓ‬ ‫ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﻭﺍﻟﺘﻲ ﺘﻌﻨﻲ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﻓﻲ ﻤﺠﻤﻠﻪ‪ .‬ﻭﺘﻘﺭ ﺍﻟﻤـﺴﻭ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ ﺠﺎﻨﺒﺎﻥ ﺃﺴﺎﺴﻴﺎﻥ ﻤﻥ ﺠﻭﺍﻨﺏ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻹﻨﺠﺎﺒﻴﺔ‪ ،‬ﻭﺫﻟـﻙ‬ ‫ﺒﺄﻥ ﺘﻭﻗﻲ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻜﻤﺎ ﻴﺭﺩ ﻓﻲ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺘﺴﺭﻴﻊ ﺍﻟﺘﻘﺩﻡ ﻨﺤﻭ ﺒﻠﻭﻍ ﺍﻟﻤﺭﺍﻤﻲ ﻭﺍﻷﻫﺩﺍﻑ ﺍﻟﺩﻭﻟﻴﺔ ﺫﺍﺕ ﺍﻟﺼﻠﺔ ﺒﺎﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪.‬‬

‫‪ ١‬ﻟﻺﻁﻼﻉ ﻋﻠﻰ ﻤﻭﺠﺯ‪ ،‬ﺍﻨﻅﺭ ﺍﻟﻭﺜﻴﻘﺔ ﺝ ﺹ ﻉ‪ /٢٠٠٣/٥٦‬ﺴﺠﻼﺕ‪ ،١/‬ﺍﻟﻤﻠﺤﻕ ‪.٥‬‬

‫‪ ٢‬ﺍﻟﻭﺜﻴﻘﺔ ﺝ‪ ١١/٥٩‬ﺇﻀﺎﻓﺔ ‪.٢‬‬

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‫ﺝ‪١١/٥٩‬‬

‫ﺎ‪ ،‬ﻭﺍﻟﺘﻲ ﻴﺯﻴﺩ ﻋﺩﺩﻫﺎ‬ ‫ﻤﻤﺭﻀﺔ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻟﻤﻌﻠﻭﻡ ﺃﻥ ﺍﻟﻜﺜﻴﺭ ﻤﻥ ﺍﻟﺠﺭﺍﺜﻴﻡ ﻭﺍﻟﻔﻴﺭﻭﺴﺎﺕ ﻭﺍﻟﻁﻔﻴﻠﻴﺎﺕ ﺍﻟ ‪‬‬ ‫‪-٣‬‬ ‫ﹰ‪ ،‬ﺒﻤﺎ ﻓﻴﻬﺎ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪ ،‬ﻴﻨﺘﻘل ﺒﺎﻟﺩﺭﺠﺔ ﺍﻷﻭﻟﻰ ﻋﻥ ﻁﺭﻴﻕ ﺍﻻﺘﺼﺎل ﺍﻟﺠﻨﺴﻲ‪ .‬ﻭﻴﻨﺘﻘـل‬ ‫‪‬ﻤﺭﻀﺎ‬ ‫ﻼﻤ‬ ‫ﻋﻠﻰ ‪ ٣٠‬ﻋﺎﻤ ﹰ‬ ‫ﺒﻌﻀﻬﺎ ﺃﻴﻀﹰ‬ ‫ﺎ ﻋﻥ ﻁﺭﻴﻕ ﻤﺸﺘﻘﺎﺕ ﺍﻟﺩﻡ ﺍﻟﻤﻠﻭﺜﺔ ﻭﻨﻘل ﺍﻷﻨﺴﺠﺔ‪ ،‬ﻜﻤﺎ ﻴﻨﺘﻘل ﻤﻥ ﺍﻷﻡ ﺇﻟﻰ ﺍﻟﻁﻔل ﺃﺜﻨﺎﺀ ﻓﺘﺭﺍﺕ ﺍﻟﺤﻤـل‬ ‫ﺎ ﻓﻲ ﺠﻤﻴﻊ‬ ‫ﻭﺍﻟﻭﻻﺩﺓ ﻭﺍﻹﺭﻀﺎﻉ‪ .‬ﻭﺘﺸﻴﺭ ﺘﻘﺩﻴﺭﺍﺕ ﺍﻟﻤﻨﻅﻤﺔ ﺇﻟﻰ ﺃﻥ ﺍﻟﺭﺠﺎل ﻭﺍﻟﻨﺴﺎﺀ ﻓﻲ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺭﻴﺔ ‪ ٤٩-١٥‬ﻋﺎﻤﹰ‬ ‫ﺎ ﺒﺄﻜﺜﺭ ﻤﻥ ‪ ٣٤٠‬ﻤﻠﻴﻭﻥ ﺤﺎﻟﺔ ﺠﺩﻴﺩﺓ ﻤﻥ ﺍﻹﺼﺎﺒﺎﺕ ﺒـﺎﻷﻤﺭﺍﺽ ﺍﻟﻤﻌﺩﻴـﺔ ﺍﻟـﺸﺎﺌﻌﺔ‬ ‫ﺃﻨﺤﺎﺀ ﺍﻟﻌﺎﻟﻡ ﻴﺼﺎﺒﻭﻥ ﺴﻨﻭﻴﹰ‬ ‫‪‬ﻫﺭﻱ ﻭﺍﻟﺴﻴﻼﻥ ﻭﺍﻷﻤﺭﺍﺽ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﺍﻟﻤﻌﺩﻴـﺔ‬ ‫ﺎ )ﺃﻱ ﺍﻟﺯ‬ ‫ﺍﻟﺠﺭﺜﻭﻤﻴﺔ ﺃﻭ ﺘﻠﻙ ﺍﻟﻨﺎﺠﻤﺔ ﻋﻥ ﺍﻷﻭﺍﻟﻲ‪ ،‬ﻭﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ﺭﺍﺕ(‪.‬‬ ‫ﺍﻟﻨﺎﺠﻤﺔ ﻋﻥ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻤﺘﺩﺜﺭﺍﺕ ﻭﺩﺍﺀ ﺍﻟﻤﺸﻌ‬ ‫ﺎ ﻤﻭﺠﻭﺩﺓ ﻓﻲ ﺍﻟﺠﺴﻡ ﺩﻭﻥ ﺃﻥ ﺘﺅﺩﻱ ﺇﻟـﻰ ﻅﻬـﻭﺭ ﺃﻋـﺭﺍﺽ ﺃﻭ ﻤـﻊ‬ ‫ﻭﻗﺩ ﺘﻜﻭﻥ ﺍﻟﻌﺩﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪-٤‬‬ ‫ﺍ ﻭﺨﻴﻤﺔ ﻭﻁﻭﻴﻠﺔ ﺍﻷﺠل ﻜﺎﻟﻌﻘﻡ ﻭﺍﻟﺤﻤـل ﺍﻟﻤﻨﺘﺒـﺫ ﻭﺒﻌـﺽ‬ ‫ﺃﻋﺭﺍﺽ ﺨﻔﻴﻔﺔ ﻭﻋﺎﺒﺭﺓ‪ ،‬ﻭﻟﻜﻨﻬﺎ ﻴﻤﻜﻥ ﺃﻥ ﺘﺘﺭﻙ ﺁﺜﺎﺭﹰ‬ ‫ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﺯﻤﻨﺔ ﻭﺍﻟﻭﻓﺎﺓ ﺍﻟﻤﺒﻜﺭﺓ‪ .‬ﻜﻤﺎ ﺃﻥ ﺇﺼﺎﺒﺔ ﺍﻷﺠﻨﺔ ﻭﺍﻟﻭﻟﺩﺍﻥ ﺒﻌﺩﻭﻯ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻨﺎﺠﻤﺔ ﻋـﻥ ﺍﻟﻤﺘـﺩﺜﺭﺍﺕ‬ ‫‪‬ﻫﺭﻱ ﻴﻤﻜﻥ ﺃﻥ ﺘﺅﺩﻱ ﺇﻟﻰ ﺤﺎﻻﺕ ﺨﻁﻴﺭﺓ ﺘﺘﻬﺩﺩ ﺤﻴﺎﺘﻬﻡ ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺍﻹﺼـﺎﺒﺔ ﺒـﺄﻤﺭﺍﺽ ﺨﻠﻘﻴـﺔ‬ ‫ﻭﺍﻟﺴﻴﻼﻥ ﻭﺍﻟﺯ‬ ‫ﻭﺍﻹﺼﺎﺒﺔ ﺒﺎﻻﻟﺘﻬﺎﺏ ﺍﻟﺭﺌﻭﻱ ﻭﺍﻨﺨﻔﺎﺽ ﺍﻟﻭﺯﻥ ﻋﻨﺩ ﺍﻟﻤﻴﻼﺩ‪ .‬ﺃﻤﺎ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﻓﺘﺯﻴـﺩ‬ ‫ﻤﻥ ﺍﺤﺘﻤﺎﻻﺕ ﺘﻁﻭﺭ ﺴﺭﻁﺎﻥ ﻋﻨﻕ ﺍﻟﺭﺤﻡ‪ ،‬ﻭﻫﻭ ﺍﻟﺴﺒﺏ ﺍﻟﺭﺌﻴﺴﻲ ﺍﻟﺜﺎﻨﻲ ﻟﻭﻓﻴﺎﺕ ﺍﻟﺴﺭﻁﺎﻥ ﻟﺩﻯ ﺍﻹﻨﺎﺙ ﻓﻲ ﺠﻤﻴـﻊ‬ ‫ﺃﻨﺤﺎﺀ ﺍﻟﻌﺎﻟﻡ‪ ،‬ﺤﻴﺙ ﻴﺘﺴﺒﺏ ﻓﻲ ﻤﻭﺕ ﻨﺤﻭ ‪ ٢٤٠ ٠٠٠‬ﺍﻤﺭﺃﺓ ﺴﻨﻭﻴﹰ‬ ‫ﺎ‪ ١.‬ﻭﻴﻌﺘﺒﺭ ﺍﻟﺘﺸﺨﻴﺹ ﺍﻟـﺼﺤﻴﺢ ﻟﻸﻤـﺭﺍﺽ‬ ‫ﺎ ﻟﺘﻭﻓﻴﺭ ﺍﻟﻌﻼﺝ ﺍﻟﻤﻼﺌﻡ ﻭﺍﻟﻨﺎﺠﻊ‪.‬‬ ‫ﺍ ﺃﺴﺎﺴﻴﹰ‬ ‫ﺎ ﺃﻤﺭﹰ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﹰ‪ ،‬ﺃﻥ‬ ‫ﺎ‪ .‬ﻭﻫـﻲ‪ :‬ﺃﻭﻻ‬ ‫ﻭﻫﻨﺎﻙ ﺃﺭﺒﻊ ﻓﻭﺍﺌﺩ ﺭﺌﻴﺴﻴﺔ ﺘﺩﻓﻊ ﺇﻟﻰ ﺍﻻﺴﺘﺜﻤﺎﺭ ﻓﻲ ﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪-٥‬‬ ‫ﺎ ﺴﻭﺍﺀ ﻓﻲ‬ ‫ﺍﻟﻤﻜﺎﻓﺤﺔ ﺘﺴﺎﻋﺩ ﻋﻠﻰ ﺘﻘﻠﻴﺹ ﺍﻟﻌﺏﺀ ﺍﻟﻀﺨﻡ ﻟﻸﻤﺭﺍﺽ ﻭﺍﻟﻭﻓﻴﺎﺕ ﺍﻟﻨﺎﺠﻤﺔ ﻋﻥ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻤﺤﺩﻭﺩﺓ ﺍﻟﻤﻭﺍﺭﺩ ﺃﻭ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻤﺘﻘﺩﻤﺔ‪ ،‬ﺇﻤﺎ ﺒﺼﻭﺭﺓ ﻤﺒﺎﺸﺭﺓ‪ ،‬ﻤﻥ ﺨﻼل ﺍﻷﺜﺭ ﺍﻟﺫﻱ ﺘﺤﺩﺜﻪ ﻓﻲ ﻨﻭﻋﻴﺔ ﺍﻟﺤﻴﺎﺓ‪،‬‬ ‫ﻼ ﻋـﺎﻟﻲ‬ ‫ﺎ‪ ،‬ﺃﻥ ﺘﻌﺩ ﺘﺩﺨ ﹰ‬ ‫ﺃﻭ ﺒﺼﻭﺭﺓ ﻏﻴﺭ ﻤﺒﺎﺸﺭﺓ‪ ،‬ﻤﻥ ﺨﻼل ﺃﺜﺭﻫﺎ ﻋﻠﻰ ﺍﻻﻗﺘﺼﺎﺩ ﺍﻟﻭﻁﻨﻲ ﻭﺍﻗﺘﺼﺎﺩ ﺍﻷﻓﺭﺍﺩ‪ .‬ﺜﺎﻨﻴﹰ‬ ‫ﺎ ﺘﺴﺎﻋﺩ ﻋﻠﻰ ﺍﻨﺘﻘـﺎل ﻫـﺫﺍ‬ ‫ﺍﻟﻤﺭﺩﻭﺩ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ؛ ﻓﺎﻟﻌﺩﻭﻯ ﺒﺄﻤﺭﺍﺽ ﺃﺨﺭﻯ ﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ؛ ﻭﻤﻨﻬﺎ ﺃﻤﺭﺍﺽ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺘﻨﺎﺴﻠﻲ ﺒﺼﻔﺔ ﺨﺎﺼﺔ ﻭﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﺒﺼﻔﺔ ﻋﺎﻤـﺔ ﺍﻟﺘـﻲ ﺘﺯﻴـﺩ‬ ‫ﺍﻟﻔﻴﺭﻭﺱ ﺠﻨﺴﻴﹰ‬ ‫ﹰ‪ ،‬ﺃﻨﻬﺎ ﺘـﺴﺎﻋﺩ‬ ‫ﻓﺭﺹ ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻤﻥ ‪ ٥٠‬ﺇﻟﻰ ‪ ٣٠٠‬ﻤﺭﺓ ﻓﻲ ﻜل ﺍﺘﺼﺎل ﺠﻨﺴﻲ ﻴﺘﻡ ﺩﻭﻥ ﻭﻗﺎﻴﺔ‪ .‬ﻭﺜﺎﻟﺜﺎ‬ ‫ﹰ‪ ،‬ﻓﺈﻨﻬـﺎ‬ ‫ﻋﻠﻰ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﺍﻟﺨﻁﻴﺭﺓ ﻜﺎﻟﻌﻘﻡ ﺍﻷﻨﺒﻭﺒﻲ ﻭﻭﻓﻴﺎﺕ ﺍﻷﻤﻭﻤﺔ ﻭﺴﺭﻁﺎﻥ ﻋﻨﻕ ﺍﻟﺭﺤﻡ‪ .‬ﻭﺃﺨﻴـﺭﺍ‬ ‫‪‬ﻫﺭﻱ‬ ‫ﺘﺅﺩﻱ ﺇﻟﻰ ﺍﻟﺤﺩ ﻤﻥ ﺤﺼﺎﺌل ﺍﻟﺤﻤل ﺍﻟﺴﻠﺒﻴﺔ ﻤﺜل ﺍﻹﻤﻼﺹ ﻭﺍﻟﻭﻓﺎﺓ ﻓﻲ ﺍﻟﻔﺘﺭﺓ ﺍﻟﻤﺤﻴﻁﺔ ﺒﺎﻟﻭﻻﺩﺓ ﻤﻥ ﺠﺭﺍﺀ ﺍﻟﺯ‬ ‫ﻭﺍﻟﻌﻤﻰ ﺍﻟﻨﺎﺠﻡ ﻋﻥ ﺍﻟﺴﻴﻼﻥ ﻭﺍﻟﻌﺩﻭﻯ ﺒﺎﻟﻤﺘﺩﺜﺭﺍﺕ‪.‬‬ ‫ﺍ ﻟﻠﻤـﻭﺍﺭﺩ‬ ‫ﺎ ﺃﻤﺭ ﻤﻤﻜﻥ ﻭﻟﻜﻨﻪ ﻴﺸﺘﺭﻁ ﻭﺠﻭﺩ ﺇﺭﺍﺩﺓ ﺴﻴﺎﺴـﻴﺔ ﻭﺤـﺸﺩﹰ‬ ‫ﻭﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪-٦‬‬ ‫ﺍﻟﻼﺯﻤﺔ ﻤﻥ ﺃﺠل ﺍﻟﺒﺩﺀ ﻓﻲ ﺍﻷﻨﺸﻁﺔ ﻭﻤﻭﺍﺼﻠﺘﻬﺎ ﻭﺍﻟﻨﺠﺎﺡ ﻓﻲ ﺘﻨﻔﻴﺫﻫﺎ‪ .‬ﻭﻫﻨﺎﻙ ﺒﻌﺽ ﺍﻷﻤﺜﻠﺔ ﻋﻠﻰ ﺍﻟﻨﺠﺎﺡ ﺍﻟﻤﺤﺭﺯ‬ ‫ﻓﻲ ﺒﻴﺌﺎﺕ ﻤﺤﺩﻭﺩﺓ ﺍﻟﻤﻭﺍﺭﺩ ﻭﻤﺘﺒﺎﻴﻨﺔ ﻓﻴﻤﺎ ﺒﻴﻨﻬﺎ ﻜﻤﺎ ﻓﻲ ﺤﺎﻟﺔ ﺘﺎﻴﻠﻨﺩ ﻭﺃﻭﻏﻨﺩﺍ‪ ،‬ﻭﻓﻲ ﺒﻠﺩﺍﻥ ﺃﺨﺭﻯ ﻤﺜـل ﺍﻟـﺩﺍﻨﻤﺭﻙ‬ ‫ﻭﺍﻟﺴﻭﻴﺩ ﻭﺍﻟﻤﻤﻠﻜﺔ ﺍﻟﻤﺘﺤﺩﺓ ﻟﺒﺭﻴﻁﺎﻨﻴﺎ ﺍﻟﻌﻅﻤﻰ ﻭﺃﻴﺭﻟﻨﺩﺍ ﺍﻟﺸﻤﺎﻟﻴﺔ‪ .‬ﻭﻫﻨﺎﻙ ﺍﻵﻥ ﺸﺭﺍﻜﺎﺕ ﻭﻤـﻭﺍﺭﺩ ﻭﺘﻜﻨﻭﻟﻭﺠﻴـﺎﺕ‬ ‫ﺍﺒﺘﻜﺎﺭﻴﺔ ﻭﺨﺒﺭﺍﺕ ﻭﺍﺴﻌﺔ ﺠﺩﻴﺩﺓ ﻟﻤﻜﺎﻓﺤﺔ ﻭﺒﺎﺀ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪ .‬ﺃﻤﺎ ﺍﻟﻭﻗﺎﻴﺔ‪ ،‬ﺒﻤﺎ ﻓﻴﻬﺎ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻤﺒﻜـﺭﺓ‬ ‫ﺎ‪ ،‬ﻓﻴﺠﺏ ﺃﻥ ﺘﺼﺒﺢ ﺩﻋﺎﻤﺔ ﺃﺴﺎﺴﻴﺔ ﻤﻥ ﺩﻋﺎﺌﻡ ﻤﻭﺍﺠﻬﺔ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪،‬‬ ‫ﺍﻟﻔﻌﺎﻟﺔ ﻟﻸﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺫﻟﻙ ﻤﺎ ﻴﻨﺹ ﻋﻠﻴﻪ ﺍﻟﻘﺭﺍﺭ ﺍﻟﺫﻱ ﺍﺘﺨﺫﺘﻪ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻟﻌﺎﻤﺔ ﻟﻸﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ ﻓﻲ ﻋﺎﻡ ‪ ٢٠٠١‬ﺒﺎﻋﺘﻤﺎﺩ ﺇﻋﻼﻥ ﺍﻻﻟﺘـﺯﺍﻡ‬ ‫ﺎ ﺁﺨﺭ ﻤﻥ ﺃﺴﻠﺤﺔ ﺍﻟﻭﻗﺎﻴﺔ‪ .‬ﻭﻫﻨﺎﻙ ﻟﻘﺎﺡ ﻤﺄﻤﻭﻥ ﻭﻓﻌـﺎل‬ ‫ﺒﺸﺄﻥ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪ ٢.‬ﻭﺘﺸﻜل ﺍﻟﻠﻘﺎﺤﺎﺕ ﺴﻼﺤﹰ‬ ‫ﻤﻀﺎﺩ ﻻﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ ﺍﻟﺒﺎﺌﻲ ﻭﻤﻥ ﺸﺄﻥ ﺇﺩﺭﺍﺝ ﺍﺴﺘﻌﻤﺎﻟﻪ ﻓﻲ ﺒﺭﺍﻤﺞ ﺍﻟﺘﻠﻘﻴﺢ ﺍﻟﻭﻁﻨﻴﺔ ﺃﻥ ﻴﺴﺎﻋﺩ ﻋﻠﻰ ﺍﻟﻭﻗﺎﻴـﺔ ﻤـﻥ‬ ‫‪ ١‬ﺍﻟﺘﻘﺭﻴﺭ ﺍﻟﺨﺎﺹ ﺒﺎﻟﺼﺤﺔ ﻓﻲ ﺍﻟﻌﺎﻟﻡ ﻟﻌﺎﻡ ‪ :٢٠٠٤‬ﺘﻐﻴﻴﺭ ﻤﺴﺎﺭ ﺍﻟﺘﺎﺭﻴﺦ‪ ،‬ﺠﻨﻴﻑ‪ ،‬ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ‪.٢٠٠٤ ،‬‬

‫‪ ٢‬ﻗﺭﺍﺭ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻟﻌﺎﻤﺔ ﻟﻸﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ ﺩﺇ‪.٢/٦٢-‬‬

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‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻭﻴﻘﻠل ﻤﻥ ﻓﺭﺹ ﺍﻹﺼﺎﺒﺔ ﺒﺄﻤﺭﺍﺽ ﺍﻟﻜﺒﺩ ﻓﻰ ﻤﺭﺍﺤل ﻻﺤﻘﺔ‪ .‬ﻭﻴﺘـﻀﺢ‬ ‫ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ ﺍﻟﺒﺎﺌﻲ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻥ ﻨﺘﺎﺌﺞ ﺘﻁﻌﻴﻡ ﺍﻟﻤﺘﻁﻭﻋﻴﻥ ﺒﺎﻟﻠﻘﺎﺤﺎﺕ ﺍﻟﻤﻀﺎﺩﺓ ﻟﻔﻴﺭﻭﺴﺎﺕ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﻭﺠﻭﺩ ﻓﺭﺹ ﻜﺒﻴﺭﺓ ﻭﺍﻋﺩﺓ ﻓﻲ‬ ‫ﻫﺫﺍ ﺍﻟﻤﻀﻤﺎﺭ‪ ،‬ﻭﻻﺒﺩ ﻤﻥ ﺍﻟﻨﻅﺭ ﻓﻲ ﺇﺩﺭﺍﺝ ﺍﻟﻠﻘﺎﺤﺎﺕ ﺍﻟﻨﺎﺠﺤﺔ ﻓﻲ ﺒﺭﺍﻤﺞ ﺍﻟﺘﻤﻨﻴﻊ ﺍﻟﻭﻁﻨﻴﺔ ﻤﻥ ﺃﺠل ﻀﻤﺎﻥ ﺤﻤﺎﻴـﺔ‬ ‫ﺎ ﻜﻌﻨﺼﺭ ﻤﻥ ﺍﻟﻌﻨﺎﺼـﺭ‬ ‫ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﻗﺒل ﺃﻥ ﻴﺒﺩﺃﻭﺍ ﻨﺸﺎﻁﻬﻡ ﺍﻟﺠﻨﺴﻲ‪ .‬ﻭﻴﺠﺏ ﺩﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻬﺎﻤﺔ ﻓﻲ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﻭﻁﻨﻴﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ‪.‬‬ ‫ﺎ‪ .‬ﺃﻭﻻﻫـﺎ ﺃﻥ ﺍﻟﺠﻬـل ﻭﻗﻠـﺔ‬ ‫ﻭﻫﻨﺎﻙ ﺃﺭﺒﻊ ﻋﻘﺒﺎﺕ ﺭﺌﻴﺴﻴﺔ ﺘﻌﺘﺭﺽ ﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫‪-٧‬‬ ‫ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﻴﺅﺩﻴﺎﻥ ﺇﻟﻰ ﺇﺩﺍﻤﺔ ﺍﻟﻤﻔﺎﻫﻴﻡ ﺍﻟﺨﺎﻁﺌﺔ ﻭﺍﻟﻭﺼﻡ ﺍﻟﻤﻼﺯﻡ ﻟﻬﺎ‪ .‬ﻭﻴﺅﺩﻱ ﻫﺫﺍ ﺍﻟﻭﺼﻡ ﺒـﺩﻭﺭﻩ ﺇﻟـﻰ ﻤﻘﺎﻭﻤـﺔ‬ ‫ﺍﻟﻤﺭﻀﻰ ﻻﻟﺘﻤﺎﺱ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻤﻨﺎﺴﺒﺔ‪ ،‬ﻭﺼﻌﻭﺒﺔ ﺇﺒﻼﻍ ﺍﻷﺯﻭﺍﺝ‪ ،‬ﻭﺘﻔﻀﻴل ﺍﻟﺘﻤﺎﺱ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻓﻲ ﺇﻁـﺎﺭ ﺍﻟﻘﻁـﺎﻉ‬ ‫ﺍﻟﺼﺤﻲ ﺍﻟﺨﺎﺹ‪ ،‬ﻭﻫﻲ ﻟﻴﺴﺕ ﻜﺎﻓﻴﺔ ﻓﻲ ﻤﻌﻅﻡ ﺍﻷﺤﻴﺎﻥ‪ .‬ﻭﺘﻅﻬﺭ ﻫﺫﻩ ﺍﻟﻤﺸﻜﻠﺔ ﺒﺼﻔﺔ ﺨﺎﺼﺔ ﻓﻲ ﺍﻟﺒﻴﺌﺎﺕ ﺍﻟﺸﺤﻴﺤﺔ‬ ‫ﹰ‪ ،‬ﺃﻥ ﻁﺒﻴﻌﺔ ﻋﺩﻡ ﻅﻬﻭﺭ ﺍﻷﻋﺭﺍﺽ ﺍﻟﺘﻲ ﺘﺘﺴﻡ ﺒﻬﺎ ﻤﻌﻅﻡ ﺍﻷﻤـﺭﺍﺽ‬ ‫ﺍﻟﻤﻭﺍﺭﺩ ﻭﻟﺩﻯ ﺍﻟﻔﺌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﻬﻤﺸﺔ‪ .‬ﺜﺎﻨﻴﺎ‬ ‫ﺎ‪ ،‬ﻭﺍﻻﻓﺘﻘﺎﺭ ﻟﺒﺭﺍﻤﺞ ﺍﻟﺘﺤﺭﻱ ﻭﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﺍﻟﺴﺭﻴﻌﺔ ﻭﺍﻟﺯﻫﻴﺩﺓ ﺍﻟﺘﻜﻠﻔﺔ ﻴﺅﺩﻴﺎﻥ ﺇﻟﻰ ﺇﺼﺎﺒﺔ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺃﻋﺩﺍﺩ ﻜﺒﻴﺭﺓ ﻤﻥ ﺍﻟﻨﺎﺱ ﺒﺄﻤﺭﺍﺽ ﻤﺯﻤﻨﺔ ﻭﺒﻤﻌﺎﻨﺎﺘﻬﻡ ﻤﻥ ﺍﻟﻌﻭﺍﻗﺏ ﺍﻟﻁﻭﻴﻠﺔ ﺍﻷﺠـل ﺍﻟﻨﺎﺠﻤـﺔ ﻋـﻥ ﻋـﺩﻡ ﻋـﻼﺝ‬ ‫ﹰ‪ ،‬ﻭﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﺴﻴﺎﺴﺎﺕ‪ ،‬ﻴﺅﺩﻱ ﺍﻟﻭﺼﻡ ﻭﺍﻹﺠﺤﺎﻑ ﻭﻋﺩﻡ ﺘﻘﺩﻴﺭ ﻋﺏﺀ ﺍﻹﺼـﺎﺒﺔ ﺒـﺎﻷﻤﺭﺍﺽ‬ ‫ﺃﻤﺭﺍﻀﻬﻡ‪ .‬ﺜﺎﻟﺜﺎ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﹰ‪ ،‬ﻓﻘﺩ ﺜﺒﺕ ﺃﻥ ﺍﻟﺠﻬﻭﺩ ﺍﻟﺭﺍﻤﻴﺔ ﻟﺩﻤﺞ ﺭﻋﺎﻴﺔ‬ ‫ﺎ ﺇﻟﻰ ﻨﻘﺹ ﺍﻟﺘﻤﻭﻴل ﺍﻟﻤﺨﺼﺹ ﻟﺘﺩﺍﺒﻴﺭ ﺍﻟﻤﻜﺎﻓﺤﺔ‪ .‬ﻭﺃﺨﻴﺭﺍ‬ ‫ﺎ‪.‬‬ ‫ﺍ ﻤﻤﺎ ﻜﺎﻥ ﻤﺘﻭﻗﻌﹰ‬ ‫ﺎ ﻓﻲ ﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻫﻲ ﺃﻤﺭ ﺃﻜﺜﺭ ﺘﻌﻘﻴﺩﹰ‬ ‫ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻻﺴﺘﺠﺎﺒﺔ ﻋﺎﻟﻤﻴﺔ ﺴﺭﻴﻌﺔ ﻟﺘﻭﻗﻲ ﻭﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺍ ﺘﻭﺠﻴﻬﻴﹰ‬ ‫‪‬ﺩﺓ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺇﻁﺎﺭﹰ‬ ‫ﻭﺘﺘﻴﺢ ﻤﺴﻭ‬ ‫‪-٨‬‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻋﻥ ﻁﺭﻴﻕ ﻋﻨﺼﺭﻴﻥ ﻋﻤﻠﻴﻴﻥ ﺤﺎﺴﻤﻴﻥ ﻫﻤﺎ‪:‬‬ ‫ﺎ‪ ،‬ﻭﻴﻐﻁﻲ ﺠﻭﺍﻨﺏ ﻤﺜل‬ ‫ﻋﻨﺼﺭ ﺘﻘﻨﻲ ﻟﺸﺭﺡ ﺍﻷﻨﺸﻁﺔ ﺍﻷﺴﺎﺴﻴﺔ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫)ﺃ(‬ ‫ﺼﺤﺔ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ‪ ،‬ﻭﺇﺼﺎﺒﺔ ﺍﻟﻨﺴﺎﺀ ﺒﺎﻟﻌﺩﻭﻯ ﺩﻭﻥ ﻅﻬﻭﺭ ﺃﻋﺭﺍﺽ ﻋﻠـﻴﻬﻥ ﻭﺘﻭﻋﻴـﺔ ﺍﻟﻔﺌـﺎﺕ ﺍﻟـﺴﻜﺎﻨﻴﺔ‬ ‫ﺎ ﻭﺍﻟﻔﺌﺎﺕ ﺍﻟﺘﻲ ﻻ ﺘﻤﻠـﻙ‬ ‫ﺍﻟﻤﻌﺭﻀﺔ ﻟﻤﺨﺎﻁﺭ ﻜﺒﺭﻯ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻹﺼﺎﺒﺔ ﺒﻌﺩﻭﻯ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻘﺩﺭﺓ ﺍﻟﻜﺎﻓﻴﺔ ﻋﻠﻰ ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﺴﻴﺘﻌﻴﻥ ﺘﻜﻴﻴﻑ ﻫﺫﺍ ﺍﻟﺠﺯﺀ ﻤﻥ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻤـﻊ‬ ‫ﻜل ﺇﻗﻠﻴﻡ ﺃﻭ ﺒﻠﺩ؛‬ ‫)ﺏ( ﻋﻨﺼﺭ ﺍﻟﺩﻋﻭﺓ‪ ،‬ﻭﻫﻭ ﻴﺭﻤﻲ ﻤﻥ ﺨﻼل ﺘﻨﻔﻴﺫ ﺤﻤﻼﺕ ﻋﺎﻟﻤﻴﺔ ﻭﻭﻁﻨﻴﺔ‪ ،‬ﻟﻠﺘﻭﻋﻴﺔ ﺒﺸﺄﻥ ﺍﻷﻤﺭﺍﺽ‬ ‫ﺎ ﻭﺇﻴﺠﺎﺩ ﺍﻹﺭﺍﺩﺓ ﺍﻟﺴﻴﺎﺴﻴﺔ ﺍﻟﻼﺯﻤﺔ ﻟﻤﻌﺎﻟﺠﺔ ﻫﺫﻩ ﺍﻟﻤﺸﻜﻠﺔ‪.‬‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ﺩﺓ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻟﻠﺘﻨﻔﻴﺫ ﺃﻭ ﻟﺘﻭﺴـﻴﻊ ﻨﻁـﺎﻕ‬ ‫ﻭﺴﺘﻘﻭﻡ ﺍﻟﺒﻠﺩﺍﻥ ﺒﺎﺨﺘﻴﺎﺭ ﺍﻷﻨﺸﻁﺔ ﺍﻟﻤﻌﻴﻨﺔ ﺍﻟﺘﻲ ﺘﻘﺘﺭﺤﻬﺎ ﻤﺴﻭ‬ ‫‪-٩‬‬ ‫ﺍﻟﺘﻨﻔﻴﺫ ﺒﺎﻻﺴﺘﻨﺎﺩ ﺇﻟﻰ ﺠﺩﻭﺍﻫﺎ ﻭﻋﻭﺍﺌﺩ ﺍﻻﺴﺘﺜﻤﺎﺭ ﺍﻟﻘﺎﺒﻠﺔ ﻟﻠﻘﻴﺎﺱ‪ .‬ﻭﻴﻤﻜﻥ ﻟﻬﺫﻩ ﺍﻷﻨﺸﻁﺔ ﺃﻥ ﺘﺸﺘﻤل ﻋﻠﻰ ﻤـﺎ ﻴﻠـﻲ‪:‬‬ ‫ﺎ ﻋﻥ ﻁﺭﻴـﻕ ﺍﻟﺘـﺩﺒﻴﺭ‬ ‫ﺘﻭﺴﻴﻊ ﻨﻁﺎﻕ ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﺨﺩﻤﺎﺕ ﺍﻟﺘﺸﺨﻴﺹ ﻭﺍﻟﻌﻼﺝ ﺍﻟﻤﻼﺌﻡ ﻟﻸﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﻼﺠﻲ ﺍﻟﻤﺘﻼﺯﻤﻲ ﻓﻲ ﻤﻭﺍﻗﻊ ﻨﻘﺎﻁ ﺍﻟﺭﻋﺎﻴﺔ‪ ،‬ﻤﻊ ﺇﺠﺭﺍﺀ ﺍﻟﻔﺤﺹ ﺍﻟﻤﺨﺘﺒﺭﻱ ﺃﻭ ﺒﺩﻭﻨﻪ؛ ﻭﺘﺩﺭﻴﺏ ﺃﻭ ﺘﺠﺩﻴﺩ ﺘﺩﺭﻴﺏ‬ ‫ﻤﻭﻅﻔﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻓﻲ ﺇﻁﺎﺭ ﺃﺴﻠﻭﺏ ﻴﺭﻜﺯ ﻋﻠﻰ ﺍﻟﺯﺒﺎﺌﻥ؛ ﻭﺘﻨﻔﻴﺫ ﺘﺩﺨﻼﺕ ﺨﺎﺼﺔ ﺒﺎﻟﺒﻠـﺩﺍﻥ ﺘﺭﻜـﺯ ﻋﻠـﻰ‬ ‫ﺍﻟﺴﻜﺎﻥ ﺍﻟﺫﻴﻥ ﺘﺭﺘﻔﻊ ﻟﺩﻴﻬﻡ ﻋﻭﺍﻤل ﺍﺨﺘﻁﺎﺭ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﻭﻯ؛ ﻭﺇﺫﻜﺎﺀ ﺍﻟﻭﻋﻲ ﻭﺘﺤﺴﻴﻥ ﺍﻟﻤﻬﺎﺭﺍﺕ ﻟﺩﻯ ﺍﻟﺸﺒﺎﺏ ﻤﻥ‬ ‫ﺨﻼل ﺍﻟﺘﺜﻘﻴﻑ ﻭﺇﺴﺩﺍﺀ ﺍﻟﻤﺸﻭﺭﺓ ﻓﻲ ﻤﺠﺎل ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻤﻥ ﺃﺠل ﺘﻭﻗﻲ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌـﺩﻭﻯ؛ ﻭﺘﻭﺴـﻴﻊ ﻨﻁـﺎﻕ‬ ‫‪‬ﻫﺭﻱ ﻟﺩﻯ ﺍﻟﺤﻭﺍﻤل ﻓﻲ ﻤﻭﺍﻗﻊ ﻨﻘﺎﻁ ﺍﻟﺭﻋﺎﻴﺔ؛ ﻭﺘﺤﺴﻴﻥ ﺘﺭﺼﺩ ﺍﻟﺠﻴل ﺍﻟﺜﺎﻨﻲ ﻟﻔﻴﺭﻭﺱ ﺍﻷﻴـﺩﺯ‪،‬‬ ‫ﺍﺨﺘﺒﺎﺭ ﻭﻤﻌﺎﻟﺠﺔ ﺍﻟﺯ‬ ‫ﺎ ﻤﻥ ﺃﺠـل ﺭﺼـﺩ ﺃﻭﺒﺌـﺔ ﻫـﺫﻩ‬ ‫ﻤﻊ ﺍﻟﺘﺭﺼﺩ ﺍﻟﺒﻴﻭﻟﻭﺠﻲ ‪ -‬ﺍﻟﻁﺒﻲ ﻭﺍﻟﺘﺭﺼﺩ ﺍﻟﺴﻠﻭﻜﻲ ﻟﻸﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻌﺩﻴﺔ ﻭﺃﻭﺒﺌﺔ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ؛ ﻭﺍﻟﻘﻴﺎﻡ ﺒﺠﻤﻊ ﺍﻟﻤﻌﻁﻴﺎﺕ ﻭﺘﺤﻠﻴﻠﻬﺎ ﻤﻊ ﻤﺴﺢ ﺃﻨـﺸﻁﺔ ﺇﻴﺘـﺎﺀ‬ ‫ﺍﻟﺨﺩﻤﺎﺕ ﻤﻥ ﺃﺠل ﺭﺼﺩ ﺍﻻﺴﺘﺠﺎﺒﺔ ﻭﻋﺏﺀ ﺍﻟﻤﺭﺽ‪.‬‬

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‫ﺝ‪١١/٥٩‬‬

‫‪‬ﺩﺓ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻋﻠﻰ ﻭﺠﻭﺩ ﻅﺭﻭﻑ ﻤﺅﺍﺘﻴﺔ‪ ،‬ﻴﺘﻡ ﻓﻴﻬﺎ ﺘﺄﻤﻴﻥ ﺍﻟﺘﺯﺍﻡ ﺍﻟﺤﻜﻭﻤـﺎﺕ ﻭﺍﻟـﺸﺭﻜﺎﺀ‬ ‫‪ -١٠‬ﻭﺘﻌﺘﻤﺩ ﻤﺴﻭ‬ ‫ﺍﻟﻭﻁﻨﻴﻴﻥ ﻭﺍﻟﺩﻭﻟﻴﻴﻥ؛ ﻭﺘﻭﻓﻴﺭ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻜﺎﻓﻴﺔ؛ ﻭﺘﻨﻔﻴﺫ ﺒﺭﺍﻤﺞ ﺘﺭﺍﻋﻲ ﺍﻟﺜﻘﺎﻓﺎﺕ ﻭﺍﺤﺘﻴﺎﺠـﺎﺕ ﺍﻟﺠﻨـﺴﻴﻥ ﻭﺍﻟﻌﻘﺒـﺎﺕ‬ ‫ﺍﻟﻨﺎﺠﻤﺔ ﻋﻥ ﺍﻟﻭﺼﻡ؛ ﻭﺘﻨﺴﻴﻕ ﺍﻻﺴﺘﺠﺎﺒﺔ‪ .‬ﻭﺘﻡ ﻓﻲ ﻫﺫﺍ ﺍﻟﺴﻴﺎﻕ ﺇﺩﺭﺍﺝ ﻗﺎﺌﻤﺔ ﺘﺘﻀﻤﻥ ﺒﻌﺽ ﺍﻟﺘﺩﺨﻼﺕ ﺫﺍﺕ ﺍﻷﻭﻟﻭﻴﺔ‬ ‫ﺍﻟﻌﺎﻟﻴﺔ ﺍﺨﺘﻴﺭﺕ ﻋﻠﻰ ﺃﺴﺎﺱ ﺍﻟﺒﻴﻨﺎﺕ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻷﺜﺭ ﻭﺍﻟﺠﺩﻭﻯ‪ ،‬ﻭﺍﻗﺘﺭﺍﺡ ﺍﻷﻁﺭ ﺍﻟﺯﻤﻨﻴﺔ ﻭﺍﻷﻫﺩﺍﻑ ﺍﻟﻤﺘﻭﺨﺎﺓ‪.‬‬

‫ﺍﻹﺠﺭﺍﺀ ﺍﻟﻤﻁﻠﻭﺏ ﻤﻥ ﺠﻤﻌﻴﺔ ﺍﻟﺼﺤﺔ‬ ‫ﺠﻤﻌﻴﺔ ﺍﻟﺼﺤﺔ ﻤﺩﻋﻭﺓ ﺇﻟﻰ ﺍﻟﻨﻅﺭ ﻓﻲ ﺍﻋﺘﻤﺎﺩ ﻤﺸﺭﻭﻉ ﺍﻟﻘﺭﺍﺭ ﺍﻟﺘﺎﻟﻲ‪.‬‬ ‫ﺠﻤﻌﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺍﻟﺘﺎﺴﻌﺔ ﻭﺍﻟﺨﻤﺴﻭﻥ‪،‬‬ ‫ﺎ؛‪١‬‬ ‫‪‬ﺩﺓ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺒﺸﺄﻥ ﺘﻭﻗﻲ ﻭﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻗﺩ ﻨﻅﺭﺕ ﻓﻲ ﻤﺴﻭ‬

‫‪-١١‬‬

‫ﺎ ﻓـﻲ‬ ‫ﹼﺭ ﺒﺎﻟﻘﺭﺍﺭ ﺝ ﺹ ﻉ‪ ،٣٧-٤٦‬ﺍﻟﺫﻱ ﻴﻌﺘﺭﻑ ﺒﺩﻭﺭ ﺴﺎﺌﺭ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻭﺇﺫ ﺘﺫﻜ‬ ‫ﺘﻔﺸﻲ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ؛ ﻭﺍﻟﻘﺭﺍﺭ ﺝ ﺹ ﻉ‪ ،١٤-٥٣‬ﺍﻟﺫﻱ ﻴﻁﻠـﺏ ﺇﻟـﻰ ﺍﻟﻤـﺩﻴﺭ ﺍﻟﻌـﺎﻡ ﻭﻀـﻊ‬ ‫ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻋﺎﻟﻤﻴﺔ ﻟﻠﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﻤﻥ ﺃﺠل ﻤﻭﺍﺠﻬﺔ ﻭﺒﺎﺀ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﻭﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺒﺎﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺸﺎﻤﻠﺔ ﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﺔ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻷﻴﺩﺯ‬ ‫ﺎ؛ ﻭﺍﻟﻘﺭﺍﺭ ﺝ ﺹ ﻉ‪ ،٣٠-٥٦‬ﺍﻟﺫﻱ ﻴﺤﻴﻁ ﻋﻠﻤﹰ‬ ‫ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ؛ ﻭﺍﻟﻘﺭﺍﺭ ﺝ ﺹ ﻉ‪ ،١٢-٥٧‬ﺍﻟﺫﻱ ﻴﻌﺘﻤﺩ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺘﺴﺭﻴﻊ ﺍﻟﺘﻘﺩﻡ ﻨﺤﻭ ﺒﻠﻭﻍ ﺍﻟﻤﺭﺍﻤﻲ‬ ‫ﻭﺍﻷﻫﺩﺍﻑ ﺍﻹﻨﻤﺎﺌﻴﺔ ﺍﻟﺩﻭﻟﻴﺔ ﺫﺍﺕ ﺍﻟﺼﻠﺔ ﺒﺎﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ؛‬ ‫ﻭﺇﺫ ﺘﻘﺭ ﻭﺘﺅﻜﺩ ﺍﻻﻟﺘﺯﺍﻡ ﺍﻟﺫﻱ ﺃﻋﺭﺏ ﻋﻨﻪ ﻗﺎﺩﺓ ﺩﻭل ﺍﻟﻌﺎﻟﻡ‪ ،‬ﺇﺒﺎﻥ ﻤﺅﺘﻤﺭ ﺍﻟﻘﻤـﺔ ﺍﻟﻌـﺎﻟﻤﻲ ﻟﻌـﺎﻡ‬ ‫‪) ٢٠٠٥‬ﻨﻴﻭﻴﻭﺭﻙ‪ ١٦-١٤ ،‬ﺃﻴﻠﻭل‪ /‬ﺴﺒﺘﻤﺒﺭ ‪ ،(٢٠٠٥‬ﺒﺘﺤﻘﻴﻕ ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻟﻠﺠﻤﻴﻊ ﺒﺤﻠـﻭل ﻋـﺎﻡ‬ ‫ﺎ‪ ،‬ﺒﻤـﺎ ﻓﻴﻬـﺎ‬ ‫‪ ٢٠١٥‬ﻭﺇﺩﺭﺍﺝ ﻫﺫﺍ ﺍﻟﻬﺩﻑ ﻓﻲ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﺭﺍﻤﻴﺔ ﻟﺒﻠﻭﻍ ﺍﻷﻫﺩﺍﻑ ﺍﻟﻤﺘﻔﻕ ﻋﻠﻴﻬﺎ ﺩﻭﻟﻴﹰ‬ ‫ﺍ‬ ‫ﺍﻷﻫﺩﺍﻑ ﺍﻟﺘﻲ ﺘﺭﺩ ﻓﻲ ﺍﻹﻋﻼﻥ ﺒﺸﺄﻥ ﺍﻷﻟﻔﻴﺔ‪ ،‬ﻭﺒﺄﻥ ﺒﻠﻭﻍ ﺍﻟﻤﺭﺍﻤﻲ ﺍﻹﻨﻤﺎﺌﻴﺔ ﻟﻸﻟﻔﻴﺔ ﻴـﺴﺘﻠﺯﻡ ﺍﺴـﺘﺜﻤﺎﺭﹰ‬ ‫ﻭﺍﻟﺘﺯﺍﻤﹰ‬ ‫ﺎ‬ ‫ﺎ ﺇﺯﺍﺀ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻹﻨﺠﺎﺒﻴﺔ‪ ،‬ﻭﺍﻟﺘﻲ ﺘﺸﺘﻤل ﻋﻠﻰ ﺘﻭﻗﻲ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺎ ﺴﻴﺎﺴﻴﹰ‬ ‫ﻭﻤﻜﺎﻓﺤﺘﻬﺎ؛‪٢‬‬ ‫ﺎ؛‬ ‫ﺘﻌﺘﻤﺩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺒﺸﺄﻥ ﺘﻭﻗﻲ ﻭﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﺤﺙ ﺍﻟﺩﻭل ﺍﻷﻋﻀﺎﺀ ﻋﻠﻰ ﻤﺎ ﻴﻠﻲ‪:‬‬ ‫ﺍﻋﺘﻤﺎﺩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻭﺍﻻﺴﺘﻨﺎﺩ ﺇﻟﻴﻬﺎ ﻓﻲ ﺍﻟﺘﺄﻜﺩ ﻤﻥ ﺃﻥ ﺍﻟﺠﻬﻭﺩ ﺍﻟﻭﻁﻨﻴﺔ ﺍﻟﺭﺍﻤﻴﺔ ﻟﺒﻠـﻭﻍ‬ ‫)‪(١‬‬ ‫ﺎ ﻭﺇﺠﺭﺍﺀﺍﺕ ﻤﻼﺌﻤﺔ ﻟﻭﻀﻊ ﺍﻷﻭﺒﺌﺔ ﺍﻟﻤﺤﻠﻲ ﻭﺘﻬﺩﻑ ﺇﻟﻰ‬ ‫ﺍﻟﻤﺭﺍﻤﻲ ﺍﻹﻨﻤﺎﺌﻴﺔ ﻟﻸﻟﻔﻴﺔ ﺘﺘﻀﻤﻥ ﺨﻁﻁﹰ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺘﻌﺒﺌﺔ ﺍﻹﺭﺍﺩﺓ ﺍﻟﺴﻴﺎﺴﻴﺔ ﻭﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ‬ ‫ﺘﻭﻗﻲ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺎﻟﻴﺔ ﻟﻬﺫﺍ ﺍﻟﻐﺭﺽ؛‬ ‫‪-١‬‬ ‫‪-٢‬‬

‫‪ ٢‬ﻗﺭﺍﺭ ﺍﻟﺠﻤﻌﻴﺔ ﺍﻟﻌﺎﻤﺔ ﻟﻸﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ ‪.١/٦٠‬‬

‫‪ ١‬ﺍﻟﻭﺜﻴﻘﺔ ﺝ‪ ،١١/٥٩‬ﺍﻟﻤﻠﺤﻕ‪.‬‬

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‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻜﻌﻨﺼﺭ ﻗﺎﺌﻡ ﺒﺫﺍﺘﻪ ﻓﻲ ﺒﺭﺍﻤﺞ ﺍﻟﻭﻗﺎﻴﺔ‬ ‫ﺇﺩﺭﺍﺝ ﺘﻭﻗﻲ ﻭﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫)‪(٢‬‬ ‫ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻹﻨﺠﺎﺒﻴﺔ؛‬ ‫ﺎ ﻟﻺﺼـﺎﺒﺔ‬ ‫ﻤﺭﺍﻗﺒﺔ ﺘﻨﻔﻴﺫ ﺍﻟﺨﻁﻁ ﺍﻟﻭﻁﻨﻴﺔ ﻟﻠﺘﺄﻜﺩ ﻤﻥ ﺤﺼﻭل ﺍﻷﺸﺨﺎﺹ ﺍﻷﻜﺜﺭ ﺘﻌﺭﻀﹰ‬ ‫)‪(٣‬‬ ‫ﺎ ﻋﻠﻰ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﻭﺍﻷﺩﻭﺍﺕ ﺍﻟﻼﺯﻤﺔ ﻟﻠﻭﻗﺎﻴﺔ‪ ،‬ﻭﻋﻠﻰ ﺘﺸﺨﻴﺹ ﺇﺼﺎﺒﺘﻬﻡ‬ ‫ﺒﺎﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻤﻌﺎﻟﺠﺘﻬﺎ ﻓﻲ ﺍﻟﻭﻗﺕ ﺍﻟﻤﻨﺎﺴﺏ؛‬ ‫ﺘﻁﻠﺏ ﺇﻟﻰ ﺍﻟﻤﺩﻴﺭ ﺍﻟﻌﺎﻡ ﻤﺎ ﻴﻠﻲ‪:‬‬ ‫ﺍﻟﺘﻌﺎﻭﻥ ﻤﻊ ﺴﺎﺌﺭ ﻤﺅﺴﺴﺴﺎﺕ ﻤﻨﻅﻭﻤﺔ ﺍﻷﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ ﻋﻠﻰ ﻭﻀﻊ ﺨﻁﺔ ﻋﻤل ﺘﺤﺩﺩ ﻓﻴﻬﺎ‬ ‫)‪(١‬‬ ‫ﺍﻷﻭﻟﻭﻴﺎﺕ ﻭﺍﻷﻨﺸﻁﺔ ﻭﺍﻟﺠﺩﻭل ﺍﻟﺯﻤﻨﻲ ﻭﻤﺅﺸﺭﺍﺕ ﺍﻷﺩﺍﺀ ﺍﻟﻼﺯﻤﺔ ﻟﺘﻨﻔﻴﺫ ﺍﻻﺴـﺘﺭﺍﺘﻴﺠﻴﺔ ﻋﻠـﻰ‬ ‫ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻌﺎﻟﻤﻲ ﻭﺍﻹﻗﻠﻴﻤﻲ‪ ،‬ﻭﺘﻘﺩﻴﻡ ﺍﻟﺩﻋﻡ ﺍﻟﻼﺯﻡ ﻟﻠﺘﻨﻔﻴﺫ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﺒﻠﺩﺍﻥ ﻭﻤﺭﺍﻗﺒﺔ ﺍﻟﺨﻁـﻁ‬ ‫ﺎ ﻭﺘﻭﻗﻴﻬﺎ؛‬ ‫ﺍﻟﻭﻁﻨﻴﺔ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﻭﻋﻴﺔ ﺍﻟﺩﻭل ﺍﻷﻋﻀﺎﺀ ﺒﺄﻫﻤﻴﺔ ﺇﻋـﺩﺍﺩ ﻭﺘﻌﺯﻴـﺯ ﻭﺘﻤﻭﻴـل ﺍﻟﺘـﺸﺭﻴﻌﺎﺕ ﻭﺍﻟﺨﻁـﻁ‬ ‫)‪(٢‬‬ ‫ﺎ؛‬ ‫ﻭﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﺩﺍﻋﻤﺔ ﻟﺘﻭﻗﻲ ﻭﻤﻜﺎﻓﺤﺔ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺀ ﻋﻠﻰ ﻁﻠﺒﻬﺎ‪ ،‬ﻻﻋﺘﻤﺎﺩ ﺍﻻﺴـﺘﺭﺍﺘﻴﺠﻴﺔ ﻭﺘﻨﻔﻴـﺫﻫﺎ ﺒﺄﺴـﻠﻭﺏ‬ ‫ﺩﻋﻡ ﺍﻟﺩﻭل ﺍﻷﻋﻀﺎﺀ‪ ،‬ﺒﻨﺎ ً‬ ‫)‪(٣‬‬ ‫ﺎ‪ ،‬ﻭﻟﺘﻘﻴـﻴﻡ ﺃﺜـﺭ ﺍﻻﺴـﺘﺭﺍﺘﻴﺠﻴﺔ‬ ‫ﻴﺘﻨﺎﺴﺏ ﻤﻊ ﺍﻟﻭﻀﻊ ﺍﻟﻭﺒﺎﺌﻲ ﺍﻟﻤﺤﻠﻲ ﻟﻸﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻓﻌﺎﻟﻴﺘﻬﺎ؛‬ ‫)‪(٤‬‬ ‫ﺘﻘﺩﻴﻡ ﺘﻘﺎﺭﻴﺭ ﺇﻟﻰ ﺠﻤﻌﻴﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻓﻲ ﺍﻷﻋﻭﺍﻡ ‪ ٢٠٠٩‬ﻭ ‪ ٢٠١٢‬ﻭ ‪ ،٢٠١٥‬ﻋﻥ‬ ‫ﻁﺭﻴﻕ ﺍﻟﻤﺠﻠﺱ ﺍﻟﺘﻨﻔﻴﺫﻱ‪ ،‬ﺘﺘﻨﺎﻭل ﺍﻟﺘﻘﺩﻡ ﺍﻟﻤﺤﺭﺯ ﻓﻲ ﺘﻨﻔﻴﺫ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ‪.‬‬ ‫‪-٣‬‬

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‫‪A59/11‬‬

‫‪ANNEX‬‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫‪‬ﺩﺓ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ‬ ‫ﻤﺴﻭ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ ‪٢٠١٥-٢٠٠٦‬‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻟﻤﺤﺘﻭﻴﺎﺕ‬ ‫ﺍﻟﺼﻔﺤﺔ‬ ‫‪٩‬‬ ‫‪١١‬‬ ‫‪١٢‬‬ ‫‪١٢‬‬ ‫‪١٦‬‬ ‫ﺍﻟﺘﻤﻬﻴﺩ ‪..........................................................................................‬‬ ‫ﻟﻤﺤﺎﺕ ‪..........................................................................................‬‬ ‫‪‬ﺩ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ ‪...................................‬‬ ‫ﺎ‪ :‬ﻤﺸﻜﻠﺔ ﺘﻬﺩ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫‪-١‬‬ ‫‪ ١-١‬ﺍﻟﻌﺏﺀ ﺍﻟﻌﺎﻟﻤﻲ ‪........................................................................‬‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﺍﻵﻥ؟ ‪.‬‬ ‫‪ ٢-١‬ﻤﺎ ﻫﻲ ﺃﺴﺒﺎﺏ ﺍﻻﺴﺘﺜﻤﺎﺭ ﻓﻲ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

‫‪١٨‬‬

‫‪١٦‬‬ ‫‪١٦‬‬ ‫‪١٧‬‬ ‫‪١٨‬‬

‫‪١٨‬‬ ‫‪١٩‬‬ ‫‪١٩‬‬ ‫‪٢٠‬‬ ‫‪٢٢‬‬ ‫‪٢٣‬‬

‫‪٢٥‬‬ ‫‪٢٥‬‬ ‫‪٢٦‬‬ ‫‪٢٦‬‬ ‫‪٢٧‬‬ ‫‪٢٩‬‬ ‫‪٢٩‬‬ ‫‪٣٠‬‬

‫ﺎ ‪........‬‬ ‫‪ ١-٢-١‬ﺍﻟﺤﺩ ﻤﻥ ﺍﻟﻤﺭﺍﻀﺔ ﻭﻤﻌﺩل ﺍﻟﻭﻓﻴﺎﺕ ﺫﺍﺕ ﺍﻟﻌﻼﻗﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪ ٢-٢-١‬ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ‪............................‬‬ ‫‪ ٣-٢-١‬ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﺍﻟﻭﺨﻴﻤﺔ ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ ‪....................................‬‬ ‫‪ ٤-٢-١‬ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﻀﺎﺌﺭﺓ ﻟﻠﺤﻤل ‪..........................................‬‬ ‫‪ ٣-١‬ﻓﺭﺹ ﺍﻹﺴﺭﺍﻉ ﺒﻭﺘﻴﺭﺓ ﺍﻟﺘﺼﺩﻱ ‪......................................................‬‬ ‫‪ ١-٣-١‬ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻔﻌﺎﻟﺔ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻹﺼﺎﺒـﺔ ﺒﻔﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ‬ ‫ﺍﻟﺒﺸﺭﻱ ‪......................................................................‬‬ ‫‪ ٢-٣-١‬ﺸﺭﺍﻜﺎﺕ ﺠﺩﻴﺩﺓ‪................................................................‬‬ ‫‪ ٣-٣-١‬ﺍﻟﺘﻘﻨﻴﺎﺕ ﺍﻟﺠﺩﻴﺩﺓ ﻟﺘﻌﺯﻴﺯ ﺃﻨﺸﻁﺔ ﺍﻟﺘﺼﺩﻱ‪........................................‬‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ ‪.........‬‬ ‫‪ ٤-٣-١‬ﺃﺴﻠﻭﺏ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪ ٥-٣-١‬ﺘﺸﺠﻴﻊ ﻋﺎﻤﺔ ﺍﻟﺴﻜﺎﻥ ﻭﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻌﺎﻟﻴﺔ ﺍﻻﺨﺘﻁﺎﺭ ﻋﻠﻰ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﺎﺯل‬ ‫ﺍﻟﺫﻜﺭﻱ ‪.......................................................................‬‬ ‫ﺎ ‪...........‬‬ ‫‪ ٦-٣-١‬ﺍﻟﻤﻌﻭﻗﺎﺕ ﺍﻟﺘﻲ ﺘﻌﺭﻗل ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

‫‪٣٢‬‬ ‫‪٣٣‬‬ ‫‪٣٣‬‬ ‫‪٣٨‬‬ ‫‪٣٩‬‬

‫ﻤﺭﺍﻤﻲ ﻭﻨﻁﺎﻕ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ‪..............................................................‬‬ ‫‪-٢‬‬ ‫‪ ٢-١‬ﺍﻟﻬﺩﻑ ﻭﺍﻷﻏﺭﺍﺽ ‪...................................................................‬‬ ‫‪ ٢-٢‬ﺍﻟﻔﺌﺎﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ ‪.....................................................................‬‬ ‫‪ ٣-٢‬ﺍﻟﻤﺒﺎﺩﺉ ﺍﻹﺭﺸﺎﺩﻴﺔ ‪....................................................................‬‬ ‫‪ ٤-٢‬ﺍﻟﻌﻨﺎﺼﺭ ﺍﻷﺴﺎﺴﻴﺔ ﻟﻌﻤﻠﻴﺔ ﺍﻻﺴﺘﺠﺎﺒﺔ ‪..................................................‬‬ ‫ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺘﻘﻨﻴﺔ‪ :‬ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺍﻟﻨﺠﺎﺡ ﻓﻲ ﺍﻟﻭﻗﺎﻴﺔ ﻤـﻥ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨﺴﻴـﺎ‬ ‫‪-٣‬‬ ‫ﻭﻤﻜﺎﻓﺤﺘﻬﺎ ‪................................................................................‬‬ ‫ﺎ ‪...........................................‬‬ ‫‪ ١-٣‬ﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ ‪.......................................‬‬ ‫‪ ٢-٣‬ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪ ١-٢-٣‬ﺘﻌﺯﻴﺯ ﺍﻟﺴﻠﻭﻙ ﺍﻟﺼﺤﻲ ‪........................................................‬‬ ‫‪ ٢-٢-٣‬ﺘﻭﻓﻴﺭ ﺍﻟﻌﺎﺯل ﺍﻟﺫﻜﺭﻱ ﻭﺍﻟﻭﺴﺎﺌل ﺍﻷﺨﺭﻯ ﺍﻟﺤﺎﺌﻠﺔ ‪................................‬‬ ‫ﺎ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ ‪..............‬‬ ‫‪ ٣-٢-٣‬ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪ ٤-٢-٣‬ﺇﺘﺎﺤﺔ ﺍﻷﺩﻭﻴﺔ ﻭﺍﻟﺘﻜﻨﻭﻟﻭﺠﻴﺎﺕ ﺍﻟﻤﻼﺌﻤﺔ‪..........................................‬‬ ‫‪ ٥-٢-٣‬ﺍﻟﻨﻬﻭﺽ ﺒﺎﻟﺒﺭﻨﺎﻤﺞ ‪............................................................‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫‪٤٠‬‬ ‫‪٤٣‬‬ ‫‪٤٤‬‬ ‫‪٥٠‬‬ ‫‪٥١‬‬ ‫‪٥٢‬‬

‫‪٤٠‬‬ ‫‪٤٤‬‬

‫‪٥٣‬‬ ‫‪٥٤‬‬ ‫‪٥٧‬‬ ‫‪٥٨‬‬ ‫‪٥٩‬‬ ‫‪٦١‬‬ ‫‪٦٢‬‬ ‫‪٦٣‬‬ ‫‪٦٢‬‬

‫‪٥٢‬‬

‫‪٧١‬‬ ‫‪٧١‬‬ ‫‪٧١‬‬ ‫‪٧٢‬‬ ‫‪٧٣‬‬ ‫‪٧٤‬‬

‫‪٦٤‬‬ ‫‪٦٨‬‬ ‫‪٦٩‬‬

‫‪ ٢-٥-٣‬ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ‪................................................................‬‬ ‫‪ ٣-٥-٣‬ﺘﻤﻭﻴل ﺍﻟﺨﺩﻤﺎﺕ ‪...............................................................‬‬ ‫‪ ٤-٥-٣‬ﺘﻁﻭﻴﺭ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﺒﺸﺭﻴﺔ ‪.......................................................‬‬ ‫‪ ٥-٥-٣‬ﺩﻋﻡ ﺍﻟﻤﺨﺘﺒﺭﺍﺕ ﻹﺩﺍﺭﺓ ﺍﻟﺒﺭﻨﺎﻤﺞ ‪...............................................‬‬ ‫‪ ٦-٥-٣‬ﺇﺩﺍﺭﺓ ﺍﻟﻤﺸﺘﺭﻭﺍﺕ ﻭﺍﻟﻠﻭﺠﺴﺘﻴﺎﺕ ‪................................................‬‬ ‫‪ ٦-٣‬ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﻤﺤﺩﺩﺓ ﻟﻸﻭﻟﻭﻴﺎﺕ ﻤﻥ ﺃﺠل ﺍﻟﻘﻴﺎﻡ ﺒﺈﺠﺭﺍﺀﺍﺕ ﻓﻭﺭﻴﺔ ‪.......................‬‬ ‫ﺎ ‪................‬‬ ‫‪ ١-٦-٣‬ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻋﺎﻟﻲ ﺍﻟﺠﻭﺩﺓ ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘـﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪ ٢-٦-٣‬ﺇﺘﺎﺤﺔ ﺍﻟﺴﻠﻊ ﻭﺍﻷﺩﻭﻴﺔ ﺍﻷﺴﺎﺴﻴﺔ ‪................................................‬‬ ‫‪ ٣-٦-٣‬ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺘﻲ ﻴﺠﺏ ﺇﺠﺭﺍﺅﻫﺎ ﻟﻠﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻌﺎﻟﻴـﺔ ﺍﻻﺨﺘﻁـﺎﺭ ﻭﺍﻷﻜﺜـﺭ‬ ‫ﻋﺭﻀﺔ ﻟﻺﺼﺎﺒﺔ ‪............................................................‬‬ ‫‪‬ﺩ ﻭﺠﻤﻊ ﺍﻟﻤﻌﻁﻴﺎﺕ ‪............................................‬‬ ‫‪ ٤-٦-٣‬ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺭﺼ‬ ‫‪ ٥-٦-٣‬ﺃﺴﻠﻭﺏ ﺍﻟﺘﻨﻔﻴﺫ ﺍﻟﻤﺘﻜﺎﻤل‪ :‬ﺍﻟﻤﺴﺅﻭﻟﻴﺎﺕ ﺍﻟﻤﺸﺘﺭﻜﺔ‪.................................‬‬

‫‪ ٣-٣‬ﺘﺤﺴﻴﻥ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﻤﻥ ﺃﺠل ﻭﻀﻊ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﺒﺭﺍﻤﺞ‪...............................‬‬ ‫‪‬ﺩ ‪......................................................................‬‬ ‫‪ ١-٣-٣‬ﺍﻟﺘﺭﺼ‬ ‫‪ ٢-٣-٣‬ﺍﻟﺭﺼﺩ ﻭﺍﻟﺘﻘﻴـﻴﻡ ‪.............................................................‬‬ ‫‪ ٤-٣‬ﺍﻟﺘﺩﺍﺨل ﻤﻊ ﺒﺭﺍﻤﺞ ﻭﺸﺭﻜﺎﺀ ﺁﺨﺭﻴﻥ ‪..................................................‬‬ ‫‪ ١-٤-٣‬ﺒﺭﺍﻤﺞ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﺍﻟﻌﺎﻡ ‪...................................................‬‬ ‫‪ ٢-٤-٣‬ﺍﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ ‪...............................................................‬‬ ‫‪ ٣-٤-٣‬ﺇﺸﺭﺍﻙ ﺍﻟﻤﺠﺘﻤﻊ ‪...............................................................‬‬ ‫‪ ٤-٤-٣‬ﺍﻟﺸﺭﻜﺎﺀ ﺍﻵﺨﺭﻭﻥ ‪............................................................‬‬ ‫‪ ٥-٣‬ﺘﻌﺯﻴﺯ ﻗﺩﺭﺍﺕ ﻭﻁﺎﻗﺎﺕ ﺍﻷﻨﻅﻤﺔ ﺍﻟﺼﺤﻴﺔ ﻟﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﻓﻌﺎﻟﺔ ﻭﻤﺅﺜﺭﺓ ‪...............‬‬ ‫ﺎ ‪..............‬‬ ‫‪ ١-٥-٣‬ﺇﺘﺎﺤﺔ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

‫ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺩﻋﻭﺓ ﻭﺍﻟﻤﺴﺎﻨﺩﺓ‪ :‬ﺍﺴﺘﻨﻬﺎﺽ ﺍﻟﻘﻴﺎﺩﺓ ﺍﻟﺴﻴﺎﺴﻴﺔ ﻭﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﺎﻟﻴﺔ ‪........‬‬ ‫‪-٤‬‬ ‫‪ ١-٤‬ﺍﻟﺩﻋﻭﺓ ﻭﺍﻟﻤﺴﺎﻨﺩﺓ ‪.....................................................................‬‬ ‫‪ ٢-٤‬ﺍﻟﻌﻤل ﻤﻊ ﻭﺴﺎﺌل ﺍﻹﻋﻼﻡ ‪.............................................................‬‬ ‫‪ ٣-٤‬ﺇﻗﺎﻤﺔ ﺸﺭﻜﺎﺕ ﻓﺎﻋﻠﺔ ‪..................................................................‬‬ ‫‪ ٤-٤‬ﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﺎﻟﻴﺔ ‪..................................................................‬‬ ‫ﺍﻟﻤﺭﺍﺠﻊ ‪.........................................................................................‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﺘﻤﻬﻴﺩ‬ ‫ﺎ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺍﻟﻌﺩﺍﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪ ،‬ﺤﻭﺍﻟﻰ ﻤﻠﻴﻭﻥ ﺸﺨﺹ ﻜل ﻴﻭﻡ‪.‬‬ ‫ﺘﺼﻴﺏ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺘﺘﻤﺜل ﻨﺘﺎﺌﺞ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﻓﻲ ﻅﻬﻭﺭ ﺃﻋﺭﺍﺽ ﺤﺎﺩﺓ ﻭﻋﺩﺍﻭﻯ ﻤﺯﻤﻨﺔ ﻭﻏﻴﺭﻫﺎ ﻤﻥ ﺍﻵﺜﺎﺭ ﺍﻟﺨﻁﻴﺭﺓ ﺍﻟﺘﻲ ﺘﻅﻬﺭ ﻓﻲ‬ ‫ﻤﺭﺍﺤل ﻻﺤﻘﺔ ﻤﻥ ﺍﻟﻌﻤﺭ ﻤﺜل ﺍﻟﻌﻘﻡ‪ ،‬ﻭﺍﻟﺤﻤل ﺍﻟﻬﺎﺠﺭ ﺃﻭ ﺍﻟﻤﻨﺘﺒﺫ‪ ،‬ﻭﺴﺭﻁﺎﻥ ﻋﻨﻕ ﺍﻟﺭﺤﻡ ﻭﻤﻭﺕ ﺍﻷﺠﻨﺔ ﻭﺍﻟﺒـﺎﻟﻐﻴﻥ‬ ‫ﺎ ﻤﺜل ﺍﻟﺯﻫﺭﻱ‪ ،‬ﺃﻭ ﺍﻟﻘﺭﺤﺔ ﺍﻟﻘﺭﻴﺤﻴﺔ‪ ،‬ﺃﻭ‬ ‫ﻓﻲ ﻨﻬﺎﻴﺔ ﺍﻷﻤﺭ‪ .‬ﻜﻤﺎ ﺃﻥ ﺇﺼﺎﺒﺔ ﺃﻱ ﺸﺨﺹ ﺒﻌﺩﺍﻭﻯ ﺃﺨﺭﻯ ﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻬﺭﺒﺱ ﺍﻟﺘﻨﺎﺴﻠﻲ ﺘﺯﻴﺩ ﺒﺸﺩﺓ ﻤﻥ ﻤﺨﺎﻁﺭ ﺍﻜﺘﺴﺎﺏ ﺃﻭ ﻨﻘل ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ .‬ﻭﺘﺸﻴﺭ ﺍﻟﺒﺤﻭﺙ ﺍﻟﺠﺩﻴﺩﺓ‬ ‫ﺍ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒـﺸﺭﻱ ﻭﺴـﺎﺌﺭ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺇﻟﻰ ﺤﺩﻭﺙ ﺘﻔﺎﻋل ﻗﻭﻱ ﻓﻲ ﻤﺎ ﺒﻴﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﺒﻜﺭﺓ ﺠﺩﹰ‬ ‫ﺎ‪ .‬ﻭﻴﻌﺯﻯ ‪ ٪٤٠‬ﺃﻭ ﺃﻜﺜﺭ ﻤﻥ ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺒﻬﺫﺍ ﺍﻟﻔﻴﺭﻭﺱ ﺇﻟﻰ ﻫﺫﺍ ﺍﻟﺘﻔﺎﻋل‪ .‬ﻭﻋﻠﻰ ﺍﻟﺭﻏﻡ ﻤﻥ ﻫﺫﻩ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻓﻘﺩﺕ ﺯﺨﻤﻬﺎ ﺨﻼل ﺍﻟﺴﻨﻭﺍﺕ ﺍﻟﺨﻤﺱ‬ ‫ﺍﻟﻘﺭﺍﺌﻥ‪ ،‬ﻓﺈﻥ ﺍﻟﺠﻬﻭﺩ ﺍﻟﻤﺒﺫﻭﻟﺔ ﻟﻠﺴﻴﻁﺭﺓ ﻋﻠﻰ ﺍﻨﺘﺸﺎﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍ ﻟﺘﺤﻭل ﺍﻟﺘﺭﻜﻴﺯ ﺇﻟﻰ ﻤﻌﺎﻟﺠﺎﺕ ﺍﻷﻤﺭﺍﺽ ﺍﻟﺘﻲ ﻴﺴﺒﺒﻬﺎ ﻫﺫﺍ ﺍﻟﻔﻴﺭﻭﺱ‪.‬‬ ‫ﺍﻟﻤﻨﺼﺭﻤﺔ ﻨﻅﺭﹰ‬ ‫ﺎ ﻟﻠﺨﺩﻤﺎﺕ ﺍﻟـﺸﺎﻤﻠﺔ‬ ‫ﺍ ﻤﺘﻤﻤﹰ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ ﺠﺯﺀﹰ‬ ‫ﻭﻤﻥ ﺜﻡ ﻴﻨﺒﻐﻲ ﺃﻥ ﺘﺼﺒﺢ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﻠﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻭﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﺤﺘﻰ ﻴﺘﺴﻨﻰ ﺘﺤﻘﻴﻕ ﺍﻟﻤﺭﺍﻤﻲ ﺍﻹﻨﻤﺎﺌﻴﺔ ﻟﻸﻟﻔﻴﺔ ﻭﺍﻻﺴﺘﺠﺎﺒﺔ ﻟﻠﺩﻋﻭﺓ ﺇﻟﻰ ﺘﺤﺴﻴﻥ ﺍﻟﺼﺤﺔ‬ ‫ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻹﻨﺠﺎﺒﻴﺔ‪ ،‬ﻜﻤﺎ ﻫﻭ ﻤﺤﺩﺩ ﻓﻲ ﺒﺭﻨﺎﻤﺞ ﻋﻤل ﺍﻟﻤﺅﺘﻤﺭ ﺍﻟﺩﻭﻟﻲ ﻟﻠﺴﻜﺎﻥ ﻭﺍﻟﺘﻨﻤﻴـﺔ ﺍﻟﺘـﺎﺒﻊ ﻟﻸﻤـﻡ ﺍﻟﻤﺘﺤـﺩﺓ‬ ‫)ﺍﻟﻘﺎﻫﺭﺓ‪.(١٩٩٤ ،‬‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،٢٠١٥-٢٠٠٦ ،‬ﻋﻠـﻰ‬ ‫ﻭﺘﺘﻀﻤﻥ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻋﻨﺼﺭﻴﻥ‪ :‬ﻋﻨﺼﺭ ﺘﻘﻨﻲ ﻭﻋﻨﺼﺭ ﻟﻠﺩﻋﻡ ﻭﺍﻟﻤﺴﺎﻨﺩﺓ‪ .‬ﻭﻴﺘﻨﺎﻭل ﺍﻟﻌﻨﺼﺭ ﺍﻟﺘﻘﻨﻲ ﻟﻼﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﻁﺭﻕ ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﻤﻥ‬ ‫ﺎ‪ ،‬ﻭﺇﺘﺎﺤـﺔ‬ ‫ﺨﻼﻟﻬﺎ ﺘﻌﺯﻴﺯ ﺍﻟﺴﻠﻭﻙ ﺍﻟﺠﻨﺴﻲ ﺍﻟﺼﺤﻲ‪ ،‬ﻭﺘﻘﺩﻴﻡ ﺍﻟﻭﺴﺎﺌل ﺍﻟﺤﺎﺌﻠﺔ ﺍﻟﺘﻲ ﺘﻘﻲ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻭﺭﺼﺩ ﻭﺘﻘﻴﻴﻡ ﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺭﻋﺎﻴﺔ ﻓﻌﺎﻟﺔ‪ ،‬ﻴﺴﻬل ﺍﻟﻭﺼﻭل ﺇﻟﻴﻬﺎ‪ ،‬ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﹸﻡ ﺍﻟﺼﺤﻴﺔ ﺒﻤﺎ ﻴﺴﺎﻋﺩ ﻋﻠﻰ ﺘﻨﻔﻴﺫ ﺍﻟﺒﺭﻨﺎﻤﺞ‪ .‬ﻜﻤـﺎ‬ ‫ﻨﻅ‬ ‫ﺎ‪ .‬ﻭﻫﻨﺎﻙ ﺘﻭﻀﻴﺢ ﻟﻠﺨﻁﻭﺍﺕ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻟﺘﻁﻭﻴﺭ ﻁﺎﻗﺎﺕ ﺍﻟ ﹸ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﻴﺘﻡ ﺍﻟﺘﺭﻜﻴﺯ ﻋﻠﻰ ﺃﺴﺎﻟﻴﺏ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ ﺍﻟﻤﺭﺘﻜﺯﺓ ﻋﻠﻰ ﻗﺭﺍﺌﻥ ﻋﻠﻤﻴﺔ ﺴﻠﻴﻤﺔ ﻭﺘﺤﻠﻴل ﻟﻠﻤﺭﺩﻭﺩﻴﺔ‪.‬‬ ‫ﻭﺘﺅﻜﺩ ﻫﺫﻩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻋﻠﻰ ﺃﻫﻤﻴﺔ ﺘﻭﺴﻴﻊ ﻨﻁﺎﻕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﺎﻟﻴﺔ ﺍﻟﺠﻭﺩﺓ ﻟﻠﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ ﻭﻻﺴﻴﻤﺎ ﻓﻲ ﻤﺠﺎل ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻭﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴـﺔ ﻭﺍﻟﺠﻨـﺴﻴﺔ‪ ،‬ﻭﺨـﺩﻤﺎﺕ ﺭﻋﺎﻴـﺔ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪ .‬ﻜﻤﺎ ﺃﻨﻬﺎ ﺘﺅﻜﺩ ﻋﻠﻰ ﻀﺭﻭﺭﺓ ﺘﻭﻓﻴﺭ ﺍﻟﻔﺭﺹ ﻟﺯﻴﺎﺩﺓ ﻨﻁﺎﻕ ﺍﻟﺘﻐﻁﻴﺔ ﻤﻥ ﺨﻼل ﺍﻟﺘﻀﺎﻓﺭ‬ ‫ﻤﻊ ﺍﻟﻘﻁﺎﻋﺎﺕ ﺍﻟﺤﻜﻭﻤﻴﺔ ﻭﺍﻟﻤﻨﻅﻤﺎﺕ ﺍﻟﻤﺠﺘﻤﻌﻴﺔ‪ ،‬ﻭﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺒﺎﻟﻤﺅﺴﺴﺎﺕ ﺍﻟﺨﺎﺼﺔ‪.‬‬ ‫ﻭﺘﻘﻊ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻤـﻥ‬ ‫ﺎ ﺒﺄﻋﻠﻰ ﻤﻌﺩل ﺘﻭﺍﺘﺭ ﻓﻲ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺍﻟﻤﻬﻤﺸﺔ ﺍﻟﺘـﻲ ﺘﻌـﺎﻨﻲ ﺃﺴﺎﺴـﹰ‬ ‫ﻤﺸﻜﻼﺕ ﻤﻌﻴﻨﺔ ﻓﻲ ﺍﻟﻭﺼﻭل ﺇﻟﻰ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻭﺘﻤﺜل ﻋﻤﻠﻴﺔ ﺘﺄﻤﻴﻥ ﻤﺴﺘﻭﻯ ﺍﻟﺩﻋﻡ ﺍﻟـﻼﺯﻡ ﻟﺘـﻭﻓﻴﺭ‬ ‫ﺎ ﻋﻠﻰ ﺍﻟﺭﻏﻡ ﻤﻤﺎ ﺘﺤﻘﻘﻪ ﻤﻥ ﻤﺯﺍﻴﺎ ﺼﺤﻴﺔ ﻋﻤﻭﻤﻴﺔ ﺠﻤﺔ‪.‬‬ ‫ﺍ ﺼﻌﺒﹰ‬ ‫ﺘﺩﺨﻼﺕ ﻓﻌﺎﻟﺔ ﻟﻬﺫﻩ ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺃﻤﺭﹰ‬ ‫ﺃﻤﺎ ﺍﻟﻘﺴﻡ ﺍﻟﺨﺎﺹ ﺒﺎﻟﺘﻭﺍﺨﻲ ﻓﻴﻘﺩﻡ ﺍﻟﻤﺸﻭﺭﺓ ﻭﺍﻟﻨﺼﺢ ﻟﻤﺩﻴﺭﻱ ﺍﻟﺒﺭﺍﻤﺞ ﺤﻭل ﻁﺭﻕ ﻭﺃﺴﺎﻟﻴﺏ ﺤﺸﺩ ﺃﻋﻠـﻰ‬ ‫ﻤﺴﺘﻭﻯ ﻤﻥ ﺍﻻﻟﺘﺯﺍﻡ ﺍﻟﺫﻱ ﻴﺸﻜل ﺍﻟﺩﻋﺎﻤﺔ ﺍﻷﺴﺎﺴﻴﺔ ﻻﺴﺘﺠﺎﺒﺔ ﺫﺍﺕ ﻭﺘﻴﺭﺓ ﻤﺘﺴﺎﺭﻋﺔ‪.‬‬ ‫ﻓﻌﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻌﺎﻟﻤﻲ‪ ،‬ﻨﺠﺩ ﺃﻨﻪ ﺒﺎﻟﺭﻏﻡ ﻤﻥ ﻭﺠﻭﺩ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺃﻨﻤﺎﻁ ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪ ،‬ﺇﻻ ﺃﻥ ﺍﻟﻨﻤﻁ‬ ‫ﺍﻟﺠﻨﺴﻲ ﻫﻭ ﺍﻟﻨﻤﻁ ﺍﻟﺴﺎﺌﺩ ﻟﻠﺴﺭﺍﻴﺔ‪ .‬ﻭﻤﻥ ﺜﻡ ﻴ‬ ‫ﺎ‪ .‬ﻓﻌﻠـﻰ ﻤـﺩﻯ‬ ‫‪‬ﻌﺘﺒﺭ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﺒﻤﺜﺎﺒﺔ ﻋﺩﻭﻯ ﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺎ‬ ‫ﺍﻟﺴﻨﻭﺍﺕ‪ ،‬ﻗﺩﻤﺕ ﺍﻟﺩﺭﺍﺴﺎﺕ ﺍﻟﺒﻴﻭﻟﻭﺠﻴﺔ ﻭﺍﻟﺩﺭﺍﺴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻭﺒﺎﺌﻴﺎﺕ‪ ،‬ﻗﺭﺍﺌﻥ ﻋﻠﻰ ﺃﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻟﺩﻯ ﺍﻟﺸﺨﺹ‪ ،‬ﺘﻜﻭﻥ ﺒﻤﺜﺎﺒﺔ ﻋﻭﺍﻤل ﻤﻌﺯﺯﺓ ﻻﻜﺘﺴﺎﺏ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺴﺭﺍﻴﺘﻪ‪ .‬ﻭﻫﺫﺍ ﺒـﺩﻭﺭﻩ ﺃﺩﻯ ﺇﻟـﻰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﺒـﺄﻥ‬ ‫ﺎ ﺘﻴﺴﺭ ﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ" ﻤﻤﺎ ﺃﻋﻁـﻰ ﺍﻨﻁﺒﺎﻋـﹰ‬ ‫ﺍﻟﻤﻘﻭﻟﺔ ﺍﻟﻤﺘﻌﺎﺭﻑ ﻋﻠﻴﻬﺎ "ﺒﺄﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪.‬‬ ‫ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻴﺨﺘﻠﻑ ﻋﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺘﻴﺴﺭ ﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ" ﻓﻲ ﻫـﺫﻩ‬ ‫ﻭﻤﻥ ﺜﻡ ﻓﺈﻥ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﺒﺎﺭﺓ ﺍﻟﻌﺎﻤﺔ "ﺇﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺒﺨﻼﻑ ﺍﻷﻴﺩﺯ‪ .‬ﻭﻋﻨﺩﻤﺎ ﻴﺘﻁﻠﺏ ﺍﻷﻤﺭ‬ ‫ﺍﻟﻭﺜﻴﻘﺔ‪ ،‬ﻴﺠﺏ ﺃﻥ ﻴﻔﻬﻡ ﻤﻨﻬﺎ ﺃﻨﻬﺎ ﺘﺸﻴﺭ ﺇﻟﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‬ ‫ﺎ" ﺃﻭ "ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺍﻟﻤﺯﻴﺩ ﻤﻥ ﺍﻹﻴﻀﺎﺡ‪ ،‬ﻓﺈﻨﻨﺎ ﻨﺴﺘﺨﺩﻡ ﻋﺒﺎﺭﺍﺕ ﻤﺜل "ﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻷﺨﺭﻯ ﺒﺨﻼﻑ ﺍﻷﻴﺩﺯ"‪ .‬ﻭﺒﻭﺠﻪ ﻋﺎﻡ‪ ،‬ﻓﺈﻥ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻭﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺘﻲ ﻤﻥ ﺸﺄﻨﻬﺎ ﻭﻗﻑ ﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪،‬‬ ‫ﺎ‪.‬‬ ‫ﺎ ﻓﻲ ﺤﺎﻟﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﻔﻴﺩ ﺃﻴﻀﹰ‬

‫‪10‬‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻟﻤﺤﺎﺕ‬ ‫ﺘﻘﻊ ﺃﻜﺜﺭ ﻤﻥ ‪ ٣٤٠‬ﻤﻠﻴﻭﻥ ﺤﺎﻟﺔ ﺠﺩﻴﺩﺓ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺒﺎﻟﺠﺭﺍﺜﻴﻡ ﺃﻭﺍﻟﺒﻜﺘﻴﺭﻴـﺎ‬ ‫ﺎ ﻓﻲ ﺸﺘﻰ ﺃﺭﺠﺎﺀ ﺍﻟﻌﺎﻟﻡ‪ ،‬ﻜل ﻋﺎﻡ‪.‬‬ ‫ﻭﺒﺎﻷﻭﺍﻟﻲ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

‫ﻴﺅﺩﻱ ﻋﺩﻡ ﻋﻼﺝ ﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺒﺎﻟﻤﻜﻭﺭﺍﺕ ﺍﻟﺒﻨﻴﺔ ﻭﺍﻟﻤﺘﺩﺜﺭﺍﺕ‪ ،‬ﻟـﺩﻯ ﺍﻟﻨـﺴﺎﺀ‪ ،‬ﺇﻟـﻰ‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﺄﻤﺭﺍﺽ ﺍﻟﺘﻬﺎﺒﻴﺔ ﺒﺎﻟﺤﻭﺽ ﺒﻨﺴﺒﺔ ﺘﺼل ﺇﻟﻰ ‪ ٪٤٠‬ﻤﻥ ﻋـﺩﺩ ﺍﻟﺤـﺎﻻﺕ‪ ،‬ﻭﺇﻥ‬ ‫ﻭﺍﺤﺩﺓ ﻤﻥ ﻜل ﺃﺭﺒﻊ ﻤﻥ ﻫﺫﻩ ﺍﻟﺤﺎﻻﺕ ﺘﺅﺩﻱ ﺇﻟﻰ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﻘﻡ‪.‬‬

‫ﻴﺅﺩﻱ ﻋﺩﻡ ﻋﻼﺝ ﺍﻹﺼﺎﺒﺔ ﺍﻟﻤﺒﻜﺭﺓ ﺒﺎﻟﺯﻫﺭﻱ‪ ،‬ﺃﺜﻨﺎﺀ ﺍﻟﺤﻤل‪ ،‬ﺇﻟﻰ ﻤﻭﺕ ﺍﻟﺠﻨﻴﻥ ﺒﻤﻌـﺩل ‪،٪٢٥‬‬ ‫ﻜﻤﺎ ﺃﻥ ﻫﺫﺍ ﺍﻟﻤﺭﺽ ﻤﺴﺅﻭل ﻋﻥ ‪ ٪١٤‬ﻤﻥ ﻭﻓﻴﺎﺕ ﺍﻟﻭﻟﺩﺍﻥ‪ ،‬ﻭﻨﺴﺒﺔ ‪ ٪٤٠‬ﻤﻥ ﺍﻟﻭﻓﻴﺎﺕ ﺍﻟﺘـﻲ‬ ‫ﺘﺤﺩﺙ ﻓﻲ ﺍﻟﻔﺘﺭﺓ ﺍﻟﻤﺤﻴﻁﺔ ﺒﺎﻟﻭﻻﺩﺓ ﺒﺸﻜل ﻋﺎﻡ‪ .‬ﻭﺇﻥ ﺘﻔﺸﻲ ﺍﻟﺯﻫﺭﻱ ﻟﺩﻯ ﺍﻟﺤﻭﺍﻤل‪ ،‬ﻓﻲ ﻗـﺎﺭﺓ‬ ‫ﺃﻓﺭﻴﻘﻴﺎ‪ ،‬ﻋﻠﻰ ﺴﺒﻴل ﺍﻟﻤﺜﺎل‪ ،‬ﻴﺘﺭﺍﻭﺡ ﺒﻴﻥ ‪ ٪٤‬ﻭ‪.٪١٥‬‬

‫ﺇﻥ ﺘﻭﻓﺭ ﻟﻘﺎﺤﺎﺕ ﺠﺩﻴﺩﺓ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﻴﻤﻜﻥ ﺃﻥ ﻴﺅﺜﺭ ﻋﻠﻰ ﺍﻟﻭﻓﺎﺓ ﺍﻟﻤﺒﻜﺭﺓ‬ ‫ﺍﻟﺘﻲ ﺘﺤﺩﺙ ﻟﺤﻭﺍﻟﻰ ‪ ٢٤٠ ٠٠٠‬ﺍﻤﺭﺃﺓ ﻤﻥ ﺠﺭﺍﺀ ﺍﻹﺼﺎﺒﺔ ﺒﺴﺭﻁﺎﻥ ﻋﻨﻕ ﺍﻟﺭﺤﻡ‪ ،‬ﻜل ﻋـﺎﻡ‬ ‫ﻓﻲ ﺍﻷﻤﺎﻜﻥ ﺫﺍﺕ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻔﻘﻴﺭﺓ‪.‬‬

‫ﻴﻔﻘﺩ ﺤﻭﺍﻟﻰ ‪ ٤٠٠٠‬ﻤﻭﻟﻭﺩ ﺃﺒﺼﺎﺭﻫﻡ‪ ،‬ﻜل ﻋﺎﻡ‪ ،‬ﺤﻭل ﺍﻟﻌﺎﻟﻡ ﺒﺴﺒﺏ ﺍﻹﺼﺎﺒﺔ ﺒﻌﺩﺍﻭﻯ ﻋﻴﻨﻴﺔ ﺘﻌﺯﻯ‬ ‫ﺇﻟﻰ ﻋﺩﺍﻭﻯ ﻏﻴﺭ ﻤﻌﺎﻟﺠﺔ ﺒﺎﻟﻤﻜﻭﺭﺍﺕ ﺍﻟﺒﻨﻴﺔ ﻭﺍﻟﻤﺘﺩﺜﺭﺍﺕ‪ ،‬ﺃﺜﻨﺎﺀ ﺍﻟﺤﻤل‪.‬‬

‫‪11‬‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﹸﻬﺩﺩ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ‬ ‫ﺎ‪ :‬ﻤﺸﻜﻠﺔ ﺘ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬

‫‪-١‬‬

‫‪ ١-١‬ﺍﻟﻌﺏﺀ ﺍﻟﻌﺎﻟﻤﻲ‬ ‫ﻫﻨﺎﻙ ﺃﻜﺜﺭ ﻤﻥ ‪ ٣٠‬ﻤﻤﺭﺍﺽ )ﻋﺎﻤل ﻤﺴﺒﺏ ﻟﻠﻤﺭﺽ( ﺒﻜﺘﻴﺭﻱ ﻭﻓﻴﺭﻭﺴﻲ ﻭﻁﻔﻴﻠﻲ‪ ،‬ﺘﻨﺘﻘل ﻋﻥ ﻁﺭﻴـﻕ‬ ‫ﺎ ﺘﻨﺘﻘل‪ ،‬ﻓﻲ ﻤﻌﻅﻡ ﺍﻷﺤﻭﺍل‪ ،‬ﺃﺜﻨﺎﺀ ﺍﻟﺠﻤﺎﻉ‪،‬‬ ‫ﺍﻟﻤﻤﺎﺭﺴﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ )‪ .(١‬ﻭﻋﻠﻰ ﺍﻟﺭﻏﻡ ﻤﻥ ﺃﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻤﻥ ﺍﻷﻡ ﺇﻟﻰ ﺍﻟﺠﻨﻴﻥ ﺃﺜﻨﺎﺀ ﻓﺘﺭﺓ ﺍﻟﺤﻤل ﺃﻭ ﺃﺜﻨﺎﺀ ﻭﻻﺩﺓ ﺍﻟﻁﻔل‪ ،‬ﻭﻋﻥ ﻁﺭﻴـﻕ‬ ‫ﺇﻻ ﺃﻥ ﺍﻟﺴﺭﺍﻴﺔ ﻴﻤﻜﻥ ﺃﻥ ﺘﺤﺩﺙ ﺃﻴﻀﹰ‬ ‫ﻤﺸﺘﻘﺎﺕ ﺍﻟﺩﻡ ﺃﻭ ﻨﻘل ﺍﻷﻨﺴﺠﺔ‪ ،‬ﻭﻓﻲ ﺒﻌﺽ ﺍﻷﺤﻴﺎﻥ‪ ،‬ﻤﻥ ﺨﻼل ﻭﺴﺎﺌل ﺃﺨﺭﻯ ﻏﻴﺭ ﻤﺭﺘﺒﻁﺔ ﺒﻤﻤﺎﺭﺴـﺔ ﺍﻟﺠـﻨﺱ‪.‬‬ ‫ﺎ ﺍﻟﻌﺩﺍﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﺍﻟﺘﻲ ﺘـﺅﺩﻱ ﺇﻟـﻰ‬ ‫ﺎ ﺍﻟﺘﻲ ﺘﺸﻤل ﺃﻴﻀﹰ‬ ‫ﻭﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ﻨﻅﺭ ﺇﻟﻴﻬﺎ ﻜﻤﺸﻜﻠﺔ ﺭﺌﻴﺴﻴﺔ ﻤﻥ ﻤﺸﺎﻜل ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴـﺔ‪،‬‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﻤﺭﺽ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﺍﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪ ،‬ﺃﺼﺒﺢ ﻴ‬ ‫ﺎ‬ ‫ﺎ ﻤﻥ ﺃﻜﺜﺭ ﺍﻟﻌﻭﺍﻤل ﺍﻟﻤﺴﺒﺒﺔ ﻟﻸﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻭﺫﻟﻙ ﻤﻨﺫ ﺴﻨﻭﺍﺕ ﻋﺩﻴﺩﺓ‪ .‬ﻭﻴﻭﻀﺢ ﺍﻟﺠﺩﻭل ﺭﻗﻡ ‪ ،١‬ﺒﻌﻀﹰ‬ ‫ﹰ‪ ،‬ﻭﺍﻷﻤﺭﺍﺽ ﺍﻟﺘﻲ ﺘﺴﺒﺒﻬﺎ‪.‬‬ ‫ﺸﻴﻭﻋﺎ‬ ‫ﺎ‪ ،‬ﺍﻟﻘﺎﺒﻠـﺔ ﻟﻠـﺸﻔﺎﺀ‪ ،‬ﻭﻻﺴـﻴﻤﺎ‬ ‫ﻭﻴﻘﺩﺭ ﺒﺄﻥ ﺃﻜﺜﺭ ﻤﻥ ‪ ٣٤٠‬ﻤﻠﻴﻭﻥ ﺤﺎﻟﺔ ﺠﺩﻴﺩﺓ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ﺔ )ﺍﻟـﺴﻴﻼﻥ( ﻭﺍﻟﻤﺘـﺩﺜﺭﺓ ﺍﻟﺤﺜﺭﻴـﺔ ﻭﺍﻟﻤـﺸﻌﺭﺓ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻨﺎﺠﻤﺔ ﻋﻥ ﺍﻟﻠﻭﻟﺒﻴﺔ ﺍﻟﺸﺎﺤﺒﺔ )ﺍﻟﺯﻫﺭﻱ( ﻭﺍﻟﻨﻴﺴﺭﻴﺔ ﺍﻟﺒﻨﻴ‬ ‫ﹰ‪ ،‬ﻤﻊ‬ ‫ﺍﻟﻤﻬﺒﻠﻴﺔ‪ ،‬ﺘﺤﺩﺙ ﻜل ﻋﺎﻡ ﻓﻲ ﺸﺘﻰ ﺃﺭﺠﺎﺀ ﺍﻟﻌﺎﻟﻡ ﻓﻲ ﺍﻟﺭﺠﺎل ﻭﻓﻲ ﺍﻟﻨﺴﺎﺀ ﻀﻤﻥ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺭﻴﺔ ‪ ٤٩-١٥‬ﻋﺎﻤﺎ‬ ‫ﻭﻗﻭﻉ ﺃﻋﻠﻰ ﻨﺴﺒﺔ ﻤﻨﻬﺎ ﻓﻲ ﺇﻗﻠﻴﻡ ﺠﻨﻭﺏ ﻭﺠﻨﻭﺏ ﺸﺭﻕ ﺁﺴﻴﺎ‪ ،‬ﺘﻠﻴﻬﺎ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻭﺍﻗﻌﺔ ﺠﻨﻭﺏ ﺍﻟﺼﺤﺭﺍﺀ ﺍﻷﻓﺭﻴﻘﻴﺔ‪ ،‬ﺜﻡ‬ ‫ﺎ‪،‬‬ ‫ﺃﻤﺭﻴﻜﺎ ﺍﻟﻼﺘﻴﻨﻴﺔ‪ ،‬ﻭﻤﻨﻁﻘﺔ ﺍﻟﻜﺎﺭﻴﺒﻲ )‪ .(٢‬ﻜﻤﺎ ﺘﺤﺩﺙ ﻤﻼﻴـﻴﻥ ﺍﻟﺤﺎﻻﺕ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻔﻴﺭﻭﺴﻴﺔ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺎ ﻜل ﻋﺎﻡ‪ .‬ﻭﻤﻥ ﺒﻴﻥ ﻫﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ ،‬ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﻋﺩﺍﻭﻯ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺘﻨﺎﺴـﻠﻲ‬ ‫ﺃﻴﻀﹰ‬ ‫"‬ ‫ﺍﻟﺒﺴﻴﻁ‪ ،‬ﻭﻋﺩﺍﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﺍﻟﺘﻨﺎﺴﻠﻲ‪ ،‬ﻭﻓﻴﺭﻭﺱ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ ﺍﻟﻭﺒـﺎﺌﻲ "ﺍﻟﺒـﺎﺌﻲ" ‪ .‬ﻭﻋﻠـﻰ‬ ‫ﺎ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﺒﻠﺩﺍﻥ ﺍﻟﻨﺎﻤﻴﺔ‬ ‫ﹰ‪ ،‬ﺨﺼﻭﺼﹰ‬ ‫ﺍﻟﺼﻌﻴﺩ ﺍﻟﻌﺎﻟﻤﻲ‪ ،‬ﺘﺸﻜل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻀﺨﻤﺎ‬ ‫ﺎ ﻭﺍﻗﺘﺼﺎﺩﻴﹰ‬ ‫ﺎ ﺼﺤﻴﹰ‬ ‫ﺎ ﻋﺒﺌﹰ‬ ‫ﺤﻴﺙ ﺘﻜﻭﻥ ﻤﺴﺅﻭﻟﺔ ﻋﻥ ‪ ٪١٧‬ﻤﻥ ﺍﻟﺨﺴﺎﺌﺭ ﺍﻻﻗﺘﺼﺎﺩﻴﺔ ﺍﻟﻨﺎﺘﺠﺔ ﻋﻥ ﺍﻋﺘﻼل ﺍﻟﺼﺤﺔ )‪.(٣‬‬ ‫ﻭﺘﻤﺜل ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ‪ ،‬ﺍﻟـﻨﻤﻁ ‪ ،٢‬ﺍﻟـﺴﺒﺏ ﺍﻟﺭﺌﻴـﺴﻲ ﻟﻺﺼـﺎﺒﺔ ﺒـﺄﻤﺭﺍﺽ ﺍﻟﻘﺭﺤـﺎﺕ‬ ‫ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﻓﻲ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻨﺎﻤﻴﺔ‪ .‬ﻭﺘﻭﻀﺢ ﺍﻟﻤﻌﻁﻴﺎﺕ ﺍﻟﻤﺄﺨﻭﺫﺓ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻭﺍﻗﻌﺔ ﺠﻨﻭﺏ ﺍﻟﺼﺤﺭﺍﺀ ﺍﻷﻓﺭﻴﻘﻴﺔ ﺃﻥ‬ ‫‪ ٪٨٠–٪٣٠‬ﻤﻥ ﺍﻟﻨﺴﺎﺀ ﻭ‪ ٪٥٠–٪١٠‬ﻤﻥ ﺍﻟﺭﺠﺎل ﻤﺼﺎﺒﻭﻥ ﺒﻬﺫﻩ ﺍﻟﻌﺩﻭﻯ‪ .‬ﻭﻴﺘﺭﺍﻭﺡ ﻤﻌﺩل ﺍﻨﺘﺸﺎﺭ ﻤـﺭﺽ‬ ‫ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ‪ ،‬ﺍﻟﻨﻤﻁ ‪ ،٢‬ﺒﻴﻥ ﺍﻟﻨﺴﺎﺀ ﻓﻲ ﻭﺴﻁ ﻭﺠﻨﻭﺏ ﺃﻤﺭﻴﻜﺎ ﺒﻴﻥ ‪ ٪٢٠‬ﻭ‪ .٪٤٠‬ﻭﻓﻲ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻵﺴـﻴﻭﻴﺔ‬ ‫ﺍﻟﻨﺎﻤﻴﺔ‪ ،‬ﻴﺘﺭﺍﻭﺡ ﻤﻌﺩل ﺍﻨﺘﺸﺎﺭ ﻫﺫﺍ ﺍﻟﻤﺭﺽ ﻟﺩﻯ ﺍﻟﺴﻜﺎﻥ ﺒﻭﺠﻪ ﻋﺎﻡ‪ ،‬ﺒـﻴﻥ ‪ ٪١٠‬ﻭ‪ .٪٣٠‬ﻭﻓـﻲ ﺍﻟﻭﻻﻴـﺎﺕ‬ ‫ﺍﻟﻤﺘﺤﺩﺓ ﺍﻷﻤﺭﻴﻜﻴﺔ ﻴﺼل ﻤﻌﺩل ﺍﻨﺘﺸﺎﺭ ﻨﻔﺱ ﺍﻟﻤﺭﺽ ﻓﻲ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺭﻴﺔ ‪ ٤٩-١٤‬ﻋﺎﻤﹰ‬ ‫ﺎ ﺇﻟﻰ ‪ .(٤) ٪١٩‬ﻭﻓـﻲ‬ ‫ﺸﺘﻰ ﺃﺭﺠﺎﺀ ﺍﻟﻌﺎﻟﻡ‪ ،‬ﺘﺭﺘﻔﻊ ﺇﻴﺠﺎﺒﻴﺔ ﺍﻟﻤﺼل‪ ،‬ﺒﺸﻜل ﻤﺘﺠﺎﻨﺱ‪ ،‬ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ ﺃﻜﺜﺭ ﻤﻨﻬﺎ ﻟﺩﻯ ﺍﻟﺭﺠﺎل‪ ،‬ﻜﻤـﺎ ﺃﻨﻬـﺎ‬ ‫ﺎ ﻓـﻲ ﻨﻘـل ﺍﻟﻌـﺩﻭﻯ‬ ‫ﺍ ﻤﻬﻤﹰ‬ ‫ﺘﺘﺯﺍﻴﺩ ﻤﻊ ﺍﻟﺘﻘﺩﻡ ﻓﻲ ﺍﻟﻌﻤﺭ )‪ .(٥‬ﻭﺘﻠﻌﺏ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ ﺩﻭﺭﹰ‬ ‫ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ .‬ﻭﻗﺩ ﺃﻅﻬﺭﺕ ﺩﺭﺍﺴﺔ ﺃﺠﺭﻴﺕ ﻓﻲ ﻤﻭﺍﻨﺯﺍ‪ ،‬ﺒﺠﻤﻬﻭﺭﻴﺔ ﺘﻨﺯﺍﻨﻴﺎ ﺍﻟﻤﺘﺤـﺩﺓ‪ ،‬ﺃﻥ‬ ‫‪ ٪٧٤‬ﻤﻥ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﺒﻴﻥ ﺍﻟﺭﺠﺎل ﻭ‪ ٪٢٢‬ﺒﻴﻥ ﺍﻟﻨﺴﺎﺀ‪ ،‬ﻴﻤﻜﻥ ﺃﻥ ﺘﻌـﺯﻯ ﺇﻟـﻰ‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ‪ ،‬ﺍﻟﻨﻤﻁ ‪.(٦) ٢‬‬ ‫ﺎ‪ .‬ﻭﻫـﻲ ﺘـﺴﺒﺏ‬ ‫‪‬ﻤﺭﻀﺎﺕ ﺍﻟﻔﻴﺭﻭﺴﻴﺔ ﺍﻟﻬﺎﻤﺔ ﻭﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫‪‬ﻌﺩ ﻓﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﺃﺤﺩ ﺍﻟﻤ‬ ‫ﻭﻴ‬ ‫ﺎ ﻤﻥ ﺴﺭﻁﺎﻥ ﻋﻨﻕ ﺍﻟﺭﺤﻡ ﻤﻤﺎ ﻴﺅﺩﻱ ﺇﻟﻰ ﺤﺩﻭﺙ ‪ ٢٤٠ ٠٠٠‬ﻭﻓﺎﺓ‪،‬‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﺤﻭﺍﻟﻲ ‪ ٥٠٠ ٠٠٠‬ﺤﺎﻟﺔ ﺴﻨﻭﻴﹰ‬ ‫ﺃﻜﺜﺭﻫﺎ ﻓﻲ ﺍﻟﺒﻠﺩﺍﻥ ﻓﻘﻴﺭﺓ ﺍﻟﻤﻭﺍﺭﺩ )‪.(٩-٧‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ‪ ،‬ﻭﻤﻥ ﺨﻼل ﺍﺸﺘﺭﺍﻙ ﺃﻜﺜﺭ ﻤﻥ ﺸﺨﺹ ﻓـﻲ‬ ‫ﻴﺅﺩﻱ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ ﺍﻟﻭﺒﺎﺌﻲ "ﺍﻟﺒﺎﺌﻲ"‪ ،‬ﺍﻟﺫﻱ ﻴﻤﻜﻥ ﺃﻥ ﻴﻨﺘﻘل ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻋﻥ ﻁﺭﻴﻕ ﻨﻘل ﺍﻟﺩﻡ‪ ،‬ﻭﻤﻥ ﺍﻷﻡ ﻟﻠﻁﻔل‪ ،‬ﺇﻟﻰ ﺍﻹﺼﺎﺒﺔ ﺒﻤﺎ ﻴﻘﺩﺭ ﺒـ ‪ ٣٥٠‬ﻤﻠﻴـﻭﻥ‬ ‫ﺍﺴﺘﺨﺩﺍﻡ ﺇﺒﺭ ﺍﻟﺤﻘﻥ‪ ،‬ﻭﺃﻴﻀﹰ‬ ‫‪‬ﻊ ﺍﻟﻜﺒـﺩ‬ ‫ﺤﺎﻟﺔ ﻤﻥ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ ﺍﻟﻤﺯﻤﻥ‪ ،‬ﻭﺤﺩﻭﺙ ﻤﺎ ﻻ ﻴﻘل ﻋﻥ ﻤﻠﻴﻭﻥ ﺤﺎﻟﺔ ﻭﻓﺎﺓ ﻜل ﻋﺎﻡ ﻤﻥ ﺠﺭﺍﺀ ﺘـﺸﻤ‬ ‫ﻭﺴﺭﻁﺎﻥ ﺍﻟﻜﺒﺩ )‪ .(١٠‬ﻭﻫﻨﺎﻙ ﺒﺎﻟﻔﻌل ﻟﻘﺎﺡ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ "ﺍﻟﺒﺎﺌﻲ" ﻤﻤﺎ ﻴﺤﺩ ﻤﻥ ﺤـﺎﻻﺕ‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﺴﺭﻁﺎﻥ ﺍﻟﻜﺒﺩ )‪.(١٢،١١‬‬

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‫ﺍ ﺇﻟﻰ ﺍﻻﺘﺠﺎﻫﺎﺕ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﻭﺍﻟﺩﻴﻤﻭﻏﺭﺍﻓﻴﺔ ﻭﺍﺘﺠﺎﻫﺎﺕ ﺍﻟﻬﺠـﺭﺓ‪ ،‬ﻓـﺈﻥ ﺍﻟﻤﺠﺘﻤﻌـﺎﺕ ﺍﻟـﺴﻜﺎﻨﻴﺔ‬ ‫ﻭﺍﺴﺘﻨﺎﺩﹰ‬ ‫ﺎ‪ ،‬ﺴﺘﻅل ﺁﺨﺫﺓ ﻓﻲ ﺍﻻﺭﺘﻔﺎﻉ ﺒﺸﻜل ﻜﺒﻴﺭ‪ .‬ﻭﺒﻴﻨﻤﺎ ﻴﺒﻠﻎ‬ ‫ﺍﻟﻤﻌﺭﻀﺔ ﻟﻌﻭﺍﻤل ﺍﻻﺨﺘﻁﺎﺭ ﻟﻺﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺃﻥ ﺘﻭﺍﺠﻪ ﺍﻷﻤـﻡ‬ ‫ﺎ ﻤﺩﺍﻩ ﻓﻲ ﺍﻟﻌﺎﻟﻡ ﺍﻟﻨﺎﻤﻲ‪ ،‬ﻓﻤﻥ ﺍﻟﻤﺘﻭﻗﻊ ﺃﻴﻀﹰ‬ ‫ﺍﻟﻌﺏﺀ ﺍﻟﻨﺎﺸﺊ ﻋﻥ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‬ ‫‪‬ﺍﺀ ﻫﺫﺍ ﺍﻟﻤﺭﺽ ﻭﺍﻟﺫﻱ ﻴﻤﻜﻥ ﻋﺯﻭﻩ ﺇﻟﻰ ﺍﻨﺘﺸﺎﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻔﻴﺭﻭﺴﻴﺔ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍ ﻤﻥ ﺠﺭ‬ ‫ﺎ ﻤﺘﺯﺍﻴﺩﹰ‬ ‫ﺍﻟﺼﻨﺎﻋﻴﺔ ﻋﺒﺌﹰ‬ ‫ﻏﻴﺭ ﺍﻟﻘﺎﺒﻠﺔ ﻟﻠﻌﻼﺝ‪ ،‬ﻭﺍﻻﺘﺠﺎﻫﺎﺕ ﺍﻟﺴﻠﻭﻜﻴﺔ ﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﻭﺯﻴﺎﺩﺓ ﺍﻟﺴﻔﺭ‪ .‬ﻭﺇﻥ ﺍﻟﺘﻜﻠﻔﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ‬ ‫ﺎ‪ ،‬ﻭﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﺍﻟﻨﺎﺠﻤﺔ ﻋﻨﻬﺎ‪ ،‬ﻫﻲ ﺘﻜﻠﻔﺔ ﺒﺎﻫﻅﺔ‪ .‬ﻭﺘﻌﺩ ﻫﺫﻩ ﺍﻷﻤﺭﺍﺽ ﻤﻥ ﺒﻴﻥ ﺃﻜﺜﺭ ﻋﺸﺭﺓ ﺃﺴﺒﺎﺏ‪،‬‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﺴﺘﺩﻋﻲ ﺯﻴﺎﺭﺓ ﺍﻟﻤﺭﻴﺽ ﻟﻤﺭﺍﻓﻕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻓﻲ ﻤﻌﻅﻡ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻨﺎﻤﻴﺔ‪ ،‬ﺒﻤﺎ ﻴﺴﺘﻨﻔﺩ‪ ،‬ﺒﺸﻜل ﻀﺨﻡ‪ ،‬ﺍﻟﻤﻴﺯﺍﻨﻴﺎﺕ‬ ‫ﺎ ﻤﺴﺅﻭﻟﺔ ﻋﻥ‬ ‫ﻷﺴﺭ‪ .‬ﻭﺇﻥ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺘﻲ ﺘﻭﺠﻪ ﺇﻟﻰ ﻤﻌﺎﻟﺠﺔ ﻋﻭﺍﻗﺏ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺼﺤﻴﺔ ﺍﻟﻭﻁﻨﻴﺔ ﻭﺩﺨل ﺍ ُ‬ ‫ﻨﺴﺒﺔ ﻜﺒﻴﺭﺓ ﻤﻥ ﺘﻜﺎﻟﻴﻑ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺜﺎﻟﺜﻴﺔ )ﺍﻟﺘﺨﺼﺼﻴﺔ( ﻓﻴﻤﺎ ﻴﺨﺘﺹ ﺒﺘﺤﺭﻱ ﻭﻤﻌﺎﻟﺠﺔ ﺤـﺎﻻﺕ ﺴـﺭﻁﺎﻥ‬ ‫ﻋﻨﻕ ﺍﻟﺭﺤﻡ‪ ،‬ﻭﻤﻌﺎﻟﺠﺔ ﺃﻤﺭﺍﺽ ﺍﻟﻜﺒﺩ‪ ،‬ﻭﺘﻘﺼﻲ ﺃﻤﺭﺍﺽ ﺍﻟﻌﻘﻡ‪ ،‬ﻭﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﺍﻀﺔ ﻓﻲ ﻓﺘﺭﺓ ﻤـﺎ ﺤـﻭل ﺍﻟـﻭﻻﺩﺓ‪،‬‬ ‫ﻭﻓﻘﺩﺍﻥ ﺍﻟﺒﺼﺭ ﻟﺩﻯ ﺍﻷﻁﻔﺎل‪ ،‬ﻭﺍﻷﻤﺭﺍﺽ ﺍﻟﺭﺌﻭﻴﺔ ﻟﺩﻯ ﺍﻷﻁﻔﺎل‪ ،‬ﻭﺁﻻﻡ ﺍﻟﺤﻭﺽ ﺍﻟﻤﺯﻤﻨﺔ ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ‪ .‬ﻭﺘﺘـﻀﻤﻥ‬ ‫ﺎ‪ ،‬ﺍﻟﺼﺭﺍﻋﺎﺕ ﺍﻟﺘﻲ ﺘﺤﺩﺙ ﺒﻴﻥ ﺍﻟﺸﺭﻜﺎﺀ ﻓﻲ ﺍﻟﺠﻨﺱ‪ ،‬ﻭﺍﻟﻌﻨﻑ ﺍﻟﻤﻨﺯﻟﻲ‪.‬‬ ‫ﺍﻟﺘﻜﻠﻔﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‬ ‫ﻭﺘﺘﺼﺎﻋﺩ ﺍﻟﺘﻜﺎﻟﻴﻑ ﺒﺸﻜل ﺃﻜﺒﺭ ﻋﻨﺩ ﺍﻷﺨﺫ ﻓﻲ ﺍﻻﻋﺘﺒﺎﺭ ﺘﺄﺜﻴﺭ ﺘﻤﻴﻡ ﺍﻟﻌﺎﻤل ﺍﻟﺨﺎﺹ ﺒﺴﺎﺌﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ﺯ ﻟﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪.‬‬ ‫ﺍﻟﻤﻌﺯ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻭﺍﻷﻤﺭﺍﺽ ﺍﻟﺘﻲ ﺘﺴﺒﺒﻬﺎ‬ ‫‪‬ﻤﺭﻀﺎﺕ ﺍﻟﺭﺌﻴﺴﻴﺔ ﺍﻟﻤﺴﺒﺒﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻟﺠﺩﻭل ‪ :١‬ﺍﻟﻤ‬ ‫ﺍﻟﻤﻅﺎﻫﺭ ﺍﻟﺴﺭﻴﺭﻴﺔ ﻭﺍﻷﻤﺭﺍﺽ ﺍﻷﺨﺭﻯ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﻬﺎ‬ ‫ﺩﺍﺀ ﺍﻟﺴﻴﻼﻥ‬ ‫ﺍﻟﺭﺠﺎل‪ :‬ﺇﻓﺭﺍﺯ ﺇﺤﻠﻴﻠﻲ )ﺍﻟﺘﻬﺎﺏ ﺍﻹﺤﻠﻴل(‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﺒﺭﺒﺦ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﺨﺼﻴﺔ‪،‬‬ ‫ﻋﻘﻡ‬ ‫ﺍﻟﻨﺴﺎﺀ‪ :‬ﺍﻟﺘﻬﺎﺏ ﻋﻨﻕ ﺍﻟﺭﺤﻡ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺒﻁﺎﻨﺔ ﺍﻟﺭﺤﻡ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﻨﻔﻴﺭ‪ ،‬ﻤﺭﺽ‬ ‫ﺍﻟﺘﻬﺎﺒﻲ ﺤﻭﻀﻲ‪ ،‬ﻋﻘﻡ‪ ،‬ﺘﻤﺯﻕ ﺍﻟﻐﺸﺎﺀ ﻗﺒل ﻤﻭﻋﺩ ﺍﻟﻭﻻﺩﺓ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺤـﻭﺍﺌﻁ‬ ‫ﺍﻟﻜﺒﺩ‬ ‫ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﻤﺴﺘﻘﻴﻡ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﺒﻠﻌﻭﻡ‪ ،‬ﻋﺩﻭﻯ ﻤﻨﺘﺜﺭﺓ ﺒﺎﻟﻤﻜﻭﺭﺍﺕ‬ ‫ﺍﻟﺒﻨﻴﺔ‬ ‫ﺍﻟﻭﻟﺩﺍﻥ‪ :‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﻤﻠﺘﺤﻤﺔ‪ ،‬ﺘﻨﺩﺏ ﺍﻟﻘﺭﻨﻴﺔ ﻭﺍﻟﻌﻤﻰ‬ ‫ﻋﺩﻭﻯ ﺍﻟﻤﺘﺩﺜﺭﺍﺕ‬ ‫ﺍﻟﺭﺠﺎل‪ :‬ﺇﻓﺭﺍﺯ ﺇﺤﻠﻴﻠﻲ )ﺍﻟﺘﻬﺎﺏ ﺍﻹﺤﻠﻴل(‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﺒﺭﺒﺦ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﺨﺼﻴﺔ‪،‬‬ ‫ﻋﻘﻡ‬ ‫ﺍﻟﻨﺴﺎﺀ‪ :‬ﺍﻟﺘﻬﺎﺏ ﻋﻨﻕ ﺍﻟﺭﺤﻡ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺒﻁﺎﻨﺔ ﺍﻟﺭﺤﻡ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﻨﻔﻴﺭ‪ ،‬ﻤﺭﺽ‬ ‫ﺍﻟﺘﻬﺎﺒﻲ ﺤﻭﻀﻲ‪ ،‬ﻋﻘﻡ‪ ،‬ﺘﻤﺯﻕ ﺍﻟﻐﺸﺎﺀ ﻗﺒل ﻤﻭﻋﺩ ﺍﻟﻭﻻﺩﺓ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺤـﻭﺍﺌﻁ‬ ‫ﺍﻟﻜﺒﺩ‪ ،‬ﻭﺍﻟﺫﻱ ﻴﻜﻭﻥ ﻋﺩﻴﻡ ﺍﻷﻋﺭﺍﺽ ﺒﺼﻔﺔ ﻋﺎﻤﺔ‬ ‫ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﻤﺴﺘﻘﻴﻡ‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﺒﻠﻌﻭﻡ‪ ،‬ﻤﺘﻼﺯﻤﺔ ﺭﺍﻴﺘﺭ‬ ‫ﺍﻟﻭﻟﺩﺍﻥ‪ :‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﻤﻠﺘﺤﻤﺔ‪ ،‬ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﺭﺌﻭﻱ‬ ‫ﺎ‬ ‫ﻭﺭﻡ ﺤﺒﻴﺒﻲ ﻟﻤﻔﻲ ﻤﻨﻘﻭل ﺠﻨﺴﻴﹰ‬ ‫ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﻗﺭﺤﺔ‪ ،‬ﺘﻭﺭﻡ ﺍﻹﺭﺒﻴﺘﺎﻥ )ﺍﻷﺩﺒﺎل(‪ ،‬ﺍﻟﺘﻬﺎﺏ ﺍﻟﻤﺴﺘﻘﻴﻡ‬ ‫ﺍﻟﺯﻫﺭﻱ‬ ‫ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﻗﺭﺤﺔ ﺃﻭﻟﻴﺔ )ﺘﻘﺭﺤﺎﺕ( ﻤﻊ ﺘﻀﺨﻡ ﻤﻭﻀـﻌﻲ ﻓـﻲ ﺍﻟﻌﻘـﺩ‬ ‫ﺍﻟﻠﻤﻔﺎﻭﻴﺔ‪ ،‬ﻁﻔﺢ ﺠﻠﺩﻱ‪ ،‬ﺃﻭﺭﺍﻡ ﻟﻘﻤﻴﺔ )) ﻻﺘﺎ ((‪ ،‬ﺃﻀﺭﺍﺭ ﺒﺎﻟﻌﻅﺎﻡ‪ ،‬ﻭﺃﻀـﺭﺍﺭ‬ ‫ﻗﻠﺒﻴﺔ ﻭﻋﺎﺌﻴﺔ ﻭﻋﺼﺒﻴﺔ‬ ‫ﺍﻟﻨﺴﺎﺀ‪ :‬ﻓﻘﺩﺍﻥ ﺍﻟﺤﻤل )ﺇﺠﻬﺎﺽ ﺃﻭ ﻤﻭﺕ ﺍﻟﺠﻨﻴﻥ(‪ ،‬ﺍﻟﻭﻻﺩﺓ ﻗﺒل ﺍﻷﻭﺍﻥ‬ ‫ﺍﻟﻭﻟﺩﺍﻥ‪ :‬ﻤﻭﺕ ﺍﻟﺠﻨﻴﻥ‪ ،‬ﺍﻟﺯﻫﺭﻱ ﺍﻟﺨﻠﻘﻲ‬ ‫ﻗﺭﻴﺢ‬ ‫ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﻗﺭﺤﺎﺕ ﺘﻨﺎﺴﻠﻴﺔ ﻤﺅﻟﻤﺔ ﻗﺩ ﺘﻜﻭﻥ ﻤﺼﺤﻭﺒﺔ ﺒﺘﻘﺭﺤﺎﺕ‬ ‫ﻭﺭﻡ ﺤﺒﻴﺒﻲ ﺇﺭﺒﻲ )ﺩﺍﺀ ﺍﻟﺩﻭﻨﻭﻓﺎﻨﻴﺎﺕ(‬ ‫ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﺘﻭﺭﻤﺎﺕ ﻋﻘﺩﻴﺔ ﻭﺁﻓﺎﺕ ﺘﻘﺭﺤﻴـﺔ ﻓـﻲ ﺍﻟﻤﻨـﺎﻁﻕ ﺍﻹﺭﺒﻴـﺔ‬ ‫ﻭﺍﻟﺸﺭﺠﻴﺔ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ‬ ‫ﺍﻟﺭﺠﺎل‪ :‬ﺇﻓﺭﺍﺯﺍﺕ ﺇﺤﻠﻴﻠﻴﺔ )ﺍﻟﺘﻬﺎﺏ ﺇﺤﻠﻴﻠﻲ ﻻ ﺴﻴﻼﻨﻲ(‬ ‫ﺍﻟﻨﺴﺎﺀ‪ :‬ﺍﻟﺘﻬﺎﺏ ﻤﻬﺒﻠﻲ ﺠﺭﺜﻭﻤﻲ‪ ،‬ﻭﺍﺤﺘﻤﺎل ﻤﺭﺽ ﺍﻟﺘﻬﺎﺒﻲ ﺤﻭﻀﻲ‬ ‫ﺍﻟﺭﺠﺎل‪ :‬ﺇﻓﺭﺍﺯﺍﺕ ﺇﺤﻠﻴﻠﻴﺔ )ﺍﻟﺘﻬﺎﺏ ﺇﺤﻠﻴﻠﻲ ﻻ ﺴﻴﻼﻨﻲ(‬ ‫ﺍﻟﻨﺴﺎﺀ‪ :‬ﺍﻟﺘﻬﺎﺏ ﻤﻬﺒﻠﻲ ﺠﺭﺜﻭﻤﻲ‪ ،‬ﻭﺍﺤﺘﻤﺎل ﻤﺭﺽ ﺍﻟﺘﻬﺎﺒﻲ ﺤﻭﻀﻲ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﺠﺭﺜﻭﻤﻴﺔ )ﺍﻟﺒﻜﺘﻴﺭﻴﺔ(‬ ‫ﺍﻟﻤﻤﺭﺍﺽ‬

‫ﺍﻟﻤﻜﻭﺭﺓ ﺍﻟﺒﻨﻴﺔ‬

‫ﺍﻟﻤﺘﺩﺜﺭﺓ ﺍﻟﺤﺜﺭﻴﺔ‬

‫ﺍﻟﻤﺘﺩﺜﺭﺓ ﺍﻟﺤﺜﺭﻴﺔ‬ ‫)ﺍﻟﺫﺭﺍﺭﻱ ل ‪ – ١‬ل ‪(٣‬‬ ‫ﺍﻟﻠﻭﻟﺒﻴﺔ ﺍﻟﺸﺎﺤﺒﺔ‬

‫ﺍﻟﻤﺴﺘﺩﻤﻴﺔ ﺍﻟﺩﻭﻜﺭﻴﺔ‬ ‫‪‬ﺩﺓ( ﺍﻟﺤﺒﻴﺒﻭﻤﻴﺔ‬ ‫ﺍﻟﻜﻠﺒﺴﻴﻼ )ﺍﻟﻤﻐﻤ‬ ‫ﺍﻟﻤﻔﻁﻭﺭﺓ ﺍﻟﺤﺒﻴﺒﻴﺔ‬ ‫ﺍﻟﻤﻴﻭﺭﺓ ﺍﻟﺤﺎﻟﺔ ﻟﻠﻴﻭﺭﻴﺎ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﻤﻅﺎﻫﺭ ﺍﻟﺴﺭﻴﺭﻴﺔ ﻭﺍﻷﻤﺭﺍﺽ ﺍﻷﺨﺭﻯ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﻬﺎ‬

‫ﻤﺘﻼﺯﻤﺔ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﻤﻜﺘﺴﺏ )ﺍﻷﻴﺩﺯ(‬ ‫ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﺃﻤﺭﺍﺽ ﻤﺭﺘﺒﻁﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺍﻷﻴﺩﺯ‬ ‫ﻓﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ‪ ،‬ﺍﻟﻨﻤﻁ ‪ ٢‬ﺍﻟﻬﺭﺒﺱ ﺍﻟﺘﻨﺎﺴﻠﻲ‬ ‫ﻓﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ ﺍﻟـﻨﻤﻁ ‪ ١‬ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﺁﻓﺎﺕ ﻭﺘﻘﺭﺤﺎﺕ ﺤﻭﻴﺼﻠﻴﺔ ﻓﻲ ﺍﻟﻤﻨﻁﻘﺔ ﺍﻟﺸﺭﺠﻴﺔ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ‬ ‫ﺎ(‬ ‫ﺎ ﻤﺎ ﻴﻜﻭﻥ ﻤﻤﻴﺘﹰ‬ ‫ﺍﻟﻭﻟﺩﺍﻥ‪ :‬ﻫﺭﺒﺱ ﻭﻟﻴﺩﻱ )ﻏﺎﻟﺒﹰ‬ ‫ﺍ(‬ ‫)ﺃﻗل ﺍﻨﺘﺸﺎﺭﹰ‬ ‫ﺍﻟﺜﺂﻟﻴل ﺍﻟﺘﻨﺎﺴﻠﻴﺔ‬ ‫ﻓﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ‬ ‫ﺍﻟﺭﺠﺎل‪ :‬ﺜﺂﻟﻴل ﻗﻀﻴﺒﻴﺔ ﻭﺸﺭﺠﻴﺔ‪ ،‬ﺴﺭﻁﺎﻨﺔ ﺍﻟﻘﻀﻴﺏ‬ ‫ﺍﻟﻨﺴﺎﺀ‪ :‬ﺜﺂﻟﻴل ﻗﺭﺤﻴﺔ‪ ،‬ﻭﺸﺭﺠﻴﺔ ﻭﻋﻨﻕ ﺭﺤﻤﻴﺔ‪ ،‬ﺴﺭﻁﺎﻨﺔ ﻋﻨـﻕ ﺍﻟـﺭﺤﻡ‪،‬‬ ‫ﺴﺭﻁﺎﻨﺔ ﻗﺭﺤﻴﺔ ﻭﺸﺭﺠﻴﺔ‬ ‫ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ ﺍﻟﻔﻴﺭﻭﺴﻲ‬ ‫ﻓﻴﺭﻭﺱ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ "ﺍﻟﺒﺎﺌﻲ"‬ ‫ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﺍﻟﺘﻬﺎﺏ ﻜﺒﺩﻱ ﺤﺎﺩ‪ ،‬ﺘﻠﻴﻑ ﺍﻟﻜﺒﺩ‪ ،‬ﺴﺭﻁﺎﻥ ﺍﻟﻜﺒﺩ‬ ‫ﺍﻟﻌﺩﻭﻯ ﺒﺎﻟﻔﻴﺭﻭﺴﺔ ﺍﻟﻤﻀﺨﻤﺔ ﻟﻠﺨﻼﻴﺎ‬ ‫ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﺤﻤﻰ ﺘﺤﺕ ﺍﻟﺴﺭﻴﺭﻴﺔ ﺃﻭ ﻏﻴﺭ ﻨﻭﻋﻴﺔ‪ ،‬ﺘﻭﺭﻤﺎﺕ ﻋﻘﺩﻴﺔ ﻟﻤﻔﻴﺔ‬ ‫ﺍﻟﻔﻴﺭﻭﺴﺔ ﺍﻟﻤﻀﺨﻤﺔ ﻟﻠﺨﻼﻴﺎ‬ ‫ﻤﻨﺘﺸﺭﺓ‪ ،‬ﺃﻤﺭﺍﺽ ﻜﺒﺩﻴﺔ‪ ،‬ﺇﻟﺦ‪.‬‬ ‫ﺍﻟﻤﻠﻴﺴﺎﺀ ﺍﻟﻤﻌﺩﻴﺔ‬ ‫ﻓﻴﺭﻭﺴﺔ ﺍﻟﻤﻠﻴﺴﺎﺀ ﺍﻟﻤﻌﺩﻴﺔ‬ ‫ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﻋﻘﺩ ﺠﻠﺩﻴﺔ ﻤﺴﺭﺭﺓ ﺠﺎﻤﺩﺓ ﻓﻲ ﺍﻟﻤﻨﺎﻁﻕ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﺃﻭ ﻋﺎﻤـﺔ‬ ‫ﻓﻲ ﺍﻟﺠﺴﻡ‬ ‫ـﺔ ﺴﺎﺭﻜﻭﻤﺔ ﻜﺎﺒﻭﺯﻱ‬ ‫ـﺎﺒﻭﺯﻱ ﺍﻟﻤﺭﺘﺒﻁـ‬ ‫ـﺎﺭﻜﻭﻤﺔ ﻜـ‬ ‫ﺴـ‬ ‫ﺒﻔﻴﺭﻭﺱ ﺍﻟﻬـﺭﺒﺱ )ﺃﻭ ﻓﻴـﺭﻭﺱ ﻜﻼ ﺍﻟﺠﻨﺴﻴﻥ‪ :‬ﻨﻭﻉ ﻨﺸﻁ ﻤﻥ ﺍﻟﺴﺭﻁﺎﻥ ﻟﺩﻯ ﺍﻷﺸﺨﺎﺹ ﺍﻟﺫﻴﻥ ﻴﻌﺎﻨﻭﻥ ﻤـﻥ‬ ‫ﻤﻨﺎﻋﺔ ﻤﻜﺒﺘﺔ‬ ‫ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻨﻤﻁ ‪(٨‬‬ ‫‪‬ﺭﺍﺕ‬ ‫ﺸﻌ‬ ‫ﻤﹶ‬ ‫ﺩﺍﺀ ﺍﻟ ‪‬‬ ‫ﺎ ﻤﺎ ﻴﻜـﻭﻥ‬ ‫ﺍﻟﺭﺠﺎل‪ :‬ﺇﻓﺭﺍﺯﺍﺕ ﺇﺤﻠﻴﻠﻴﺔ )ﺍﻟﺘﻬﺎﺏ ﺇﺤﻠﻴﻠﻲ ﻏﻴﺭ ﺴﻴﻼﻨﻲ( ﻏﺎﻟﺒﹰ‬ ‫ﻋﺩﻴﻡ ﺍﻷﻋﺭﺍﺽ‬ ‫ﺍﻟﻨﺴﺎﺀ‪ :‬ﺍﻟﺘﻬﺎﺏ ﻤﻬﺒﻠﻲ ﻤﺼﺤﻭﺏ ﺒﺈﻓﺭﺍﺯﺍﺕ ﺯﺒﺩﻴﺔ ﻏﺯﻴـﺭﺓ‪ ،‬ﻭﻻﺩﺓ ﻗﺒـل‬ ‫ﺍﻷﻭﺍﻥ‪ ،‬ﻨﻘﺹ ﻭﺯﻥ ﺍﻟﻤﻭﻟﻭﺩ ﻋﻨﺩ ﺍﻟﻭﻻﺩﺓ‬ ‫ﺍﻟﻭﻟﺩﺍﻥ‪ :‬ﻨﻘﺹ ﺍﻟﻭﺯﻥ ﻋﻨﺩ ﺍﻟﻭﻻﺩﺓ‬ ‫‪‬ﺔ ﺍﻟﺒﻴﻀﺎﺀ‬ ‫ﻴﻀ‬ ‫ﺒ‪‬‬ ‫ﻤ‪‬‬ ‫ﺍﻟ ‪‬‬ ‫ﺍﻟﺭﺠﺎل‪ :‬ﻋﺩﻭﻯ ﺴﻁﺤﻴﺔ ﻋﻠﻰ ﺤﺸﻔﺔ ﺍﻟﻘﻀﻴﺏ‬ ‫ﺍﻟﻨﺴﺎﺀ‪ :‬ﺍﻟﺘﻬﺎﺏ ﻗﺭﺤﻲ ﻤﻬﺒﻠﻲ ﻤﻊ ﺇﻓﺭﺍﺯﺍﺕ ﺜﺨﻴﻨﺔ ﺭﺍﺌﺒﺔ ﻤﻊ ﺤﻜﺔ ﻭﺤﺭﻗﺎﻥ‬ ‫ﻓﺭﺠﻲ‬ ‫ﻋﺩﻭﻯ ﻗﻤل ﺍﻟﻌﺎﻨﺔ‬ ‫ﺠﺭﺏ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺒﺎﻷﻭﺍﻟﻲ ﺍﻟﺤﻴﻭﺍﻨﻴﺔ‬

‫ﺍﻟﻤﻤﺭﺍﺽ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻔﻴﺭﻭﺴﻴﺔ‬ ‫ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‬

‫‪‬ﺭﺓ ﺍﻟﻤﻬﺒﻠﻴﺔ‬ ‫ﺸﻌ‬ ‫ﻤﹶ‬ ‫ﺍﻟ ‪‬‬

‫ﺍﻟﻌﺩﺍﻭﻯ ﺒﺎﻟﻔﻁﺭﻴﺎﺕ‬

‫ﺍﻟﻌﺩﺍﻭﻯ ﺒﺎﻟﻁﻔﻴﻠﻴﺎﺕ‬ ‫ﻗﻤل ﺍﻟﻌﺎﻨﺔ‬ ‫ﺍﻟﻘﺎﺭﻤﺔ ﺍﻟﺠﺭﺒﻴﺔ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪،‬‬ ‫ﻤﺎ ﻫﻲ ﺃﺴﺒﺎﺏ ﺍﻻﺴﺘﺜﻤﺎﺭ ﻓﻲ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻵﻥ؟‬ ‫ﺎ‬ ‫ﺍﻟﺤﺩ ﻤﻥ ﺍﻟﻤﺭﺍﻀﺔ ﻭﻤﻌﺩل ﺍﻟﻭﻓﻴﺎﺕ ﺫﺍﺕ ﺍﻟﻌﻼﻗﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬

‫‪٢-١‬‬ ‫‪١-٢-١‬‬

‫ﻼ ﻤﻥ ﺍﻟﻤﺭﺍﻀﺔ ﻭﺍﻟﻭﻓﻴـﺎﺕ ﻓـﻲ‬ ‫ﺎ ﻫﺎﺌ ﹰ‬ ‫ﺎ‪ ،‬ﻏﻴﺭ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪ ،‬ﻋﺒﺌﹰ‬ ‫ﺘﻔﺭﺽ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻤﺤﺩﻭﺩﺓ ﺍﻟﻤﻭﺍﺭﺩ ﻭﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻤﺘﻘﺩﻤﺔ ﻋﻠﻰ ﺍﻟﺴﻭﺍﺀ‪ ،‬ﺒﺸﻜل ﻤﺒﺎﺸﺭ ﻤﻥ ﺨﻼل ﺘﺄﺜﻴﺭﻫﺎ ﻋﻠـﻰ ﻨﻭﻋﻴـﺔ ﺍﻟﺤﻴـﺎﺓ‬ ‫ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻭﺼﺤﺔ ﺍﻟﻁﻔل‪ ،‬ﻭﺒﺸﻜل ﻏﻴﺭ ﻤﺒﺎﺸﺭ ﻤﻥ ﺨﻼل ﺩﻭﺭﻫﺎ ﻓﻲ ﺘﻴﺴﻴﺭ ﺍﻟﺴﺭﺍﻴﺔ ﺍﻟﺠﻨـﺴﻴﺔ ﻟﻔﻴـﺭﻭﺱ‬ ‫ﺍﻷﻴﺩﺯ ﻭﻤﻥ ﺨﻼل ﺘﺄﺜﻴﺭﻫﺎ ﻋﻠﻰ ﺍﻟﻭﻀﻊ ﺍﻻﻗﺘﺼﺎﺩﻱ ﺍﻟﻭﻁﻨﻲ ﻭﺍﻟﻔﺭﺩﻱ‪.‬‬ ‫‪‬ﻫﺔ ﻭﻤﺅﻟﻤﺔ ﻭﺃﻤﺭﺍﺽ ﻨﻔﺴﻴﺔ‪.‬‬ ‫ﻭﺘﺘﻔﺎﻭﺕ ﺍﻟﻌﻭﺍﻗﺏ ﺍﻟﺼﺤﻴﺔ ﻓﻲ ﻤﺩﺍﻫﺎ ﻤﻥ ﺃﻤﺭﺍﺽ ﺤﺎﺩﺓ ﺨﻔﻴﻔﺔ ﺇﻟﻰ ﺁﻓﺎﺕ ﻤﺸﻭ‬ ‫ﺎ ﺤﺎﺩﺓ ﺃﻭ ﻤﺯﻤﻨﺔ ﻟﻠﻨﺴﺎﺀ ﺃﺴـﻔل ﺍﻟـﺒﻁﻥ‪.‬‬ ‫ﺎ ﻟﻠﺭﺠﺎل ﺃﺜﻨﺎﺀ ﺍﻟﺘﺒﻭل‪ ،‬ﻭﺁﻻﻤﹰ‬ ‫ﹰ‪ ،‬ﺘﺴﺒﺏ ﺁﻻﻤﹰ‬ ‫ﻓﺎﻟﻌﺩﻭﻯ ﺒﺎﻟﻤﻜﻭﺭﺓ ﺍﻟﺒﻨﻴﺔ‪ ،‬ﻤﺜﻼ‬ ‫ﻭﻤﺎ ﻟﻡ ﺘﻌﺎﻟﺞ ﻋﺩﻭﻯ ﺍﻟﺯﻫﺭﻱ‪ ،‬ﺭﻏﻡ ﺃﻨﻬﺎ ﻻ ﺘﺴﺒﺏ ﺁﻻﻤﹰ‬ ‫ﺎ‬ ‫ﺎ ﻓﻲ ﺍﻟﻤﺭﺍﺤل ﺍﻟﻤﺒﻜﺭﺓ‪ ،‬ﻓﺈﻨﻬﺎ ﻴﻤﻜﻥ ﺃﻥ ﺘـﺴﺒﺏ ﺃﻤﺭﺍﻀـﹰ‬ ‫ﻋﺼﺒﻴﺔ ﻭﻗﻠﺒﻴﺔ ﻭﻋﻅﻤﻴﺔ ﻓﻲ ﻤﺭﺍﺤل ﻻﺤﻘﺔ ﻤﻥ ﺍﻟﻌﻤﺭ‪ ،‬ﻭﻓﻘﺩﺍﻥ ﺍﻟﺠﻨﻴﻥ ﻟﺩﻯ ﺍﻟﺤﻭﺍﻤل ﻓﻲ ﺤﺎﻟﺔ ﺍﻟﻌـﺩﻭﻯ ﺍﻟﺤـﺎﺩﺓ‪.‬‬ ‫ﺎ ﻤﺅﻟﻤﺔ ﻤﺴﺒﺒﺔ ﻟﻠﻌﺠﺯ ﻗﺩ ﺘﺅﺩﻱ ﺇﻟﻰ ﺘﺨﺭﻴﺏ ﺍﻟﻨﺴﻴﺞ ﺇﺫﺍ ﺘﺄﺨﺭﺕ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻋـﻥ ﺒـﻀﻌﺔ‬ ‫ﻭﺘﺴﺒﺏ ﺍﻟﻘﺭﺡ ﺍﻟﻠﻴﻨﺔ ﻗﺭﺤﹰ‬ ‫ﺃﻴﺎﻡ‪ ،‬ﻭﻻﺴﻴﻤﺎ ﻓﻲ ﺍﻷﺸﺨﺎﺹ ﺍﻟﻤﻨﻘﻭﺼﻲ ﺍﻟﻤﻨﺎﻋﺔ‪ .‬ﺃﻤﺎ ﺍﻟﻌﺩﻭﻯ ﺒﺎﻟﻬﺭﺒﺱ ﺍﻟﺘﻨﺎﺴﻠﻲ ﻓﺘﺴﺒﺏ ﻤﻌﺎﻨﺎﺓ ﻨﻔـﺴﻴﺔ ﺠﻨـﺴﻴﺔ‬ ‫ﺍ ﻟﻁﺒﻴﻌﺘﻬﺎ ﺍﻟﻤﻌﺎﻭﺩﺓ ﻭﺍﻟﻤﺅﻟﻤﺔ‪ ،‬ﻭﻻﺴﻴﻤﺎ ﻟﺩﻯ ﺍﻟﺸﺒﺎﺏ‪.‬‬ ‫ﺸﺩﻴﺩﺓ ﻨﻅﺭﹰ‬ ‫ﻼ ﻋﻠﻰ ﺍﻷﻓﺭﺍﺩ ﻭﺍﻟﺒﻠﺩﺍﻥ ﻜﻜل‪ ،‬ﻭﺘﺅﺜﺭ ﻓﻲ ﺍﻨﺘﺎﺠﻴﺘﻬﻡ‪ .‬ﻭﺘﺸﻤل ﺍﻟﺘﻜـﺎﻟﻴﻑ‬ ‫ﺎ ﺜﻘﻴ ﹰ‬ ‫ﺎ ﺍﻗﺘﺼﺎﺩﻴﹰ‬ ‫ﻜﻤﺎ ﺃﻨﻬﺎ ﺘﻔﺭﺽ ﻋﺒﺌﹰ‬ ‫ﺎ ﺘﻜﺎﻟﻴﻑ ﻤﺒﺎﺸﺭﺓ‪ ،‬ﻁﺒﻴﺔ ﻭﻏﻴﺭ ﻁﺒﻴﺔ‪ ،‬ﻟﻠﺭﻋﺎﻴﺔ ﻭﺍﻟﻤﻭﺍﺩ؛ ﻭﺘﻜﺎﻟﻴﻑ ﺃﺨﺭﻯ ﻏﻴـﺭ‬ ‫ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﺒﺎﺸﺭﺓ ﺘﺘﻤﺜل ﻓﻲ ﺍﻟﻭﻗﺕ ﺍﻟﺫﻱ ﺃﻤﻀﺎﻩ ﺍﻟﺸﺨﺹ ﻓﻲ ﺍﻟﻤﺭﺽ‪ ،‬ﻋﻨﺩﻤﺎ ﻴﻌﺠﺯ ﻋﻥ ﺍﻟﻤﺸﺎﺭﻜﺔ ﻓﻲ ﺃﻱ ﺃﻨﺸﻁﺔ ﺇﻨﺘﺎﺠﻴـﺔ‬ ‫ﺍ ﻟﻠﺭﻋﺎﻴﺔ ﺃﻭ ﻷﺨﺫ ﻋﻴﻨﺔ ﻤﻨـﻪ(‪.‬‬ ‫)ﻤﺜل ﺍﻟﺴﻔﺭ ﻟﻠﺤﺼﻭل ﻋﻠﻰ ﺍﻟﻤﻌﺎﻟﺠﺔ‪ ،‬ﺃﻭ ﻭﻗﺕ ﺍﻟﻤﻜﺙ ﻓﻲ ﺍﻟﻤﺭﻓﻕ ﺍﻟﺼﺤﻲ ﺍﻨﺘﻅﺎﺭﹰ‬ ‫ﺎ ﻴﺠﻌﻠﻬﺎ ﺠﺩﻴﺭﺓ ﺒﺎﻟﻤﻜﺎﻓﺤﺔ ﻜﻤـﺸﻜﻠﺔ ﻤـﻥ ﻤـﺸﻜﻼﺕ ﺍﻟـﺼﺤﺔ‬ ‫ﺇﻥ ﺤﺠﻡ ﺍﻟﻌﺏﺀ ﺍﻟﻌﺎﻟﻤﻲ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﻤﻭﻤﻴﺔ‪.‬‬

‫ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‬

‫‪٢-٢-١‬‬

‫ﺎ ﻭﻤﻌﺎﻟﺠﺘﻬﺎ ﻴﺤﺩﺍﻥ ﻤﻥ ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻋﻥ ﻁﺭﻴﻕ ﺍﻻﺘﺼﺎل‬ ‫ﺇﻥ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺠﻨﺴﻲ‪ ،‬ﻭﻻﺴﻴﻤﺎ ﺒﻴﻥ ﺍﻟﻔﺌﺎﺕ ﺍﻟﺘﻲ ﻟﻬﺎ ﻋﺩﺩ ﻜﺒﻴﺭ ﻤﻥ ﺍﻟﻘﺭﻨﺎﺀ ﻓﻲ ﺍﻟﻌﻼﻗﺔ ﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﻤﺜل ﺍﻟﺒﻐﺎﻴﺎ ﻭﺍﻟﻤﺘﺭﺩﺩﻴﻥ ﻋﻠﻴﻬﻥ‪.‬‬ ‫ﻜﻤﺎ ﺃﻥ ﻭﺠﻭﺩ ﺍﻟﺘﻬﺎﺏ ﻏﻴﺭ ﻤﻌﺎﻟﺞ ﺃﻭ ﻋﺩﻭﻯ ﺘﻘﺭﺤﻴﺔ ﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻴﺯﻴﺩ ﻤﻥ ﻤﺨﺎﻁﺭ ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﺃﺜﻨـﺎﺀ‬ ‫ﺍﻟﻌﻼﻗﺔ ﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﺍﻟﺘﻲ ﻟﻡ ﺘﺘﺨﺫ ﻟﻬﺎ ﺍﻻﺤﺘﻴﺎﻁﺎﺕ ﺍﻟﻭﻗﺎﺌﻴﺔ‪ ،‬ﺒﻴﻥ ﻗـﺭﻴﻥ ﻤـﺼﺎﺏ ﺒﺎﻟﻌـﺩﻭﻯ ﻭﻗـﺭﻴﻥ ﺁﺨـﺭ ﻏﻴـﺭ‬ ‫ﺎ ﻓﻲ ﺘﻌﺯﻴﺯ ﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻴﻜـﻭﻥ ﺃﻜﺒـﺭ ﺇﺫﺍ‬ ‫ﻤﺼﺎﺏ )‪ .(١٣‬ﻭﻴﺒﺩﻭ ﺃﻥ ﺩﻭﺭ ﺴﺎﺌﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻻ ﻋﻥ ﺤﺩﻭﺙ ﻨـﺴﺒﺔ‬ ‫ﻜﺎﻨﺕ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﺘﻘﺭﺤﻴﺔ‪ .‬ﺇﺫ ﺘﻭﻀﺢ ﺍﻟﺒﻴﻨﺎﺕ ﺍﻟﺤﺩﻴﺜﺔ ﺃﻥ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺘﻨﺎﺴﻠﻲ ﻗﺩ ﻴﻜﻭﻥ ﻤﺴﺅﻭ ﹰ‬ ‫ﻜﺒﻴﺭﺓ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﺃﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻜﺎﺒﺘﺔ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ‪ ،‬ﺍﻟﻨﻤﻁ ‪ ٢‬ﺘﺤﺩ‬ ‫ﻤﻥ ﺇﺼﺎﺒﺔ ﺍﻟﻨﺴﺎﺀ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ )‪ .(١٦-١٤‬ﻭﻫﻨﺎﻙ ﺘﻘﺩﻴﺭﺍﺕ ﺒﺄﻥ ﺃﻤﺭﺍﺽ ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﺘﺯﻴﺩ ﻤﻥ ﻤﺨﺎﻁﺭ‬ ‫ﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﺒﻤﻘﺩﺍﺭ ‪ ٣٠٠ – ٥٠‬ﻀﻌﻑ ﻟﻜل ﻤﺭﺓ ﻴﺤﺩﺙ ﻓﻴﻬﺎ ﺠﻤﺎﻉ ﺒﻐﻴـﺭ ﺍﺴـﺘﺨﺩﺍﻡ‬ ‫ﻭﺴﻴﻠﺔ ﻭﺍﻗﻴﺔ )‪.(١٧‬‬ ‫ﺎ ﻭﺍﺤﺩﺓ ﻤﻥ ﺍﻟﻤﻨﺎﻓﺫ ﺍﻟﺭﺌﻴﺴﻴﺔ ﻟﻠﻭﻗﺎﻴـﺔ‬ ‫ﻭﺘﻌﺘﺒﺭ ﺍﻟﻤﺭﺍﻓﻕ ﺍﻟﺘﻲ ﺘﻘﺩﻡ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻥ ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺤﻴﺙ ﺇﻥ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ ﻴﻠﺘﻤـﺴﻭﻥ ﺍﻟﺭﻋﺎﻴـﺔ ﺒـﺴﺒﺏ ﺍﻹﺼـﺎﺒﺔ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻫﻡ ﺇﺤﺩﻯ ﺍﻟﻔﺌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﺭﺌﻴـﺴﻴﺔ ﺍﻟﻤـﺴﺘﻬﺩﻓﺔ ﺒﺎﻟﺘﻭﻋﻴـﺔ ﺍﻟﺘـﻲ ﺘﺘﻌﻠـﻕ ﺒﺎﻟﻭﻗﺎﻴـﺔ‪،‬‬ ‫ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺒﺎﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﻁﻭﻋﻴﺔ ﻭﺍﻟﺴﺭﻴﺔ ﻟﻠﻜﺸﻑ ﻋﻥ ﻭﺠﻭﺩ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﺭﺒﻤـﺎ ﻴﺤﺘـﺎﺠﻭﻥ ﺇﻟـﻰ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﺃﻭ ﺍﻷﻴﺩﺯ‪ .‬ﻭﻗﺩ ﻴﻌﺎﻨﻲ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ ﻴﺤﻀﺭﻭﻥ‬ ‫ﺎ‪ ،‬ﻓﻲ ﺍﻟﻭﻗﺕ ﻨﻔﺴﻪ‪ ،‬ﻤﻥ ﻋﺩﻭﻯ ﺃﻭﻟﻴﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪،‬‬ ‫ﺎ ﻋﻥ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﻠﻌﻴﺎﺩﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺒﺤﺜﹰ‬ ‫ﺎ‪ .‬ﻭﻟﻘﺩ ﻜﺎﻥ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﺍﻟﻤﻌﺯﻭل ﻤﻥ ﺍﻟـﺴﺎﺌل‬ ‫ِﻤل ﺍﻟﻔﻴﺭﻭﺴﻲ ﻟﺩﻴﻬﻡ ﻤﺭﺘﻔﻌﹰ‬ ‫ﻭﻋﺎﺩﺓ ﻤﺎ ﻴﻜﻭﻥ ﺍﻟﺤ‬ ‫ﺍﻟﻤﻨﻭﻱ ﺃﻋﻠﻰ ﺴﺕ ﻤﺭﺍﺕ ﻟﺩﻯ ﺍﻟﺭﺠﺎل ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﺘﻬﺎﺏ ﺍﻹﺤﻠﻴل ﺍﻟﺴﻴﻼﻨﻲ ﻓﻲ ﻤﺎﻻﻭﻱ‪ .‬ﻭﻓﻲ ﺃﻋﻘﺎﺏ ﺍﻟﻌﻼﺝ ﻤﻥ‬ ‫ﺍﻟﺘﻬﺎﺏ ﺍﻹﺤﻠﻴل‪ ،‬ﺍﻨﺨﻔﺽ ﺍﻟﺤﻤل ﺍﻟﻔﻴﺭﻭﺴﻲ ﺇﻟﻰ ﻤﻌﺩﻻﺕ ﻤﺸﺎﺒﻬﺔ ﻟﺘﻠﻙ ﺍﻟﻤﻭﺠﻭﺩﺓ ﻟﺩﻯ ﺍﻟﺭﺠﺎل ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻌـﺩﻭﻯ‬ ‫ﺍ ﻓﻲ ﺍﻟﻭﻻﻴـﺎﺕ‬ ‫ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﺩﻭﻥ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﺘﻬﺎﺏ ﺍﻹﺤﻠﻴل )‪ .(١٨‬ﻭﻓﻲ ﺩﺭﺍﺴﺔ ﺠﺭﺕ ﻤﺅﺨﺭﹰ‬ ‫ﺎ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﻟﺩﻴﻬﻡ ﺇﺼﺎﺒﺔ ﺘﺘﺭﺍﻭﺡ ﺒـﻴﻥ ﺍﻷﻭﻟﻴـﺔ‬ ‫ﻼ ﻤﺼﺎﺒﹰ‬ ‫ﺍﻟﻤﺘﺤﺩﺓ ﺍﻷﻤﺭﻴﻜﻴﺔ ﻋﻠﻰ ‪ ٥٢‬ﺭﺠ ﹰ‬ ‫ﺎ ﺒﻤﻀﺎﺩﺍﺕ ﺍﻟﻔﻴﺭﻭﺴﺎﺕ ﺍﻟﻘﻬﻘﻬﺭﻴﺔ‪ ،‬ﻜﺎﻨﺕ‬ ‫ﻭﺍﻟﺜﺎﻨﻭﻴﺔ ﺒﺎﻟﺯﻫﺭﻱ‪ ،‬ﺍﺘﻀﺢ ﺃﻥ ‪ ٪٥٨‬ﻤﻥ ﻫﺅﻻﺀ ﺍﻟﺫﻴﻥ ﻜﺎﻨﻭﺍ ﻴﺘﻠﻘﻭﻥ ﻋﻼﺠﹰ‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﺯﻫﺭﻱ ﻟﺩﻴﻬﻡ ﻤﺼﺤﻭﺒﺔ ﺒﺯﻴﺎﺩﺓ ﻜﺒﻴﺭﺓ ﻓﻲ ﺍﻟﺤﻤل ﺍﻟﻔﻴﺭﻭﺴﻲ‪ ،‬ﻟﻔﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ ﺍﻟﻤﻨـﺎﻋﻲ ﺍﻟﺒـﺸﺭﻱ‪،‬‬ ‫ﻭﺍﻨﺨﻔﺎﺽ ﻜﺒﻴﺭ ﻓﻲ ﻋﺩﺩ ﺨﻼﻴﺎ ‪ .CD4‬ﻭﻟﻘﺩ ﻤﻜﻨﺕ ﻤﻌﺎﻟﺠﺔ ﺍﻟﺯﻫﺭﻱ ﻤﻥ ﺍﺴﺘﻌﺎﺩﺓ ﺍﻟﻤﻨﺎﻋﺔ ﻭﺘﺭﻜﻴﺯﺍﺕ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻓﻲ ﺍﻟﻤﻨﺎﻁﻕ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﻟﻤﻌﺩﻻﺘﻬﺎ ﻓﻲ ﻤﺭﺤﻠﺔ ﻤﺎ ﻗﺒل ﺍﻟﻌﺩﻭﻯ‪ ،‬ﺒﻤﺎ ﻴﺅﻜﺩ ﺃﻫﻤﻴﺔ ﺍﻟﻭﻗﺎﻴﺔ ﻭﺍﻟﻤﺴﺎﺭﻋﺔ‬ ‫ﻓﻲ ﻋﻼﺝ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﺯﻫﺭﻱ ﻟﺩﻯ ﺍﻷﺸﺨﺎﺹ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻜﺎﺴﺘﺭﺍﺘﻴﺠﻴﺔ‬ ‫ﻭﻗﺎﺌﻴﺔ‪ ،‬ﺇﻟﻰ ﺠﺎﻨﺏ ﺘﺤﺴﻴﻥ ﺠﻭﺩﺓ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻸﺸﺨﺎﺹ ﺍﻟﺫﻴﻥ ﻴﺘﻌﺎﻴﺸﻭﻥ ﻤﻊ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ )‪.(١٩‬‬ ‫ﺎ‪ ،‬ﻭﺘﺸﺠﻴﻊ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌـﺎﺯل‬ ‫‪‬ﺎﻟﺔ‪ ،‬ﻭﻤﻌﺎﻟﺠﺔ ﺃﻱ ﻋﺩﺍﻭﻯ ﺃﺨﺭﻯ ﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻴﻤﻜﻥ ﺃﻥ ﻴﻜﻭﻥ ﻟﻠﺭﺴﺎﺌل ﺍﻟﻭﻗﺎﺌﻴﺔ ﺍﻟﻔﻌ‬ ‫ﺍ ﻋﻠﻰ ﺍﻟﺤﺩ ﻤﻥ ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪.‬‬ ‫ﺍ ﻜﺒﻴﺭﹰ‬ ‫ﺍﻟﺫﻜﺭﻱ‪ ،‬ﺘﺄﺜﻴﺭﹰ‬ ‫ﺇﻥ ﺍﻟﻬﺩﻑ ﺍﻟﺴﺎﺒﻊ ﻟﻠﻤﺭﻤﻰ ﺍﻟﺴﺎﺩﺱ ﻤﻥ ﺍﻟﻤﺭﺍﻤﻲ ﺍﻹﻨﻤﺎﺌﻴﺔ ﻟﻸﻟﻔﻴﺔ ﻴﺩﻋﻭ ﺍﻷﻤﻡ ﺇﻟﻰ ﻭﻗﻑ ﺍﻨﺘﺸﺎﺭ ﻤـﺭﺽ‬ ‫ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﻭﺍﻟﻌﻭﺩﺓ ﺒﻪ ﺇﻟﻰ ﺍﻟﻤﻌﺩﻻﺕ ﺍﻷﻭﻟﻰ‪ .‬ﻭﻓﻲ ﺠﻤﻬﻭﺭﻴﺔ ﺘﻨﺯﺍﻨﻴﺎ ﺍﻟﻤﺘﺤﺩﺓ‪ ،‬ﺃﻅﻬـﺭﺕ ﺍﻟﻁـﺭﻕ‬ ‫ﺎ ﻴﻤﻜﻥ ﺃﻥ ﺘﻘﻠل ﻤﻥ ﺍﻟﺴﺭﺍﻴﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ‬ ‫ﺍﻟﻌﻠﻤﻴﺔ ﺍﻟﺼﺎﺭﻤﺔ‪ ،‬ﺃﻥ ﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﱠﻀﺕ ﺍﻟﻤﻌﺎﻟﺠـﺔ ﺍﻟﺠﻴـﺩﺓ ﻟﻤﺘﻼﺯﻤـﺎﺕ‬ ‫ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺒﻁﺭﻴﻘﺔ ﺘـﺘﺼﻑ ﺒﺎﻟﻔﻌﺎﻟﻴﺔ ﺍﻟﻌﺎﻟﻴﺔ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ‪ ،‬ﻭﺫﻟﻙ ﺤﻴﻥ ﺨﻔ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﺤﺩﻭﺙ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﺒﻨﺴﺒﺔ ‪ ٪٣٨‬ﻓﻲ ﺘﺠﺭﺒﺔ ﺘﺩﺨل ﻤﺠﺘﻤﻌﻲ‬ ‫ﻓﻲ ﻤﻭﺍﻨﺯﺍ‪ .‬ﻭﺭﺒﻤﺎ ﻴﻤﻜﻥ ﺘﻌﻤﻴﻡ ﺘﺠﺭﺒﺔ ﻤﻭﺍﻨﺯﺍ ﻋﻠﻰ ﻤﺠﺘﻤﻌﺎﺕ ﺴﻜﺎﻨﻴﺔ ﺃﺨﺭﻯ ﺘـﺘﺭﻜﺯ ﻓﻴﻬـﺎ ﺍﻹﺼـﺎﺒﺔ ﺍﻟﻭﺒﺎﺌﻴـﺔ‬ ‫ﹸﻜﺘﺴﺏ ﻤـﻥ‬ ‫ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ .‬ﻭﺇﻥ ﻤﻌﻅﻡ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﺘﻲ ﺘﺤﺩﺙ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﺘ‬ ‫ﺍﻟﺸﺭﻜﺎﺀ ﺍﻟﻌﺎﺒﺭﻴﻥ‪ ،‬ﻜﻤﺎ ﺃﻥ ﻤﻌﺩل ﺍﻨﺘﺸﺎﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺍﻟﻘﺎﺒﻠﺔ ﻟﻠﻤﻌﺎﻟﺠﺔ‪ ،‬ﻤﺭﺘﻔﻊ‪ .‬ﻭﻤﻥ ﺜﻡ ﺘﻌﺘﺒﺭ ﻤﻌﺎﻟﺠﺔ‬ ‫ﹸﺴﻬﻡ ﻓﻲ ﺘﺤﻘﻴﻕ ﺍﻟﻬﺩﻑ ﺍﻟﺴﺎﺒﻊ ﻟﻠﻤﺭﻤـﻰ ﺍﻟـﺴﺎﺩﺱ ﻤـﻥ‬ ‫ﺎ‪ ،‬ﺃﺤﺩ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻔﻌﺎﻟﺔ‪ ،‬ﻭﺍﻟﺘﻲ ﺘ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺭﺍﻤﻲ ﺍﻹﻨﻤﺎﺌﻴﺔ ﻟﻸﻟﻔﻴﺔ‪.‬‬

‫ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﺍﻟﻭﺨﻴﻤﺔ ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ‬

‫‪٣-٢-١‬‬

‫ﺎ ﺍﻟﺴﺒﺏ ﺍﻟﺭﺌﻴﺴﻲ ﺍﻟﺫﻱ ﻴﻤﻜﻥ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻨﻪ ﻟﻠﻌﻘﻡ‪ .‬ﻭﺇﻥ ﻤﺎ ﺒـﻴﻥ ‪ ٪١٠‬ﻭ‪٪٤٠‬‬ ‫ﺘﻤﺜل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻥ ﺍﻟﻨﺴﺎﺀ ﺍﻟﻤﺼﺎﺒﺎﺕ ﺒﻌﺩﻭﻯ ﻏﻴﺭ ﻤﻌﺎﻟﺠﺔ ﺒﺎﻟﻤﺘﺩﺜﺭﺍﺕ ﻴﺼﺒﻥ ﺒﻤﺭﺽ ﺍﻟﺘﻬﺎﺒﻲ ﺤﻭﻀﻲ )‪ .(٢٠‬ﻤﻥ ﺠﻬﺔ ﺃﺨـﺭﻯ‪،‬‬ ‫ﻓﺈﻥ ﻤﺎ ﻴﻠﺤﻕ ﺒﺎﻟﺒﻭﻕ ﻤﻥ ﺘﻠﻑ ﻋﻘﺏ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﻭﻯ‪ ،‬ﻤﺴﺅﻭل ﻋﻥ ‪ ٪٤٠ – ٪٣٠‬ﻤﻥ ﺤﺎﻻﺕ ﺍﻟﻌﻘﻡ ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ‪.‬‬ ‫ﻋﻼﻭﺓ ﻋﻠﻰ ﺫﻟﻙ – ﻓﺈﻥ ﺍﻟﻨﺴﺎﺀ ﺍﻟﻠﻭﺍﺘﻲ ﺃﺼﺒﻥ ﺒﻤﺭﺽ ﺍﻟﺘﻬﺎﺒﻲ ﺤﻭﻀﻲ‪ ،‬ﻴﺼﺒﺤﻥ ﻤﻌﺭﻀﺎﺕ ﻟﻠﺤﻤل ﺍﻟﻤﻨﺘﺒﺫ )ﺍﻟﺤﻤل‬ ‫ﺍﻟﺒﻭﻗﻲ( ﺒﻭﺍﻗﻊ ‪ ١٠ – ٦‬ﻤﺭﺍﺕ ﺃﻜﺜﺭ ﻤﻥ ﺃﻭﻟﺌﻙ ﺍﻟﻼﺘﻲ ﻟﻡ ﻴﺼﺒﻥ ﺒﻬﺫﺍ ﺍﻟﻤﺭﺽ‪ ،‬ﻜﻤﺎ ﺃﻥ ‪ ٪٥٠ – ٪٤٠‬ﻤﻥ ﺤﺎﻻﺕ‬ ‫ﺍﻟﺤﻤل ﺍﻟﻤﻨﺘﺒﺫ ﻴﻤﻜﻥ ﻋﺯﻭﻫﺎ ﺇﻟﻰ ﺇﺼﺎﺒﺔ ﺴﺎﺒﻘﺔ ﺒﻤﺭﺽ ﺍﻟﺘﻬﺎﺒﻲ ﺤﻭﻀﻲ )‪.(٢١‬‬ ‫ﻭﺘﺅﺩﻱ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﺇﻟﻰ ﺤﺩﻭﺙ ﺤﻭﺍﻟﻲ ‪ ٥٠٠,٠٠٠‬ﺤﺎﻟﺔ ﺴـﺭﻁﺎﻥ ﻋﻨـﻕ‬ ‫ﺎ ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ‪ ،‬ﺒﻌﺩ ﺴﺭﻁﺎﻥ ﺍﻟﺜﺩﻱ‪ ،‬ﻭﺘﺘﺴﺒﺏ ﻓﻲ ﻭﻓـﺎﺓ‬ ‫ﺎ‪ .‬ﻭﻫﻲ ﺘﻤﺜل ﺜﺎﻨﻲ ﺃﻜﺜﺭ ﺃﻨﻭﺍﻉ ﺍﻟﺴﺭﻁﺎﻥ ﺸﻴﻭﻋﹰ‬ ‫ﺭﺤﻤﻲ ﺴﻨﻭﻴﹰ‬ ‫ﺓ ﺴﻨﻭﻴﺎ‬ ‫ﺤﻭﺍﻟﻰ ‪ ٢٤٠ ٠٠٠‬ﺴﻴﺩ ﹰ‬ ‫ﹰ‪ ،‬ﻤﻌﻅﻤﻬﺎ ﻴﻘﻊ ﻓﻲ ﺍﻷﻤﺎﻜﻥ ﺍﻟﻔﻘﻴﺭﺓ ﺍﻟﻤﻭﺍﺭﺩ )‪.(٩-٧‬‬ ‫‪17‬‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻭﻴﺴﻌﻰ ﺍﻟﻬﺩﻑ ﺍﻟﺴﺎﺩﺱ ﻟﻠﻤﺭﻤﻰ ﺍﻟﺨﺎﻤﺱ ﻤﻥ ﺍﻟﻤﺭﺍﻤﻲ ﺍﻹﻨﻤﺎﺌﻴﺔ ﻟﻸﻟﻔﻴﺔ ﺇﻟﻰ ﺨﻔﺽ ﻤﻌﺩل ﻭﻓﻴﺎﺕ ﺍﻷﻤﻭﻤﺔ‬ ‫ﺒﺤﻠﻭل ﺍﻟﻌﺎﻡ ‪ ٢٠١٥‬ﺒﻤﻘﺩﺍﺭ ﺜﻼﺜﺔ ﺃﺭﺒﺎﻉ ﻤﺎ ﻜﺎﻨﺕ ﻋﻠﻴﻪ‪ .‬ﻭﺇﻥ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻷﻤﺭﺍﺽ ﺍﻻﻟﺘﻬﺎﺒﻴﺔ ﺍﻟﺤﻭﻀﻴﺔ ﻤﻥ ﺸﺄﻨﻬﺎ‬ ‫ﺃﻥ ﺘﺴﻬﻡ ﻓﻲ ﺘﺤﻘﻴﻕ ﻫﺫﺍ ﺍﻟﻤﺭﻤﻰ ﻤﻥ ﺨﻼل ﺍﻟﺤﺩ ﻤﻥ ﺃﻋﺩﺍﺩ ﺍﻟﻭﻓﻴﺎﺕ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﺎﻟﺤﻤل ﺍﻟﻤﻨﺘﺒﺫ‪ ،‬ﻜﻤﺎ ﺃﻥ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ‬ ‫ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﺴﻭﻑ ﺘﺅﺩﻱ ﺇﻟﻰ ﺨﻔﺽ ﺃﻋﺩﺍﺩ ﺍﻟﻨﺴﺎﺀ ﺍﻟﻼﺘﻲ ﻴﻘﻀﻲ ﻋﻠـﻴﻬﻥ ﺴـﺭﻁﺎﻥ‬ ‫ﻋﻨﻕ ﺍﻟﺭﺤﻡ‪.‬‬

‫ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﻀﺎﺌﺭﺓ ﻟﻠﺤﻤل‬

‫‪٤-٢-١‬‬

‫ﺎ‪ ،‬ﺍﻟﺘﻲ ﻻ ﺘـﺘﻡ ﻤﻌﺎﻟﺠﺘﻬﺎ‪ ،‬ﻤﻊ ﺤﺩﻭﺙ ﻋﺩﺍﻭﻯ ﺨﻠﻘﻴﺔ ﻭﺃﺨﺭﻯ ﺘﻘﻊ ﻓـﻲ‬ ‫ﺘـﺘﺭﺍﻓﻕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪.‬‬ ‫ﺍﻟﻔﺘﺭﺓ ﺍﻟﻤﺤﻴﻁﺔ ﺒﺎﻟﻭﻻﺩﺓ ﻋﻨﺩ ﺍﻟﻭﻟﺩﺍﻥ‪ ،‬ﺨﺎﺼﺔ ﻓﻲ ﺍﻟﻤﻨﺎﻁﻕ ﺍﻟﺘﻲ ﻻ ﺘـﺘﻡ ﻓﻴﻬﺎ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻴﺤﺩﺙ ﻓﻲ ‪ ٪٢٥‬ﻤﻥ ﺤﺎﻻﺕ ﺍﻟﺤﻤل ﻟﺩﻯ ﺍﻟﺴﻴﺩﺍﺕ ﺍﻟﻤﺼﺎﺒﺎﺕ ﺒﺎﻟﺯﻫﺭﻱ ﺍﻟﻤﺒﻜﺭ ﻏﻴﺭ ﺍﻟﻤﻌﺎﻟﺞ‪ ،‬ﺃﻥ ﻴﻭﻟـﺩ‬ ‫ﹰ‪ ،‬ﻭﻓﻲ ‪ ٪١٤‬ﻤﻥ ﻫﺫﻩ ﺍﻟﺤﺎﻻﺕ ﻴﻤﻭﺕ ﺍﻟﻁﻔل ﺨﻼل ﺍﻟﻔﺘﺭﺓ ﺍﻟﻤﺤﻴﻁﺔ ﺒﺎﻟﻭﻻﺩﺓ‪ ،‬ﻤﻤﺎ ﻴﺠﻌل ﻤﻌﺩل ﺍﻟﻭﻓﻴﺎﺕ‬ ‫ﺍﻟﻁﻔل ﻤﻴﺘﺎ‬ ‫ﺨﻼل ﺍﻟﻔﺘﺭﺓ ﺍﻟﻤﺤﻴﻁﺔ ﺒﺎﻟﻭﻻﺩﺓ ﺤﻭﺍﻟﻲ ‪ .٪٤٠‬ﻭﻴﺘﺭﺍﻭﺡ ﻤﻌﺩل ﺍﻨﺘﺸﺎﺭ ﺍﻟﺯﻫﺭﻱ ﻟﺩﻯ ﺍﻟﺤﻭﺍﻤل ﻓﻲ ﺃﻓﺭﻴﻘﻴـﺎ‪ ،‬ﻋﻠـﻰ‬ ‫ﺴﺒﻴل ﺍﻟﻤﺜﺎل‪ ،‬ﻤـﺎ ﺒﻴﻥ ‪ ٪٤‬ﻭ‪ .(٢٢) ٪١٥‬ﻭﺘﺅﺩﻱ ﺍﻹﺼﺎﺒﺔ ﺒﻌﺩﺍﻭﻯ ﺍﻟﻤﻜﻭﺭﺍﺕ ﺍﻟﺒﻨﻴﺔ ﻏﻴﺭ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺇﻟﻰ ﺤـﺩﻭﺙ‬ ‫ﺇﺠﻬﺎﺽ ﺘﻠﻘﺎﺌﻲ ﻭ ﺨﺩﺍﺝ )ﻭﻻﺩﺍﺕ ﻤﺒﺘﺴﺭﺓ( ﻓﻲ ‪ ٪٣٥‬ﻤﻥ ﺍﻟﺤﻭﺍﻤل ﺍﻟﻤﺼﺎﺒﺎﺕ ﺒﻬﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ‪ ،‬ﻜﻤﺎ ﺘـﺼل ﻨـﺴﺒﺔ‬ ‫ﻭﻓﻴﺎﺕ ﺍﻟﻭﻟﺩﺍﻥ ﻓﻲ ﺍﻟﻔﺘﺭﺓ ﺍﻟﻤﺤﻴﻁﺔ ﺒﺎﻟﻭﻻﺩﺓ ﻟﺩﻯ ﻫﺅﻻﺀ ﺍﻟﺴﻴﺩﺍﺕ ﺇﻟﻰ ‪ .(٢٣) ٪١٠‬ﻭﻓﻲ ﻏﻴﺎﺏ ﺍﻟﻌﻼﺝ ﺍﻟﻭﻗـﺎﺌﻲ‪،‬‬ ‫ﻓﺈﻥ ‪ ٪٥٠-٪٣٠‬ﻤﻥ ﺍﻟﻭﻟﺩﺍﻥ ﺍﻟﺫﻴﻥ ﻴﻭﻟﺩﻭﻥ ﻷﻤﻬﺎﺕ ﻤﺼﺎﺒﺎﺕ ﺒﺴﻴﻼﻥ ﻭﻻ ﻴﺨﻀﻌﻥ ﻟﻠﻤﻌﺎﻟﺠﺔ‪ ،‬ﻭﻨﺴﺒﺔ ﺘﺼل ﺇﻟـﻰ‬ ‫ﺎ ﻟﻠﻤﻌﺎﻟﺠـﺔ‪ ،‬ﻴـﺼﺎﺒﻭﻥ‬ ‫‪ ٪٣٠‬ﻤﻥ ﺍﻟﻭﻟﺩﺍﻥ ﺍﻟﺫﻴﻥ ﻴﻭﻟﺩﻭﻥ ﻷﻤﻬﺎﺕ ﻤﺼﺎﺒﺎﺕ ﺒﻌﺩﻭﻯ ﺒﺎﻟﻤﺘﺩﺜﺭﺍﺕ ﻭﻻ ﻴﺤﻀﺭﻥ ﺃﻴﻀﹰ‬ ‫ﺒﺎﻟﺭﻤﺩ ﺍﻟﻭﻟﻴﺩﻱ ﺍﻟﺫﻱ ﻴﻤﻜﻥ ﺃﻥ ﻴﻔﻀﻲ ﺇﻟﻰ ﺍﻟﻌﻤﻰ )‪ .(٢٥-٢٤‬ﻭﻴﻨﺘﻬﻲ ﺍﻟﺤﺎل ﺒﺄﻥ ﻴﺼﺎﺏ ‪ ٤٠٠٠-١٠٠٠‬ﻭﻟﻴـﺩ‪،‬‬ ‫ﻜل ﻋﺎﻡ ﺒﺎﻟﻌﻤﻰ ﺒﺴﺒﺏ ﻫﺫﻩ ﺍﻟﺤﺎﻟﺔ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﻌﺎﻟﻡ )‪.(٢٦‬‬ ‫ِﻠﻘﻲ ﻤـﻥ ﺸـﺄﻨﻪ ﺃﻥ ﻴﻭﻓــﺭ ﺍﻟﻭﻗﺎﻴـﺔ‬ ‫ﺎ ﻟﻠﻘﻴﺎﻡ ﺒﺘﺩﺨﻼﺕ ﻓﻌﺎﻟﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﺯﻫﺭﻱ ﺍﻟﺨ‬ ‫ﺍ ﻋﺎﻟﻤﻴﹰ‬ ‫ﻭﺇﻥ ﺠﻬﺩﹰ‬ ‫ﹰ‪ ،‬ﻓـﻲ ﻗـﺎﺭﺓ ﺃﻓﺭﻴﻘﻴـﺎ‬ ‫ﻟـ ‪ ٤٩٢ ٠٠٠‬ﺤﺎﻟﺔ ﻭﻟﻴﺩ ﻤﻴﺕ ﺃﻭ ﻭﻓﺎﺓ ﻟﻠﻭﻟﺩﺍﻥ ﺨﻼل ﺍﻟﻔﺘﺭﺓ ﺍﻟﻤﺤﻴﻁﺔ ﺒـﺎﻟﻭﻻﺩﺓ‪ ،‬ﺴـﻨﻭﻴﺎ‬ ‫ﻭﺤﺩﻫﺎ )‪ .(٢٧‬ﻭﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻟﻔﻌﺎﻟﻴﺔ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ‪ ،‬ﻓﺈﻨﻪ ﻓﻲ ﻤﻭﺍﻨﺯﺍ‪ ،‬ﺒﺠﻤﻬﻭﺭﻴﺔ ﺘﻨﺯﺍﻨﻴﺎ ﺍﻟﻤﺘﺤﺩﺓ‪ ،‬ﻭﻤـﻊ ﺍﻨﺘـﺸﺎﺭ‬ ‫ﺎ ﻟﻜـل ﺴـﻴﺩﺓ ﻴـﺘﻡ ﺘﺤـﺭﻱ‬ ‫ﺍ ﺃﻤﺭﻴﻜﻴﹰ‬ ‫ﺍﻟﺯﻫﺭﻱ ﺍﻟﻨﺸﻁ ﻟﺩﻯ ‪ ٪٨‬ﻤﻥ ﺍﻟﺤﻭﺍﻤل‪ ،‬ﺘﻘﺩﺭ ﺘﻜﻠﻔﺔ ﺍﻟﺘﺩﺨل ﺒـ ‪ ١,٤٤‬ﺩﻭﻻﺭﹰ‬ ‫ﺎ ﻟﻜل ﺴﻨﺔ‬ ‫ﺍ ﺃﻤﺭﻴﻜﻴﹰ‬ ‫ﺍ ﺃﻤﺭﻴﻜﻴﹰ‬ ‫ﺍﻟﻤﺭﺽ ﻟﺩﻴﻬﺎ‪ ،‬ﻭ‪ ٢٠‬ﺩﻭﻻﺭﹰ‬ ‫ﺎ ﻟﻜل ﺍﻤﺭﺃﺓ ﻴﺘﻡ ﻋﻼﺠﻬﺎ ﻤﻥ ﻫﺫﺍ ﺍﻟﻤﺭﺽ‪ ،‬ﻭ‪ ١٠,٥٦‬ﺩﻭﻻﺭﹰ‬ ‫ﻤﻥ ﺴﻨﻭﺍﺕ ﺍﻟﻌﻤﺭ ﺍﻟﻤﺼﺤﺤﺔ ﺒﺎﺤﺘﺴﺎﺏ ﻤﺩﺓ ﺍﻟﻌﺠﺯ‪ ،‬ﻴﺘﻡ ﺇﻨﻘﺎﺫﻫﺎ‪ .‬ﻭﺘﺘﺭﺍﻭﺡ ﺍﻟﺘﻜﻠﻔـﺔ ﻟﻜـل ﺴـﻨﺔ ﻤـﻥ ﺴـﻨﻭﺍﺕ‬ ‫ﺍﻟﻌﻤﺭ ﺍﻟﻤﺼﺤﺤﺔ ﺒﺎﺤﺘﺴﺎﺏ ﻤﺩﺓ ﺍﻟﻌﺠﺯ ﻭﺍﻟﺘﻲ ﻴﺘﻡ ﺇﻨﻘﺎﺫﻫﺎ ﻤﻥ ﺨﻼل ﻜﺎﻓﺔ ﺍﻟﺩﺭﺍﺴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺘﺤـﺭﻱ ﺍﻟﺯﻫـﺭﻱ‪،‬‬ ‫ﺍ ﺃﻤﺭﻴﻜﻴﹰ‬ ‫ﺒﻴﻥ ‪ ٤‬ﻭ‪ ١٩‬ﺩﻭﻻﺭﹰ‬ ‫ﺎ )‪.(٢٨‬‬

‫‪‬ﻱ‬ ‫ﻓﺭﺹ ﺍﻹﺴﺭﺍﻉ ﺒﻭﺘﻴﺭﺓ ﺍﻟﺘﺼﺩ‬ ‫ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻔﻌﺎﻟﺔ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‬

‫‪٣-١‬‬ ‫‪١-٣-١‬‬

‫ﺎ ﻓﻌﺎﻟﻴﺘﻬﺎ‬ ‫ﺎ ﻫﻭ ﺃﺤﺩ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺘﻲ ﺜﺒﺘﺕ ﻋﻠﻤﻴﹰ‬ ‫ﺇﻥ ﺘﺤﺴﻴﻥ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﺨﻔﺽ ﻤﻌﺩل ﺤﺩﻭﺙ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻟﺩﻯ ﺍﻟﺴﻜﺎﻥ ﺒـﺸﻜل ﻋـﺎﻡ )‪ .(٣١-٢٩‬ﻭﺇﺫﺍ ﺘـﻡ‬ ‫ﺍﺴﺘﻬﺩﺍﻑ ﺘﻭﺠﻴﻪ ﺍﻟﺨﺩﻤﺎﺕ ﺇﻟﻰ ﻤﺠﻤﻭﻋﺔ ﻤﻌﻴﻨﺔ ﻤﻥ ﺍﻟﺴﻜﺎﻥ ﻤﻌﺭﻀﺔ ﻷﺨﻁﺎﺭ ﺴﺭﺍﻴﺔ ﻋﺎﻟﻴﺔ‪ ،‬ﻓـﺈﻥ ﺍﻟﻔﻌﺎﻟﻴـﺔ ﻟﻘـﺎﺀ‬ ‫ﺍ ﻤﺅﻜﺩﹰ‬ ‫ﺍﻟﺘﻜﺎﻟﻴﻑ ﺘﺼﺒﺢ ﺃﻤﺭﹰ‬ ‫ﺍ ﺒﺼﻭﺭﺓ ﺃﻜﺒﺭ )‪.(٣٢‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺸﺭﺍﻜﺎﺕ ﺠﺩﻴﺩﺓ‬

‫‪٢-٣-١‬‬

‫ﺎ ﺒﻤﻜﺎﻓﺤـﺔ‬ ‫ﻫﻨﺎﻙ ﺘﺼﻤﻴﻡ ﻋﺎﻟﻤﻲ ﻤﺘﺠﺩﺩ ﻟﻤﻜﺎﻓﺤﺔ ﻭﺒﺎﺀ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﻭﺍﻟﺫﻱ ﻴﺘﻀﻤﻥ ﺍﻟﺘﺯﺍﻤـﹰ‬ ‫ﺎ ﺒﻭﺼﻑ ﺫﻟﻙ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻭﻗﺎﺌﻴﺔ ﻤﺒﺩﺌﻴﺔ‪ .‬ﺇﻥ ﺇﻋﻼﻥ ﺍﻷﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ ﻟﻼﻟﺘﺯﺍﻡ ﺒﻤﻜﺎﻓﺤﺔ ﻤﺭﺽ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ )ﺤﺯﻴﺭﺍﻥ‪ /‬ﻴﻭﻨﻴﻭ ‪ ،(٢٠٠١‬ﻴﻨﺹ ﻋﻠﻰ ﺃﻨﻪ ﺒﻴﻨﻤﺎ ﺘﻌﺩ ﺍﻟﺭﻋﺎﻴﺔ ﻭﺍﻟﺩﻋﻡ ﻭﺍﻟﻤﻌﺎﻟﺠﺔ ﻋﻨﺎﺼﺭ‬ ‫‪‬ﻱ ﻟﺠﺎﺌﺤـﺔ‬ ‫‪‬ﻱ‪ ،‬ﻓﺈﻥ ﺍﻟﻭﻗﺎﻴﺔ ﻻﺒﺩ ﺃﻥ ﺘﻜﻭﻥ ﻫﻲ ﺍﻟﺩﻋﺎﻤﺔ ﺍﻷﺴﺎﺴﻴﺔ ﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﺘـﺼﺩ‬ ‫ﺃﺴﺎﺴﻴﺔ ﻀﻤﻥ ﺠﻬﻭﺩ ﺍﻟﺘﺼﺩ‬ ‫ﺎ‪ .‬ﻭﻗﺩ ﺸﻬﺩﺕ ﺴﺎﺤﺔ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺩﻭﻟﻴﺔ ﺸﺭﻜﺎﺀ‬ ‫ﺍﻷﻴﺩﺯ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻤﺒﻜﺭﺓ ﻭﺍﻟﻔﻌﺎﻟﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻤﺼﺎﺩﺭ ﺘﻤﻭﻴل ﺠﺩﻴﺩﺓ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ‪ ،‬ﺠﻤﻌﻴﺎﺕ ﺍﻟﻤﺴﺎﻨﺩﺓ ﻭﺍﻟﺩﻓﺎﻉ ﻋﻥ ﺍﻟﺤﻘﻭﻕ‪ ،‬ﻭﺸﺒﻜﺎﺕ ﻭﺠﻤﺎﻋﺎﺕ ﺘﺘﻤﺘﻊ ﺒﻨﻔـﻭﺫ‬ ‫ﻭﺘﺄﺜﻴﺭ ﻗﻭﻱ‪ ،‬ﺇﻟﻰ ﺠﺎﻨﺏ ﺸﺭﻜﺎﺀ ﻤﻥ ﺍﻟﻘﻁﺎﻋﺎﺕ ﻏﻴﺭ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻤﺜل ﺍﻟﻘﻁﺎﻉ ﺍﻟﺘﺠﺎﺭﻱ ﻭﺍﻟﻤﺅﺴﺴﺎﺕ ﺍﻟﺨﻴﺭﻴﺔ‪ .‬ﻭﻤـﻥ‬ ‫ﺍﻟﻤﻤﻜﻥ ﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﺎﻟﻴﺔ ﻋﻥ ﻁﺭﻴﻕ ﻤﺼﺎﺩﺭ ﺍﻟﺘﻤﻭﻴل ﺍﻟﺠﺩﻴﺩﺓ ﻫﺫﻩ‪ ،‬ﺇﻀﺎﻓﺔ ﺇﻟﻰ ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﻭﺠﻭﺩﺓ ﺒﺎﻟﻔﻌـل‪،‬‬ ‫ﺎ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﻤﺭﺽ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪١.‬‬ ‫‪‬ﻱ ﺍﻟﻤﻜﺜﻑ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﺘﺤﻘﻴﻕ ﺍﻟﺘﺼﺩ‬ ‫ﻭﻴﺸﻴﺭ ﺍﻟﻁﻴﻑ ﺍﻟﻤﺘﻨﻭﻉ ﻤﻥ ﺍﻟﺘﺩﺨﻼﺕ ﻭﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﻨﺎﺠﺤﺔ ﺍﻟﻤﺤﻘﻘﺔ ﻓﻲ ﺍﻷﻤﺎﻜﻥ ﺍﻟﻤﺤﺩﻭﺩﺓ ﺍﻟﻤـﻭﺍﺭﺩ‪ ،‬ﻤﺜـل‬ ‫ﺘﺎﻴﻠﻨﺩ ﻭﺃﻭﻏﻨﺩﺍ‪ ،‬ﻭﺒﻠﺩﺍﻥ ﺃﺨﺭﻯ ﻤﺜل ﺍﻟﺩﺍﻨﻤﺭﻙ ﻭﺍﻟﺴﻭﻴﺩ ﻭﺍﻟﻤﻤﻠﻜﺔ ﺍﻟﻤﺘﺤﺩﺓ‪ ،‬ﺇﻟﻰ ﺃﻨﻪ ﺒﺎﻹﻤﻜـﺎﻥ ﻤﻜﺎﻓﺤـﺔ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ ﺒﺎﺴﺘﻨﻬﺎﺽ ﺍﻟﺘﺄﻴـﻴﺩ ﺍﻟﺴﻴﺎﺴﻲ ﻭﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻜﺎﻓﻴﺔ ﻟﻠﻘﻴﺎﻡ ﺒﻬﺫﻩ ﺍﻷﻨﺸﻁﺔ ﻭﺍﺴﺘﻤﺭﺍﺭﻫﺎ ﺒـﺸﻜل ﺤﺎﺴـﻡ‪.‬‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻻ ﻤﺭﺍﺀ ﻓﻲ ﺃﻥ ﺍﻟﺘﻌﺎﻭﻥ ﺒﻴﻥ ﺍﻟﺒﻠﺩﺍﻥ ﻭﺍﻟﺸﺭﺍﻜﺎﺕ ﻤﻊ ﺍﻟﻭﻜﺎﻻﺕ ﺍﻟﻤﻌﻨﻴﺔ ﻤﻥ ﺸﺄﻨﻪ ﺘﻴﺴﻴﺭ ﺘﺒﺎﺩل ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﻭﺘﻌﻤﻴﻡ‬ ‫ﺍﻟﺩﺭﻭﺱ ﺍﻟﻨﺎﺠﺤﺔ‪.‬‬ ‫ﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺭﺒﻁ ﺠﻬﻭﺩ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻤﻥ ﺍﻷﻡ ﺇﻟﻰ ﺍﻟﻁﻔل‪ ،‬ﺒﺠﻬـﻭﺩ‬ ‫ِﻠﻘﻲ ﻟﺘﻔﺎﺩﻱ ﻭﻗﻭﻉ ﺍﻟﻜﺎﺭﺜﺔ ﺍﻟﻤﺘﻤﺜﻠﺔ ﻓﻲ ﻭﻗﺎﻴﺔ ﺍﻟﺭﻀﻊ ﻤﻥ ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ‬ ‫ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺩﺍﺀ ﺍﻟﺯﻫﺭﻱ ﺍﻟﺨ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺒﻴﻨﻤﺎ ﻫﻡ ﻴﻤﻭﺘﻭﻥ ﻤﻥ ﺠﺭﺍﺀ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﺯﻫﺭﻱ‪ ،‬ﻜﻤﺎ ﻜﺎﻥ ﺍﻟﺤﺎل ﻓﻲ ﻫﺎﻴﺘﻲ )‪ .(٣٣‬ﻋﻼﻭﺓ ﻋﻠﻰ‬ ‫ﺫﻟﻙ‪ ،‬ﻓﺈﻥ ﻫﺫﺍ ﺍﻟﺭﺒﻁ ﻤﻥ ﺸﺄﻨﻪ ﺃﻥ ﻴﻌﺯﺯ‪ ،‬ﺒﺸﻜل ﺃﻜﺒﺭ‪ ،‬ﻤﻥ ﻓﻌﺎﻟﻴﺔ ﺍﻟﺘﺩﺨﻼﺕ ﻟﻘﺎﺀ ﺘﻜﺎﻟﻴﻔﻬﺎ‪.‬‬

‫‪‬ﻱ‬ ‫ﺍﻟﺘﻘﻨﻴﺎﺕ ﺍﻟﺠﺩﻴﺩﺓ ﻟﺘﻌﺯﻴﺯ ﺃﻨﺸﻁﺔ ﺍﻟﺘﺼﺩ‬

‫‪٣-٣-١‬‬

‫ﺎ ﻭﺴـﺒل ﺍﻟﺘﻤﻨﻴـﻊ ﻀـﺩﻫﺎ‬ ‫ﺇﻥ ﺍﻟﺘﻘﺩﻡ ﺍﻟﺫﻱ ﺘﻡ ﺘﺤﻘﻴﻘﻪ ﻓﻲ ﻤﺠﺎل ﺘﺸﺨﻴﺹ ﻭﻋﻼﺝ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻟﺤﻴﻠﻭﻟﺔ ﺩﻭﻥ ﺍﻹﺼﺎﺒﺔ ﺒﻬﺎ‪ ،‬ﺘﻭﻓﺭ ﺍﻟﻔﺭﺹ ﻟﺭﺅﻯ ﻭﻭﺴﺎﺌل ﻭﺤﻠﻭل ﺠﺩﻴﺩﺓ ﺘﺠﺎﻩ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻨﻬﺎ ﻭﻤﻥ ﻋﺩﺍﻭﻯ ﺍﻟﺠﻬﺎﺯ‬ ‫ﺍﻟﺘﻨﺎﺴﻠﻲ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ ﻭﺘﺭﺼﺩ ﺍﻹﺼﺎﺒﺔ ﺒﻬﺎ‪.‬‬

‫ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﺍﻟﺴﺭﻴﻌﺔ‬ ‫ﺘﻤﻜﻥ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺠﺩﻴﺩﺓ ﺍﻟﺘﻲ ﺘﺠﺭﻯ ﻓﻲ ﻨﻘﺎﻁ ﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻜﺸﻑ ﺍﻟﻠﻭﻟﺒﻴﺔ‪ ،‬ﻤﻥ ﺘﺤﺭﻱ ﺩﺍﺀ ﺍﻟﺯﻫﺭﻱ ﻓـﻲ‬ ‫ﺍﻟﻤﺭﺍﻜﺯ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻨﺎﺌﻴﺔ ﻤﻊ ﺘﻘﺩﻴﻡ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻼﺯﻤﺔ ﺩﻭﻥ ﺘﺄﺨﻴﺭ‪.‬‬ ‫•‬

‫‪ ١‬ﺘﺸﻤل ﺒﻌﺽ ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﻤﺘﻭﻓﺭﺓ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ ﺍﻟﺼﻨﺩﻭﻕ ﺍﻟﻌـﺎﻟﻤﻲ ﻟﻤﻜﺎﻓﺤـﺔ ﺍﻷﻴـﺩﺯ ﻭﺍﻟـﺴل ﻭﺍﻟﻤﻼﺭﻴـﺎ‪،‬‬ ‫ﻭﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻭﺍﻟﻤﺒﺎﺩﺭﺍﺕ ﺍﻟﺘﻲ ﺘﺴﺘﻬﺩﻑ ﺯﻴﺎﺩﺓ ﺴﺒل ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﻤﻀﺎﺩﺍﺕ ﺍﻟﻔﻴﺭﻭﺴﺎﺕ ﺍﻟﻘﻬﻘﺭﻴـﺔ‪ ،‬ﻭﺨﻁـﺔ ﻁـﻭﺍﺭﺉ‬ ‫ﺍﻟﺭﺌﻴﺱ ﺒﻭﺵ ﻹﻏﺎﺜﺔ ﻤﺭﻀﻰ ﺍﻷﻴﺩﺯ‪ ،‬ﺍﻟﺘﻲ ﺘﻘﺩﻡ ‪ ١٥‬ﺒﻠﻴﻭﻥ ﺩﻭﻻﺭ ﺃﻤﺭﻴﻜﻲ )ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﻤﺎ ﻴﻘﺭﺏ ﻤـﻥ ‪ ٩‬ﺒﻼﻴـﻴﻥ ﺩﻭﻻﺭ‬ ‫ﺃﻤﺭﻴﻜﻲ ﻓﻲ ﺼﻭﺭﺓ ﺘﻤﻭﻴل ﺠﺩﻴﺩ( ﻟﻤﻜﺎﻓﺤﺔ ﺠﺎﺌﺤﺔ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪ ،‬ﻋﻠﻰ ﻤﺩﻯ ﺨﻤﺱ ﺴﻨﻭﺍﺕ‪ ،‬ﻤﻊ ﺍﻟﺘﺭﻜﻴﺯ ﻋﻠـﻰ‬ ‫ﺎ‬ ‫‪ ١٥‬ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻷﻜﺜﺭ ﺍﺒﺘﻼﺀ ﺒﻬﺫﺍ ﺍﻟﻤﺭﺽ ﻭﺒﺭﺍﻤﺞ ﺍﻟﺒﻨﻙ ﺍﻟﺩﻭﻟﻲ ﺍﻟﻤﺘﻌﺩﺩﺓ ﺍﻟﻘﻁﺎﻋﺎﺕ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻭﺍﻷﻴﺩﺯ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻭﺍﻻﺴﺘﺭﺸـﺎﺩ‬ ‫ﻴﻤﻜﻥ ﺍﺴﺘﺨﺩﺍﻡ ﺍﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﻀﺨﻴﻡ ﻟﻠﺤﻤﻭﺽ ﺍﻟﻨﻭﻭﻴﺔ ﻟﺭﺼﺩ ﺍﺘﺠﺎﻫﺎﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﻬﺎ ﻟﺘﻭﺠﻴﻪ ﺒﺭﻭﺘﻭﻜﻭﻻﺕ ﺘﻌﺩﻴل ﺍﻟﻤﻌﺎﻟﺠﺔ‪ .‬ﻭﻴﻤﻜﻥ ﺍﺴﺘﺨﺩﺍﻡ ﺒﻌﺽ ﻫﺫﻩ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﻋﻠـﻰ ﺍﻟﻌﻴﻨـﺎﺕ ﺍﻟـﺴﻬﻠﺔ‬ ‫ﺎ‪.‬‬ ‫ﺍﻟﺘﺠﻤﻴﻊ ﻤﺜل ﺍﻟﺒﻭل ﻭﺍﻟﻤﺴﺤﺔ ﺍﻟﻤﻬﺒﻠﻴﺔ ﺍﻟﺘﻲ ﺘﺠﺭﻯ ﺫﺍﺘﻴﹰ‬ ‫ﺎ ﺘﻁﻭﻴﺭ ﺠﻴل ﺠﺩﻴﺩ ﻤﻥ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﺍﻟﺴﺭﻴﻌﺔ ﻭﺍﻟﺯﻫﻴﺩﺓ ﺍﻟﺜﻤﻥ ﻭﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻜﺸﻑ ﻋﻥ‬ ‫ﻴﺠﺭﻱ ﺤﺎﻟﻴﹰ‬ ‫ﻋﺩﺍﻭﻯ ﺍﻟﻤﺘﺩﺜﺭﺍﺕ‪.‬‬ ‫ﺎ ﺍﻟﺘﻲ ﺃﺼـﺒﺤﺕ ﺃﺴـﻌﺎﺭﻫﺎ ﻤﻴـﺴﻭﺭﺓ‪ ،‬ﻤﺜـل‬ ‫ﻫﻨﺎﻙ ﺒﻌﺽ ﺍﻷﺩﻭﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻻ ﻓﻴﻬﺎ‪ ،‬ﻭﺍﻷﺴﻴﻜﻠﻭﻓﻴﺭ‪ ،‬ﻜﻤﺎ ﺃﻥ ﻫﻨﺎﻙ ﺃﺩﻭﻴﺔ ﺃﺨـﺭﻯ ﻤﺜـل‬ ‫ﺍﻟﺴﻴـﺒﺭﻭﻓﻠﻭﻜﺴﺎﺴﻴﻥ‪ ،‬ﻟﻸﻤﺭﺍﺽ ﺍﻟﺘﻲ ﻴﻜﻭﻥ ﻓﻌﺎ ﹰ‬ ‫ﺍﻷﺯﻴﺜﺭﻭﻤﺎﻴﺴﻴﻥ ﻭﺍﻟﺴﻴﻔﻴﻜﺴﻴﻡ‪ ،‬ﺍﻟﺘﻲ ﺘﺘﻤﺘﻊ ﺒﺎﻟﻤﻴﺯﺓ ﺍﻹﻀﺎﻓﻴﺔ ﺍﻟﻤﺘﻤﺜﻠﺔ ﻓﻲ ﻜﻭﻨﻬﺎ ﺃﺤﺎﺩﻴﺔ ﺍﻟﺠﺭﻋﺔ‪ ،‬ﻭﺍﻟﺘﻲ ﺴﻭﻑ‬ ‫ﺘﺼﺒﺢ ﺃﻗل ﺴﻌﺭﹰ‬ ‫ﺍ ﻤﻊ ﺍﻨﻘﻀﺎﺀ ﻓﺘﺭﺓ ﺘﺴﺠﻴل ﺒﺭﺍﺀﺘﻬﺎ‪ .‬ﻭﻗﺩ ﺘﻡ ﻭﻀﻊ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺘـﺄﻤﻴﻥ ﻜﻤﻴـﺎﺕ‬ ‫ﺎ ﻓﻲ ﻤﻌﺎﻟﺠﺔ ﺍﻹﺼﺎﺒﺎﺕ ﺍﻟﻤﺒﻜﺭﺓ ﺒﺎﻟﺯﻫﺭﻱ‪ ،‬ﻭﻴﻤﻜﻥ ﺇﻋﻁﺎﺅﻩ ﻜﻤﻌﺎﻟﺠـﺔ‬ ‫ﻀﺨﻤﺔ ﻤﻨﻬﺎ‪ .‬ﻭﻻﻴﺯﺍل ﺍﻟﺒﻨﺴﻠﻴﻥ ﻨﺎﺠﻌﹰ‬ ‫ﺃﺤﺎﺩﻴﺔ ﺍﻟﺠﺭﻋﺔ‪ ،‬ﻭﺇﻥ ﻜﺎﻨﺕ ﺘﺘﻡ ﻋﻥ ﻁﺭﻴﻕ ﺍﻟﺤﻘﻥ‪.‬‬ ‫ﺇﻥ ﺍﻟﻠﻘﺎﺤﺎﺕ ﺍﻟﻭﻗﺎﺌﻴﺔ ﺍﻟﻤﻀﺎﺩﺓ ﻟﻸﻨﻤﺎﻁ ﺍﻟﻤﻜﻭﻨﺔ ﻟﻠﻭﺭﻡ ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺘﺒـﺸﺭ ﺒـﺎﻟﺨﻴﺭ‬ ‫ﺍﻟﻜﺜﻴﺭ ﻭﺴﺭﻋﺎﻥ ﻤﺎ ﺴﻭﻑ ﺘﺼﺒﺢ ﻤﺘﺎﺤﺔ ﻭﻤﺘﻭﻓﺭﺓ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺃﻥ ﻴﺘﻌﺎﻭﻥ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﺩﻭﻟﻲ ﻤﻊ ﺍﻟﺒﻠـﺩﺍﻥ ﻹﻋـﺩﺍﺩ‬ ‫ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻭﻭﻀﻌﻬﺎ ﻟﺘﻌﺯﻴﺯ ﺘﻨﻔﻴﺫﻫﺎ ﻭﺍﺴﺘﺨﺩﺍﻤﻬﺎ ﻓﻲ ﺒﺭﺍﻤﺞ ﺍﻟﺘﻤﻨﻴﻊ ﺍﻟﻭﻁﻨﻲ ﻟﻀﻤﺎﻥ ﺘﺤﻘﻴﻕ ﺘﻐﻁﻴﺔ ﻋﻠﻰ‬ ‫ﺎ )‪.(٣٥،٣٤‬‬ ‫ﻤﺴﺘﻭﻯ ﻋﺎل‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻓﻲ ﻓﺌﺔ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﻗﺒل ﺃﻥ ﻴﺼﺒﺤﻭﺍ ﻨﺸﻁﻴﻥ ﺠﻨﺴﻴﹰ‬

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‫ﺍﻟﻤﺩﺍﻭﺍﺓ‬ ‫•‬

‫ﺍﻟﻠﻘﺎﺤﺎﺕ‬

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‫ﻻ ﻴﺘﻭﻓﺭ ﺤﺘﻰ ﺍﻵﻥ ﻟﻘﺎﺡ ﻤﻀﺎﺩ ﻟﻠﻨﻤﻁ ‪ ٢‬ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ‪ ،‬ﺇﻻ ﺃﻥ ﺃﺤﺩ ﺍﻟﻠﻘﺎﺤﺎﺕ ﻴﺒـﺸﺭ ﺒـﺎﻟﺨﻴﺭ‬ ‫ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ ﺍﻟﻼﺘﻲ ﻟﻡ ﻴﺘﻌﺭﻀﻥ ﺴﺎﺒﻘﹰ‬ ‫ﺎ ﻟﻺﺼﺎﺒﺔ ﺒﺎﻟﻨﻤﻁ ﺍﻷﻭل ﺃﻭ ﺍﻟﻨﻤﻁ ﺍﻟﺜﺎﻨﻲ ﻤﻥ ﻫﺫﺍ ﺍﻟﻔﻴﺭﻭﺱ )‪ .(٣٦‬ﻭﺘﻤﺱ‬ ‫ﺍﻟﺤﺎﺠﺔ ﻹﺠﺭﺍﺀ ﺍﻟﻤﺯﻴﺩ ﻤﻥ ﺍﻟﺘﺠﺎﺭﺏ ﺍﻟﻤﻴﺩﺍﻨﻴﺔ ﻓﻲ ﺃﻤﺎﻜﻥ ﻤﺨﺘﻠﻔﺔ ﻟﺘﻘﻴـﻴﻡ ﻓﺎﺌﺩﺘﻪ ﻓﻲ ﻤﺠﻤﻭﻋﺔ ﻤﺘﻨﻭﻋـﺔ ﻤـﻥ‬ ‫ﺍ ﻻﺭﺘﻔﺎﻉ ﻤﻌﺩل ﺍﻨﺘﺸﺎﺭ ﺍﻟﻌﺩﻭﻯ ﺒﺎﻟﻨﻤﻁ ‪ ٢‬ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻟﻬـﺭﺒﺱ‬ ‫ﺍﻷﻭﺴﺎﻁ ﺃﻭ ﺍﻟﺒﻴﺌﺎﺕ ﺍﻟﻭﺒﺎﺌﻴﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ‪ .‬ﻭﻨﻅﺭﹰ‬ ‫ﺍﻟﺒﺴﻴﻁ‪ ،‬ﻭﺃﻫﻤﻴﺘﻪ ﻓﻲ ﺯﻴﺎﺩﺓ ﺍﻨﺘﻘﺎل ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪ ،‬ﻓﺈﻥ ﺍﺴﺘﺨﺩﺍﻡ ﻟﻘﺎﺡ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻨﺘﺸﺎﺭ ﺍﻟﻌﺩﻭﻯ ﺒﺎﻟﻨﻤﻁ ‪ ٢‬ﻤﻥ‬ ‫ﻓﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ ﻓﻲ ﻤﺭﺤﻠﺔ ﻤﺒﻜﺭﺓ ﻴﺒﺸﺭ ﺒﻜل ﺍﻟﺨﻴﺭ‪ .‬ﻭﻤﻥ ﺜﻡ ﻴﺠﺏ ﺃﻥ ﻴﺘﻀﺎﻓﺭ ﺍﻟﻤﺠﺘﻤـﻊ ﺍﻟـﺩﻭﻟﻲ‪،‬‬ ‫ﻭﻭﻜﺎﻻﺕ ﺍﻟﺘﻤﻭﻴل‪ ،‬ﻭﺍﻟﺤﻜﻭﻤﺎﺕ‪ ،‬ﻟﻠﺘﺨﻁﻴﻁ ﻭﻹﺤﺭﺍﺯ ﺘﻘﺩﻡ ﻓﻲ ﻤﻀﻤﺎﺭ ﺇﻋﺩﺍﺩ ﻟﻘﺎﺤﺎﺕ ﻓﻌﺎﻟـﺔ ﻀـﺩ ﺍﻟﻌـﺩﻭﻯ‬ ‫ﺒﺎﻟﻨﻤﻁ ‪ ٢‬ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ‪.‬‬ ‫ﺎ ﻭﻗﺎﺌﻴﹰ‬ ‫ﺇﻥ ﻫﻨﺎﻙ ﻟﻘﺎﺤﹰ‬ ‫ﺎ ﻀﺩ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ "ﺏ"‪ ،‬ﻤﻨﺫ ﻋﺎﻡ ‪ ،١٩٨٢‬ﻭﺒﺎﻟﺘﺎﻟﻲ ﻴﻨﺒﻐﻲ ﻋﻠﻰ ﺍﻟﺒﻠﺩﺍﻥ ﻭﻀـﻊ ﺨﻁـﻁ‬ ‫ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ "ﺏ" ﻭﺍﺴﺘﻨﻬﺎﺽ ﺘﻀﻤﻴﻥ ﺍﻟﻠﻘﺎﺡ ﺍﻟﺤﺎﻟﻲ ﻓﻲ ﺒﺭﺍﻤﺞ ﺍﻟﺘﻤﻨﻴﻊ ﻤﻥ ﺃﺠل ﻀـﻤﺎﻥ ﺘﻤﻨﻴـﻊ‬ ‫ﺎ ﻭﺍﻟﻤﻌﺭﻀﻴﻥ ﻟﺨﻁﺭ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﻭﻯ ﺒﺎﻟﺘﻬـﺎﺏ‬ ‫ﺍﻷﻁﻔﺎل ﺒﻜل ﺍﻟﺒﻠﺩﺍﻥ‪ ،‬ﻭﺇﺘﺎﺤﺘﻪ ﻟﻜل ﺍﻟﺒﺎﻟﻐﻴﻥ ﺍﻟﻨﺎﺸﻁﻴﻥ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻜﺒﺩ "ﺏ"‪.‬‬

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‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‬ ‫ﺃﺴﻠﻭﺏ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬

‫‪٤-٣-١‬‬

‫ﺎ ﻋﻥ ﻁﺭﻴﻕ ﺍﺴﺘﺨﺩﺍﻡ ﻤﺠﻤﻭﻋﺔ ﻤﺅﻟﻔﺔ‬ ‫ﻴﻤﻜﻥ ﺘﺤﻘﻴﻕ ﻭﻗﺎﻴﺔ ﻭﺭﻋﺎﻴﺔ ﻓﻌﺎﻟﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻭﺍﻟﻭﻗﺎﻴﺔ ﻤﻨﻬﺎ‪ ،‬ﻟﺘﻐﻁﻲ‬ ‫ﻤﻥ ﺃﺴﺎﻟﻴﺏ ﺍﻟﺘﺼﺩﻱ‪ .‬ﺤﻴﺙ ﻴﺠﺏ ﺘﻭﺴﻴﻊ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻀﻤﻭﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ ﺍﻟﺘﻲ ﺘﺸﻤل ﺍﻵﺘﻲ‪:‬‬ ‫‪20‬‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺘﺸﺠﻴﻊ ﺍﻟﺴﻠﻭﻙ ﺍﻟﺠﻨﺴﻲ ﺍﻟﻤﺄﻤﻭﻥ‪.‬‬ ‫ﺘﺸﺠﻴﻊ ﺍﻟﺴﻠﻭﻙ ﺍﻟﻤﺘﻌﻠﻕ ﺒﺎﻻﻟﺘﻤﺎﺱ ﺍﻟﻤﺒﻜﺭ ﻟﻠﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫ﺎ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ ﺒﻁﺭﻴﻘﺔ ﺃﻓﻘﻴﺔ ﻋﺒﺭ ﺠﻤﻴﻊ ﺒﺭﺍﻤﺞ ﺍﻟﺭﻋﺎﻴﺔ‬ ‫ﺘﻨﻔﻴﺫ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﻤﺭﺍﻓﻕ ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻭﺍﻟﺠﻨﺴﻴﺔ ﻭﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤﺔ ﻓﻴﺭﻭﺱ ﺍﻟﻌـﻭﺯ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻌﺭﻭﻑ ﺃﻨﻪ ﻗﺩ ﺘﻡ ﻓﻲ ﻋﺩﺩ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ ﺘﻭﺜﻴﻕ ﺒﺭﺍﻤﺞ ﻤﺘﻜﺎﻤﻠـﺔ ﻭﻨﺎﺠﺤـﺔ‬ ‫ﺎ‪ ،‬ﻭﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‬ ‫ﻭﺘﺘﺴﻡ ﺒﺎﻟﻔﻌﺎﻟﻴﺔ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ‪ ،‬ﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻟﺴل‪ ،‬ﺤﻴﺙ ﻴﺘﻡ ﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ ﻤﻥ ﻗﺒل ﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﻤﺭﺍﻜـﺯ ﺍﻟﺭﻋﺎﻴـﺔ‬ ‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﺃﻨﻔﺴﻬﻡ‪ .‬ﻭﻴﺘﻤﺘﻊ ﻫﺫﺍ ﺍﻷﺴﻠﻭﺏ ﺒﺎﻟﺠﺎﺫﺒﻴﺔ‪ ،‬ﻭﻴﻭﻓﺭ ﺍﻟﺘﻜﺎﻟﻴﻑ ﻟﻜل ﻤﻥ ﺍﻟﻌﻤﻴل ﻭﺍﻟﻨﻅـﺎﻡ‬ ‫ﺍﻟﺼﺤﻲ ﻋﻠﻰ ﺤﺩ ﺴﻭﺍﺀ‪.‬‬ ‫ﺎ‪ ،‬ﻭﻴﺸﺘﻤل ﻋﻠﻰ‪:‬‬ ‫ﺇﻴﺠﺎﺩ ﺃﺴﻠﻭﺏ ﺸﺎﻤل ﻟﻠﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

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‫ﺎ؛‬ ‫ ﺘﺤﺩﻴﺩ ﻫﻭﻴﺔ ﻤﺘﻼﺯﻤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻤﻨﺎﺴﺒﺔ ﺒﻤﻀﺎﺩﺍﺕ ﺍﻟﻤﻴﻜﺭﻭﺒﺎﺕ ﻟﻬﺫﻩ ﺍﻟﻤﺘﻼﺯﻤﺔ؛‬‫ﺎ‪ ،‬ﺒﻤﺎ ﻓـﻲ ﺫﻟـﻙ ﻓﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ‬ ‫ ﺘﻘﺩﻴﻡ ﺍﻟﻤﺸﻭﺭﺓ ﻭﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺼﺤﻲ ﺤﻭل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ؛‬ ‫ ﺍﻟﺘﺸﺠﻴﻊ ﻋﻠﻰ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﺎﺯل ﺍﻟﺫﻜﺭﻱ؛‬‫ ﻭﺇﺒﻼﻍ ﺍﻟﺯﻭﺝ )ﺭﺍﺠﻊ ﺍﻟﻘﺴﻡ ‪ ٣,٢,٣‬ﻟﻤﺯﻴﺩ ﻤﻥ ﺍﻟﺘﻔﺎﺼﻴل(‪.‬‬‫ﻭﻻﺒﺩ ﺃﻥ ﺘﻜﻭﻥ ﺍﻟﺘﺩﺨﻼﺕ ﻭﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻤﺴﺘﻨﺩﺓ‪ ،‬ﻷﻗﺼﻰ ﺤﺩ ﻤﻤﻜﻥ‪ ،‬ﻋﻠﻰ ﺍﻟﺒـﺭﺍﻫﻴﻥ‪ .‬ﻭﻤـﻥ ﺨـﻼل‬ ‫ﺍﻟﺘﻁﺒﻴﻕ ﻭﺍﻟﺘﻘﻴـﻴﻡ ﺍﻟﺩﻗﻴﻕ ﻟﻠﺘﺩﺨﻼﺕ ﺍﻟﻤﺒﺘﻜﺭﺓ‪ ،‬ﻴﻤﻜﻥ ﺠﻤﻊ ﺒﻴﻨﺎﺕ ﻭﺒﺭﺍﻫﻴﻥ ﺠﺩﻴﺩﺓ ﺘﺴﺘﺨﺩﻡ ﻓﻲ ﺇﻀـﺎﻓﺔ ﻤﻌﻠﻭﻤـﺎﺕ‬ ‫‪‬ﻡ‪ ،‬ﺜـﻡ )ﺇﺫﺍ ﺘﺤﻘـﻕ‬ ‫ﱢﻁ‪ ،‬ﺍﻓﻌل‪ ،‬ﻗﻴ‬ ‫ﻟﻼﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻭﺍﻟﺒﺭﺍﻤﺞ‪ ،‬ﻭﺯﻴﺎﺩﺓ ﺍﻟﻤﻌﺩﻻﺕ‪ .‬ﻭﺍﻷﻫﻤﻴﺔ ﺒﻤﻜﺎﻥ ﺘﻁﺒﻴﻕ ﻤﻔﻬﻭﻡ‪ :‬ﺨﻁ‬ ‫ﺍﻟﻨﺠﺎﺡ( ﺍﻨﻬﺽ ﺒﻬﺎ )‪ .(PDAS‬ﻭﻓﻴﻤﺎ ﻴﻠﻲ ﺒﻌﺽ ﺍﻷﺴﺎﻟﻴﺏ ﺍﻟﻤﺒﺘﻜﺭﺓ ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺍﺴﺘﺨﺩﺍﻤﻬﺎ ﻭﺍﻟﺘﻌﻭﻴل ﻋﻠﻴﻬﺎ ﻓﻲ ﻤﺜل‬ ‫ﻫﺫﻩ ﺍﻟﻌﻤﻠﻴﺎﺕ‪:‬‬ ‫ﺍﻟﻌﻼﺝ ﺍﻟﻅﻨﻲ ﺍﻟﺩﻭﺭﻱ‪ .‬ﻟﻘﺩ ﺃﻅﻬﺭﺕ ﻫﺫﻩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﻘﺼﻴﺭﺓ ﺍﻟﻤﺩﻯ ﻓﻌﺎﻟﻴﺔ ﻓﻲ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ ﻋﻨﺩ ﺍﺴﺘﻬﺩﺍﻓﻬﺎ ﻟﻤﺠﻤﻭﻋﺎﺕ ﺴﻜﺎﻨﻴﺔ ﻤﺤﺩﺩﺓ‪ ،‬ﻓﻲ ﺍﻟﻤﺭﺍﻓﻕ ﺍﻟﻤﻼﺌﻤﺔ‪.‬‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ .‬ﺤﻴﺙ ﺇﻥ ﺍﻟﺘﺴﻭﻴﻕ‬ ‫ﺍﻟﺘﺴﻭﻴﻕ ﺃﻭ ﺍﻟﺘﺭﻭﻴﺞ ﺍﻻﺠﺘﻤﺎﻋﻲ ﻟﻠﺴﻠﻊ ﺍﻟﺨﺎﺼﺔ ﺒﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‬ ‫ﱠﻔﺔ ﺃﻭ ﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ‪ ،‬ﺍﻟﺘﻲ ﺘﺴﺘﻬﺩﻑ ﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺍﻻﺠﺘﻤﺎﻋﻲ ﻟﻸﺩﻭﻴﺔ ﺍﻟﻤﻐﻠ‬ ‫ﻭﺍﻟﻭﻗﺎﻴﺔ ﻤﻨﻬﺎ )ﺒﺎﻹﻀﺎﻓﺔ ﺇﻟﻰ ﺍﻟﺘﺩﺭﻴﺏ ﻋﻠﻰ ﺍﺴﺘﺨﺩﺍﻤﻬﻡ ﺒﺼﻭﺭﺓ ﺼﺤﻴﺤﺔ ﻭﻤﺘﺴﻘﺔ( ﻗﺩ ﺴﺎﻫﻤﺕ ﻓـﻲ‬ ‫ﺘﺤﺴﻴﻥ ﺴﺒل ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﻓﻲ ﺒﻌﺽ ﺍﻷﻤﺎﻜﻥ‪.‬‬ ‫ﺘﻭﻓﻴﺭ ﺨﺩﻤﺎﺕ ﺴﻬﻠﺔ ﺍﻻﺴﺘﺨﺩﺍﻡ ﻟﻠﻤﺭﺍﻫﻘﻴﻥ‪ .‬ﻓﻘﺩ ﺃﻅﻬﺭﺕ ﺍﻟﺘﺠﺭﺒﺔ ﻜﻴﻔﻴﺔ ﺠﻌل ﻫﺫﻩ ﺍﻟﺨـﺩﻤﺎﺕ ﺃﻜﺜـﺭ‬ ‫ﻻ ﻤﻥ ﻗﺒل ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﻭﺃﻜﺜﺭ ﺘﻠﺒﻴﺔ ﻻﺤﺘﻴﺎﺠﺎﺘﻬﻡ‪ ،‬ﻴﻨﺒﻐﻲ ﻋﻠﻰ ﻜل ﺒﻠﺩ ﺍﻻﻨﺘﻔـﺎﻉ ﺒﻬـﺫﻩ ﺍﻟﻤﻌـﺎﺭﻑ‬ ‫ﻗﺒﻭ ﹰ‬ ‫•‬ ‫•‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻼ ﻋـﻥ‬ ‫ﻭﺍﻟﺨﺒﺭﺍﺕ ﻓﻲ ﻤﻭﺍﺀﻤﺔ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﻨﺎﺴﺒﺔ ﺒﻤﺎ ﻴﺘﻨﺎﺴﺏ ﻤﻊ ﺍﺤﺘﻴﺎﺠﺎﺕ ﻜل ﺒﻠﺩ ﻭﻤﻭﻗﻊ‪ ،‬ﻓـﻀ ﹰ‬ ‫ﺍﻟﻌﻤل ﻋﻠﻰ ﺍﻟﻭﺼﻭل ﺇﻟﻰ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﻭﺘﻠﺒﻴﺔ ﺍﺤﺘﻴﺎﺠﺎﺘﻬﻡ‪.‬‬ ‫ﺇﺸﺭﺍﻙ ﺍﻟﺫﻜﻭﺭ‪ ،‬ﻭﺘﺤﻔﻴﺯﻫﻡ ﻤﻥ ﺨﻼل ﺘﻘﺩﻴﻡ ﺍﻟﺨﺩﻤﺎﺕ ﻟﻬﻡ‪ .‬ﻭﻗﺩ ﺃﺜﺒﺘﺕ ﺍﻟﻤﺸﺎﺭﻴﻊ ﺍﻻﺭﺘﻴﺎﺩﻴـﺔ ﺍﻟﺘـﻲ‬ ‫ﺎ؛ ﻭﻤﻥ ﺜﻡ ﻓﻼﺒﺩ ﻤﻥ ﺘﻬﻴﺌﺔ ﺍﻟﺨﺒﺭﺍﺕ ﺍﻟﻤﻜﺘﺴﺒﺔ ﻤﻨﻬﺎ ﻭﺘﻜﻴـﻴﻔﻬﺎ ﺒﻤـﺎ‬ ‫ﺎ ﻤﻠﻤﻭﺴﹰ‬ ‫ﺘﺴﺘﻬﺩﻑ ﺍﻟﺭﺠﺎل ﻨﺠﺎﺤﹰ‬ ‫ﻴﺘﻼﺀﻡ ﻭﺍﻟﻅﺭﻭﻑ ﻭﺍﻷﻨﺸﻁﺔ ﺍﻟﻤﺤﻠﻴﺔ‪ ،‬ﻭﻤﻥ ﺜﻡ ﺍﻟﻨﻬﻭﺽ ﺒﻬﺎ‪.‬‬ ‫‪‬ﺩ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺇﺠﺭﺍﺀﺍﺕ‬ ‫ﻴﺠﺏ ﺃﻥ ﺘﺸﻤل ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺠﻴل ﺍﻟﺜﺎﻨﻲ ﺍﻟﺨﺎﺼﺔ ﺒﺘﺭﺼ‬ ‫ﺎ‪ .‬ﺤﻴﺙ ﺇﻥ ﻤﺜل ﻫﺫﻩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻤﻥ ﺸﺄﻨﻬﺎ ﺘﻘﺩﻴﻡ ﺒﺭﺍﻤﺞ‬ ‫ﺍﻟﺘﺭﺼﺩ ﺍﻟﺴﻠﻭﻜﻲ ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﻭﻓﺭ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﺍﻟﻼﺯﻤﺔ ﺤﻭل ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﻼﺌﻤﺔ ﻟﻤﻜﺎﻓﺤﺔ ﻜل ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‬ ‫ﺎ‪.‬‬ ‫ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫•‬

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‫ﺘﺸﺠﻴﻊ ﻋﺎﻤﺔ ﺍﻟﺴﻜﺎﻥ ﻭﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻌﺎﻟﻴﺔ ﺍﻻﺨﺘﻁﺎﺭ ﻋﻠـﻰ ﺍﺴـﺘﺨﺩﺍﻡ ﺍﻟﻌـﺎﺯل‬ ‫ﺍﻟﺫﻜﺭﻱ‬

‫‪٥-٣-١‬‬

‫ﺇﻥ ﻫﻨﺎﻙ ﺒﻴﻨﺎﺕ ﻜﺎﻓﻴﺔ ﺘﻅﻬﺭ ﻓﻌﺎﻟﻴﺔ ﺍﻟﻌﺎﺯل ﺍﻟﺫﻜﺭﻱ ﻋﻨﺩ ﺍﺴﺘﺨﺩﺍﻤﻪ ﺒﺼﻭﺭﺓ ﺼﺤﻴﺤﺔ ﻭﻤﺘﺴﻘﺔ ﻓﻲ ﺘـﻭﻓﻴﺭ‬ ‫ﺍﻟﺤﻤﺎﻴﺔ ﻀﺩ ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﻨﺴﺎﺀ ﻭﺍﻟﺭﺠﺎل ﻋﻠﻰ ﺤﺩ ﺴﻭﺍﺀ‪ ،‬ﻭﻜﺫﻟﻙ ﻓﻲ‬ ‫ﺘﻘﻠﻴل ﻋﻭﺍﻤل ﺍﻟﺨﻁﺭ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻨﺘﻘﺎل ﺍﻟﻌﺩﻭﻯ ﺒﺩﺍﺀ ﺍﻟﺴﻴﻼﻥ ﺇﻟﻰ ﺍﻟﺭﺠﺎل‪ .‬ﻭﻻ ﻴﺘﺭﺍﻓﻕ ﺍﻻﺴﺘﺨﺩﺍﻡ ﺍﻟﻤﺘﺴﻕ ﻭﺍﻟﺼﺤﻴﺢ‬ ‫ﻟﻠﻭﺍﻗﻲ ﺍﻟﺫﻜﺭﻱ ﻓﻘﻁ ﻤﻊ ﺘﻘﻠﻴل ﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﺘﻘﻠﻴل ﺍﻨﺘﻘﺎل ﺍﻟﻌﺩﻭﻯ ﺍﻹﺤﻠﻴﻠﻴﺔ ﻟﻠﺭﺠﺎل‪ ،‬ﺒل‬ ‫ﻴﺘﺭﺍﻓﻕ ﻜﺫﻟﻙ ﻤﻊ ﺍﻨﺨﻔﺎﺽ ﺍﻜﺘﺴﺎﺏ )‪:(٣٧‬‬ ‫ ﺍﻟﺭﺠﺎل ﻭﺍﻟﻨﺴﺎﺀ ﻟﻠﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺘﻨﺎﺴﻠﻲ ﺍﻟﺒﺴﻴﻁ – ﺍﻟﻨﻤﻁ ‪٢‬؛‬‫ ﺍﻟﺭﺠﺎل ﻭﺍﻟﻨﺴﺎﺀ ﻟﻠﻌﺩﻭﻯ ﺒﺎﻟﺯﻫﺭﻱ؛‬‫ ﺍﻟﺭﺠﺎل ﻭﺍﻟﻨﺴﺎﺀ ﻟﻠﻌﺩﻭﻯ ﺒﺎﻟﻤﺘﺩﺜﺭﺍﺕ؛‬‫ ﺍﻟﻨﺴﺎﺀ ﻟﺩﺍﺀ ﺍﻟﺴﻴﻼﻥ؛‬‫‪‬ﺭﺍﺕ؛‬ ‫ﺸﻌ‬ ‫ﻤﹶ‬ ‫ ﺍﻟﻨﺴﺎﺀ ﻟﻠﻌﺩﻭﻯ ﺒﺩﺍﺀ ﺍﻟ ‪‬‬‫ﻓﻘﺩ ﺃﺴﻔﺭ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﺎﺯل ﺍﻟﺫﻜﺭﻱ ﻋﻥ ﺍﻟﺘﻘﻬﻘﺭ ﺍﻟﻤﺘﺴﺎﺭﻉ ﺍﻟﻭﺘﻴﺭﺓ ﻟﻶﻓﺎﺕ ﺍﻟﺘﻲ ﺘـﺼﻴﺏ ﻋﻨـﻕ ﺍﻟـﺭﺤﻡ‬ ‫ﻭﻓﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﺍﻟﻤﺼﺎﺤﺏ ﻟﻬﺎ‪ ،‬ﻭﺍﻟﺘﺼﻔﻴﺔ ﺍﻟﻤﺘﺴﺎﺭﻋﺔ ﺍﻟﻭﺘﻴﺭﺓ ﺃﻴﻀﹰ‬ ‫ﺎ ﻟﻠﻌﺩﻭﻯ ﺍﻟﺘﻨﺎﺴـﻠﻴﺔ ﻟﻠﻨـﺴﺎﺀ‬ ‫ﺒﻔﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ‪.‬‬ ‫ﻭﻓﻲ ﻅل ﻭﺠﻭﺩ ﻫﺫﻩ ﺍﻟﺒﻴﻨﺎﺕ‪ ،‬ﻓﺈﻨﻪ ﻤﻥ ﺍﻷﻫﻤﻴﺔ ﺒﻤﻜﺎﻥ ﺘﻘﻴـﻴﻡ ﺤﺠﻡ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﻭﻯ ﺒﻔﻴـﺭﻭﺱ ﺍﻷﻴـﺩﺯ‬ ‫ﺎ ﻓﻲ ﻋﻤﻭﻡ ﺍﻟﺴﻜﺎﻥ ﻭﻟﺩﻯ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﻌﺭﻀﺔ ﻟﻠﺨﻁﺭ‪ .‬ﻭﻓﻲ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﺘﻲ‬ ‫ﻭﺴﺎﺌﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻓﻴﻬﺎ ﻋﺎﻟﻴﺔ ﻓﻲ ﻜل ﻤـﻥ ﻋﻤـﻭﻡ‬ ‫ﺘﻜﻭﻥ ﻤﻌﺩﻻﺕ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺴﺎﺌﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺴﻜﺎﻥ ﻭﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﻌﺭﻀﺔ ﻟﻠﺨﻁﺭ‪ ،‬ﻓﻼﺒﺩ ﻤﻥ ﺘﻘﺩﻴﻡ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﻤﻤﺎﺭﺴـﺎﺕ ﺍﻟﺠﻨـﺴﻴﺔ‬ ‫ﺍﻷﻜﺜﺭ ﻤﺄﻤﻭﻨﻴﺔ ﻟﻠﻤﺠﻤﻭﻋﺘﻴﻥ ﻓﻲ ﺼﻭﺭﺓ ﻤﻀﻤﻭﻤﺔ‪ .‬ﺘﺘﻀﻤﻥ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺘﻴﻥ‪ :‬ﺘﺸﺠﻴﻊ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌـﺎﺯل ﺍﻟـﺫﻜﺭﻱ‬ ‫ﻭﺘﻭﺯﻴﻌﻪ‪ ،‬ﻭﺍﻻﺴﺘﻌﻔﺎﻑ ﺃﻭ ﺍﻻﻤﺘﻨﺎﻉ ﻋﻥ ﻤﻤﺎﺭﺴﺔ ﺍﻟﺠﻨﺱ‪ ،‬ﻭﺘﺄﺨﻴﺭ ﺒﺩﺀ ﺍﻟﻤﻌﺎﺸﺭﺓ ﺍﻟﺠﻨـﺴﻴﺔ‪ ،‬ﻭﺍﻻﻗﺘـﺼﺎﺭ ﻋﻠـﻰ‬ ‫ﺍﻟﻤﻤﺎﺭﺴﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ ﻀﻤﻥ ﺍﻹﻁﺎﺭ ﺍﻟﺸﺭﻋﻲ ﻟﻠﺯﻭﺍﺝ‪ .‬ﻭﻓﻲ ﺍﻷﻤﺎﻜﻥ ﺍﻟﺘﻲ ﺘﻜﻭﻥ ﻓﻴﻬﺎ ﺍﻟﻌـﺩﻭﻯ ﺒﻔﻴـﺭﻭﺱ ﺍﻷﻴـﺩﺯ‬ ‫ﺎ ﻤﺭﻜﺯﺓ ﻓﻲ ﻤﺠﻤﻭﻋﺎﺕ ﺴﻜﺎﻨﻴﺔ ﻤﻌﺭﻀﺔ ﻟﻠﺨﻁـﺭ‪ ،‬ﻴﻨﺒﻐـﻲ ﺃﻥ ﺘﻤﺜـل ﺍﻟﺘـﺩﺨﻼﺕ‬ ‫ﻭﺴﺎﺌﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺴﺘﻬﺩﻓﺔ ﺃﻭﻟﻭﻴﺔ‪ ،‬ﻭﻟﻜﻥ ﻟﻴﺱ ﺇﻟﻰ ﺍﻟﺤﺩ ﺍﻟﺫﻱ ﻴﺅﺩﻱ ﻻﺴﺘﺒﻌﺎﺩ ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﻭﺍﻟﻭﻗﺎﻴـﺔ ﺍﻷﺨـﺭﻯ ﻟﻌﻤـﻭﻡ‬ ‫ﺍﻟﺴﻜﺎﻥ ﺃﻭ ﺘﻭﻋﻴﺘﻬﻡ‪.‬‬ ‫‪22‬‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ‬ ‫ﺍﻟﻤﻌﻭﻗﺎﺕ ﺍﻟﺘﻲ ﺘﻌﺭﻗل ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬

‫‪٦-٣-١‬‬

‫ﺎ‪ ،‬ﻏﻴﺭ ﻓﻴﺭﻭﺱ‬ ‫ﻟﻘﺩ ﺘﺭﺍﺠﻊ ﻋﻠﻰ ﻤﺩﻯ ﺍﻷﻋﻭﺍﻡ ﺍﻟﺨﻤﺴﺔ ﺍﻟﻔﺎﺌﺘﺔ ﺍﻻﻫﺘﻤﺎﻡ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻷﻴﺩﺯ‪ ،‬ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﻭﻜﺫﻟﻙ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻼﺯﻤﺔ ﻟﺫﻟﻙ‪ ،‬ﻋﻠﻰ ﺍﻟﺭﻏﻡ ﻤﻥ ﺃﻫﻤﻴﺘﻬﺎ ﻜﻌﻭﺍﻤل ﻤﻌﺯﺯﺓ ﻟﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﻜﻌﻭﺍﻤل ﺫﺍﺕ ﺇﺴﻬﺎﻡ ﻤﺒﺎﺸﺭ ﻓﻲ ﻤﻌﺩﻻﺕ ﺍﻟﻤﺭﺍﻀﺔ ﻭﺍﻟﻭﻓﻴﺎﺕ ﻓﻲ ﺍﻟﻌﺎﻟﻡ‪ .‬ﻟﻘﺩ ﺤﻭل ﺍﻟﻤﺩﺍﻓﻌﻭﻥ ﻋﻥ‬ ‫ﺤﻘﻭﻕ ﻤﺭﻀﻰ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ ﺘﺭﻜﻴﺯﻫﻡ ﻭﺩﻋﻤﻬﻡ‪ ،‬ﺇﻟﻰ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺒﻤـﻀﺎﺩﺍﺕ ﺍﻟﻔﻴﺭﻭﺴـﺎﺕ ﺍﻟﻘﻬﻘﺭﻴـﺔ‬ ‫ﻭﺇﺠﺭﺍﺀ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﻭﻭﻀﻊ ﺴﻴﺎﺴﺎﺕ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﻤﺸﻭﺭﺓ ﻟﻠﻤﺼﺎﺒﻴﻥ ﺒﻌﺩﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪.‬‬ ‫ﻭﻋﻠﻰ ﺍﻟﺭﻏﻡ ﻤﻥ ﻤﻨﺎﻗﺸﺎﺕ ﻭﺒﺭﻨﺎﻤﺞ ﺍﻟﻌﻤل ﺍﻟﺫﻱ ﺃﻭﺼﻰ ﺒﻪ ﺍﻟﻤﺅﺘﻤﺭ ﺍﻟﺩﻭﻟﻲ ﻟﻠﺴﻜﺎﻥ ﻭﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺘﺎﺒﻊ ﻟﻸﻤﻡ‬ ‫ﻋﻘﺩ ﻓﻲ ﺍﻟﻘﺎﻫﺭﺓ ﻋﺎﻡ ‪ ١٩٩٤‬ﻭﺍﻟﻤﺅﺘﻤﺭ ﺍﻟﻌﺎﻟﻤﻲ ﺍﻟﺭﺍﺒﻊ ﺍﻟﻤﻌﻨﻲ ﺒﺎﻟﻤﺭﺃﺓ‪ ،‬ﺍﻟﺫﻱ ﻋﻘﺩ ﻓﻲ ﺒﻜﻴﻥ ﻓﻲ ﻋﺎﻡ‬ ‫ﺍﻟﻤﺘﺤﺩﺓ ﻭﺍﻟﺫﻱ ‪‬‬ ‫‪ ،١٩٩٥‬ﺒﺎﻟﻨﺴﺒﺔ ﻟﻤﻔﻬﻭﻡ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻹﻨﺠﺎﺒﻴﺔ‪ ،‬ﻓﻲ ﺇﻁﺎﺭ ﺍﻟﺤﻕ ﻓﻲ ﺍﻹﻨﺠﺎﺏ‪ ،‬ﻓﻠﻡ ﻴﺘﺤﻤﺱ ﺍﻟﻤـﺩﺍﻓﻌﻭﻥ ﻋـﻥ‬ ‫ﺎ )ﺒﻤﺎ ﻓﻴﻬﻡ ﺍﻟﻤﺭﻀـﻰ ﺍﻟﻤـﺼﺎﺒﻭﻥ‬ ‫ﺤﻘﻭﻕ ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻹﺩﻤﺎﺝ ﺃﻨﺸﻁﺔ ﻭﻗﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ( ﻭﺭﻋﺎﻴﺘﻬﻡ‪ ،‬ﻀﻤﻥ ﺃﻋﻤﺎﻟﻬﻡ )‪ .(٣٩ ،٣٨‬ﻓﻘﺩ ﺘﺒﻴﻥ ﺃﻥ ﺇﺩﺭﺍﺝ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﻤﺭﻀـﻰ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ ﻭﺭﻋﺎﻴﺘﻬﻡ ﻀﻤﻥ ﺒﺭﺍﻤﺞ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻟﺘﺤـﺴﻴﻥ ﺍﻟﺘﻐﻁﻴـﺔ‪ ،‬ﺃﺼـﻌﺏ ﻤـﻥ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺘﻭﻗﻊ‪ .‬ﻭﻟﻘﺩ ﻜﺎﻨﺕ ﺍﻟﺘﺠﺎﺭﺏ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺩﻤﺞ ﻫﺫﻩ ﺍﻷﻨﺸﻁﺔ ﻤﺘﺒﺎﻴﻨﺔ ﺍﻟﻨﺘﺎﺌﺞ‪ .‬ﻭﻟﻴﺴﺕ ﻫﻨﺎﻙ ﻤﻌﻠﻭﻤﺎﺕ ﻜﺎﻓﻴـﺔ ﺤـﻭل‬ ‫ﺃﻓﻀل ﺍﻷﺸﻜﺎل ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺃﻥ ﻴﻜﻭﻥ ﻋﻠﻴﻬﺎ ﺩﻤﺞ ﻫﺫﻩ ﺍﻟﺘﺩﺨﻼﺕ ﻭﺍﻟﺘﺄﺜﻴﺭ ﺍﻟﺫﻱ ﻴﻤﻜﻥ ﺃﻥ ﺘﺤﻘﻘﻪ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻟﻭﻗﺎﻴﺔ‬ ‫ﻤﻥ ﺍﻟﻌﺩﻭﻯ ﻭﺍﻟﺤﻤل ﻏﻴﺭ ﺍﻟﻤﺭﻏﻭﺏ ﻓﻴﻪ )‪.(٤٠‬‬ ‫ﺇﻀﺎﻓﺔ ﺇﻟﻰ ﺫﻟﻙ‪ ،‬ﻓﻘﺩ ﺘﺒﻴﻥ ﺃﻥ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﻤﺘﻼﺯﻤﺎﺕ ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ ﺍﻟﻼﺘﻲ ﻴﻌﺎﻨﻴﻥ ﻤﻥ ﺇﻓﺭﺍﺯﺍﺕ ﻤﻬﺒﻠﻴﺔ‬ ‫ﻗﺩ ﺃﺜﺒﺕ ﺼﻌﻭﺒﺘﻪ ﻜﺄﺩﺍﺓ ﺍﻜﺘﺸﺎﻑ ﻭﺘﺩﺒﻴﺭ ﻋﻼﺠﻲ ﻟﻌﺩﺍﻭﻯ ﻋﻨﻕ ﺍﻟﺭﺤﻡ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻓﻲ ﺤﺎﻻﺕ ﺍﻻﻨﺘﺸﺎﺭ ﺍﻟﻤـﻨﺨﻔﺽ‬ ‫ﺎ‪ .‬ﻭﻟﻘﺩ ﺍﺴﺘﻠﺯﻡ ﺫﻟﻙ ﻀﺭﻭﺭﺓ ﻭﺠﻭﺩ ﺍﺨﺘﺒﺎﺭﺍﺕ ﺘﺸﺨﻴﺼﻴﺔ ﺴـﺭﻴﻌﺔ ﻭﻤﻴـﺴﻭﺭﺓ ﺍﻟﺘﻜـﺎﻟﻴﻑ‬ ‫ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍ ﺒﺸﻜل‬ ‫ﺎ‪ .‬ﺇﻻ ﺃﻥ ﺘﻁﻭﻴﺭ ﻫﺫﻩ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﻴﺘﻡ ﺒﺒﻁﺀ‪ ،‬ﻭﺃﻴﻨﻤﺎ ﺘﻭﻓﺭﺕ‪ ،‬ﻓﻬﻲ ﻤﻜﻠﻔﺔ ﺠﺩﹰ‬ ‫ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻴﺠﻌل ﺍﻟﺤﻜﻭﻤﺎﺕ ﻏﻴﺭ ﻗﺎﺩﺭﺓ ﻋﻠﻰ ﺇﺩﺭﺍﺠﻬﺎ ﻀﻤﻥ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻭﻁﻨﻴﺔ ﺍﻟﻤﻌﻨﻴﺔ ﺒﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ‪.‬‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﻭﻫﻨﺎﻙ ﻋﺩﺩ ﻤﻥ ﺍﻟﺼﻌﻭﺒﺎﺕ ﺍﻷﺨﺭﻯ ﺍﻟﺘﻲ ﺘﺠﺎﺒﻪ ﻤﺤﺎﻭﻻﺕ ﺘﻌﺯﻴﺯ ﺘﺩﺨﻼﺕ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻤﺘﻌﺩﺩﺓ ﺍﻷﻭﺠﻪ )ﻭﺃﻨﻬﺎ ﺘﺸﻤل ﻋﺩﻡ ﺍﻟﻤﺴﺎﻭﺍﺓ‬ ‫ﺎ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻌﺭﻭﻑ ﺃﻥ ﺍﻟﻤﺤﺩﺩﺍﺕ ﺍﻟﻭﺒﺎﺌﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﻴﻥ ﺍﻟﺠﻨﺴﻴﻥ‪ ،‬ﻭﺍﻟﻔﻘﺭ‪ ،‬ﻭﻏﻴﺭﻫﺎ ﻤﻥ ﺍﻟﺘﺒﺎﻴﻨﺎﺕ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﻭﺍﻻﻗﺘﺼﺎﺩﻴﺔ(‪ ،‬ﻜﻤﺎ ﺃﻥ ﺍﻟﺠﻬﻭﺩ ﺍﻟﺘﺩﺨﻠﻴـﺔ ﻟﻠﻭﻗﺎﻴـﺔ ﻤـﻥ‬ ‫ﺎ‪ ،‬ﻓﺸﻠﺕ ﻓﻲ ﺍﻷﺨﺫ ﺒﻌﻴﻥ ﺍﻻﻋﺘﺒﺎﺭ ﺍﻟﻨﻁﺎﻕ ﺍﻟﻜﺎﻤل ﻟﻠﻤﺤﺩﺩﺍﺕ ﺍﻟﺩﻓﻴﻨﺔ ﺃﻭ ﺍﻟﻤﺴﺘﺒﻁﻨﺔ‪ .‬ﻭﻋﻠـﻰ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻭﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ‪ ،‬ﻫﻭ ﺃﻤـﺭ‬ ‫ﻤﺴﺘﻭﻯ ﺍﻟﺭﻋﺎﻴﺔ‪ ،‬ﻓﺈﻥ ﺍﺴﺘﻤﺭﺍﺭ ﺍﻹﻤﺩﺍﺩ ﺒﺎﻷﺩﻭﻴﺔ ﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻼ ﻋـﻥ‬ ‫ﺤﻴﻭﻱ ﻭﺤﺎﺴﻡ‪ ،‬ﻭﻫﻭ ﺘﺤﺩ ﻟﻡ ﻴﺘﻡ ﺤﺘﻰ ﺍﻵﻥ ﻤﻭﺍﺠﻬﺘﻪ ﺒﻨﺠﺎﺡ‪ ،‬ﻭﺫﻟﻙ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻷﻨﻅﻤﺔ ﺍﻟﺼﺤﻴﺔ‪ .‬ﻓـﻀ ﹰ‬ ‫ﺎ‪ ،‬ﻓﺈﻨـﻪ ﻤـﻥ‬ ‫ﺍﻻﻓﺘﻘﺎﺭ ﺇﻟﻰ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﻤﺸﻭﺭﺓ ﺤﻭل ﺘﻘﻠﻴل ﺍﻻﺨﺘﻁﺎﺭ‪ .‬ﻭﻓﻲ ﻤﺠﺎل ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻀﺭﻭﺭﻱ ﺃﻥ ﺘﻜﻭﻥ ﻫﻨﺎﻙ ﻤﺸﺎﺭﻜﺔ ﻋﻠﻰ ﻨﻁﺎﻕ ﺃﻜﺒﺭ ﻤﻥ ﻗﺒل ﻤﺨﺘﻠﻑ ﺍﻟﻘﻁﺎﻋﺎﺕ‪ ،‬ﻭﺍﻷﻨﻅﻤﺔ ﻭﺍﻟﻤﺠﺘﻤﻌﺎﺕ )ﺒﻤﺎ ﻓﻴﻬﺎ‬ ‫ﹰ‪ ،‬ﻭﺒﺨﺎﺼـﺔ‪ ،‬ﻓـﻲ ﻤﺠـﺎل‬ ‫ﺍﻟﻤﻨﻅﻤﺎﺕ ﺍﻟﻼﺤﻜﻭﻤﻴﺔ ﻭﺍﻟﻌﻘﺎﺌﺩﻴﺔ(‪ ،‬ﺇﻻ ﺃﻥ ﻫﺫﻩ ﺍﻟﻤﺸﺎﺭﻜﺔ ﺍﻟﻭﺍﺴﻌﺔ ﻻﺘﺯﺍل ﺘﻤﺜل ﺘﺤﺩﻴﺎ‬ ‫ﺍﻟﻤﺸﺎﺭﻜﺔ ﺍﻟﻤﺠﺘﻤﻌﻴﺔ‪.‬‬ ‫ﻭﻋﻼﻭﺓ ﻋﻠﻰ ﺃﻭﺠﻪ ﺍﻟﻘﺼﻭﺭ ﻫﺫﻩ‪ ،‬ﻓﺈﻥ ﺍﻟﻌﻭﺍﻤل ﺍﻟﺩﻓﻴﻨﺔ ﺍﻟﺘﺎﻟﻴﺔ ﺘﺴﻬﻡ ﻜﺫﻟﻙ ﻓـﻲ ﻓـﺸل ﺠﻬـﻭﺩ ﻤﻜﺎﻓﺤـﺔ‬ ‫ﺎ‪:‬‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻴﺴﻬﻡ ﻓﻲ ﺍﺴﺘﻤﺭﺍﺭ ﺍﻟﻤﻔﺎﻫﻴﻡ ﺍﻟﺨﺎﻁﺌﺔ ﻋﻥ ﻫﺫﻩ‬ ‫ﺍﻟﺠﻬل ﻭﻨﻘﺹ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﻋﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻷﻤﺭﺍﺽ ﻭﺍﻟﻭﺼﻤﺔ ﺍﻟﻤﺘﺭﺍﻓﻘﺔ ﻤﻌﻬﺎ‪.‬‬ ‫•‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﺇﻟﻰ ﺃﻥ ﺘﻜﻭﻥ ﻋﺩﻴﻤﺔ ﺍﻷﻋﺭﺍﺽ‪ ،‬ﺃﻭ ﻻ ﻴﺘﻡ ﺇﺩﺭﺍﻙ ﻭﺠﻭﺩﻫﺎ‬ ‫ﺘﻨﺯﻉ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺤﺘﻰ ﺘﻅﻬﺭ ﻤﻀﺎﻋﻔﺎﺘﻬﺎ ﻭﻋﻭﺍﻗﺒﻬﺎ‪ ،‬ﻭﺨﺎﺼﺔ ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ‪.‬‬ ‫ﺎ )ﻭﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺘـﻲ ﺘﻘـﺩﻡ ﺨـﺩﻤﺎﺕ‬ ‫ﺘﻤﺜل ﺍﻟﻭﺼﻤﺔ ﺍﻟﻤﺘﺭﺍﻓﻘﺔ ﻤﻊ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﻟﻠﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ( ﺤﺎﺠﺯﹰ‬ ‫ﺎ ﻓﻲ ﻭﺠﻪ ﺘﻨﻔﻴﺫ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺭﺍﻤﻴﺔ‬ ‫ﺍ ﻭﻗﻭﻴﹰ‬ ‫ﺍ ﻤﺴﺘﻤﺭﹰ‬ ‫ﺎ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ‪.‬‬ ‫ﺇﻟﻰ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

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‫ﻭﺘﺅﺩﻱ ﺍﻟﻭﺼﻤﺔ ﺍﻟﻤﺘﺭﺍﻓﻘﺔ ﻤﻊ ﺍﻹﺼﺎﺒﺔ ﺒﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ ،‬ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﻔﺭﺩ ﻭﺍﻟﻤﺠﺘﻤﻊ‪ ،‬ﺇﻟﻰ‪:‬‬ ‫ ﺘﺭﺩﺩ ﺍﻟﻤﺭﻴﺽ ﻓﻲ ﺍﻟﺘﻤﺎﺱ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻤﺒﻜﺭﺓ؛‬‫ ﺘﻔﻀﻴل ﺍﻟﺘﻤﺎﺱ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻓﻲ ﺍﻟﻤﺭﺍﻓﻕ ﺍﻟﺼﺤﻴﺔ ﺒﺎﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ‪ ،‬ﺴﻭﺍﺀ ﻜﺎﻥ ﺍﻟﻘﺎﺌﻤﻭﻥ ﻋﻠﻰ ﺘﻘـﺩﻴﻤﻬﺎ‬‫ﺎ ﻤﺅﻫﻠﻴﻥ‪ ،‬ﺃﻭ ﺼﻴﺎﺩﻟﺔ‪ ،‬ﺃﻭ ﻤﻤﺎﺭﺴﻴﻥ ﻟﻠﻁﺏ ﺍﻟﺸﻌﺒﻲ ﺃﻭ ﺃﻱ ﺃﻨﻭﺍﻉ ﺃﺨﺭﻯ ﻤﻥ ﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ‪،‬‬ ‫ﺃﺸﺨﺎﺼﹰ‬ ‫ﺍ ﻹﺩﺭﺍﻙ ﻤﺭﻀﻰ ﻫﺫﻩ ﺍﻷﻤﺭﺍﺽ ﺃﻥ ﻴﺴﺭ ﺍﻟﻭﺼﻭل ﺇﻟﻰ ﻫﺫﻩ ﺍﻟﺭﻋﺎﻴﺔ ﻭﺍﻟﺴﺭﻴﺔ ﺍﻟﺘﻲ ﺘﺤﺎﻁ‬ ‫ﻭﺫﻟﻙ ﻨﻅﺭﹰ‬ ‫ﺒﻬﺎ ﻭﻋﺩﻡ ﺇﻟﺤﺎﻕ ﺍﻟﻭﺼﻤﺔ ﺍﻟﻤﻘﺘﺭﻥ ﺒﻬﺫﻩ ﺍﻟﺭﻋﺎﻴﺔ‪ ،‬ﻫﻭ ﺃﻜﺒﺭ ﺒﻜﺜﻴﺭ ﻤﻤﺎ ﻴﺘﻭﻓﺭ ﻓﻲ ﺍﻟﻤﺭﺍﻓﻕ ﺍﻟـﺼﺤﻴﺔ‬ ‫ﺍﻟﺘﺎﺒﻌﺔ ﻟﻠﻘﻁﺎﻉ ﺍﻟﻌﺎﻡ؛‬ ‫ ﺼﻌﻭﺒﺔ ﺇﺒﻼﻍ ﺍﻷﺯﻭﺍﺝ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ﺎ ﻭﻤﻌﺎﻟﺠﺘﻬﻡ‪.‬‬ ‫ﻭﻋﻠﻰ ﻤﺴﺘﻭﻯ ﻭﻀﻊ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﺘﺨﺎﺫ ﺍﻟﻘﺭﺍﺭﺍﺕ‪ ،‬ﺘﺅﺨﺫ ﺍﻟﻌﻭﺍﻤل ﺍﻟﺘﺎﻟﻴﺔ ﺒﻌﻴﻥ ﺍﻻﻋﺘﺒﺎﺭ‪:‬‬ ‫ﺎ ﻤﻥ ﻗﺒـل ﻭﺍﻀـﻌﻲ ﺍﻟـﺴﻴﺎﺴﺎﺕ ﻭﻤﺘﺨـﺫﻱ‬ ‫ﹸﻭﻟﻰ ﺃﻭﻟﻭﻴﺔ ﻀﻌﻴﻔﺔ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘ‬ ‫ﺍﻟﻘﺭﺍﺭﺍﺕ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺃﻥ ﻴﺘﻔﺎﻗﻡ ﻫﺫﺍ ﺍﻟﻭﻀﻊ ﺒﺴﺒﺏ ﺍﻟﻭﺼﻤﺔ ﻭﺍﻟﺘﻤﻴﻴـﺯ ﺍﻟﻤـﺭﺘﺒﻁﻴﻥ ﺒﺎﻟﻤـﺼﺎﺒﻴﻥ‬ ‫ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻭﺍﻟﺠﻬل ﺒﺄﻫﻤﻴﺔ ﺘﺄﺜﻴﺭ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﻋﻠﻰ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺘﻨﻤﻴﺔ ﺍﻻﻗﺘﺼﺎﺩﻴﺔ‪.‬‬ ‫ﻴﺘﺯﺍﻴﺩ ﻟﺠﻭﺀ ﺍﻟﺠﻬﺎﺕ ﺍﻟﻤﺎﻨﺤﺔ ﺇﻟﻰ ﺍﻷﺴﺎﻟﻴﺏ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﻜﺎﻤل ﺍﻟﻘﻁﺎﻋﺎﺕ ﺒﺎﻟـﺸﻜل ﺍﻟـﺫﻱ ﻴﺠﻌﻠﻬـﺎ‬ ‫ﻻ ﻤﻥ ﺘﻭﺠﻴﻬﻬﺎ ﺇﻟﻰ ﻤﺸﺭﻭﻋﺎﺕ ﻤﺤﺩﺩﺓ ﻤﺜل ﻤﻜﺎﻓﺤـﺔ‬ ‫ﺘﺨﺼﺹ ﻤﻌﻭﻨﺎﺘﻬﺎ ﻟﻜﺎﻤل ﺍﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﺒﺩ ﹰ‬ ‫ﺎ‪ .‬ﻭﺒﺎﻟﺭﻏﻡ ﻤﻥ ﺃﻥ ﺫﻟﻙ ﻴﺘﻴﺢ ﻟﻭﺯﺍﺭﺍﺕ ﺍﻟﺼﺤﺔ ﺘﺤﺩﻴﺩ ﺍﻷﻭﻟﻭﻴﺎﺕ ﺍﻟﻭﻁﻨﻴﺔ‪ ،‬ﺇﻻ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺒﺴﺒﺏ ﺍﻟﻭﺼﻤﺔ‬ ‫ﺃﻨﻪ ﻴﺅﺩﻱ ﻜﺫﻟﻙ ﺒﺎﻟﺒﻠﺩﺍﻥ ﺍﻟﺘﻲ ﺍﻋﺘﺎﺩﺕ ﺇﻋﻁﺎﺀ ﺃﻫﻤﻴﺔ ﺃﻗل ﺇﻟﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻓﻲ ﻤﻴﺯﺍﻨﻴﺎﺕ ﺍﻟﺼﺤﺔ ﻟﺩﻴﻬﺎ‪ ،‬ﺇﻟﻰ ﺍﻻﺴﺘﻤﺭﺍﺭ ﻓﻲ ﺫﻟﻙ‪.‬‬ ‫‪‬ﻼﺤﻅ ﺇﺨﻔﺎﻕ ﻓﻲ ﺘﻘﺩﻴﻡ ﺍﻟﺘﺜﻘﻴﻑ ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﻨﺎﺴﺒﺔ ﻟﻠﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﻌـﺭﻭﻑ ﻋﻨﻬـﺎ ﺒـﺼﻔﺔ‬ ‫ﻴ‬ ‫ﺎ‪ ،‬ﻤﺜـل ﺍﻟـﺸﺒﺎﺏ ﻭﺍﻟﻤـﺭﺍﻫﻘﻴﻥ‪ ،‬ﻭﺍﻟﺒﻐﺎﻴـﺎ‬ ‫ﺨﺎﺼﺔ‪ ،‬ﺃﻨﻬﺎ ﻋﺭﻀﺔ ﻟﻺﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻋﻤﻼﺌﻬﻡ‪ ،‬ﻭﺍﻟﻠﻭﺍﻁﻴﻴﻥ‪ ،‬ﻭﺍﻟﻤﺨﻨﺜﻴﻥ‪ ،‬ﻭﻤﺘﻌﺎﻁﻲ ﻤﻭﺍﺩ ﺍﻹﺩﻤـﺎﻥ ﻭﺍﻟـﺴﺠﻨﺎﺀ ﻭﺍﻟﺘﺠﻤﻌـﺎﺕ ﺍﻟـﺴﻜﺎﻨﻴﺔ‬ ‫ﺍﻟﻤﻬﺎﺠﺭﺓ )ﺴﻭﺍﺀ ﻟﻠﻌﻤل ﺃﻭ ﻟﻼﺴﺘﺠﻤﺎﻡ ﻭﺍﻟﺘﺭﻓﻴﻪ(‪ ،‬ﺍﻷﻁﻔﺎل ﻭﺍﻟـﺸﺒﺎﺏ ﺍﻟﻤـﺸﺭﺩﻴﻥ ﻓـﻲ ﺍﻟﻁﺭﻗـﺎﺕ‬ ‫ﻭﺍﻷﺸﺨﺎﺹ ﺍﻟﻤﺘﺄﺜﺭﻴﻥ ﺒﺎﻟﺼﺭﺍﻋﺎﺕ ﻭﺍﻟﻘﻼﻗل ﺍﻟﻤﺩﻨﻴﺔ‪.‬‬ ‫•‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻤﺭﺍﻤﻲ ﻭﻨﻁﺎﻕ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ‬

‫‪-٢‬‬

‫‪ ١-٢‬ﺍﻟﻬﺩﻑ ﻭﺍﻷﻏﺭﺍﺽ‬ ‫ﺇﻥ ﺍﻟﻬﺩﻑ ﻤﻥ ﻫﺫﻩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻫﻭ ﺘﻘﺩﻴﻡ ﺇﻁﺎﺭ ﻟﺘﻭﺠﻴﻪ ﺍﻻﺴﺘﺠﺎﺒﺔ ﺍﻟﻌﺎﻟﻤﻴـﺔ ﺍﻟﻤﺘـﺴﺎﺭﻋﺔ ﺍﻟـﻭﺘﻴﺭﺓ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﻭﺫﻟﻙ ﺒﻐﻴﺔ ﺒﻠﻭﻍ ﻤﺭﺍﻤﻲ ﺍﻟﺘﻨﻤﻴﺔ ﺍﻟﺩﻭﻟﻴﺔ‪ .‬ﻭﺘﺭﻜﺯ ﺍﻻﺴـﺘﺭﺍﺘﻴﺠﻴﺔ‪،‬‬ ‫ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻋﻠﻰ ﺘﺤﻘﻴﻕ ﺍﻷﻫﺩﺍﻑ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬ ‫ﺯﻴﺎﺩﺓ ﺍﻟﺘﺯﺍﻡ ﺍﻟﺤﻜﻭﻤﺎﺕ ﺍﻟﻭﻁﻨﻴﺔ ﻭﺍﻟﺸﺭﻜﺎﺀ ﺍﻟﻭﻁﻨﻴﻴﻥ ﻭﺍﻟﺩﻭﻟﻴﻴﻥ ﺍﻟﻤﻌﻨﻴﻴﻥ ﺒﺎﻟﺘﻨﻤﻴﺔ ﻭﺍﻟﺘﻁﻭﻴﺭ‪ ،‬ﺒﺎﻟﻭﻗﺎﻴﺔ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ؛‬ ‫ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﻌﺯﻴﺯ ﺤﺸﺩ ﺍﻟﺘﻤﻭﻴل ﻭﺇﻋﺎﺩﺓ ﺘﺨﺼﻴﺹ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﻤﻊ ﺍﻟﺘﺭﻜﻴﺯ ﻋﻠﻰ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺘﻲ ﺘﺭﻜﺯ ﻋﻠﻰ ﺍﻟﻨﺘﺎﺌﺞ‬ ‫ﻭﺘﺤﻅﻰ ﺒﺎﻷﻭﻟﻭﻴﺔ ﺍﻟﻭﻁﻨﻴﺔ‪ ،‬ﻭﺘﺅﻜﺩ ﻋﻠﻰ ﻓﻌﺎﻟﻴﺔ ﺍﻟﻤﻌﻭﻨﺎﺕ‪ ،‬ﻭﺘﻌﺯﻴﺯ ﺍﻟﺸﻌﻭﺭ ﺒﺎﻟﻤﻠﻜﻴـﺔ ﻭﺍﻟﻤـﺴﺎﺀﻟﺔ‪،‬‬ ‫ﻭﺍﻟﻤﻭﺍﺀﻤﺔ‪ ،‬ﻭﺘﻘﻴﻴﻡ ﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﻤﺤﻘﻘﺔ؛‪١‬‬ ‫ﺍﻟﺘﺄﻜﺩ ﻤﻥ ﺃﻥ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﻘﻭﺍﻨﻴﻥ ﻭﺍﻟﻤﺒﺎﺩﺭﺍﺕ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻠﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ ﻻ ﺘﺤﻤل ﺨﻁﺭ ﺍﻟﻭﺼﻤﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﻭﺘﺭﺍﻋﻲ ﺍﻟﺤﺴﺎﺴﻴﺔ ﺒﻴﻥ ﺍﻟﺠﻨﺴﻴﻥ‪ ،‬ﻓﻲ ﺇﻁـﺎﺭ ﺍﻟـﺴﻴﺎﻕ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺜﻘﺎﻓﻲ ﻭﺍﻻﺠﺘﻤﺎﻋﻲ ﺍﻟﺴﺎﺌﺩ؛‬ ‫ﺘﺴﺨﻴﺭ ﺍﻟﻘﻭﻯ ﻭﺍﻟﻁﺎﻗﺎﺕ ﻟﺩﻯ ﻜﺎﻓﺔ ﺍﻟﺸﺭﻜﺎﺀ ﻭﺍﻟﻤﺅﺴﺴﺎﺕ ﻟﻠﻨﻬﻭﺽ ﺒـﺎﻟﺘﺩﺨﻼﺕ ﺍﻟﺭﺍﻤﻴﺔ ﺇﻟﻰ ﺍﻟﻭﻗﺎﻴﺔ‬ ‫ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ ﻭﻀﻤﺎﻥ ﺍﺴﺘﻤﺭﺍﺭﻫﺎ‪.‬‬ ‫•‬ ‫•‬

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‫ﺎ ﻴﻤﻜﻥ ﺘﻜﻴﻴﻔﻬﺎ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﺒﻠﺩﺍﻨﻲ ﻭﺍﻹﻗﻠﻴﻤﻲ‪.‬‬ ‫ﺍﻟﻌﻨﺼﺭ ﺍﻟﺘﻘﻨﻲ‪ :‬ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺘﻘﻨﻴﺔ ﻋﺎﻟﻤﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻭﺭﻋﺎﻴـﺔ ﻤﺭﻀـﺎﻫﺎ‬ ‫ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﻁﺭﻕ ﺘﻘﺩﻴﻡ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﺒﺭﻤﺠﻴﺔ ﺍﻟﺭﺌﻴﺴﻴﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺒﺼﻭﺭﺓ ﻤﻨﺎﺴﺒﺔ‪ .‬ﻭﺘﺴﺘﻨﺘﺞ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺘﻘﻨﻴﺔ ﺍﻟﺩﺭﻭﺱ ﺍﻟﻤﺴﺘﻔﺎﺩﺓ ﻭﺍﻟﺘﺩﺍﺒﻴﺭ ﺍﻟﺘﻲ ﺃﺜﺒﺘﺕ ﻨﺠﺎﺤﻬـﺎ ﻭﺍﻟﺘـﻲ ﻴﺠـﺏ‬ ‫ﺍﻟﻨﻬﻭﺽ ﺒﻬﺎ‪ .‬ﻜﻤﺎ ﺴﺘﻭﻀﺢ ﺃﻭﺠﻪ ﺍﻟﻘﺼﻭﺭ ﻓﻲ ﺍﻟﻤﺠﺎﻻﺕ ﺍﻟﺭﺌﻴﺴﻴﺔ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬ ‫ ﺘﻭﻓﺭ ﺃﻭ ﻀﻤﺎﻥ ﺍﺴﺘﻤﺭﺍﺭ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻤﻘﺩﻤﺔ ﻟﻠﻤﺠﺘﻤﻌﺎﺕ ﺍﻟـﺴﻜﺎﻨﻴﺔ ﺍﻟﻤـﺴﺘﻬﺩﻓﺔ ﺫﺍﺕ‬‫ﺍﻷﻭﻟﻭﻴﺔ )ﻤﺜل ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﻭﺍﻟﺒﻐﺎﻴﺎ(؛‬ ‫ ﺘﺸﺨﻴﺹ ﻭﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﺘﻲ ﻻ ﺘﺘﺭﺍﻓﻕ ﺒﺄﻋﺭﺍﺽ؛‬‫ ﺍﻟﻨﻬﺞ ﺍﻟﻤﺘﻼﺯﻤﻲ ﻓﻲ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﻨﺠﻴﺞ ﺍﻟﻤﻬﺒﻠﻲ ﻏﻴﺭ ﺍﻟﻁﺒﻴﻌﻲ؛‬‫ﺎ ﻟﺩﻯ ﺍﻷﺯﻭﺍﺝ؛‬ ‫ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ ﻤﺴﻠﻙ ﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ؛‬‫ ﻤﺩﻯ ﺘﻭﺍﻓﺭ ﻭﻤﻌﻭﻟﻴﺔ ﺍﻟﻤﻌﻁﻴﺎﺕ ﺍﻟﻼﺯﻤﺔ ﻷﻏﺭﺍﺽ ﺍﻟﺘﺨﻁﻴﻁ‪.‬‬‫‪Paris Declaration on Aid Effectiveness: Ownership, Harmonisation, Alignment, Results and Mutual‬‬ ‫‪Accountability. Paris, March 2005.‬‬

‫ﺎ ﺒﻌﻨﺼﺭﻴﻥ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﻴﻥ‪:‬‬ ‫ﻭﺘﺴﺘﺭﺸﺩ ﻋﻤﻠﻴﺔ ﺍﻻﺴﺘﺠﺎﺒﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﺃﻥ ﺘﺤﺩﺩ ﺍﻟﻔﺭﺹ ﺍﻟﻤﻼﺌﻤﺔ ﻟﻠﺘﺭﺍﺒﻁ ﺍﻟﺒﻨﻴﻭﻱ ﻭﺍﻟﺘﻜﺎﻤل ﻤﻊ ﺒﺭﺍﻤﺞ ﻤﺭﺽ‬ ‫ﻭﻤﻥ ﺸﺄﻥ ﻫﺫﻩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺃﻴﻀﹰ‬ ‫ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪ ،‬ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻭﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﻭﻤﺸﺎﺭﻜﺔ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ ﻓﻲ ﺫﻟﻙ‪.‬‬ ‫ﺎ ﺒﻬﺩﻑ ﺯﻴﺎﺩﺓ ﺍﻟـﻭﻋﻲ‬ ‫ﻋﻨﺼﺭ ﺍﻟﺩﻋﻡ ﻭﺍﻟﻤﺴﺎﻨﺩﺓ‪ :‬ﺍﻟﻘﻴﺎﻡ ﺒﺤﻤﻠﺔ ﻋﺎﻟﻤﻴﺔ ﻟﻤﺴﺎﻨﺩﺓ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺇﻟﻰ ﺠﻨﺏ ﻤﻊ ﺍﻟﻤﺒﺎﺩﺭﺍﺕ ﺍﻷﺨﺭﻯ ﻤﺜل ﻤﺒـﺎﺩﺭﺓ ﺍﻟﻘـﻀﺎﺀ ﻋﻠـﻰ‬ ‫ﻭﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﻌﺎﻟﻡ ﺃﺠﻤﻊ‪ ،‬ﺠﻨﺒﹰ‬ ‫ﺍﻟﺯﻫﺭﻱ ﺍﻟﺨﻠﻘﻲ‪ ،‬ﻭﻤﻜﺎﻓﺤﺔ ﻭﺍﺴﺘﺌﺼﺎل ﺃﻤﺭﺍﺽ ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ ﺍﻟﻘﺎﺒﻠﺔ ﻟﻠﻌﻼﺝ‪ ،‬ﻭﻤﻜﺎﻓﺤﺔ ﺍﻟﻬـﺭﺒﺱ ﺍﻟﺘﻨﺎﺴـﻠﻲ‪،‬‬ ‫ﻭﻋﺩﺍﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ‪.‬‬

‫‪ ٢-٢‬ﺍﻟﻔﺌﺎﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ‬ ‫ﺘﻭﻀﺢ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺨﻁﻭﻁ ﺍﻟﻌﺎﻤﺔ ﻭﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﺭﺌﻴﺴﻴﺔ ﻟﻌﻤﻠﻴﺔ ﺍﻻﺴﺘﺠﺎﺒﺔ ﺍﻟﻔﻌﺎﻟـﺔ ﻟﻌـﺏﺀ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ‪ ،‬ﻜﻤﺎ ﺘﻘﺩﻡ ﻤﻌﻠﻭﻤﺎﺕ ﻋﻥ ﺍﻷﻤﻭﺭ ﻭﺍﻟﻘﻀﺎﻴﺎ ﺍﻷﺴﺎﺴﻴﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﻭﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﻬﺎ‪ .‬ﻭﻫﻲ ﻟﻴﺴﺕ ﻤﺤﺎﻭﻟﺔ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﺘﻘﺩﻴﻡ ﺩﻻﺌل ﺇﺭﺸﺎﺩﻴﺔ ﺤﻭل ﻜﻴﻔﻴﺔ ﺘﻁﻭﻴﺭ ﺍﻷﻨﺸﻁﺔ ﺃﻭ ﺘﻨﻔﻴﺫﻫﺎ‪.‬‬ ‫ﻭﺍﻟﻔﺌﺎﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ ﻟﻬﺫﻩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻫﻲ‪ :‬ﻤﺩﻴﺭﻭ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻭﻁﻨﻴﺔ ﻟﻤﻜﺎﻓﺤﺔ ﻤﺭﺽ ﺍﻷﻴـﺩﺯ ﻭﺍﻟﻌـﺩﻭﻯ‬ ‫ﺒﻔﻴﺭﻭﺴﻪ‪ ،‬ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻭﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﻭﺍﻟﻤﻌﻨﻴﻭﻥ ﻓﻲ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﻤﻥ ﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﻓﻲ ﺍﻟﻘﻁﺎﻋﻴﻥ ﺍﻟﻌـﺎﻡ‬ ‫ﻭﺍﻟﺨﺎﺹ‪ ،‬ﻭﻭﺯﺭﺍﺀ ﺍﻟﺼﺤﺔ‪ ،‬ﻭﺼﺎﻨﻌﻭ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﻏﻴﺭﻫﻡ ﻤﻥ ﻤﺘﺨﺫﻱ ﺍﻟﻘﺭﺍﺭﺍﺕ ﻓﻲ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ‪ ،‬ﻭﺍﻟﻭﻜﺎﻻﺕ‬ ‫ﺍﻟﺩﻭﻟﻴﺔ )ﺒﻤﺎ ﻓﻴﻬﺎ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ( ﻭﺍﻟﺸﺭﻜﺎﺀ ﻏﻴﺭ ﺍﻟﺤﻜﻭﻤﻴﻴﻥ ﻭﺍﻹﺩﺍﺭﺍﺕ ﻭﺍﻟﻬﻴﺌﺎﺕ ﺍﻟﺤﻜﻭﻤﻴﺔ ﺍﻷﺨـﺭﻯ‪،‬‬ ‫ﻭﺍﻟﺠﻬﺎﺕ ﺍﻟﻤﺎﻨﺤﺔ‪.‬‬

‫‪ ٣-٢‬ﺍﻟﻤﺒﺎﺩﺉ ﺍﻹﺭﺸﺎﺩﻴﺔ‬ ‫ﺎ ﻭﺍﻟﺨﺎﺼـﺔ‬ ‫ﻴﺘﻭﻓﺭ ﺍﻟﺩﻋﻡ ﻭﺍﻟﺘﺄﻴﻴﺩ ﺍﻟﻤﻁﻠﻭﺒﻴﻥ ﻟﻬﺫﻩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻤﻥ ﻭﺍﻗﻊ ﺍﻷﻁﺭ ﺍﻟﻤﺘﻔـﻕ ﻋﻠﻴﻬـﺎ ﺩﻭﻟﻴـﹰ‬ ‫ﺒﺎﻷﺨﻼﻗﻴﺎﺕ ﻭﺤﻘﻭﻕ ﺍﻹﻨﺴﺎﻥ‪ ،‬ﻭﺍﻟﺘﻲ ﺘﻘﺭ ﺒﺤﻕ ﻜﺎﻓﺔ ﺍﻷﻓﺭﺍﺩ ﻓﻲ ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﺃﺭﻓﻊ ﻤﺴﺘﻭﻴﺎﺕ ﺍﻟﺼﺤﺔ ﺒﻤﺎ ﻓـﻲ‬ ‫ﺫﻟﻙ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻹﻨﺠﺎﺒﻴﺔ‪ .‬ﻭﺘﺘﻔﻕ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻤﻊ ﺍﻹﻁﺎﺭ ﺍﻟﻘﺎﻨﻭﻨﻲ ﺍﻟﺫﻱ ﻴﺤﻜﻡ ﻤﺘﻁﻠﺒﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‬ ‫ﺍﻟﺨﺎﺼﺔ ﺒﺎﻷﻁﻔﺎل ﻭﺍﻟﻤﺭﺍﻫﻘﻴﻥ‪ ،‬ﻭﺒﺨﺎﺼﺔ‪ ،‬ﺍﻟﺤﻕ ﻓﻲ ﻋﺩﻡ ﺍﻟﺘﻌﺭﺽ ﻟﻺﻜﺭﺍﻩ ﺃﻭ ﺍﻹﻴﺫﺍﺀ ﺒﻤﺎ ﻓـﻲ ﺫﻟـﻙ ﺍﻻﻨﺘﻬـﺎﻙ‬ ‫ﺍﻟﺠﻨﺴﻲ‪.‬‬ ‫ﻭﺘﺭﺘﻜﺯ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻋﻠﻰ ﺍﻟﻤﺒﺎﺩﺉ ﺍﻹﺭﺸﺎﺩﻴﺔ ﺍﻟﺘﺎﻟﻴﺔ‪:‬‬ ‫ﻻﺒﺩ ﻤﻥ ﻤﻌﺎﻟﺠﺔ ﻗﻀﻴﺔ ﻋﺩﻡ ﺍﻟﻤﺴﺎﻭﺍﺓ ﺒﻴﻥ ﺍﻟﺠﻨﺴﻴﻥ ﻤﻥ ﺨـﻼل ﺍﻟﺘـﺩﺨﻼﺕ ﺫﺍﺕ ﺍﻟﺘـﺄﺜﻴﺭ ﻋﻠـﻰ ﺍﻹﺭﺍﺩﺓ‬ ‫‪-١‬‬ ‫ﺍﻟﺴﻴﺎﺴﻴﺔ‪ ،‬ﻭﻋﻠﻰ ﺍﻷﻋﺭﺍﻑ ﻭﺍﻻﺘﺠﺎﻫﺎﺕ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﻓﻲ ﺍﻟﺠﻨﺴﻴﻥ ﻭﻭﻀﻊ ﺍﻟﻤﺭﺃﺓ‪ ،‬ﻭﺇﻥ ﺍﻟﺘﻌﺯﻴﺯ ﺍﻟﻔﻌﺎل ﻟﻤـﺴﺅﻭﻟﻴﺔ‬ ‫ﺎ‪ ،‬ﻫﻲ ﻋﻨﺎﺼﺭ ﺤﺎﺴﻤﺔ ﻀﻤﻥ ﺃﻨﺸﻁﺔ ﺍﻻﺴﺘﺠﺎﺒﺔ ﺍﻟﻔﻌﺎﻟﺔ‬ ‫ﺍﻟﺭﺠل ﻭﺘﻤﻜﻴﻥ ﺍﻟﻤﺭﺃﺓ ﻓﻲ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺘﻲ ﺘﺭﺍﻋﻲ ﺍﻟﺤﺴﺎﺴﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﺠﻨﺴﻴﻥ‪.‬‬ ‫ﺎ ﻭﺭﻋﺎﻴـﺔ‬ ‫ﻻﺒﺩ ﻤﻥ ﻭﺠﻭﺩ ﺘﻼﺤﻡ ﻤﺘﺼل ﻭﻤﺴﺘﻤﺭ ﺒﻴﻥ ﺘﺩﺨﻼﺕ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫‪-٢‬‬ ‫ﺍ ﻋﻠﻰ ﺍﻟﻤﺤﺩﺩﺍﺕ‬ ‫ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺎ‪ .‬ﻭﻫﺫﺍ ﻴﺸﻤل ﺇﻴﺠﺎﺩ ﺘﻭﺍﺯﻥ ﻤﻼﺌﻡ ﻭﻤﺠﻤﻭﻋﺔ ﻤﺘﻨﻭﻋﺔ ﻤﻥ ﺍﻷﻨﺸﻁﺔ‪ ،‬ﺍﻋﺘﻤﺎﺩﹰ‬ ‫ﺎ‪ ،‬ﻭﺃﻨﻤﺎﻁ ﺍﻟﻌﺩﺍﻭﻯ ﻭﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﺘﺎﺤـﺔ‪ .‬ﻭﺇﻥ ﺘـﻭﻓﺭ ﺍﻟﻌـﻭﺍﺯل‬ ‫ﺍﻟﻭﻁﻨﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﻭﺒﺎﺌﻴﺎﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻓﻲ ﻜل ﺍﻟﻤﻭﺍﻗﻊ‪ ،‬ﻫـﻲ‬ ‫ﺍﻟﺫﻜﺭﻴﺔ ﻭﺇﻤﻜﺎﻨﻴﺔ ﺍﻟﺘﻭﺼل ﻟﻬﺎ‪ ،‬ﻭﻭﺠﻭﺩ ﺍﻷﺩﻭﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺘﻲ ﺘﺤﺩﺩ ﺍﻟﻔﻌﺎﻟﻴﺔ ﺍﻟﺘﺎﻤﺔ ﻟﻌﻤﻠﻴﺔ ﺍﻻﺴﺘﺠﺎﺒﺔ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍ ﻻ ﻴﺘﺠﺯﺃ ﻤﻥ ﻨﻁﺎﻕ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﺸﺎﻤﻠﺔ‬ ‫ﺎ ﺠﺯﺀﹰ‬ ‫ﻴﺠﺏ ﺃﻥ ﺘﻜﻭﻥ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪-٣‬‬ ‫ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪ .‬ﻭﺇﻥ ﺍﻟﺘﻌﺎﻭﻥ ﺍﻟﻭﺜﻴﻕ ﺍﻟﺼﻠﺔ ﺒﺒﺭﺍﻤﺞ ﺍﻟـﺼﺤﺔ ﺍﻟﺠﻨـﺴﻴﺔ ﻭﺍﻟـﺼﺤﺔ‬ ‫ﺍﻹﻨﺠﺎﺒﻴﺔ ﻀﻤﻥ ﺇﻁﺎﺭ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺍﻟﻤﻌﻨﻴﺔ ﺒﺎﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﺸـﺄﻨﻪ ﺃﻥ ﻴـﺴﻬﻡ‪ ،‬ﻭﺒـﺸﻜل‬ ‫ﻜﺒﻴﺭ‪ ،‬ﻓﻲ ﺘﺤﻘﻴﻕ ﺍﻟﻤﺭﺍﻤﻲ ﺍﻹﻨﻤﺎﺌﻴﺔ ﻟﻸﻟﻔﻴﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪ ،‬ﻜﻤﺎ ﺃﻨﻪ ﺃﻤﺭ ﺤﺎﺴﻡ ﻓﻲ ﺘﻨﻔﻴﺫ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ‬ ‫ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﻜل ﻤﻥ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪.‬‬ ‫ﺎ ﻀـﻤﻥ‬ ‫ﺍ ﺤﻴﻭﻴـﹰ‬ ‫ﺎ ﺃﻤـﺭﹰ‬ ‫ﻴﻌﺩ ﺍﻟﺘﻌﺎﻭﻥ ﺍﻟﻭﺜﻴﻕ ﺒﻴﻥ ﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤﺔ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪-٤‬‬ ‫ﻋﻤﻠﻴﺔ ﺍﻻﺴﺘﺠﺎﺒﺔ ﻓﺎﻟﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﻤﺤﻔﻭﻓﺔ ﺒﺎﻟﻤﺨﺎﻁﺭ ﺍﻟﺘﻲ ﺘﺅﺩﻱ ﺇﻟﻰ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻫﻲ ﻨﻔﺴﻬﺎ ﺍﻟﺘﻲ ﺘـﺅﺩﻱ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﺘﻤﺜـل ﻋﻨﺎﺼـﺭ‬ ‫‪‬ﺒل ﺭﻋﺎﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻜﻤﺎ ﺃﻥ ﺴ‬ ‫ﺇﻟﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺃﺴﺎﺴﻴﺔ ﻓﻲ ﺍﻟﻭﻗﺎﻴﺔ ﺍﻷﻭﻟﻴﺔ ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻓﻲ ﺍﻟﻤﻭﺍﻗـﻊ ﻭﺍﻟﻤﺠﻤﻭﻋـﺎﺕ ﺍﻟـﺴﻜﺎﻨﻴﺔ ﺫﺍﺕ ﻤﻌـﺩﻻﺕ‬ ‫ﺍﻻﻨﺘﺸﺎﺭ ﺍﻟﻤﻨﺨﻔﻀﺔ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ .‬ﻭﺇﻥ ﻀﻡ ﺃﻭﺠﻪ ﺍﻟﻘﻭﺓ ﻓﻲ ﺍﻟﺒﺭﻨﺎﻤﺠﻴﻥ ﻤﻥ ﺸﺄﻨﻪ ﺃﻥ ﻴﺤﻘـﻕ‬ ‫ﺎ‪ .‬ﻭﺇﻥ‬ ‫ﺎ ﻓﻲ ﺃﻨﺸﻁﺔ ﺍﻟﻤﻜﺎﻓﺤﺔ ﻀﺩ ﻜل ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺴـﺎﺌﺭ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻷﺨـﺭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺘﻼﺤﻤﹰ‬ ‫ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻟﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻷﻴـﺩﺯ ﻭﺍﻟﻌـﺩﻭﻯ ﺒﻔﻴﺭﻭﺴـﻪ‬ ‫‪ ،٢٠٠٧-٢٠٠٣‬ﻭﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﻤﺸﺘﺭﻜﺔ ﺒﻴﻥ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻭﺒﺭﻨﺎﻤﺞ ﺍﻷﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻷﻴﺩﺯ‪،‬‬ ‫ﺍﻟﺭﺍﻤﻴﺔ ﺇﻟﻰ ﺘﺤﻘﻴﻕ ﻤﺭﻤﻰ ﺍﻟﺤﺼﻭل ﺍﻟﺸﺎﻤل ﻋﻠﻰ ﺍﻟﻭﻗﺎﻴﺔ ﻭﺍﻟﺭﻋﺎﻴﺔ ﻭﺍﻟﻤﻌﺎﻟﺠﺔ‪ ،‬ﺴﺘﻜﻭﻥ ﺒﻤﺜﺎﺒﺔ ﺇﺠـﺭﺍﺀﺍﺕ ﻭﺃﻁـﺭ‬ ‫ﻓﻌﺎﻟﺔ ﻀﻤﻥ ﻫﺫﺍ ﺍﻟﺘﻌﺎﻭﻥ‪.‬‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ .‬ﻭﻴﺠﺏ ﺃﻥ ﺘﻀﻡ ﺍﻟـﻨﻬﺞ‬ ‫ﺇﻥ ﺒﻨﺎﺀ ﺸﺭﺍﻜﺎﺕ ﻀﺭﻭﺭﻱ ﻟﺘﺤﺴﻴﻥ ﺭﻋﺎﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪-٥‬‬ ‫ﺍﻟﻤﺘﻌﺩﺩﺓ ﺍﻟﻘﻁﺎﻋﺎﺕ ﻭﺯﺍﺭﺍﺕ ﺍﻟﺼﺤﺔ ﻭﺍﻟﺘﻌﻠﻴﻡ‪ ،‬ﻭﺍﻟﺭﻴﺎﻀﺔ‪ ،‬ﻭﺍﻟﺴﻴﺎﺤﺔ‪ ،‬ﻭﺍﻟﻤﻭﺍﺼﻼﺕ‪ ،‬ﻭﺍﻟﻘﻭﺍﺕ ﺍﻟﻨﻅﺎﻤﻴﺔ ﻭﺍﻟﻘـﻭﺍﺕ‬ ‫ﺍﻟﻤﺴﻠﺤﺔ ﻭﺍﻟﻘﻁﺎﻋﺎﺕ ﺍﻟﺨﺎﺼﺔ ﻭﻏﻴﺭ ﺍﻟﺭﺴﻤﻴﺔ‪.‬‬ ‫ﻀﺭﻭﺭﺓ ﺇﺸﺭﺍﻙ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ )ﺒﻤﺎ ﻓﻴﻬﺎ ﺍﻟﻤﻨﻅﻤﺎﺕ ﺍﻟﻼﺤﻜﻭﻤﻴﺔ ﻭﺍﻟﻌﻘﺎﺌﺩﻴﺔ( ﻭﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﻌﺭﻀﺔ‬ ‫‪-٦‬‬ ‫ﻟﺨﻁﺭ ﺍﻹﺼﺎﺒﺔ ﻜﺸﺭﻜﺎﺀ ﻓﻲ ﻭﻀﻊ ﻭﺘﻨﻔﻴﺫ ﻭﺘﻘﻴﻴﻡ ﺍﻟﺘﺩﺨﻼﺕ ﻭﺍﻟﺨﺩﻤﺎﺕ‪ ،‬ﻤﻥ ﺃﺠل ﺇﺜﺭﺍﺀ ﺍﻟﻌﻤﻠﻴﺔ‪ ،‬ﻭﺼﻴﺎﻨﺔ ﺍﻟﻤﻠﻜﻴـﺔ‬ ‫ﻭﺍﻟﺤﺴﺎﺴﻴﺔ ﺍﻟﺜﻘﺎﻓﻴﺔ ﻟﻠﻌﻤﻠﻴﺔ ﻭﻨﺘﺎﺌﺠﻬﺎ‪ ،‬ﻭﺤﺸﺩ ﺍﻻﻟﺘﺯﺍﻡ ﺒﺘﻨﻔﻴﺫﻫﺎ‪.‬‬ ‫ﺘﻘﻠﻴﺹ ﺍﻟﻭﺼﻤﺔ ﻭﺍﻟﺘﻤﻴﻴﺯ ﺍﻟﻤﺘﺭﺍﻓﻘﻴﻥ ﻤﻊ ﻫﺫﺍ ﺍﻷﻤﺭ‪ ،‬ﻭﺫﻟﻙ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻴﻴﻥ ﺍﻟﻔﺭﺩﻱ ﻭﺍﻟﻤﺠﺘﻤﻌﻲ‪ ،‬ﻋﻨﺼﺭ‬ ‫‪-٧‬‬ ‫ﺃﺴﺎﺴﻲ ﻤﻥ ﺃﺠل ﺘﺤﺴﻴﻥ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻤﺎﺱ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺘﻭﻓﻴﺭ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻤـﻥ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪.‬‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

‫‪ ٤-٢‬ﺍﻟﻌﻨﺎﺼﺭ ﺍﻷﺴﺎﺴﻴﺔ ﻟﻌﻤﻠﻴﺔ ﺍﻻﺴﺘﺠﺎﺒﺔ‬ ‫ﺎ‪ ،‬ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻴﻴﻥ ﺍﻟـﻭﻁﻨﻲ‬ ‫ﺇﻥ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻷﺴﺎﺴﻴﺔ ﻟﺒﺭﻨﺎﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻹﻗﻠﻴﻤﻲ‪ ،‬ﺜﺎﺒﺘﺔ ﻭﺭﺍﺴﺨﺔ ﻭﺘﺸﻤل ﺍﻵﺘﻲ‪:‬‬ ‫ﺎ ﻟﻠﺘﺤﻘﻕ ﻤﻥ ﻜﻭﻨﻬﺎ‬ ‫ﻤﺭﺍﺠﻌﺔ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﻷﻨﻅﻤﺔ ﻭﺍﻟﻘﻭﺍﻨﻴﻥ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻏﻴﺭ ﻋﻘﺎﺒﻴﺔ ﺃﻭ ﻗﺴﺭﻴﺔ ﻭﺃﻨﻬﺎ ﺘﺴﻬﻡ ﻓﻲ ﺘﺤﻘﻴﻕ ﻏﺎﻴﺎﺕ ﺒﺭﺍﻤﺞ ﻭﺨﺩﻤﺎﺕ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﻫـﺫﻩ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﻭﻤﻜﺎﻓﺤﺘﻬﺎ؛‬ ‫ﺘﻌﺯﻴﺯ ﺍﻟﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ :‬ﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﺠﻨﺱ ﺍﻟﻤﺄﻤﻭﻥ‪ ،‬ﻭﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﺘﻤـﺎﺱ ﺍﻟﺭﻋﺎﻴـﺔ ﺍﻟـﺼﺤﻴﺔ‬ ‫ﻭﺍﻻﻟﺘﺯﺍﻡ ﺒﺎﻟﻌﻼﺝ ﻭﺇﺒﻼﻍ ﺍﻷﺯﻭﺍﺝ ﻤﻥ ﻭﺍﻗﻊ ﺍﻟﻤﺴﺅﻭﻟﻴﺔ ﻭﺘﻘﺩﻴﻡ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻬﻡ؛‬ ‫•‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺒﺭﺍﻤﺞ ﺍﺴﺘﻘﺼﺎﺀ ﺍﻟﺤﺎﻻﺕ ﺃﺜﻨﺎﺀ ﺍﻟﺤﻤـل‬ ‫ﺇﻴﺘﺎﺀ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻭﺘﻘﺩﻴﻡ ﺍﻟﻌﻼﺝ ﺍﻟﻭﻗﺎﺌﻲ ﻟﻠﻭﻟـﺩﺍﻥ ﻋﻨـﺩ‬ ‫ﺍﻟﻤﺘﻌﻠﻕ ﺒﻤﺭﺽ ﺍﻟﺯﻫﺭﻱ ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻻﺩﺘﻬﻡ ﻭﺍﻟﺘﻤﻨﻴﻊ ﻀﺩ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ ﺍﻟﺒﺎﺌﻲ؛‬ ‫ﻀﻤﺎﻥ ﻭﺠﻭﺩ ﺇﻤﺩﺍﺩﺍﺕ ﻤﺄﻤﻭﻨﺔ ﻭﻓﻌﺎﻟﺔ ﻴﻤﻜﻥ ﺍﻟﺘﻌﻭﻴل ﻋﻠﻴﻬﺎ ﻷﺩﻭﻴﺔ ﻭﺴﻠﻊ ﺫﺍﺕ ﺠﻭﺩﺓ ﻋﺎﻟﻴﺔ ﺘﻜﻭﻥ ﻓﻲ‬ ‫ﺎ‪ ،‬ﺒﻤﺎ ﻓـﻲ ﺫﻟـﻙ ﺍﻟﻌـﻭﺍﺯل‬ ‫ﻤﺘﻨﺎﻭل ﺇﻤﻜﺎﻨﻴﺎﺕ ﺍﻟﻤﺭﻀﻰ ﺨﺎﺼﺔ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﺫﻜﻭﺭ ﻭﺍﻹﻨﺎﺙ ﻭﺍﻟﻭﺴﺎﺌل ﺍﻟﺤﺎﺌﻠﺔ ﺍﻷﺨﺭﻯ؛‬ ‫ﺘﻘﻭﻴﺔ ﻋﻨﺎﺼﺭ ﺍﻟﺩﻋﻡ ﺒﻤﺎ ﻴﺸﻤل ﺘﻜﻴﻴﻑ ﺍﻟـﺩﻻﺌل ﺍﻹﺭﺸـﺎﺩﻴﺔ ﺍﻟﻤﻌﻴﺎﺭﻴـﺔ‪ ،‬ﻭﺍﻟﺘـﺩﺭﻴﺏ‪ ،‬ﻭﺸـﺒﻜﺎﺕ‬ ‫ﺍﻟﻤﻌﻠﻭﻤﺎﺕ‪ ،‬ﻭﺇﻤﺩﺍﺩﻴﺎﺕ ﺃﻭ ﻟﻭﺠﻴﺴﺘﻴﺎﺕ ﺍﻟﺴﻠﻊ‪ ،‬ﻭﺍﻟﺩﻋﻡ ﺍﻟﻤﺨﺘﺒﺭﻱ‪ ،‬ﻭﺍﻟﺘﺭﺼﺩ ﻭﺍﻟﺒﺤﻭﺙ‪.‬‬

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‫ﺎ‬ ‫ﻻﺒﺩ ﻤﻥ ﺍﺴﺘﻜﺸﺎﻑ ﻁﺭﻕ ﻤﺒﺘﻜﺭﺓ ﻟﺘﺠﻤﻴﻊ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﺭﺌﻴﺴﻴﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤـﻥ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﻭﺘﻘﺩﻴﻤﻬﺎ ﻓﻲ ﺤﺯﻤﺔ ﻭﺍﺤﺩﺓ‪ ،‬ﻭﻴﺘﻤﺜل ﺍﻟﺘﺤﺩﻱ ﻓﻲ ﺍﻟﺘﻌﺭﻑ ﻋﻠﻰ ﺃﻓﻀل ﺍﻟﺴﺒل ﻜﻲ ﻴﻤﻜﻥ ﺍﻟﻘﻴﺎﻡ ﺒـ‪:‬‬ ‫ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻭﺴﺎﺌل ﻭﺍﻟﺘﻘﻨﻴﺎﺕ ﺴﻭﺍﺀ ﺍﻟﻤﺘﻭﻓﺭﺓ ﺃﻭ ﺍﻟﺠﺩﻴﺩﺓ‪ ،‬ﺒﺎﻟﺸﻜل ﺍﻟﺫﻱ ﻴﺤﻘﻕ ﺍﻟﻔﺎﺌﺩﺓ ﻟﻸﻓﺭﺍﺩ ﺍﻟﺫﻴﻥ ﻫﻡ‬‫ﻓﻲ ﺃﺸﺩ ﺍﻟﺤﺎﺠﺔ ﺇﻟﻴﻬﺎ؛‬ ‫ ﺘﺤﺴﻴﻥ ﺒﻴﺌﺔ ﻭﻭﺴﻁ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﻁﺒﻴﺔ ﻟﺘﻴﺴﻴﺭ ﺍﻟﻭﺼﻭل ﺇﻟﻴﻬﺎ ﻭﺠﻌل ﺍﺴـﺘﺨﺩﺍﻤﻬﺎ ﺃﻴـﺴﺭ ﻭﺃﻥ ﺘﻜـﻭﻥ‬‫ﺃﻨﺸﻁﺘﻬﺎ ﻤﺘﻤﺭﻜﺯﺓ ﺤﻭل ﺍﻟﻌﻤﻴل ﻟﺘﻠﺒﻴﺔ ﺍﺤﺘﻴﺎﺠﺎﺘﻪ؛‬ ‫ ﻨﻘل ﻭﺇﺒﻼﻍ ﺍﻟﺭﺴﺎﺌل ﺍﻟﺼﺤﻴﺔ ﺒﺎﻷﺴﻠﻭﺏ ﺍﻟﺫﻱ ﻴﺠﻌﻠﻬﺎ ﺠﺩﻴﺭﺓ ﺒﺎﻟﺘﺫﻜﺭ ﻭﻴﺤﻘﻕ ﻓﻌﺎﻟﻴﺘﻬﺎ؛‬‫ ﺇﻗﺎﻤﺔ ﺼﻼﺕ ﻗﻭﻴﺔ ﻤﻊ ﺍﻟﻭﺴﺎﺌل ﺍﻹﻋﻼﻤﻴﺔ ﻭﺘﻭﻅﻴﻑ ﻤﺘﺤﺩﺜﻴﻥ ﺒﻠﺴﺎﻥ ﺍﻟﻬﻴﺌﺔ ﺃﻭ ﺍﻟﺠﻤﺎﻋﺔ‪ ،‬ﻤﻥ ﺍﻟـﺫﻴﻥ‬‫ﺎ ﻋﺒﺭ ﺍﻟﺸﺒﻜﺎﺕ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﺍﻟﺘﻲ‬ ‫ﻴﻤﻜﻥ ﺃﻥ ﻴﻨﺎﻀﻠﻭﺍ ﻭﻴﻨﺎﺼﺭﻭﺍ ﻗﻀﻴﺔ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻴﺼﻌﺏ ﺍﺨﺘﺭﺍﻗﻬﺎ؛‬ ‫ ﺘﻌﺯﻴﺯ ﺃﻨﺸﻁﺔ ﺍﻟﺘﺼﺩﻱ ﺍﻟﻤﺘﻌﺩﺩ ﺍﻟﻘﻁﺎﻋﺎﺕ‪ ،‬ﺍﻟﺫﻱ ﻴﺘﻡ ﻤﻥ ﺨﻼل ﻗﻁﺎﻋﺎﺕ ﺃﺨﺭﻯ ﻏﻴـﺭ ﺍﻟﻘﻁﺎﻋـﺎﺕ‬‫ﺍﻟﺼﺤﻴﺔ ﻤﺜل ﺍﻟﻘﻁﺎﻋﺎﺕ ﺍﻟﻘﻀﺎﺌﻴﺔ ﻭﺍﻟﺘﻌﻠﻴﻤﻴﺔ‪ ،‬ﻭﺼﻨﺎﻋﺔ ﺍﻟﺴﻴﺎﺤﺔ‪ ،‬ﻭﺍﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ؛‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ؛‬ ‫ ﺇﻗﺎﻤﺔ ﺸﺭﺍﻜﺔ ﺒﻴﻥ ﺍﻟﻘﻁﺎﻋﻴﻥ ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ ﺍﺴﺘﻨﻬﺎﺽ ﻭﺤﺸﺩ ﺍﻟﻭﻜﺎﻻﺕ ﺍﻟﺩﻭﻟﻴﺔ‪ ،‬ﻭﺍﻟﺤﻜﻭﻤﺎﺕ ﺍﻟﻭﻁﻨﻴﺔ‪ ،‬ﻭﺍﻟﻤﺅﺴﺴﺎﺕ ﺍﻟﺨﻴﺭﻴﺔ ﺍﻟﺨﺎﺼﺔ‪ ،‬ﻭﺃﺼﺤﺎﺏ‬‫ﺍﻟﻤﺼﺎﻟﺢ ﺍﻟﺘﺠﺎﺭﻴﺔ‪ ،‬ﺤﻭل ﻤﺠﻤﻭﻋﺔ ﺘﺩﺨﻼﺕ ﻭﻤﺒﺎﺩﺭﺍﺕ ﺘﻤﺜل ﺃﻭﻟﻭﻴﺎﺕ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ‬ ‫ﺎ؛‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ ﺍﻟﺘﺤﺭﻙ ﺍﻟﺫﻱ ﻴﺘﺠﺎﻭﺯ ﺍﻟﺒﺤﺙ ﻋﻥ "ﺤﻠﻭل ﺴﺤﺭﻴﺔ" ﻟﺘﺩﺨﻼﺕ ﻤﺘﻌﺩﺩﺓ ﺍﻷﻭﺠﻪ ﺘﺴﻴﺭ ﻓﻲ ﺍﻨﺴﺠﺎﻡ ﻭﺘﻨﺎﻏﻡ‬‫ﻤﻥ ﺨﻼل ﻋﻨﺎﺼﺭ ﻭﻤﺴﺘﻭﻴﺎﺕ ﻋﺩﻴﺩﺓ‪ ،‬ﻤﻊ ﻀﻤﺎﻥ ﺍﺴﺘﻤﺭﺍﺭﻫﺎ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺘﻘﻨﻴﺔ‪ :‬ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺍﻟﻨﺠﺎﺡ ﻓﻲ ﺍﻟﻭﻗﺎﻴﺔ ﻤـﻥ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‬ ‫ﺠﻨﺴﻴ ﹰ‬

‫‪-٣‬‬

‫ﺎ‬ ‫‪ ١-٣‬ﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺍ ﻋﻠﻰ ﻤﺩﻯ ﺍﻟﻌﺸﺭﻴﻥ‬ ‫ﺍ ﻜﺒﻴﺭﹰ‬ ‫ﺎ ﺘﻁﻭﺭﹰ‬ ‫ﻟﻘﺩ ﺘﻁﻭﺭﺕ ﻤﻌﺭﻓﺘﻨﺎ ﺤﻭل ﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺴﻨﺔ ﺍﻟﻤﺎﻀﻴﺔ‪ ،‬ﻤﺩﻓﻭﻋﺔ ﺒﻔﻌل ﺍﻟﻭﺒﺎﺀ ﺍﻟﻌﺎﻟﻤﻲ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺍﻷﻤﺭ ﺍﻟﺫﻱ ﺯﺍﺩ ﻤﻥ ﺠﻬﻭﺩ ﻤﻜﺎﻓﺤﺔ‬ ‫ﺎ‪ .‬ﻭﻟﻘﺩ ﺃﻭﻀﺤﺕ ﺍﻟﻨﻤﺎﺫﺝ ﺍﻟﺭﻴﺎﻀﻴﺔ ﻭﺍﻟﺒﺤﻭﺙ ﺃﻫﻤﻴﺔ ﺍﻟﺸﺒﻜﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ ﻓﻲ ﺘﺤﺩﻴﺩ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ﻥ ﻤﻥ ﻋﻤﻠﻴﺔ ﻓﻬﻡ ﻜﻴﻔﻴﺔ ﺤﺩﻭﺙ ﺍﻟﺴﺭﺍﻴﺔ‪ .‬ﻭﻫﻨﺎﻙ ﺘـﺄﺜﻴﺭﺍﺕ‬ ‫ﺎ‪ ،‬ﺍﻷﻤﺭ ﺍﻟﺫﻱ ﺤﺴ‬ ‫ﻤﺩﻯ ﺍﻨﺘﺸﺎﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ ﺒﻭﻀﻊ ﻭﺘﺼﻤﻴﻡ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻟﻠﻭﻗﺎﻴـﺔ ﻤـﻥ ﻫـﺫﻩ‬ ‫ﻟﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪.‬‬ ‫ﺎ ﻓﻲ ﺃﻱ ﻤﺠﺘﻤﻊ ﺴﻜﺎﻨﻲ‪ ،‬ﺤﻴﺙ ﺇﻥ ﺃﻭﺒﺌﺔ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ‪ ،‬ﻟﻴﺱ ﺜﺎﺒﺘﹰ‬ ‫ﺇﻥ ﺘﻭﺯﻴﻊ ﻤﻌﺩﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺘﺘﻁﻭﺭ‪ ،‬ﻤﻊ ﺍﻟﻭﻗﺕ‪ ،‬ﻭﺘﻤﺭ ﻓﻲ ﺃﻁﻭﺍﺭ ﻤﺨﺘﻠﻔﺔ ﺘﺘﻤﻴﺯ ﺒﺘﻐﻴﺭ ﺃﻨﻤﺎﻁﻬﺎ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺘﻭﺯﻴﻊ ﻭﺴـﺭﺍﻴﺔ‬ ‫ﺍﻟﻜﺎﺌﻨﺎﺕ ﺍﻟﻤﻤﺭﻀﺔ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺩﺍﺨل ﻭﻓﻲ ﻤﺎ ﺒﻴﻥ ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺃﻭ ﺍﻟﺠﻤﺎﻋﺎﺕ ﺍﻟﻔﺭﻋﻴﺔ )‪ .(٤١‬ﻭﺒﺼﻔﺔ‬ ‫ﺎ‪ ،‬ﺘﻨﺘﻘل‪ ،‬ﻋﻠﻰ ﺍﻷﺭﺠﺢ‪ ،‬ﺒﻴﻥ ﻭﻤﻥ ﺍﻷﺸﺨﺎﺹ ﺍﻟـﺫﻴﻥ ﺘﻜـﻭﻥ‬ ‫ﻋﺎﻤﺔ‪ ،‬ﻓﺈﻥ ﺍﻟﻜﺎﺌﻨﺎﺕ ﺍﻟﻤﺴﺒﺒﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻋﻭﺍﻤل ﺍﻟﺨﻁﺭ ﻟﺩﻴﻬﻡ ﻤﺭﺘﻔﻌﺔ‪ ،‬ﻭﺒﻤﻌﺩﻻﺕ ﻋﺩﻭﻯ ﻋﺎﻟﻴﺔ ﻭﺘﻐﻴﻴﺭ ﺍﻟﻘﺭﻨﺎﺀ ﺒﺎﺴﺘﻤﺭﺍﺭ ﺨﺎﺭﺝ ﺇﻁﺎﺭ ﺍﻟﺯﻭﺍﺝ ﺍﻟـﺸﺭﻋﻲ‬ ‫ﺎ ﻟﻠﺨﻁـﺭ‬ ‫‪‬ﻤﺭﻀﺎﺕ ﺇﻟﻰ ﺍﻟﻔﺌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻷﻗـل ﺘﻌﺭﻀـﹰ‬ ‫) ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻷﺴﺎﺴﻴﺔ(‪ .‬ﻭﻤﻊ ﺘﻔﺎﻗﻡ ﺍﻟﻭﺒﺎﺀ‪ ،‬ﺘﻨﺘﺸﺭ ﺍﻟﻤ‬ ‫) ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﺠﺴﺭﻴﺔ( ﻭﺍﻟﺫﻴﻥ ﻴﻜﻭﻨﻭﻥ ﺒﻤﺜﺎﺒﺔ ﺤﻠﻘﺔ ﻭﺼل ﺠﻨﺴﻴﺔ ﺒﻴﻥ ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻷﺴﺎﺴﻴﺔ ﻭﻋﺎﻤـﺔ‬ ‫ﹸﺯﻴﺩ ﺍﻟﻅﺭﻭﻑ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﺃﻭ ﺍﻻﻗﺘﺼﺎﺩﻴﺔ ﻟﺒﻌﺽ ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﻤﻥ ﺘﻌﺭﻀﻬﻡ ﺒﺼﻭﺭﺓ ﺃﻜﺒـﺭ‬ ‫ﺍﻟﺴﻜﺎﻥ‪ .‬ﻭﻗﺩ ﺘ‬ ‫ﻻﻜﺘﺴﺎﺏ ﺃﻭ ﻨﻘل ﻫﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ ،‬ﻭﺒﺎﻟﺘﺎﻟﻲ ﺘﻨﻘﻠﻬﻡ ﺇﻟﻰ ﻫﺫﻩ ﺍﻟﻔﺌﺔ ﺍﻟﺠﺴﺭﻴﺔ‪ .‬ﻭﺘﺘﻐﻴﺭ ﻫﺫﻩ ﺍﻟـﺸﺒﻜﺎﺕ ﺍﻟﺠﻨـﺴﻴﺔ ﻤـﻥ‬ ‫ﻤﻜﺎﻥ ﺇﻟﻰ ﻤﻜﺎﻥ ﺁﺨﺭ‪ ،‬ﻭﻟﻜﻥ‪ ،‬ﻭﺒﺼﻔﺔ ﻋﺎﻤﺔ‪ ،‬ﻴﻘﻭﻡ ﺍﻷﺯﻭﺍﺝ ﺍﻟﺫﻴﻥ ﺘﻜـﻭﻥ ﻤﻌـﺩﻻﺕ ﺍﻟﻌـﺩﻭﻯ ﻟـﺩﻴﻬﻡ ﻤﺭﺘﻔﻌـﺔ‬ ‫)ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﺠﺴﺭﻴﺔ(‪ ،‬ﺒﺩﻭﺭﻫﻡ‪ ،‬ﺒﻨﻘل ﺍﻟﻌﺩﻭﻯ ﺇﻟﻰ ﺃﺯﻭﺍﺠﻬﻡ‪ ،‬ﻜﺯﻭﺠﺎﺘﻬﻡ ﺃﻭ ﻀﻤﻥ ﺍﻟﻤﺠﺘﻤـﻊ ﺍﻟﻌـﺎﻡ‪.‬‬ ‫ﺎ ﺩﺍﺨل ﺍﻟﻤﺠﺘﻤﻊ‪.‬‬ ‫ﺎ ﻟﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻤﺒﺴﻁﹰ‬ ‫ﻭﻴﻤﺜل ﺍﻟﺸﻜل ﺭﻗﻡ ‪ ١‬ﻨﻤﻭﺫﺠﹰ‬

‫ﺎ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﺴﻜﺎﻨﻲ‬ ‫ﺍﻟﺸﻜل ﺭﻗﻡ ‪ .١‬ﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﻌﺎﻡ‬

‫ﻤﺠﻤﻭﻋﺎﺕ ﺴﻜﺎﻨﻴﺔ‬ ‫ﺠﺎﺴﺭﺓ‬ ‫ﻨﺎﻗﻠﻭﻥ ﺒﺘﻭﺍﺘﺭﺍﺕ‬ ‫ﻋﺎﻟﻴﺔ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻭﻴﺘﻌﻘﺩ ﺍﻟﻭﻀﻊ ﺒﺸﻜل ﺃﻜﺒﺭ ﺒﻔﻌل ﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺍﻟﺘﻔﺎﻋل ﺍﻟﻤﺨﺘﻠﻔﺔ ﺒﻴﻥ ﺍﻟﻤﻀﻴﻑ ﻭﺒـﻴﻥ ﺍﻟﻌﺎﻤـل ﺍﻟﻤـﺴﺒﺏ‬ ‫ﻟﻠﻤﺭﺽ ﻭﺍﻟﺘﻲ ﻴﺤﻜﻤﻬﺎ ﻤﺘﺜﺎﺒﺘﺔ ﻋﺘﺒﻴﺔ‪ ،‬ﻫﻲ ‪ ،R0‬ﻭﻫﻲ ﺍﻟﻌﺩﺩ ﺍﻟﺘﻜﺎﺜﺭﻱ ﺍﻷﺴﺎﺴﻲ‪ .‬ﻭﻫﺫﻩ ﺍﻟﻤﺘﺜﺎﺒﺘﺔ‪ ،R0 ،‬ﺘﻤﺜل ﺍﻟﻌـﺩﺩ‬ ‫ﺍﻟﻤﺘﻭﻗﻊ ﻤﻥ ﺍﻟﺤﺎﻻﺕ ﺍﻟﺜﺎﻨﻭﻴﺔ ﺍﻟﻨﺎﺘﺠﺔ ﻋﻥ ﺤﺎﻟﺔ ﻭﺤﻴﺩﺓ ﻓﻲ ﻤﺠﺘﻤﻊ ﺴﻜﺎﻨﻲ ﻷﺸﺨﺎﺹ ﻟﺩﻴﻬﻡ ﺍﻻﺴـﺘﻌﺩﺍﺩ ﻟﻺﺼـﺎﺒﺔ‪.‬‬ ‫ﻭﺍﻟﻤﺘﺜﺎﺒﺘﺔ ‪ R0‬ﻫﻲ ﻨﺘﺎﺝ ﻟﺜﻼﺜﺔ ﻤﺘﻐﻴﺭﺍﺕ ﻤﻤﺜﻠﺔ ﺒـ ‪ ،R0= ß×D×C‬ﺤﻴﺙ ﺘﻜﻭﻥ "‪ "ß‬ﻫﻲ ﻗـﺩﺭﺓ ﺍﻟﻌﺎﻤـل ﺍﻟﻤـﺴﺒﺏ‬ ‫ﻟﻠﻤﺭﺽ ﻓﻲ ﻜل ﺍﺘﺼﺎل ﺠﻨﺴﻲ ﻭﺍﺤﺩ ﻋﻠﻰ ﻨﻘل ﺍﻟﻌﺩﻭﻯ )ﺍﻹﻋﺩﺍﺀ( ﻭﺘﻜﻭﻥ "‪ "D‬ﻫﻲ ﻤﺩﺓ ﺍﻹﻋﺩﺍﺀ ﻭ"‪ "C‬ﻫﻲ ﻤﻌـﺩل‬ ‫‪‬ﻤﺭﻀﺎﺕ )ﺍﻟﻤﺴﺘﺩﻤﻴﺔ ﺍﻟﺩﻭﻜﺭﻴﺔ( ﻋﺎﻟﻴﺔ ﺍﻹﻋﺩﺍﺀ ﻭﻟﻜﻥ ﻟﻤﺩﺓ ﻗﺼﻴﺭﺓ‬ ‫ﺘﻐﻴﺭ ﺍﻷﻨﻤﺎﻁ ﺍﻟﺠﻨﺴﻴﺔ )‪ .(٤٢‬ﻭﺘﻜﻭﻥ ﺒﻌﺽ ﺍﻟﻤ‬ ‫)ﻤﺜل ﺍﻟﻤﺴﺘﺩﻤﻴﺔ ﺍﻟﺩﻭﻜﺭﻴﺔ‪ ،‬ﺍﻟﺘﻲ ﺘﺴﺒﺏ ﺍﻟﻘﺭﻴﺢ(‪ ،‬ﺒﻴﻨﻤﺎ ﻫﻨﺎﻙ ﻜﺎﺌﻨﺎﺕ ﺃﺨﺭﻯ ﻤﺴﺒﺒﺔ ﻟﻠﻤﺭﺽ ﻤﺜل ﻓﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ‬ ‫ﹰ‪ ،‬ﻟﻜﻨﻬﺎ ﺘﺴﺘﻤﺭ ﻤـﺩﺓ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﻓﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ – ﺍﻟﻨﻤﻁ ‪ ،٢‬ﺫﺍﺕ ﺨﺎﺼﻴﺔ ﺇﻋﺩﺍﺌﻴﺔ ﻤﻨﺨﻔﻀﺔ ﻨﺴﺒﻴﺎ‬ ‫ﻁﻭﻴﻠﺔ‪ .‬ﻤﻥ ﺠﻬﺔ ﺃﺨﺭﻯ‪ ،‬ﻓﺈﻥ ﺍﻟﻨﻴﺴﻴﺭﻴﺔ ﺍﻟﺒﻨﻴﺔ‪ ،‬ﻭﺍﻟﻤﺘﺩﺜﺭﺓ ﺍﻟﺤﺜﺭﻴﺔ‪ ،‬ﻭﺍﻟﻠﻭﻟﺒﻴﺔ ﺍﻟﺸﺎﺤﺒﺔ )ﺍﻟﺘﻲ ﺘـﺴﺒﺏ ﺍﻟﺯﻫـﺭﻱ(‪،‬‬ ‫ﺘﺘﻤﻴﺯ ﺒﺨﺎﺼﻴﺔ ﻭﻤﺩﺓ ﺇﻋﺩﺍﺌﻴﺔ ﻤﺘﻭﺴﻁﺔ )‪ .(٤٤ ،٤٣‬ﻭﻫﻜﺫﺍ‪ ،‬ﻓﺈﻥ ﺍﻟﻨﻤﻁ ﺍﻟﺫﻱ ﻴﺘﻁﻭﺭ ﻤﻥ ﺨﻼﻟﻪ ﻭﺒـﺎﺀ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ ﻻﺨﺘﻼﻑ ﺍﻟﺘﻔﺎﻋﻼﺕ ﻓﻲ ﻤﺎ ﺒﻴﻥ ﺍﻟﺴﻜﺎﻥ ﻭﺍﻟﻜﺎﺌﻥ ﺍﻟﻤﺴﺒﺏ ﻟﻠﻤﺭﺽ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺃﺨﺫ ﻜﺎﻓـﺔ‬ ‫ﺎ ﻴﺨﺘﻠﻑ ﻭﻓﻘﹰ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻫﺫﻩ ﺍﻟﻌﻭﺍﻤل ﻓﻲ ﺍﻟﺤﺴﺒﺎﻥ‪ ،‬ﻜﻠﻤﺎ ﺃﻤﻜﻥ‪ ،‬ﻭﺫﻟﻙ ﻋﻨﺩ ﺍﻟﺘﺨﻁﻴﻁ ﻹﻗﺎﻤﺔ ﺒﺭﺍﻤﺞ ﻓﻌﺎﻟﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪.‬‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻭﺘﺸﻤل ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﻫﻭ ﻴﺘﺒـﺎﻴﻥ‬ ‫ﻭﻫﻨﺎﻙ ﻋﻭﺍﻤل ﺍﻟﺨﻁﺭ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺤﺴﺏ ﺍﻟﺠﻨﺱ‪ ،‬ﻟﺩﻯ ﺍﻷﻤﻬﺎﺕ ﻭﺃﻁﻔﺎﻟﻬﻥ ﺤﻴﺙ ﻴﺘﺄﺜﺭ ﺒﺸﻜل ﻏﻴﺭ ﻗﻴﺎﺴﻲ‪ .‬ﻭﻴﻤﻜﻥ ﻋﺯﻭ ﺍﻟﻔﺭﻭﻕ ﻓﻲ ﺍﻟﻘﺎﺒﻠﻴﺔ ﻟﻺﺼﺎﺒﺔ‬ ‫ﻭﺍﻟﻌﻭﺍﻗﺏ ﺇﻟﻰ ﺍﻻﺴﺘﻌﺩﺍﺩ ﺍﻟﺒﻴﻭﻟﻭﺠﻲ‪ ،‬ﻭﺍﻟﺘﻔﺎﻀﻼﺕ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﺎﻟﺫﻜﻭﺭﺓ ﻭﺍﻷﻨﻭﺜﺔ ﻤﺜل ﻋﺩﻡ ﺍﻟﻤﺴﺎﻭﺍﺓ ﻓﻲ ﺍﻟـﺴﻠﻁﺎﺕ‪،‬‬ ‫ﺃﻭ ﺍﻟﺼﻼﺤﻴﺎﺕ‪ ،‬ﻭﺍﻟﻌﻭﺍﻤل ﺍﻟﺴﻠﻭﻜﻴﺔ ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺍﻟﻤﻤﺎﺭﺴﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﻭﺴﻠﻭﻙ ﺍﻟﺘﻤﺎﺱ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﻓـﻲ‬ ‫ﺒﻌﺽ ﺍﻷﻤﺎﻜﻥ‪ ،‬ﻀﻌﻑ ﺍﻟﺘﻭﺼل ﻭﺍﻟﺤﺼﻭل ﻋﻠﻰ ﺍﻟﺭﻋﺎﻴﺔ‪ ،‬ﻭﺍﻨﺨﻔﺎﺽ ﺍﻟﻤﺴﺘﻭﻴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‪.‬‬

‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‬ ‫‪ ٢-٣‬ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﻤﻊ ﺃﺨﺫ ﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺍﻟﺴﺭﺍﻴﺔ ﺍﻟﺘﻲ ﺃﻭﺠﺯﺕ ﺃﻋﻼﻩ ﻓﻲ ﺍﻟﺤﺴﺒﺎﻥ‪ ،‬ﻴﺠﺏ ﺃﻥ ﺘﻜﻭﻥ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﻭﻗﺎﻴﺔ ﻤـﻥ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﻤﻼﺌﻤﺔ ﺤﺘﻰ ﻴﻤﺘﺩ ﻨﻁﺎﻕ ﺘﺄﺜﻴﺭﻫﺎ ﻭﻤﻜﺘﺴﺒﺎﺘﻬﺎ ﺇﻟﻰ ﺃﻗﺼﻰ ﺤﺩ ﻤﻤﻜﻥ‪ .‬ﻭﻴﻨﺒﻐـﻲ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻟﻸﻤﻭﺭ ﺍﻟﺘﺎﻟﻴﺔ ﻤﻥ ﻗﺒل ﻭﺍﻀﻌﻲ ﻫﺫﻩ ﺍﻟﺒﺭﺍﻤﺞ‪:‬‬ ‫ﺃﻥ ﻴﻜﻭﻥ ﻫﻨﺎﻙ ﺘﻔﻬﻤﹰ‬ ‫ﺎ ﻟﻠﺨﻁﺭ؛‬ ‫ ﺃﻱ ﻤﻥ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﻫﻲ ﺍﻷﻜﺜﺭ ﺘﻌﺭﻀﹰ‬‫ ﻤﺎ ﻫﻲ ﺍﻟﺴﻠﻭﻜﻴﺎﺕ ﺃﻭ ﺍﻟﻅﺭﻭﻑ ﺍﻟﺘﻲ ﺘﻀﻊ ﻫﺫﻩ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﻓﻲ ﺩﺍﺌﺭﺓ ﺍﻟﺨﻁﺭ؛‬‫ ﻤﺎ ﻫﻲ ﺃﻓﻀل ﺍﻷﺴﺎﻟﻴﺏ ﻭﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺍﺘﺨﺎﺫﻫﺎ ﻟﻭﻗﻑ ﺴﻠﺴﻠﺔ ﺍﻟﺴﺭﺍﻴﺔ؛‬‫ ﻜﻴﻑ ﻴﻤﻜﻥ ﺘﺤﺩﻴﺩ ﺍﻷﻭﻟﻭﻴﺎﺕ‪ ،‬ﻭﺍﻟﻨﻬﻭﺽ ﺒﺎﻟﺘﺩﺨﻼﺕ؛‬‫ﺎ ﻓـﻲ ﺍﻟﻤﺠﺘﻤـﻊ‬ ‫ﻭﻓﻲ ﺒﻌﺽ ﺍﻟﻤﻭﺍﻗﻊ ﺍﻟﺠﻐﺭﺍﻓﻴﺔ ﻭﺒﻌﺽ ﺍﻟﺒﻠﺩﺍﻥ‪ ،‬ﺘﻜﻭﻥ ﻤﻌﺩﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺴﻜﺎﻨﻲ ﺍﻟﻌﺎﻡ ﻤﺭﺘﻔﻌﺔ‪ ،‬ﺒﻴﻨﻤﺎ ﺘﻜﻭﻥ ﻫﺫﻩ ﺍﻟﻤﻌﺩﻻﺕ ﺍﻟﻤﺭﺘﻔﻌﺔ‪ ،‬ﻤﻘﺼﻭﺭﺓ ﻋﻠﻰ ﻤﺠﻤﻭﻋﺎﺕ ﺴﻜﺎﻨﻴﺔ ﻤﻌﻴﻨﺔ‪ ،‬ﻭﺫﻟﻙ ﻓـﻲ‬ ‫ﺎ‪ ،‬ﻭﺍﻟـﺴﻠﻭﻜﻴﺎﺕ‬ ‫ﺒﻌﺽ ﺍﻟﺒﻠﺩﺍﻥ ﻭﺍﻷﻤﺎﻜﻥ ﺍﻷﺨﺭﻯ‪ .‬ﻭﺇﻥ ﺃﻨﺸﻁﺔ ﺘﺤﺩﻴﺩ ﻤﺴﺘﻭﻴﺎﺕ ﺤﺩﻭﺙ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺍﻟﺠﻨﺴﻴﺔ )ﻤﺜل ﻋﺩﺩ ﺍﻷﺯﻭﺍﺝ ﻭﻤﻌﺩل ﺘﻐﻴﺭﻫﻥ( ﻭﺍﻟﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﻭﻗﺎﺌﻴﺔ )ﻤﺜل ﺍﻻﺴﺘﺨﺩﺍﻡ ﺍﻟﺼﺤﻴﺢ ﻭﺍﻟﻤﺘـﺴﻕ ﻟﻠﻌـﺎﺯل‬ ‫ﺍﻟﺫﻜﺭﻱ(‪ ،‬ﻭﺍﻟﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﺎﻟﺼﺤﺔ )ﻤﺜل ﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﺘﻤﺎﺱ ﺍﻟﻤﻌﺎﻟﺠﺔ( ﻓـﻲ ﺍﻟﻤﺠﻤﻭﻋـﺎﺕ ﺍﻟـﺴﻜﺎﻨﻴﺔ ﺫﺍﺕ‬ ‫ﻤﻌﺩﻻﺕ ﺍﻟﻌﺩﻭﻯ ﺍﻟﻤﺭﺘﻔﻌﺔ ﻭﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﻤﻌﺭﻀﺔ ﺃﻜﺜﺭ ﻤﻥ ﻏﻴﺭﻫﺎ ﻟﻺﺼﺎﺒﺔ ﻭﺍﻟﻤﺠﺘﻤﻊ ﺍﻟـﺴﻜﺎﻨﻲ ﺍﻟﻌـﺎﻡ‪ ،‬ﺘﻘـﺩﻡ‬ ‫ﺎ ﻓﻲ‬ ‫ﺎ ﻭﺘﺴﺎﻋﺩ ﻋﻠﻰ ﺘﺤﺩﻴﺩ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻷﻜﺜﺭ ﻨﺠﺎﺤﹰ‬ ‫ﻤﻌﻠﻭﻤﺎﺕ ﻗﻴﻤﺔ ﺤﻭل ﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻟﻼﺤﺘﻴﺎﺠـﺎﺕ‬ ‫ﺘﺤﻘﻴﻕ ﺍﻷﺜﺭ ﺍﻟﻤﻁﻠﻭﺏ ﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﻤﻜﺎﻓﺤﺔ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺘﺤﺩﻴﺩ ﺃﻭﻟﻭﻴﺔ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ ﻭﺫﻟﻙ ﻭﻓﻘﹰ‬ ‫ﻭﺍﻟﻤﺘﻁﻠﺒﺎﺕ‪ ،‬ﻭﺍﻟﺠﺩﻭﻯ‪ ،‬ﻭﺘﻭﻓﺭ ﺍﻟﻤﻭﺍﺭﺩ‪.‬‬ ‫ﻭﺘﺘﺒﺎﻴﻥ ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﺘﻲ ﻴﺘﻁﻠﺏ ﺍﻷﻤﺭ ﺘﺤﻠﻴل ﺴﻠﻭﻜﻴﺎﺘﻬﺎ ﻭﻗﺎﺒﻠﻴﺘﻬﺎ ﻟﻺﺼﺎﺒﺔ‪ ،‬ﺒﻐﺭﺽ ﺇﻤﻜﺎﻨﻴـﺔ‬ ‫ﺍﺴﺘﻬﺩﺍﻓﻬﺎ ﺒﺈﺠﺭﺍﺀﺍﺕ ﺘﺩﺨﻠﻴﺔ‪ ،‬ﻭﺫﻟﻙ ﻤﻥ ﻤﻨﻁﻘﺔ ﻷﺨﺭﻯ‪ ،‬ﻭﻤﻥ ﺒﻠﺩ ﻵﺨﺭ‪ .‬ﻭﻓﻲ ﻤﺎ ﻴﻠﻲ ﺒﻌﺽ ﺍﻟﻔﺌﺎﺕ ﺍﻟﺘـﻲ ﻴﻨﻅـﺭ‬ ‫ﺇﻟﻴﻬﺎ ﻋﻠﻰ ﺃﻨﻬﺎ ﺒﺤﺎﺠﺔ ﻟﻠﺘﺩﺨﻼﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ‪:‬‬ ‫ ﺍﻟﺒﻐﺎﻴﺎ ﻤﻥ ﺍﻹﻨﺎﺙ ﻭﺍﻟﺫﻜﻭﺭ ﻭﺍﻟﻤﺨﻨﺜﻴﻥ ﻭﻋﻤﻼﺌﻬﻡ ﺍﻟﺫﻴﻥ ﻗﺩ ﻴﻜﻭﻨﻭﻥ ﺃﻭ ﻻ ﻴﻜﻭﻨﻭﻥ ﻴﻤﺎﺭﺴﻭﻥ ﺍﻟﺠﻨﺱ‬‫ﻤﻊ ﻗﺭﻨﺎﺌﻬﻡ ﺍﻟﻤﻌﺎﺸﺭﻴﻥ ﻟﻬﻡ؛‬ ‫ ﺍﻟﺴﻜﺎﻥ ﺍﻟﻤﺭﺘﺤﻠﻭﻥ ﻤﺜل ﺴﺎﺌﻘﻲ ﺍﻟﺸﺎﺤﻨﺎﺕ ﻟﻤﺴﺎﻓﺎﺕ ﻁﻭﻴﻠﺔ‪ ،‬ﻭﺍﻟـﺼﻴﺎﺩﻴﻥ‪ ،‬ﻭﺍﻟﻤﻼﺤـﻴﻥ‪ ،‬ﻭﺍﻟﻌﻤـﺎل‬‫ﺍﻟﻤﻬﺎﺠﺭﻴﻥ ﻭﺍﻟﺫﻴﻥ ﺘﺯﻴﺩ ﻋﻭﺍﻤل ﺍﻟﺨﻁﺭ ﻟﺩﻴﻬﻡ ﺒﺴﺒﺏ ﺤﺭﻜﺘﻬﻡ ﺍﻟﻤﺴﺘﻤﺭﺓ‪ ،‬ﻭﺍﺭﺘﻔﺎﻉ ﻋﺎﻤـل ﺍﺨﺘﻁـﺎﺭ‬ ‫ﺍﻻﺘﺼﺎل ﺍﻟﺠﻨﺴﻲ ﻟﺩﻴﻬﻡ؛‬ ‫ ﺍﻟﻠﻭﺍﻁﻴﻭﻥ ﺍﻟﺫﻴﻥ ﻴﻘﺘﺭﻓﻭﻥ ﻤﻤﺎﺭﺴﺎﺕ ﺠﻨﺴﻴﺔ ﺸﺭﺠﻴﺔ ﻤﻊ ﺍﻟﻜﺜﻴﺭ ﻤﻥ ﺍﻟﻤﺘﺭﺩﺩﻴﻥ ﻋﻠﻴﻬﻡ ﺩﻭﻥ ﺍﻜﺘـﺭﺍﺙ‬‫ﻟﻤﺎ ﻴﺘﺭﺘﺏ ﻋﻠﻴﻬﺎ ﻤﻥ ﻤﺨﺎﻁﺭ؛‬ ‫ﺎ ﻤﻊ ﻨﺴﺎﺀ ﺇﻟﻰ ﺠﺎﻨﺏ ﺍﻟﻠﻭﺍﻁﺔ؛‬ ‫ ﺍﻟﻠﻭﺍﻁﻴﻭﻥ ﺍﻟﺫﻴﻥ ﻴﻤﺎﺭﺴﻭﻥ ﺍﻟﺠﻨﺱ ﺃﻴﻀﹰ‬‫ ﻤﺘﻌﺎﻁﻭ ﻤﻭﺍﺩ ﺍﻹﺩﻤﺎﻥ‪ ،‬ﻭﺒﺨﺎﺼﺔ‪ ،‬ﻤﻥ ﻜﺎﻥ ﻤﻨﻬﻡ ﻤﻥ ﺍﻟﺒﻐﺎﻴﺎ ﺃﻭ ﻴﻤﺎﺭﺱ ﺍﻟﺒﻐﺎﺀ ﻟﻠﺤﺼﻭل ﻋﻠﻰ ﺘﻜﺎﻟﻴﻑ‬‫ﻤﻭﺍﺩ ﺍﻹﺩﻤﺎﻥ ﺃﻭ ﻤﻥ ﺍﻟﺫﻴﻥ ﻴﻤﺎﺭﺴﻭﻥ ﺍﻟﺠﻨﺱ ﻤﻊ ﻏﻴﺭ ﺍﻟﻤﺘﻌﺎﻁﻴﻥ ﻟﻬﺫﻩ ﺍﻟﻤﻭﺍﺩ؛‬ ‫ ﺍﻟﻤﺴﺎﺠﻴﻥ‪ ،‬ﺨﺎﺼﺔ ﺍﻷﺤﺩﺍﺙ ﻤﻨﻬﻡ؛‬‫ ﺍﻟﻼﺠﺌﻭﻥ ﻭﺍﻟﻤﺸﺭﺩﻭﻥ‪ ،‬ﺨﺎﺭﺝ ﺃﻭﺩﺍﺨل ﺒﻠﺩﺍﻨﻬﻡ؛‬‫ ﺍﻟﻌﺴﻜﺭﻴﻭﻥ‪ ،‬ﺴﻭﺍﺀ ﻓﻲ ﺍﻟﺠﻴﺵ ﺃﻭ ﺍﻟﺸﺭﻁﺔ؛‬‫ ﺍﻟﺴﻴﺎﺡ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻤﻥ ﻴﺒﺤﺙ ﻤﻨﻬﻡ ﺃﺜﻨﺎﺀ ﺍﻟﺴﻴﺎﺤﺔ ﻋﻥ ﺍﻟﺒﻐﺎﺀ؛‬‫ ﺍﻟﻨﺴﺎﺀ ﺃﻭ ﺍﻟﺭﺠﺎل ﺍﻟﺫﻴﻥ ﻴﺘﻌﺭﻀﻭﻥ ﻟﻼﻨﺘﻬﺎﻜﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﺃﻭ ﺍﻻﻨﺘﻬﺎﻜﺎﺕ ﺍﻟﻘﺎﺌﻤﺔ ﻋﻠﻰ ﻤﺠﺭﺩ ﻜﻭﻨﻬﻥ‬‫ﻤﻥ ﺍﻹﻨﺎﺙ ﺃﻭ ﻜﻭﻨﻬﻡ ﻤﻥ ﺍﻟﺫﻜﻭﺭ؛‬ ‫ ﺍﻷﻁﻔﺎل ﻭﺍﻟﺸﺒﺎﺏ ﺃﻭ ﺍﻷﻴﺘﺎﻡ ﺍﻟﻤﺸﺭﺩﻭﻥ ﻭﻴﺘﻌﺭﻀﻭﻥ ﻟﻺﻴﺫﺍﺀ‪.‬‬‫ﺎ ﻭﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ‬ ‫ﻭﺍﻟﻤﺭﺍﻫﻘﻭﻥ ﻤﻌﺭﻀﻭﻥ ﻟﻌﻭﺍﻤل ﺨﻁﺭ ﺨﺎﺼﺔ ﻟﻺﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺒﺸﺭﻱ ﻷﻨﻬﻡ ﻗﺩ ﻴﻔﺘﻘﺩﻭﻥ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﺃﻭ ﺍﻟﻤﻬﺎﺭﺍﺕ ﺃﻭ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺃﻭ ﺍﻟﺩﻋﻡ ﺍﻟﺫﻱ ﻴﺤﺘﺎﺠﻭﻨﻪ ﺃﺜﻨـﺎﺀ ﻤﺭﺤﻠـﺔ‬ ‫ﺍﻟﻨﻤﺎﺀ ﺍﻟﺠﻨﺴﻲ ﻟﺩﻴﻬﻡ‪ .‬ﻭﺘﻨﺯﻉ ﻋﻼﻗﺎﺘﻬﻡ ﺍﻟﺠﻨﺴﻴﺔ ﻷﻥ ﺘﻜﻭﻥ ﻏﻴﺭ ﻤﺨﻁﻁ ﻟﻬﺎ ﻭﻤﺘﺸﺘﺘﺔ‪ ،‬ﻭﻓﻲ ﻜﺜﻴﺭ ﻤـﻥ ﺍﻟﺤـﺎﻻﺕ‬ ‫ﺘﻜﻭﻥ ﺭﺍﺠﻌﺔ ﻟﻭﺠﻭﺩ ﻀﻐﻭﻁ ﺃﻭ ﻗﺴﺭ ﺃﻭ ﺇﻜﺭﺍﻩ ﻤﻘﺎﺒل ﺘﺤﻘﻴﻕ ﻤﻜﺎﺴﺏ ﻤﺎل ﺃﻭ ﻀﻤﺎﻥ ﺍﻟﻤﻘﺒﻭﻟﻴـﺔ‪ .‬ﻭﺍﻟﻤﺭﺍﻫﻘـﺎﺕ‪،‬‬ ‫ﺎ ﻷﺴﺒﺎﺏ ﺒﻴﻭﻟﻭﺠﻴﺔ ﻭﺍﺠﺘﻤﺎﻋﻴـﺔ‬ ‫ﺒﺼﻔﺔ ﺨﺎﺼﺔ‪ ،‬ﻤﻌﺭﻀﺎﺕ ﺃﻜﺜﺭ ﻤﻥ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﻟﻺﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻗﺘﺼﺎﺩﻴﺔ‪ .‬ﻓﻔﻲ ﺒﻌﺽ ﺍﻟﺜﻘﺎﻓﺎﺕ‪ ،‬ﻴﺘﺯﻭﺝ ﻤﻥ ﻫﻡ ﻓﻲ ﺴﻥ ﺍﻟﻤﺭﺍﻫﻘﺔ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﺍﻟﻔﺘﻴﺎﺕ‪ ،‬ﻓﻲ ﺴﻥ ﻤﺒﻜﺭﺓ‪ ،‬ﻤﻤﺎ ﻴﺴﺘﻠﺯﻡ‬ ‫ﺍ ﻻﻨﻁﺒـﺎﻕ‬ ‫ﺎ ﻨﻅﺭﹰ‬ ‫ﻤﻥ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻭﻁﻨﻴﺔ ﺃﻥ ﺘﺩﺭﻙ ﺃﻥ ﺍﻟﻔﺘﻴﺎﺕ ﺍﻟﺼﻐﻴﺭﺍﺕ ﻴﻜﻥ ﺃﻜﺜﺭ ﻋﺭﻀﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﻭﺍﻤل ﺍﻟﺒﻴﻭﻟﻭﺠﻴﺔ ﻭﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﺍﻟﺴﺎﻟﻔﺔ ﺍﻟﺫﻜﺭ ﻋﻠﻴﻬﻥ‪ ،‬ﻭﺇﻥ ﻜﻥ ﺴﻴﻌﺎﻤﻠﻥ ﻜﺒﺎﻟﻐﺎﺕ ﺒﺴﺒﺏ ﺯﻭﺍﺠﻬـﻥ‪ .‬ﻭﺘﺘﻁﻠـﺏ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒـﺸﺭﻱ‪ ،‬ﺒـﻴﻥ‬ ‫ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ل ﻤﺠﻤﻭﻋﺔ ﻤﻥ ﺍﻟﻘﻁﺎﻋﺎﺕ ﺍﻟﻤﺨﺘﻠﻔﺔ‪ .‬ﻭﻴﻜﻭﻥ ﺍﻟﻘﻁـﺎﻉ‬ ‫ﻗﺒ‬ ‫ﺎ ﻤﻥ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﻨﺎﺴﺒﺔ ﻟﻠﺴﻥ‪ ،‬ﺍﻟﻤﻘﺩﻤﺔ ﻤﻥ ِ‬ ‫ﺍﻟﺸﺒﺎﺏ‪ ،‬ﻁﻴﻔﹰ‬ ‫ﻻ ﻋﻥ ﺍﻟﻘﻴﺎﻡ ﺒﻌﺩﺩ ﻤﻥ ﻫﺫﻩ ﺍﻟﺘﺩﺨﻼﺕ‪ ،‬ﻤﻥ ﺨﻼل ﻤﺠﻤﻭﻋﺔ ﻤﻥ ﺍﻟﺸﺭﻜﺎﺀ ﻓﻲ ﺍﻟﻨﻅﺎﻡ ﺍﻟـﺼﺤﻲ‪.‬‬ ‫ﺍﻟﺼﺤﻲ ﻨﻔﺴﻪ ﻤﺴﺅﻭ ﹰ‬ ‫ﻭﻴﺘﻌﺭﺽ ﺍﻟﻘﺴﻡ ‪ ١-٤-٣‬ﻤﻥ ﻫﺫﻩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺒﺎﻟﻤﻨﺎﻗﺸﺔ ﻟﺒﻌﺽ ﻫﺫﻩ ﺍﻷﻨﺸﻁﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﻤﺭﺍﻫﻘﻴﻥ‪.‬‬ ‫ﻭﻤﻥ ﺜﻡ ﻴﺠﺏ ﺘﻘﺩﻴﻡ ﻜل ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ ﻓﻲ ﺴﻴﺎﻕ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻔﻌﺎﻟﺔ ﺍﻟﻤﻘﺩﻤـﺔ ﻟﻤﺭﻀـﻰ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ‪ ،‬ﻭﻏﻴﺭﻫﺎ ﻤﻥ ﺍﻻﺤﺘﻴﺎﺠﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻤﻘﺩﻤﺔ ﻟﻌﻤﻭﻡ ﺍﻟﺴﻜﺎﻥ‪ ،‬ﻭﺍﻟﻔﺌﺎﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ‪.‬‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

‫ﺘﻌﺯﻴﺯ ﺍﻟﺴﻠﻭﻙ ﺍﻟﺼﺤﻲ‬

‫‪١-٢-٣‬‬

‫ﺎ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺨﻼل ﺘـﻭﻓﻴﺭ ﺍﻟﻤﻌﻠﻭﻤـﺎﺕ ﺍﻟـﺼﺭﻴﺤﺔ‬ ‫‪‬ﻱ ﺍﻟﻔﻌﺎل ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﺒﺩﺃ ﻋﻤﻠﻴﺔ ﺍﻟﺘﺼﺩ‬ ‫ﻭﺍﻟﺩﻗﻴﻘﺔ ﻋﻥ ﺍﻟﻤﻤﺎﺭﺴﺔ ﺍﻟﺠﻨﺴﻴﺔ ﺍﻟﻤﺄﻤﻭﻨﺔ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ‪ ،‬ﺘﻌﺯﻴﺯ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﺎﺯل ﺍﻟﺫﻜﺭﻱ‪ ،‬ﺘـﺄﺨﻴﺭ ﺒـﺩﺀ ﺍﻟﻨـﺸﺎﻁ‬ ‫ﺍﻟﺠﻨﺴﻲ‪ ،‬ﻭﺍﻟﺘﻌﻔﻑ ﻗﺒل ﺍﻟﺯﻭﺍﺝ‪ ،‬ﻭﺍﻻﻗﺘﺼﺎﺭ ﻋﻠﻰ ﻤﻤﺎﺭﺴﺔ ﺍﻟﺠﻨﺱ ﻤﻊ ﺍﻟﺯﻭﺝ ﺃﻭ ﺍﻟﺯﻭﺠﺔ‪ ،‬ﺃﻭ ﻀﻤﻥ ﺇﻁﺎﺭ ﺍﻟﺯﻭﺍﺝ‬ ‫ﺍﻟﺸﺭﻋﻲ‪ .‬ﻭﺒﺎﻹﻀﺎﻓﺔ ﻟﻠﺘﺩﺨﻼﺕ ﺍﻟﻭﻗﺎﺌﻴﺔ‪ ،‬ﻓﻼﺒﺩ ﻤﻥ ﺘﻭﻓﻴﺭ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻟﺘـﻭﻓﻴﺭ ﺍﻟﻤﻌﺎﻟﺠـﺔ ﺍﻟﺒـﺎﻜﺭﺓ‬ ‫ﺎ‪.‬‬ ‫ﻭﺍﻟﻔﻌﺎﻟﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺇﻥ ﺍﻟﺘﻭﺍﺼل ﺒﺸﺄﻥ ﺘﻐﻴﻴﺭ ﺍﻟﺴﻠﻭﻙ‪ ،‬ﻫﻭ ﺠﺯﺀ ﻤﻥ ﻋﻤﻠﻴﺔ ﺘﻜﺎﻤﻠﻴﺔ ﻤﺘﻌﺩﺩﺓ ﺍﻟﻤﺴﺘﻭﻴﺎﺕ‪ ،‬ﺘﺘﺴﻡ ﺒﺎﻟﺘﻔﺎﻋﻠﻴﺔ ﻤﻊ‬ ‫ﺎ ﻟﻬﺫﺍ ﺍﻟﻐﺭﺽ ﺒﺎﺴـﺘﺨﺩﺍﻡ ﻤﺠﻤﻭﻋـﺔ‬ ‫ﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﻭﺘﻬﺩﻑ ﺇﻟﻰ ﺘﻁﻭﻴﺭ ﺭﺴﺎﺌل ﻭﺃﺴﺎﻟﻴﺏ ﻤﺼﻤﻤﺔ ﺨﺼﻴﺼﹰ‬ ‫ﺎ‪ ،‬ﻜﻤﺎ‬ ‫ﻤﺨﺘﻠﻔﺔ ﻤﻥ ﺍﻟﻘﻨﻭﺍﺕ‪ .‬ﻭﻴﺠﺏ ﺇﺩﻤﺎﺝ ﺍﻟﺘﻭﺍﺼل ﻟﺘﻐﻴـﻴﺭ ﺍﻟﺴﻠﻭﻙ ﻓﻲ ﺠﻬﻭﺩ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻴﺠﺏ ﺩﻤﺠﻪ ﻀﻤﻥ ﺃﻨﺸﻁﺔ ﺍﻟﺩﻋﻡ ﻭﺍﻟﺭﻋﺎﻴﺔ‪ ،‬ﻓﻬﺫﻩ ﺍﻟﻌﻤﻠﻴﺔ ﻴﻤﻜﻨﻬﺎ ﺯﻴﺎﺩﺓ ﺍﻟﻤﻌﺭﻓﺔ ﻭﺤﻔﺯ ﺍﻟﺤـﻭﺍﺭ ﻓـﻲ ﺍﻟﻤﺠﺘﻤـﻊ‪،‬‬ ‫ﻭﺘﻌﺯﻴﺯ ﺍﻟﺘﻐﻴﻴﺭ ﺍﻷﺴﺎﺴﻲ ﻓﻲ ﺍﻟﻤﻭﺍﻗﻑ‪ ،‬ﻭﺍﻟﺘﻘﻠﻴل ﻤﻥ ﺁﺜﺎﺭ ﺍﻟﻭﺼﻤﺔ ﻭﺍﻟﺘﻤﻴـﻴﺯ؛ ﻭﺨﻠﻕ ﻁﻠـﺏ ﻋﻠـﻰ ﺍﻟﻤﻌﻠﻭﻤـﺎﺕ‬ ‫ﻭﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﻤﺴﺎﻨﺩﺓ ﻋﻤﻠﻴﺔ ﻭﻀﻊ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﻷﻨﻅﻤﺔ ﻭﺍﻟﻘﻭﺍﻨﻴﻥ ﺍﻟﻤﻼﺌﻤﺔ؛ ﻭﺘﻌﺯﻴـﺯ ﺍﻟﺘـﺩﺨﻼﺕ‬ ‫ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻭﺍﻟﺭﻋﺎﻴﺔ‪ ،‬ﻭﺍﻟﺩﻋﻡ؛ ﻭﺘﺤﺴﻴﻥ ﺍﻟﻤﻬﺎﺭﺍﺕ ﺍﻟﻔﺭﺩﻴﺔ‪ ،‬ﻭﺍﺤﺘﺭﺍﻡ ﺍﻟﺫﺍﺕ )‪.(٤٥‬‬ ‫ﻭﻤﻥ ﺍﻟﻤﻬﻡ‪ ،‬ﻟﺩﻯ ﺍﻨﺘﻘﺎﺀ ﻗﻨﻭﺍﺕ ﺍﻻﺘﺼﺎل ﺍﻟﺘﻲ ﻴﺘﻡ ﻤﻥ ﺨﻼﻟﻬﺎ ﺇﻁﻼﻕ ﺍﻟﺭﺴﺎﺌل ﺍﻟﺭﺍﻤﻴﺔ ﺇﻟﻰ ﺘﻐﻴﻴﺭ ﺍﻟﺴﻠﻭﻙ‪،‬‬ ‫ﻤﻌﺭﻓﺔ ﺃﻱ ﻫﺫﻩ ﺍﻟﺭﺴﺎﺌل ﻫﻭ ﺍﻷﻗﺩﺭ ﻋﻠﻰ ﺍﻟﻭﺼﻭل ﺒﻔﻌﺎﻟﻴﺔ ﺇﻟﻰ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﺴﻜﺎﻨﻲ ﺍﻟﻤﺴﺘﻬﺩﻑ‪ .‬ﻭﻤﻥ ﺒﻴﻥ ﺍﻟﻘﻨـﻭﺍﺕ‬ ‫ﺍﻟﻨﺎﺠﺤﺔ ﻓﻲ ﺇﻴﺼﺎل ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ‪ ،‬ﺍﻟﺯﻤﻼﺀ ﺍﻟﺫﻴﻥ ﻴﻀﻁﻠﻌﻭﻥ ﺒﺎﻟﺘﺜﻘﻴﻑ ﻟﺯﻤﻼﺌﻬﻡ ﻭﻗﺎﺩﺓ ﺍﻟﺭﺃﻱ‪ ،‬ﻜﻤﺎ ﺜﺒﺘـﺕ‬ ‫ﺎ ﻓﻌﺎﻟﻴﺔ ﺍﻷﺤﺎﺩﻴﺙ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺘﻲ ﺘﺘﻡ ﻤﻥ ﺨﻼل ﺍﻟﺸﺒﻜﺎﺕ ﺍﻟﻤﺅﺴﺴﻴﺔ ﺃﻭ ﺍﻟﺘﻲ ﺘﻌﺘﻤﺩ ﻋﻠﻰ ﺍﻻﺘﺼﺎل ﻓﻲ ﻤﺎ ﺒـﻴﻥ‬ ‫ﺃﻴﻀﹰ‬ ‫ﺍﻷﻓﺭﺍﺩ‪ ،‬ﺃﻭ ﺍﻟﻤﻨﺎﻗﺸﺎﺕ ﺍﻟﺠﻤﺎﻋﻴﺔ ﺃﻭ ﺍﻟﺘﻲ ﺘﻌﺘﻤﺩ ﺍﻷﺴﻠﻭﺏ ﺍﻟﻔﺭﺩﻱ‪ ،‬ﻤﻥ ﺸﺨﺹ ﻵﺨﺭ‪ .‬ﻭﺘﻔﻴﺩ ﺍﻟﺒـﺭﺍﻤﺞ ﺍﻟﻤﺩﺭﺴـﻴﺔ‬ ‫ﺒﺤﺴﺏ ﺍﻟﺴﻥ ﻓﻲ ﺍﻟﻭﺼﻭل ﺇﻟﻰ ﺍﻟﺸﺒﺎﺏ ﺍﻟﻤﻭﺠﻭﺩﻴﻥ ﻓﻲ ﺍﻟﻤﺩﺍﺭﺱ‪ ،‬ﺃﻤﺎ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻸﺸﺨﺎﺹ ﻏﻴﺭ ﺍﻟﻤﻭﺠـﻭﺩﻴﻥ ﻓـﻲ‬ ‫ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﻤﺩﺭﺴﻲ‪ ،‬ﻓﻴﻨﺒﻐﻲ ﺘﻭﻅﻴﻑ ﻗﻨﻭﺍﺕ ﺃﺨﺭﻯ ﻟﻠﺘﻭﺍﺼل ﻤﻌﻬﻡ ﻤﺜل ﺍﻟﺘﻌﻠﻡ ﻤﻥ ﺍﻷﻗﺭﺍﻥ‪.‬‬ ‫ﺎ ﺒـﺸﻜل ﺠﻴـﺩ‪.‬‬ ‫ﺎ ﻜﺎﻨﺕ ﺍﻟﻘﻨﺎﺓ ﺍﻟﺘﻲ ﻴﺘﻡ ﺍﺨﺘﻴﺎﺭﻫﺎ‪ .‬ﻓﻤﻥ ﺍﻟﻤﻬﻡ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻠﻐﺔ ﺍﻟﺘﻲ ﺘﻜﻭﻥ ﻤﻔﻬﻭﻤﺔ ﻤﺤﻠﻴﹰ‬ ‫ﻭﺃﻴﹰ‬ ‫ﻭﻴﻨﺒﻐﻲ ﺍﻟﺘﻨﺒﻪ ﺇﻟﻰ ﻀﺭﻭﺭﺓ ﺃﻥ ﺘﺘﻤﻴﺯ ﺍﻟﺭﺴﺎﺌل ﺒﺎﻟﺤﺴﺎﺴﻴﺔ ﻟﻠﺫﻜﻭﺭﺓ ﻭﺍﻷﻨﻭﺜﺔ ﻭﻟﻠﺜﻘﺎﻓﺔ‪ ،‬ﻭﺃﻨﻬﺎ ﻻ ﺘﻘﻭﻡ ﺒﺘﻌﺯﻴـﺯ ﺃﻴـﺔ‬ ‫ﺎ‬ ‫ﺍ ﺨﺎﺼﹰ‬ ‫ﺎ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺇﻋﺩﺍﺩ ﺃﻨﺸﻁﺔ ﺍﻟﻭﻗﺎﻴﺔ ﺇﻋﺩﺍﺩﹰ‬ ‫ﺃﻋﺭﺍﻑ ﻤﻭﺠﻭﺩﺓ ﻴﻤﻜﻥ ﺃﻥ ﺘﺯﻴﺩ ﻤﻥ ﺍﻨﺘﺸﺎﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﻠﻤﺠﺘﻤﻊ ﺍﻟﺴﻜﺎﻨﻲ ﺍﻟﻤﺤﺩﺩ ﺍﻟﺫﻱ ﺘﺴﺘﻬﺩﻓﻪ ﻫﺫﻩ ﺍﻷﻨﺸﻁﺔ‪ ،‬ﻤﻊ ﺍﻷﺨﺫ ﻓﻲ ﺍﻟﺤﺴﺒﺎﻥ‪ ،‬ﺃﻭﻀﺎﻉ ﺍﻟﻨﺎﺱ‪ ،‬ﻭﻗﺎﺒﻠﻴﺘﻬﻡ ﻟﻺﺼﺎﺒﺔ‪،‬‬ ‫ﻭﺍﺤﺘﻴﺎﺠﺎﺘﻬﻡ ﺍﻟﺨﺎﺼﺔ‪.‬‬ ‫ﻭﻴﺠﺏ ﺍﺴﺘﺨﺩﺍﻡ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻤﺒﺘﻜﺭﺓ ﻟﺯﻴﺎﺩﺓ ﺍﻟﻁﻠﺏ ﻋﻠﻰ ﺨﺩﻤﺎﺕ ﺫﺍﺕ ﺠﻭﺩﺓ ﻋﺎﻟﻴﺔ ﻟﻤﻜﺎﻓﺤـﺔ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ‪ ،‬ﻤﺜل ﺍﻟﻁﺭﻕ ﺍﻟﺘﻲ ﺘﺘﻭﺠﻪ ﻨﺤﻭ ﺍﻟﺘﺴﻭﻴﻕ ﺒﺭﻓﻊ ﺍﻟﻭﻋﻲ ﻟﺩﻯ ﺍﻟﻤﺴﺘﻬﻠﻙ ﺤﻭل ﻤﺎ ﻴﻤﻜﻥ ﻟﻠﻤـﺴﺘﻬﻠﻙ ﺃﻥ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻴﺘﻭﻗﻊ ﺍﻟﺤﺼﻭل ﻋﻠﻴﻪ ﻤﻥ ﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﻤﻥ ﻤﻌﺎﻟﺠﺔ ﺼﺤﻴﺤﺔ ﻋﺎﻟﻴﺔ ﺍﻟﺠﻭﺩﺓ‪ .‬ﻭﻴﺴﺘﻨﺩ ﻫﺫﺍ ﺍﻷﺴﻠﻭﺏ ﻋﻠﻰ ﺍﻟﻘﺎﻋـﺩﺓ‬ ‫ﺍﻟﻤﻨﻁﻘﻴﺔ ﺍﻟﺘﻲ ﺘﻔﻴﺩ ﺃﻥ ﺯﻴﺎﺩﺓ ﺍﻟﻁﻠﺏ ﺘﺅﺜﺭ ﻋﻠﻰ ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟـﺼﺤﻴﺔ‪ .‬ﻭﺇﻥ ﺇﺤـﺩﺍﺙ ﺘﻭﻗﻌـﺎﺕ ﻋﺎﻟﻴـﺔ‬ ‫ﻻ ﻴﻜﻭﻥ ﺒﺎﻹﻤﻜﺎﻥ ﺘﻠﺒﻴﺘﻬﺎ ﺃﻭ ﺍﻟﻭﻓﺎﺀ ﺒﻬﺎ‪ ،‬ﻴﻤﻜﻥ ﺃﻥ ﺘﻜﻭﻥ ﻟﻪ ﺁﺜﺎﺭ ﻀﺎﺭﺓ ﺒﻬﺫﻩ ﺍﻟﻘﻀﻴﺔ‪.‬‬ ‫ﺎ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ‪ ،‬ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﻤﺸﻭﺭﺓ‬ ‫ﻭﻻﺒﺩ ﺃﻥ ﺘﻜﻭﻥ ﺍﻟﺘﻭﻋﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺤﻭل ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍ ﻻ ﻴﺘﺠﺯﺃ ﻤﻥ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻤﻘﺩﻤﺔ ﻟﻤﺭﻀﻰ‬ ‫ﻭﺍﻹﺠﺭﺍﺀ ﺍﻟﻁﻭﻋﻲ ﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪ ،‬ﺠﺯﺀﹰ‬ ‫ﺎ‪ ،‬ﺤﻴﺙ ﺇﻥ ﻫﺫﻩ ﺍﻟﻌﻤﻠﻴﺔ ﺘﻭﻟﺩ ﺍﻟﺩﺍﻓﻊ ﻟﺘﻐﻴﻴﺭ ﺍﻟﺴﻠﻭﻙ ﺍﻟﺠﻨﺴﻲ ﻟﺩﻯ ﻜـل ﻤـﻥ ﺍﻷﺸـﺨﺎﺹ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻋﻠﻰ‬ ‫ﺍﻟﻤﺼﺎﺒﻴﻥ ﻭﺍﻷﺸﺨﺎﺹ ﻏﻴﺭ ﺍﻟﻤﺼﺎﺒﻴﻥ ﻋﻠﻰ ﺤﺩ ﺴﻭﺍﺀ‪ .‬ﻜﻤﺎ ﻴﺠﺏ ﺃﻥ ﺘﺭﻜﺯ ﺍﻟﺭﺴﺎﺌل ﺍﻟﺘﺜﻘﻴﻔﻴﺔ ﻭﺍﻟﺘﻭﻋﻴﺔ ﺃﻴﻀﹰ‬ ‫ﺎ‪ ،‬ﻟﺘﺠﻨﺏ ﺘﻜﺭﺍﺭ ﺤﺩﻭﺙ‬ ‫ﻀﺭﻭﺭﺓ ﺇﺒﻼﻍ ﺍﻟﺯﻭﺝ ﻭﺨﻀﻭﻋﻪ ﻟﻠﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﺍﻟﻤﻨﺎﺴﺏ ﻤﻥ ﺃﻱ ﻋﺩﺍﻭﻯ ﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ‪.‬‬

‫ﺘﻭﻓﻴﺭ ﺍﻟﻌﺎﺯل ﺍﻟﺫﻜﺭﻱ ﻭﺍﻟﻭﺴﺎﺌل ﺍﻷﺨﺭﻯ ﺍﻟﺤﺎﺌﻠﺔ‬

‫‪٢-٢-٣‬‬

‫‪‬ﻌﺘﺒﺭ ﺍﻟﻭﺍﻗﻲ ﺍﻟﺫﻜﺭﻱ ﺍﻟﻤﺼﻨﻭﻉ ﻤﻥ ﺍﻟﻼﺘﻜﺱ ﻤﻥ ﺃﻜﺜﺭ ﺍﻷﺴﺎﻟﻴﺏ ﺍﻟﺘﻜﻨﻭﻟﻭﺠﻴﺔ ﺍﻟﻤﺘﺎﺤﺔ ﻓﻌﺎﻟﻴﺔ‪ ،‬ﻓﻲ ﺘﻘﻠﻴﺹ‬ ‫ﻴ‬ ‫ﺎ‪ .‬ﻭﺒﺎﻟﺭﻏﻡ ﻤـﻥ ﻓﻌﺎﻟﻴـﺔ ﺍﻟﻌـﺎﺯل ﺍﻷﻨﺜـﻭﻱ‬ ‫ﺍﻟﺴﺭﺍﻴﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻟﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ .‬ﻭﻴﻤﺜـل ﺍﻟﻌـﺎﺯل‬ ‫ﺍ ﻟﺘﻜﻠﻔﺘﻪ ﺍﻟﻌﺎﻟﻴﺔ ﻨﺴﺒﻴﹰ‬ ‫ﻭﻤﺄﻤﻭﻨﻴﺘﻪ‪ ،‬ﺇﻻ ﺃﻥ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻭﻁﻨﻴﺔ ﻟﻡ ﺘﻨﺘﻔﻊ ﺒﻪ ﻋﻠﻰ ﺍﻟﻭﺠﻪ ﺍﻷﻜﻤل ﻨﻅﺭﹰ‬ ‫ﺍﻟﺫﻜﺭﻱ ﻭﺍﻟﻌﺎﺯل ﺍﻷﻨﺜﻭﻱ ﻋﻨﺼﺭﻴﻥ ﺭﺌﻴﺴﻴﻴﻥ ﻤﻥ ﻋﻨﺎﺼﺭ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﻭﻗﺎﻴﺔ ﺍﻟﺸﺎﻤﻠﺔ‪ ،‬ﻭﻤﻥ ﺜﻡ ﻴﻨﺒﻐﻲ ﺇﺘﺎﺤﺘﻬﻤﺎ‬ ‫ﺎ ﺒﻤﺎ ﻓﻴﻬـﺎ‬ ‫ﺒﺼﻭﺭﺓ ﻤﺘﺴﻘﺔ ﻟﻜل ﺍﻟﻤﺤﺘﺎﺠﻴﻥ ﺇﻟﻴﻬﻡ ﺒﻐﺭﺽ ﺘﻘﻠﻴﺹ ﻤﺨﺎﻁﺭ ﺍﻟﺘﻌﺭﺽ ﺍﻟﺠﻨﺴﻲ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ )‪.(٤٦‬‬ ‫ﻭﻴﺘﻡ ﺍﻵﻥ ﺇﺠﺭﺍﺀ ﺍﺨﺘﻴﺎﺭﺍﺕ ﻟﺘﻘﻴﻴﻡ ﻓﻌﺎﻟﻴﺔ ﺍﻟﺤﺠﺎﺏ ﻟﺤﻤﺎﻴﺔ ﻋﻨﻕ ﺍﻟﺭﺤﻡ ﻤﻥ ﻓﻴـﺭﻭﺱ ﺍﻷﻴـﺩﺯ ﻭﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ ﺃﻓﻀل ﺃﺩﺍﺓ ﻟﻠﺤﻤﺎﻴﺔ ﻴﻤﻜـﻥ ﻟﻠﻤـﺭﺃﺓ‬ ‫ﺎ‪ .‬ﻭﺘﻤﺜل ﻤﺒﻴﺩﺍﺕ ﺍﻟﻤﻴﻜﺭﻭﺒﺎﺕ ﺍﻟﻤﻬﺒﻠﻴﺔ ﻭﺍﻟﺤﺠﺎﺏ ﺴﻭﻴﹰ‬ ‫ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺘﺤﻜﻡ ﻓﻴﻬﺎ‪ .‬ﻭﺤﺎﻟﻴﹰ‬ ‫ﺎ ﻫﻨﺎﻙ ﻋﺩﺩ ﻤﻥ ﻤﺒﻴﺩﺍﺕ ﺍﻟﻤﻴﻜﺭﻭﺒﺎﺕ ﻗﻴﺩ ﺍﻻﺨﺘﺒﺎﺭ )‪ .(١٣‬ﻓﺈﺫﺍ ﺃﺜﺒﺘﺕ ﺃﻱ ﻤـﻥ ﻫـﺫﻩ ﺍﻟﻭﺴـﺎﺌل‬ ‫ﺎ ﻓﻌﺎﻟﻴﺔ‪ ،‬ﻓﻼﺒﺩ ﻤﻥ ﺇﻋﺩﺍﺩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﻼﺯﻤﺔ ﻟﺘﻴﺴﻴﺭ ﺍﺴﺘﺨﺩﺍﻤﻬﺎ ﻓﻲ‬ ‫ﺍﻟﺠﺩﻴﺩﺓ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﻭﺍﻗﻊ ﺍﻟﺠﻐﺭﺍﻓﻴﺔ ﻭﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ‪.‬‬ ‫ﻭﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﺨﺎﺼﺔ ﺒﺎﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﺎﺯل ﺍﻟﺫﻜﺭﻱ ﻀﺭﻭﺭﻴﺔ ﻭﻻﺯﻤﺔ ﻟﻠﺘﺄﻜﺩ ﻤﻥ ﺘﻠﺒﻴﺔ ﺍﻻﺤﺘﻴﺎﺠﺎﺕ ﻭﺍﻟﻤﺘﻁﻠﺒﺎﺕ‬ ‫ﺍﻟﻭﻁﻨﻴﺔ ﻋﻠﻰ ﻨﺤﻭ ﻤﺴﺘﻤﺭ ﻭﻤﺘﺴﻕ‪ .‬ﻭﺒﻤﺠﺭﺩ ﺘﺄﻤﻴﻨﻬﺎ‪ ،‬ﻴﺠﺏ ﺘﻌﺯﻴﺯ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ ﻭﺘﻭﺯﻴﻌﻬﺎ ﻋﻥ ﻁﺭﻴﻕ‬ ‫ﻜﻼ ﺍﻟﻘﻁﺎﻋﻴﻥ ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﻜل ﻤﻥ ﺍﻟﻤﻭﺍﻗﻊ ﺍﻟﺴﺭﻴﺭﻴﺔ )ﺍﻹﻜﻠﻴﻨﻴﻜﻴﺔ( ﻭﻏﻴﺭ ﺍﻟﺴﺭﻴﺭﻴﺔ‪ .‬ﻭﺘﻌﺩ ﻋﻴـﺎﺩﺍﺕ‬ ‫ﺭﻋﺎﻴﺔ ﺍﻷﻤﻭﻤﺔ ﻭﺍﻟﻁﻔﻭﻟﺔ‪ ،‬ﻭﺘﻨﻅﻴﻡ ﺍﻷﺴﺭﺓ‪ ،‬ﻤﻨﺎﻓﺫ ﺠﻴﺩﺓ ﻟﺘﻭﺯﻴﻊ ﺍﻟﻌﺎﺯل ﺍﻟﺫﻜﺭﻱ‪ ،‬ﺤﻴﺙ ﺘﻜﻭﻥ ﻤﺘﺎﺤﺔ ﻟﻠﻨﺴﺎﺀ ﺍﻟﻼﺘﻲ‬ ‫ﺎ‪ .‬ﻭﻟﻘـﺩ ﺜﺒﺘـﺕ ﻓﻌﺎﻟﻴـﺔ ﺒـﺭﺍﻤﺞ ﺍﻟﺘـﺴﻭﻴﻕ‬ ‫ﻥ ﻤﻌﺭﻀﺎﺕ ﻟﻌﻭﺍﻤل ﺨﻁﺭ ﻟﻺﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻗﺩ ﻴﻜ ‪‬‬ ‫ﺍﻻﺠﺘﻤﺎﻋﻲ‪ ،‬ﺒﺸﻜل ﺨﺎﺹ‪ ،‬ﻓﻲ ﻀﻤﺎﻥ ﺘﻭﻓﻴﺭ ﺠﻭﺩﺓ ﻋﺎﻟﻴﺔ ﻤﻥ ﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ ﺫﺍﺕ ﺍﻟﻜﻠﻔﺔ ﺍﻟﻤﻌﻘﻭﻟﺔ‪ ،‬ﻓﻲ ﺍﻟﻭﻗـﺕ‬ ‫ﻭﺍﻟﻤﻜﺎﻥ ﺍﻟﺫﻱ ﺘﻁﻠﺏ ﻓﻴﻪ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﻜل ﻤﻥ ﺍﻟﻤﻨﺎﻓﺫ ﺍﻟﺘﻘﻠﻴﺩﻴﺔ ﻭﻏﻴﺭ ﺍﻟﺘﻘﻠﻴﺩﻴﺔ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺘﻜﻤﻠﺔ ﻋﻤﻠﻴـﺔ ﺘﻭﺯﻴـﻊ‬ ‫ﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ ﻋﻥ ﻁﺭﻴﻕ ﻤﺭﺍﻜﺯ ﺍﻟﺘﻭﺯﻴﻊ ﺍﻟﻤﺠﺘﻤﻌﻴﺔ ﻭﺨﺩﻤﺎﺕ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻻﺘﺼﺎل ﺒﺎﻟﺠﻤـﺎﻫﻴﺭ‪ ،‬ﻭﺫﻟـﻙ ﺇﻟـﻰ‬ ‫ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ‪.‬‬

‫ﺎ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ‬ ‫ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬

‫‪٣-٢-٣‬‬

‫ﺎ‪ ،‬ﻫﻭ ﺘﻭﻓﻴﺭ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ‬ ‫ﺇﻥ ﺍﻟﻤﺭﻤﻰ ﻤﻥ ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻟﻌﻭﺍﻗﺏ ﺍﻟﺘﻲ ﺘﺤﺩﺙ ﻋﻠﻰ ﺍﻟﻤﺩﻯ ﺍﻟﻁﻭﻴل ﻤﻥ ﺠﺭﺍﺀ ﻫﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ ،‬ﻟﺩﻯ ﺍﻷﺸﺨﺎﺹ ﺍﻟﺫﻴﻥ ﻴﻜﻭﻨﻭﻥ ﻗﺩ ﺃﺼـﻴﺒﻭﺍ‬ ‫ﺒﺎﻟﻌﺩﻭﻯ ﺒﺎﻟﻔﻌل‪ ،‬ﻭﺍﻟﺤﺩ ﻤﻥ ﺍﻨﺘﺸﺎﺭ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﺇﻟﻰ ﺍﻷﺯﻭﺍﺝ ﻏﻴﺭ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺎ‪ ،‬ﺃﻭ ﺇﻟﻰ ﺍﻟﺠﻨﻴﻥ ﺃﻭ ﺍﻟﻭﻟﻴﺩ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ‬ ‫ﺍﻟﺨﻴﺎﺭﺍﺕ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺎ ﻓﻲ ﺃﻱ ﻤﺠﺘﻤﻊ ﺴﻜﺎﻨﻲ ﻜﺎﻥ‪ ،‬ﻜﻤـﺎ ﺃﻥ ﻫﻨـﺎﻙ‬ ‫ﺴﻴﻜﻭﻥ ﻫﻨﺎﻙ ﺃﺸﺨﺎﺹ ﻤﺼﺎﺒﻭﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺃﻨﺎﺱ ﻏﻴﺭ ﻤﺼﺎﺒﻴﻥ ﺒﻬﺎ‪ .‬ﻭﺴﺘﻘﻭﻡ ﻨﺴﺒﺔ ﻤﻥ ﻜل ﻤﻥ ﻫﺎﺘﻴﻥ ﺍﻟﻤﺠﻤﻭﻋﺘﻴﻥ ﺒﺎﻟﺘﻤﺎﺱ ﺍﻟﺭﻋﺎﻴﺔ ﺴﻭﺍﺀ ﻟﻭﺠﻭﺩ ﺃﻋﺭﺍﺽ ﻗﺩ‬ ‫ﺎ‪ ،‬ﻭﺴﻭﺍﺀ ﻜﺎﻥ ﻫﺅﻻﺀ ﺍﻷﺸـﺨﺎﺹ ﻤـﺼﺎﺒﻴﻥ ﺒﺎﻟﻌـﺩﻭﻯ ﺃﻭ ﻏﻴـﺭ‬ ‫ﺘﺭﻯ ﺃﻨﻬﺎ ﺫﺍﺕ ﻋﻼﻗﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﺼﺎﺒﻴﻥ‪ ،‬ﺃﻭ ﺒﺴﺒﺏ ﻋﻠل ﺃﺨﺭﻯ ﻏﻴﺭ ﺘﻠﻙ ﺍﻷﻤﺭﺍﺽ‪ .‬ﻭﻓﻲ ﻨﻔﺱ ﺍﻟﻭﻗﺕ‪ ،‬ﺴﻴﻜﻭﻥ ﻫﻨﺎﻙ ﻋﺩﺩ ﻤﻥ ﺍﻷﺸﺨﺎﺹ‪ ،‬ﻀﻤﻥ‬ ‫ﺍﻟﻤﺠﺘﻤﻊ‪ ،‬ﻟﺩﻴﻬﻡ ﺃﻋﺭﺍﺽ ﺍﻹﺼﺎﺒﺔ ﺒﻬﺫﻩ ﺍﻟﻌﺩﻭﻯ‪ ،‬ﻭﻤﻊ ﺫﻟﻙ ﻻ ﻴﻠﺘﻤﺴﻭﻥ ﺍﻟﺭﻋﺎﻴﺔ ﻟﺴﺒﺏ ﺃﻭ ﻵﺨﺭ‪ ،‬ﻜﻤﺎ ﺴﻴﻜﻭﻥ ﻫﻨﺎﻙ‬ ‫ﻼ ﺒﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ .‬ﻭﻻﺒﺩ ﻤﻥ ﺘﺤﺩﻴﺩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ‬ ‫ﺃﻨﺎﺱ ﻻ ﺘﻅﻬﺭ ﻋﻠﻴﻬﻡ ﺃﻋﺭﺍﺽ ﺍﻹﺼﺎﺒﺔ ﻭﻴﻜﻭﻨﻭﻥ ﻤﺼﺎﺒﻴﻥ ﻓﻌ ﹰ‬ ‫ﺍﻟﻤﻨﺎﺴﺒﺔ ﻭﻭﻀﻌﻬﺎ ﻤﻭﻀﻊ ﺍﻟﺘﻨﻔﻴﺫ ﻟﻠﺘﻌﺎﻤل ﻤﻊ ﻫﺫﻩ ﺍﻟﻔﺌﺎﺕ ﺍﻟﻤﺨﺘﻠﻔﺔ ﻤﻥ ﺍﻷﺸﺨﺎﺹ ﻭﺫﻟﻙ ﻋﻠﻰ ﻤـﺴﺘﻭﻯ ﺍﻟﻤﺠﺘﻤـﻊ‬ ‫ﻭﻜﺫﻟﻙ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﻤﺭﺍﻜﺯ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫ﺎ ﻟﻤﺜل ﻫﺫﺍ ﺍﻟﺴﻴﻨﺎﺭﻴﻭ‪ ،‬ﺤﻴﺙ ﻴﻤﺜل ﺍﻟﺠﺎﻨﺏ ﺍﻷﻴﺴﺭ ﺍﻷﺸﺨﺎﺹ ﺍﻟﺫﻴﻥ ﻟﺩﻴﻬﻡ‬ ‫ﺎ ﺒﻴﺎﻨﻴﹰ‬ ‫ﻴﻘﺩﻡ ﺍﻟﺸﻜل ﺭﻗﻡ ‪ ٢‬ﺘﺨﻁﻴﻁﹰ‬ ‫ﻋﺩﻭﻯ ﺜﺎﺒﺘﺔ ﺒﻴﻨﻤﺎ ﻴﻤﺜل ﺍﻟﺠﺎﻨﺏ ﺍﻷﻴﻤﻥ ﻫﺅﻻﺀ ﺍﻷﺸﺨﺎﺹ ﻏﻴﺭ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺄﻱ ﻋﺩﻭﻯ‪ .‬ﻭﻴﻤﺜل ﺍﻟﻨﺼﻑ ﺍﻟﻌﻠﻭﻱ ﻤﻥ‬ ‫ﺎ(‪.‬‬ ‫ﺍﻟﺠﺩﻭل ﺍﻟﻤﺠﻤﻭﻋﺔ ﺍﻟﺘﻲ ﻻ ﺘﻅﻬﺭ ﻋﻠﻴﻬﺎ ﺃﻋﺭﺍﺽ )ﺴﻭﺍﺀ ﻜﺎﻥ ﺃﻭ ﻟﻡ ﻴﻜﻥ ﻟﺩﻴﻬﻡ ﻋﺩﻭﻯ ﻤﻥ ﺍﻟﻨﻤﻁ ﺍﻟﻤﻨﻘﻭل ﺠﻨﺴﻴﹰ‬ ‫ﻭﻴﻤﺜل ﺍﻟﻨﺼﻑ ﺍﻟﺴﻔﻠﻲ ﻤﻥ ﺍﻟﺠﺩﻭل ﻤﺠﻤﻭﻋﺔ ﻤﻥ ﺍﻷﺸﺨﺎﺹ ﺍﻟﺫﻴﻥ ﻻ ﺘﻅﻬﺭ ﻋﻠﻴﻬﻡ ﺃﻋﺭﺍﺽ‪ .‬ﻭﻋﻠﻰ ﺫﻟـﻙ‪ ،‬ﻓـﺈﻥ‬ ‫ﺍﻟﺭﺒﻊ ﺍﻟﻌﻠﻭﻱ ﺍﻷﻴﺴﺭ ﻤﻥ ﺍﻟﺠﺩﻭل ﻴﻤﺜل ﺍﻷﺸﺨﺎﺹ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻌﺩﻭﻯ ﻭﺘﻅﻬﺭ ﻋﻠﻴﻬﻡ ﺃﻋﺭﺍﻀﻬﺎ‪ ،‬ﺒﻴﻨﻤﺎ ﻴﻤﺜل ﺍﻟﺭﺒـﻊ‬ ‫ﺍﻟﺴﻔﻠﻲ ﺍﻷﻴﺴﺭ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻌﺩﻭﻯ ﺩﻭﻥ ﻅﻬﻭﺭ ﺃﻋﺭﺍﺽ‪ .‬ﻭﺍﻟﺘﺤﺩﻱ ﻫﻭ ﻜﻴﻑ ﻴﻤﻜﻥ ﺍﻜﺘﺸﺎﻑ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﻭﻯ ﻟﺩﻯ‬ ‫ﻫﺅﻻﺀ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺎ ﻭﻟﻜﻨﻬﻡ ﻻ ﻴﺸﻌﺭﻭﻥ ﺒﺄﻋﺭﺍﺽ‪ .‬ﻭﻴﻤﺜل ﺍﻟﺭﺒﻊ ﺍﻟﻌﻠﻭﻱ ﺍﻷﻴﻤﻥ ﻤﻥ ﺍﻟﺠﺩﻭل‪ ،‬ﺍﻷﺸﺨﺎﺹ ﻏﻴـﺭ‬ ‫ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﻭﻯ ﻭﻟﻜﻨﻬﻡ ﻴﺤﻀﺭﻭﻥ ﺇﻟﻰ ﻤﺭﺍﻓﻕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﻟﺩﻴﻬﻡ ﺃﻋﺭﺍﺽ ﺘﻭﺤﻲ ﺒﺈﺼﺎﺒﺘﻬﻡ ﺒﺎﻟﻌـﺩﻭﻯ‪.‬‬ ‫ﺎ‪ ،‬ﻭﻟﻜﻨﻬﺎ ﺘﺤﺘﺎﺝ ﺇﻟﻰ ﻤﻌﻠﻭﻤﺎﺕ ﻭﺘﻁﻤﻴﻨﺎﺕ‬ ‫ﻭﻫﺫﻩ ﺍﻟﻔﺌﺔ ﻤﻥ ﺍﻷﺸﺨﺎﺹ ﻻ ﺘﺤﺘﺎﺝ ﺇﻟﻰ ﻤﻌﺎﻟﺠﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺇﻀﺎﻓﺔ ﺇﻟﻰ ﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﻠﺔ ﺍﻟﺘﻲ ﻗﺩ ﺘﻜﻭﻥ ﻤﺴﺅﻭﻟﺔ ﻋﻥ ﺍﻷﻋﺭﺍﺽ ﺍﻟﺘﻲ ﻴﺸﻜﻭﻥ ﻤﻨﻬــﺎ‪ .‬ﻭﺒﺎﻟﻨﺴﺒـﺔ ﻟـﻬﺫﻩ ﺍﻟﻔﺌـﺔ‬ ‫ﻓﺈﻥ ﺍﻟﺘﺤﺩﻱ ﻫﻭ ﻜﻴﻑ ﻴﻤﻜﻥ ﺍﺴﺘﺒﻌـﺎﺩ ﺍﻹﺼﺎﺒــﺔ ﺒﺎﻟﻌﺩﻭﻯ‪ .‬ﻭﻴﺼﻭﺭ ﺍﻟﺭﺒـﻊ ﺍﻟﺴﻔﻠﻲ ﺍﻷﻴﻤﻥ ﺍﻷﺸـﺨﺎﺹ ﻏﻴـﺭ‬ ‫ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﻭﻯ ﻭﻻ ﻴﺸﻜﻭﻥ ﻤﻥ ﺃﻴﺔ ﺃﻋﺭﺍﺽ‪ ،‬ﻭﻫﺫﻩ ﺍﻟﻔﺌﺔ ﻤﻥ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﺴﻜﺎﻨﻲ ﻫﻲ ﻓﺌﺔ ﺘﺘﻤﺘﻊ ﺒﺎﻟﺼﺤﺔ ﻭﺘﺤﺘﺎﺝ‬ ‫ﺇﻟﻰ ﻤﻌﻠﻭﻤﺎﺕ ﻭﻤﻌﺭﻓﺔ ﻟﻴﻅﻠﻭﺍ ﺨﺎﻟﻴﻥ ﻤﻥ ﺃﻴﺔ ﻋﺩﻭﻯ‪ ،‬ﺴﻭﺍﺀ ﺩﺍﺨل ﺍﻟﻤﺠﺘﻤﻊ‪ ،‬ﺃﻭ ﺇﺫﺍ ﺤﻀﺭﻭﺍ ﺇﻟﻰ ﺃﻱ ﻤﺭﻜﺯ ﺼﺤﻲ‪.‬‬ ‫ﺎ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ‪ ،‬ﻤﻭﻀﺤﺔ‬ ‫ﻭﺍﻟﺨﻴﺎﺭﺍﺕ ﻭﺍﻟﺴﻠﻊ ﺍﻟﻼﺯﻤﺔ ﻟﺘﻘﺩﻴﻡ ﺒﺭﻨﺎﻤﺞ ﺸﺎﻤل ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻀﻤﻥ ﺍﻟﻤﻨﺎﻗﺸﺔ ﺍﻟﻭﺍﺭﺩﺓ ﺃﺩﻨﺎﻩ‪ ،‬ﻤﻊ ﺍﻷﺨﺫ ﺒﻌﻴﻥ ﺍﻻﻋﺘﺒﺎﺭ ﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺍﻟﺴﺭﺍﻴﺔ ﻭﺍﻟﻔﺌﺎﺕ ﺍﻟﻤﺨﺘﻠﻔﺔ ﻟﻸﺸـﺨﺎﺹ ﺍﻟـﺫﻴﻥ‬ ‫ﻴﺯﻭﺭﻭﻥ ﻤﺭﺍﻓﻕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫ﺎ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻔﻌﺎﻟﺔ‪ ،‬ﻭﺍﻟﻤﻘﺒﻭﻟـﺔ ﻭﺍﻟﺘـﻲ ﻴﻤﻜـﻥ‬ ‫ﻭﻴﻨﺒﻐﻲ ﺃﻥ ﺘﻌﺯﺯ ﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻟﻠﻭﻗﺎﻴـﺔ ﻤـﻥ‬ ‫ﺍﻟﻭﺼﻭل ﺇﻟﻴﻬﺎ ﻭﺘﻘﻭﻡ ﺒﺘﻘﺩﻴﻡ ﺘﺩﺒﻴﺭ ﻋﻼﺠﻲ ﺸﺎﻤل ﻟﻸﺸﺨﺎﺹ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺤﺩﻭﺙ ﻤﺯﻴﺩ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ‪ .‬ﻭﻜﺫﻟﻙ ﻤﻥ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﺍﻟﻜﺜﻴﺭﺓ ﻭﺍﻟﻌﻭﺍﻗﺏ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﻬﺫﻩ ﺍﻟﺤﺎﻻﺕ ﻭﺍﻟﺘﻲ ﺘﺤﺩﺙ ﻋﻠﻰ‬ ‫ﺍﻟﻤﺩﻯ ﺍﻟﻁﻭﻴل‪ .‬ﻭﻓﻴﻤﺎ ﻴﻠﻲ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﻤﻜﻭﻨﺔ ﻟﺒﺭﻨﺎﻤﺞ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﺍﻟﺸﺎﻤل ﻟﻠﻤﺭﻀـﻰ ﺍﻟﻤـﺼﺎﺒﻴﻥ ﺒﺎﻟﻌـﺩﺍﻭﻯ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ )‪:(٤٨ ،٤٧‬‬ ‫ ﺘﺤﺩﻴﺩ ﺍﻟﺘﺸﺨﻴﺹ ﺍﻟﺼﺤﻴﺢ ﻤﻥ ﺨﻼل ﺍﻟﺘﺸﺨﻴﺹ ﻭﻓﻕ ﺍﻟﻤﺘﻼﺯﻤﺎﺕ ﺃﻭ ﺍﻟﺘﺸﺨﻴﺹ ﺍﻟﻤﺨﺘﺒﺭﻱ؛‬‫ ﺘﻘﺩﻴﻡ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻔﻌﺎﻟﺔ؛‬‫ ﺨﻔﺽ ﺃﻭ ﻤﻨﻊ ﺤﺩﻭﺙ ﺍﻟﻤﺯﻴﺩ ﻤﻥ ﺴﻠﻭﻙ ﺍﻟﻤﺨﺎﻁﺭﺓ ﻤﻥ ﺨﻼل ﺃﻨﺸﻁﺔ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺼﺤﻲ؛‬‫ ﺘﺸﺠﻴﻊ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﺎﺯل ﺍﻟﺫﻜﺭﻱ ﻭﺘﻭﺯﻴﻌﻪ؛‬‫‪ -‬ﺍﻟﺘﺄﻜﺩ ﻤﻥ ﺃﻥ ﺍﻷﺯﻭﺍﺝ ﻗﺩ ﺘﻡ ﺇﺒﻼﻏﻬﻡ ﻭﻤﻌﺎﻟﺠﺘﻬﻡ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻭﻋـﺩﺍﻭﻯ ﺍﻟﺠﻬـﺎﺯ‬ ‫ﺍﻟﺸﻜل ﺭﻗﻡ ‪ -٢‬ﺘﻤﺜﻴل ﺩﻴﻨﺎﻤﻴﻜﻲ ﻟﻸﻋﺭﺍﺽ ﺍﻟﺴﺭﻴﺭﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴ ﹰ‬ ‫ﺍﻹﻨﺠﺎﺒﻲ ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﻁﻠﻭﺒﺔ‬ ‫ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﺴﻜﺎﻨﻲ ﺍﻟﻌﺎﻡ‬ ‫ﺃﺸﺨﺎﺹ ﻤﺼﺎﺒﻭﻥ ﺒﻌﺩﺍﻭﻯ ﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ‬ ‫ﺠﻨﺴﻴ ﹰ‬ ‫ﻤﺼﺎﺒﻭﻥ ﻭﻟﺩﻴﻬﻡ ﺃﻋﺭﺍﺽ‬ ‫ﻻ ﻴﻠﺘﻤﺴﻭﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﻅﻬﻭﺭ ﺃﻋﺭﺍﺽ‬ ‫ﺍﻟﻤﻌﺎﻟﺠﺔ ﻀﺭﻭﺭﻴﺔ‬ ‫ﺘﺩﺒﻴﺭ ﻋﻼﺠﻲ ﻤﻭﺤﺩ ﻟﻠﺤﺎﻻﺕ‬ ‫ﺘﺜﻘﻴﻑ ﻭﺘﻭﻋﻴﺔ ﺼﺤﻴﺔ ﻟﺯﻴﺎﺩﺓ ﺍﻟﻭﻋﻲ‬ ‫ﺤﻭل ﺃﻋﺭﺍﺽ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ‪/‬ﻋﺩﺍﻭﻯ ﺍﻟﺠﻬﺎﺯ ﺍﻟﺘﻨﺎﺴﻠﻲ‬ ‫ﺠﻨﺴﻴ ﹰ‬ ‫ﻭﺘﺤﺴﻴﻥ ﺴﻠﻭﻙ ﺍﻟﺘﻤﺎﺱ ﺍﻟﺭﻋﺎﻴﺔ‬ ‫ﺍﻟﺼﺤﻴﺔ‬ ‫ﺭﺴﺎﺌل ﻭﻗﺎﺌﻴﺔ ﺤﻭل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ ﺒﻤﺎ ﻓﻴﻬﺎ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ‬ ‫ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻟﺒﺸﺭﻱ‬ ‫ﻤﺼﺎﺒﻭﻥ ﻭﻻ ﺘﻅﻬﺭ ﻟﺩﻴﻬﻡ ﺃﻋﺭﺍﺽ‬ ‫ﻻ ﻴﻠﺘﻤﺴﻭﻥ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ‬ ‫ﻋﺩﻡ ﻅﻬﻭﺭ ﺃﻋﺭﺍﺽ‬ ‫ﺯﻴﺎﺩﺓ ﺍﻟﻭﻋﻲ ﻭﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺼﺤﻲ ﺤﻭل‬ ‫ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻭﺍﻟﻨﻅﺎﻓﺔ ﺍﻟﺸﺨﺼﻴﺔ‬ ‫ﺃﺸﺨﺎﺹ ﻏﻴﺭ ﻤﺼﺎﺒﻴﻥ ﺒﻌﺩﺍﻭﻯ ﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ‬ ‫ﺠﻨﺴﻴ ﹰ‬ ‫ﻏﻴﺭ ﻤﺼﺎﺒﻴﻥ ﻭﻟﻜﻥ ﻟﺩﻴﻬﻡ ﺃﻋﺭﺍﺽ‬ ‫ﻻ ﻴﻠﺘﻤﺴﻭﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﻅﻬﻭﺭ ﺃﻋﺭﺍﺽ‬ ‫ﺘﺠﻨﺏ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻏﻴﺭ ﺍﻟﻀﺭﻭﺭﻴﺔ‬

‫ﻴﻠﺘﻤﺴﻭﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ‬

‫ﺘﺩﺨﻼﺕ‬

‫ﺍﻷﻋﺭﺍﺽ ﺍﻟﺴﺭﻴﺭﻴﺔ‬

‫ﺭﺴﺎﺌل ﻭﻗﺎﺌﻴﺔ ﺤﻭل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ ﺒﻤﺎ ﻓﻴﻬﺎ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ‬ ‫ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻟﺒﺸﺭﻱ‬ ‫ﻏﻴﺭ ﻤﺼﺎﺒﻴﻥ ﻭﻻ ﺘﻅﻬﺭ ﻟﺩﻴﻬﻡ ﺃﻋﺭﺍﺽ‬ ‫ﻻ ﻴﻠﺘﻤﺴﻭﻥ ﺍﻟﺭﻋﺎﻴﺔ‬ ‫ﻋﺩﻡ ﻅﻬﻭﺭ ﺃﻋﺭﺍﺽ‬

‫ﻴﺤﻀﺭﻭﻥ ﻟﻤﺭﺍﻓﻕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ ﺃﻭ ﻋﺩﺍﻭﻯ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟـﺼﺤﻴﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ـﺭﻯ ﺍﻟﺠﻬﺎﺯ ﺍﻟﺘﻨﺎﺴﻠﻲ‬ ‫ـﺒﺎﺏ ﺃﺨـ‬ ‫ﻷﺴـ‬ ‫ﻏﻴﺭ‬

‫ﺍﻟﻤﻌﺎﻟﺠﺔ ﻀﺭﻭﺭﻴﺔ‬ ‫ﻜﺸﻑ ﻭﺘﺤﺭﻱ ﺍﻟﺤﺎﻻﺕ‪ ،‬ﺩﻤﺞ‬ ‫ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﺍﻟﺴﺭﻴﻌﺔ‬ ‫ﺎ‪ ،‬ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻟﻅﻨﻴﺔ ﺍﻟﺩﻭﺭﻴﺔ‬ ‫ﺤﻤﻼﺕ ﻟﺯﻴﺎﺩﺓ ﺍﻟﻭﻋﻲ‬ ‫ﺭﺴﺎﺌل ﻭﻗﺎﺌﻴﺔ ﺤﻭل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ ﺒﻤﺎ ﻓﻴﻬﺎ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ‬ ‫ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻟﺒﺸﺭﻱ‬

‫ﻋﺩﻡ ﺍﻟﺤﺎﺠﺔ ﻟﻠﻤﻌﺎﻟﺠﺔ‬

‫ﺘﺩﺨﻼﺕ‬

‫ﺯﻴﺎﺩﺓ ﺍﻟﻭﻋﻲ ﻭﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺼﺤﻲ ﺤﻭل‬ ‫ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻭﺍﻟﻨﻅﺎﻓﺔ ﺍﻟﺸﺨﺼﻴﺔ‬ ‫ﺭﺴﺎﺌل ﻭﻗﺎﺌﻴﺔ ﺤﻭل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ ﺒﻤﺎ ﻓﻴﻬﺎ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ‬ ‫ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻟﺒﺸﺭﻱ‬

‫ﻭﻤﺘﻰ ﻤﺎ ﺘﻡ ﺘﺸﺨﻴﺹ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﻭﻯ ﺃﻭ ﺍﻟﺸﻙ ﻓﻲ ﺤﺩﻭﺜﻬﺎ‪ ،‬ﻓﻴﺠﺏ ﺍﻹﺴﺭﺍﻉ ﻓﻲ ﺘﻘﺩﻴﻡ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻔﻌﺎﻟﺔ‬ ‫ﺎ ﻟﺘﺠﻨﺏ ﺤﺩﻭﺙ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﻭﻟﻜﺴﺭ ﺴﻠﺴﻠﺔ ﺍﻨﺘﺸﺎﺭ ﺍﻟﻤﺭﺽ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺃﻥ ﻴﺘﻠﻘـﻰ ﺍﻟﻌﻤﻴـل‬ ‫ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻭﺘﻭﻋﻴﺔ ﺼﺤﻴﺔ ﺤﻭل ﺍﻻﻟﺘﺯﺍﻡ ﺒﺎﻟﻤﻌﺎﻟﺠﺔ‪ ،‬ﻭﻜﺫﻟﻙ ﺘﻭﻓﻴﺭ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟـﻸﺯﻭﺍﺝ ﻭﺇﺒﻼﻏﻬـﻡ ﺒﺎﻟﻌـﺩﺍﻭﻯ‬ ‫ﺘﺜﻘﻴﻔﹰ‬ ‫ﺎ‪ ،‬ﻭﺘﻘﻠﻴل ﻋﻭﺍﻤل ﺍﻻﺨﺘﻁﺎﺭ‪ ،‬ﻭﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﺎﺯل‪ .‬ﻜﻤﺎ ﻴﺠﺏ ﺇﺤﺎﻟﺔ ﺍﻟﻤﺭﻴﺽ ﻟﻌﻼﺝ ﺍﻟﻤـﻀﺎﻋﻔﺎﺕ ﺃﻭ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﻭﺍﻗﺏ ﺍﻟﻤﻭﺠﻭﺩﺓ‪ ،‬ﻋﻨﺩﻤﺎ ﺘﻘﺘﻀﻲ ﺍﻟﺤﺎﺠﺔ‪.‬‬ ‫‪35‬‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ‬ ‫ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻤﺘﻼﺯﻤﺎﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺎ‪ ،‬ﺇﻤﺎ ﻋﻥ ﻁﺭﻴﻕ ﺍﻟﻤﻅﻬـﺭ‬ ‫ﻴﺘﻡ‪ ،‬ﻋﻠﻰ ﻨﺤﻭ ﺘﻘﻠﻴﺩﻱ‪ ،‬ﺘﺸﺨﻴﺹ ﺃﻱ ﺤﺎﻟﺔ ﻤﻥ ﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻏﻴﺭ ﺩﻗﻴﻕ( ﺃﻭ ﺒﻭﺍﺴﻁﺔ ﺍﺨﺘﺒﺎﺭ ﻴﺠﺭﻯ ﻓﻲ ﺍﻟﻤﺨﺘﺒﺭ‪ ،‬ﻭﺍﻟـﺫﻱ ﻴﻤﻜـﻥ ﺃﻥ‬ ‫ﺍﻟﺴﺭﻴﺭﻱ ﻭﺤﺩﻩ )ﻭﺍﻟﺫﻱ ﻤﺎ ﻴﻜﻭﻥ ﻏﺎﻟﺒﹰ‬ ‫ﺘﻜﺘﻨﻔﻪ ﺘﻌﻘﻴﺩﺍﺕ ﺃﻭ ﺃﻥ ﻴﻜﻭﻥ ﻤﻜﻠﻔﺎ‬ ‫ﺍ‬ ‫ﹰ‪ ،‬ﻭﺒﺼﻔﺔ ﻋﺎﻤﺔ ﻴﺅﺨﺭ ﺍﻟﻤﻌﺎﻟﺠﺔ‪ ،‬ﻓﻲ ﺍﻨﺘﻅﺎﺭ ﻅﻬﻭﺭ ﺍﻟﻨﺘﺎﺌﺞ‪ .‬ﻭﺤﺘﻰ ﻟﻭ ﻜﺎﻥ ﺃﻤﺭﹰ‬ ‫ﹰ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻓﻲ ﺍﻷﻤـﺎﻜﻥ‬ ‫ﺎ ﻤﺤﺩﻭﺩﺍ‬ ‫ﹰ‪ ،‬ﻓﺈﻥ ﺘﻭﻓﺭ ﺍﻟﺘﺸﺨﻴﺹ ﺍﻟﻤﺭﺘﻜﺯ ﻋﻠﻰ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﻤﺨﺘﺒﺭﻴﺔ ﻴﻜﻭﻥ ﻏﺎﻟﺒﹰ‬ ‫ﻤﺭﻏﻭﺒﺎ‬ ‫ﺍ ﻟﻠﺘﻜﺎﻟﻴﻑ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻻﺴﺘﻤﺭﺍﺭ ﻋﻤل ﺍﻟﻤﺨﺘﺒﺭ ﻭﺍﻹﻤﺩﺍﺩ ﺍﻟﻤﺴﺘﻤﺭ‬ ‫ﺍﻟﺘﻲ ﺘﻌﺎﻨﻲ ﻤﻥ ﻤﺼﺎﻋﺏ ﻓﻲ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﻭﺫﻟﻙ ﻨﻅﺭﹰ‬ ‫ﻭﺍﻟﻤﻨﺴﻕ ﻟﻠﻤﻭﺍﺩ ﺍﻟﻤﺨﺘﺒﺭﻴﺔ ﺍﻟﻼﺯﻤﺔ ﻟﻼﺨﺘﺒﺎﺭ‪ ،‬ﺇﻀﺎﻓﺔ ﺇﻟﻰ ﻀﻤﺎﻥ ﻤﺭﺍﻗﺒﺔ ﺍﻟﺠﻭﺩﺓ‪ .‬ﻟﻬﺫﻩ ﺍﻷﺴـﺒﺎﺏ‪ ،‬ﻓـﺈﻥ ﻤﻨﻅﻤـﺔ‬ ‫ﺎ ﻟﺩﻯ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ ﺘﺒـﺩﻭ‬ ‫ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺘﻭﺼﻲ ﺒﺈﺠﺭﺍﺀ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻤﺘﻼﺯﻤﺎﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﺩﻴﻬﻡ ﻋﻼﻤﺎﺕ ﻭﺃﻋﺭﺍﺽ ﻤﺴﺘﻤﺭﺓ ﻭﻤﺘﺴﻘﺔ ﻴﺘﻡ ﺇﻴﻀﺎﺤﻬﺎ ﻓﻲ ﻤﺨﻁﻁ ﻤﺠﺭﺒﺎﺕ ﺒﺴﻴﻁ ﻴﻤﻜﻥ ﺍﺴﺘﺨﺩﺍﻤﻪ ﻋﻠﻰ ﻤﺴﺘﻭﻯ‬ ‫ﻋﻴﺎﺩﺍﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‪١.‬‬ ‫ﻭﻴﺭﺘﻜﺯ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻤﺘﻼﺯﻤﺎﺕ ﻋﻠﻰ ﺍﺴﺘﻌﺭﺍﻑ ﻤﺘﻼﺯﻤﺔ ﻤﺎ‪ ،‬ﺃﻱ ﻤﺠﻤﻭﻋﺔ ﺃﻋﺭﺍﺽ ﻭﻋﻼﻤﺎﺕ ﻴـﺘﻡ‬ ‫ﺍ‪ .‬ﻭﺘﻭﺠﻪ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﺨﺎﺼﺔ ﺒﻜل ﻤﺘﻼﺯﻤﺔ ﻨﺤـﻭ‬ ‫‪‬ﻤﺭﻀﺎﺕ‪ ،‬ﻴﻜﻭﻥ ﻗﺩ ﺘﻡ ﺘﺤﺩﻴﺩﻫﺎ ﺠﻴﺩﹰ‬ ‫ﺇﺩﺭﺍﻜﻬﺎ ﺒﺴﻬﻭﻟﺔ ﻤﻊ ﻭﺠﻭﺩ ﻤ‬ ‫‪‬ﻤﺭﻀﺎﺕ ﺍﻟﻤﺴﺒﺒﺔ ﻟﻠﻤﺭﺽ ﺍﻟﻤﺴﺅﻭﻟﺔ ﻋﻥ ﺤﺩﻭﺙ ﻫﺫﻩ ﺍﻟﻤﺘﻼﺯﻤﺔ ﺩﺍﺨل ﺫﻟﻙ ﺍﻟﻤﻭﻗﻊ ﺍﻟﺠﻐﺭﺍﻓﻲ‪ .‬ﻭﻟﻘﺩ ﻅﻬﺭ‬ ‫ﻏﺎﻟﺒﻴﺔ ﺍﻟﻤ‬ ‫ﺃﻥ ﻟﻬﺫﺍ ﺍﻷﺴﻠﻭﺏ ﺍﻟﻤﺘﻼﺯﻤﻲ ﻓﻌﺎﻟﻴﺔ ﻋﺎﻟﻴﺔ ﻓﻲ ﻋﻼﺝ ﺍﻟﺘﻬﺎﺏ ﺍﻹﺤﻠﻴل ﻭﺍﻟﺘﻬﺎﺏ ﺍﻟﺒﺭﺒﺦ‪ ،‬ﻟﺩﻯ ﺍﻟﺭﺠﺎل‪ ،‬ﻭﺍﻟﻘﺭﺤـﺎﺕ‬ ‫ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﻟﺩﻯ ﻜل ﻤﻥ ﺍﻟﺭﺠﺎل ﻭﺍﻟﻨﺴﺎﺀ‪ ،‬ﻜﻤﺎ ﺃﻨﻪ ﻴﻔﻴﺩ ﻓﻲ ﻋﻼﺝ ﺍﻷﻁﻔﺎل ﺍﻟﻤـﺼﺎﺒﻴﻥ ﺒﺎﻟﺭﻤـﺩ ﺍﻟﻭﻟﻴـﺩﻱ‪ .‬ﻭﻴﺠـﺏ‬ ‫ﻤﻼﺤﻅﺔ ﺃﻥ ﻤﺘﻼﺯﻤﺔ ﺍﻹﻓﺭﺍﺯﺍﺕ ﺍﻟﻤﻬﺒﻠﻴﺔ ﻟﻴﺴﺕ ﻨﻭﻋﻴﺔ‪ ،‬ﻜﻤﺎ ﺃﻨﻬﺎ ﻻ ﺘﻌﻁﻲ ﺤﺴﺎﺴﻴﺔ ﺘﺴﺎﻋﺩ ﻓﻲ ﺍﻟـﺘﻜﻬﻥ ﺒﻭﺠـﻭﺩ‬ ‫ﺍﻟﻤﻜﻭﺭﺍﺕ ﺍﻟﺒﻨﻴﺔ‪ ،‬ﺃﻭ ﺍﻟﻤﺘﺩﺜﺭﺍﺕ ﺃﻭ ﺃﻱ ﻋﺩﺍﻭﻯ ﺃﺨﺭﻯ ﻤﻥ ﺘﻠﻙ ﺍﻟﺘﻲ ﺘـﺼﻴﺏ ﻋﻨـﻕ ﺍﻟـﺭﺤﻡ‪ .‬ﺇﻻ ﺃﻨـﻪ ﺇﺫﺍ ﻜـﺎﻥ‬ ‫ﺍﻟﻬﺩﻑ ﺍﻟﻤﺒﺩﺌﻲ ﻫﻭ ﻤﻌﺎﻟﺠﺔ ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﻤﻬﺒﻠﻲ‪ ،‬ﺍﻟﻤﻌﺯﻭ‪ ،‬ﻋﻠﻰ ﺴﺒﻴل ﺍﻟﻤﺜﺎل‪ ،‬ﺇﻟﻰ ﺍﻻﻟﺘﻬـﺎﺏ ﺍﻟﻤﻬﺒﻠـﻲ ﺍﻟﺠﺭﺜـﻭﻤﻲ‬ ‫ﻻ ﻟﻘـﺎﺀ ﺍﻟﺘﻜـﺎﻟﻴﻑ ﻓـﻲ ﻜﺎﻓـﺔ‬ ‫ﺍ ﻭﻴﺼﺒﺢ ﻓﻌـﺎ ﹰ‬ ‫ﺃﻭ ﺇﻟﻰ ﺍﻟﻤﺸﻌﺭﺓ ﺍﻟﻤﻬﺒﻠﻴﺔ‪ ،‬ﻓﻴﻜﻭﻥ ﺍﻷﺴﻠﻭﺏ ﺍﻟﺫﻱ ﺘﻡ ﺍﻷﺨﺫ ﺒﻪ ﻤﻔﻴﺩﹰ‬ ‫ﺍﻷﻤﺎﻜﻥ )‪.(٥٠ ،٤٩‬‬ ‫ﺎ ﺩﻭﻥ ﻅﻬﻭﺭ ﺃﻋﺭﺍﺽ ﺩﺍﻟﺔ ﻋﻠﻴﻬﺎ‪ ،‬ﻭﻫﺫﺍ ﺍﻷﻤﺭ ﻫﻭ ﻤﻥ ﺍﻷﻤـﻭﺭ‬ ‫ﺎ ﻤﺎ ﺘﺤﺩﺙ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻏﺎﻟﺒﹰ‬ ‫ﺍﻟﺸﺎﺌﻌﺔ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ‪ ،‬ﻭﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻟﻭﺠﻭﺩ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻤﺨﺘﻠﻔﺔ ﻟﻠﻜﺸﻑ ﻋﻥ ﻫـﺫﻩ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﺘـﻲ ﻻ‬ ‫ﺎ ﺒﻜـﺸﻑ ﺃﻭ‬ ‫ﺘﺘﺭﺍﻓﻕ ﺒﺄﻋﺭﺍﺽ ﻭﺍﻟﻘﻴﺎﻡ ﺒﺎﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻬﺎ‪ .‬ﻭﻴﺠﺏ ﺃﻥ ﺘﻜﻭﻥ ﺒﻌﺽ ﻫﺫﻩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻤﺨﺘـﺼﹰ‬ ‫ﺎ ﻟﻬـﻡ‬ ‫ﺘﺤﺭﻱ ﻫﺫﻩ ﺍﻟﺤﺎﻻﺕ‪ ،‬ﻤﻊ ﻭﺠﻭﺩ ﺘﺩﺨﻼﺕ ﻟﻠﻭﺼﻭل ﺇﻟﻰ ﺍﻷﺯﻭﺍﺝ ﻟﺘﻭﻓﻴﺭ ﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺎ‪،‬‬ ‫ﻭﺯﻴﺎﺩﺓ ﺍﻟﻤﻌﺎﺭﻑ ﻭﺍﻟﺘﻭﻋﻴﺔ ﺒﺎﻟﻤﺨﺎﻁﺭ ﺍﻟﻔﺭﺩﻴﺔ‪ .‬ﻭﺘﺸﻴﺭ ﻋﻤﻠﻴﺔ ﻜﺸﻑ ﺍﻟﺤﺎﻻﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺇﻟﻰ ﺇﺠﺭﺍﺀ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﻟﺩﻯ ﺍﻷﺸﺨﺎﺹ ﻤﻠﺘﻤﺴﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻷﺴﺒﺎﺏ ﻏﻴﺭ ﺘﻠﻙ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻹﺼﺎﺒﺔ ﺒﻌـﺩﺍﻭﻯ‬ ‫ﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ .‬ﻭﻤﻥ ﺒﻴﻥ ﺍﻟﺘﻁﺒﻴﻘﺎﺕ ﺍﻟﺒﺎﻟﻐﺔ ﺍﻷﻫﻤﻴﺔ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ ﺒﻜﺸﻑ ﺍﻟﺤﻘﺎﺌﻕ‪ ،‬ﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ‬ ‫ﺎ ﻓﻲ ﻋﻴﺎﺩﺓ ﺭﻋﺎﻴﺔ ﺍﻟﺤﻤل ﻭﻀﻤﻥ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﺼﺤﺔ ﺍﻷﻤﻭﻤﺔ ﻭﺍﻟﻁﻔﻭﻟﺔ ﻭﺘﻨﻅﻴﻡ ﺍﻷﺴﺭﺓ‪ .‬ﻭﻤـﻥ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻷﻤﺜﻠﺔ ﺍﻟﺸﺎﺌﻌﺔ ﻓﻲ ﻜﺸﻑ ﺍﻟﺤﻘﺎﺌﻕ‪ ،‬ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺭﻭﺘﻴﻨﻴﺔ ﺍﻟﺘﻲ ﺘﺠﺭﻯ ﻟﻠﺤﻭﺍﻤل ﺒﺸﺄﻥ ﺘﺤـﺭﻱ ﻭﺠـﻭﺩ ﻤـﺭﺽ‬ ‫ﺍﻟﺯﻫﺭﻱ ﻓﻲ ﻋﻴﺎﺩﺍﺕ ﺭﻋﺎﻴﺔ ﺍﻟﺤﻭﺍﻤل ﻭﻭﺤﺩﺍﺕ ﺭﻋﺎﻴﺔ ﺼﺤﺔ ﺍﻷﻤﻭﻤﺔ‪.‬‬ ‫ﻭﺘﺸﻴﺭ ﻋﻤﻠﻴﺔ ﺍﻟﺘﺤﺭﻱ ﺇﻟﻰ ﺍﺨﺘﺒﺎﺭ ﻫﺅﻻﺀ ﺍﻷﺸﺨﺎﺹ ﺍﻟﺫﻴﻥ ﻻ ﻴﻘﻭﻤﻭﻥ ﺒﺎﻻﻟﺘﻤـﺎﺱ ﺍﻟﻤﺒﺎﺸـﺭ ﻟﻠﺭﻋﺎﻴـﺔ‬ ‫ﺍﻟﺼﺤﻴﺔ‪ .‬ﻓﻌﻠﻰ ﺴﺒﻴل ﺍﻟﻤﺜﺎل‪ ،‬ﻓﺈﻥ ﺍﺨﺘﺒﺎﺭ ﺍﻟﻤﺘﺒﺭﻋﻴﻥ ﺒﺎﻟﺩﻡ ﻟﻠﻜﺸﻑ ﻋﻥ ﺍﻹﺼﺎﺒﺔ ﺒـﺎﻟﺯﻫﺭﻱ‪ ،‬ﻭﻓﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﺒﺎﻻﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩﻱ ﺍﻟﺒﺎﺌﻲ‪ ،‬ﻫﻭ ﺃﺤﺩ ﺍﻟﺘﻁﺒﻴﻘﺎﺕ ﺍﻟﻬﺎﻤﺔ ﻟﻌﻤﻠﻴﺔ ﺍﻟﺘﺤﺭﻱ‪ .‬ﻜـﺫﻟﻙ ﻓـﺈﻥ ﺍﻟﺘﺤـﺭﻱ‬ ‫‪ ١‬ﻟﻘﺩ ﻭﻀﻌﺕ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺒﺭﻭﺘﻭﻜﻭﻻﺕ ﻟﺴﺒﻊ ﻤﺘﻼﺯﻤﺎﺕ ﻫﻲ‪ :‬ﺍﻹﻓﺭﺍﺯﺍﺕ ﺍﻟﻤﻬﺒﻠﻴﺔ‪ ،‬ﺍﻹﻓـﺭﺍﺯﺍﺕ ﺍﻹﺤﻠﻴﻠﻴـﺔ‪،‬‬ ‫ﺍﻟﻘﺭﺤﺔ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ‪ ،‬ﺁﻻﻡ ﺃﺴﻔل ﺍﻟﺒﻁﻥ‪ ،‬ﺍﻟﻭﺭﻡ ﺍﻟﺼﻔﻨﻲ‪ ،‬ﺍﻟﺩﺒل ﺍﻹﺭﺒﻲ‪ ،‬ﻭﺍﻟﺘﻬﺎﺏ ﺍﻟﻤﻠﺘﺤﻤﺔ ﺍﻟﻭﻟﻴﺩﻱ )‪.(٤٧‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻻ ﻭﻴﺘﻡ ﻤﻊ ﻤﺭﺍﻋﺎﺓ ﺍﻟﺴﺭﻴﺔ ﺍﻟﻭﺍﺠﺒﺔ ﻭﺤﻘﻭﻕ ﺍﻹﻨﺴﺎﻥ ﺍﻟﻤﺭﻋﻴﺔ‪ ،‬ﻴﻤﻜﻥ‬ ‫ﺎ ﻭﻤﻘﺒﻭ ﹰ‬ ‫ﺎ ﻭﻤﺠﺩﻴﹰ‬ ‫ﺍﻟﻤﺠﺘﻤﻌﻲ‪ ،‬ﻋﻨﺩﻤﺎ ﻴﻜﻭﻥ ﻤﻤﻜﻨﹰ‬ ‫ﺎ ﻭﻤﻌﺎﻟﺠﺔ ﺍﻷﺸـﺨﺎﺹ‬ ‫ﺃﻥ ﻴﻜﻭﻥ ﺒﻤﺜﺎﺒﺔ ﻭﺴﻴﻠﺔ ﻓﻌﺎﻟﺔ ﻟﻠﻜﺸﻑ ﻋﻥ ﺍﻟﺤﺎﻻﺕ ﻏﻴﺭ ﺍﻟﻌﺭﻀﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺎ‪ .‬ﻭﺇﻥ ﺍﺴﺘﻬﺩﺍﻑ ﻫﺅﻻﺀ ﺍﻷﺸﺨﺎﺹ ﺍﻟﺫﻴﻥ ﻴﺘﻌﺭﻀﻭﻥ ﻟﻌﻭﺍﻤل ﺍﺨﺘﻁﺎﺭ ﻋﺎﻟﻴﺔ‪ ،‬ﺒﻌﻤﻠﻴﺔ ﺍﻟﺘﺤـﺭﻱ‪ ،‬ﻤـﻥ‬ ‫ﺸﺄﻨﻪ ﺃﻥ ﻴﺤﺴﻥ ﻤﻥ ﺍﻟﻔﻌﺎﻟﻴﺔ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ ﻟﺒﺭﺍﻤﺞ ﺍﻟﺘﺤﺭﻱ‪.‬‬ ‫ﻭﺒﻴﻨﻤﺎ ﺘﺘﻁﻠﺏ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﻜﺸﻑ ﻭﺘﺤﺭﻱ ﺍﻟﺤﺎﻻﺕ‪ ،‬ﺇﺠﺭﺍﺀﺍﺕ ﺃﻜﺜﺭ ﻤﻥ ﺍﻟﺘﻁـﻭﻴﺭ ﺍﻟـﺴﺭﻴﻊ‬ ‫ﺎ‪ ،‬ﻓﺈﻨﻬﺎ ﺴـﺘﻜﻭﻥ ﺃﻜﺜـﺭ ﺠـﺩﻭﻯ ﻋﻨـﺩﻤﺎ ﺘـﺼﺒﺢ ﻤﺜـل ﻫـﺫﻩ‬ ‫ﻟﻼﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﻤﺘﺎﺤﺔ ﻭﻤﺘﻭﻓﺭﺓ‪ .‬ﻭﻓﻲ ﺠﻤﻴﻊ ﺍﻷﺤﻭﺍل‪ ،‬ﻴﺠﺏ ﺘﻭﺠﻴﻪ ﺍﻻﻨﺘﺒﺎﻩ ﺍﻟﺘﺎﻡ ﻟﻸﻤﻭﺭ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﺴﺭﻴﺔ ﻭﺍﻟﺘﻭﻋﻴـﺔ‬ ‫ﻭﺍﻟﻤﻌﺎﻟﺠﺔ )‪.(٥١‬‬

‫ﺎ‬ ‫ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺈﺒﻼﻍ ﺍﻟﺯﻭﺝ ﺒﺈﻤﻜﺎﻨﻴﺔ ﺍﻟﺘﻌﺭﺽ ﻟﻺﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺍ ﻻ ﻴﺘﺠﺯﺃ ﻤﻥ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﺤﺎﻻﺕ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺇﻥ ﺇﺒﻼﻍ ﺍﻟﺯﻭﺝ‪ ،‬ﻭﺍﻟﺘﻲ ﺘﻌﺩ ﺠﺯﺀﹰ‬ ‫ﺎ‪ ،‬ﻫﻲ ﻋﻤﻠﻴﺔ ﻴﺘﻡ ﻤﻥ ﺨﻼﻟﻬﺎ ﺇﺒﻼﻍ ﺍﻷﺯﻭﺍﺝ ﻟﻠﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ ﺘﺸﺨﺹ ﺤﺎﻻﺘﻬﻡ ﺒﺎﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﺒﺈﻤﻜﺎﻨﻴﺔ ﺘﻌﺭﻀﻬﻡ ﻟﻠﻌﺩﻭﻯ‪ ،‬ﻭﺫﻟﻙ ﺒﻐﺭﺽ ﺠﻌﻠﻬﻡ ﻴﺴﺘﻔﻴﺩﻭﻥ ﻤﻥ ﺨﺩﻤﺎﺕ ﺍﻟﺘﺤﺭﻱ ﻭﺍﻟﻤﻌﺎﻟﺠـﺔ‪ .‬ﻭﺘﻬـﺩﻑ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪.‬‬ ‫ﻋﻤﻠﻴﺔ ﺇﺒﻼﻍ ﺍﻷﺯﻭﺍﺝ ﺇﻟﻰ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﻤﻌﺎﻭﺩﺓ ﺇﺼﺎﺒﺔ ﺍﻟﺤﺎﻟﺔ ﺍﻟﺩﺍﻟﺔ ﻭﺍﻟﺘﻘﻠﻴل ﻤﻥ ﺍﻨﺘﺸﺎﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻭﻫﻨﺎﻙ ﺜﻼﺜﺔ ﺃﺴﺎﻟﻴﺏ ﻴﺘﻡ ﺍﺴﺘﺨﺩﺍﻤﻬﺎ ﻹﺒﻼﻍ ﺍﻟﺯﻭﺝ‪:‬‬ ‫ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﺸﺨﺹ ﺍﻟﻨﺎﻗل ﻟﻠﻌﺩﻭﻯ ﻷﻁﺭﺍﻑ ﺜﺎﻟﺜﺔ )ﻋﺎﺩﺓ ﻤﺎ ﻴﻜﻭﻥ ﺃﺤﺩ ﺍﻟﻌﺎﻤﻠﻴﻥ ﻓﻲ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴـﺔ‬ ‫ﺍﻟﺼﺤﻴﺔ( ﻹﺒﻼﻍ ﺍﻷﺯﻭﺍﺝ؛‬ ‫ﺘﺘﻡ ﺇﺤﺎﻟﺔ ﺍﻟﻤﺭﻴﺽ ﻋﻨﺩﻤﺎ ﻴﻘﻭﻡ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺩﺍﻟﻭﻥ ﺒﺈﺒﻼﻍ ﺃﺯﻭﺍﺠﻬﻡ‪ ،‬ﺃﻭ ﻋﻨﺩ ﺇﻤﺩﺍﺩ ﺍﻟﻤﺭﻀﻰ ﺒﺎﻷﺩﻭﻴﺔ‬ ‫ﻟﺘﺴﻠﻴﻤﻬﺎ ﻟﻸﺯﻭﺍﺝ )‪(٥٢‬؛‬ ‫ﺘﺘﻡ ﺇﺤﺎﻟﺔ ﺍﻟﺸﺨﺹ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺇﻟﻴﻪ ﺍﻟﻌﺩﻭﻯ ﻋﻨﺩﻤﺎ ﻴﻭﺍﻓﻕ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺩﺍﻟﻭﻥ ﻋﻠﻰ ﺇﺒﻼﻍ ﺃﺯﻭﺍﺠﻬﻡ‪ ،‬ﻤـﻊ‬ ‫ﺇﺩﺭﺍﻙ ﺃﻥ ﺍﻟﻘﺎﺌﻤﻴﻥ ﻋﻠﻰ ﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺴﻭﻑ ﻴﺨﻁﺭﻭﻥ ﺃﻭﻟﺌﻙ ﺍﻷﺯﻭﺍﺝ ﺍﻟﺫﻴﻥ ﻻ ﻴﺘﻘـﺩﻤﻭﻥ‬ ‫ﻟﻠﺨﻀﻭﻉ ﻟﻠﻤﻌﺎﻟﺠﺔ ﺨﻼل ﻓﺘﺭﺓ ﺯﻤﻨﻴﺔ ﻤﻌﻴﻨﺔ‪.‬‬ ‫•‬ ‫•‬ ‫•‬

‫ﻭﺇﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻭﺒﺎﺌﻴﺔ )ﻤﻌﺎﻟﺠﺔ ﻨﻔﺱ ﺍﻟﻜﺎﺌﻨﺎﺕ ﺍﻟﻤﻤﺭﻀﺔ ﺃﻭ ﻨﻔﺱ ﺍﻟﻤﺘﻼﺯﻤﺔ ﺍﻟﻤﻭﺠﻭﺩﺓ ﻟﺩﻯ ﺍﻟﺤﺎﻟﺔ ﺍﻟﺩﺍﻟـﺔ(‬ ‫ﹸﻌﻁﻰ ﻟﺠﻤﻴﻊ ﺍﻷﺯﻭﺍﺝ ﺍﻟﺫﻴﻥ ﻜﺎﻥ ﻟﻬﻡ ﺍﺘﺼﺎل ﺠﻨﺴﻲ ﻗﺭﻴﺏ ﻤﻊ ﺍﻟﺸﺨﺹ ﺍﻟﻤﺼﺎﺏ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻌـﺭﻭﻑ ﺃﻥ‬ ‫ﻻﺒﺩ ﻭﺃﻥ ﺘ‬ ‫ﹰ‪ ،‬ﺤﻴﺙ ﺇﻨﻪ ﻴﻘﺩﻡ‬ ‫ﺎ‪ ،‬ﻟﻜﻨﻪ ﻤﻬﻡ ﺠﺩﺍ‬ ‫ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﺯﻭﺝ ﻫﻭ ﺃﺤﺩ ﺃﺼﻌﺏ ﻋﻨﺎﺼﺭ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻓﺭﺼﺔ ﻫﺎﻤﺔ ﻻﺴﺘﻌﺭﺍﻑ ﺍﻷﺸﺨﺎﺹ ﺍﻟﺫﻴﻥ ﻟﺩﻴﻬﻡ ﺇﺼﺎﺒﺎﺕ ﻻ ﺘﺘﺭﺍﻓﻕ ﺒﺄﻋﺭﺍﺽ‪ ،‬ﻭﻤﻥ ﺜﻡ ﻤﻌﺎﻟﺠﺘﻬﻡ‪ ،‬ﻭﺒﺼﻔﺔ ﺨﺎﺼﺔ‬ ‫ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ ﻓﻲ ﻤﺭﺤﻠﺔ ﺍﻹﺼﺎﺒﺔ ﺍﻟﻤﺒﻜﺭﺓ ﻭﻗﺒﻴل ﺤﺩﻭﺙ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﺍﻟﻤﺭﻀﻴﺔ ﻟﺩﻴﻬﻥ‪ .‬ﻭﻤﻊ ﺫﻟﻙ‪ ،‬ﻓـﻼ ﻴﺠـﺏ ﺃﻥ‬ ‫ﺘﻜﻭﻥ ﻤﻌﺎﻟﺠﺔ ﺍﻟﺯﻭﺝ ﻗﺴﺭﻴﺔ‪ ،‬ﻭﻻﺒﺩ ﻤﻥ ﺍﻟﺘﺄﻜﺩ ﻤﻥ ﻤﺭﺍﻋﺎﺓ ﺠﻭﺍﻨﺏ ﺍﻟﺴﺭﻴﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺤﺎﻟﺔ ﺍﻟﻤﺭﻴﺽ ﻭﻜـﺫﻟﻙ ﺃﺨـﺫ‬ ‫ﻤﺴﺄﻟﺔ ﺍﻟﺫﻜﻭﺭﺓ ﻭﺍﻷﻨﻭﺜﺔ ﻓﻲ ﺍﻟﺤﺴﺒﺎﻥ‪ ،‬ﻤﻊ ﺍﻹﺩﺭﺍﻙ ﺒﺄﻥ ﺘﺄﺜﻴﺭﺍﺕ ﻫﺫﻩ ﺍﻷﻤﻭﺭ ﺒﺎﻟﻨﺴﺒﺔ ﻟـﻸﺯﻭﺍﺝ ﺘﺨﺘﻠـﻑ ﺤـﺴﺏ‬ ‫ﺍﻟﺫﻜﻭﺭﺓ ﻭﺍﻷﻨﻭﺜﺔ ﻭﺍﻷﻋﺭﺍﻑ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﺍﻟﺴﺎﺌﺩﺓ‪.‬‬ ‫ﹸﻬﺞ ﺍﻟﺜﻼﺜـﺔ ﺃﻭ ﺍﺨﺘﻴـﺎﺭ‬ ‫ﻭﻟﻴﺱ ﻫﻨﺎﻙ ﻤﻥ ﺒﻴﻨﺔ ﺃﻭ ﺒﺭﻫﺎﻥ ﻗﻭﻱ ﺃﻭ ﻤﺘﺴﻕ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻟﺘﺄﺜﻴﺭﺍﺕ ﺍﻟﻨﺴﺒﻴﺔ ﻟﻠـﻨ‬ ‫ﺍﻟﻤﺭﻴﺽ ﻓﻲ ﻤﺎ ﺒﻴﻥ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ‪ .‬ﻭﺘﺴﺘﻠﺯﻡ ﺇﺤﺎﻻﺕ ﺍﻟﻤﺭﻀﻰ ﺘﻜﻠﻔﺔ ﺨﺩﻤﺎﺕ ﺃﻗل ﻭﻴﻤﻜﻥ ﺃﻥ ﺘﻜﻭﻥ ﺃﻜﺜﺭ ﻓﻌﺎﻟﻴـﺔ‬ ‫ﻓﻲ ﻅل ﻭﺠﻭﺩ ﺃﻨﺸﻁﺔ ﺘﺜﻘﻴﻑ ﻭﺘﻭﻋﻴﺔ ﻤﻼﺌﻤﺔ )‪ .(٥٣‬ﻭﻫﻨﺎﻙ ﺤﺎﺠﺔ ﺇﻟﻰ ﻤﺯﻴﺩ ﻤﻥ ﺍﻟﺒﺤﻭﺙ ﺍﻟﻤﻴﺩﺍﻨﻴﺔ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻓﻲ‬ ‫ﹸﻬﺞ ﺍﻟﻤﺨﺘﻠﻔﺔ ﻹﺒﻼﻍ ﺍﻷﺯﻭﺍﺝ‪ ،‬ﻭﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﻤﻘﺒﻭﻟﻴﺔ ﺫﻟﻙ‪ ،‬ﻭﻋـﺩﺩ ﺍﻷﺯﻭﺍﺝ ﺍﻟـﺫﻴﻥ‬ ‫ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻨﺎﻤﻴﺔ‪ ،‬ﻭﺫﻟﻙ ﻟﺘﻘﻴﻴﻡ ﺍﻟﻨ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻴﺘﻘﺩﻤﻭﻥ ﻟﻠﺨﻀﻭﻉ ﻟﻠﻔﺤﺹ ﺍﻟﻁﺒﻲ‪ ،‬ﻭﺘﺄﺜﻴﺭ ﺫﻟﻙ ﻋﻠﻰ ﻤﻌﺩﻻﺕ ﻤﻌﺎﻭﺩﺓ ﺇﺼﺎﺒﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺩﺍﻟﻴﻥ ﻭﻭﻗﻭﻉ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ ﻜﺎﻨﺕ ﺍﻟﻁﺭﻴﻘﺔ ﺍﻟﺘﻲ ﺘﺘﺒﻊ ﻓﻲ ﺇﺒﻼﻍ ﺍﻷﺯﻭﺍﺝ‪ ،‬ﻓـﺈﻥ ﺍﻟﺘﻜـﺎﻟﻴﻑ ﻭﺍﻟـﻀﺭﺭ‬ ‫ﺎ‪ .‬ﻋﻼﻭﺓ ﻋﻠﻰ ﺫﻟﻙ‪ ،‬ﻭﺃﻴﹰ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺤﺘﻤل ﺍﻟﻤﺘﻌﻠﻕ ﺒﺎﻟﻌﻤﻠﻴﺔ‪ ،‬ﻫﻤﺎ ﻓﻲ ﺤﺎﺠﺔ ﺇﻟﻰ ﺍﻟﺭﺼﺩ ﻭﺍﻟﺘﻭﺜﻴﻕ‪.‬‬

‫ﺇﺘﺎﺤﺔ ﺍﻷﺩﻭﻴﺔ ﻭﺍﻟﺘﻜﻨﻭﻟﻭﺠﻴﺎﺕ ﺍﻟﻤﻼﺌﻤﺔ‬

‫‪٤-٢-٣‬‬

‫ﺎ‬ ‫ﺍﻷﺩﻭﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺍ ﻏﺎﻴﺔ ﻓﻲ ﺍﻷﻫﻤﻴﺔ ﻟﻨﺠﺎﺡ ﺒﺭﻨﺎﻤﺞ‬ ‫ﺎ ﺃﻤﺭﹰ‬ ‫ﻴﻌﺩ ﺍﻟﺘﻭﻓﻴﺭ ﺍﻟﻤﺴﺘﻤﺭ ﻟﻸﺩﻭﻴﺔ ﺍﻟﻤﻼﺌﻤﺔ ﻟﻌﻼﺝ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻴﻜﺴﺭ ﺴﻠﺴﻠﺔ ﺍﻻﻨﺘـﺸﺎﺭ‬ ‫ﺎ‪ .‬ﻭﺇﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﺴﺭﻴﻌﺔ ﻭﺍﻟﻔﻌﺎﻟﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻴﻘﻲ ﻤﻥ ﺤﺩﻭﺙ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﻭﺍﻟﻌﻭﺍﻗﺏ ﺍﻟﺘﻲ ﺘﺘﻁﻭﺭ ﻋﻠﻰ ﺍﻟﻤﺩﻯ ﺍﻟﺒﻌﻴﺩ‪ .‬ﻭﺇﻥ ﻤﻌﻅﻡ ﺍﻷﺩﻭﻴـﺔ ﺍﻟﻤـﺴﺘﺨﺩﻤﺔ ﻓـﻲ‬ ‫ﻼ ﺃﻤـﺎﻡ ﺘﻭﻓﺭﻫـﺎ‪.‬‬ ‫ﺎ ﻫﻲ ﺃﺩﻭﻴﺔ ﻏﻴﺭ ﻤﻜﻠﻔﺔ‪ ،‬ﻜﻤﺎ ﺃﻥ ﺍﻟﺘﻜﺎﻟﻴﻑ ﻴﺠﺏ ﺃﻻ ﺘﻤﺜل ﺤـﺎﺌ ﹰ‬ ‫ﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻫﻨﺎﻙ ﺒﻌﺽ ﺍﻟﻤﺴﺘﺤﻀﺭﺍﺕ ﺍﻟﺠﺩﻴﺩﺓ ﻭﺍﻟﻤﺤﺴﻨﺔ‪ ،‬ﺍﻟﻤﺭﺘﻔﻌﺔ ﺍﻟﺜﻤﻥ ﺍﻟﺘﻲ ﺘﺘﻁﻠﺏ ﺁﻟﻴﺎﺕ ﺘﺄﻤﻴﻥ ﻤﻌﻴﻨـﺔ ﻟﺠﻌﻠﻬـﺎ ﻓـﻲ‬ ‫ﻤﺘﻨﺎﻭل ﺍﻟﺤﻜﻭﻤﺎﺕ ﻭﺍﻟﻌﻤﻼﺀ‪ .‬ﻭﻗﺩ ﺘﺸﻤل ﺍﻟﻌﻭﺍﻤل ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺠﻌل ﻫﺫﻩ ﺍﻟﻤﺴﺘﺤﻀﺭﺍﺕ ﻓﻲ ﺍﻟﻤﺘﻨﺎﻭل‪ ،‬ﻤﻼﻤﺢ ﻭﻁﻨﻴـﺔ‬ ‫ﻭﺇﻗﻠﻴﻤﻴﺔ ﻭﺩﻭﻟﻴﺔ ﻤﺜل ﺒﺭﺍﺀﺍﺕ ﺍﻻﺨﺘﺭﺍﻉ‪ ،‬ﻭﺍﻟﺤﺠﻡ ﺍﻟﻤﺤﺩﻭﺩ ﻭﺍﻟﻤﻨﺎﻓﺴﺔ ﺍﻟﻤﺤﺩﻭﺩﺓ‪ ،‬ﻭﺍﻟﺭﺴﻭﻡ ﺍﻟﺠﻤﺭﻜﻴﺔ ﺍﻟﺘﻲ ﺘﻔـﺭﺽ‬ ‫ﻋﻠﻰ ﺍﻷﺼﻨﺎﻑ ﺍﻟﻤﺴﺘﻭﺭﺩﺓ‪ ،‬ﻭﺍﻟﻀﺭﺍﺌﺏ ﺍﻟﻤﺤﻠﻴﺔ‪ ،‬ﻭﺭﻓﻊ ﺍﻷﺴﻌﺎﺭ ﻋﻠﻰ ﻤﺒﻴﻌﺎﺕ ﺍﻟﺠﻤﻠﺔ ﻭﺍﻟﺘﻭﺯﻴﻊ ﻭﺍﻟﺼﺭﻑ‪.‬‬ ‫ﺎ ﻭﻤﻌﺘـﺩل‬ ‫ﺎ ﻫﻭ ﺫﻟﻙ ﺍﻟﺩﻭﺍﺀ ﺍﻟﺫﻱ ﻴﻜﻭﻥ ﻨﺎﺠﻌـﹰ‬ ‫ﺎ ﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻟﺩﻭﺍﺀ ﺍﻟﺫﻱ ﻴﻜﻭﻥ ﻤﻼﺌﻤﹰ‬ ‫‪‬ﺔ‪ ،‬ﻭﻻ ﻴﻭﺍﺠﻪ ﻤﻘﺎﻭﻤﺔ ﺍﻟﻤﻴﻜﺭﻭﺒﺎﺕ ﻟﻪ‪ ،‬ﻭﺍﻟﺫﻱ ﻴﺅﺨﺫ ﻋﻥ ﻁﺭﻴﻕ ﺍﻟﻔﻡ‪ ،‬ﻭﻴﻔﻀل ﺃﻥ ﻴﺅﺨﺫ ﻜﺠﺭﻋﺔ ﻭﺍﺤﺩﺓ‪ ،‬ﻭﺃﻻ‬ ‫ﺍﻟﺴﻤﻴ‬ ‫ﺎ ﺍﺴﺘﻌﻤﺎﻟﻪ ﺃﺜﻨﺎﺀ ﺍﻟﺤﻤل ﺃﻭ ﺍﻹﺭﻀﺎﻉ‪ .‬ﻭﻗﺩ ﻴﻨﺘﺞ ﻋﻥ ﻭﻀﻊ ﺴﻴﺎﺴﺔ ﺩﻭﺍﺌﻴـﺔ ﺫﺍﺕ ﻤـﺴﺘﻭﻴـﻴﻥ ﻴـﺘﻡ‬ ‫ﻴﻜﻭﻥ ﻤﻤﻨﻭﻋﹰ‬ ‫ﺒﻤﻘﺘﻀﺎﻫﺎ ﺘﻭﻓﻴﺭ ﺃﺩﻭﻴﺔ ﺃﻗل ﻓﺎﻋﻠﻴﺔ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﻤﺭﺍﻜﺯ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻓﻲ ﺍﻟﻤﻨﺎﻁﻕ ﺍﻟﻨﺎﺌﻴﺔ‪ ،‬ﻭﺠﻌـل ﺍﻷﺩﻭﻴـﺔ‬ ‫ﺍﻷﻜﺜﺭ ﻓﺎﻋﻠﻴﺔ )ﻭﺍﻟﺘﻲ ﺘﻜﻭﻥ ﻋﺎﺩﺓ ﻤﺭﺘﻔﻌﺔ ﺍﻟﺘﻜﻠﻔﺔ( ﻤﺘﻭﻓﺭﺓ ﻓﻘﻁ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻤﺭﺠﻌﻲ‪ ،‬ﻗﺩ ﻴﻨﺘﺞ ﻋﻥ ﺫﻟﻙ ﻤﻌـﺩل‬ ‫ﻏﻴﺭ ﻤﻘﺒﻭل ﻤﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻔﺎﺸﻠﺔ‪ ،‬ﻭﺤﺩﻭﺙ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﻭﺤﺩﻭﺙ ﻤﻘﺎﻭﻤﺔ ﻤﻴﻜﺭﻭﺒﻴﺔ ﺴﺭﻴﻌﺔ ﻟﻸﺩﻭﻴﺔ‪ ،‬ﻭﺘﺂﻜل ﻟﻠﺜﻘـﺔ‬ ‫ﻓﻲ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫ﻭﻟﻜﻲ ﻴﻤﻜﻥ ﻟﻠﺒﻠﺩﺍﻥ ﺍﻟﺘﺄﻜﺩ ﻤﻥ ﺍﺴﺘﻤﺭﺍﺭ ﺍﻹﻤﺩﺍﺩ ﺒﺎﻷﺩﻭﻴﺔ ﺍﻟﻤﺄﻤﻭﻨﺔ ﻭﺍﻟﻔﻌﺎﻟﺔ ﻟﻤﻌﺎﻟﺠـﺔ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ‪ ،‬ﻓﻼﺒﺩ ﻤﻥ ﻭﺠﻭﺩ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻟﻠﻤـﺸﺘﺭﻴﺎﺕ ﺍﻟﻤـﻀﻤﻭﻨﺔ ﺍﻻﺴـﺘﻤﺭﺍﺭ ﻭﺍﻟﺘـﻲ ﻴﻤﻜـﻥ ﺃﻥ ﺘـﻀﻤﻥ ﺘـﻭﻓﺭ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻋﻠﻰ ﺍﻷﻗل‪ .‬ﻭﻗﺩ ﺘﻡ ﺍﻟﺘﻌﺭﺽ ﺒﺎﻟﻤﻨﺎﻗﺸﺔ ﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺘﺄﻤﻴﻥ ﺍﻷﺩﻭﻴﺔ ﻓﻲ ﺍﻟﻘﺴﻡ‬ ‫ﻤﺨﺯﻭﻥ ﺇﻀﺎﻓﻲ ﻜﺎﻑ ﻟﺴﺘﻴﻥ ﻴﻭﻤﹰ‬ ‫‪ ٦-٥-٣‬ﻤﻥ ﻫﺫﻩ ﺍﻟﻭﺜﻴﻘﺔ‪.‬‬

‫ﺎ‬ ‫ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺎ ﻴﺤﺩﺙ ﻓﻲ ﺍﻟﻌﺎﻟﻡ ﺍﻟﻨﺎﻤﻲ‪ ،‬ﺤﻴﺙ ﺘﻜـﻭﻥ‬ ‫ﺇﻥ ﺤﻭﺍﻟﻰ ‪ ٪٩٠–٨٠‬ﻤﻥ ﺍﻟﻌﺏﺀ ﺍﻟﻌﺎﻟﻤﻲ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺇﺘﺎﺤﺔ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﻟﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ ﻤﺤﺩﻭﺩﺓ ﺃﻭ ﻤﻨﻌﺩﻤﺔ‪ .‬ﻭﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻟﺘﻁﻭﻴﺭ ﺍﺨﺘﺒـﺎﺭﺍﺕ ﺘﺸﺨﻴـﺼﻴﺔ‬ ‫ﺴﺭﻴﻌﺔ ﻟﻬﺫﻩ ﺍﻷﻨﻭﺍﻉ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﻟﺘﺤﺴﻴﻥ ﺠﻭﺩﺓ ﺍﻟﺭﻋﺎﻴﺔ ﻭﺍﻟﺘﺸﺨﻴﺹ ﻟﻠﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺎ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﺍﻟﻤﻭﺍﻗﻊ‬ ‫ﻭﺍﻷﻤﺎﻜﻥ ﺫﺍﺕ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﺤﺩﻭﺩﺓ‪ .‬ﻭﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻋﺎﺠﻠﺔ ﻟﻭﺠﻭﺩ ﺍﺨﺘﺒﺎﺭﺍﺕ ﺘﺸﺨﻴﺼﻴﺔ ﻤﺤﺴﻨﺔ ﻟﺤـﺎﻻﺕ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ‬ ‫ﺎ ﻭﺍﻟﻤﻨﺎﻁﻕ ﺍﻟﻤﻭﻁﻭﻨﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺤﻴﺙ ﺘﻜﻭﻥ ﺒﻌﺽ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻟﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪.‬‬ ‫ﻼ ﻫﺎﻤﹰ‬ ‫ﻋﺎﻤ ﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﻠﻘﺎﺤﺎﺕ‬ ‫ﺒﺎﻟﻨﻅﺭ ﺇﻟﻰ ﺃﻥ ﻭﻗﺎﻴﺔ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻌﺎﻟﻴﺔ ﺍﻻﺨﺘﻁﺎﺭ ﺘﻤﺜل‪ ،‬ﺒﺼﻔﺔ ﻋﺎﻤﺔ‪ ،‬ﻁﺭﻴﻘﺔ ﻓﺎﻋﻠـﺔ ﻟﻤﻜﺎﻓﺤـﺔ‬ ‫ﺎ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ‪ ،‬ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ‬ ‫ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻌﺩﻴﺔ‪ ،‬ﻓﺈﻥ ﺍﻟﺒﺤﺙ ﻋﻥ ﻟﻘﺎﺤﺎﺕ ﻓﺎﻋﻠﺔ ﻤﻀﺎﺩﺓ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍ‪ .‬ﻭﺴﻭﻑ ﻴﻜﻭﻥ ﺘﻭﻓﺭ ﺍﻟﻠﻘﺎﺤﺎﺕ ﺍﻟﻤﻀﺎﺩﺓ ﻟﻬﺫﻩ ﺍﻟﻌﺩﻭﻯ ﺒﻤﺜﺎﺒﺔ ﺇﻀﺎﻓﺔ‬ ‫ﺩ ﻤﻬﻤﺔ ﻤﻠﺤﺔ ﺠﺩﹰ‬ ‫ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻴﻌ ‪‬‬ ‫ﺎ ﻀـﺩ‬ ‫ﺎ ﻭﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻤﻥ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ‪ .‬ﻭﻻ ﻴﻭﺠﺩ ﺃﻱ ﻟﻘﺎﺡ ﻓﻌﺎل ﺤﺎﻟﻴـﹰ‬ ‫ﻫﺎﻤﺔ ﻟﻠﺘﻜﻨﻭﻟﻭﺠﻴﺎﺕ ﺍﻟﻤﻭﺠﻭﺩﺓ ﺤﺎﻟﻴﹰ‬ ‫ﺎ‪ ،‬ﺴﻭﻯ ﻟﻘﺎﺡ ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩﻱ "ﺏ"‪.‬‬ ‫ﺍﻟﻜﺎﺌﻨﺎﺕ ﺍﻟﻤﻤﺭﻀﺔ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍ ﻋﻤـﺎ‬ ‫ﻭﺴﻭﻑ ﻴﺼﺒﺢ ﺍﻟﻠﻘﺎﺡ ﺍﻟﻭﺍﻗﻲ ﺍﻟﻤﻀﺎﺩ ﻷﻨﻭﺍﻉ ﺍﻟﻔﻴﺭﻭﺴﺎﺕ ﺍﻟﻤﺴﺒﺒﺔ ﻟﻸﻭﺭﺍﻡ ﺍﻟﺤﻠﻴﻤﻴﺔ ﺍﻟﺒﺸﺭﻴﺔ‪ ،‬ﻤﺘﻭﻓﺭﹰ‬ ‫ﺍ ﻭﺜﺒﺕ ﻤﻥ ﺨﻼﻟﻬﺎ ﺘﻁﻭﻴﺭ ﻟﻘﺎﺡ ﻓﻌﺎل ﻭﻤـﺅﺜﺭ ﻟﻠﻭﻗﺎﻴـﺔ ﻤـﻥ‬ ‫ﻗﺭﻴﺏ‪ ،‬ﻭﺫﻟﻙ ﺤﺴﺏ ﻤﺎ ﺃﻅﻬﺭﺘﻪ ﺘﺠﺭﺒﺔ ﺘﻤﺕ ﻤﺅﺨﺭﹰ‬ ‫ﺤﺩﻭﺙ ﻭﺍﺴﺘﻤﺭﺍﺭ ﻋﺩﺍﻭﻯ ﻋﻨﻕ ﺍﻟﺭﺤﻡ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ – ﺍﻟﻨﻤﻁ ‪ ١٦‬ﻭﺍﻟﻨﻤﻁ ‪ .(٣٥) ١٨‬ﻭﻟﻘﺩ ﺘﻡ ﺇﺠـﺭﺍﺀ‬ ‫ﻤﻨﺎﻗﺸﺎﺕ ﺘﺤﺕ ﺭﻋﺎﻴﺔ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻟﺘﺤﺩﻴﺩ ﺍﻟﺘﺭﺘﻴﺒﺎﺕ ﺍﻟﻤﻼﺌﻤﺔ ﻟﻠﻭﺼﻭل ﺇﻟﻰ ﻨﻘﻁﺔ ﺍﻟﻨﻬﺎﻴـﺔ ﺍﻟﺨﺎﺼـﺔ‬ ‫ﺒﻠﻘﺎﺤﺎﺕ ﻓﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﺘﻭﻟﻴﺩ ﺍﻻﻫﺘﻤﺎﻡ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻘﻁﺭﻱ ﻭﺇﺩﺭﺍﻙ ﺤﻘﻴﻘـﺔ ﺃﻥ ﺍﻟﻌـﺩﻭﻯ‬ ‫ﺒﻔﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﺘﻤﺜل ﻤﺸﻜﻠﺔ ﺨﺎﺼﺔ ﺒﺎﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ‪ .‬ﻭﺘﺸﺠﻊ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺍﻟﺒﻠﺩﺍﻥ‬ ‫ﻋﻠﻰ ﺩﺭﺍﺴﺔ ﻓﻭﺍﺌﺩ ﺇﺩﺨﺎل ﻫﺫﻩ ﺍﻟﻠﻘﺎﺤﺎﺕ ﻓﻲ ﺒﺭﺍﻤﺠﻬﺎ‪ ،‬ﻭﺍﺴﺘﻁﻼﻉ ﻤﺩﻯ ﺠﺩﻭﺍﻫﺎ ﻭﻤﻘﺒﻭﻟﻴﺘﻬﺎ ﻋﻨﺩﻤﺎ ﻴﺘﻌﻠـﻕ ﺍﻷﻤـﺭ‬ ‫ﺒﺘﻁﺒﻴﻕ ﻤﺜل ﻫﺫﻩ ﺍﻟﺒﺭﺍﻤﺞ )‪.(٣٤‬‬ ‫ﺎ ﺒﺎﻟﻤﻘﺎﺭﻨـﺔ ﻤـﻊ‬ ‫ﻟﻘﺩ ﺃﻅﻬﺭﺕ ﺍﻟﺘﺠﺎﺭﺏ ﺍﻟﺴﺭﻴﺭﻴﺔ ﺃﻥ ﺍﻟﻠﻘﺎﺡ ﺍﻟﻤﻀﺎﺩ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ ﻜﺎﻥ ﻨﺎﺠﻌـﹰ‬ ‫ﺇﻏﻔﺎل ﺇﻋﻁﺎﺌﻪ‪ ،‬ﺇﻻ ﺃﻥ ﻨﺠﺎﻋﺘﻪ ﺍﻗﺘﺼﺭﺕ ﻓﻘﻁ ﻋﻠﻰ ﺍﻟﺴﻴﺩﺍﺕ‪ ،‬ﺩﻭﻥ ﺍﻟﺭﺠﺎل‪ ،‬ﻜﻤﺎ ﺍﻗﺘﺼﺭﺕ ﻋﻠﻰ ﺍﻟﺴﻴﺩﺍﺕ ﺍﻟﻼﺘﻲ ﻟﻡ‬ ‫ﻴﺘﻌﺭﻀﻥ ﻟﻌﺩﻭﻯ ﺴﺎﺒﻘﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ ﻤﻥ ﺍﻟﻨﻤﻁ ‪ .(٣٦) ١‬ﻭﻤـﻊ ﺍﺴـﺘﻤﺭﺍﺭ ﺍﻷﺒﺤـﺎﺙ ﻭﺍﻟﺘﺠـﺎﺭﺏ‬ ‫ﺍﻟﺴﺭﻴﺭﻴﺔ )ﺍﻹﻜﻠﻴﻨﻴﻜﻴﺔ( ﻋﻠﻰ ﻓﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ – ﺍﻟﻨﻤﻁ ‪ ،٢‬ﻴﺠﺏ ﻋﻠﻰ ﻤﺩﻴﺭﻱ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻘﻁﺭﻴﺔ ﺍﻻﺴﺘﻤﺭﺍﺭ‬ ‫ﻓﻲ ﺒﺤﺙ ﻭﻤﻨﺎﻗﺸﺔ ﺇﺠﺭﺍﺀ ﺘﺠﺎﺭﺏ ﻋﻠﻰ ﺍﻟﻠﻘﺎﺡ ﺍﻟﻤﻀﺎﺩ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ – ﺍﻟﻨﻤﻁ ‪ ٢‬ﻓﻲ ﺃﻤـﺎﻜﻥ ﻭﻤﻭﺍﻗـﻊ‬ ‫ﻭﺒﺎﺌﻴﺔ ﻤﺨﺘﻠﻔﺔ ﻭﺫﻟﻙ ﺒﻐﻴﺔ ﺘﻘﻴﻴﻡ ﻤﺩﻯ ﻓﺎﺌﺩﺘﻪ ﻭﻤﻘﺒﻭﻟﻴﺘﻪ ﻭﺠﺩﻭﺍﻩ‪ ،‬ﻤﻊ ﺍﻟﻘﻴﺎﻡ ﻓﻲ ﻨﻔﺱ ﺍﻟﻭﻗﺕ ﺒﺒﻨﺎﺀ ﺍﻟﻘﺩﺭﺍﺕ ﻭﺍﻟﻁﺎﻗﺎﺕ‬ ‫ﻹﺠﺭﺍﺀ ﺍﻟﺒﺤﻭﺙ ﻭﺘﻁﺒﻴﻘﻬﺎ‪.‬‬ ‫ﻭﻤﻥ ﺃﺠل ﺇﻨﺠﺎﺡ ﺘﻨﻔﻴﺫ ﺃﻱ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺘﻤﻨﻴﻊ‪ ،‬ﻓﻼﺒﺩ ﻤﻥ ﺘﺤﺩﻴﺩ ﺍﻟﻔﺌﺔ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ ﺒﻌﻨﺎﻴﺔ ﺘﺎﻤﺔ‪ ،‬ﻜﻤـﺎ ﻴﺠـﺏ‬ ‫ﺍﻟﺘﺄﻜﺩ ﻤﻥ ﻤﻘﺒﻭﻟﻴﺔ ﺍﻟﻠﻘﺎﺡ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻀﻤﻥ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﺴﻜﺎﻨﻲ ﺍﻟﺫﻱ ﻗﺩ ﻻ ﻴﺩﺭﻙ ﺃﻥ ﻋﻭﺍﻤل ﺍﻻﺨﺘﻁـﺎﺭ ﻟﻺﺼـﺎﺒﺔ‬ ‫ﺎ‪ ،‬ﻤﺭﺘﻔﻌﺔ ﻟﺩﻴﻪ‪ .‬ﻭﺒﻤﺠﺭﺩ ﺘﺤﺩﻴﺩ ﺍﻟﻔﺌﺔ ﺍﻟﺴﻜﺎﻨﻴﺔ‪ ،‬ﻭﺍﻜﺘﻤﺎل ﺍﺴﺘﻨﻬﺎﻀﻬﺎ ﻟﻘﺒﻭل ﺍﻟﺘﻤﻨﻴﻊ‪ ،‬ﻓﺴﻭﻑ‬ ‫ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻴﻜﻭﻥ ﻤﻥ ﺍﻷﻫﻤﻴﺔ ﺒﻤﻜﺎﻥ ﺘﺯﻭﻴﺩ ﻫﺫﻩ ﺍﻟﻔﺌﺔ ﺍﻟﺴﻜﺎﻨﻴﺔ‪ ،‬ﻋﻠﻰ ﻨﺤﻭ ﺴﺭﻴﻊ ﻭﻤﺘﺴﻕ‪ ،‬ﺒﺎﻟﻠﻘﺎﺡ ﺍﻟﻨﺎﺠﻊ‪ ،‬ﻭﺫﻟﻙ ﻟﻀﻤﺎﻥ ﻨﺠﺎﺡ‬ ‫ﹰ‪ ،‬ﻭﻋﻠﻰ ﻨﺤـﻭ‬ ‫ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺘﻤﻨﻴﻊ‪ .‬ﻭﻴﻤﻜﻥ ﺃﺨﺫ ﺍﻟﺩﺭﻭﺱ ﻤﻥ ﺒﻌﺽ ﺒﺭﺍﻤﺞ ﺍﻟﺘﻤﻨﻴﻊ ﻀﺩ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻌﺩﻴﺔ ﻭﺃﻴﻀﺎ‬ ‫ﺼﺤﻴﺢ‪ ،‬ﻤﻥ ﻋﺩﻡ ﻭﺠﻭﺩ ﺘﻁﺒﻴﻕ ﻭﺍﺴﻊ ﺍﻻﻨﺘﺸﺎﺭ ﻟﻠﻘﺎﺡ ﻤﺘﻭﻓﺭ ﻭﻤﻭﺠﻭﺩ ﻀﺩ ﺍﻟﺴﺭﺍﻴﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻟﻔﻴـﺭﻭﺱ ﺍﻻﻟﺘﻬـﺎﺏ‬ ‫ﺍﻟﻜﺒﺩﻱ "ﺏ"‪.‬‬

‫ﺍﻟﻨﻬﻭﺽ ﺒﺎﻟﺒﺭﻨﺎﻤﺞ‬

‫‪٥-٢-٣‬‬

‫ﺇﻥ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻻﺭﺘﻴﺎﺩﻴﺔ ﺍﻟﺘﻲ ﺘﺘﻡ ﻋﻠﻰ ﻨﻁﺎﻕ ﺼﻐﻴﺭ‪ ،‬ﻻ ﺘﺴﻔﺭ ﺇﻻ ﻋﻥ ﺘﻐﻁﻴﺔ ﻟﺒﻌﺽ ﺍﻟﻤﻨـﺎﻁﻕ ﺍﻟﺠﻐﺭﺍﻓﻴـﺔ‬ ‫ﻭﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﺤﺩﻭﺩﺓ‪ ،‬ﻭﻻ ﻴﺠﺏ ﺍﻨﺘﻅﺎﺭ ﺤﺩﻭﺙ ﺃﻱ ﺘﺄﺜﻴﺭ ﺫﻱ ﺒﺎل ﻟﻬﺫﻩ ﺍﻟﺒﺭﺍﻤﺞ ﻋﻠﻰ ﺍﻟﻌﺏﺀ ﺍﻟﻤﺭﻀﻲ‬ ‫ﺎ‪ .‬ﻭﻫﻨﺎﻙ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﺨﺎﺼﺔ ﺒﻤﻜﺎﻓﺤﺔ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﺘﻲ ﻴﻨﺯﻉ‬ ‫ﺍﻟﺫﻱ ﻴﻘﻊ ﻤﻥ ﺠﺭﺍﺀ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻨﻔﺫﻭﻫﺎ ﺇﻟﻰ ﺘﻁﺒﻴﻕ ﺘﺩﺨﻼﺕ ﻋﻠﻰ ﻨﻁﺎﻕ ﺼﻐﻴﺭ ﻀﻤﻥ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﺴﻜﺎﻨﻲ ﻭﺭﻏﻡ ﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﺠﻴﺩﺓ ﺍﻟﺘﻲ ﺘﺤﻘﻘﻬﺎ ﺇﻻ ﺃﻨﻬﺎ‬ ‫ﻻ ﺘﺼل ﺇﻟﻰ ﻗﻁﺎﻉ ﺃﻭﺴﻊ ﻤﻥ ﺍﻟﺴﻜﺎﻥ ﺒﺤﻴﺙ ﻴﻜﻭﻥ ﻟﻬﺎ ﺘﺄﺜﻴﺭ ﺃﻜﺒﺭ‪ .‬ﻭﻟﻜﻲ ﻴﻤﻜﻥ ﺘﺤﻘﻴﻕ ﺘﺄﺜﻴﺭ ﺃﻋﻅﻡ‪ ،‬ﻻﺒﺩ ﻭﺃﻥ ﻴﺘﻡ‬

‫‪39‬‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﻭﺘﻠﻙ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ‬ ‫ﺘﻘﻴﻴﻡ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻭﻗﺎﺌﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﻌﻨﺎﺼﺭﻫﺎ ﺍﻟﺘﻘﻨﻴﺔ‪ ،‬ﻭﻤﻥ ﺜﻡ ﺍﻟﻨﻬﻭﺽ ﺒﺘﻠﻙ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺘﻲ ﺘﺜﺒﺕ ﻓﻌﺎﻟﻴﺘﻬﺎ‪ .‬ﻭﺇﻥ ﺍﻟﻬﺩﻑ ﻤﻥ ﻭﺭﺍﺀ ﺍﻟﻨﻬﻭﺽ ﺒﺎﻟﺒﺭﻨﺎﻤﺞ‬ ‫ﻫﻭ ﻀﻤﺎﻥ ﻭﺼﻭل ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻔﻌﺎﻟﺔ ﺇﻟﻰ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﺘﻲ ﺘﻜﻭﻥ ﻓﻲ ﺤﺎﺠﺔ ﺇﻟﻰ ﻫﺫﻩ ﺍﻟﺨﺩﻤﺎﺕ‪ .‬ﻭﻫﺫﺍ ﻴﻌﻨﻲ‬ ‫ﺯﻴﺎﺩﺓ ﻨﻁﺎﻕ ﺍﻟﺘﻐﻁﻴﺔ ﺍﻟﺠﻐﺭﺍﻓﻴﺔ ﻭﻋﺩﺩ ﺍﻷﺸﺨﺎﺹ ﺍﻟﺫﻴﻥ ﻴﺘﻡ ﺘﻘﺩﻴﻡ ﺍﻟﺨﺩﻤﺔ ﺇﻟﻴﻬﻡ ﻀﻤﻥ ﻓﺌﺔ ﻤﺎ ﻤﻥ ﺍﻟﻤﺠﺘﻤـﻊ‪ ،‬ﻤـﻊ‬ ‫ﺯﻴﺎﺩﺓ ﻨﻁﺎﻕ ﺘﻨﻔﻴﺫ ﺍﻟﺒﺭﻨﺎﻤﺞ ﻟﻴﺼل ﺇﻟﻰ ﺘﺠﻤﻌﺎﺕ ﺴﻜﺎﻨﻴﺔ ﻤﺴﺘﻬﺩﻓﺔ ﺃﺨﺭﻯ‪ ،‬ﻭﻜﺫﻟﻙ ﺘﻭﺴﻴﻊ ﻨﻁﺎﻕ ﺍﻟﺘـﺩﺨﻼﺕ ﺍﻟﺘـﻲ‬ ‫ﻴﻘﺩﻤﻬﺎ ﻫﺫﺍ ﺍﻟﺒﺭﻨﺎﻤﺞ‪.‬‬ ‫ﻋﻼﻭﺓ ﻋﻠﻰ ﺫﻟﻙ‪ ،‬ﻓﺈﻥ ﺘﻭﺴﻴﻊ ﻨﻁﺎﻕ ﺍﻟﺨﺩﻤﺎﺕ ﻭﺍﻟﻨﻬﻭﺽ ﺒﺎﻟﺒﺭﻨﺎﻤﺞ ﺴﻭﻑ ﻴﻜﻭﻥ ﻟﻪ ﺃﻋﻅﻡ ﺍﻷﺜﺭ‪ ،‬ﺇﺫﺍ ﻤﺎ ﺘﻡ‬ ‫ﺍﻟﺘﺭﻜﻴﺯ ﻋﻠﻰ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﺘﻲ ﺘﻜﻭﻥ ﻟﻬﺎ ﺍﻷﻭﻟﻭﻴﺔ ﻀﻤﻥ ﻋﻤﻠﻴﺔ ﺍﻻﺴﺘﻬﺩﺍﻑ )ﺃﻱ ﻫـﺅﻻﺀ ﺍﻟـﺫﻴﻥ ﻴﻜـﻭﻥ‬ ‫ﺎ( ﻭﺃﻥ ﺘﺼل ﻫﺫﻩ ﺍﻟﺨﺩﻤﺎﺕ ﺇﻟﻰ ﺃﻜﺒﺭ ﻋﺩﺩ ﻤﻤﻜـﻥ‬ ‫ﺍ ﻋﻠﻰ ﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ ﺍﻨﺘﺸﺎﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﺄﺜﻴﺭﻫﻡ ﻜﺒﻴﺭﹰ‬ ‫ﻤﻥ ﺍﻷﺸﺨﺎﺹ ﻀﻤﻥ ﻫﺫﻩ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ‪ .‬ﻜﺫﻟﻙ‪ ،‬ﻓﺈﻥ ﺘﻭﺴﻴﻊ ﻨﻁﺎﻕ ﻫﺫﻩ ﺍﻟﺨﺩﻤﺎﺕ ﻭﺍﻟﻨﻬﻭﺽ ﺒﻬـﺎ ﻴﺘﻁﻠـﺏ‬ ‫ﺎ ﻋﻠﻰ ﺍﻵﺘﻲ‪:‬‬ ‫ﺍ ﺨﺎﺼﹰ‬ ‫ﺘﺭﻜﻴﺯﹰ‬ ‫ ﺠﻭﺩﺓ ﺍﻟﺨﺩﻤﺎﺕ‪ ،‬ﺤﻴﺙ ﺇﻥ ﻫﻨﺎﻙ ﺨﻁﻭﺭﺓ ﻤﻥ ﺍﻟﺘﺨﻠﻲ ﻋﻥ ﺠﻭﺩﺓ ﻭﺘﺭﻜﻴﺯ ﺍﻟﺠﻬـﻭﺩ‪ ،‬ﻤﻘﺎﺒـل‬‫ﺍﻟﻭﺼﻭل ﺇﻟﻰ ﻋﺩﺩ ﺃﻜﺒﺭ ﻤﻥ ﺍﻷﺸﺨﺎﺹ؛‬ ‫ ﺍﻟﻁﺎﻗﺔ ﺍﻻﻤﺘﺼﺎﺼﻴﺔ‪ ،‬ﺃﻱ ﻀﻤﺎﻥ ﺘﻭﻓﺭ ﻤﻭﺍﺭﺩ ﻜﺎﻓﻴﺔ ﻟﺩﻋﻡ ﻋﻤﻠﻴﺔ ﺘﻭﺴﻴﻊ ﻨﻁﺎﻕ ﺍﻟﺨـﺩﻤﺎﺕ‬‫ﻭﺍﻟﻨﻬﻭﺽ ﺒﻬﺎ؛‬ ‫ ﻀﻤﺎﻥ ﺍﻻﺴﺘﻤﺭﺍﺭ‪ :‬ﻗﺒل ﺍﻟﺸﺭﻭﻉ ﻓﻲ ﻋﻤﻠﻴﺔ ﺘﻭﺴﻴﻊ ﻨﻁﺎﻕ ﺍﻟﺨﺩﻤﺎﺕ ﻭﺍﻟﻨﻬﻭﺽ ﺒﻬﺎ‪ ،‬ﻴﺠـﺏ‬‫ﺇﻨﺸﺎﺀ ﺍﻵﻟﻴﺎﺕ ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﻤﻥ ﺨﻼﻟﻬﺎ ﺍﺴﺘﻤﺭﺍﺭ ﺘﻭﺍﻓﺭ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﻘﺩﻤﺔ‪.‬‬

‫‪ ٣-٣‬ﺘﺤﺴﻴﻥ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﻤﻥ ﺃﺠل ﻭﻀﻊ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﺒﺭﺍﻤﺞ‬ ‫‪‬ﺩ‬ ‫ﺍﻟﺘﺭﺼ‬ ‫‪١-٣-٣‬‬

‫ﺎ ﻭﺫﻟﻙ ﻋﻠﻰ ﻜل ﻤـﻥ ﺍﻟـﺼﻌﻴﺩ ﺍﻟـﻭﻁﻨﻲ‪،‬‬ ‫‪‬ﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻟﺘﺤﺴﻴﻥ ﺇﺠﺭﺍﺀﺍﺕ ﺘﺭﺼ‬ ‫ﻭﺍﻹﻗﻠﻴﻤﻲ ﻭﺍﻟﻌﺎﻟﻤﻲ‪ ،‬ﻭﺫﻟﻙ ﻷﻏﺭﺍﺽ ﺍﻟﻤﺴﺎﻨﺩﺓ‪ ،‬ﻭﺘﺨﻁﻴﻁ ﺍﻟﺒﺭﺍﻤﺞ ﻭﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺭﺼﺩ ﻭﺍﻟﺘﻘﻴـﻴﻡ ﻭﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ‪.‬‬ ‫ﺎ‪ ،‬ﻭﺍﻟﺘﻲ ﺘﺤﺘﺎﺝ ﺇﻟﻰ ﺘﺤﺴﻴﻥ‪ ،‬ﻤﺎ ﻴﻠﻲ‪:‬‬ ‫‪‬ﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺘﺸﻤل ﺍﻟﻌﻨﺎﺼﺭ ﺍﻷﺴﺎﺴﻴﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺘﺭﺼ‬ ‫ﺍﻹﺒﻼﻍ ﻋﻥ ﺍﻟﺤﺎﻻﺕ ﻭﺍﻟﺘﻲ ﻴﺘﻡ ﺘﺼﻨﻴﻔﻬﺎ ﺤﺴﺏ ﺍﻟﻌﻤﺭ ﻭﺍﻟﺠﻨﺱ )ﺍﻟﺘﻘـﺎﺭﻴﺭ ﻭﻓـﻕ ﺍﻟﻤﺘﻼﺯﻤـﺎﺕ ﺃﻭ‬ ‫‪‬ـل‬ ‫ﻗﺒ‬ ‫ﺎ ﻟﻤﺎ ﻴﺘﻭﻓﺭ ﻤﻥ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ‪ ،‬ﺃﻭ ﺘﻘﺎﺭﻴﺭ ﻋﺎﻤﺔ ﺸﺎﻤﻠﺔ ﺃﻭ ﻤﻌﺩﺓ ﻤـﻥ ِ‬ ‫ﺍﻷﺴﺒﺎﺏ‪ ،‬ﻭﻓﻘﹰ‬ ‫ﻌﺎل ﻟﻺﺒﻼﻍ ﻋﻥ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻌﺩﻴﺔ‪ ،‬ﻭﺍﻟﻜﻴﻔﻴﺔ‬ ‫ﻤﻭﺍﻗﻊ ﺨﺎﻓﺭﺓ‪ ،‬ﻭﻤﺎ ﺇﺫﺍ ﻜﺎﻥ ﻫﻨﺎﻙ ﻨﻅﺎﻡ ﺇﺒﻼﻍ ﻭﻁﻨﻲ ﻓ ‪‬‬ ‫ﺎ ﺒﻬﺎ(؛‬ ‫ﺍﻟﺘﻲ ﻴﺘﻡ ﺘﻘﺩﻴﻡ ﻭﺘﻨﻅﻴﻡ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ )ﺍﻟﺤـﺎﻻﺕ‬ ‫ﺘﻘﻴـﻴﻡ ﻭﺭﺼﺩ ﻤﻌﺩل ﺍﻻﻨﺘﺸﺎﺭ ﻟﺘﺤﺩﻴﺩ ﻭﻤﺘﺎﺒﻌﺔ ﺍﻟﻌﺏﺀ ﺍﻟﻤﺭﻀﻲ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺼﺤﻭﺒﺔ ﺒﺄﻋﺭﺍﺽ ﻭﻏﻴﺭ ﺍﻟﻤﺼﺤﻭﺒﺔ ﺒﻬﺎ( ﻓﻲ ﺘﺠﻤﻌﺎﺕ ﺴﻜﺎﻨﻴﺔ ﻤﺤﺩﺩﺓ؛‬ ‫ﺎ؛‬ ‫ﺘﻘﻴـﻴﻡ ﺍﻟﻤﺴﺒﺒﺎﺕ ﺍﻟﻤﺭﻀﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺭﺼﺩ ﺍﻟﻤﻘﺎﻭﻤﺔ ﻟﻠﻤﻀﺎﺩﺍﺕ ﺍﻟﻤﻴﻜﺭﻭﺒﻴﺔ؛‬ ‫•‬

‫•‬ ‫•‬ ‫•‬

‫‪40‬‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﺩﺭﺍﺴﺎﺕ ﺍﻟﺨﺎﺼﺔ‪ ،‬ﺘﻘﻴـﻴﻡ ﺍﻟﺠﻭﺩﺓ ﻟﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴـﺔ ﺒﺎﺴـﺘﺨﺩﺍﻡ ﻁﺭﻴﻘـﺔ ﺍﻟﻌﻤـﻼﺀ ﺍﻟﻐﺎﻤـﻀﻴﻥ‬ ‫)‪.(mystery clients‬‬

‫•‬

‫ﺎ ﻫﻲ ﺒﻤﺜﺎﺒﺔ ﺃﻨﺸﻁﺔ ﺘﻜﻤﻴﻠﻴﺔ‪ ،‬ﻭﺘﻌﺘﻤﺩ ﺍﻟﻁﺭﻕ ﺍﻟﺘﻲ ﻴﺘﻡ ﺇﺠﺭﺍﺀ ﻜل ﻭﺍﺤـﺩ ﻤﻨﻬـﺎ‬ ‫ﺇﻥ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﻤﺫﻜﻭﺭﺓ ﺁﻨﻔﹰ‬ ‫ﺎ‪ ،‬ﻭﻜﺫﻟﻙ ﻋﻠﻰ ﺃﻨﻅﻤﺔ ﺍﻹﺒﻼﻍ ﺍﻟﻤﻭﺠـﻭﺩﺓ ﻭﺍﻟﻤـﺴﺘﺨﺩﻤﺔ‪،‬‬ ‫‪‬ﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻋﻠﻰ ﻭﺠﻭﺩ ﺒﻨﻴﺔ ﺃﺴﺎﺴﻴﺔ ﻟﺘﺭﺼ‬ ‫ﻭﺫﻟﻙ ﻜﺠﺯﺀ ﻤﻥ ﺍﻟﻨﻅﺎﻡ ﺍﻟﻤﺘﻜﺎﻤل ﻟﺘﺭﺼ‬ ‫‪‬ﺩ ﺍﻷﻤﺭﺍﺽ‪ .‬ﻤﻥ ﺠﻬﺔ ﺃﺨﺭﻯ‪ ،‬ﻓﺈﻥ ﻟﻭﺒﺎﺀ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ‬ ‫ﺼﺩ ﻭﺘﺤﺩﻴﺩ ﺍﻷﻭﻟﻭﻴﺎﺕ ﻓﻴﻤﺎ ﻴﺨﺘﺹ ﺒﺎﻟﻌﺩﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺒﺸﺭﻱ ﺘﺄﺜﻴﺭﺍﺕ ﻋﻠﻰ ﺃﻨﺸﻁﺔ ﺍﻟﺘﺭ ‪‬‬ ‫ﺎ )‪.(٥٥ ،٥٤‬‬

‫‪‬ﺩ ﺍﻟﺠﻴل ﺍﻟﺜﺎﻨﻲ ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‬ ‫ﺘﺭﺼ‬ ‫ﺎ ﺒﺘﺭﺼﺩ ﺍﻟﺠﻴل ﺍﻟﺜﺎﻨﻲ ﻤﻥ ﻓﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ‬ ‫ﺎ ﻭﺜﻴﻘﹰ‬ ‫ﺎ ﺍﺭﺘﺒﺎﻁﹰ‬ ‫ﺘﺭﺘﺒﻁ ﺃﻨﺸﻁﺔ ﺘﺭﺼﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ﺩ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﺍﻹﺒـﻼﻍ ﻋـﻥ ﺤـﺎﻻﺕ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﻫﻲ ﺘﺸﻤل‪ ،‬ﺒﺎﻹﻀﺎﻓﺔ ﺇﻟﻰ ﺘﺭﺼ‬ ‫‪‬ﺩ ﺍﻟﺴﻠﻭﻜﻲ ﻟﺭﺼﺩ ﺍﻻﺘﺠﺎﻫﺎﺕ ﺍﻟﺴﻠﻭﻜﻴﺔ ﺍﻟﻤﻨﻁﻭﻴﺔ ﻋﻠﻰ ﻤﺨﺎﻁﺭ ﺒﻤﺭﻭﺭ ﺍﻟﻭﻗـﺕ‪،‬‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﻤﺭﺽ ﺍﻷﻴﺩﺯ‪ ،‬ﺍﻟﺘﺭﺼ‬ ‫‪‬ﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺘﺭﺼ‬ ‫ﺎ ﻓﻲ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﻌﺭﻀـﺔ‬ ‫ﺎ ﻟﺭﺼﺩ ﺍﻨﺘﺸﺎﺭ ﺴﺎﺌﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﺨﻁﺭ ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ .‬ﻓﻌﻠﻰ ﺴﺒﻴل ﺍﻟﻤﺜﺎل‪ ،‬ﻴﻤﻜﻥ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﺩﺭﺍﺴﺎﺕ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﻔﻴﺭﻭﺱ‬ ‫ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ – ﺍﻟﻨﻤﻁ ‪ ،٢‬ﻜﻤﺅﺸﺭﺍﺕ ﻟﺘﺤﺩﻴﺩ ﺍﻟﻔﺌﺎﺕ ﺍﻟﻤﺴﺘﻀﻌﻔﺔ ﺍﻟﻘﺎﺒﻠﺔ ﻟﻺﺼـﺎﺒﺔ ﺒﻔﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ‬ ‫‪‬ﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ .‬ﻟﺫﻟﻙ‪ ،‬ﻓﺈﻥ ﺘﻘﻭﻴﺔ ﺇﺠﺭﺍﺀﺍﺕ ﺘﺭﺼ‬ ‫‪‬ـﺩ‬ ‫ﺎ‪ ،‬ﻴﻌﺩ ﺃﺤﺩ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﻬﺎﻤﺔ ﻟﺘﺭﺼ‬ ‫ﺍﻟﺠﻴل ﺍﻟﺜﺎﻨﻲ ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪.‬‬ ‫ﺎ ﻭﺍﻟﻤﺴﻭﺤﺎﺕ ﺍﻟﺴﻠﻭﻜﻴﺔ‪،‬‬ ‫‪‬ﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻴﻨﺒﻐﻲ ﺃﻥ ﻴﻜﻭﻥ ﻫﻨﺎﻙ ﺍﺭﺘﺒﺎﻁ ﻭﺜﻴﻕ ﺒﻴﻥ ﺃﻨﺸﻁﺔ ﺘﺭﺼ‬ ‫ﺎ ﻭﺴﻠﻭﻜﻴﺎﺕ‬ ‫ﺨﺎﺼﺔ ﺘﻠﻙ ﺍﻟﻤﺴﻭﺤﺎﺕ ﺍﻟﺘﻲ ﺘﺠﺭﻯ ﻋﻥ ﺍﻟﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﻭﻤﺤﺩﺩﺍﺕ ﻭﺒﺎﺌﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺒﻤﺴﺘﻭﻴﺎﺕ ﺃﻗـل ﻤـﻥ‬ ‫ﺍﻟﺘﻤﺎﺱ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﻋﻼﻗﺘﻬﺎ ﺒﺎﻟﻜﺸﻑ ﻭﺍﻹﺒﻼﻍ ﻋﻥ ﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍ ﻓﻲ ﺘﻘﻴـﻴﻡ ﻭﺘﺤﺩﻴﺩ ﺃﻱ ﻤﻥ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﻫـﻲ ﺍﻟﺘـﻲ‬ ‫‪‬ﺩ ﻫﺎﻤﺔ ﺠﺩﹰ‬ ‫ﺤﻘﻴﻘﺘﻬﺎ ﺍﻟﻔﻌﻠﻴﺔ‪ .‬ﻭﺘﻌﺘﺒﺭ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺭﺼ‬ ‫ﻴﺠﺏ ﺃﻥ ﺘﻭﺠﻪ ﺇﻟﻴﻬﺎ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ‪.‬‬ ‫ﱢﺯ ﻋﻠﻰ ﺍﻟﻘـﻀﺎﻴﺎ ﺍﻟﻤﺘﻌﻠﻘـﺔ‬ ‫ﺎ ﺤﺎﺠﺔ ﺇﻟﻰ ﺇﺠﺭﺍﺀ ﺩﺭﺍﺴﺎﺕ ﺨﺎﺼﺔ‪ ،‬ﺘـﺘﻡ ﺒﺼﻭﺭﺓ ﺩﻭﺭﻴﺔ‪ ،‬ﺘﺭﻜ‬ ‫ﻭﻫﻨﺎﻙ ﺃﻴﻀﹰ‬ ‫‪‬ﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﺘﺭﺼ‬ ‫ﺍ ﻤﻥ ﺍﻹﺒﻼﻍ ﺍﻟﺭﻭﺘﻴﻨﻲ ﻋـﻥ ﺍﻟﺤـﺎﻻﺕ ﺃﻭ ﺘﻘﻴــﻴﻡ ﻤﻌـﺩل‬ ‫ﺎ‪ ،‬ﻭﺍﻟﺘﻲ ﻻ ﺘﻌﺩ ﺠﺯﺀﹰ‬ ‫ﺍﻻﻨﺘﺸﺎﺭ‪ .‬ﻭﻴﻤﻜﻥ ﺃﻥ ﺘﺸﻤل ﻫﺫﻩ ﺍﻟﺩﺭﺍﺴﺎﺕ ﺘﻘﺼﻴﺎﺕ ﺤﻭل ﻓﺎﺸﻴﺎﺕ ﻋﺩﺍﻭﻯ ﻤﻌﻴﻨﺔ ﺘﻨﺘﻘل ﻋﻥ ﻁﺭﻴﻕ ﺍﻟﺠﻨﺱ‪ ،‬ﻤﺜـل‬ ‫ﻓﺎﺸﻴﺎﺕ ﺍﻟﺯﻫﺭﻱ ﻭﺍﻟﻭﺭﻡ ﺍﻟﺤﺒﻴﺒﻲ ﺍﻟﻠﻤﻔﻲ‪ ،‬ﻭﺍﻟﻘﺭﺡ‪ ،‬ﺍﻟﺘﻲ ﺤﺩﺜﺕ ﺒﻴﻥ ﺒﻌﺽ ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟـﺴﻜﺎﻨﻴﺔ ﻭﻓـﻲ ﺒﻌـﺽ‬ ‫ﺍﻷﻤﺎﻜﻥ ﺍﻟﺠﻐﺭﺍﻓﻴﺔ‪.‬‬ ‫ﻭﻴﻨﺒﻐﻲ ﺇﺸﺭﺍﻙ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ ﺇﻟﻰ ﺃﻗﺼﻰ ﺤﺩ ﻤﻤﻜﻥ ﻓﻲ ﻨﻅﺎﻡ ﺍﻹﺒﻼﻍ ﻋﻥ ﺍﻟﺤﺎﻻﺕ ﻭﺫﻟﻙ ﻋﻠﻰ ﺍﻟـﺭﻏﻡ‬ ‫ﺎ ﺒﺴﺒﺏ ﻤﺎ ﻴﻌﺘﺭﻱ‬ ‫ﺎ ﻤﺎ ﻴﺤﺩﺙ ﻟﻺﻨﺴﺎﻥ ﻹﺒﻼﻍ ﺍﻟﺴﻠﻁﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻋﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻥ ﺍﻟﺘﺭﺩﺩ ﺍﻟﺫﻱ ﻏﺎﻟﺒﹰ‬ ‫ﺍﻹﻨﺴﺎﻥ ﻤﻥ ﻗﻠﻕ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﺴﺭﻴﺔ ﺃﻭ ﺍﻟﻭﺼﻤﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﺃﻭ ﺍﻟﻼﻤﺒﺎﻻﺓ‪ ،‬ﺃﻭ ﺍﻻﻋﺘﻘﺎﺩ ﺒﻌﺩﻡ ﺠﺩﻭﻯ ﺇﺒﻼﻍ ﺍﻟـﺴﻠﻁﺎﺕ‬ ‫ﺎ‪ ،‬ﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ‪ ،‬ﺇﻟﻰ ﺍﻟﺤﺼﻭل ﻋﻠـﻰ‬ ‫ﺍﻟﺼﺤﻴﺔ ﺒﺫﻟﻙ‪ .‬ﻭﻴﺴﻌﻰ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻭﻥ ﺒﻌﺩﺍﻭﻯ ﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻻ ﻋﻠـﻰ‬ ‫ﹰ‪ ،‬ﺃﻭ ﻤﻥ ﺍﻟﺠﻬﺎﺕ ﻏﻴﺭ ﺍﻟﺭﺴﻤﻴﺔ ﺒﺎﻟﻘﻁـﺎﻉ ﺍﻟﺨـﺎﺹ‪ ،‬ﺩﻭﻥ ﺍﻟﺤـﺼﻭل ﺃﻭ ﹰ‬ ‫ﺍﻷﺩﻭﻴﺔ ﻤﻥ ﺍﻟﺼﻴﺩﻟﻴﺎﺕ ﻤﺒﺎﺸﺭﺓ‬ ‫ﺍ ﻤﻥ ﺍﻹﺒﻼﻍ ﻋﻥ ﺍﻟﺤﺎﻻﺕ ﺒﻤـﺴﺘﻭﻯ‬ ‫ﺍ ﻜﺒﻴﺭﹰ‬ ‫‪‬ل ﻁﺒﻴﺏ ﺴﺭﻴﺭﻱ‪ .‬ﻭﻫﺫﻩ ﺍﻟﻤﻤﺎﺭﺴﺎﺕ ﺘﻤﺜل ﺠﺯﺀﹰ‬ ‫ﻗﺒ‬ ‫ﺘﺸﺨﻴﺹ ﻟﻠﺤﺎﻟﺔ ﻤﻥ ِ‬ ‫ﺃﻗل ﻤﻥ ﺤﻘﻴﻘﺘﻬﺎ‪ ،‬ﻭﻗﺩ ﻴﻜﻭﻥ ﻤﻥ ﺍﻟﻀﺭﻭﺭﻱ ﺇﺠﺭﺍﺀ ﺩﺭﺍﺴﺎﺕ ﺨﺎﺼﺔ ﻟﺘﺤﺩﻴﺩ ﻤﺩﻯ ﺍﻨﺘﺸﺎﺭ ﻫـﺫﺍ ﺍﻟـﺴﻠﻭﻙ ﻭﺤﺠـﻡ‬ ‫ﺍﻟﺤﺎﻻﺕ ﺍﻟﺘﻲ ﻻ ﻴﺘﻡ ﺍﻹﺒﻼﻍ ﻋﻨﻬﺎ‪ ،‬ﻭﻴﺠﺏ ﺍﻟﻨﻅﺭ ﻓﻲ ﺇﻤﻜﺎﻨﻴﺔ ﺇﻴﺠﺎﺩ ﺤﻭﺍﻓﺯ ﻟﻠﺘﺸﺠﻴﻊ ﻋﻠﻰ ﺍﻹﺒﻼﻍ ﻋﻥ ﺍﻟﺤـﺎﻻﺕ‪.‬‬ ‫ﻭﻗﺩ ﻴﺸﻤل ﺫﻟﻙ ﻤﻨﺢ ﺍﻟﺘﻘﺩﻴﺭ ﺃﻭ ﺍﻹﻋﻔﺎﺀ ﻤﻥ ﺍﻟﺘﻜﺎﻟﻴﻑ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫‪‬ﺩ ﺍﻟﺤﺎﻟﻴﺔ ﻭﺫﻟﻙ ﻤﻥ ﺨﻼل ﺘﺤﺴﻴﻥ ﺍﻟﻤﺭﺍﻓـﻕ ﻭﺍﻟﻤـﻭﺍﺩ ﺍﻟﻤﺨﺘﺒﺭﻴـﺔ‬ ‫ﹸﻅﻡ ﺍﻟﺘﺭﺼ‬ ‫ﻭﻫﻨﺎﻙ ﺤﺎﺠﺔ ﺇﻟﻰ ﺘﻘﻭﻴﺔ ﻨ‬ ‫ﻭﺘﻁﻭﻴﺭ ﻤﻬﺎﺭﺍﺕ ﺍﻟﻌﺎﻤﻠﻴﻥ ﺒﻬﺎ‪ ،‬ﻭﺘﻌﺯﻴﺯ ﺁﻟﻴﺎﺕ ﺍﻹﺒﻼﻍ ﻋﻥ ﺍﻟﺤﺎﻻﺕ‪ ،‬ﺨﺎﺼﺔ ﻋﻨﺩﻤﺎ ﺘﻜﻭﻥ ﺍﻟﻤﺭﺍﻓﻕ ﺍﻟﺘﺸﺨﻴـﺼﻴﺔ‬ ‫‪‬ﺩ ﺍﻟﺤﺎﻟﻴﺔ‪ ،‬ﺍﻟﺘﻘﺩﻴﺭﺍﺕ ﺍﻟﺘﻲ ﺘــﺘﻡ ﺒﺄﻗـل ﻤـﻥ‬ ‫ﹸﻅﻡ ﺍﻟﺘﺭﺼ‬ ‫ﻤﻭﺠﻭﺩﺓ ﻭﻤﺴﺘﺨﺩﻤﺔ‪ .‬ﻭﻤﻤﺎ ﻴﺯﻴﺩ ﻤﻥ ﻤﺤﺩﻭﺩﻴﺔ ﻗﺩﺭﺍﺕ ﻨ‬ ‫ﺎ‪ ،‬ﺍﻟﻤﻌﺯﻭ ﺇﻟﻰ ﺤـﺎﻻﺕ ﺍﻟﻌـﺩﻭﻯ ﻏﻴـﺭ ﺍﻟﻤـﺼﺤﻭﺒﺔ‬ ‫ﺃﺤﺠﺎﻤﻬﺎ ﺍﻟﺤﻘﻴﻘﻴﺔ ﻟﻠﻌﺏﺀ ﺍﻟﻤﺭﻀﻲ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﺄﻋﺭﺍﺽ‪ ،‬ﻟﺫﻟﻙ‪ ،‬ﻻﺒﺩ ﻤﻥ ﻭﻀﻊ ﻭﺘﻁﺒﻴﻕ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻤﺼﺎﺤﺒﺔ ﻟﺘﺤﺭﻱ ﻭﻜﺸﻑ ﺤﺎﻻﺕ ﺍﻹﺼﺎﺒﺔ ﺒﻬﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ‪.‬‬

‫ﺍﻟﻤﻌﻁﻴﺎﺕ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻟﺩﻋﻡ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﺘﺜﻘﻴﻑ‬ ‫ﺇﻥ ﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻹﺠﺭﺍﺀ ﺘﺠﻤﻴﻊ ﺴﺭﻴﻊ ﻟﻠﻤﻌﻁﻴﺎﺕ ﺍﻟﻤﻭﺜﻭﻗﺔ ﻟﺘﻘﺩﻴﺭ ﺍﻟﻌﺏﺀ ﺍﻟﻤﺭﻀﻲ ﻟﻠﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ ﺍﻟﺘﺄﺜﻴﺭ ﺍﻻﻗﺘﺼﺎﺩﻱ ﻟﻬﺎ‪ .‬ﻭﺘﻭﻓﺭ ﻫﺫﻩ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ‪ ،‬ﺒـﺩﻭﺭﻫﺎ‪ ،‬ﺍﻷﺴـﺎﺱ‬ ‫ﺎ‪ ،‬ﻭﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﺍﻟﻤﺘﺭﺘﺒﺔ ﻋﻠﻴﻬﺎ ﻭﺃﻴﻀﹰ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻋﻠﻰ ﺍﻷﺼـﻌﺩﺓ‬ ‫ﺍﻟﻤﻨﻁﻘﻲ ﻟﺘﻭﺠﻴﻪ ﺍﻻﻫﺘﻤﺎﻡ ﺒﻭﻀﻊ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺘﺨﺼﻴﺹ ﺍﻟﻤﻭﺍﺭﺩ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻭﻁﻨﻴﺔ ﻭﺍﻹﻗﻠﻴﻤﻴﺔ ﻭﺍﻟﻌﺎﻟﻤﻴﺔ‪.‬‬

‫ﺍﻟﻤﻌﻁﻴﺎﺕ ﺍﻟﻼﺯﻤﺔ ﻟﺘﻭﺠﻴﻪ ﻋﻤﻠﻴﺔ ﺘﺨﻁﻴﻁ ﺍﻟﺒﺭﺍﻤﺞ ﻭﺃﻨﺸﻁﺔ ﺍﻟﺭﺼﺩ‬ ‫ﺎ ﻭﺫﻟـﻙ ﻟـﺩﻋﻡ ﻋﻤﻠﻴـﺔ ﺇﺩﺍﺭﺓ‬ ‫ﺎ ﻟﻤﻌﻁﻴﺎﺕ ﺴﺭﻴﻌﺔ ﻭﻤﻭﺜﻭﻗﺔ ﻋﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻫﻨﺎﻙ ﺤﺎﺠﺔ ﺃﻴﻀﹰ‬ ‫ﺎ ﻓـﻲ ﺍﻟﺘﺠﻤﻌـﺎﺕ ﺍﻟـﺴﻜﺎﻨﻴﺔ‬ ‫ﺍﻟﺒﺭﺍﻤﺞ‪ .‬ﻭﺘﻔﻴﺩ ﺍﻟﺩﺭﺍﺴﺎﺕ ﺍﻟﺘﻲ ﺘﺠﺭﻯ ﺤﻭل ﻤﻌﺩﻻﺕ ﺍﻨﺘﺸﺎﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺨﺘﻠﻔﺔ‪ ،‬ﻓﻲ ﺘﻘﻴـﻴﻡ ﺘﻭﺯﻴﻌﺎﺕ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ‪ ،‬ﻭﺘﺤﺩﻴﺩ ﺃﻭﻟﻭﻴﺎﺕ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ‪ ،‬ﻭﺘﻘﺩﻴﺭ ﻤﺩﻯ ﻋﺏﺀ‬ ‫ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺍﻟﺘﻲ ﻻ ﺃﻋﺭﺍﺽ ﻟﻬﺎ ﻋﻠﻰ ﺍﻟﻤﺠﺘﻤﻊ‪ .‬ﻭﺍﻟﻤﻌﻁﻴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﺘﺠﺎﻫﺎﺕ ﺍﻷﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ ﻓﻲ ﺘﻘﻴﻴﻡ ﻤﺩﻯ ﻓﻌﺎﻟﻴﺔ ﻭﺘﺄﺜﻴﺭﺍﺕ ﺒﺭﺍﻤﺞ ﻭﺘﺩﺨﻼﺕ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﻫﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ ،‬ﻜﻤﺎ ﺃﻨﻬـﺎ ﺘـﺴﺎﻋﺩ‬ ‫ﺎ ﺘﻔﻴﺩ ﺃﻴﻀﹰ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﻜﻤﺅﺸﺭﺍﺕ ﺒﻴﻭﻟﻭﺠﻴﺔ ﻻﺘﺠﺎﻫﺎﺕ ﺍﻟﻤﻤﺎﺭﺴﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ ﻏﻴﺭ ﺍﻟﻤﺄﻤﻭﻨﺔ‪.‬‬

‫ﺍﻟﻤﻌﻁﻴﺎﺕ ﺍﻟﻼﺯﻤﺔ ﻟﺘﻭﺠﻴﻪ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ‬ ‫ﺍ ﻤـﻥ ﺍﻟﺯﻤـﺎﻥ‪،‬‬ ‫ﺇﻥ ﻤﻘﺎﻭﻤﺔ ﺍﻟﻤﻴﻜﺭﻭﺒﺎﺕ ﻟﻠﺩﻭﺍﺀ ﺘﺅﺩﻱ ﺇﻟﻰ ﺘﻼﺸﻲ ﻓﻌﺎﻟﻴﺘﻪ‪ ،‬ﺍﻟﺘﻲ ﺍﺴﺘﻐﺭﻕ ﺘﻁﻭﻴﺭﻫﺎ ﻋﻘﻭﺩﹰ‬ ‫ﺒﺴﺒﺏ ﺇﺴﺎﺀﺓ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻷﺩﻭﻴﺔ ﺒﺼﻔﺔ ﺃﺴﺎﺴﻴﺔ‪ ،‬ﻤﻥ ﺨﻼل ﺍﻻﺴﺘﺨﺩﺍﻡ ﻏﻴﺭ ﺍﻟﺘﻔﺭﻴﻘﻲ ﻟﻪ ﻭﻭﺼﻔﻪ ﺒﺼﻭﺭﺓ ﺘﺯﻴﺩ ﻋـﻥ‬ ‫‪‬ل ﺍﻟﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ ﻻ ﻴﺴﺘﻜﻤﻠﻭﻥ ﺩﻭﺭﺓ ﺍﻟﻌﻼﺝ ﺴﻭﺍﺀ ﺒـﺴﺒﺏ ﻋـﺩﻡ‬ ‫ﻗﺒ‬ ‫ﺍﻟﺤﺩ ﺍﻟﻤﻁﻠﻭﺏ‪ .‬ﻭﻴﺴﺎﺀ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻷﺩﻭﻴﺔ ﻤﻥ ِ‬ ‫ﻼ ﻤﻥ ﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﻤﺭﻀﺎﻫﻡ ﻋﻠﻰ ﺍﺨﺘﻴﺎﺭ ﺍﻟﺠﺭﻋﺎﺕ ﺍﻷﻗـل‬ ‫ﺍﻻﻟﺘﺯﺍﻡ ﺃﻭ ﺒﺴﺒﺏ ﺍﻟﻔﻘﺭ‪ .‬ﻭﻴﺠﺒﺭ ﺍﻟﻔﻘﺭ ﻜ ﹰ‬ ‫ﻤﻥ ﺍﻷﺩﻭﻴﺔ ﺍﻟﻤﻭﺼﻭﻓﺔ ﺃﻭ ﺍﻟﺒﺩﺍﺌل ﺍﻷﺭﺨﺹ ﻭﺍﻷﻗل ﻓﻌﺎﻟﻴﺔ ﻤﻥ ﺃﺠل ﺘﻭﻓﻴﺭ ﺍﻟﻤﺎل‪ .‬ﻭﻤﻤﺎ ﻴﺯﻴﺩ ﺍﻟﻁﻴﻥ ﺒﻠﺔ‪ ،‬ﺃﻨﻪ ﻴﺘﻌﻴﻥ‬ ‫ﺎ ﺒﻤﺠﺭﺩ ﺃﻥ ﺘﻜﻭﻥ ﺍﻷﺨﻴـﺭﺓ ﻗـﺩ ﻓﻘـﺩﺕ‬ ‫ﺍ ﻓﻲ ﺍﻟﺜﻤﻥ ﻟﺘﺤل ﻤﺤل ﺍﻷﺩﻭﻴﺔ ﺍﻷﺭﺨﺹ ﺜﻤﻨﹰ‬ ‫ﺍﺴﺘﺨﺩﺍﻡ ﺃﺩﻭﻴﺔ ﺃﻏﻠﻰ ﻜﺜﻴﺭﹰ‬ ‫ﻓﻌﺎﻟﻴﺘﻬﺎ‪.‬‬ ‫ﻤﻥ ﺍﻟﻀﺭﻭﺭﻱ ﻗﻴﺎﻡ ﺍﻟﺴﻠﻁﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺒﺸﻜل ﻤﻨﺘﻅﻡ‪ ،‬ﺒﺭﺼﺩ ﻭﺍﺴﺘﻜﺸﺎﻑ ﻤﻌﺩﻻﺕ ﺍﻻﻨﺘـﺸﺎﺭ ﺍﻟﻨـﺴﺒﻲ‬ ‫ﺎ ﻓﻲ ﺍﻷﻤﺎﻜﻥ ﻭﺍﻟﻤﻭﺍﻗﻊ ﺍﻟﻤﺤﻠﻴـﺔ‪ ،‬ﻭﻨـﺸﻭﺀ‬ ‫ﻟﻠﻜﺎﺌﻨﺎﺕ ﺍﻟﻤﻤﺭﻀﺔ ﺍﻟﻤﺴﺅﻭﻟﺔ ﻋﻥ ﻤﺘﻼﺯﻤﺎﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻭﺫﻟﻙ ﻤﻥ ﺃﺠل ﺍﻻﺴﺘﻤﺭﺍﺭ ﻓﻲ ﺘﺤﺩﻴﺙ ﺍﻟﺩﻻﺌل ﺍﻹﺭﺸﺎﺩﻴـﺔ‬ ‫ﺍﻟﻤﻘﺎﻭﻤﺔ ﻟﻸﺩﻭﻴﺔ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻟﻸﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﺍﻟﺘﻲ‬ ‫ﻟﻠﻤﻌﺎﻟﺠــﺔ ﻭﺍﻟﻘﻭﺍﺌﻡ ﺍﻟﻭﻁﻨﻴـﺔ ﻟﻸﺩﻭﻴـﺔ ﺍﻷﺴﺎﺴﻴﺔ‪ .‬ﻭﺘﺘﻀﻤﻥ ﺍﻟﻜﺎﺌﻨﺎﺕ ﺍﻟﻤﺴﺒﺒﺔ ﻟﻸﻤﺭﺍﺽ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﺘﻁﻠ‬ ‫ﱠﺏ‪ ،‬ﺒﺼﻔﺔ ﺨﺎﺼﺔ‪ ،‬ﺍﻟﻘﻴﺎﻡ ﺒﺄﻨﺸﻁﺔ ﺭﺼﺩ ﻟﻬﺎ‪ :‬ﺍﻟﻨﻴﺴﻴﺭﻴﺔ ﺍﻟﺒﻨﻴﺔ‪ ،‬ﻭﺍﻟﻤﺴﺘﺩﻤﻴﺔ ﺍﻟﺩﻭﻜﺭﻴﺔ‪ ،‬ﻤﻥ ﺒـﻴﻥ ﺍﻟﺠـﺭﺍﺜﻴﻡ ﺃﻭ‬ ‫ﺎ‪.‬‬ ‫ﺍﻟﺒﻜﺘﻴﺭﻴﺎ‪ ،‬ﻭﻓﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ – ﺍﻟﻨﻤﻁ ‪ ،٢‬ﻤﻥ ﺒﻴﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻔﻴﺭﻭﺴﻴﺔ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻭﺤﻴﺙ ﺘـﺘﺒﺎﻴﻥ ﻤﺴﺘﻭﻴﺎﺕ ﺍﻟﻤﻘﺎﻭﻤﺔ ﺒﺸﻜل ﻜﺒﻴﺭ‪ ،‬ﻤﻥ ﺒﻠﺩ ﻵﺨﺭ‪ ،‬ﻓﺈﻥ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻻ ﺘﻭﺼـﻲ‬ ‫ﺎ ﻋﻥ ﺫﻟﻙ‪ ،‬ﻴﺠﺏ ﻋﻠﻰ ﻜل ﺒﻠﺩ ﻤﻥ ﺍﻟﺒﻠـﺩﺍﻥ‬ ‫ﺒﺎﻟﻘﻴﺎﻡ ﺒﺄﻱ ﻋﻼﺝ ﻤﻨﻔﺭﺩ ﻴﺘﻡ ﻜﺨﻁ ﺃﻭل ﻋﻼﺠﻲ ﻟﺩﺍﺀ ﺍﻟﺴﻴﻼﻥ‪ .‬ﻭﻋﻭﻀﹰ‬ ‫ﺍﺘﺨﺎﺫ ﺍﻟﻘﺭﺍﺭﺍﺕ ﻓﻲ ﻫﺫﺍ ﺍﻟﺸﺄﻥ ﺤﺴﺏ ﺃﻨﻤﺎﻁ ﺍﻟﻤﻘﺎﻭﻤﺔ ﺍﻟﻤﻭﺠﻭﺩﺓ ﺒﻪ – ﻭﻫﺫﺍ ﺒﻤﺜﺎﺒﺔ ﻤﺄﺯﻕ‪ ،‬ﺒﺎﻟﻨﻅﺭ ﺇﻟﻰ ﺤﻘﻴﻘـﺔ ﺃﻥ‬ ‫‪‬ﺩ‪ ،‬ﻭﺘﻘﻭﻡ ﺒﺎﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﻤﻌﻁﻴﺎﺕ ﻏﻴﺭ ﻤﺒﺎﺸﺭﺓ ﻤﺘﺠﻤﻌﺔ ﻤﻥ ﺒﻠﺩﺍﻥ‬ ‫ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ ﻏﻴﺭ ﻗﺎﺩﺭﺓ ﻋﻠﻰ ﺇﺠﺭﺍﺀ ﺘﺭﺼ‬ ‫ﻤﺠﺎﻭﺭﺓ‪ ،‬ﺃﻭ ﺍﺴﺘﺨﺩﺍﻡ ﺘﻘﺩﻴﺭﺍﺕ ﺇﻗﻠﻴﻤﻴﺔ‪.‬‬

‫ﺍﻟﺭﺼﺩ ﻭﺍﻟﺘﻘﻴـﻴﻡ‬

‫‪٢-٣-٣‬‬

‫ﱡﺩ ﻤـﻥ ﺃﻥ ﺍﻷﻨـﺸﻁﺔ ﻴـﺘﻡ‬ ‫‪‬ﻡ ﺍﻟﺫﻱ ﻴﺘﻡ ﺘﺤﻘﻴﻘﻪ ﺨﻼل ﺘﻨﻔﻴﺫ ﺒﺭﻨﺎﻤﺞ ﻤﺎ ﻭﺫﻟﻙ ﻟﻠﺘﺄﻜ‬ ‫ﻴﻨﺒﻐﻲ ﺍﻟﻘﻴﺎﻡ ﺒﺭﺼﺩ ﺍﻟﺘﻘﺩ‬ ‫ﺇﺠﺭﺍﺅﻫﺎ ﺤﺴﺏ ﻤﺎ ﻫﻭ ﻤﺨﻁﻁ ﻟﻪ‪ ،‬ﻭﻓﻲ ﺍﻟﻭﻗﺕ ﺍﻟﻤﺤﺩﺩ ﻟﻬﺎ‪ ،‬ﻭﻀﻤﻥ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﺨﺼﺼﺔ‪ ،‬ﻭﺘﺤﺩﻴﺩ ﻤﺎ ﺇﺫﺍ ﻜﺎﻨﺕ ﻫﺫﻩ‬ ‫ﺍﻷﻨﺸﻁﺔ ﺘﺅﺩﻱ ﺇﻟﻰ ﺍﻟﻨﺘﺎﺌﺞ ﺃﻭ ﺍﻟﺘﺄﺜﻴﺭ ﺍﻟﻤﺭﺠﻭ ﻓﻴﻬﺎ‪ .‬ﻭﻫﻨﺎﻙ ﻨﻘﺹ ﻓﻲ ﺍﻟﻤﻌﻁﻴﺎﺕ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﺘﻨﻔﻴﺫ‪ ،‬ﺍﻷﻤﺭ ﺍﻟﺫﻱ‬ ‫ﺎ‪ ،‬ﻭﺘﻘـﺩﻴﺭ‬ ‫ﱡﻼﺕ ﺍﻟﻤﺨﺘﻠﻔﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻴﺠﻌل ﻤﻥ ﺍﻟﺼﻌﺏ ﺇﺠﺭﺍﺀ ﻗﻴﺎﺱ ﺩﻗﻴﻕ ﻟﻔﻌﺎﻟﻴﺔ ﺍﻟﺘﺩﺨ‬ ‫ﺍ ﻓﻲ ﺘﻭﺠﻴﻪ ﻋﻤﻠﻴﺔ ﻭﻀـﻊ ﺍﻷﻭﻟﻭﻴـﺎﺕ ﻭﺍﻟﺘﺨﻁـﻴﻁ‬ ‫ﺘﻌﺘﺒﺭ ﻫﺎﻤﺔ ﺠﺩﹰ‬ ‫ﻓﻌﺎﻟﻴﺘﻬﺎ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ‪ .‬ﻭﻤﺜل ﻫﺫﻩ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﹸ‬ ‫ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻲ ﻭﺘﺨﺼﻴﺹ ﺍﻟﻤﻭﺍﺭﺩ‪ .‬ﻟﺫﻟﻙ‪ ،‬ﻴﻨﺒﻐﻲ ﺍﻟﺒﺩﺀ ﺒﻌﻤﻠﻴﺔ ﺘﺠﻤﻴﻊ ﻭﺘﺤﻠﻴل ﻟﻠﻤﻌﻁﻴﺎﺕ ﻤﻥ ﺃﺠل ﺘـﺘﺒﻊ ﺍﻟﻤﻌﺎﻴـﻴﺭ‬ ‫ﺍﻟﻘﻴﺎﺴﻴﺔ‪ ،‬ﻭﺫﻟﻙ ﻤﻥ ﺃﺠل ﻗﻴﺎﺱ ﺍﻵﺘﻲ‪:‬‬ ‫ ﺘﻘﺩﻴﻡ ﺍﻟﺨﺩﻤﺎﺕ )ﻤﺜل ﻋﺩﺩ ﺍﻟﻌﻤﻼﺀ ﺍﻟﻤﺘﻠﻘﻴﻥ ﻟﻠﺨﺩﻤﺔ‪ ،‬ﺍﻟﺤﻭﺍﻤل ﺍﻟﻼﺘﻲ ﺘﻡ ﺘﺤﺭﻱ ﺤﺎﻻﺘﻬﻥ ﻭﻤـﻥ ﺜـﻡ‬‫ﻤﻌﺎﻟﺠﺘﻬﻥ ﻤﻥ ﻤﺭﺽ ﺍﻟﺯﻫﺭﻱ‪ ،‬ﻭﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ ﺍﻟﺘﻲ ﺘﻡ ﺘﻭﺯﻴﻌﻬﺎ‪ ،‬ﻭﺍﻷﺸﺨﺎﺹ ﺍﻟـﺫﻴﻥ ﺃﺤﻴﻠـﻭﺍ‬ ‫ﻹﺠﺭﺍﺀ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﻁﻭﻋﻴﺔ ﻭﺘﻠﻘﻲ ﺍﻟﺘﻭﻋﻴﺔ(؛‬ ‫ ﺠﻭﺩﺓ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﻤﻘﺩﻤﺔ )ﻤﺜل ﻨﺴﺒﺔ ﺍﻟﻌﻤﻼﺀ ﺍﻟﻤﻌﺎﻟﺠﻴﻥ ﻭﻓﻘﹰ‬‫ﺎ ﻟﻠﺩﻻﺌل ﺍﻹﺭﺸﺎﺩﻴﺔ ﺍﻟﻭﻁﻨﻴـﺔ ﺒﺎﺴـﺘﺨﺩﺍﻡ‬ ‫ﺍﻟﻤﺅﺸﺭﺍﺕ ﺍﻟﻘﻴﺎﺴﻴﺔ ﻤﺜل ﻤﺅﺸﺭﺍﺕ ﺍﻟﻭﻗﺎﻴﺔ ﺤﺴﺏ ﺍﻷﻭﻟﻭﻴﺎﺕ(؛‬ ‫ ﻤﺩﻯ ﻜﻔﺎﻴﺔ ﺃﻨﻤﺎﻁ ﺍﻟﻌﺎﻤﻠﻴﻥ )ﺒﻤﻌﺭﻓﺔ ﺃﻋﺩﺍﺩ ﺍﻟﻤﺭﻀﻰ‪ ،‬ﻋﻠﻰ ﺴﺒﻴل ﺍﻟﻤﺜﺎل(؛‬‫ ﺍﺴﺘﺠﺎﺒﺔ ﺍﻟﻌﻤﻼﺀ ﻭﺭﻀﺎﻫﻡ )ﻤﺜل ﺇﺠﻤﺎﻟﻲ ﻋﺩﺩ ﺍﻟﻌﻤﻼﺀ ﺍﻟﺫﻴﻥ ﺘﻠﻘﻭﺍ ﺍﻟﺨﺩﻤﺔ‪ ،‬ﺍﻟﺯﻴﺎﺭﺍﺕ ﺍﻷﻭﻟﻴﺔ ﻤﻘﺎﺒل‬‫ﺍﻟﺯﻴﺎﺭﺍﺕ ﺍﻟﻤﺘﻜﺭﺭﺓ ﺃﻭ ﺯﻴﺎﺭﺍﺕ ﺍﻟﻤﺘﺎﺒﻌﺔ‪ ،‬ﻨﺴﺒﺔ ﻤﻥ ﻴـﺴﺘﺨﺩﻤﻭﻥ ﻤﺭﺍﻓـﻕ ﺍﻟﺭﻋﺎﻴـﺔ ﻜﺨﻴـﺎﺭ ﺃﻭل‬ ‫ﻟﻠﻤﻌﺎﻟﺠﺔ(؛‬ ‫ ﻤﺼﺭﻭﻓﺎﺕ ﺍﻟﺒﺭﻨﺎﻤﺞ ﺍﻟﺭﺃﺴﻤﺎﻟﻴﺔ ﻭﺍﻟﻤﺘﻜﺭﺭﺓ‪ ،‬ﻟﺘﻘﻴـﻴﻡ ﺍﻟﻔﺎﻋﻠﻴﺔ‪ ،‬ﻭﺍﻟﻔﻌﺎﻟﻴﺔ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ‪.‬‬‫ﺔ ﺇﻟﻰ ﺫﻟﻙ‪ ،‬ﻓﻤﻥ ﺍﻷﻫﻤﻴﺔ ﺒﻤﻜﺎﻥ ﺃﻥ ﻴﺘﻡ ﺭﺒﻁ ﻨﺘﺎﺌﺞ ﻫﺫﺍ ﺍﻟﺭﺼﺩ‪ ،‬ﻭﺍﻟﺘﻲ ﻴﻤﻜـﻥ ﺍﻗﺘـﺼﺎﺭﻫﺎ ﻋﻠـﻰ‬ ‫ﺇﻀﺎﻓ ﹰ‬ ‫ﺍﻟﺒﺤﻭﺙ ﺍﻟﻤﻴﺩﺍﻨﻴﺔ‪ ،‬ﺒﺘﻨﻔﻴﺫ ﺍﻟﺒﺭﻨﺎﻤﺞ ﻭﺃﻥ ﻴﺘﻡ ﺫﻟﻙ ﺒﻁﺭﻴﻘﺔ ﻫﺎﺩﻓﺔ‪ .‬ﻭﻴﺘﻌﻴﻥ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻨﺘﺎﺌﺞ ﻟﺘﻘﻴـﻴﻡ ﻭﺘﺤﺴﻴﻥ ﺍﻟﺒﺭﺍﻤﺞ‬ ‫ﺍﻟﺠﺎﺭﻱ ﺘﻨﻔﻴﺫﻫﺎ ﻭﻜﺫﻟﻙ ﻟﻭﻀﻊ ﺒﺭﺍﻤﺞ ﺠﺩﻴﺩﺓ‪ .‬ﻭﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻹﺠﺭﺍﺀ ﺍﻟﻤﺯﻴﺩ ﻤﻥ ﺍﻟﺒﺤﻭﺙ ﺍﻟﻤﻴﺩﺍﻨﻴﺔ ﻟﺘﺤﺩﻴﺩ ﺍﻟﺘﺩﺨﻼﺕ‬ ‫ﺍﻟﺘﻲ ﺘﻌﻤل ﺒﺼﻭﺭﺓ ﺃﻓﻀل ﻓﻲ ﺃﻤﺎﻜﻥ ﻤﻌﻴﻨﺔ ﻭﺍﻟﺒﺤﺙ ﻜﺫﻟﻙ ﻓﻲ ﺍﻟﻘﻀﺎﻴﺎ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟـﺼﺤﺔ ﺍﻟﺠﻨـﺴﻴﺔ ﻭﺍﻹﻨﺠﺎﺒﻴـﺔ‬ ‫ﻟﻠﺴﻴﺩﺍﺕ‪ ،‬ﻭﺫﻟﻙ ﻟﻼﺴﺘﺭﺸﺎﺩ ﺒﻬﺎ ﻓﻲ ﺼﻴﺎﻏﺔ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻭﺘﺩﺨﻼﺕ ﺫﺍﺕ ﺤﺴﺎﺴﻴﺔ ﻟﻠﺠﻨﺴﻴﻥ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﺘﺩﺍﺨل ﻤﻊ ﺒﺭﺍﻤﺞ ﻭﺸﺭﻜﺎﺀ ﺁﺨﺭﻴﻥ‬

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‫‪ ١-٤-٣‬ﺒﺭﺍﻤﺞ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﺍﻟﻌﺎﻡ‬ ‫ﺎ ﺒﺎﻟﺒﺭﺍﻤﺞ ﺍﻟﺼﺤﻴﺔ ﺍﻷﺨﺭﻯ ﺍﻟﻤﺨﺘﺼﺔ ﺒﺼﺤﺔ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﻭﺘﻨﻅﻴﻡ ﺍﻷﺴﺭﺓ‪،‬‬ ‫ﺘﺭﺘﺒﻁ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺼﺤﺔ ﺍﻟﻤﺭﺃﺓ‪ ،‬ﻭﺍﻷﻤﻭﻤﺔ ﺍﻟﻤﺄﻤﻭﻨﺔ‪ ،‬ﻭﺍﻟﺘﻤﻨﻴﻊ‪ ،‬ﻭﺒﻘﺎﺀ ﺍﻟﻁﻔل‪ ،‬ﻭﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌـﺩﻭﻯ ﺒﻔﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ ﺍﻟﻤﻨـﺎﻋﻲ‬ ‫ﺍﻟﺒﺸﺭﻱ‪ .‬ﻭﻫﺫﻩ ﺍﻟﺒﺭﺍﻤﺞ ﻴﻌﺘﻤﺩ ﺒﻌﻀﻬﺎ ﻋﻠﻰ ﺍﻟﺒﻌﺽ ﺍﻵﺨﺭ‪ ،‬ﻭﻻﺒﺩ ﻤﻥ ﺃﻥ ﺘـﺘﻔﺎﻋل ﻤﻊ ﺒﻌﻀﻬﺎ ﺍﻟﺒﻌﺽ ﺃﻭ ﺘﺘﻜﺎﻤل‬ ‫ﺍﺴﺘﺭﺍﺘﻴﺠﻴﹰ‬ ‫ﺎ‬ ‫ﺎ‪ .‬ﻭﻫﺫﺍ ﺍﻟﺘﻜﺎﻤل ﺃﻤﺭ ﺤﺘﻤﻲ ﻤﻥ ﺃﺠل ﺘﻭﺴﻴﻊ ﻨﻁﺎﻕ ﺍﻟﺘﻐﻁﻴﺔ ﺒﺎﻟﻤﺩﺨﻼﺕ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺫﻟﻙ ﺒﻐﺭﺽ ﺍﻟﺘﻘﻠﻴل ﻤﻥ ﺍﻟﻔﺭﺹ ﺍﻟﻀﺎﺌﻌﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﻭﻗﺎﻴﺔ‪ ،‬ﻭﺍﻟﻜﺸﻑ ﻋﻥ ﺍﻟﺤﺎﻻﺕ ﺍﻟﻤـﺼﺎﺒﺔ ﺒﻬـﺫﻩ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﻭﻤﻌﺎﻟﺠﺘﻬﺎ‪ .‬ﻭﻴﺠﺏ ﻜﺫﻟﻙ ﺘﻌﺯﻴﺯ ﻭﺘﻘﻭﻴﺔ ﺍﻟﺘﻌﺎﻭﻥ ﻓﻲ ﻤﺎ ﺒﻴﻥ ﺍﻟﻘﻁﺎﻋﻴﻥ ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ ﻟﻠﺤﺼﻭل ﻋﻠﻰ ﺠﻭﺩﺓ ﺃﻓﻀل‬ ‫ﻭﺘﻐﻁﻴﺔ ﺃﻜﺒﺭ‪ .‬ﺇﻻ ﺃﻥ ﻫﺫﺍ ﺍﻟﺘﺩﺍﺨل ﺃﻭ ﺍﻟﺘﺭﺍﺒﻁ ﻴ‬ ‫ﺎ ﺒﻔﻌل ﺍﻟﺤﺎﺠﺔ ﻟﻠﻘﻴﺎﻡ ﺒﻤﻬﺎﻡ ﺃﺨﺭﻯ ﺇﻀﺎﻓﻴﺔ ﻭﺇﺩﺨﺎﻟﻬـﺎ‬ ‫ﺍ ﺼﻌﺒﹰ‬ ‫‪‬ﻌﺩ ﺃﻤﺭﹰ‬ ‫ﻀﻤﻥ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻘﺎﺌﻤﺔ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻋﻨﺩﻤﺎ ﺘﺨﺘﻠﻑ ﻤﺭﺍﻤﻴﻬﺎ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻤﻬﺎﻡ ﺍﻟﺠﺩﻴﺩﺓ ﻋﻥ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﻘﺩﻤـﺔ‬ ‫ﺎ‪ .‬ﻭﻗﺩ ﺘﻜﻭﻥ ﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻟﻭﺠﻭﺩ ﺇﺸﺭﺍﻑ ﺇﻀﺎﻓﻲ ﻭﺩﻋﻡ ﻤﺎﻟﻲ ﻭﺇﺩﺍﺭﻱ‪ ،‬ﻭﺇﻟﻰ ﺃﻥ ﻴﺘﻭﺍﺠﺩ ﻜل ﻫﺫﺍ‪ ،‬ﻓﻠﻥ ﻴﻜـﻭﻥ‬ ‫ﻓﻌﻠﻴﹰ‬ ‫ﺎ ﺍﻻﻓﺘﺭﺍﺽ ﺒﺄﻥ ﺍﻟﺘﻜﺎﻤل ﻗﺩ ﺘﻡ ﺇﻨﺸﺎﺅﻩ‪ .‬ﻭﺭﻏﻡ ﺇﺴﻬﺎﻡ ﺍﻻﺭﺘﺒﺎﻁ ﺍﻟﺒﻴﻨﻲ ﻭﺘﻜﺎﻤل ﺍﻟﺒﺭﺍﻤﺞ ﻓﻲ ﺘﻴﺴﻴﺭ ﻋﻤﻠﻴﺔ ﺯﻴﺎﺩﺓ‬ ‫ﻤﻤﻜﻨﹰ‬ ‫ﺭﻗﻌﺔ ﺍﻟﺘﻐﻁﻴﺔ ﺒﺎﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﻘﺩﻤﺔ ﻟﻠﻌﻤﻼﺀ‪ ،‬ﻭﻭﺼﻭﻟﻬﻡ ﺇﻟﻰ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﻜﺫﻟﻙ ﻋﻤﻠﻴﺔ ﺍﻟﺘﺨﻁﻴﻁ ﺍﻹﺩﺍﺭﻱ‪ ،‬ﺇﻻ‬ ‫ﺃﻥ ﺘﺤﻘﻴﻘﻬﺎ ﻟﻴﺱ ﺒﺎﻷﻤﺭ ﺍﻟﺴﻬل ﻭﻻ ﻫﻭ ﺃﺭﺨﺹ ﻤﻥ ﺤﻴﺙ ﺍﻟﺘﻜﻠﻔﺔ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﺍﻟﻤﺭﺤﻠﺔ ﺍﻷﻭﻟﻰ‪ ،‬ﺤﻴﺙ ﺘﺼﺒﺢ ﺍﻟﻔﻭﺍﺌﺩ‬ ‫ﻤﻠﻤﻭﺴﺔ ﻭﻤﺤﺴﻭﺴﺔ ﻓﻘﻁ ﺒﻌﺩ ﻤﻭﺍﺠﻬﺔ ﺍﻟﺼﻌﻭﺒﺎﺕ ﻭﺘﻜﺒﺩ ﺍﻟﻨﻔﻘﺎﺕ ﻓﻲ ﺍﻟﻤﺭﺤﻠﺔ ﺍﻷﻭﻟﻴﺔ‪.‬‬

‫ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‬ ‫ﺎ‪ ،‬ﻫـﻭ‬ ‫ﺇﻥ ﺍﻷﺴﻠﻭﺏ ﺍﻟﻐﺎﻟﺏ ﻟﺴﺭﺍﻴﺔ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺍﻻﺘﺼﺎل ﺍﻟﺠﻨﺴﻲ‪ .‬ﻭﺘـﺘﻀﻤﻥ ﺍﻟﺴﺒل ﺍﻷﺨﺭﻯ ﻟﻠﺴﺭﺍﻴﺔ‪ ،‬ﺒﺎﻟﻨﺴﺒﺔ ﻟﻼﺜﻨﻴﻥ‪ ،‬ﺘﻌﺎﻁﻲ ﺍﻟﻤﺨﺩﺭﺍﺕ ﻋﻥ ﻁﺭﻴﻕ ﺍﻟﺤﻘـﻥ‪،‬‬ ‫ﻭﺍﻟﺩﻡ‪ ،‬ﻭﻤﺸﺘﻘﺎﺘﻪ‪ ،‬ﻭﺍﻷﻋﻀﺎﺀ ﺃﻭ ﺍﻷﻨﺴﺠﺔ ﺍﻟﺠﺴﻤﺎﻨﻴﺔ ﺍﻟﻤﺘﺒﺭﻉ ﺒﻬﺎ‪ ،‬ﻭﺍﻟﺴﺭﺍﻴﺔ ﻤﻥ ﺍﻷﻡ ﺇﻟـﻰ ﺠﻨﻴﻨﻬـﺎ ﺃﻭ ﻭﻟﻴـﺩﻫﺎ‪.‬‬ ‫ﻭﺍﻟﻜﺜﻴﺭ ﻤﻥ ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﻲ ﻴﺘﻡ ﺍﺘﺨﺎﺫﻫﺎ ﺒﻬﺩﻑ ﻭﻗﻑ ﺍﻟﺴﺭﺍﻴﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﺴـﺎﺌﺭ‬ ‫ﺎ ﻫﻲ ﻨﻔﺴﻬﺎ‪ ،‬ﻜﻤﺎ ﺃﻥ ﺍﻟﺤﺎل ﻫﻭ ﻨﻔﺴﻪ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﻔﺌﺎﺕ ﻭﺍﻟﺘﺠﻤﻌـﺎﺕ ﺍﻟـﺴﻜﺎﻨﻴﺔ ﺍﻟﺘـﻲ ﻴـﺘﻡ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﱡﻼﺕ ﺍﻟﻤﻁﻠﻭﺒﺔ‪.‬‬ ‫ﱢﻲ ﺍﻟﺘﺩﺨ‬ ‫ﺍﺴﺘﻬﺩﺍﻓﻬﺎ ﻟﺘﻠﻘ‬ ‫ﺎ‪ ،‬ﻓﺈﻨﻬﺎ ﺘﺴﻬل ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨـﺎﻋﻲ‬ ‫ﻭﻓﻲ ﺤﺎﻟﺔ ﻭﺠﻭﺩ ﺒﻌﺽ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺤﻴﺙ ﺃﻅﻬﺭ ﻋﺩﺩ ﻤﻥ ﺍﻟﺩﺭﺍﺴﺎﺕ‪ ،‬ﺍﺭﺘﺒﺎﻁ ﻜل ﻤﻥ ﺍﻟﻜﺎﺌﻨﺎﺕ ﺍﻟﻤﻤﺭﻀﺔ ﺍﻟﺘﻘﺭﺤﻴﺔ ﻭﻏﻴﺭ ﺍﻟﺘﻘﺭﺤﻴﺔ‪ ،‬ﺒﺩﺭﺠﺎﺕ‬ ‫ﻤﺘﻔﺎﻭﺘﺔ‪ ،‬ﺒﻌﻭﺍﻤل ﺍﺨﺘﻁﺎﺭ ﺒﻨﺴﺒﺔ ﺘـﺘﺭﺍﻭﺡ ﺒﻴﻥ ‪ ١‚٥‬ﻭ‪) ٨‚٥‬ﺭﺍﺠﻊ ﺍﻟﺠﺩﻭل ﺭﻗﻡ ‪ .(٢‬ﻭﻴﻤﻜﻥ ﺃﻥ ﺘﻜـﻭﻥ ﺍﺤﺘﻤﺎﻟﻴـﺔ‬ ‫ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻟﻜل ﻋﻤل ﻤﻔﺭﺩ‪ ،‬ﺃﻋﻠﻰ ﺒﻜﺜﻴﺭ ﻤﻥ ﺍﻟﻤﺨﺎﻁﺭ ﺍﻟﻨﺴﺒﻴﺔ ﺍﻟﺘﻲ ﺘﻼﺤﻅ‬ ‫ﻓﻲ ﺍﻟﺩﺭﺍﺴﺎﺕ ﺍﻻﺴﺘﺒﺎﻗﻴﺔ )ﺍﻷﺘﺭﺍﺒﻴﺔ(‪ .‬ﻭﻴﺭﺠﻊ ﺍﻟﺴﺒﺏ ﻓﻲ ﺫﻟﻙ ﺇﻟﻰ ﺃﻥ ﺍﻟﻤﺸﺎﺭﻜﻴﻥ ﻻ ﻴﺼﺎﺒﻭﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ ﺒﺸﻜل ﻤﺴﺘﻤﺭ‪ ،‬ﺨﻼل ﻓﺘﺭﺓ ﺍﻟﻤﺘﺎﺒﻌﺔ‪ .‬ﻭﻋﻠﻰ ﺍﻟﺭﻏﻡ ﻤﻥ ﺃﻥ ﺘﺄﺜﻴﺭ ﺍﻟﻌﺎﻤل ﺍﻟﻤﺘﻤﻡ ﻴﺒﺩﻭ ﺃﻋﻠﻰ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻸﻤﺭﺍﺽ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺘﻘﺭﺤﻴﺔ‪ ،‬ﺇﻻ ﺃﻥ ﺍﻟﻌﺩﺍﻭﻯ ﻏﻴﺭ ﺍﻟﺘﻘﺭﺤﻴﺔ ﻴﻤﻜﻥ ﺃﻥ ﺘﻜﻭﻥ ﺃﻜﺜﺭ ﺃﻫﻤﻴﺔ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﺒﻌﺽ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺒـﺴﺒﺏ‬ ‫ﺘﻭﺍﺘﺭﻫﺎ ﻭﺍﻨﺘﺸﺎﺭﻫﺎ‪ .‬ﻭﻟﻘﺩ ﺃﻀﺎﻓﺕ ﺒﻌﺽ ﺍﻟﺩﺭﺍﺴﺎﺕ ﺍﻟﺘﺩﺨﻠﻴﺔ ﺍﻟﺤﺩﻴﺜﺔ‪ ،‬ﻤﻌﻠﻭﻤﺎﺕ ﻭﺜﻘل ﻟﺘﺄﺜﻴﺭ ﺍﻟﻌﺎﻤل ﺍﻟﻤﺘﻤﻡ ﺍﻟﺨﺎﺹ‬ ‫ﺒﻤﺭﺽ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪.‬‬ ‫ﻟﻘﺩ ﺃﻅﻬﺭﺕ ﺘﺠﺭﺒﺔ ﺍﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﻤﺠﺘﻤﻌﻴﺔ ﺍﻟﻌﺸﻭﺍﺌﻴﺔ ﺍﻟﺘﻲ ﺃﺠﺭﻴﺕ ﻓﻲ ﻤﻘﺎﻁﻌﺔ ﻤﻭﺍﻨﺯﺍ ﺒﺠﻤﻬﻭﺭﻴﺔ ﺘﻨﺯﺍﻨﻴـﺎ‬ ‫ﺎ ﺍﻟﻤﺼﺤﻭﺒﺔ ﺒﺄﻋﺭﺍﺽ‪ ،‬ﺒﺎﺴﺘﺨﺩﺍﻡ ﻋﻨﺎﺼـﺭ ﺍﻟﺘـﺩﺒﻴﺭ‬ ‫ﺍﻟﻤﺘﺤﺩﺓ ﺃﻥ ﺘﻌﺯﻴﺯ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﻼﺠﻲ ﻟﻠﻤﺘﻼﺯﻤﺎﺕ ﻤﻥ ﺨﻼل ﻋﻴﺎﺩﺍﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﺍﻟﻤﻭﺠﻭﺩﺓ ﺒﺎﻟﻔﻌل‪ ،‬ﻗﺩ ﻗﻠل ﻤـﻥ ﻨـﺴﺒﺔ ﺤـﺩﻭﺙ‬ ‫ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﺒﻨﺴﺒﺔ ‪ .٪٣٨‬ﻜﻤﺎ ﺃﻅﻬﺭﺕ ﻨﺘﺎﺌﺞ ﺩﺭﺍﺴﺔ ﺃﺠﺭﻴﺕ ﻓﻲ ﻤﺎﻻﻭﻱ ﻋﻠﻰ ﺭﺠﺎل‬ ‫ﺇﻴﺠﺎﺒﻴﻲ ﺍﻟﻤﺼل ﻟﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ – ﺍﻟﻨﻤﻁ ‪ ،١‬ﺃﻥ ﺍﻟﺭﺠﺎل ﺍﻟﺫﻴﻥ ﻜﺎﻨﺕ ﻟـﺩﻴﻬﻡ ﺇﺼـﺎﺒﺔ ﺒﺎﻟﺘﻬـﺎﺏ‬ ‫ﺍﻹﺤﻠﻴل‪ ،‬ﻜﺎﻥ ﺘﺭﻜﻴﺯ ﺍﻟﺤﻤﺽ ﺍﻟﻨﻭﻭﻱ ﺍﻟﺭﻴﺒﻲ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ – ﺍﻟﻨﻤﻁ ‪ ،١‬ﻓﻲ ﺒﻼﺯﻤـﺎ ﺍﻟـﺴﺎﺌل‬ ‫‪44‬‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﻤﻨﻭﻱ ﻟﺩﻴﻬﻡ‪ ،‬ﺃﻋﻠﻰ ﺜﻤﺎﻨﻲ ﻤﺭﺍﺕ ﻤﻥ ﺍﻟﺭﺠﺎل ﺍﻟﺫﻴﻥ ﻜﺎﻨﻭﺍ ﺇﻴﺠﺎﺒﻴﻲ ﺍﻟﻤﺼل ﻟﻠﻔﻴﺭﻭﺱ‪ ،‬ﺩﻭﻥ ﺃﻥ ﻴﻜﻭﻨﻭﺍ ﻤـﺼﺎﺒﻴﻥ‬ ‫ﺎ ﺒﺄﻋﻠﻰ ﻨﺴﺒﺔ ﺘﺭﻜﻴﺯ ﻟﻔﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ ﺍﻟﻤﻨـﺎﻋﻲ‬ ‫ﺒﺎﻟﺘﻬﺎﺏ ﺍﻹﺤﻠﻴل )‪ .(١٨‬ﻭﻜﺎﻥ ﺘﻭﺭﻡ ﺍﻟﺨﺼﻴﺔ ﺒﺎﻟﻤﻨﻲ ﻤﺼﺤﻭﺒﹰ‬ ‫ﺍﻟﺒﺸﺭﻱ – ﺍﻟﻨﻤﻁ ‪ ١‬ﻓﻲ ﺍﻟﺴﺎﺌل ﺍﻟﻤﻨﻭﻱ‪ .‬ﻭﺒﻌﺩ ﺘﻠﻘﻲ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﺘﻬـﺎﺏ ﺍﻹﺤﻠﻴـل ﻟﻌـﻼﺝ ﺒﻤـﻀﺎﺩﺍﺕ‬ ‫ﺎ‪ ،‬ﻗل ﺘﺭﻜﻴﺯ ﺍﻟﺤﻤﺽ ﺍﻟﻨﻭﻭﻱ ﺍﻟﺭﻴﺒﻲ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨـﺎﻋﻲ‬ ‫ﺎ ﻀﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﻴﻜﺭﻭﺒﺎﺕ‪ ،‬ﻤﻭﺠﻬﹰ‬ ‫ﱢـﻲ ﺍﻟﻌـﻼﺝ‪ ،‬ﺇﻻ ﺃﻥ ﺘﺭﻜﻴـﺯ‬ ‫ﺍﻟﺒﺸﺭﻱ – ﺍﻟﻨﻤﻁ ‪ ،١‬ﻓﻲ ﺍﻟﺴﺎﺌل ﺍﻟﻤﻨﻭﻱ ﺒﺸﻜل ﻜﺒﻴﺭ ﻓﻲ ﻏﻀﻭﻥ ﺃﺴﺒﻭﻋﻴﻥ ﻤﻥ ﺘﻠﻘ‬ ‫ﺍﻟﺤﻤﺽ ﺍﻟﻨﻭﻭﻱ ﻟﻠﻔﻴﺭﻭﺱ‪ ،‬ﻟﻡ ﻴﺘﻐﻴﺭ ﻓﻲ ﺒﻼﺯﻤﺎ ﺍﻟﺩﻡ‪ .‬ﻭﻟﻡ ﻴﻜﻥ ﻫﻨﺎﻙ ﺘﻐﻴﺭ ﻜﺒﻴﺭ ﻓﻲ ﺘﺭﻜﻴـﺯ ﺍﻟﺤﻤـﺽ ﺍﻟﻨـﻭﻭﻱ‬ ‫ﺍﻟﺭﻴﺒﻲ ﻟﻬﺫﺍ ﺍﻟﻔﻴﺭﻭﺱ ﻓﻲ ﺒﻼﺯﻤﺎ ﺍﻟﺴﺎﺌل ﺍﻟﻤﻨﻭﻱ ﻭﺫﻟﻙ ﺨﻼل ﻓﺘﺭﺓ ﺍﻷﺴﺒﻭﻋﻴﻥ‪ ،‬ﻓﻲ ﺍﻟﻔﺌﺔ ﺍﻟﺸﺎﻫﺩﺓ‪ .‬ﻭﺘـﻭﺤﻲ ﻫـﺫﻩ‬ ‫ﺍﻟﻨﺘﺎﺌﺞ ﺒﺄﻥ ﻤﻌﺎﻟﺠﺔ ﺍﻟﺘﻬﺎﺏ ﺍﻹﺤﻠﻴل ﺘﻘﻠل ﻤﻥ ﺇﻋﺩﺍﺀ ﺍﻟﺭﺠﺎل ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ – ﺍﻟﻨﻤﻁ ‪ ،١‬ﻤﻤﺎ ﻴﻘﺩﻡ‬ ‫ﺎ‬ ‫ﻼ ﺁﺨﺭ ﻋﻠﻰ ﺃﻥ ﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪ ،‬ﻭﺍﻟﺘﻲ ﺘﺸﻤل ﺍﻟﻜﺸﻑ ﻋﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺩﻟﻴ ﹰ‬ ‫ﻭﻤﻌﺎﻟﺠﺘﻬﺎ ﻟﺩﻯ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻔﻌل ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ – ﺍﻟﻨﻤﻁ ‪ ،١‬ﻗﺩ ﻴﻔﻴﺩ ﻓﻲ ﻜﺒﺢ ﺠﻤـﺎﺡ‬ ‫ﻫﺫﺍ ﺍﻟﻭﺒﺎﺀ‪.‬‬ ‫ﺎ ﻫﻲ ﺨﻴﺎﺭ ﻋﺎﻟﻲ ﺍﻟﻤﺭﺩﻭﺩ‪ ،‬ﻭﻋﻠﻰ ﺍﻟﺒﻠﺩﺍﻥ ﺍﺴﺘﺜﻤﺎﺭ ﺫﻟﻙ‪ ،‬ﺒﺴﺒﺏ ﻜـﻭﻥ‬ ‫ﺇﻥ ﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻷﻥ ﻫﺫﻩ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻫﻲ ﺒﻤﺜﺎﺒﺔ ﺇﺠﺭﺍﺀ ﺘﺩﺨﻠﻲ ﻟﻠﻭﻗﺎﻴﺔ ﻤـﻥ‬ ‫ﺍ ﻟﻺﺼﺎﺒﺔ ﺒﺎﻷﻤﺭﺍﺽ‪ ،‬ﻭﺃﻴﻀﹰ‬ ‫ﺎ ﺨﻁﻴﺭﹰ‬ ‫ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﺴﺒﺒﹰ‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ .‬ﻟﺫﺍ‪ ،‬ﻴﺠﺏ ﺃﻥ ﻴﻜﻭﻥ ﻫﻨﺎﻙ ﺍﺭﺘﺒﺎﻁ ﻗﻭﻱ ﺒﻴﻥ ﺒﺭﻨﺎﻤﺠﻲ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﺃﻥ ﻴـﺘﻡ ﺍﻟﺤﻔـﺎﻅ ﻋﻠـﻰ ﻫـﺫﺍ ﺍﻻﺭﺘﺒـﺎﻁ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ل ﻜل ﻤﻨﻬﻤﺎ ﺠﻬﻭﺩ ﺍﻵﺨﺭ‪ ،‬ﻓﻲ ﻀﻭﺀ ﺍﻟﺘﻔﺎﻋﻼﺕ ﺍﻟﺘﺂﺯﺭﻴﺔ ﺒﻴﻥ ﺍﻟﻌـﺩﻭﻯ ﺒﻔﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ‬ ‫ﻭﺍﺴﺘﻤﺭﺍﺭﻩ‪ ،‬ﻭﺃﻥ ﻴﻜﻤ‬ ‫ﺎ ﻭﺒﻴﻥ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﻤﺸﺘﺭﻜﺔ ﻓﻲ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﻜﻠﻴﻬﻤﺎ‪ .‬ﻭﻫﻨﺎﻙ ﺘﻜﺎﻤل ﻜﻠـﻲ ﺃﻭ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﻭﺴﺎﺌﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻭﻤﻜﺎﻓﺤﺔ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺃﻭ ﻴﺘﻡ ﺍﻟﺘﻨـﺴﻴﻕ‬ ‫ﺠﺯﺌﻲ ﺒﻴﻥ ﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﻴﻨﻬﻤﺎ ﻤﻥ ﺨﻼل ﺘﺨﻁﻴﻁ ﻤﺸﺘﺭﻙ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺃﻗﺎﻟﻴﻡ ﻭﺒﻠﺩﺍﻥ ﺍﻟﻌﺎﻟﻡ‪.‬‬ ‫ﻭﺘﺸﻤل ﻤﺠﺎﻻﺕ ﺍﻟﺘﻌﺎﻭﻥ ﺒﻴﻥ ﻫﺫﻩ ﺍﻟﺒﺭﺍﻤﺞ‪ ،‬ﺍﻟﺩﻋﻭﺓ ﻭﺍﻟﻤﺴﺎﻨﺩﺓ‪ ،‬ﻭﺼﻴﺎﻏﺔ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﺘـﺩﺭﻴﺏ‪ ،‬ﻭﺘﺨﻁـﻴﻁ‬ ‫‪‬ﺩ ﻭﺍﻟﺒﺤﻭﺙ‪ .‬ﻭﻻ ﻴﺠﺏ ﺃﻥ ﺘﻘﺘﺼﺭ ﺃﻨﺸﻁﺔ ﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤـﺔ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﻭﺇﻋﺩﺍﺩ ﺍﻟﺒﺭﺍﻤﺞ‪ ،‬ﻭﺃﻨﺸﻁﺔ ﺍﻟﺘﻘﻴـﻴﻡ ﻭﺍﻟﺘﺭﺼ‬ ‫ﺎ ﻤﻥ ﺍﻟﺘﺸﺎﺭﻙ ﻓﻲ‬ ‫ﺎ ﻭﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻓﻘﻁ ﻋﻠﻰ ﺍﻟﺘﻌﺎﻭﻥ ﻓﻴﻤﺎ ﺒﻴﻨﻬﻤﺎ‪ ،‬ﺒل ﻻﺒﺩ ﺃﻴﻀﹰ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻟﺘﺤﻘﻴﻕ ﺍﻵﺘﻲ‪:‬‬ ‫ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﺨﺎﺼﺔ ﺒﻬﻤﺎ ﻷﻏﺭﺍﺽ ﺘﺨﻁﻴﻁ ﻭﺇﻋﺩﺍﺩ ﻭﺘﻨﻔﻴﺫ ﻫﺫﻩ ﺍﻷﻨﺸﻁﺔ‪ .‬ﻭﻴﻤﻜﻥ ﺃﻥ ﻴﻌﻤﻼ ﻤﻌﹰ‬ ‫ﺘﺜﻘﻴﻑ ﺍﻟﻌﻤﻼﺀ ﺤﻭل ﺍﻟﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﻤﺤﻔﻭﻓﺔ ﺒﺎﻟﻤﺨﺎﻁﺭ ﻭﻁﺭﻕ ﺍﻟﻭﻗﺎﻴﺔ‪ ،‬ﻭﺫﻟﻙ ﻋﻠﻰ ﻤـﺴﺘﻭﻯ ﻤﺭﺍﻜـﺯ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﺩﺍﺨل ﺍﻟﻤﺠﺘﻤﻊ‪ ،‬ﻭﺒﺎﺸﺘﺭﺍﻙ ﺍﻟﻘﻁﺎﻋﻴﻥ ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ‪ ،‬ﻋﻠﻰ ﻗﺩﻡ ﺍﻟﻤﺴﺎﻭﺍﺓ؛‬ ‫•‬ ‫•‬

‫ﺎ ﻟﺘﺤﺴﻴﻥ ﺠﻭﺩﺓ ﺍﻟﺤﻴﺎﺓ ﻟﻸﺸـﺨﺎﺹ‬ ‫‪‬ﺎﻟﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﺴﺘﺤﻜﻤﺔ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﻭﻓﻴﺭ ﻤﻌﺎﻟﺠﺔ ﻓﻌ‬ ‫ﺍﻟﻤﺘﻌﺎﻴﺸﻴﻥ ﻤﻊ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﺘﻘﻠﻴل ﺇﻤﻜﺎﻨﻴﺔ ﺍﻹﻋﺩﺍﺀ؛‬

‫ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﻤﺤﺎﻓﻅﺔ ﻋﻠﻰ ﺍﻟﺨﺼﻭﺼﻴﺔ ﻭﺍﻟﺴﺭﻴﺔ ﻭﺍﻻﺨﺘﺒﺎﺭ ﺍﻟﻁـﻭﻋﻲ ﻟﻠﻜـﺸﻑ ﻋـﻥ‬ ‫ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻟﺘﻤﻜﻴﻥ ﺍﻷﺸﺨﺎﺹ ﻤﻥ ﻤﻌﺭﻓﺔ ﻭﻀﻌﻬﻡ ﺍﻟﻤﺭﻀﻲ ﺍﻟﻤﺘﻌﻠﻕ ﺒﺎﻹﺼﺎﺒﺔ‬ ‫ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ‪ ،‬ﻤﻊ ﺇﺠﺭﺍﺀ ﺍﻟﺘﻘﻴـﻴﻡ ﺍﻟﻤﻨﺎﺴﺏ ﻷﻏﺭﺍﺽ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺒﻤﻀﺎﺩﺍﺕ ﺍﻟﻔﻴﺭﻭﺴـﺎﺕ‬ ‫ﺍﻟﻘﻬﻘﺭﻴﺔ؛‬

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‫ﻀﻤﺎﻥ ﺇﺴﻬﺎﻡ ﺍﻻﺴﺘﺜﻤﺎﺭﺕ ﺍﻟﻭﻁﻨﻴﺔ ﻓﻲ ﺍﻟﺒﻨﻴﺔ ﺍﻷﺴﺎﺴﻴﺔ ﻟﻠﻨﻅﻡ ﺍﻟﺼﺤﻴﺔ ﻭﻨﻅﻡ ﺘﻭﺯﻴﻊ ﺍﻟـﺴﻠﻊ‪ ،‬ﻓـﻲ‬ ‫ﺎ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟـﻙ ﻓﻴـﺭﻭﺱ‬ ‫ﺘﺤﺴﻴﻥ ﺠﻭﺩﺓ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﻤﻘﺩﻤﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﺘﻴﺴﻴﺭ ﺘﻭﺼل ﻫﺅﻻﺀ ﺍﻟﻤﺭﻀﻰ ﺇﻟﻰ ﻫﺫﻩ ﺍﻟﺨﺩﻤﺎﺕ؛‬ ‫ﻀﻤﺎﻥ ﻭﺠﻭﺩ ﻤﻀﻤﻭﻤﺔ ﺸﺎﻤﻠﺔ ﻟﺭﻋﺎﻴﺔ ﺍﻟﺤﻭﺍﻤل ﺘـﺘﻀﻤﻥ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺤﺭﻱ ﺍﻟﻼﺯﻤﺔ ﻟﻠﻜﺸﻑ ﻋـﻥ‬ ‫ﺎ‪ ،‬ﻭﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﺍﻟﺯﻫﺭﻱ‪.‬‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪45‬‬

‫‪‬ﺒل ﺍﻟﻭﺼﻭل ﺇﻟﻰ ﺍﻷﺩﻭﻴﺔ ﻭﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴـﺔ ﺫﺍﺕ‬ ‫ﻭﻀﻊ ﻭﺘﻨﻔﻴﺫ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺘﻬﺩﻑ ﺇﻟﻰ ﺘﺤﺴﻴﻥ ﺴ‬ ‫ﺍﻟﺠﻭﺩﺓ ﺒﺄﺴﻌﺎﺭ ﺘﻜﻭﻥ ﻓﻲ ﺍﻟﻤﺘﻨﺎﻭل؛‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ ﺒﻭﺼﻔﻬﺎ ﻋﺎﻤل ﺍﺨﺘﻁﺎﺭ ﻟﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ‬ ‫ﺍﻟﺠﺩﻭل ‪ -٢‬ﺩﺭﺍﺴﺎﺕ ﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‬ ‫ﻨﺴﺒﺔ‬ ‫ﺍﻻﺤﺘﻤﺎل‬ ‫‪٣,٦‬‬ ‫‪٣,٦‬‬ ‫‪٤,٨‬‬ ‫‪١,٩‬‬ ‫‪٢,٥‬‬ ‫‪٣,١٨‬‬

‫ﺍﻻﺨﺘﻁﺎﺭ‬ ‫ﺍﻟﻨﺴﺒﻲ‬

‫ﺎ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺍﻟﺘﻲ ﺘﻤﺕ ﺩﺭﺍﺴﺘﻬﺎ‬ ‫ﺩﺍﺀ ﺍﻟﻤﺘﺩﺜﺭﺍﺕ‬ ‫ﺍﻟﻤﺘﺩﺜﺭﺍﺕ‬ ‫ﺍﻟﺴﻴﻼﻥ‬ ‫ﺍﻟﻤﺸﻌﺭﺍﺕ‬ ‫ﺍﻟﺴﻴﻼﻥ‬

‫ﺍﻟﺨﺎﻀﻌﻭﻥ ﻟﻠﺩﺭﺍﺴﺔ‬ ‫ﺍﻟﺒﻐﺎﻴﺎ – ﻜﻴﻨﻴﺎ‬

‫ﺍﻟﻤﺭﺠﻊ‬ ‫ﺒﻠﻭﻤﺭ‪(٥٦) ١٩٩١،‬‬ ‫ﻻﺠﺎ‪(٥٧) ١٩٩٣ ،‬‬

‫ﺍﻟﺒﻐﺎﻴﺎ – ﺠﻤﻬﻭﺭﻴـﺔ ﺍﻟﻜﻭﻨﻐـﻭ ﺩﺍﺀ‬ ‫ﺩﺍﺀ‬ ‫ﺍﻟﺩﻴﻤﻘﺭﺍﻁﻴﺔ‬ ‫ﺩﺍﺀ‬ ‫ﺃﺘﺭﺍﺏ ﻤﻥ ﺍﻟﺠﻨﺴﻴﻥ ﺒﺎﻟﻭﻻﻴـﺎﺕ ﺩﺍﺀ‬ ‫ﺍﻟﻤﺘﺤﺩﺓ‬

‫ﻜﺴﻠﺭ‪(٥٨) ١٩٩٤ ،‬‬ ‫ﻜﺭﻴﺏ‪(٥٩) ١٩٩٥ ،‬‬ ‫ﻜﺎﻤﻴﺭﻭﻥ‪(٦٠) ١٩٨٩ ،‬‬ ‫ﺘﻠﺯﺍﻙ‪(٦١) ١٩٩٣ ،‬‬

‫ﺩﺍﺀ ﺍﻟﺴﻴﻼﻥ ﺍﻟﻤﺴﺘﻘﻴﻤﻲ‬ ‫ﺍﻟﻠﻭﺍﻁﻴﻭﻥ ﻓﻲ ﻜﻨﺩﺍ‬ ‫‪٤,٧‬‬ ‫ﺍﻟﺭﺠﺎل ﺍﻟﺫﻴﻥ ﻴﻤﺎﺭﺴﻭﻥ ﺍﻟﺠﻨﺱ ﺍﻟﻘﺭﻴﺢ ﺒﺼﻭﺭﺓ ﻋﺎﻤﺔ‬ ‫ﻤﻊ ﻨﺴﺎﺌﻬﻡ – ﻜﻴﻨﻴﺎ‬ ‫ﺍﻟﺭﺠﺎل ﺍﻟﺫﻴﻥ ﻴﻤﺎﺭﺴﻭﻥ ﺍﻟﺠﻨﺱ ﺍﻟﻘﺭﻴﺢ – ﺃﻤﺭﺍﺽ ﺍﻟﻘﺭﺤـﺎﺕ ‪٣,٠‬‬ ‫ﻤﻊ ﻨﺴﺎﺌﻬﻡ –– ﺍﻟﻭﻻﻴﺎﺕ ﺍﻟﻤﺘﺤﺩﺓ ﺍﻟﺠﻨﺴﻴﺔ‬ ‫ﺍﻷﻤﺭﻴﻜﻴﺔ‬ ‫ﺍﻟﺯﻫﺭﻱ‬ ‫ﺃﻤﺭﺍﺽ ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ‬ ‫ﻭﺍﻟﻬﺭﺒﺱ‬

‫‪٣,٧‬‬ ‫‪٢,٤–٢‬‬ ‫‪٥,٨‬‬ ‫‪٤,٢‬‬ ‫‪٨,٥–٣,٣‬‬ ‫‪٤,٤‬‬ ‫‪٢,٢–١,٥‬‬

‫ﻟﻴﻤﺒﺎ ﻜﺎﺭ ﻨﺠﺎﻨـﺎﺭﺕ – ﺍﻟﺒﻐﺎﻴﺎ – ﺘﺎﻴﻠﻨﺩ‬ ‫‪(٦٢) ١٩٩٩‬‬ ‫ﺍﻤﺒﻴﺯﻓﻭ –‪(٦٣) ١٩٩٦‬‬ ‫ﺒﻭﻟﻴﻨﺠﺭ‪(٦٤) ١٩٩٧ ،‬‬ ‫ﺴﺘﺎﻡ‪(٦٥) ١٩٨٨ ،‬‬ ‫ﻫﻭﻟﻤﺒﺭﺝ‪(٦٦) ١٩٨٨ ،‬‬ ‫ﺩﺍﺭﻭ‪(٦٧) ١٩٨٧ ،‬‬

‫ـﻲ ﺃﻤﺭﺍﺽ ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ ‪+‬‬ ‫ـﻭﻁﻨﻲ ﺍﻷﻓﺭﻴﻘـ‬ ‫ـﺅﺘﻤﺭ ﺍﻟـ‬ ‫ﺍﻟﻤـ‬ ‫ﺃﻤﺭﺍﺽ ﺍﻟﺤﻭﺽ ﺍﻻﻟﺘﻬﺎﺒﻴﺔ‬ ‫ﻟﻠﻤﺭﺃﺓ‪ ،‬ﺯﻴﻤﺒﺎﺒﻭﻱ‬ ‫ﺍﻟﻤﺭﺍﺠﻌﻭﻥ ﻟﻌﻴـﺎﺩﺓ ﺍﻟﻌـﺩﺍﻭﻯ ﺃﻤﺭﺍﺽ ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ‬ ‫ﺎ ﻓﻲ ﺍﻟﻬﻨﺩ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻠﻭﺍﻁﻴﻭﻥ ﻓﻲ ﺍﻟﻭﻻﻴﺎﺕ ﺍﻟﻤﺘﺤﺩﺓ ﺍﻟﻬﺭﺒﺱ‪ ،‬ﺍﻟﺯﻫﺭﻱ‬ ‫ﺍﻷﻤﺭﻴﻜﻴﺔ‬ ‫ﺍﻟﻠﻭﺍﻁﻴﻭﻥ ﻓﻲ ﺍﻟﻭﻻﻴﺎﺕ ﺍﻟﻤﺘﺤﺩﺓ ﺍﻟﻬﺭﺒﺱ‬ ‫ﺍﻷﻤﺭﻴﻜﻴﺔ‬ ‫ﺍﻟﻠﻭﺍﻁﻴﻭﻥ ﻓﻲ ﺍﻟﻭﻻﻴﺎﺕ ﺍﻟﻤﺘﺤﺩﺓ ﺍﻟﺯﻫﺭﻱ‬ ‫ﺍﻷﻤﺭﻴﻜﻴﺔ‬

‫ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‬ ‫ﺎ‪ ،‬ﻭﺨـﺩﻤﺎﺕ ﺍﻟـﺼﺤﺔ‬ ‫‪‬ﻤﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻫﻨﺎﻙ ﺍﺭﺘﺒﺎﻁ ﻭﺍﺴﻊ ﺍﻟﻨﻁﺎﻕ ﻤﺎ ﺒﻴﻥ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﻘﺩ‬ ‫ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪ ،‬ﺤﻴﺙ ﺇﻥ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﻤﻘﺩﻤﺔ ﻟﻬﻡ ﺘﺴﻌﻰ ﻟﺘﺤﺴﻴﻥ ﺠﻭﺩﺓ ﺍﻟﺤﻴﺎﺓ‪ ،‬ﻭﺒﺼﻔﺔ ﺨﺎﺼﺔ‪ ،‬ﺍﻟﺤﻴـﺎﺓ‬ ‫ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻹﻨﺠﺎﺒﻴﺔ ﻟﻠﻨﺴﺎﺀ ﻭﺍﻟﺭﺠﺎل‪ .‬ﻭﻓﻴﻤﺎ ﻴﻠﻲ ﺃﻫﻡ ﻤﺠﺎﻻﺕ ﺍﻻﺭﺘﺒﺎﻁ ﺍﻟﺒﻴﻨﻲ‪ ،‬ﺒﻴﻥ ﺨـﺩﻤﺎﺕ ﺭﻋﺎﻴـﺔ ﻤﺭﻀـﻰ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻭﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪:‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ‪ .‬ﺤﻴﺙ ﺇﻥ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﺍﻟﺤﻭﺍﻤـل‪،‬‬ ‫ﺘﺤﺴﻴﻥ ﺇﻤﻜﺎﻨﻴﺔ ﺇﺘﺎﺤﺔ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺼﺤﺔ ﺍﻷﻤﻭﻤﺔ ﻭﺍﻟﻁﻔﻭﻟﺔ ﻭﻋﻴﺎﺩﺍﺕ ﺘﻨﻅﻴﻡ ﺍﻷﺴﺭﺓ‪ ،‬ﺘﺨﺩﻡ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﺴﻴﺩﺍﺕ ﻤﻤﻥ ﻫﻥ ﻓﻲ ﺴﻥ ﺍﻹﻨﺠـﺎﺏ‪،‬‬ ‫ﱢل ﺸﺒﻜﺔ ﻤﻥ ﺍﻟﻤﺭﺍﻓﻕ ﺍﻟﺼﺤﻴﺔ ﻴﻤﻜﻥ ﺃﻥ ﺘﺘﺴﻊ ﻭﺘﺘﻴﺢ ﺭﻋﺎﻴﺔ ﺤﺎﻻﺕ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﻭﻫﻲ ﺘﺸﻜ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺇﻀﺎﻓﺔ ﺇﻟﻰ ﺘﻐﻁﻴﺔ ﺸﺭﻴﺤﺔ ﻜﺒﻴﺭﺓ ﻤﻥ ﺍﻟﻨﺴﺎﺀ ﻀﻤﻥ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﻌﺎﻡ‪ ،‬ﻭﺍﻟﺘﻲ ﻗﺩ ﻻ ﻴﻤﻜﻥ ﺍﻟﻭﺼﻭل ﺇﻟﻴﻬـﺎ‬ ‫ﺎ ﺍﻟﻤﻁﻠﻘﺔ ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻁﺒﻴﺔ ﺍﻟﻌﻼﺠﻴﺔ ﺍﻟﻌﺎﻤﺔ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ‪ ،‬ﻓـﻲ‬ ‫ﻤﻥ ﺨﻼل ﻋﻴﺎﺩﺍﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻫﺫﻩ ﺍﻟﻤﺭﺍﻓﻕ‪ ،‬ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﺘﺜﻘﻴﻑ ﻭﺍﻟﻤﺸﻭﺭﺓ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺘﻲ ﺘﺘﻨﺎﺴﺏ ﻤﻊ ﻜل ﻤﺠﻤﻭﻋـﺔ ﻋﻤﺭﻴـﺔ‬ ‫ﻋﻠﻰ ﺤﺩﺓ ﺤﻭل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻭﻋﻭﺍﻤل ﺍﻻﺨﺘﻁﺎﺭ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﻬﺎ‪ ،‬ﻭﻫﺫﻩ ﺍﻷﻨﺸﻁﺔ ﺘﻔﻴﺩ ﻓﻲ ﺘﺤﻘﻴـﻕ‬ ‫ﺍﻟﻤﺯﻴﺩ ﻤﻥ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﻭﻯ ﺒﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ .‬ﻭﻤﻥ ﺨﻼل ﺇﻨﺸﺎﺀ ﺒﺭﺍﻤﺞ ﺘﺤﺭ ﻨﻅﺎﻤﻴـﺔ؛ ﻴﻤﻜـﻥ ﺍﻜﺘـﺸﺎﻑ‬ ‫ﺎ ﻏﻴﺭ ﺍﻟﻤﺼﺤﻭﺒﺔ ﺒﺄﻋﺭﺍﺽ ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ‪ ،‬ﻭﻤﻌﺎﻟﺠﺘﻬﺎ‪ ،‬ﺍﻷﻤﺭ ﺍﻟـﺫﻱ‬ ‫ﺤﺎﻻﺕ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻴﻤﻜﻥ ﻤﻌﻪ ﺘﺠﻨﺏ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﻀﺎﺌﺭﺓ ﺍﻟﺘﻲ ﺘﺤﺩﺙ ﺨﻼل ﻓﺘﺭﺓ ﺍﻟﺤﻤل ﻭﺍﻟﻨﺎﺸﺌﺔ ﻤﻥ ﺍﻟﺤـﺎﻻﺕ ﻏﻴـﺭ‬ ‫ﺎ‪.‬‬ ‫ﺍﻟﻤﻌﺎﻟﺠﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍ ﻓﻲ ﺍﻋﺘﻼل‬ ‫ﺎ ﻜﺒﻴﺭﹰ‬ ‫ﺎ ﻭﻋﺩﺍﻭﻯ ﺍﻟﺠﻬﺎﺯ ﺍﻹﻨﺠﺎﺒﻲ ﺘﺴﻬﻡ ﺇﺴﻬﺎﻤﹰ‬ ‫ﺘﺤﺴﻴﻥ ﺼﺤﺔ ﺍﻟﻤﺭﺃﺓ‪ .‬ﺇﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺼﺤﺔ ﺍﻟﻤﺭﺃﺓ ﻭﺫﻟﻙ ﻤﻥ ﺨﻼل ﺯﻴﺎﺩﺓ ﺨﻁﺭ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﻘﻡ‪ ،‬ﻭﺍﻟﺤﻤل ﺍﻟﻤﻨﺘﺒـﺫ‪ ،‬ﻭﺴـﺭﻁﺎﻥ ﻋﻨـﻕ ﺍﻟـﺭﺤﻡ‪،‬‬ ‫ﻭﺍﻹﺠﻬﺎﺽ ﺍﻟﺘﻠﻘﺎﺌﻲ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ .‬ﻟﺫﻟﻙ‪ ،‬ﻓﺈﻥ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ‪ ،‬ﻭﺍﻟﻜﺸﻑ ﻋﻨﻬﺎ ﻭﻋﻼﺠﻬﺎ ﻓﻲ ﻤﺭﺍﺤﻠﻬﺎ ﺍﻟﻤﺒﻜﺭﺓ‪ ،‬ﻫﻲ ﻤﻥ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﻬﺎﻤﺔ ﻭﺍﻟﺭﺌﻴﺴﻴﺔ ﻟﺨﺩﻤﺎﺕ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺭﻋﺎﻴﺔ ﺼﺤﺔ ﺍﻟﻤﺭﺃﺓ‪.‬‬ ‫ﺎ ﺃﻭ‬ ‫ﱡﺩ ﻤﻥ ﺍﻟﺨﻴﺎﺭ ﺍﻟﻤﺘﻌﻠﻕ ﺒﻭﺴﻴﻠﺔ ﻤﻨﻊ ﺍﻟﺤﻤل ﻭﻤﺄﻤﻭﻨﻴﺘﻬﺎ‪ .‬ﺤﻴﺙ ﺇﻥ ﻭﺠﻭﺩ ﺇﺼﺎﺒﺔ ﺒﻌﺩﻭﻯ ﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺍﻟﺘﺄﻜ‬ ‫ﻋﺩﻭﻯ ﺒﺎﻟﺠﻬﺎﺯ ﺍﻹﻨﺠﺎﺒﻲ‪ ،‬ﺘﻘﻴﺩ ﺇﺘﺎﺤﺔ ﺍﻟﻨﻁﺎﻕ ﺍﻟﻜﺎﻤل ﻟﻭﺴﺎﺌل ﻤﻨﻊ ﺍﻟﺤﻤل ﺃﻤﺎﻡ ﺍﻟﻤﺭﺃﺓ‪ ،‬ﻜﻤﺎ ﺃﻥ ﺍﻟﻤـﺭﺃﺓ ﺍﻟﺘـﻲ‬ ‫ﺎ ﺃﻭ ﻋﺩﻭﻯ ﺍﻟﺠﻬﺎﺯ ﺍﻹﻨﺠﺎﺒﻲ ﺇﻟـﻰ‬ ‫ﺘﺴﺘﺨﺩﻡ ﺍﻟﻭﺴﻴﻠﺔ ﺍﻟﻤﺎﻨﻌﺔ ﻟﻠﺤﻤل ﻗﺩ ﺘﻌﺯﻭ ﺃﻋﺭﺍﺽ ﺍﻟﻌﺩﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺴﻴﻠﺔ ﻤﻨﻊ ﺍﻟﺤﻤل‪ ،‬ﺒﺎﻻﻋﺘﻘﺎﺩ ﺃﻥ ﻫﺫﻩ ﺍﻷﻋﺭﺍﺽ ﻫﻲ ﺁﺜﺎﺭ ﺠﺎﻨﺒﻴﺔ )ﻤﻤﺎ ﻴﺅﺩﻱ ﺇﻟﻰ ﺘﻘﻠﻴل ﻤﻘﺒﻭﻟﻴﺘﻬﺎ ﻭﺍﻟﺘﻭﻗـﻑ‬ ‫ﻋﻥ ﺍﺴﺘﺨﺩﺍﻡ ﻭﺴﻴﻠﺔ ﻤﻨﻊ ﺍﻟﺤﻤل(‪ .‬ﻭﺘﺄﺘﻲ ﻋﻤﻠﻴﺔ ﺘﺤﺭ‬ ‫ﺎ‪ ،‬ﻭﻜﺫﻟﻙ ﺍﻟﺘﻭﻋﻴـﺔ‪،‬‬ ‫‪‬ﻱ ﻭﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻟﺤﻤﺎﻴﺔ ﺍﻟﻤﺯﺩﻭﺠﺔ‪ ،‬ﻜﻌﻨﺎﺼﺭ ﻫﺎﻤﺔ ﻓﻲ ﺇﻁﺎﺭ ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺨﻴﺎﺭ ﻤﻨﻊ ﺍﻟﺤﻤل ﻭﺍﻟﺘﺄﻜﺩ ﻤﻥ ﻤﺄﻤﻭﻨﻴﺘﻪ‪.‬‬ ‫ﺍﻟﺘﻌﺎﻤل ﻤﻊ ﺍﻟﻌﻨﻑ ﺍﻟﺠﻨﺴﻲ ﺍﻟﻘﺎﺌﻡ ﻋﻠﻰ ﺃﺴﺎﺱ ﻨﻭﻉ ﺍﻟﺠﻨﺱ‪ .‬ﻓﺎﻟﻌﻨﻑ ﻀﺩ ﺍﻟﻨﺴﺎﺀ ﻴﻤﻜﻥ ﺃﻥ ﺘﻜﻭﻥ ﻟـﻪ ﻨﺘـﺎﺌﺞ‬ ‫ﺎ‪ ،‬ﻭﺍﻟﺤﺎﺠـﺔ‬ ‫ﺨﻁﻴﺭﺓ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻟﻠﻤﺭﺃﺓ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺍﻜﺘﺴﺎﺏ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺎ ﻭﺍﻟﻌﻼﺝ ﺍﻟﻭﻗﺎﺌﻲ ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪،‬‬ ‫ﺘﻘﺘﻀﻲ ﺘﻭﻓﻴﺭ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺤﺎﺠﺔ ﻟﻠﺒﺤﺙ ﻋﻥ ﻁﺭﻕ ﺘﺘﺴﻡ ﺒﺎﻟﺤﺴﺎﺴﻴﺔ ﻟﻠﺠﻨﺴﻴﻥ ﻹﺒﻼﻍ ﺍﻟـﺯﻭﺝ‬ ‫ﺒﻌﺩ ﺍﻟﺘﻌﺭﺽ ﻟﻼﻏﺘﺼﺎﺏ‪ .‬ﻭﻫﻨﺎﻙ ﺃﻴﻀﹰ‬ ‫ﺎ ﻟﻭﻗﻭﻉ ﺍﻟﻌﻨﻑ‪ .‬ﻭﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻟﺘﺤﺩﻴﺩ ﺩﺭﺍﺴﺎﺕ‬ ‫ﺎ‪ ،‬ﻭﺫﻟﻙ ﺘﺠﻨﺒﹰ‬ ‫ﻓﻲ ﺤﺎل ﻭﺠﻭﺩ ﺃﻴﺔ ﺇﺼﺎﺒﺔ ﺒﻌﺩﺍﻭﻯ ﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻭﺫﻟـﻙ ﻓـﻲ ﺍﻷﻤـﺎﻜﻥ‬ ‫ﺍﻟﺤﺎﻟﺔ ﺍﻟﻨﺎﺠﺤﺔ ﺤﻭل ﻤﻭﻀﻭﻉ ﺇﺒﻼﻍ ﺍﻟﺯﻭﺝ ﻋﻥ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ .‬ﻭﻓﻲ ﻨﻔﺱ ﺍﻟﻭﻗﺕ ﺍﻟﺒﺩﺀ ﻓﻲ ﺇﺠﺭﺍﺀ ﺍﻟﺒﺤﻭﺙ ﺍﻟﻌﻤﻠﻴﺎﺘﻴﺔ ﻤﻥ ﺃﺠل ﺘﻌﻠﻡ ﻜﻴﻔﻴﺔ ﺇﺒـﻼﻍ ﺍﻟـﺯﻭﺝ‬ ‫ﺍﻟﻤﺨﺘﻠﻁﺔ ﺜﻘﺎﻓﻴﹰ‬ ‫ﺎ‪.‬‬ ‫ﺎ ﻭﺩﻴﻨﻴﹰ‬ ‫ﺎ ﻭﺜﻘﺎﻓﻴﹰ‬ ‫ﻼ ﻓﻲ ﺍﻷﻤﺎﻜﻥ ﺍﻟﻤﺨﺘﻠﻔﺔ ﺍﺠﺘﻤﺎﻋﻴﹰ‬ ‫ﺒﻁﺭﻴﻘﺔ ﺃﻜﺜﺭ ﺘﻘﺒ ﹰ‬ ‫ﺘﺤﺭﻱ ﻭﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺃﻥ ﺘﺤﺴﻥ‬ ‫‪‬ﻱ ﻭﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ .‬ﻴﻤﻜﻥ ﻟﺨﺩﻤﺎﺕ ﺘﺤﺭ‬ ‫ﻤﻥ ﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﺼﺤﻴﺔ ﺒﻌﺩ ﺇﺠﺭﺍﺀ ﺍﻹﺠﻬﺎﺽ ﺍﻻﺨﺘﻴﺎﺭﻱ‪ ،‬ﺤﻴﺙ ﺇﻥ ﻭﺠﻭﺩ ﻋﺩﻭﻯ ﻓﻲ ﺍﻟﺠﻬﺎﺯ ﺍﻹﻨﺠﺎﺒﻲ ﺍﻟﺴﻔﻠﻲ‪،‬‬ ‫ﻭﻗﺕ ﺤﺩﻭﺙ ﺍﻹﺠﻬﺎﺽ‪ ،‬ﻴ‬ ‫‪‬ﻌﺘﺒﺭ ﻋﺎﻤل ﺍﺨﺘﻁﺎﺭ ﻟﻭﻗﻭﻉ ﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﺍﻟﺘﺎﻟﻴﺔ ﻟﻺﺠﺭﺍﺀ ﺍﻟﺠﺭﺍﺤﻲ )‪ .(٦٨‬ﻟـﺫﻟﻙ‪،‬‬ ‫ﺎ‪ ،‬ﻫﻭ ﺒﻤﺜﺎﺒﺔ ﺨﻁﻭﺓ ﻫﺎﻤﺔ ﻓـﻲ‬ ‫ﻓﺈﻥ ﺇﺠﺭﺍﺀ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻗﺒل ﺍﻹﺠﻬﺎﺽ‪ ،‬ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺴﺒﻴل ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﺘﺎﻟﻴﺔ ﻟﻠﺠﺭﺍﺤﺔ‪.‬‬ ‫ﺇﺩﻤﺎﺝ ﺍﻷﺴﺎﻟﻴﺏ ﺍﻟﻤﺘﺴﻤﺔ ﺒﺎﻟﺤﺴﺎﺴﻴﺔ ﻟﻠﺠﻨﺴﻴﻥ‪ .‬ﺘﻭﺍﺠﻪ ﻜل ﻤﻥ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ ﻭﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪ ،‬ﺘﺤﺩﻴﺎﺕ ﻤﺘﺸﺎﺒﻬﺔ ﻓﻲ ﺩﻤﺞ ﺍﻷﺴﺎﻟﻴﺏ ﺫﺍﺕ ﺍﻟﺤﺴﺎﺴﻴﺔ ﻟﻠﺫﻜﻭﺭﺓ ﻭﺍﻷﻨﻭﺜـﺔ‪،‬‬ ‫ﺠﻨﺴﻴﹰ‬ ‫‪47‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻭﺒﺨﺎﺼﺔ ﻓﻲ ﺇﺸﺭﺍﻙ ﺍﻟﺭﺠﺎل‪ ،‬ﻭﺍﻟﻭﺼﻭل ﺇﻟﻰ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﻬﻤـﺸﺔ ﺃﻭ ﺍﻟﻤﻬﻤﻠـﺔ )ﻤﺜـل ﺍﻟﺒﻐﺎﻴـﺎ‪،‬‬ ‫ﻭﻤﺘﻌﺎﻁﻲ ﺍﻟﻤﺨﺩﺭﺍﺕ‪ ،‬ﻭﺍﻟﻔﻘﺭﺍﺀ ﻓﻲ ﺍﻟﻤﻨﺎﻁﻕ ﺍﻟﺤﻀﺭﻴﺔ ﻭﺍﻟﺭﻴﻔﻴﺔ‪ ،‬ﻭﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻬﺎﺠﺭﺓ‪ ،‬ﻭﺍﻟﻤﺸﺭﺩﻴﻥ‬ ‫ﻭﺍﻟﻼﺠﺌﻴﻥ( ﻭﺍﻻﺴﺘﺠﺎﺒﺔ ﻟﻠﻤﺘﻁﻠﺒﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻤﺭﺍﻫﻘﻴﻥ‪.‬‬ ‫ﺎ‪،‬‬ ‫ﺎ‪ .‬ﻫﻨﺎﻙ ﻋﺩﺍﻭﻯ ﺘﺼﻴﺏ ﺍﻟﺠﻬﺎﺯ ﺍﻹﻨﺠﺎﺒﻲ‪ ،‬ﻏﻴﺭ ﺘﻠﻙ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﺼﺤﺒﻬﺎ ﻋﺎﺩﺓ ﺃﻋﺭﺍﺽ ﻴﻤﻜﻥ ﺍﻋﺘﺒﺎﺭﻫﺎ ﺨﻁﺄ‪ ،‬ﺃﻋﺭﺍﺽ ﻋﺩﻭﻯ ﻤﻥ ﺍﻟﻨﻤﻁ ﺍﻟﺫﻱ ﻴﻨﺘﻘل ﻋﻥ ﻁﺭﻴﻕ ﻤﻤﺎﺭﺴـﺔ‬ ‫ﺍﻟﺠﻨﺱ‪ .‬ﻓﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﺩﺍﺨﻠﻴﺔ ﺍﻟﻤﻨﺸﺄ‪ ،‬ﻭﺍﻟﺘﻲ ﺘﻨﺘﻘل ﻋﻥ ﻁﺭﻴﻕ ﺍﻟﺠﻨﺱ‪ ،‬ﻤﺜل ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﻤﻬﺒﻠﻲ ﺍﻟﺒﻜﺘﻴـﺭﻱ ﻭﺩﺍﺀ‬ ‫ﺍﻟﻤﺒﻴﻀﺎﺕ‪ ،‬ﺘﺤﺩﺙ ﺒﻔﻌل ﺤﺩﻭﺙ ﺘﻐﻴﺭﺍﺕ ﻓﻲ ﺘﻭﺍﺯﻥ ﺍﻟﻨﺒﻴﺕ ﺍﻟﺒﻜﺘﻴﺭﻱ ﺍﻟﻁﺒﻴﻌﻲ ﻭﺍﻟﻭﻗﺎﺌﻲ ﺍﻟﻤﻭﺠﻭﺩ ﻓﻲ ﺍﻟﺠﻬﺎﺯ‬ ‫ﺍﻹﻨﺠﺎﺒﻲ ﻟﻠﻤﺭﺃﺓ‪ .‬ﻭﻴﻌﺘﺒﺭ ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﻤﻬﺒﻠﻲ ﺃﻜﺜﺭ ﺃﻨﻭﺍﻉ ﻋﺩﺍﻭﻯ ﺍﻟﺠﻬﺎﺯ ﺍﻹﻨﺠﺎﺒﻲ ﺸﻴﻭﻋﹰ‬ ‫ﺎ ﻓﻲ ﺍﻟﻌﺎﻟﻡ‪ ،‬ﻜﻤﺎ ﺃﻨـﻪ‬ ‫ﺎ ﻓﻲ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻨﺎﻤﻴﺔ‪ .‬ﻭﻟﻘﺩ ﺘﺒﻴﻥ ﺃﻥ ﻨﺴﺒﺔ ﺘﺼل ﺇﻟـﻰ‬ ‫ﻴﻤﺜل ﺃﻜﺜﺭ ﺍﻷﺴﺒﺎﺏ ﺍﻟﻤﺅﺩﻴﺔ ﻟﻺﻓﺭﺍﺯﺍﺕ ﺍﻟﻤﻬﺒﻠﻴﺔ ﺸﻴﻭﻋﹰ‬ ‫‪ ٪٥٠‬ﻤﻥ ﺇﺠﻤﺎﻟﻲ ﺍﻟﺤﻭﺍﻤل ﻤﺼﺎﺒﺎﺕ ﺒﺎﻻﻟﺘﻬﺎﺏ ﺍﻟﻤﻬﺒﻠﻲ ﺍﻟﺒﻜﺘﻴﺭﻱ ﻓﻲ ﺃﻓﺭﻴﻘﻴﺎ‪ ،‬ﺠﻨﻭﺏ ﺍﻟـﺼﺤﺭﺍﺀ ﺍﻟﻜﺒـﺭﻯ‪.‬‬ ‫ﻭﻫﺫﺍ ﺍﻟﻤﺭﺽ ﻴﻨﻅﺭ ﺇﻟﻴﻪ ﻋﻠﻰ ﺃﻨﻪ ﺴﺒﺏ ﻓﻲ ﺤﺩﻭﺙ ﺍﻟﻭﻻﺩﺓ ﺍﻟﻤﺒﺘﺴﺭﺓ‪ ،‬ﻭﻨﻘﺹ ﺍﻟﻭﺯﻥ ﻋﻨﺩ ﺍﻟﻭﻟﺩﺍﻥ‪ ،‬ﻭﺘﻤـﺯﻕ‬ ‫ﺍﻷﻏﺸﻴﺔ ﻗﺒل ﺍﻷﻭﺍﻥ‪ ،‬ﻭﺤﺎﻻﺕ ﺍﻹﻨﺘﺎﻥ ﺍﻟﺘﺎﻟﻴﺔ ﻟﻠﻭﻻﺩﺓ‪ ،‬ﻭﺍﻹﺠﻬﺎﺽ ﺍﻟﺘﻠﻘـﺎﺌﻲ )‪ .(٦٩‬ﻭﻟﻘـﺩ ﺩﺨﻠـﺕ ﺍﻟﻨﺎﺒﺘـﺔ‬ ‫ﺍﻟﺠﺭﺜﻭﻤﻴﺔ ‪ Bacterial vaginosis‬ﻀﻤﻥ ﺃﺴﺒﺎﺏ ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨـﺎﻋﻲ ﺍﻟﺒـﺸﺭﻱ )‪.(٧٠‬‬ ‫ﻭﺘﺘﻁﻠﺏ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺼﺤﻲ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﻋﺩﺍﻭﻯ ﺍﻟﺠﻬﺎﺯ ﺍﻹﻨﺠﺎﺒﻲ‪ ،‬ﻭﻤﻀﺎﻋﻔﺎﺘﻬﺎ‪ ،‬ﺍﺘﺒﺎﻉ ﺃﺴﻠﻭﺏ‬ ‫ﺎ‪ ،‬ﻓﻲ ﺍﻷﻤﺎﻜﻥ ﺍﻟﺘﻲ ﺘﻘﺩﻡ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟـﺼﺤﻴﺔ‬ ‫ﻤﺸﺘﺭﻙ‪ ،‬ﻤﻊ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻹﻨﺠﺎﺒﻴﺔ‪.‬‬ ‫ﺘﻌﺯﻴﺯ ﻤﺄﻤﻭﻨﻴﺔ ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﻲ ﺘﺘﻡ ﻋﺒﺭ ﻋﻨﻕ ﺍﻟﺭﺤﻡ‪ .‬ﻓﻌﻠﻰ ﺴﺒﻴل ﺍﻟﻤﺜﺎل‪ ،‬ﻴﻨﺒﻐـﻲ ﺍﺨﺘﺒـﺎﺭ ﺍﻟﻌﻤـﻼﺀ ﺃﻭ‬ ‫ﺎ‪ ،‬ﻗﺒل ﺇﺩﺨﺎل ﺍﻟﻭﺴﻴﻠﺔ ﺍﻟﻤﺎﻨﻌﺔ ﻟﻠﺤﻤل ﺇﻟـﻰ‬ ‫ﻤﻌﺎﻟﺠﺘﻬﻡ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﺩﺍﺨﻠﻴﺔ ﺍﻟﻤﻨﺸﺄ ﺃﻭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﱡﺏ ﺘﻠﻭﺙ ﺍﻟﺠﻬﺎﺯ ﺍﻟﺘﻨﺎﺴﻠﻲ ﺍﻟﻌﻠﻭﻱ ﺒﺎﻟﺒﻜﺘﻴﺭﻴﺎ ﺍﻟﺼﺎﻋﺩﺓ‪ .‬ﻭﻜﺒـﺩﻴل ﻟـﺫﻟﻙ‪،‬‬ ‫ﺍﻟﺭﺤﻡ‪ ،‬ﺃﻭ ﺇﻨﻬﺎﺀ ﺍﻟﺤﻤل‪ ،‬ﻭﺫﻟﻙ ﻟﺘﺠﻨ‬ ‫ﺎ‬ ‫ﺎ ﻤﺨﺘﻠﻔﹰ‬ ‫ﻴﻨﺒﻐﻲ ﺘﺸﺠﻴﻊ ﺍﻟﻨﺴﺎﺀ ﺍﻟﻼﺘﻲ ﻴﺨﺘﺭﻥ ﺍﺴﺘﺨﺩﺍﻡ ﻭﺴﻴﻠﺔ ﻤﻨﻊ ﺤﻤل ﺘﻭﻀﻊ ﺩﺍﺨل ﺍﻟﺭﺤﻡ‪ ،‬ﺒﺄﻥ ﻴﺨﺘﺭﻥ ﻨﻭﻋﹰ‬ ‫ﻤﻥ ﻭﺴﺎﺌل ﻤﻨﻊ ﺍﻟﺤﻤل‪ ،‬ﺇﺫﺍ ﻤﺎ ﻜﻥ ﻴﻌﺘﺒﺭﻥ ﺃﻨﻔﺴﻬﻥ ﻤﻌﺭﻀﺎﺕ ﻟﺨﻁﺭ ﺍﻹﺼﺎﺒﺔ ﺒﻌﺩﻭﻯ ﻤﻥ ﺍﻟـﻨﻤﻁ ﺍﻟﻤﻨﻘـﻭل‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ )‪.(٧١‬‬ ‫ﺎ ﻭﺍﻟﻠﻘﺎﺤﺎﺕ ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺘﻭﻓﺭﻫﺎ ﻟﻠﻭﻗﺎﻴﺔ ﻤـﻥ ﺴـﺭﻁﺎﻥ ﺍﻟﺠﻬـﺎﺯ‬ ‫ﺍﻟﺘﻭﺴﻊ ﻓﻲ ﺘﻭﻓﻴﺭ ﺍﻟﻠﻘﺎﺤﺎﺕ ﺍﻟﻤﻭﺠﻭﺩﺓ ﺤﺎﻟﻴﹰ‬ ‫ﺎ‪ .‬ﻭﻤﻥ ﺸﺄﻥ ﺍﻟﺘﻌﺎﻭﻥ ﻭﺍﻟﺘﺨﻁﻴﻁ ﺍﻟﻤﺸﺘﺭﻙ ﺒـﻴﻥ‬ ‫ﺍﻟﺘﻨﺎﺴﻠﻲ ﻭﺴﺭﻁﺎﻥ ﺍﻟﻜﺒﺩ ﻭﻤﻥ ﺒﻌﺽ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻭﺒﺭﺍﻤﺞ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻹﻨﺠﺎﺒﻴﺔ ﻓﻲ ﺇﻁـﺎﺭ ﺍﻟﺒـﺭﺍﻤﺞ ﺍﻟﻭﻁﻨﻴـﺔ‬ ‫ﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﻠﺘﻤﻨﻴﻊ ﺃﻥ ﺘﺴﺎﻫﻡ ﻓﻲ ﺘﻴﺴﻴﺭ ﺍﻟﻠﻘﺎﺤﺎﺕ ﺍﻟﺤﺎﻟﻴﺔ ﻭﺍﻟﻤﺤﺘﻤﻠﺔ ﻤﺜل ﻟﻘﺎﺡ ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩﻱ ﺍﻟﺒﺎﺌﻲ ﻭﻟﻘﺎﺤﺎﺕ ﻓﻴﺭﻭﺱ‬ ‫ﺍ ﻻﺴﺘﻘﺒﺎل ﻭﺇﺩﺨﺎل ﺃﻱ ﻟﻘﺎﺡ ﺠﺩﻴﺩ‪.‬‬ ‫ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺇﻀﺎﻓﺔ ﺇﻟﻰ ﺘﻭﻓﻴﺭ ﺴﻠﺴﻠﺔ ﻴﺘﻡ ﺇﻋﺩﺍﺩﻫﺎ ﺠﻴﺩﹰ‬ ‫•‬

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‫ﺇﻀﺎﻓﺔ ﺇﻟﻰ ﺫﻟﻙ‪ ،‬ﻓﺈﻥ ﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻓﻲ ﺃﻓﻀل ﺍﻷﻭﻀﺎﻉ ﺍﻟﺘـﻲ ﺘﻤﻜﻨﻬـﺎ ﻤـﻥ‬ ‫ﻀﻤﺎﻥ ﺼﺤﺔ ﺍﻟﻤﺭﺃﺓ ﻭﺼﺤﺔ ﺍﻟﻭﻟﺩﺍﻥ ﻭﺍﻷﻁﻔﺎل ﻭﺫﻟﻙ ﻤـﻥ ﺨـﻼل ﺘﻌﺎﻭﻨﻬـﺎ ﻤـﻊ ﺒـﺭﺍﻤﺞ ﻤﻜﺎﻓﺤـﺔ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ‪ .‬ﻭﻤﻥ ﺃﺠل ﺫﻟﻙ‪ ،‬ﻓﺈﻨﻪ ﻴﻨﺒﻐﻲ ﻋﻠﻰ ﺍﻟﻘﺎﺌﻤﻴﻥ ﻋﻠﻰ ﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨـﺴﻴﺔ ﻭﺍﻟـﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴـﺔ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﱡﻕ ﻤﻥ ﺍﻵﺘﻲ‪:‬‬ ‫ﺍﻟﺘﺤﻘ‬ ‫ﺎ‪ ،‬ﻭﻴـﺸﻤل ﺍﻟﻌﻘﺎﺒﻴـل‬ ‫ﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺼﺤﻲ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺴﺎﺌﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺍﻟﻁﻭﻴﻠﺔ ﺍﻷﻤﺩ ﻤﺜل ﻤﺭﺽ ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﺤﻭﻀﻲ ‪ PID‬ﻭﺍﻟﻌﻘﻡ‪ ،‬ﻭﺍﻟﺤﻤل ﺍﻟﻤﻨﺘﺒﺫ ﻭﺴﺭﻁﺎﻥ ﺍﻟﺠﻬﺎﺯ ﺍﻟﺘﻨﺎﺴـﻠﻲ‪ .‬ﺇﻥ‬ ‫ﻋﺩﻡ ﺍﻹﻨﺼﺎﻑ ﺒﻴﻥ ﺍﻟﺠﻨﺴﻴﻥ‪ ،‬ﻭﺍﻷﺩﻭﺍﺭ ﺍﻟﻘﺎﺌﻤﺔ ﻋﻠﻰ ﺍﻟﺜﻘﺎﻓﺎﺕ‪ ،‬ﻭﺍﻟﻌﻭﺍﻤل ﺍﻟﺒﻴﻭﻟﻭﺠﻴﺔ ﻜﻠﻬﺎ ﻋﻭﺍﻤل ﺘﺴﺎﻫﻡ ﻓـﻲ‬ ‫ﺘﻌﺭﺽ ﺍﻟﻨﺴﺎﺀ ﻭﺍﻟﺸﺒﺎﺏ ﻟﺨﻁﺭ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ‪ .‬ﻭﻤﻥ ﺍﻷﻫﻤﻴﺔ ﺒﻤﻜﺎﻥ ﺇﺩﺭﺍﻙ ﻤﺩﻯ ﺘﺄﺜﻴﺭ ﺍﻷﻨﺸﻁﺔ ﺍﻟﻌﺭﻗﻴﺔ‬ ‫ﻭﺍﻟﺜﻘﺎﻓﺎﺕ ﻭﺍﻟﺘﻭﺠﻪ ﺍﻟﺠﻨﺴﻲ ﻭﺍﻟﻤﻜﺎﻥ ﺍﻟﺠﻐﺭﺍﻓﻲ )ﺍﻷﻤﺎﻜﻥ ﺍﻟﺤﻀﺭﻴﺔ ﺃﻭ ﺍﻟﺭﻴﻔﻴﺔ ﺃﻭ ﺍﻟﻤﻬﻤﺸﺔ ﺍﻟﺘـﻲ ﻴـﺼﻌﺏ‬ ‫•‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﻭﺼﻭل ﺇﻟﻴﻬﺎ(‪ ،‬ﻭﺍﻟﻌﻤﺭ ﻭﺍﻟﻤﻬﺎﺭﺍﺕ ﺍﻟﺤﻴﺎﺘﻴﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ‪ ،‬ﻤﻥ ﺃﺠل ﺇﻋﺩﺍﺩ ﻭﺘﻭﺠﻴﻪ ﺍﻻﺴﺘﺠﺎﺒﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﻌﺏﺀ‬ ‫ﺎ ﻭﻤﻀﺎﻋﻔﺎﺘﻬﺎ ﺇﻀﺎﻓﺔ ﺇﻟﻰ ﺍﻟﻌﻘﺎﺒﻴل ﺍﻟﻁﻭﻴﻠﺔ ﺍﻷﻤﺩ ﺍﻟﺘﻲ ﻗﺩ ﺘﻅﻬﺭ‪.‬‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﺯﻫﺭﻱ ﺍﻟﺨﻠﻘﻲ‪ .‬ﺘﻌﺘﻤﺩ ﻋﻤﻠﻴﺔ ﺍﻟﻭﻗﺎﻴﺔ ﺍﻟﻔﻌﺎﻟﺔ ﻤﻥ ﻤﺭﺽ ﺍﻟﺯﻫﺭﻱ ﺍﻟﺨﻠﻘﻲ ﺒـﺸﻜل ﺃﻭﻟـﻲ ﻋﻠـﻰ‬ ‫ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﺯﻫﺭﻱ ﻟﺩﻯ ﺍﻟﺤﻭﺍﻤل‪ .‬ﻭﺇﺫﺍ ﻟﻡ ﻴﻨﺠﺢ ﺫﻟﻙ‪ ،‬ﻓﺈﻥ ﺍﻟﻭﻗﺎﻴﺔ ﺍﻟﺜﺎﻨﻭﻴﺔ ﺘﺸﻤل ﺍﻟﺘﺤﺭﻱ ﻋـﻥ ﺍﻟﺯﻫـﺭﻱ‬ ‫ﺃﺜﻨﺎﺀ ﻓﺘﺭﺓ ﺍﻟﺤﻤل ﻭﺘﻘﺩﻴﻡ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻤﻼﺌﻤﺔ ﻟﻜل ﻤﻥ ﺍﻟﻤﺭﺃﺓ ﻭﺯﻭﺠﻬﺎ‪ .‬ﻭﺒﺎﻟﻨﻅﺭ ﺇﻟـﻰ ﺍﻟﺘﻜﻠﻔـﺔ ﺍﻻﺠﺘﻤﺎﻋﻴـﺔ‬ ‫ﻭﺍﻻﻗﺘﺼﺎﺩﻴﺔ ﻟﻤﺭﺽ ﺍﻟﺯﻫﺭﻱ ﺍﻟﺨﻠﻘﻲ‪ ،‬ﻭﺇﻤﻜﺎﻨﻴﺔ ﺤﺩﻭﺙ ﺘﻐﻴﺭﺍﺕ ﻓﻲ ﻭﺒﺎﺌﻴﺔ ﻫﺫﺍ ﺍﻟﻤﺭﺽ‪ ،‬ﻓﺈﻥ ﺘﺤﺭﻱ ﻤﺭﺽ‬ ‫ﻡ ﻤﻌﺎﻟﺠﺘﻪ ﻟﺩﻯ ﺍﻟﻨﺴﺎﺀ ﺍﻟﻼﺘﻲ ﻴﻜﻭﻥ ﻟﺩﻴﻬﻥ ﺘﻔﺎﻋل ﻤﺼﻠﻲ‪ ،‬ﻫﻭ ﺒﻤﺜﺎﺒﺔ ﺘـﺩﺨل‬ ‫ـ‪‬‬ ‫ﺍﻟﺯﻫﺭﻱ ﺃﺜﻨﺎﺀ ﺍﻟﺤﻤل ﻭﻤﻥ ﺜ َ‬ ‫ﻴﺘﺼﻑ ﺒﺎﻟﻔﻌﺎﻟﻴﺔ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﺯﻫﺭﻱ ﺍﻟﺨﻠﻘﻲ ﻭﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﺍﻟﺘﻲ ﺘﻨﺘﺞ ﻋﻥ ﻋﺩﻡ ﻤﻌﺎﻟﺠﺘﻪ ﻟـﺩﻯ‬ ‫ﺍﻵﺒﺎﺀ‪ ،‬ﺤﺘﻰ ﻓﻲ ﺍﻷﻤﺎﻜﻥ ﺍﻟﺘﻲ ﺘﻘل ﻓﻴﻬﺎ ﻤﻌﺩﻻﺕ ﺍﻻﻨﺘﺸﺎﺭ ﻋﻥ ‪.٪١‬‬ ‫‪‬ﻱ ﻫﺫﺍ ﺍﻟﻤﺭﺽ ﺒﺼﻔﺔ ﺭﻭﺘﻴﻨﻴﺔ ﻟﺩﻯ ﺍﻟﺤﻭﺍﻤل ﺃﺜﻨﺎﺀ ﺃﻭل ﺯﻴﺎﺭﺓ ﻟﻬـﻥ ﻓـﻲ ﻋﻴـﺎﺩﺓ ﺭﻋﺎﻴـﺔ‬ ‫ ﻴﻨﺒﻐﻲ ﺘﺤﺭ‬‫ﺍﻟﺤﻭﺍﻤل‪ ،‬ﻭﺒﺼﻭﺭﺓ ﻤﺜﺎﻟﻴﺔ‪ ،‬ﻗﺒل ﺍﻷﺴﺒﻭﻉ ﺍﻟﺜﺎﻤﻥ ﻭﺍﻟﻌﺸﺭﻴﻥ ﻤﻥ ﻋﻤﺭ ﺍﻟﺤﻤل )‪ .(٧٢‬ﻭﻓﻲ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﺘـﻲ‬ ‫ﺘﺭﺘﻔﻊ ﻓﻴﻬﺎ ﻋﻭﺍﻤل ﺨﻁﻭﺭﺓ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﺯﻫﺭﻱ ﺍﻟﺨﻠﻘﻲ‪ ،‬ﻴﺠﺏ ﺍﻟﻨﻅﺭ ﻓﻲ ﺇﻤﻜﺎﻨﻴﺔ ﻭﻀﻊ ﺴﻴﺎﺴﺔ ﺘﺴﺘﻭﺠﺏ‬ ‫ﺇﺠﺭﺍﺀ ﺍﺨﺘﺒﺎﺭ ﺘﺤﺭﻱ ﻋﻨﺩ ﺍﻷﺴﺒﻭﻉ ﺍﻟﺴﺎﺩﺱ ﻭﺍﻟﺜﻼﺜﻴﻥ ﻤﻥ ﻋﻤﺭ ﺍﻟﺤﻤل ﺃﻭ ﻋﻨـﺩ ﺍﻟـﻭﻻﺩﺓ‪ .‬ﻭﺴـﻭﻑ‬ ‫ل ﻤﻥ‬ ‫ﺘﻘﺘﻀﻲ ﺍﻟﺤﺎﺠﺔ ﻭﻀﻊ ﺩﻻﺌل ﺇﺭﺸﺎﺩﻴﺔ ﻭﻁﻨﻴﺔ ﻭﺍﻀﺤﺔ ﺘﺘﻌﻠﻕ ﺒﺎﻟﻤﺘﺎﺒﻌﺔ ﺍﻟﺴﺭﻴﺭﻴﺔ ﻭﺍﻟﺴﻴﺭﻭﻟﻭﺠﻴﺔ ﻟﻜ ﱟ‬ ‫ﺍﻷﻡ ﻭﺍﻟﻁﻔل‪.‬‬ ‫ﺎ ﻭﻋﻤل ﺘﻘﻴﻴﻡ ﻟﻤﺨﺎﻁﺭ ﻤﻌـﺎﻭﺩﺓ‬ ‫ ﻴﻨﺒﻐﻲ ﺍﻟﻘﻴﺎﻡ ﺒﻤﻨﺎﻗﺸﺔ ﺤﻭل ﻤﻌﺎﻟﺠﺔ ﺍﻷﺯﻭﺍﺝ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﻭﻯ ﻭﺍﺘﺨﺎﺫ ﺍﻹﺠﺭﺍﺀ ﺍﻟﻤﻨﺎﺴﺏ ﺤﻴﺎل ﺫﻟﻙ‪.‬‬ ‫ﺎ‪ ،‬ﻴﻨﺒﻐﻲ ﺘﻘﺩﻴﻡ ﺍﻟﺘﻭﻋﻴـﺔ ﻭﺍﻻﺨﺘﺒـﺎﺭﺍﺕ ﺍﻟﻁﻭﻋﻴـﺔ‬ ‫ ﻜﻤﺎ ﻫﻭ ﺍﻟﺤﺎل ﻤﻊ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ﺍﻟﺴﺭﻴﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻟﻠﻨﺴﺎﺀ ﺍﻟﻼﺘﻲ ﻴﺘﺒﻴﻥ ﺃﻨﻬﻥ ﻤﺼﺎﺒﺎﺕ ﺒﺎﻟﺯﻫﺭﻱ‪ .‬ﻭﻓﻲ‬ ‫ﺍﻷﻤﺎﻜﻥ ﺍﻟﺘﻲ ﻴﻨﺘﺸﺭ ﻓﻴﻬﺎ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﺒﺼﻭﺭﺓ ﻜﺒﻴﺭﺓ‪ ،‬ﻴﺠﺏ ﺘﻘﺩﻴﻡ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺇﺠﺭﺍﺀ ﺍﻟﻔﺤﺹ ﺍﻟﻁﻭﻋﻲ‬ ‫ﻟﺠﻤﻴﻊ ﺍﻟﺤﻭﺍﻤل‪.‬‬ ‫ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﻓﻘﺩ ﺍﻟﺒﺼﺭ ﻟﺩﻯ ﺍﻟﻭﻟﺩﺍﻥ‪ .‬ﻟﻘﺩ ﺘﺒﻴﻥ ﺃﻥ ﺇﻋﻁﺎﺀ ﻋﻼﺝ ﻭﻗﺎﺌﻲ ﻤﻀﺎﺩ ﻟﻠﺭﻤﺩ ﺍﻟﻭﻟﻴﺩﻱ ﺒﻴﻥ ﺍﻟﻭﻟﺩﺍﻥ ﻫﻭ‬ ‫ﺇﺠﺭﺍﺀ ﻴﺘﺴﻡ ﺒﺎﻟﻔﻌﺎﻟﻴﺔ ﺍﻟﻌﺎﻟﻴﺔ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ‪ ،‬ﻭﺫﻟﻙ ﻋﻨﺩﻤﺎ ﻴﻜﻭﻥ ﻤﻌﺩل ﺍﻨﺘﺸﺎﺭ ﺍﻟﺴﻴﻼﻥ ﺒﻴﻥ ﺍﻟﺤﻭﺍﻤـل ﻋﻨـﺩ‬ ‫ﻤﺴﺘﻭﻯ ‪ ٪١‬ﺃﻭ ﺃﻜﺜﺭ )‪.(٢٤‬‬ ‫ﺎ ﺍﻟﻤﻘﺩﻤﺔ ﻟﻸﻁﻔﺎل ﻭﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﺍﻟﺫﻴﻥ ﺘﻌﺭﻀﻭﺍ ﻻﺴﺘﻐﻼل ﻭﺍﻋﺘﺩﺍﺀ ﺠﻨﺴﻲ‪ .‬ﺇﻥ‬ ‫ﺭﻋﺎﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻫﺫﺍ ﺍﻻﺴﺘﻐﻼل ﻭﺍﻻﻋﺘﺩﺍﺀ ﺍﻟﺠﻨﺴﻲ ﻟﻸﻁﻔﺎل ﻭﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﻗﺩ ﺃﺼﺒﺢ ﻴﻨﻅﺭ ﺇﻟﻴﻪ ﻋﻠﻰ ﺃﻨﻪ ﻴﻤﺜل ﻤﺸﻜﻠﺔ ﺍﺠﺘﻤﺎﻋﻴﺔ‬ ‫ﺨﻁﻴﺭﺓ ﺘﺘﻁﻠﺏ ﺍﻫﺘﻤﺎﻡ ﻭﻋﻨﺎﻴﺔ ﺼﺎﻨﻌﻲ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﻤﻌﻠﻤﻴﻥ ﻭﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﻤﻬﻨﻴـﻴﻥ ﺍﻟﻘﺎﺌﻤﻴﻥ ﻋﻠـﻰ ﺘﻘـﺩﻴﻡ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﺍﻷﺴﺎﺴﻴﺔ‪ ،‬ﻭﺫﻟﻙ ﻋﻨﺩ ﺍﻟﺸﻙ ﻓﻲ ﺤﺩﻭﺙ ﺍﺴﺘﻐﻼل ﺃﻭ ﺍﻨﺘﻬﺎﻙ ﺠﻨﺴﻲ‪.‬‬ ‫ﺎ ﻟﺩﻯ ﺍﻟﻁﻔل ﻭﻤﻨﻪ ﻓﻴﺭﻭﺱ‬ ‫ﻭﻴﺠﺏ ﺍﻷﺨﺫ ﺒﻌﻴﻥ ﺍﻻﻋﺘﺒﺎﺭ ﻀﺭﻭﺭﺓ ﺍﻟﺘﺤﺩﻴﺩ ﺍﻟﺩﻗﻴﻕ ﻟﻠﻌﺎﻤل ﺍﻟﻘﺎﺒل ﻟﻼﻨﺘﻘﺎل ﺠﻨﺴﻴﹰ‬ ‫‪‬ل ﻤﻤﺎﺭﺱ ﺴﺭﻴﺭﻱ ﻤﺩﺭﺏ ﻋﻠﻰ ﺍﻟﺘﻌﺎﻤل ﻤﻊ ﺍﻷﻁﻔﺎل ﻭﺫﻟﻙ ﺒﻌﺩ ﺘﺤﺩﻴﺩ ﺍﻟﻌﻤﻠﻴـﺎﺕ‬ ‫ﻗﺒ‬ ‫ﺍﻷﻴﺩﺯ‪ ،‬ﻭﺃﻥ ﻴﺘﻡ ﻫﺫﺍ ﻤﻥ ِ‬ ‫ﺎ‪ .‬ﻭﺇﻥ ﻭﺠﻭﺩ ﺃﺴﻠﻭﺏ ﻤﻌﻴﺎﺭﻱ ﻗﻴﺎﺴﻲ ﻟﻠﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﻭﺍﻟﺩﻻﺌل ﺍﻹﺭﺸﺎﺩﻴﺔ ﺍﻟﻤﺴﺘﺨﺩﻤﺔ ﻤﺤﻠﻴﹰ‬ ‫‪‬ﺸﻙ ﻓﻲ ﺃﻥ ﻴﻜﻭﻨﻭﺍ ﻗﺩ ﺘﻌﺭﻀﻭﺍ ﻟﻼﻨﺘﻬﺎﻙ ﺃﻭ ﺍﻻﻋﺘﺩﺍﺀ ﺍﻟﺠﻨﺴﻲ‪ ،‬ﻫﻭ‬ ‫ﺎ ﻟﺩﻯ ﺍﻷﻁﻔﺎل ﻭﺍﻟﻤﺭﺍﻫﻘﻴﻥ‪ ،‬ﺍﻟﺫﻴﻥ ﻴ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺃﻤﺭ ﻫﺎﻡ ﺠﺩﺍ‬ ‫ﹰ‪ ،‬ﻷﻥ ﺍﻟﻌﺩﻭﻯ ﻗﺩ ﺘﻜﻭﻥ ﻏﻴﺭ ﻤﺼﺤﻭﺒﺔ ﺒﺄﻋﺭﺍﺽ )‪ .(٤٧‬ﻭﻴﺠﺏ ﺃﻥ ﺘﻜﻭﻥ ﺨﺩﻤﺎﺕ ﺍﻟﺩﻋﻡ ﺍﻟﻨﻔﺴﻲ‬ ‫ﻼ‪.‬‬ ‫ﻭﺍﻻﺠﺘﻤﺎﻋﻲ ﻤﺸﻤﻭﻟﺔ ﻓﻲ ﺫﻟﻙ‪ ،‬ﻜﻲ ﻴﻜﻭﻥ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﺍﻟﻤﻘﺩﻡ ﻟﻬﺅﻻﺀ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺼﻐﺎﺭ ﻤﺘﻜﺎﻤ ﹰ‬ ‫•‬ ‫•‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺨﺩﻤﺎﺕ ﺼﺤﺔ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ‬ ‫ﺎ ﺃﺤﺩ ﻋﻭﺍﻤل ﺍﻻﺨﺘﻁﺎﺭ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻜﺒﻴﺭﺓ ﻭﺫﻟﻙ ﻟﺠﻤﻴﻊ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﺍﻟﻤﻨﺨﺭﻁﻴﻥ‬ ‫ﺘﻤﺜل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻓﻲ ﺃﻨﺸﻁﺔ ﺠﻨﺴﻴﺔ‪ .١‬ﻭﻓﻲ ﻜل ﻋﺎﻡ‪ ،‬ﻴﺤﺩﺙ ﺃﻥ ﻴﻠﺘﻘﻁ ﻭﺍﺤﺩ ﻤﻥ ﻜل ﻋﺸﺭﻴﻥ ﻤـﻥ ﺍﻟﻤـﺭﺍﻫﻘﻴﻥ ﺇﺤـﺩﻯ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ‪ ،‬ﻭﻴﻘل ﺍﻟﻌﻤﺭ ﺍﻟﺫﻱ ﺘﻜﺘﺴﺏ ﻓﻴﻪ ﺍﻟﻌﺩﻭﻯ ﻋﺎﻤﹰ‬ ‫ﺍﻟﺒﻜﺘﻴﺭﻴﺔ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺒﻌﺩ ﻋﺎﻡ )‪ .(٧٤‬ﻭﺇﻥ ﻏﺎﻟﺒﻴﺔ ﺍﻟﻤـﺸﺭﻭﻋﺎﺕ‬ ‫ﺍﻟﺘﻲ ﺘﻌﻤل ﻓﻲ ﻤﺠﺎل ﺘﺤﺴﻴﻥ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻹﻨﺠﺎﺒﻴﺔ ﻟﺩﻯ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ‪ ،‬ﻻ ﺘﺭﻜﺯ ﺇﻻ ﻋﻠـﻰ ﺃﻨـﺸﻁﺔ ﺍﻟﺘﻭﻋﻴـﺔ‬ ‫ﺎ ﻀﻤﻥ ﺃﻫﺩﺍﻑ‬ ‫ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺘﻨﻅﻴﻡ ﺍﻷﺴﺭﺓ ﻭﺃﻫﻤﻠﺕ ﺭﻋﺎﻴﺔ ﺤﺎﻻﺕ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺇﻴﺘﺎﺀ ﺍﻟﺨﺩﻤﺔ‪ .‬ﻭﺇﻥ ﺇﺸﺭﺍﻙ ﺍﻟﻭﺍﻟﺩﻴﻥ ﻭﺍﻟﻴﺎﻓﻌﻴﻥ "ﺼﻐﺎﺭ ﺍﻟﺸﺒﺎﺏ" ﻋﻨﺩ ﺒﻠﻭﻏﻬﻡ ﺍﻟﻌﻤﺭ ﺍﻟﻤﻨﺎﺴﺏ ﻤﻥ ﺍﻟﻨﻀﺞ ﻓﻲ ﺃﻨﺸﻁﺔ‬ ‫ﺇﻋﺩﺍﺩ ﻭﺘﺨﻁﻴﻁ ﻭﺘﻨﻔﻴﺫ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺨﺎﺼﺔ ﺒﻬﻡ ﻫﻭ ﺃﻤﺭ ﺤﺎﺴﻡ ﺇﺫﺍ ﻤﺎ ﺃﺭﻴﺩ ﺇﺤﺩﺍﺙ ﺘﺄﺜﻴﺭ ﻋﻠﻰ ﺴـﻠﻭﻜﻬﻡ‪ .‬ﻭﻴﻨﺒﻐـﻲ‬ ‫ﺎ‬ ‫ﺇﻋﺩﺍﺩ ﻭﺘﻘﺩﻴﻡ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻷﺴﺎﺴﻴﺔ ﺍﻟﺘﺎﻟﻴﺔ‪ ،‬ﻋﻠﻰ ﺃﻗل ﺘﻘﺩﻴﺭ‪ ،‬ﻓﻲ ﺇﻁﺎﺭ ﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌـﺩﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻭﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪ ،‬ﺍﻟﻤﻘﺩﻤﺔ ﻓﻲ ﺇﻁﺎﺭ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‪.‬‬ ‫ﺎ ﺒﻴﻥ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﻭﺍﻟﻴﺎﻓﻌﻴﻥ ﺃﻭ ﺼﻐﺎﺭﺍﻟﺸﺒﺎﺏ‪ .‬ﻭﻫﻨﺎﻙ ﺤﺎﺠـﺔ‬ ‫ﺘﻘﻭﻴﺔ ﺇﺠﺭﺍﺀﺍﺕ ﺘﺭﺼﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺤﺴﺏ ﺍﻟﻌﻤﺭ ﻭﺍﻟﺠﻨﺱ ﻭﺫﻟﻙ ﻜﻲ ﻴﻤﻜـﻥ ﺇﺠـﺭﺍﺀ‬ ‫ﺇﻟﻰ ﺘﺼﻨﻴﻑ ﺍﻟﻤﻌﻁﻴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﻘﻴﻴﻡ ﻤﻼﺌﻡ ﻟﻠﺒﺭﻨﺎﻤﺞ ﻭﻤﻥ ﺜﻡ ﺘﻠﺒﻴﺔ ﺍﺤﺘﻴﺎﺠﺎﺕ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﻭﻤﺘﻁﻠﺒﺎﺘﻬﻡ‪.‬‬ ‫ﺎ ﻭﻤﻀﺎﻋﻔﺎﺘﻬﺎ‪ ،‬ﻭﻜﻴﻔﻴﺔ ﺍﻟﻭﻗﺎﻴﺔ‬ ‫ﺘﺤﺴﻴﻥ ﻭﺭﻓﻊ ﺍﻟﻭﻋﻲ ﻭﺍﻟﻤﻌﺭﻓﺔ‪ ،‬ﻟﺩﻯ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ‪ ،‬ﻋﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ﺒل ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ ﻭﺍﻷﻨﺜﻭﻴﺔ ﻤـﻊ‬ ‫ﻤﻨﻬﺎ‪ .‬ﺇﻥ ﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺠﻨﺴﻲ ﺍﻟﻤﻨﺎﺴﺏ ﻭﺍﻟﺼﺤﻴﺢ ﻭﺇﺘﺎﺤﺔ ﺴ‬ ‫ﻭﺠﻭﺩ ﺭﺴﺎﺌل ﻭﺍﻀﺤﺔ ﺤﻭل ﺍﻻﺴﺘﺨﺩﺍﻡ ﺍﻟﺼﺤﻴﺢ ﻭﺍﻟﻤﺘﻭﺍﺼل ﻟﻬﺎ‪ ،‬ﻴﺠﺏ ﺃﻥ ﺘﺘﻭﺍﻓﺭ ﺃﻤﺎﻡ ﺠﻤﻴﻊ ﻤﻥ ﻴﺤﺘﺎﺠﻬﺎ‪.‬‬ ‫ﻭﻫﺫﺍ ﻤﻥ ﺸﺄﻨﻪ ﺃﻥ ﻴﺅﺩﻱ ﺇﻟﻰ ﺘﺤﻘﻴﻕ ﺍﻟﻤﺭﻤـﻰ ﺍﻟﻤـﺸﺘﺭﻙ ﻨﺤـﻭ ﺘﺤـﺴﻴﻥ ﺍﻟـﺼﺤﺔ ﺍﻟﺠﻨـﺴﻴﺔ ﻭﺴـﻼﻤﺔ‬ ‫ﺍﻟﻤﺭﺍﻫﻘﻴﻥ )‪.(٤٥‬‬ ‫ﺎ‪ .‬ﻭﻤﻥ ﻏﻴﺭ ﺍﻟﻤﺭﺠﺢ‬ ‫ﺘﺤﺴﻴﻥ ﺇﻤﻜﺎﻨﻴﺔ ﺘﻭﺼل ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﺇﻟﻰ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻟﺘﻠﺒﻴﺔ ﺍﺤﺘﻴﺎﺠﺎﺕ ﻭﻤﺘﻁﻠﺒﺎﺕ ﻜﺎﻓـﺔ‬ ‫ﺃﻥ ﻴﻜﻔﻲ ﻨﻤﻭﺫﺝ ﻭﺍﺤﺩ ﻟﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﹰ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ‪ ،‬ﻋﻴﺎﺩﺍﺕ ﺼﺤﺔ ﺍﻟﺒﺎﻟﻐﻴﻥ ﻭﺍﻟﺘـﻲ‬ ‫ﺍﻟﻤﺭﺍﻫﻘﻴﻥ‪ .‬ﻭﻴﻤﻜﻥ ﻟﻠﺨﺩﻤﺎﺕ ﺍﻟﺒﻨﺎﺀ ﻋﻠﻰ ﻤﺎ ﻫﻭ ﻤﻭﺠﻭﺩ ﻓﻌﻠﻴﺎ‬ ‫‪‬ل ﺍﻟﺸﺒﺎﺏ ﻤﻥ ﺨﻼل ﺘﻘﺩﻴﻡ ﺘﺩﺭﻴﺏ ﺨﺎﺹ ﻟﻤﻘﺩﻤﻲ ﻫﺫﻩ ﺍﻟﺨﺩﻤﺎﺕ‪ ،‬ﻭﻋﻴﺎﺩﺍﺕ ﺍﻟـﺼﺤﺔ‬ ‫ﻗﺒ‬ ‫ﺃﺼﺒﺤﺕ ﻤﺭﻏﻭﺒﺔ ﻤﻥ ِ‬ ‫"‬ ‫"‬ ‫ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﺍﻟﻤﺨﺼﺼﺔ ﻟﻠﻤﺭﺍﻫﻘﻴﻥ ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﻜل ﺸﻲﺀ ﻓﻲ ﺯﻴﺎﺭﺓ ﻭﺍﺤﺩﺓ ﺤﻴﺙ ﻴﻤﻜـﻥ‬ ‫ﻟﻠﺸﺒﺎﺏ ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﻜﺎﻓﺔ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺘﻲ ﻴﺤﺘﺎﺠﻭﻨﻬﺎ‪ ،‬ﻭﻤﺭﺍﻜﺯ ﺍﻟﺸﺒﺎﺏ ﻤﺘﻌﺩﺩﺓ ﺍﻷﻏﺭﺍﺽ‪،‬‬ ‫ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﺩﺭﺴﻴﺔ ﺃﻭ ﺍﻟﺘﺭﺍﺒﻁﻴﺔ ﺍﻟﺘﻲ ﺘﺘﻌﺎﻤل ﻭﻓﻘﹰ‬ ‫ﺎ ﻟﻠﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﻌﻤﺭﻴﺔ )‪ .(٧٥‬ﻭﻤﻊ ﺫﻟﻙ‪ ،‬ﻓﻘﺩ ﺘﻜﻭﻥ ﻫﻨﺎﻙ‬ ‫ﺤﺎﺠﺔ ﻟﻭﺠﻭﺩ ﺃﺸﻜﺎل ﺠﺩﻴﺩﺓ ﻤﺒﺘﻜﺭﺓ ﻤﺜل ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﻤﺘﻨﻘﻠﺔ‪ ،‬ﻭﺫﻟﻙ ﻤﻥ ﺃﺠل ﺍﻟﻭﺼﻭل ﺇﻟﻰ ﺍﻟﺸﺒﺎﺏ ﺍﻷﻜﺜﺭ ﻗﺎﺒﻠﻴﺔ‬ ‫ﺃﻭ ﻋﺭﻀﺔ ﻟﻺﺼﺎﺒﺔ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺍﻟﺒﻐﺎﻴﺎ ﻭﺍﻷﻁﻔﺎل ﺍﻟﻤﺸﺭﺩﻴﻥ‪ ،‬ﻭﺒﺼﻔﺔ ﺨﺎﺼﺔ ﺃﺜﻨـﺎﺀ ﺇﻗﺎﻤـﺔ ﺍﻻﺤﺘﻔـﺎﻻﺕ‬ ‫ﻭﺍﻟﻤﻬﺭﺠﺎﻨﺎﺕ‪.‬‬ ‫•‬

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‫ﺍﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ‬

‫‪٢-٤-٣‬‬

‫ﻋﻠﻰ ﺍﻟﺭﻏﻡ ﻤﻥ ﺘﻭﻓﺭ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﺠﺎﻨﻴﺔ ﻟﻠﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ‪ ،‬ﺤﺘﻰ ﻓﻲ ﺍﻟﺒﻠﺩﺍﻥ ﺫﺍﺕ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻔﻘﻴـﺭﺓ‪ ،‬ﻓﻘـﺩ‬ ‫ﺎ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﻌﻤﻼﺀ‪ ،‬ﺃﻭ ﺃﻥ ﻴﺘﻭﻓﺭ ﺒﻬﺎ ﺍﻟﻤﻬﻨﻴﻭﻥ ﺍﻟﺼﺤﻴﻭﻥ ﺍﻟﻤﻼﺌﻤـﻭﻥ ﺃﻭ ﺍﻷﺩﻭﻴـﺔ ﺍﻟﻼﺯﻤـﺔ‪.‬‬ ‫ﻻ ﺘﻜﻭﻥ ﻤﻘﺒﻭﻟﺔ ﺩﺍﺌﻤﹰ‬ ‫ﹰ‪،‬‬ ‫‪‬ﻓﺕ ﻤﻨﻅﻤﺔ ﺍﻟﺼﺤﺔ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺍﻟﻤﺭﺍﻫﻘﻴﻥ ﺒﺄﻨﻬﻡ ﺍﻷﺸﺨﺎﺹ ﺍﻟﻭﺍﻗﻌﻴﻥ ﻀﻤﻥ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺭﻴﺔ‪ ،‬ﻤﺎ ﺒﻴﻥ ‪ ١٩ – ١٠‬ﻋﺎﻤﺎ‬ ‫‪ ١‬ﻟﻘﺩ ﻋﺭ‬ ‫ﺎ‪ .‬ﻭﻓﺌﺔ ﺍﻟﻴﺎﻓﻌﻴﻥ "ﺼﻐﺎﺭ ﺍﻟﺸﺒﺎﺏ"‬ ‫‪‬ﻓﺕ ﺍﻟﺸﺒﺎﺏ ﺒﺄﻨﻬﻡ ﺍﻷﺸﺨﺎﺹ ﺍﻟﻭﺍﻗﻌﻴﻥ ﻀﻤﻥ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺭﻴﺔ ﻤﺎ ﺒﻴﻥ ‪ ٢٤ – ١٥‬ﻋﺎﻤﹰ‬ ‫ﺒﻴﻨﻤﺎ ﻋﺭ‬ ‫ﺎ )‪.(٧٣‬‬ ‫ﻫﻲ ﺨﻠﻴﻁ ﻤﻥ ﻫﺎﺘﻴﻥ ﺍﻟﻔﺌﺘﻴﻥ ﺍﻟﻤﺘﺩﺍﺨﻠﺘﻴﻥ‪ ،‬ﺒﻤﺎ ﻴﻐﻁﻲ ﺍﻟﻨﻁﺎﻕ ﺍﻟﻭﺍﻗﻊ ﺒﻴﻥ ‪ ٢٤ – ١٠‬ﻋﺎﻤﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺄ ﺇﻟﻴﻬﻡ‬ ‫ﺍ ﻤﺎ ﻴﻜﻭﻥ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ ﺃﻭ ﺍﻟﻤﻌﺎﻟﺠﻭﻥ ﺍﻟﺸﻌﺒﻴﻭﻥ‪ ،‬ﻭﻤﻘﺩﻤﻭ ﺍﻟﺭﻋﺎﻴﺔ ﻏﻴﺭ ﺍﻟﺭﺴﻤﻴﻴﻥ ﻫﻡ ﺃﻭل ﻤﺎ ﻴﻠﺠً‬ ‫ﻭﻜﺜﻴﺭﹰ‬ ‫ﺎ‪ ،‬ﺤﺘﻰ ﺃﻭﻟﺌﻙ ﺍﻟﺫﻴﻥ ﻴﺭﻭﻥ ﺃﻥ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺤﻜﻭﻤﻴﺔ ﻤﺘﻔﻭﻗـﺔ‬ ‫ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻭﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻥ ﺍﻟﻭﺠﻬﺔ ﺍﻟﺘﻘﻨﻴﺔ‪ .‬ﻭﻤﻘﺩﻤﻭ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺘﺎﺒﻌﻭﻥ ﻟﻠﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ‪ ،‬ﺴﻭﺍﺀ ﻜﺎﻨﻭﺍ ﻤﺅﻫﻠﻴﻥ ﺃﻡ ﻏﻴﺭ ﻤﺅﻫﻠﻴﻥ‪ ،‬ﻫـﻡ ﺃﻜﺜـﺭ‬ ‫ﺎ‬ ‫ﻤﻘﺒﻭﻟﻴﺔ ﻟﺩﻯ ﺍﻟﻜﺜﻴﺭ‪ ،‬ﺒﺴﺒﺏ ﻤﺎ ﻴﻌﺘﻘﺩ ﻋﻨﻬﻡ ﻤﻥ ﺃﻥ ﺍﻟﻭﺼﻭل ﺇﻟﻴﻬﻡ ﺃﻴﺴﺭ‪ ،‬ﻭﻤﺤﺎﻓﻅﺘﻬﻡ ﻋﻠﻰ ﺍﻟﺴﺭﻴﺔ ﺃﻜﺒﺭ‪ ،‬ﻭﻏﺎﻟﺒـﹰ‬ ‫ﻤﺎ ﻴﻜﻭﻥ ﺍﻻﻋﺘﻘﺎﺩ ﺍﻟﺸﺎﺌﻊ ﻫﻭ ﺃﻥ ﺘﻠﻘﻲ ﺍﻟﻌﻼﺝ ﻟﺩﻴﻬﻡ ﺃﻗل ﻭﺼﻤﺔ ﻤﻥ ﺘﻠﻘﻴﻪ ﻓﻲ ﻤﺭﺍﻓﻕ ﺍﻟﻘﻁﺎﻉ ﺍﻟﻌﺎﻡ‪ ،‬ﻜﻤﺎ ﺃﻥ ﺍﻟﺘﻁﺒﻴﺏ‬ ‫ﺍﻟﺫﺍﺘﻲ‪ ،‬ﺒﻌﺩ ﺍﻟﺸﺭﺍﺀ ﺍﻟﻤﺒﺎﺸﺭ ﻟﻸﺩﻭﻴﺔ‪ ،‬ﺒﺩﻭﻥ ﻭﺼﻔﺔ ﻁﺒﻴﺔ‪ ،‬ﻤﻥ ﺍﻟﺼﻴﺎﺩﻟﺔ ﻭﺘﺠﺎﺭ ﺍﻷﺩﻭﻴﺔ ﻭﻤﻭﺭﺩﻴﻬﺎ‪ ،‬ﻫﻭ ﺃﻤﺭ ﺸﺎﺌﻊ‬ ‫ﺎ‪.‬‬ ‫ﺃﻴﻀﹰ‬ ‫ﻭﻓﻲ ﻅل ﻫﺫﺍ ﺍﻟﺴﻴﻨﺎﺭﻴﻭ‪ ،‬ﻴﺠﺏ ﺃﻥ ﺘﺸﺭﻙ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻌﺎﻤـﺔ ﺍﻟﻘﻁﺎﻋـﺎﺕ ﺍﻟﺨﺎﺼـﺔ ﻭﻏﻴـﺭ‬ ‫ﺍﻟﺭﺴﻤﻴﺔ‪ ،‬ﺇﻟﻰ ﺠﺎﻨﺏ ﺍﻟﺸﺭﺍﻜﺎﺕ ﻤﺎ ﺒﻴﻥ ﺍﻟﻘﻁﺎﻉ ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺘـﻭﻓﻴﺭ ﺍﻟﺭﻋﺎﻴـﺔ ﻟﻤﺭﻀـﻰ‬ ‫ﺎ‪ .‬ﻭﻴﻨﺒﻐﻲ ﻗﻴﺎﻡ ﺍﻟﺤﻜﻭﻤﺎﺕ ﺒﺎﺘﺨﺎﺫ ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﻨﻅﻴﻤﻴﺔ ﺍﻟﻔﻌﺎﻟﺔ ﻭﺍﻟﻤﻼﺌﻤﺔ ﻟـﻀﻤﺎﻥ ﺘـﻭﻓﺭ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺍﻟﺘﻲ ﻴﻘـﺩﻤﻬﺎ ﺍﻟﻘﻁـﺎﻉ ﺍﻟﺨـﺎﺹ‪.‬‬ ‫ﺍﻟﺠﻭﺩﺓ ﺍﻟﺘﻘﻨﻴﺔ‪ ،‬ﻭﺍﻟﻤﺴﺎﺀﻟﺔ ﻓﻲ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻴﺘﻌﻴﻥ ﺃﻥ ﻴﺘﻡ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻘﻁﺭﻱ ﺩﺭﺍﺴﺔ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﺘﻌﺎﻭﻥ ﻭﻤﺭﺍﻗﺒﺔ ﺍﻟﺠﻭﺩﺓ‪ .‬ﻭﻗﺩ ﺘﺸﻤل ﻫﺫﻩ‬ ‫ﺘﺩﺭﻴﺏ ﺍﻟﺼﻴﺎﺩﻟﺔ ﻭﺍﻟﻤﻤﺎﺭﺴﻴﻥ ﺍﻟﻌﺎﻤﻠﻴﻥ ﻓﻲ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ ﻋﻠﻰ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﺤﺎﻻﺕ ﻭﻋﻠﻰ ﺍﻟﺩﻻﺌل‬ ‫ﺍﻹﺭﺸﺎﺩﻴﺔ ﺍﻟﻭﻁﻨﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺫﻟﻙ‪ .‬ﻜﻤﺎ ﻴﺠﺏ ﻗﻴﺎﻡ ﺍﻟﺤﻜﻭﻤﺎﺕ ﺒﺒﺤﺙ ﻜﻴﻔﻴـﺔ ﺇﻗﺎﻤـﺔ ﻋﻼﻗـﺎﺕ ﺭﺴـﻤﻴﺔ ﻟﺘﻌﺯﻴـﺯ‬ ‫ﺎ ﻤﻊ ﺍﺘﺤﺎﺩﺍﺕ ﺍﻟـﺼﻴﺎﺩﻟﺔ‪ ،‬ﻭﺭﺍﺒﻁـﺎﺕ ﺍﻟﻤﻌـﺎﻟﺠﻴﻥ‬ ‫ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﻤﻨﺎﺴﺒﺔ ﻟﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺸﻌﺒﻴﻴﻥ ﻭﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻵﺨﺭﻴﻥ‪ ،‬ﺤﺴﺏ ﻤﺎ ﻴﺘﻁﻠﺏ ﺍﻷﻤﺭ ﻓﻲ ﺍﻟﻤﻜﺎﻥ ﺃﻭ ﺍﻟﻤﻭﻗﻊ‪ ،‬ﻭﻋﻠـﻰ ﺤـﺴﺏ ﺍﻟـﺴﻴﺎﺴﺎﺕ‬ ‫ﻭﺍﻟﻘﻭﺍﻨﻴﻥ ﻭﺍﻷﻨﻅﻤﺔ ﺍﻟﻤﻌﻤﻭل ﺒﻬﺎ‪ .‬ﻭﻴﺠﺏ ﺃﻥ ﻴﺘﻡ ﻜل ﺫﻟﻙ ﺒﺎﻟﺘﻌﺎﻭﻥ ﻤﻊ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﻨﻔﺴﻬﺎ‪.‬‬

‫ﺇﺸﺭﺍﻙ ﺍﻟﻤﺠﺘﻤﻊ‬

‫‪٣-٤-٣‬‬

‫ﹰ‪،‬‬ ‫ﺇﻥ ﺍﻟﻤﺸﺎﺭﻜﺔ ﺍﻟﺘﻲ ﻴﻘﻭﻡ ﺒﻬﺎ ﺍﻟﻤﺠﺘﻤﻊ ﻓﻲ ﺍﻟﻘﺭﺍﺭﺍﺕ ﺍﻟﺘﻲ ﻟﻬﺎ ﺘﺄﺜﻴﺭ ﻋﻠﻰ ﺼﺤﺔ ﺃﻓﺭﺍﺩﻩ‪ ،‬ﺘﻌﺘﺒﺭ ﻫﺎﻤﺔ ﺠـﺩﺍ‬ ‫ﺎ‪ ،‬ﺘﺤﺘﺎﺝ ﺇﻟﻰ ﺍﺴﺘﻨﺒﺎﻁ ﺁﻟﻴﺎﺕ ﻟﻠﺤﺼﻭل ﻋﻠﻰ ﺇﺴﻬﺎﻡ ﻭﻤـﺸﺎﺭﻜﺔ ﺍﻟﻤﺠﺘﻤـﻊ‬ ‫ﻭﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﺄﻜﻤﻠﻪ ﻤﻥ ﺨﻼل ﻤﻤﺜﻠﻴﻥ ﻤﻼﺌﻤﻴﻥ ﻤﻥ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﻤﺩﻨﻲ‪ .‬ﻭﻴﻤﻜﻥ ﺘﺤﻘﻴﻕ ﺫﻟﻙ‪ ،‬ﻋﻠﻰ ﺃﻓﻀل ﻭﺠﻪ‪ ،‬ﻋﻥ ﻁﺭﻴﻕ ﺨﻠـﻕ‬ ‫ﺸﺭﺍﻜﺎﺕ ﻤﻊ ﺍﻟﻤﻨﻅﻤﺎﺕ ﻏﻴﺭ ﺍﻟﺤﻜﻭﻤﻴﺔ‪ ،‬ﻭﺍﻟﻤﻨﻅﻤﺎﺕ ﺍﻟﺨﻴﺭﻴﺔ ﻭﺍﻟﻌﻘﺎﺌﺩﻴﺔ ﻭﺍﻟﻤﺅﺴﺴﺎﺕ ﺍﻟﻤﺠﺘﻤﻌﻴﺔ ﻭﺍﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ‪.‬‬ ‫ﻜﻤﺎ ﻴﺠﺏ ﺘﻭﻋﻴﺔ ﻭﺘﺜﻘﻴﻑ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﺤﻭل ﻤﺩﻯ ﺘﻭﻓﺭ‪ ،‬ﻭﻤﺯﺍﻴﺎ ﻭﻋﻴﻭﺏ ﺍﻷﻨﻭﺍﻉ ﺍﻟﻤﺨﺘﻠﻔﺔ ﻤﻥ ﺨـﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴـﺔ‬ ‫ﺎ‪ .‬ﻭﻴﻤﻜﻥ ﺇﻨﺸﺎﺀ ﺠﻤﻌﻴﺎﺕ ﻟﻠﺩﻓﺎﻉ ﻋﻥ ﺤﻘـﻭﻕ ﺍﻟﻤـﺴﺘﻬﻠﻙ‪ ،‬ﻜﻤـﺎ ﻴﻤﻜـﻥ‬ ‫ﺍﻟﻤﻘﺩﻤﺔ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻓﻲ ﺘﺤـﺴﻴﻥ ﻫـﺫﻩ‬ ‫ﻟﻠﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ ﻴﻜﻭﻨﻭﻥ ﻋﻠﻰ ﻋﻠﻡ ﻭﺩﺭﺍﻴﺔ ﺠﻴﺩﺓ ﻭﻴﺘﻤﺘﻌﻭﻥ ﺒﺎﻟﻔﻁﻨﺔ ﻭﺍﻟﺒﺼﻴﺭﺓ‪ ،‬ﺍﻟﻤﺴﺎﻋﺩﺓ ﺃﻴﻀﹰ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ‪ .‬ﻭﻴﻤﻜﻥ ﺘﺸﺠﻴﻊ ﺍﻟﻤﺴﺘﻬﻠﻜﻴﻥ ﻋﻠﻰ ﺍﻟﻠﺠﻭﺀ ﻭﺍﺴﺘﺨﺩﺍﻡ ﻤﻘﺩﻤﻲ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﻠﺘـﺯﻤﻴﻥ ﺒﻤﻌـﺎﻴﻴﺭ ﻭﻤﻭﺍﺼـﻔﺎﺕ‬ ‫ﺍﻟﺠﻭﺩﺓ ﺍﻟﻤﺴﺒﻘﺔ ﺍﻟﺘﺤﺩﻴﺩ‪ ،‬ﻭﺍﻟﻤﺘﻔﻕ ﻋﻠﻴﻬﺎ‪ ،‬ﻭﺍﻟﻤﻌﻠﻥ ﻋﻨﻬﺎ ﺒﺸﻜل ﺠﻴﺩ‪ .‬ﻭﺘﺸﻤل ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﺘﻲ ﺘﺭﻤﻲ ﺇﻟﻰ ﺇﺸﺭﺍﻙ‬ ‫ﺍﻟﻤﺠﺘﻤﻊ‪ ،‬ﺍﻵﺘﻲ‪:‬‬ ‫ ﺘﻭﻓﻴﺭ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﺍﻟﺘﻲ ﺘﺯﻴﺩ ﻤﻥ ﻭﻋﻲ ﺍﻟﻤﺠﺘﻤﻊ ﺤﻭل ﺍﻟﻤﺸﻜﻠﺔ ﻭﺘﺯﻴﺩ ﻜﺫﻟﻙ ﻤـﻥ ﻁﻠـﺏ ﺍﻟﻤﺠﺘﻤـﻊ‬‫ﻟﻠﺘﺩﺨﻼﺕ ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﺫﻟﻙ؛‬ ‫ ﺍﻟﺘﺸﺎﻭﺭ ﺍﻟﻤﺴﺘﻤﺭ ﻤﻊ ﺍﻟﻤﺠﺘﻤﻊ؛‬‫ ﺇﺸﺭﺍﻙ ﺍﻟﻤﺠﺘﻤﻊ ﻓﻲ ﻭﻀﻊ ﻭﺘﻨﻔﻴﺫ ﺍﻟﺘﺩﺨﻼﺕ؛‬‫‪ -‬ﺇﺸﺭﺍﻙ ﺍﻟﻤﺠﺘﻤﻊ ﻓﻲ ﺍﻟﻤﺴﺅﻭﻟﻴﺔ ﻭﺘﺤﻤل ﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﺘﻲ ﺘﻔﻀﻲ ﺇﻟﻴﻬﺎ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻤﻁﺒﻘﺔ؛‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ ﺇﺸﺭﺍﻙ ﺍﻟﻘﺎﺩﺓ ﺍﻟﺴﻴﺎﺴﻴﻴﻥ ﻭﺭﻭﺍﺩ ﺍﻟﻔﻜﺭ ﻭﺍﻟﺭﺃﻱ ﺍﻟﻤﺤﻠﻴﻴﻥ‪ ،‬ﺒﻤﻥ ﻓﻴﻬﻡ ﺍﻟﻘﺎﺩﺓ ﺍﻟﺘﻘﻠﻴﺩﻴﻭﻥ ﻭﻜﺒـﺎﺭ ﺭﺠـﺎل‬‫ﺎ‪.‬‬ ‫ﺍﻟﺩﻴﻥ‪ ،‬ﻓﻲ ﺃﻨﺸﻁﺔ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺘﻜﻭﻥ ﺍﻟﻤﺅﺴﺴﺎﺕ ﺍﻟﺩﻴﻨﻴﺔ ﻭﺍﻟﻌﻘﺎﺌﺩﻴﺔ ﻓﻲ ﻤﻌﻅﻡ ﺍﻷﺤﻭﺍل ﻤﻔﻴﺩﺓ ﻭﻓﺎﻋﻠﺔ ﻓـﻲ ﺘﻜـﻭﻴﻥ ﺍﻵﺭﺍﺀ ﻭﺍﻟﻤﻭﺍﻗـﻑ‬ ‫ﻭﺍﻟﺴﻠﻭﻙ ﻟﺩﻯ ﺃﺘﺒﺎﻋﻬﺎ‪ ،‬ﻭﻟﺩﻯ ﺍﻟﻤﺠﺘﻤﻊ ﺒﺼﻔﺔ ﻋﺎﻤﺔ‪ .‬ﻓﻔﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻷﻤﺎﻜﻥ ﺘ‬ ‫ﹸﺘﺎﺡ ﻟﻬﺫﻩ ﺍﻟﻤﻨﻅﻤﺎﺕ ﻓﺭﺼﺔ ﻓﺭﻴـﺩﺓ‬ ‫ﺎ‪ ،‬ﻭﺫﻟﻙ ﻋﻥ ﻁﺭﻴﻕ ﺸﺒﻜﺎﺘﻬﺎ ﺍﻟﻤﻤﺘـﺩﺓ‬ ‫ﻟﺘﻘﺩﻴﻡ ﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺼﺤﻲ ﺤﻭل ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺴﺎﺌﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺇﻟﻰ ﺃﺒﻌﺩ ﺍﻟﻘﺭﻯ ﻭﺍﻟﻤﺠﺘﻤﻌﺎﺕ‪ .‬ﻭﻤﻥ ﺜﻡ ﻴﻤﻜﻥ ﻟﻬﺫﻩ ﺍﻟﻤﻨﻅﻤﺎﺕ ﺍﻟﻤﺠﺘﻤﻌﻴﺔ ﺃﻥ ﺘﺸﺎﺭﻙ ﻤﺸﺎﺭﻜﺔ ﺤﻴﻭﻴﺔ ﻓﻲ ﺍﻟﺘﻭﻋﻴـﺔ‪،‬‬ ‫ﻭﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﻤﻨﺯﻟﻴﺔ‪ ،‬ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﺴﺭﻴﺭﻴﺔ‪ ،‬ﺒل ﻭﺍﻟﻌﻼﺝ ﺍﻟﻤﺘﻘﺩﻡ ﺇﻀﺎﻓﺔ ﺇﻟﻰ ﺨﻔﺽ ﺍﻟﻭﺼـﻤﺔ ﻭﺍﻟﺘﻤﻴﻴـﺯ‪ .‬ﻭﻴﺠـﺏ‬ ‫ﺎ ﺒﻤـﺎ ﻓﻴﻬـﺎ‬ ‫ﺍﻨﺨﺭﺍﻁﻬﻡ ﻓﻲ ﺍﻟﻤﻨﺎﻗﺸﺎﺕ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﻨﺸﺎﻁ ﺍﻟﺠﻨﺴﻲ‪ ،‬ﻭﺍﻟﺫﻜﻭﺭﺓ ﻭﺍﻷﻨﻭﺜﺔ‪ ،‬ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻤﻥ ﺃﺠل ﺘﺴﻬﻴل ﺇﻴﺠﺎﺩ ﺒﻴﺌﺔ ﻤﻔﺘﻭﺤﺔ ﻟﻤﻨﺎﻗﺸﺔ ﻫﺫﻩ ﺍﻟﻘﻀﺎﻴﺎ‪ .‬ﻟﺫﺍ ﻜﺎﻥ ﻤﻥ‬ ‫ﺍﻟﻤﻬﻡ ﺘﻌﺯﻴﺯ ﻗﺩﺭﺍﺕ ﻫﺫﻩ ﺍﻟﻤﻨﻅﻤﺎﺕ ﻭﺘﻘﻭﻴﺔ ﻤﺠﺎﻻﺕ ﺍﻟﺘﻌﺎﻭﻥ ﻤﻌﻬﺎ ﺤﺘﻰ ﺘﻌﻤل ﺒﺼﻭﺭﺓ ﺃﻜﺜﺭ ﻓﻌﺎﻟﻴﺔ ﻤﻊ ﺍﻟﺤﻜﻭﻤﺎﺕ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪.‬‬ ‫ﻓﻲ ﻤﺠﺎل ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

‫ﺍﻟﺸﺭﻜﺎﺀ ﺍﻵﺨﺭﻭﻥ‬

‫‪٤-٤-٣‬‬

‫ﻫﻨﺎﻙ ﺸﺭﻜﺎﺀ ﻭﺃﺼﺤﺎﺏ ﻤﺼﺎﻟﺢ ﻋﺩﻴﺩﻭﻥ ﺁﺨﺭﻭﻥ‪ ،‬ﻴﺠﺏ ﺇﺸﺭﺍﻜﻬﻡ ﻓﻲ ﺃﻋﻤﺎل ﺍﻟﺘﺼﺩﻱ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ ﻟﻤﺎ ﻴﺘﻁﻠﺒﻪ ﺍﻟﻤﻭﻗﻊ ﺃﻭ ﺍﻟﻤﻜﺎﻥ‪ .‬ﻭﻴﻤﻜﻥ ﺃﻥ ﻴﺸﻤل ﺫﻟﻙ ﺇﺩﺍﺭﺍﺕ ﺤﻜﻭﻤﻴﺔ ﺃﺨﺭﻯ ﻤﺜل ﺍﻟﻤﺅﺴﺴﺎﺕ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ‬ ‫ﺎ‪ ،‬ﻭﻓﻘﹰ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻟﺭﻴﺎﻀﻴﺔ ﻭﺍﻟﺜﻘﺎﻓﻴﺔ‪ ،‬ﻭﺍﻟﻌﻤل‪ ،‬ﻭﺍﻟﺸﺭﻁﺔ ﻭﻤﺴﺅﻭﻟﻲ ﻤﺭﺍﻗﺒﺔ ﺍﻟﺤﺩﻭﺩ‪ ،‬ﻭﺍﻟﺸﺭﻜﺎﺕ ﺍﻟﺨﺎﺼﺔ ﻤﺜـل ﺸـﺭﻜﺎﺕ ﺍﻟﻨﻘـل‬ ‫ﻭﺍﻟﺴﻴﺎﺤﺔ‪ ،‬ﻭﺃﺨﺭﻯ ﻏﻴﺭﻫﺎ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺒﺤﺙ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﻤﺨﺘﻠﻔﺔ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﺒﻤﺎ ﻓﻴﻬﺎ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ ﻓﻲ ﻗﻁﺎﻉ ﺍﻟﺘﻌﻠﻴﻡ ﻭﺃﻤﺎﻜﻥ ﺍﻟﻌﻤل‪ .‬ﻭﻴﺘﻌـﻴﻥ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﻭﻀﻊ ﺍﻵﻟﻴﺎﺕ ﺍﻟﻤﻨﺎﺴﺒﺔ ﻟﺘﺸﺠﻴﻊ ﺍﻟﻬﻴﺌﺎﺕ ﻭﺍﻟﻤﺅﺴﺴﺎﺕ ﻋﻠﻰ ﺘﺤﻤل ﻤﺴﺅﻭﻟﻴﺎﺘﻬﺎ ﻭﺍﻻﺴﺘﻌﺩﺍﺩ ﻟﻠﻤﺴﺎﺀﻟﺔ ﻓﻲ ﻤﺎ ﻴﺨﺘﺹ‬ ‫ﺒﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ‪ .‬ﻭﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻓﻲ ﺒﻌﺽ ﺍﻷﻤﺎﻜﻥ‪ ،‬ﻟﻭﺠﻭﺩ ﺘﻌﺎﻭﻥ ﻴﺘﻡ ﻋﺒﺭ ﺍﻟﺤﺩﻭﺩ ﻟﺘﻨﻔﻴﺫ‬ ‫ﺘﺩﺨﻼﺕ ﺘﺠﺭﻯ ﻋﻠﻰ ﺍﻟﺘﺠﺎﺭ ﺍﻟﻤﺘﻨﻘﻠﻴﻥ ﻋﺒﺭ ﺍﻟﺤﺩﻭﺩ‪ ،‬ﻭﺃﺼﺤﺎﺏ ﺍﻟﻬﺠﺭﺓ ﺍﻟﻤﺅﻗﺘﺔ ﺃﻭ ﺍﻟﺩﺍﺌﻤﺔ‪ ،‬ﻭﺍﻷﺸﺨﺎﺹ ﺍﻟﻤﺸﺭﺩﻴﻥ‪،‬‬ ‫ﻭﺍﻷﺸﺨﺎﺹ ﺍﻟﺫﻴﻥ ﻴﺘﺤﺘﻡ ﻋﻠﻴﻬﻡ‪ ،‬ﺒﺤﻜﻡ ﺃﻋﻤﺎﻟﻬﻡ‪ ،‬ﺍﻟﻤﻜﻭﺙ ﻓﻲ ﻤﻨﺎﻁﻕ ﻤﺨﺘﻠﻔﺔ ﻓﻲ ﻭﻗﺕ ﺃﻭ ﻓﻲ ﺁﺨﺭ‪ ،‬ﺨـﻼل ﻓﺘـﺭﺓ‬ ‫ﻋﻤﻠﻬﻡ‪.‬‬

‫‪ ٥-٣‬ﺘﻌﺯﻴﺯ ﻗﺩﺭﺍﺕ ﻭﻁﺎﻗﺎﺕ ﺍﻷﻨﻅﻤﺔ ﺍﻟﺼﺤﻴﺔ ﻟﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﻓﻌﺎﻟﺔ ﻭﻤﺅﺜﺭﺓ‬ ‫‪‬ﻑ ﻋﻠﻰ ﻨﺤﻭ ﺃﻋﻡ‪ ،‬ﻋﻠﻰ ﺃﻨﻬﺎ ﺘﻀﻡ ﻜﺎﻓﺔ ﺍﻟﻬﻴﺌﺎﺕ ﻭﺍﻟﻤﺅﺴﺴﺎﺕ ﻭﺍﻟﻤﻭﺍﺩ‬ ‫ﺘﻌﺘﺒﺭ ﺍﻷﻨﻅﻤﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﺍﻟﺘﻲ ﺘﻌﺭ‬ ‫ﺍﻟﻤﺨﺼﺼﺔ ﻟﻠﻘﻴﺎﻡ ﺒﺈﺠﺭﺍﺀﺍﺕ ﺼﺤﻴﺔ‪ ،‬ﻤﻥ ﺍﻟﺸﺭﻭﻁ ﺍﻷﺴﺎﺴﻴﺔ ﻹﻋﺩﺍﺩ ﺒﺭﺍﻤﺞ ﻟﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ‪ ،‬ﻭﺭﺼﺩ ﺍﻟﻨﺘﺎﺌﺞ ﻤﺤل ﺍﻟﺒﺤﺙ ﻓﻲ ﻫﺫﻩ ﺍﻟﻭﺜﻴﻘﺔ‪ .‬ﻭﺇﻥ ﻁﺎﻗﺔ ﻭﻗﺩﺭﺓ ﺍﻟﻨﻅﺎﻡ ﺍﻟﺼﺤﻲ ﻓﻲ ﻜل ﺒﻠﺩ ﻋﻠﻰ ﺤﺩﺓ ﻫـﻲ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺍﻟﻭﺼﻭل ﺇﻟﻴﻪ ﻓﻴﻤﺎ ﻴﺘﻌﻠـﻕ‬ ‫ﺍﻟﺘﻲ ﺘﺤﺩﺩ‪ ،‬ﺒﺸﻜل ﻜﺒﻴﺭ‪ ،‬ﺍﻟﻤﺩﻯ ﺍﻟﺫﻱ ﺘﺴﺘﻁﻴﻊ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻭﻁﻨﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﺘﻘﺩﻴﻡ ﺭﻋﺎﻴﺔ ﺫﺍﺕ ﺠﻭﺩﺓ ﺭﻓﻴﻌﺔ‪ ،‬ﻓﻲ ﺃﻜﺒﺭ ﻤﺴﺎﺤﺔ ﺠﻐﺭﺍﻓﻴﺔ ﻤﻤﻜﻨﺔ‪ ،‬ﻭﺍﻟﻭﺼﻭل ﺇﻟﻰ ﺍﻟﻔﺌﺎﺕ ﺍﻟـﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﺘـﻀﺭﺭﺓ‬ ‫ﺎ ﻭﻋـﺩﺍﻭﻯ ﺍﻟﺠﻬـﺎﺯ‬ ‫ﻭﺍﻟﻤﺴﺘﻬﺩﻓﺔ‪ ،‬ﻟﺘﺤﻘﻴﻕ ﺘﺄﺜﻴﺭ ﻤﺤﺴﻭﺱ ﻨﺤﻭ ﺨﻔﺽ ﺍﻟﻌﺏﺀ ﺍﻟﺫﻱ ﺘﻤﺜﻠﻪ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻹﻨﺠﺎﺒﻲ ﺍﻷﺨﺭﻯ‪ ،‬ﻤﻊ ﺍﻟﻭﻗﺎﻴﺔ‪ ،‬ﻓﻲ ﻨﻔﺱ ﺍﻟﻭﻗﺕ ﻤﻥ ﺍﻹﺼﺎﺒﺔ ﺒﻌﺩﺍﻭﻯ ﺠﺩﻴﺩﺓ‪ .‬ﻭﺇﻥ ﺍﻟﻘﺩﺭﺓ ﻋﻠﻰ ﺘﻘـﺩﻴﻡ ﺍﻟﺨـﺩﻤﺎﺕ‬ ‫ﺒﻁﺭﻴﻘﺔ ﺘﺤﻘﻕ ﺍﻟﻤﺴﺎﻭﺍﺓ‪ ،‬ﻫﻲ ﺃﻤﺭ ﻓﻲ ﻏﺎﻴﺔ ﺍﻷﻫﻤﻴﺔ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻓﻲ ﻀﻭﺀ ﺍﻟﻭﺼﻤﺔ ﺍﻟﺘﻲ ﺘﺤـﻴﻁ ﺒﺄﻋﻤـﺎل ﺍﻟﻭﻗﺎﻴـﺔ‬ ‫ﺎ‪ .‬ﻭﻴﺘﻡ ﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻷﻤﺎﻜﻥ ﺍﻟﻤﺤﺩﻭﺩﺓ ﺍﻟﻤـﻭﺍﺭﺩ ﺘﺤﻤﻴـل ﺍﻷﻨﻅﻤـﺔ‬ ‫ﻭﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻷﻭﻟﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺼﺤﻴﺔ ﻓﻭﻕ ﻁﺎﻗﺘﻬﺎ‪ ،‬ﺩﻭﻥ ﻭﺠﻭﺩ ﺍﻟﺘﻤﻭﻴل ﺍﻟﻤﻼﺌﻡ‪ ،‬ﺃﻭ ﺍﻟﻤﻌﺩﺍﺕ ﺍﻟﺘﻲ ﺘﻌﻴﻨﻬﺎ ﻋﻠﻰ ﻤﻭﺍﺠﻬﺔ ﺤﺠﻡ ﺍﻟﻁﻠﺏ ﺍﻟﺤﺎﻟﻲ ﺃﻭ‬ ‫ﺍﻟﻤﺴﺘﻘﺒﻠﻲ ﻋﻠﻰ ﺍﻟﺭﻋﺎﻴﺔ‪ .‬ﻭﻟﺩﻯ ﺘﻌﺯﻴﺯ ﺍﻷﻨﻅﻤﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻻﺒﺩ ﻤﻥ ﺍﻟﺘﺭﻜﻴﺯ ﻋﻠﻰ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻤﻭﻴل ﻟﻀﻤﺎﻥ ﺍﺴﺘﻤﺭﺍﺭ‬ ‫ﺘﻘﺩﻴﻡ ﺍﻟﺨﺩﻤﺎﺕ )ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﻭﺘﺠﻤﻴﻌﻬﺎ‪ ،‬ﻭﺘﺨﺼﻴﺹ ﺍﻻﻋﺘﻤﺎﺩﺍﺕ‪ ،‬ﻭﺼﺭﻓﻬﺎ(‪ ،‬ﻭﺘـﺄﻤﻴﻥ ﺍﻹﺸـﺭﺍﻑ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﺠﻴﺩ ﻭﺍﻟﻤﻨﺘﻅﻡ )ﻟﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ﻭﺍﻟﻤﺴﺎﻭﺍﺓ( ﻭﻀﻤﺎﻥ ﺍﻟﺸﺭﺍﻜﺔ ﺒﻴﻥ ﺍﻟﻘﻁﺎﻋﻴﻥ ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨـﺎﺹ ﻟﺘﻭﺴـﻊ ﺍﻟﺒﺭﻨـﺎﻤﺞ‬ ‫ﻭﺍﻤﺘﺩﺍﺩ ﺨﺩﻤﺎﺘﻪ ﻟﺘﻐﻁﻴﺔ ﺃﻜﺒﺭ ﻤﺴﺎﺤﺔ ﻤﻤﻜﻨﺔ‪.‬‬ ‫ﻭﻓﻲ ﺍﻟﺒﻼﺩ ﺍﻟﺘﻲ ﻴﺠﺭﻱ ﻓﻴﻬﺎ ﺇﺼﻼﺡ ﻟﻸﻨﻅﻤﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻴﻨﺒﻐﻲ ﺒﺫل ﺍﻟﺠﻬـﻭﺩ ﻟـﻀﻤﺎﻥ ﺃﺨـﺫ ﺍﻟﺨـﺩﻤﺎﺕ‬ ‫ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺒﻌﻴﻥ ﺍﻻﻋﺘﺒﺎﺭ ﻀﻤﻥ ﻋﻤﻠﻴﺔ ﺍﻹﺼﻼﺡ ﻫﺫﻩ‪ .‬ﻭﻴﻨﺒﻐﻲ ﻜﺫﻟﻙ ﺃﻥ ﺘﻌﻜﺱ ﻋﻤﻠﻴـﺎﺕ‬ ‫ﺘﺤﺩﻴﺩ ﺍﻷﻭﻟﻭﻴﺎﺕ ﻭﺍﻟﺘﻲ ﺘﺴﺘﺨﺩﻡ ﻻﺨﺘﻴﺎﺭ ﺍﻟﻤﻀﻤﻭﻤﺔ ﺍﻷﺴﺎﺴﻴﺔ ﻟﻠﺘﺩﺨﻼﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﺘﻲ ﺘﻘﺩﻤﻬﺎ ﻤﺭﺍﻓـﻕ ﺍﻟﺭﻋﺎﻴـﺔ‬ ‫ﺎ ﻀﻤﻥ ﺍﻟﻌﺏﺀ ﺍﻟﺨﺎﺹ ﺒﺎﻻﻋﺘﻼﻻﺕ ﻓﻲ‬ ‫ﺍﻷﻭﻟﻴﺔ‪ ،‬ﻴﻨﺒﻐﻲ ﺃﻥ ﺘﻌﻜﺱ ﺍﻟﺤﺠﻡ ﺍﻟﻜﺒﻴﺭ ﺍﻟﺫﻱ ﺘﻤﺜﻠﻪ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪ .‬ﻜﻤﺎ ﻴﺠﺏ ﺃﻥ ﺘﺄﺨﺫ ﺍﻟﻤﺭﺍﻤﻲ ﺍﻹﺼﻼﺤﻴﺔ ﻟﻸﻨﻅﻤﺔ ﺍﻟﺼﺤﻴﺔ )ﺘﺤﺴﻴﻥ ﺍﻟﺠﻭﺩﺓ ﻭﺍﻟﻤﺴﺎﻭﺍﺓ ﻭﺍﺴﺘﺠﺎﺒﺔ‬ ‫ﺍﻟﻌﻤﻴل‪ ،‬ﻋﻼﻭﺓ ﻋﻠﻰ ﻀﻤﺎﻥ ﺍﺴﺘﻤﺭﺍﺭ ﻭﻓﻌﺎﻟﻴﺔ ﺍﻟﺨﺩﻤﺎﺕ(‪ ،‬ﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫‪‬ل ﺍﻟﻘﻁـﺎﻉ ﺍﻟﺨـﺎﺹ‬ ‫ﻗﺒ‬ ‫ﺎ ﺒﻌﻴﻥ ﺍﻻﻋﺘﺒﺎﺭ ﻜﺫﻟﻙ‪ .‬ﻭﻋﻠﻰ ﻭﺠﻪ ﺍﻟﺨﺼﻭﺹ‪ ،‬ﻴﻨﺒﻐﻲ ﺍﺴﺘﺨﺩﺍﻡ ﻗﻀﺎﻴﺎ ﺍﻟﺘﻤﻭﻴل ﻤﻥ ِ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻟﻤﺸﺎﺭﻜﺔ ﺍﻟﻔﻌﺎﻟﺔ ﻟﻪ‪ ،‬ﻟﺘﻭﺴﻌﺔ ﻨﻁﺎﻕ ﺇﺘﺎﺤﺔ ﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﻟﻸﻓﺭﺍﺩ‪.‬‬ ‫ﺎ ﻋﻠﻰ ﺘﺤﻠﻴل ﻤﺩﻯ ﻭﺒﺎﺌﻴﺔ ﻫـﺫﻩ‬ ‫ﻭﻴﺠﺏ ﺃﻥ ﺘﺭﻜﺯ ﺠﻬﻭﺩ ﺍﺴﺘﺠﺎﺒﺔ ﺍﻷﻨﻅﻤﺔ ﺍﻟﺼﺤﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ‪ ،‬ﻭﺍﻟﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ ﺍﻟﻤﺤﻔﻭﻓﺔ ﺒﺎﻟﻤﺨﺎﻁﺭ ﻭﺍﻟﻤﻌﺭﻀﺔ ﻟﻺﺼﺎﺒﺔ‪ ،‬ﻭﺍﻷﻨﻤﺎﻁ ﺍﻟﺴﻠﻭﻜﻴﺔ ﻻﻟﺘﻤﺎﺱ ﺍﻟﺭﻋﺎﻴـﺔ‬ ‫ﺍ ﺇﻟﻰ ﻨﺘﺎﺌﺞ ﺍﻟﺘﺤﻠﻴل‪ ،‬ﻴﺘﻌﻴﻥ ﻭﻀﻊ ﺒﺭﻨﺎﻤﺞ ﺸـﺎﻤل‬ ‫ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﻤﻬﺎﺭﺍﺕ ﻭﻤﻭﺍﻗﻑ ﻤﻘﺩﻤﻲ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ‪ .‬ﻭﺍﺴﺘﻨﺎﺩﹰ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﻟﺘﻐﻁﻲ ﻜﺎﻓﺔ ﻓﺌﺎﺕ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﻤﻁﻠﻭﺏ ﺇﺠﺭﺍﺀ ﺍﻟﺘﺩﺨﻼﺕ ﻟﻬﺎ‪ .‬ﻜﻤـﺎ‬ ‫ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻻﺤﺘﻴﺎﺠﺎﺕ ﻭﻤﺘﻁﻠﺒﺎﺕ ﻓﺌﺎﺕ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﻤﺤﺩﺩﺓ ﺍﻟﻤﻭﺠﻬﺔ ﺇﻟﻴﻬﺎ‬ ‫ﻴﻨﺒﻐﻲ ﺘﺼﻤﻴﻡ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺇﻴﺘﺎﺀ ﺍﻟﺭﻋﺎﻴﺔ ﻭﺫﻟﻙ ﻭﻓﻘﹰ‬ ‫ﺎ‬ ‫ﻫﺫﻩ ﺍﻟﺨﺩﻤﺎﺕ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺃﻥ ﻴﺸﺘﻤل ﺍﻟﺒﺭﻨﺎﻤﺞ ﻋﻠﻰ ﺘﻭﺍﺼل ﻜﺎﻓﺔ ﺠﻭﺍﻨﺏ ﺍﻟﻭﻗﺎﻴﺔ ﻤـﻥ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺍﻷﻨﺸﻁﺔ ﺍﻟﻤﻌﺯﺯﺓ ﻟﻠﺼﺤﺔ ﻭﺍﻷﻨﺸﻁﺔ ﺍﻟﻭﻗﺎﺌﻴـﺔ‪ ،‬ﻭﺍﻟﺠﻭﺍﻨـﺏ ﺍﻟﺘﻜﻨﻭﻟﻭﺠﻴـﺔ ﻭﺍﻟﺨـﺩﻤﺎﺕ‬ ‫ﺍﻟﻌﻼﺠﻴﺔ ﻭﺍﻻﺭﺘﺒﺎﻁ ﺒﺨﺩﻤﺎﺕ ﺘﻨﻅﻴﻡ ﺍﻷﺴﺭﺓ‪ ،‬ﻭﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‪ ،‬ﻭﺍﻟﺘﻤﻨﻴﻊ‪ ،‬ﻭﺍﻷﻴﺩﺯ ﻭﺍﻟﻌـﺩﻭﻯ‬ ‫ﺒﻔﻴﺭﻭﺴﻪ‪ ،‬ﻭﻏﻴﺭﻫﺎ ﻤﻥ ﺍﻟﺨﺩﻤﺎﺕ‪ .‬ﻭﻴﺠﺏ ﺃﻥ ﻴﻭﺴﻊ ﺍﻟﺒﺭﻨﺎﻤﺞ ﻤﻥ ﻨﻁﺎﻕ ﺍﻟﺘﻌﺎﻭﻥ ﻓﻲ ﻤﺎ ﺒـﻴﻥ ﻤﺨﺘﻠـﻑ ﺍﻟـﺸﺭﻜﺎﺀ‬ ‫ﺍﻟﻤﺸﺎﺭﻜﻴﻥ ﻓﻴﻪ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﻜل ﻤﻥ ﺍﻟﻘﻁﺎﻋﻴﻥ‪ ،‬ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ‪ ،‬ﻟﺘﺤﻘﻴﻕ ﺍﻻﺴﺘﺠﺎﺒﺔ‪ ،‬ﻤﺘﻌﺩﺩﺓ ﺍﻟﻘﻁﺎﻋﺎﺕ‪ ،‬ﻟﻠﺘﺼﺩﻱ ﻟﻬﺫﻩ‬ ‫ﺍﻷﻤﺭﺍﺽ‪.‬‬ ‫ﺎ ﻋﻠﻰ ﺨﻁﺔ ﻟﺭﺼﺩ ﺍﻵﺜـﺎﺭ ﺍﻟﻤﺘﺭﺘﺒـﺔ ﻋﻠـﻰ‬ ‫ﻭﻴﺠﺏ ﺃﻥ ﻴﺸﺘﻤل ﺒﺭﻨﺎﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﻨﻔﻴﺫ ﺍﻟﺘﺩﺨﻼﺕ‪ .‬ﻭﺇﻥ ﺘﻭﻓﻴﺭ ﺍﻟﻤﻌﻁﻴﺎﺕ‪ ،‬ﺒﺎﻟﺴﺭﻋﺔ ﺍﻟﻤﻁﻠﻭﺒﺔ‪ ،‬ﻋﻥ ﺃﺩﺍﺀ ﺍﻟﺒﺭﻨﺎﻤﺞ ﻭﺍﻟﺘﺄﺜﻴﺭﺍﺕ ﺍﻟﺘـﻲ ﻴﺤـﺩﺜﻬﺎ‪ ،‬ﻤـﻥ‬ ‫ﺸﺄﻨﻪ ﺃﻥ ﻴﺅﻤﻥ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻟﻠﻘﻴﺎﻡ ﺒﻤﺯﻴﺩ ﻤﻥ ﺍﻷﻨﺸﻁﺔ‪ ،‬ﻭﺘﻘﺩﻴﻡ ﺍﻟﺩﻻﺌل ﻭﺍﻟﺒﻴﻨﺎﺕ ﺤﻭل ﺍﺘﺠﺎﻫـﺎﺕ ﺍﻟﺒﺭﻨـﺎﻤﺞ‬ ‫ﺍﻟﻤﺴﺘﻘﺒﻠﻴﺔ‪.‬‬

‫ﺎ‬ ‫ﺇﺘﺎﺤﺔ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬

‫‪١-٥-٣‬‬

‫ﻓﻲ ﻤﻌﻅﻡ ﺍﻟﺒﻠﺩﺍﻥ ﻴﺘﺭﻙ ﻟﻠﻤﺭﻀﻰ ﺍﺨﺘﻴﺎﺭ ﺍﻷﻤﺎﻜﻥ ﺍﻟﺘﻲ ﻴﻤﻜﻨﻬﻡ ﻤﻥ ﺨﻼﻟﻬﺎ ﺍﻟﺘﻤـﺎﺱ ﺍﻟﺭﻋﺎﻴـﺔ ﻟﻠﻌـﺩﺍﻭﻯ‬ ‫ﺎ‪ .‬ﻭﻴﺘﻨﺎﻓﺱ ﻤﻘﺩﻤﻭ ﺍﻟﺨﺩﻤﺎﺕ ﻤﻊ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﻤﺨﺘﻠﻑ ﺃﻨﻭﺍﻉ ﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﻤﺅﻫﻠﻴﻥ ﻭﻏﻴﺭ ﺍﻟﻤﺅﻫﻠﻴﻥ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻤﻥ ﻴﻤﺎﺭﺴﻭﻥ ﺍﻟﻌﻤل ﺍﻟﺨﺎﺹ‪ ،‬ﺃﻭ ﺍﻟﻤﻤﺎﺭﺴﻴﻥ ﺍﻟﺸﻌﺒﻴﻴﻥ‪ .‬ﻭﻓﻲ ﻜل ﻤﻥ ﺍﻟﻘﻁﺎﻋﻴﻥ ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ‪ ،‬ﻫﻨﺎﻙ ﻤـﺼﺎﺩﺭ‬ ‫ﺎ ﻋﻠـﻰ‬ ‫ﺎ‪ ،‬ﺘﺸﺘﻤل ﻋﻠﻰ ﻋﻴﺎﺩﺍﺕ ﻤﺘﺨﺼﺼﺔ )ﻭﻗﻔـﹰ‬ ‫ﻤﺤﺘﻤﻠﺔ ﻟﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﻌﺽ ﻓﺌﺎﺕ ﺍﻟﻤﺭﻀﻰ( ﻟﻠﻌﻨﺎﻴﺔ ﺒﻤﺭﻀﻰ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ‪ ،‬ﻭﺃﻗﺴﺎﻡ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺨﺎﺭﺠﻴـﺔ ﺒﺎﻟﻤﺴﺘـﺸﻔﻴﺎﺕ ﺍﻟﺘـﻲ ﺘـﻀﻡ‬ ‫ﺘﺨﺼﺼﺎﺕ ﺃﺨﺭﻯ ﻤﺜل ﻋﻴﺎﺩﺍﺕ ﺍﻟﻨﺴﺎﺀ ﻭﺍﻟﺘﻭﻟﻴﺩ ﺃﻭ ﻋﻴﺎﺩﺍﺕ ﺍﻷﻤﺭﺍﺽ ﺍﻟﺠﻠﺩﻴـﺔ ﻭﺍﻟﺘﻨﺎﺴـﻠﻴﺔ‪ ،‬ﺃﻭ ﺍﻟﻤـﺴﺘﻭﺼﻔﺎﺕ‬ ‫ﻭﻤﺭﺍﻜﺯ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ‪ ،‬ﺃﻭ ﻋﻴﺎﺩﺍﺕ ﺘﻨﻅﻴﻡ ﺍﻷﺴﺭﺓ‪ ،‬ﻭﺼﺤﺔ ﺍﻷﻤﻭﻤﺔ ﻭﺍﻟﻁﻔﻭﻟﺔ‪ ،‬ﻭﺭﻋﺎﻴﺔ ﺍﻟﺤﻤل‪ .‬ﻭﻴﻌﺘﻤﺩ‬ ‫ﺎ ﺍﻟﺘﻲ ﺘﻘﺩﻡ ﻤﻥ ﺨـﻼل ﻤﺭﺍﻜـﺯ ﺍﻟﺭﻋﺎﻴـﺔ‬ ‫ﺍﻟﻤﺩﻯ ﺍﻟﺫﻱ ﺘﺼل ﺇﻟﻴﻪ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﺼﺤﻴﺔ ﺍﻷﻭﻟﻴﺔ ﺃﻭ ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺘﺨﺼﺼﻴﺔ‪ ،‬ﻋﻠﻰ ﺍﻟﻅﺭﻭﻑ ﺍﻟﻭﺒﺎﺌﻴﺔ ﻭﺍﻟﺘﻨﻅﻴﻤﻴﺔ ﻭﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﺘﺎﺤﺔ‪ .‬ﻭﻴﺠﺏ ﺍﻷﺨﺫ ﻓﻲ‬ ‫ﺍﻻﻋﺘﺒﺎﺭ ﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﺘﻤﺎﺱ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻷﻓﻀﻠﻴﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ‪.‬‬ ‫ﻭﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻷﻤﺎﻜﻥ‪ ،‬ﺘﻜﻤﻥ ﺍﻟﻤﺸﻜﻠﺔ ﻓﻲ ﻋﺩﻡ ﺘﻠﺒﻴﺔ ﺃﺤﺩ ﺍﻟﻤﺘﻁﻠﺒﺎﺕ ﺃﻭ ﺍﻻﺤﺘﻴﺎﺠﺎﺕ ﻟﺘﻘﺩﻴﻡ ﺭﻋﺎﻴﺔ ﺫﺍﺕ‬ ‫ﺎ‪ ،‬ﻓـﻲ ﺍﻟﻘﻁـﺎﻉ ﺍﻟﻌـﺎﻡ‪،‬‬ ‫ﺠﻭﺩﺓ ﻋﺎﻟﻴﺔ‪ .‬ﻭﺍﻹﻤﺩﺍﺩ ﺍﻟﻤﺴﺘﻤﺭ ﺒﺎﻟﺭﻋﺎﻴﺔ ﻟﻠﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻻ ﻴﺅﺩﻱ ﺒﺎﻟﻀﺭﻭﺭﺓ ﺇﻟﻰ ﺘﺤﻘﻴﻕ ﺘﻐﻁﻴﺔ ﺃﻓﻀل ﻟﻠﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺫﺍﺕ ﺍﻷﻭﻟﻭﻴﺔ‪ ،‬ﺤﺘﻰ ﻋﻨﺩﻤﺎ ﺘﻜﻭﻥ ﻫﺫﻩ ﺍﻟﺨﺩﻤﺎﺕ‬ ‫ﺍ ﻤﻥ ﺍﻟﻌﻭﺍﻤل ﺍﻹﻀﺎﻓﻴﺔ‪ ،‬ﻟﺘﺤﻘﻴﻕ‬ ‫ﺎ ﺩﻭﻥ ﺃﻴﺔ ﺘﻜﺎﻟﻴﻑ‪ .‬ﻭﻴﺠﺏ ﺍﻷﺨﺫ ﺒﻌﻴﻥ ﺍﻻﻋﺘﺒﺎﺭ ﻋﺩﺩﹰ‬ ‫ﺫﺍﺕ ﺠﻭﺩﺓ ﻤﺘﻔﻭﻗﺔ ﻭﺘﻘﺩﻡ ﻤﺠﺎﻨﹰ‬ ‫ﺇﺘﺎﺤﺔ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻠﻨﺎﺱ‪ ،‬ﻜﻤﺎ ﻴﺠﺏ ﺘﺒﻨﻲ ﺃﺴﻠﻭﺏ ﻴﺘﻭﺠﻪ ﺇﻟﻰ ﺍﻟﻌﻤﻴل‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﺠﻤﻴﻊ ﺍﻟﻤﻭﺍﻗﻊ ﺃﻭ ﺍﻷﻤـﺎﻜﻥ‪.‬‬ ‫ﻭﻴﺠﺏ ﺍﻻﻫﺘﻤﺎﻡ ﺒﺸﻜل ﺨﺎﺹ ﺒﺘﺤﻘﻴﻕ ﺍﻟﻤﺴﺎﻭﺍﺓ ﺒﻴﻥ ﺍﻟﺠﻨﺴﻴﻥ‪ ،‬ﻭﺍﻻﻫﺘﻤﺎﻡ ﺒﺎﻟﻤﺭﺍﻫﻘﻴﻥ ﻭﺍﻟﻔﻘﺭﺍﺀ ﻭﺍﻟﻔﺌﺎﺕ ﺍﻟﻤﻬﻤـﺸﺔ‪،‬‬ ‫ﻋﻨﺩ ﺍﻟﺘﺨﻁﻴﻁ ﻟﻠﺨﺩﻤﺎﺕ‪ .‬ﻜﻤﺎ ﻴﺠﺏ ﺘﻴﺴﻴﺭ ﻋﻤﻠﻴﺔ ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﺍﻟﺨﺩﻤﺎﺕ‪ ،‬ﺒﺸﻜل ﺃﻜﺒﺭ‪ ،‬ﻭﺫﻟﻙ ﻤﻥ ﺨﻼل ﺘﺤـﺴﻴﻥ‬ ‫‪‬ـل ﻤﻘـﺩﻤﻲ ﺨـﺩﻤﺎﺕ‬ ‫ﻗﺒ‬ ‫ﺍﻟﻌﻭﺍﻤل ﺍﻟﻤﺨﺘﻠﻔﺔ ﻤﺜل ﺒﻌﺩ ﺍﻟﻤﺴﺎﻓﺔ‪ ،‬ﻭﻤﺤل ﺍﻹﻗﺎﻤﺔ‪ ،‬ﻭﺍﻟﺘﻌﺎﻤل ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﻤﻬﻨﻲ ﻤـﻥ ِ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ‪ ،‬ﻭﻤﺭﺍﻋﺎﺓ ﺍﻟﺴﺭﻴﺔ ﻭﺘﻘﻠﻴل ﻭﻗﺕ ﺍﻻﻨﺘﻅﺎﺭ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺇﺸﺭﺍﻙ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ‪ ،‬ﺒﻤﻥ ﻓﻲ ﺫﻟﻙ ﺍﻟﺼﻴﺎﺩﻟﺔ ﻭﻤـﻥ‬ ‫ﻴﻘﻭﻡ ﺒﺼﺭﻑ ﺍﻟﺩﻭﺍﺀ‪ ،‬ﻭﺠﻌﻠﻬﻡ ﻴﻠﺘﺯﻤﻭﻥ ﺒﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﻋﺎﻟﻴﺔ ﺍﻟﺠﻭﺩﺓ‪ ،‬ﻭﻴﺸﻤل ﺫﻟﻙ ﺍﻟﻘﻴﺎﻡ ﺒـﺈﺠﺭﺍﺀﺍﺕ ﻟﻺﺸـﺭﺍﻑ‬ ‫ﺍﻟﺘﻨﻅﻴﻤﻲ ﻭﺍﻟﻤﺭﺍﻗﺒﺔ‪ .‬ﻭﻴﺠﺏ ﺘﻭﻋﻴﺔ ﻭﺘﺜﻘﻴﻑ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ ﻭﺍﻟﻤﺴﺘﻬﻠﻜﻴﻥ ﺤﻭل ﺍﻷﻤﻭﺭ ﺍﻟـﺼﺤﻴﺔ ﺒـﺼﻭﺭﺓ ﻋﺎﻤـﺔ‪،‬‬ ‫ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﺒﺼﻭﺭﺓ ﺨﺎﺼﺔ‪ ،‬ﻤﻥ ﺨﻼل ﺍﻟﺘﺭﻜﻴﺯ ﻋﻠﻰ ﺃﻫﻤﻴﺔ ﺘﺸﺨﻴﺹ ﻭﻤﻌﺎﻟﺠﺔ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ‪ ،‬ﻤـﻥ‬ ‫ﺍ ﻟﻠﻭﺼﻭل ﺇﻟـﻰ‬ ‫‪‬ل ﻤﻬﻨﻴﻴﻥ ﺼﺤﻴﻴﻥ ﻤﺩﺭﺒﻴﻥ‪ .‬ﻭﻴﻤﻜﻥ ﺃﻥ ﺘﻤﺜل ﺃﺴﻌﺎﺭ ﺃﻭ ﻭﺠﻭﺩ ﺍﻷﺩﻭﻴﺔ ﻭﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ ﺤﺎﺠﺯﹰ‬ ‫ﻗﺒ‬ ‫ِ‬ ‫ﻫﺫﻩ ﺍﻟﺨﺩﻤﺎﺕ ﻟﺩﻯ ﺒﻌﺽ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ‪ .‬ﻭﻗﺩ ﻴﺘﻁﻠﺏ ﺍﻷﻤﺭ ﺇﺠﺭﺍﺀ ﺘﻐﻴﻴﺭ ﻋﻠﻰ ﺍﻟﺴﻴﺎﺴﺎﺕ ﺒﻤﺎ ﻴﺤـﺴﻥ ﻤـﻥ‬ ‫ﻋﻤﻠﻴﺔ ﺘﻭﻓﺭ ﺍﻷﺩﻭﻴﺔ‪ ،‬ﺇﻟﻰ ﺠﺎﻨﺏ ﺍﻟﻨﻅﺭ ﻓﻲ ﺍﻟﺨﻴﺎﺭﺍﺕ ﺍﻷﺨﺭﻯ ﻜﺩﻋﻡ ﺍﻟﺩﻭﺍﺀ ﺍﻟﻤﻘﺩﻡ ﻟﻠﻔﻘـﺭﺍﺀ‪ ،‬ﻭﺘـﻭﻓﻴﺭ ﺍﻟﻌـﻭﺍﺯل‬ ‫ﺍﻟﺫﻜﺭﻴﺔ ﻋﻠﻰ ﻨﻁﺎﻕ ﻭﺍﺴﻊ ﻟﺠﻤﻴﻊ ﺍﻟﻤﺠﻤﻭﻋﺎﺕ ﺍﻟﻔﺭﻋﻴﺔ ﺍﻟﺴﻜﺎﻨﻴﺔ‪ ،‬ﻭﺘﻐﻁﻴﺔ ﺍﻟﺘﻜﺎﻟﻴﻑ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﻀـﻤﻥ ﺃﻨﻅﻤـﺔ‬ ‫ﺘﺄﻤﻴﻥ ﺼﺤﻲ ﻭﺁﻟﻴﺎﺕ ﺇﺤﺎﻟﺔ ﻟﻠﻤﺴﺘﻭﻴﺎﺕ ﺍﻷﻋﻠﻰ ﻟﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺃﻥ ﺘﺤﺴﻥ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻹﻴﺼﺎﻟﻴﺔ ﻤﻥ‬ ‫ﺘﻭﺼﻴل ﺍﻟﺨﺩﻤﺎﺕ ﺇﻟﻰ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﺘﻲ ﻴﺼﻌﺏ ﺍﻟﻭﺼﻭل ﺇﻟﻴﻬﺎ‪ ،‬ﺃﻴﻥ ﻤﺎ ﺘﻜﻭﻥ ﺍﻟﺤﺎﺠﺔ‪.‬‬

‫ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ‬

‫‪٢-٥-٣‬‬

‫ﺇﻥ ﻻﻤﺭﻜﺯﻴﺔ ﻭﺨﺼﺨﺼﺔ ﺍﻟﻘﻁﺎﻉ ﺍﻟﻁﺒﻲ ﻤﻥ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﺘﻲ ﺘﺭﻤﻲ ﺇﻟﻰ ﺇﺼﻼﺡ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﻭﺍﻟﺘـﻲ‬ ‫ﺎ‬ ‫‪‬ﻌـﺩ ﺘﺤـﺩﻴﹰ‬ ‫ﺘﻌﻭل ﺍﻟﺤﻜﻭﻤﺎﺕ ﻋﻠﻴﻬﺎ‪ ،‬ﻜﻤﺎ ﺃﻥ ﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ ﻓﻲ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ ﺍﻟﺫﻱ ﻴﻨﻤﻭ ﺒﺸﻜل ﻫﺎﺌل ﻭﺴﺭﻴﻊ‪ ،‬ﻴ‬ ‫ﺎ ﺃﻤﺎﻡ ﺍﻟﺤﻜﻭﻤﺎﺕ‪ ،‬ﻭﺫﻟﻙ ﺒﺴﺒﺏ ﻗﻠﺔ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﺍﻟﻤﺘﻭﻓﺭﺓ ﻋﻥ ﺫﻟﻙ‪ .‬ﻭﻻﺒﺩ ﻟﻠﺤﻜﻭﻤﺎﺕ ﻤﻥ ﺍﻟﻘﻴﺎﻡ ﺒﺎﻟﻤﻬﻤﺔ ﺍﻟﻌﺎﻤﺔ‬ ‫ﺭﺌﻴﺴﻴﹰ‬ ‫ﺍﻷﺴﺎﺴﻴﺔ ﺍﻟﻤﺘﻤﺜﻠﺔ ﻓﻲ ﺍﻹﺸﺭﺍﻑ ﻋﻠﻰ ﻫﺫﺍ ﺍﻟﻘﻁﺎﻉ ﻭﻭﻀﻊ ﻭﺘﻨﻔﻴﺫ ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﻲ ﺘﻀﻤﻥ ﺍﻟﺠﻭﺩﺓ ﺍﻟﻌﺎﻟﻴﺔ ﻟﺨـﺩﻤﺎﺕ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﻤﻘﺩﻤﺔ ﻷﻓﺭﺍﺩ ﺍﻟﻤﺠﺘﻤﻊ‪ ،‬ﻓﻲ ﻜﻼ ﺍﻟﻘﻁﺎﻋﻴﻥ‪ ،‬ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ‪.‬‬

‫ﺎ‬ ‫ﺍﻟﺩﻻﺌل ﺍﻹﺭﺸﺎﺩﻴﺔ ﺍﻟﻭﻁﻨﻴﺔ ﻟﻠﺘﺩﺍﺒﻴﺭ ﺍﻟﻌﻼﺠﻴﺔ ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬ ‫ﺎ‪ ،‬ﻴﺠﺏ ﺃﻥ‬ ‫ﺇﻥ ﺘﻌﺯﻴﺯ ﺍﻟﺠﻭﺩﺓ ﺍﻟﻌﺎﻟﻴﺔ ﻟﻠﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﺍﻟﺫﻱ ﻴﺘﻡ ﻟﺤﺎﻻﺕ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻴﺘﻡ ﻤﻥ ﺨﻼل ﻭﻀﻊ ﺩﻻﺌل ﺇﺭﺸﺎﺩﻴﺔ ﺘﻜﻭﻥ ﻤﺴﺘﻨﺩﺓ ﻋﻠﻰ ﺃﻨﻤﺎﻁ ﻤﺤﺩﺩﺓ ﻟﻠﻌﺩﻭﻯ ﻭﺍﻷﻤﺭﺍﺽ‪ ،‬ﻭﺘﻌﻤﻴﻡ ﻫـﺫﻩ ﺍﻟـﺩﻻﺌل‬ ‫ﻋﻠﻰ ﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﺭﻀﻰ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ‪ .‬ﻭﻴﺠﺏ ﺃﻥ ﻴﺸﺘﺭﻙ ﻤﻤﺜﻠﻭﻥ ﻋﻥ ﺍﻟﻘﻁﺎﻋﻴﻥ ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ ﻓﻲ ﻋﻤﻠﻴﺎﺕ‬ ‫ﻭﻀﻊ ﻭﺇﻗﺭﺍﺭ ﻭﺘﻌﻤﻴﻡ ﻫﺫﻩ ﺍﻟﺩﻻﺌل ﺍﻹﺭﺸﺎﺩﻴﺔ‪ .‬ﻜﻤﺎ ﻴﻨﺒﻐﻲ ﺍﻟﺘﺩﺭﻴﺏ ﻋﻠﻰ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﺩﻻﺌل ﺍﻹﺭﺸﺎﺩﻴﺔ ﺍﻟﻭﻁﻨﻴﺔ ﻭﺠﻌل‬ ‫ﺎ ﻟﻠﻌﺎﻤﻠﻴﻥ ﻓﻲ ﻜﻼ ﺍﻟﻘﻁﺎﻋﻴﻥ‪ ،‬ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ‪ ،‬ﻭﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﻁﺒﻴﺔ ﺍﻟﻌﺎﻤﻠﻴﻥ ﻓﻲ ﺍﻟﻘﻁـﺎﻉ‬ ‫ﺫﻟﻙ ﻤﺘﺎﺤﹰ‬ ‫ﺍﻟﺨﺎﺹ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺍﻟﺘﻐﻠﺏ ﻋﻠﻰ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﻌﻘﺒﺎﺕ ﺍﻟﺘﻲ ﺘﻘﻑ ﻓﻲ ﻭﺠﻪ ﺘﻘﺩﻴﻡ ﺘﺩﺒﻴﺭ ﻋﻼﺠﻲ ﺫﺍﺕ ﻜﻔﺎﺀﺓ ﻭﺠﻭﺩﺓ‬ ‫ﺕ‪،‬‬ ‫ﺎ‪ ،‬ﺒﺎﺴﺘﺨﺩﺍﻡ ﺃﺴﻠﻭﺏ ﺍﻟﻤﺘﻼﺯﻤﺎﺕ ﻀﻤﻥ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻬـﺫﻩ ﺍﻟﺤـﺎﻻ ﹰ‬ ‫ﻋﺎﻟﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﹰ‪،‬‬ ‫ﻭﺒﺼﻔﺔ ﺨﺎﺼﺔ‪ ،‬ﺩﻭﻥ ﺃﻥ ﻴﻘﺘﺼﺭ ﻋﻠﻰ ﺫﻟﻙ‪ ،‬ﻓﻲ ﺍﻷﻤﺎﻜﻥ ﺍﻟﺘﻲ ﺘﻜﻭﻥ ﺍﻟﻤﻭﺍﺭﺩ ﻓﻴﻬﺎ ﻤﺤﺩﻭﺩﺓ‪ .‬ﻭﺭﻏﻡ ﻜﻭﻨﻪ ﻤﺭﻏﻭﺒﺎ‬ ‫ﻓﺈﻥ ﺍﻟﺘﺸﺨﻴﺹ ﺍﻟﻤﺒﻨﻲ ﻋﻠﻰ ﺍﻟﺴﺒﺏ‪ ،‬ﻟﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ ،‬ﻏﻴﺭ ﻤﻤﻜﻥ ﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻷﻤﺎﻜﻥ ﺍﻟﺘﻲ ﺘﻭﺍﺠﻪ ﺼﻌﻭﺒﺔ ﻓـﻲ‬ ‫ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﻭﻴﺠﺏ ﺍﺴﺘﺸﺎﺭﺓ ﺍﻟﺨﺒﺭﺍﺀ ﻭﺍﻟﻠﺠﺎﻥ ﺍﻟﻭﻁﻨﻴﺔ‪ ،‬ﻟﻠﻭﺼﻭل ﺇﻟﻰ ﺃﻜﺜﺭ ﺍﻟﺴﺒل ﻤﻼﺀﻤـﺔ ﻟﻭﻀـﻊ ﺍﻻﺴـﺘﺭﺍﺘﻴﺠﻴﺔ‬ ‫ﺎ ﻭﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺃﻥ ﺘﻔﻴﺩ ﻜﺎﻓﺔ ﻗﻁﺎﻋﺎﺕ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟـﺫﻴﻥ‬ ‫ﺍﻟﺨﺎﺼﺔ ﺒﺈﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻴﻜﻭﻨﻭﻥ ﺒﺤﺎﺠﺔ ﺇﻟﻰ ﺘﻠﻘﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺘﺠﺎﻩ ﻫﺫﺍ ﺍﻟﻤﺭﺽ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺃﻥ ﺘﺴﻔﺭ ﻫﺫﻩ ﺍﻻﺴﺘﺸﺎﺭﺍﺕ ﻋﻥ ﻭﻀﻊ ﻤﺠﻤﻭﻋﺔ‬ ‫ﺎ ﻟﻠﻤﻭﺍﺭﺩ ﺍﻟﻤﺎﻟﻴﺔ ﻭﺍﻟﺒﺸﺭﻴﺔ ﻭﺍﻹﻨﺴﺎﻨﻴﺔ ﻭﺍﻟﺘﻘﻨﻴـﺔ‬ ‫ﻤﺨﺘﻠﻁﺔ ﻤﻥ ﺍﻟﺒﺭﻭﺘﻭﻜﻭﻻﺕ ﺍﻟﺘﻲ ﺘﻌﺩ ﻭﺘﻨﻔﺫ ﺒﺸﻜل ﺠﻴﺩ ﻭﺩﻗﻴﻕ‪ ،‬ﻭﻓﻘﹰ‬ ‫ﺍﻟﻤﺘﺎﺤﺔ‪ ،‬ﻭﻋﻠﻰ ﺤﺴﺏ ﺍﻟﻌﺏﺀ ﺍﻟﺫﻱ ﻴﻤﺜﻠﻪ ﺍﻟﻤﺭﺽ‪.‬‬

‫ﺍﻟﺘﺭﺨﻴﺹ ﻭﺍﻹﺸﻬﺎﺩ ﻭﺍﻻﻋﺘﻤﺎﺩ‬ ‫ﺘﻔﻴﺩ ﻋﻤﻠﻴﺔ ﺍﻟﺘﺭﺨﻴﺹ )ﻤﻨﺢ ﺍﻟﺭﺨﺼﺔ ﺒﻤﺯﺍﻭﻟﺔ ﺍﻟﻤﻬﻨﺔ( ﻟﻠﻤﻬﻨﻴﻴﻥ‪ ،‬ﻭﺍﻹﺸﻬﺎﺩ ﻟﻠﻤﺭﺍﻓﻕ‪ ،‬ﻓﻲ ﺍﻟﺤﻔـﺎﻅ ﻋﻠـﻰ‬ ‫ﺍﻟﺠﻭﺩﺓ ﻭﺍﻟﺴﻼﻤﺔ‪ ،‬ﻭﺍﻟﺘﻭﺯﻴﻊ ﺍﻟﺠﻐﺭﺍﻓﻲ ﺍﻟﺴﻠﻴﻡ ﻟﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺇﻻ ﺃﻥ ﻋﻤﻠﻴﺔ ﺍﻟﺘـﺭﺨﻴﺹ ﻭﺍﻹﺸـﻬﺎﺩ ﻻ‬ ‫ﺘﻨﻁﺒﻘﺎﻥ ﻓﻘﻁ ﻋﻠﻰ ﻤﺠﺎل ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺒل ﺘﻤﺘﺩ ﻜﺫﻟﻙ ﻟﺘﺸﻤل ﺼﻨﺎﻋﺎﺕ ﺍﻟﻤﺴﺘﺤﻀﺭﺍﺕ ﺍﻟﺩﻭﺍﺌﻴـﺔ ﻭﺍﻟﺘـﺄﻤﻴﻥ‬ ‫ﺍﻟﺼﺤﻲ‪ .‬ﻭﺘﺘﺤﻘﻕ ﻓﻌﺎﻟﻴﺔ ﺍﻹﺸﺭﺍﻑ ﺍﻟﺤﻜﻭﻤﻲ ﻤﻥ ﺨﻼل ﺍﻵﻟﻴﺎﺕ ﺍﻟﺘﻨﻔﻴﺫﻴﺔ ﻫﺫﻩ‪ ،‬ﻭﺍﻟﺘﻲ ﻤﻥ ﺍﻷﻓﻀل ﺃﻥ ﺘﺘﻡ ﻤﻥ ﺨﻼل‬ ‫ﺍﻟﺭﻭﺍﺒﻁ ﺍﻟﻘﻭﻴﺔ ﻭﺍﻟﻤﺸﺎﺭﻜﺔ ﺍﻟﻌﺭﻴﻀﺔ ﻟﻠﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ‪ .‬ﻜﻤﺎ ﺃﻥ ﺍﻻﺘﺤﺎﺩﺍﺕ ﺍﻟﻤﻬﻨﻴﺔ ﻭﺍﻟﺠﻬﺎﺕ ﺍﻷﺨﺭﻯ ﺫﺍﺕ ﺍﻟﺭﻗﺎﺒـﺔ‬ ‫ﺎ ﻀﻤﻥ‬ ‫ﺍ ﺃﺴﺎﺴﻴﹰ‬ ‫ﺍﻟﺫﺍﺘﻴﺔ‪ ،‬ﺍﻟﺘﻲ ﺘﻌﻤل ﺨﺎﺭﺝ ﺍﻹﻁﺎﺭ ﺍﻟﺤﻜﻭﻤﻲ ﺃﻭ ﺒﺎﻟﻤﺸﺎﺭﻜﺔ ﻤﻌﻪ‪ ،‬ﻟﻬﺎ ﺃﻫﻤﻴﺘﻬﺎ ﻜﻤﺎ ﺃﻨﻬﺎ ﺘﻤﺜل ﻋﻨﺼﺭﹰ‬ ‫ﻋﻤﻠﻴﺔ ﺍﻟﺭﻗﺎﺒﺔ ﺍﻟﺘﻨﻅﻴﻤﻴﺔ ﺍﻟﺠﻴﺩﺓ‪.‬‬ ‫ﺎ ﻤﺎ ﻴﺘﻡ ﺭﺒﻁﻪ ﺒﻌﻤﻠﻴﺔ‬ ‫ﻭﺍﻻﻋﺘﻤﺎﺩ ﻫﻭ ﻋﻤﻠﻴﺔ ﺇﺸﻬﺎﺩ ﺒﺄﻥ ﺍﻟﻤﺭﻓﻕ ﻴﺤﻘﻕ ﻤﻌﺎﻴـﻴﺭ ﻭﺍﺸﺘﺭﺍﻁﺎﺕ ﻤﻌﻴﻨﺔ‪ ،‬ﻭﻏﺎﻟﺒﹰ‬ ‫ﺍﻟﺘﻐﻁﻴﺔ ﺒﺎﻟﻌﻤﻠﻴﺎﺕ ﺍﻟﺘﻲ ﺘﻘﻭﻡ ﺒﻬﺎ ﺃﻨﻅﻤﺔ ﺍﻟﺘﺄﻤﻴﻥ ﺍﻟﺼﺤﻲ‪ .‬ﻭﺇﻥ ﺍﻟﺘﺭﺨﻴﺹ ﻭﺍﻹﺸﻬﺎﺩ‪ ،‬ﺍﻟﻠﺫﻴﻥ ﻴﺘﻤﺎﻥ ﻟﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ‬ ‫‪‬ل ﺍﻻﺘﺤﺎﺩﺍﺕ ﺍﻟﻤﻬﻨﻴﺔ‪ ،‬ﻭﻜﺫﻟﻙ ﺍﻟﺤﻤـﻼﺕ ﺍﻟﻤﺠﺘﻤﻌﻴـﺔ‬ ‫ﻗﺒ‬ ‫ﺍﻟﺼﺤﻴﺔ ﻭﻤﺭﺍﻓﻕ ﺘﻘﺩﻴﻤﻬﺎ‪ ،‬ﻭﺍﻟﻠﺫﻴﻥ ﻴﻜﻭﻨﺎﻥ ﻤﺩﻋﻭﻤﻴﻥ ﻤﻥ ِ‬ ‫ﻟﺘﻭﻋﻴﺔ ﻭﺘﺜﻘﻴﻑ ﺍﻟﻤﺴﺘﻬﻠﻙ‪ ،‬ﺍﻟﺘﻲ ﺘﻨﻔﺫ ﺒﺎﻟﻠﻐﺎﺕ ﺍﻟﻤﺤﻠﻴﺔ ﻴﻤﻜﻨﻬﻤﺎ ﺃﻥ ﻴﻔﻴﺩﺍ ﻓﻲ ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺘﻭﻓﺭ ﻤﻌﺎﻴﻴﺭ ﺍﻟﺠﻭﺩﺓ ﻓـﻲ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ‪ .‬ﻤﻥ ﺠﻬﺔ ﺃﺨﺭﻯ‪ ،‬ﻓﺈﻥ ﻋﻤﻠﻴﺔ ﺍﻋﺘﻤﺎﺩ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﺘﺩﺭﻴﺒﻴﺔ ﺍﻟﺘﻲ ﺘﻘﺩﻡ ﻟﻠﻌﺎﻤﻠﻴﻥ ﻗﺒل ﻗﻴﺎﻤﻬﻡ ﺒﺘﻘـﺩﻴﻡ ﺍﻟﺨـﺩﻤﺎﺕ‬ ‫ﺎ ﻓﻲ ﻀﻤﺎﻥ ﺘﻭﻓﺭ ﺠﻭﺍﻨﺏ ﺍﻟﺠﻭﺩﺓ )ﻭﻴﺸﻤل ﺫﻟﻙ ﺭﺼﺩ ﺍﻟﻤﻨﺎﻫﺞ ﺍﻟﺩﺭﺍﺴﻴﺔ‬ ‫ﺍ ﻫﺎﻤﹰ‬ ‫ﺎ ﺃﺜﻨﺎﺀ ﺘﻘﺩﻴﻤﻬﻡ ﻟﻬﺎ‪ ،‬ﺘﻠﻌﺏ ﺩﻭﺭﹰ‬ ‫ﻭﺃﻴﻀﹰ‬ ‫ﻭﺍﻟﺘﺩﺭﻴﺒﻴﺔ ﻭﻤﺘﻁﻠﺒﺎﺕ ﺍﻟﺘﻌﻠﻴﻡ ﺍﻟﻁﺒﻲ ﺍﻟﻤﺴﺘﻤﺭ(‪.‬‬ ‫ﻭﻋﻨﺩﻤﺎ ﺘﻜﻭﻥ ﺍﻟﻘﺩﺭﺍﺕ ﻋﻠﻰ ﺭﺼﺩ ﻭﺘﻨﻔﻴﺫ ﺍﻷﻨﻅﻤﺔ ﻤﺤﺩﻭﺩﺓ ﺃﻭ ﻏﻴﺭ ﻤﻭﺠﻭﺩﺓ ﻤﻥ ﺍﻷﺼل‪ ،‬ﻜﻤﺎ ﻫﻭ ﺍﻟﺤﺎل‬ ‫ﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻷﻤﺎﻜﻥ ﺍﻟﻤﺤﺩﻭﺩﺓ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﻴﺘﻌﻴﻥ ﻋﻠﻰ ﺼﺎﻨﻌﻲ ﺍﻟﺴﻴﺎﺴﺎﺕ ﺍﻟﻭﻁﻨﻴﻴﻥ ﻭﺍﻟﻤﺤﻠﻴﻴﻥ ﺇﻴﺠـﺎﺩ ﺍﻟﺤـﻭﺍﻓﺯ‬ ‫ﺍﻟﻼﺯﻤﺔ ﻟﻤﻜﺎﻓﺄﺓ ﺃﺼﺤﺎﺏ ﺍﻟﻤﻤﺎﺭﺴﺔ ﺍﻟﺠﻴﺩﺓ‪ .‬ﻭﺘﺸﻤل ﺍﻟﺤﻭﺍﻓﺯ ﺍﻟﻤﻤﻜﻨﺔ ﻻﻋﺘﻤﺎﺩ ﺃﻭ ﺃﺸﻜﺎل ﺍﻟﺘﻘﺩﻴﺭ ﺍﻷﺨﺭﻯ‪ ،‬ﺍﻟﻤﺭﺘﺒﻁﺔ‬ ‫ﺒﻭﺴﺎﺌل ﺍﻟﻤﻜﺎﻓﺄﺓ ﻟﻠﻌﺎﻤﻠﻴﻥ ﺒﻤﺭﺍﻓﻕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺒﺎﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ )ﻭﻴﺸﻤل ﺫﻟﻙ ﺍﻟﺘﻐﻁﻴﺔ ﺒﺎﻟﺘـﺄﻤﻴﻥ ﺍﻟـﺼﺤﻲ(‪،‬‬ ‫ﺍﻟﻘﺎﺌﻤﻴﻥ ﺒﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺸﺎﻤﻠﺔ ﻟﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻭﺒﺄﺴـﻌﺎﺭ ﻤﻌﻘﻭﻟـﺔ )‪.(٧٦‬‬ ‫ﻭﻴﻤﻜﻥ ﺃﻥ ﺘﺭﺘﺒﻁ ﺍﻟﻤﻜﺎﻓﺂﺕ ﺍﻟﺘﺤﻔﻴﺯﻴﺔ ﺒﺎﻻﻟﺘﺯﺍﻡ ﺒﺘﻘﺩﻴﻡ ﺍﻟﻤﻌﻁﻴﺎﺕ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻟﻠﺴﻠﻁﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺒـﺼﻭﺭﺓ ﻤﻨﺘﻅﻤـﺔ‪،‬‬ ‫ﻭﺍﻻﺸﺘﺭﺍﻙ ﻓﻲ ﺒﺭﺍﻤﺞ ﺍﻟﺘﻌﻠﻴﻡ ﺍﻟﻁﺒﻲ ﺍﻟﻤﺴﺘﻤﺭ‪ ،‬ﻭﺍﻻﺴﺘﻌﺩﺍﺩ ﻹﺠﺭﺍﺀ ﺍﻟﺘﺩﻗﻴﻕ ﻭﺍﻟﻤﺭﺍﺠﻌﺔ ﻋﻠﻰ ﺍﻟﻤﻤﺎﺭﺴﺎﺕ ﻓﻲ ﻫـﺫﻩ‬ ‫ﺍﻟﻤﺭﺍﻓﻕ‪ .‬ﻭﻴﻤﻜﻥ ﺃﻥ ﺘﺸﻤل ﺍﻟﺤﻭﺍﻓﺯ ﺍﻷﺨﺭﻯ ﻏﻴﺭ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﺎﻟﻤﻜﺎﻓﺂﺕ‪ ،‬ﻭﻟﻜﻨﻬﺎ ﺫﺍﺕ ﻁﺒﻴﻌﺔ ﻤﺎﻟﻴﺔ‪ ،‬ﺍﻟﺤﺼﻭل ﻋﻠﻰ‬ ‫ﺃﺩﻭﻴﺔ ﺃﻭ ﺴﻠﻊ ﺃﺨﺭﻯ ﻤﺩﻋﻤﺔ )ﻤﺜل ﺒﺭﻨﺎﻤﺞ ﺍﻟﺘﺴﻭﻴﻕ ﺍﻻﺠﺘﻤﺎﻋﻲ ﻟﻠﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ(‪ ،‬ﺃﻭ ﺍﻟﺤﺼﻭل ﺍﻟﺘﻔﻀﻴﻠﻲ ﻋﻠـﻰ‬ ‫ﺨﺩﻤﺎﺕ ﺍﻹﺤﺎﻟﺔ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﻭﺍﻟﺨﻴﺎﺭﺍﺕ ﻟﻠﻤﺸﺎﺭﻜﺔ ﻓﻲ ﺍﻷﻨﻅﻤﺔ ﺍﻟﺘﻲ ﺘﺘﻤﺘﻊ ﺒﺎﻤﺘﻴﺎﺯﺍﺕ ﺃﻭ ﻋﻘﻭﺩ ﻟﺘﻘـﺩﻴﻡ ﺨـﺩﻤﺎﺕ‬ ‫ﹰ‪ ،‬ﺍﻟﺘﻲ ﺘﻌﻁﻰ ﻟﻠﻌﻤﻼﺀ ﻤﺒﺎﺸـﺭﺓ‪.‬‬ ‫ﺨﺎﺭﺠﻴﺔ ﻤﺜل ﻗﺴﺎﺌﻡ ﺍﻟﺼﺭﻑ‪ ،‬ﺃﻭ ﺍﻷﺸﻜﺎل ﺍﻷﺨﺭﻯ ﻤﻥ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﺩﻓﻭﻋﺔ ﻤﺴﺒﻘﺎ‬ ‫ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺘﺤﺴﻴﻥ ﻋﻤﻠﻴﺔ ﺍﻻﻟﺘﺯﺍﻡ ﺒﺎﻷﻨﻅﻤﺔ ﻋﻥ ﻁﺭﻴﻕ ﺘﻭﻓﻴﺭ ﻤﻭﺍﺭﺩ ﻤﻼﺌﻤﺔ ﻟﻠﻬﻴﺌﺎﺕ ﺍﻟﺘﻨﻅﻴﻤﻴﺔ‪ ،‬ﻤـﻊ ﺍﻟﺘﻤﻴﻴـﺯ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﻭﺍﻀﺢ ﻟﻸﺩﻭﺍﺭ ﻓﻲ ﻤﺎ ﺒﻴﻥ ﺍﻟﺠﻬﺎﺕ ﺍﻟﺘﻨﻅﻴﻤﻴﺔ ﻭﺒﻴﻥ ﺃﻭﻟﺌﻙ ﺍﻟﺫﻴﻥ ﻴﺨﻀﻌﻭﻥ ﻷﻋﻤﺎل ﺍﻟﺘﻨﻅﻴﻡ‪ ،‬ﻭﺇﻨﺸﺎﺀ ﺠﻤﺎﻋـﺎﺕ‬ ‫ﻟﻠﺩﻓﺎﻉ ﻋﻥ ﺤﻘﻭﻕ ﺍﻟﻤﺴﺘﻬﻠﻙ‪.‬‬

‫ﻤﺭﺍﺠﻌﺔ ﺍﻟﺯﻤﻼﺀ ﻭﺍﻟﺘﻨﻅﻴﻡ ﺍﻟﺫﺍﺘﻲ‬ ‫ﺘﺘﻤﻴﺯ ﺍﻷﻤﺎﻜﻥ ﺍﻟﺘﻲ ﻴﻜﻭﻥ ﻟﺩﻴﻬﺎ ﺁﻟﻴﺎﺕ ﺘﻨﻅﻴﻤﻴﺔ ﻤﻁﺒﻘﺔ‪ ،‬ﺒﻭﺠﻭﺩ ﺤﻭﺍﺭ ﺩﺍﺌﻡ ﻴﺘﻡ ﻀﻤﻥ ﻨﻁﺎﻕ ﻤﻥ ﺍﻟﻤﺤﺎﻭﺭ‬ ‫‪‬ﻁﻠﺏ ﻤﻥ ﺍﻻﺘﺤﺎﺩﺍﺕ‬ ‫ﺍﻻﺨﺘﺼﺎﺼﻴﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ ﺒﻴﻨﻬﺎ ﻭﺒﻴﻥ ﺍﻟﺤﻜﻭﻤﺔ ﻭﺍﻻﺘﺤﺎﺩﺍﺕ ﺍﻟﻤﻬﻨﻴﺔ ﺒﺎﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ‪ .‬ﻭﻴﻤﻜﻥ ﺃﻥ ﻴ‬ ‫ﺍﻟﻤﻬﻨﻴﺔ ﻭﺸﺒﻜﺎﺕ ﻤﺭﺍﻓﻕ ﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﻤﺎﺭﺴﺔ ﻀﻐﻁ ﺍﻟﺯﻤﻼﺀ ﻭﺘﻌﺯﻴﺯ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻨﻅﻴﻡ ﺍﻟﺫﺍﺘﻲ ﺒﺎﻟﻤـﺸﺎﺭﻜﺔ ﻤـﻊ‬ ‫‪‬ـل ﺃﻋـﻀﺎﺀ ﻫـﺫﻩ‬ ‫ﻗﺒ‬ ‫ﺍﻟﺤﻜﻭﻤﺔ‪ .‬ﻓﻌﻠﻰ ﺴﺒﻴل ﺍﻟﻤﺜﺎل‪ ،‬ﻴﻤﻜﻨﻬﻡ ﺘﻌﺯﻴﺯ ﻋﻤﻠﻴﺔ ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺫﺍﺕ ﺠﻭﺩﺓ ﻋﺎﻟﻴـﺔ ﻤـﻥ ِ‬ ‫ﺍﻻﺘﺤﺎﺩﺍﺕ ﻤﻥ ﺨﻼل ﺇﺩﺨﺎل ﻨﻅﺎﻡ ﺍﺤﺘﺴﺎﺏ ﺍﻟﻨﻘﺎﻁ ﺍﻟﻤﻬﻨﻴﺔ )ﺃﻭ ﺍﻹﻀﺎﻓﺔ ﻜﺭﺼﻴﺩ ﻓﻲ ﺴﺠل ﺍﻟﺘﻌﻠـﻴﻡ ﺍﻟﻤﺘﻭﺍﺼـل(‪،‬‬ ‫ﻤﻘﺎﺒل ﺤﻀﻭﺭ ﺍﻟﺩﻭﺭﺍﺕ ﻭﺍﻟﺤﻠﻘﺎﺕ ﺍﻟﻌﻤﻠﻴﺔ ﺍﻟﺘﻲ ﺘﺴﻬﻡ ﻓﻲ ﺘﻌﻠﻴﻡ ﻭﺘﺤﺩﻴﺙ ﻤﻌﻠﻭﻤﺎﺕ ﺍﻟﻤﺸﺎﺭﻜﻴﻥ ﻓﻴﻬﺎ‪ .‬ﺇﻻ ﺃﻥ ﺍﻟﻌﺩﻴﺩ‬ ‫ﻤﻥ ﺍﻟﺘﺠﺎﺭﺏ ﺍﻟﻌﺸﻭﺍﺌﻴﺔ ﺍﻟﻤﺭﺍﻓﻘﺔ‪ ،‬ﻗﺩ ﺃﻅﻬﺭﺕ ﺃﻥ ﺒﺭﺍﻤﺞ ﺍﻟﺘﻌﻠﻴﻡ ﺍﻟﻁﺒﻲ ﺍﻟﻤﺴﺘﻤﺭ ﻏﻴﺭ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﺤﻭﺍﻓﺯ ﻤﺎﺩﻴـﺔ ﺃﻭ‬ ‫ﺒﺎﻟﺤﺼﻭل ﻋﻠﻰ ﻅﺭﻭﻑ ﻋﻤل ﺃﻓﻀل‪ ،‬ﻴﻜﻭﻥ ﻨﺠﺎﺤﻬﺎ ﻤﺤﺩﻭﺩﹰ‬ ‫ﺍ ﻓﻲ ﺘﺤﺴﻴﻥ ﺠﻭﺩﺓ ﺍﻟﻤﻤﺎﺭﺴﺔ )‪.(٧٧‬‬

‫ﺍﻹﺸﺭﺍﻑ ﻭﺍﻟﻤﺭﺍﻗﺒﺔ ﺍﻟﺩﺍﻋﻤﺔ‬ ‫‪‬ﻌﺩ ﺍﻟﻘﻴﺎﻡ ﺒﺯﻴﺎﺭﺍﺕ ﺇﺸﺭﺍﻓﻴﺔ ﻭﺍﻟﻤﺭﺍﻗﺒﺔ ﺍﻟﻤﻨﺘﻅﻤﺔ ﻟﻠﻤﺭﺍﻓﻕ ﺍﻟﺼﺤﻴﺔ ﻤﻥ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﻬﺎﻤﺔ ﻟﻌﻤﻠﻴـﺔ ﻀـﻤﺎﻥ‬ ‫ﻴ‬ ‫ﺍﺴﺘﻤﺭﺍﺭ ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﺫﺍﺕ ﺠﻭﺩﺓ ﻋﺎﻟﻴﺔ ﻭﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ ﻤﻌﻨﻭﻴﺎﺕ ﺍﻟﻌﺎﻤﻠﻴﻥ ﻓﻲ ﻫﺫﻩ ﺍﻟﻤﺭﺍﻓﻕ ﻭﺤﻔﺯﻫﻡ ﻋﻠـﻰ‬ ‫ﻤﻭﺍﺼﻠﺔ ﺍﻟﻌﻤل ﺒﻨﻔﺱ ﺍﻟﺭﻭﺡ‪ ،‬ﻜﻤﺎ ﺃﻅﻬﺭﺘﻪ ﺘﺠﺭﺒﺔ )ﻤﻭﺍﻨﺯﺍ( ﻓﻲ ﺠﻤﻬﻭﺭﻴﺔ ﺘﻨﺯﺍﻨﻴﺎ ﺍﻟﻤﺘﺤﺩﺓ‪ .‬ﻭﻴﺠﺏ ﺃﻻ ﺘﻘﺘﺼﺭ ﻤﺜل‬ ‫ﻫﺫﻩ ﺍﻟﺯﻴﺎﺭﺍﺕ ﺍﻹﺸﺭﺍﻓﻴﺔ ﻋﻠﻰ ﻤﺭﺍﻓﻕ ﺍﻟﻘﻁﺎﻉ ﺍﻟﻌﺎﻡ ﻓﻘﻁ‪ ،‬ﺤﻴﺙ ﻴﻤﻜﻥ ﺘﻜﻴﻴﻔﻬﺎ ﺒﺎﻟﺸﻜل ﺍﻟﺫﻱ ﻴﻨﺎﺴﺏ ﻤﺭﺍﻓﻕ ﺍﻟﻘﻁـﺎﻉ‬ ‫ﺍﻟﺨﺎﺹ‪ ،‬ﻭﺫﻟﻙ ﻟﻠﺤﻔﺎﻅ ﻋﻠﻰ ﺠﻭﺩﺓ ﺍﻟﺨﺩﻤﺎﺕ‪ ،‬ﻭﺘﻘﺩﻴﻡ ﺒﺭﺍﻤﺞ ﺍﻟﺘﻌﻠﻴﻡ ﺍﻟﻤﺴﺘﻤﺭ ﻟﻠﻌﺎﻤﻠﻴﻥ ﻓﻴﻬﺎ‪ ،‬ﻭﺠﻌل ﺫﻟـﻙ ﻭﺴـﻴﻠﺔ‬ ‫ﻟﻠﺘﻌﺎﻭﻥ ﺒﻴﻥ ﺍﻟﻘﻁﺎﻋﻴﻥ ﺍﻟﻌﺎﻡ ﻭﺍﻟﺨﺎﺹ‪ .‬ﻭﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻷﻥ ﺘﺘﻡ ﺍﻟﺯﻴﺎﺭﺍﺕ ﺍﻹﺸﺭﺍﻓﻴﺔ ﻤﻥ ﺨﻼل ﺇﺠـﺭﺍﺀﺍﺕ ﻤﻴـﺴﺭﺓ‬ ‫ﺍ ﻟﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺒل ﺘﻜﻭﻥ ﻤﺼﺩﺭ ﺘﺸﺠﻴﻊ ﻟﻬﻡ ﻭﻭﺴﻴﻠﺔ ﻟﺭﻓﻊ ﻤـﺴﺘﻭﺍﻫﻡ‬ ‫ﺤﺘﻰ ﻻ ﺘﺒﺩﻭ ﻭﻜﺄﻨﻬﺎ ﺘﻤﺜل ﺘﻬﺩﻴﺩﹰ‬ ‫ﻭﻤﻭﺍﺼﻠﺔ ﺘﺤﺴﻴﻥ ﺠﻭﺩﺓ ﺍﻟﺭﻋﺎﻴﺔ‪ .‬ﻜﻤﺎ ﺃﻥ ﺘﺩﺭﻴﺏ ﺍﻟﻤﺸﺭﻓﻴﻥ ﻫﻭ ﺃﻤﺭ ﻋﻠﻰ ﻗﺩﺭ ﻜﺒﻴـﺭ ﻤـﻥ ﺍﻷﻫﻤﻴـﺔ‪ ،‬ﻟﺘﺤﻭﻴـل‬ ‫ﻻ ﻤﻥ ﺃﻥ ﺘﻜﻭﻥ ﺃﺩﺍﺓ ﻟﻠﺤﻜﻡ ﻭﺘﺼﻴﺩ ﺍﻷﺨﻁﺎﺀ‪.‬‬ ‫ﺍﻟﻤﻬﺎﺭﺍﺕ ﺍﻟﺘﻲ ﻴﺘﻤﺘﻌﻭﻥ ﺒﻬﺎ ﻟﺘﻜﻭﻥ ﻤﺼﺩﺭ ﺩﻋﻡ ﻭﺘﺸﺠﻴﻊ ﺒﺩ ﹰ‬

‫ﻤﺭﺍﻜﺯ ﺍﻹﺤﺎﻟﺔ‬ ‫ﺇﻥ ﺇﻨﺸﺎﺀ ﻤﺭﺍﻜﺯ ﺇﺤﺎﻟﺔ ﻭﻁﻨﻴﺔ ﻭﺇﻗﻠﻴﻤﻴﺔ ﻹﺤﺎﻟﺔ ﺍﻟﺤﺎﻻﺕ ﺍﻟﻤﻌﻘﺩﺓ ﻭﻜﺫﻟﻙ ﻟﺘﺄﻜﻴﺩ ﺍﻟﺘﺸﺨﻴﺹ‪ ،‬ﻤﻥ ﺸـﺄﻨﻪ ﺃﻥ‬ ‫ﻴﺤﺴﻥ ﻋﻤﻠﻴﺔ ﻤﺭﺍﻗﺒﺔ ﺍﻟﺠﻭﺩﺓ‪ .‬ﻭﻴﺠﺏ ﺃﻥ ﺘﻜﻭﻥ ﺒﺭﻭﺘﻭﻜﻭﻻﺕ ﺍﻹﺤﺎﻟﺔ‪ ،‬ﺍﻟﺘﻲ ﻴﺘﻡ ﺒﻤﻭﺠﺒﻬﺎ ﺘﺤﺩﻴﺩ ﻤﺘﻰ ﻭﺃﻴﻥ ﻴﺠﺏ ﺃﻥ‬ ‫ﺍ ﻤﻥ ﺍﻟﺒﺭﻭﺘﻭﻜﻭﻻﺕ ﺍﻹﺩﺍﺭﻴﺔ ﺍﻟﻤﻌﻴﺎﺭﻴﺔ ﺍﻟﺘﻲ ﺘﻭﻀﻊ ﻟﻜﺎﻓﺔ ﺍﻟﻌﺎﻤﻠﻴﻥ ﺍﻟﺼﺤﻴﻴﻥ ﺍﻟﻤـﺸﺎﺭﻜﻴﻥ ﻓـﻲ‬ ‫ﺘﺘﻡ ﺍﻹﺤﺎﻟﺔ‪ ،‬ﺠﺯﺀﹰ‬ ‫ﺎ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻌﺭﻭﻑ ﺃﻥ ﺍﺭﺘﻔﺎﻉ ﻤﻌﺩﻻﺕ ﺍﻟﺘﺴﺭﺏ ﺃﻭ ﺍﻟﺘﻭﻗﻑ‬ ‫ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻋﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ‪ ،‬ﻫﻭ ﺃﻤﺭ ﺸﺎﺌﻊ ﺒﻴﻥ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ ﺘﺘﻡ ﺇﺤﺎﻟﺘﻬﻡ ﻟﻤﺜل ﻫﺫﻩ ﺍﻷﻏﺭﺍﺽ )‪ .(٧٨‬ﻭﻴﺠﺏ ﺍﻟﺤﺭﺹ ﻋﻠـﻰ‬ ‫ﺍ ﻟﺘﻀﻴﻔﻪ‪.‬‬ ‫ﺎ ﺯﺍﺌﺩﹰ‬ ‫ﻋﺩﻡ ﺇﺭﺴﺎل ﺍﻟﻤﺭﻀﻰ ﻓﻲ ﺭﺤﻼﺕ ﻁﻭﻴﻠﺔ ﻭﻤﻜﻠﻔﺔ ﺇﻟﻰ ﺍﻟﻤﺭﺍﻜﺯ ﺍﻟﺘﻲ ﻻ ﻴﻜﻭﻥ ﻟﺩﻴﻬﺎ ﺸﻴﺌﹰ‬ ‫ﺇﻥ ﺍﻹﺸﺭﺍﻑ ﺍﻟﻔﻌﺎل ﻭﺍﻟﻨﺸﻁ ﻭﺘﻘﺩﻴﻡ ﺃﻨﺸﻁﺔ ﺍﻟﺘﻌﻠﻴﻡ ﺍﻟﻁﺒﻲ ﺍﻟﻤﺴﺘﻤﺭ ﻤﻥ ﺨﻼل ﺍﺭﺘﺠﺎﻉ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﺍﻟﺨﺎﺼﺔ‬ ‫ﺒﺎﻟﺤﺎﻻﺕ‪ ،‬ﻭﺩﻭﺭﺍﺕ ﺍﻟﺘﺩﺭﻴﺏ ﺍﻟﺭﺴﻤﻴﺔ ﺃﺜﻨﺎﺀ ﺍﻟﻌﻤل‪ ،‬ﺘﺴﺎﻋﺩ ﻓﻲ ﺘﻨﻤﻴﺔ ﺍﻟﺭﻭﺍﺒﻁ ﻓﻲ ﻤﺎ ﺒﻴﻥ ﺍﻟﻤﺭﺍﻜﺯ ﺍﻟﻤﺨﺘﻠﻔﺔ‪ .‬ﻜﻤـﺎ‬ ‫ﺃﻥ ﻤﻭﺍﺼﻠﺔ ﺍﻟﺘﺸﺎﻭﺭ ﻭﺍﺴﺘﻤﺭﺍﺭ ﺍﻻﺘﺼﺎﻻﺕ ﺒﻴﻥ ﺍﻟﻤﺭﺍﻜﺯ ﺍﻟﺼﺤﻴﺔ ﻭﻤﺭﺍﻜﺯ ﺍﻹﺤﺎﻟﺔ‪ ،‬ﻋﻥ ﻁﺭﻴـﻕ ﺍﻟﺯﻴـﺎﺭﺍﺕ ﺃﻭ‬ ‫ﺎ ﻓﻲ ﺘﻨﻤﻴﺔ ﺍﻟﺜﻘﺔ ﺍﻟﻤﻬﻨﻴﺔ ﺒﻴﻨﻬﻤﺎ‪.‬‬ ‫ﺍﻻﺘﺼﺎل ﻋﻥ ﻁﺭﻴﻕ ﺍﻟﺭﺍﺩﻴﻭ‪ ،‬ﺘﺴﻬﻡ ﺃﻴﻀﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻡ ﻭﺃﻫﺩﺍﻑ ﻤﺘﻔـﻕ‬ ‫ﺇﻻ ﺃﻥ ﺍﻟﺸﻲﺀ ﺍﻷﻫﻡ ﻓﻲ ﻫﺫﺍ‪ ،‬ﻫﻭ ﺇﻨﺸﺎﺀ ﺒﺭﻨﺎﻤﺞ ﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﻤﻘﺎﻁﻌﺎﺕ ﺘﻜﻭﻥ ﻟﻪ ﻤﺭﺍ ﹴ‬ ‫ﻋﻠﻴﻬﺎ‪ ،‬ﻭﺒﺭﻭﺘﻭﻜﻭﻻﺕ ﻤﻌﻴﺎﺭﻴﺔ ﻤﻭﺤﺩﺓ‪ ،‬ﻭﺃﻫﺩﺍﻑ ﺃﺩﺍﺌﻴﺔ ﻭﺠﻠﺴﺎﺕ ﻤﺭﺍﺠﻌﺔ ﺴﻨﻭﻴﺔ ﺃﻭ ﻨـﺼﻑ ﺴـﻨﻭﻴﺔ‪ .‬ﻭﻴـﺼﺒﺢ‬ ‫ﺍﻻﺭﺘﺒﺎﻁ ﻤﻊ ﻤﺭﺍﻜﺯ ﺍﻹﺤﺎﻟﺔ ﺃﻜﺜﺭ ﺸﻤﻭﻟﻴﺔ ﻭﺘﻔﺎﻋﻠﻴﺔ‪ ،‬ﻤﻤﺎ ﻴﻔﻀﻲ ﺇﻟﻰ ﺇﻗﺎﻤﺔ ﻋﻼﻗﺔ ﻫﺎﺩﻓﺔ ﻭﻤﻭﻟﺩﺓ ﻟﻠﺩﺍﻓﻊ ﻭﺍﻟﺤﺎﻓﺯ ﻓﻲ‬ ‫ﻤﺎ ﺒﻴﻥ ﺍﻟﻌﺎﻤﻠﻴﻥ‪.‬‬

‫ﺘﻤﻭﻴل ﺍﻟﺨﺩﻤﺎﺕ‬

‫‪٣-٥-٣‬‬

‫ﻴﻌﺘﺒﺭ ﺍﻟﺘﻤﻭﻴل ﻭﺍﻟﻤﺩﻓﻭﻋﺎﺕ ﻤﻥ ﺍﻷﻋﻤﺎل ﺍﻷﺴﺎﺴﻴﺔ ﻷﻱ ﻨﻅﺎﻡ ﻤﻥ ﺃﻨﻅﻤﺔ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻭﻴﺘﺄﻟﻑ ﻤـﻥ‬ ‫ﺃﺭﺒﻌﺔ ﻤﻬﺎﻡ ﻭﺍﻀﺤﺔ‪ :‬ﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﺘﺠﻤﻴﻊ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﺘﺨﺼﻴﺹ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﺍﻟﻤﺩﻓﻭﻋﺎﺕ ﻭﺍﻟﻤﺸﺘﺭﻴﺎﺕ‪ .‬ﻭﺭﻏﻡ ﺃﻥ ﻜل‬ ‫ﻼ ﻤﻨﻬﺎ ﻟﺩﻴﻪ ﺘﻨﻅﻴﻤﻪ ﺍﻟﺨﺎﺹ ﻭﺍﻟﻤﺨﺘﻠﻑ ﻋﻥ ﺒﻘﻴﺔ ﺍﻷﻨﻅﻤﺔ‪،‬‬ ‫ﻨﻅﺎﻡ ﻤﻥ ﺍﻷﻨﻅﻤﺔ ﺍﻟﺼﺤﻴﺔ ﻴﻘﻭﻡ ﺒﻬﺫﻩ ﺍﻟﻤﻬﺎﻡ‪ ،‬ﺇﻻ ﺃﻥ ﻜ ﹰ‬ ‫ﺎ ﻓﻲ ﺍﻟﻬﻴﺎﻜل ﺍﻟﻤﺅﺴﺴﻴﺔ ﻭﺍﻟﺘﻭﻗﻌﺎﺕ ﺍﻟﻤﺠﺘﻤﻌﻴﺔ ﻭﺍﻷﻨﻅﻤﺔ ﺍﻹﺩﺍﺭﻴﺔ ﺍﻟﺤﺎﻜﻤﺔ‪ .‬ﻭﻟﻌﻤﻠﻴﺔ ﺘﻤﻭﻴل‬ ‫ﺍﻷﻤﺭ ﺍﻟﺫﻱ ﻴﻌﻜﺱ ﺘﺒﺎﻴﻨﹰ‬ ‫ﺍﻷﻨﻅﻤﺔ ﺍﻟﺼﺤﻴﺔ ﺘﺄﺜﻴﺭ ﻗﻭﻱ ﻋﻠﻰ ﺍﻟﺘﻐﻁﻴﺔ ﺍﻟﺘﻲ ﻴﻭﻓﺭﻫﺎ ﺍﻟﺒﺭﻨﺎﻤﺞ ﻭﺘﺤﻘﻴﻕ ﺍﻟﻤﺴﺎﻭﺍﺓ ﻭﺍﻟﻨﺘﺎﺌﺞ ﺍﻟﺼﺤﻴﺔ ﺒﻭﺠﻪ ﻋﺎﻡ‪.‬‬ ‫ﺎ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ‪ ،‬ﺘﺭﺘﺒﻁ ﺒﺎﻟﻀﺭﻭﺭﺓ ﺒـﺎﻟﺒﺭﺍﻤﺞ‬ ‫ﻭﻋﻤﻠﻴﺔ ﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺨﺎﺼﺔ ﺒﻤﻜﺎﻓﺤﺔ ﻤﺭﺽ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪ .‬ﻭﺇﻥ ﻀﻤﺎﻥ ﺘﺨﺼﻴﺹ ﺍﻻﻋﺘﻤﺎﺩﺍﺕ ﺍﻟﻤﺎﻟﻴﺔ ﺍﻟﻤﻼﺌﻤﺔ ﻟﻠﻭﻗﺎﻴـﺔ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﻀﻤﻥ ﺍﻟﻐﻁﺎﺀ ﺍﻟﺘﻤﻭﻴﻠﻲ ﺍﻟﻌﺎﻡ ﻷﻨﺸﻁﺔ ﻤﻜﺎﻓﺤﺔ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪،‬‬ ‫ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻟﻜل ﻤﻥ ﺍﻟﻘﺭﺍﺭﺍﺕ ﺍﻟﺩﻭﻟﻴﺔ ﻭﺍﻟﻭﻁﻨﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺠﻤﻊ ﺍﻷﻤﻭﺍل‪ ،‬ﻓﻲ ﻀﻭﺀ ﺍﻟﺤﺎﺠـﺔ ﻟﻠﻨﻬـﻭﺽ‬ ‫ﺍ ﺃﺴﺎﺴﻴﹰ‬ ‫ﻴﻌﺩ ﻋﻨﺼﺭﹰ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‬ ‫ﺍ ﻟﻜﻭﻥ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ .‬ﻭﻨﻅﺭﹰ‬ ‫ﺒﺎﻟﺘﺩﺨﻼﺕ ﺍﻟﺤﺎﻟﻴﺔ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺀ ﻻ ﻴﺘﺠﺯﺃ ﻤﻥ ﺍﻟﺘﻤﻭﻴل ﺍﻟﻤﺨﺼﺹ ﻟﻤﻜﺎﻓﺤﺔ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪ ،‬ﻓﻴﺠﺏ ﺃﻥ ﺘﻜﻭﻥ ﺍﻟﺴﻴﺎﺴﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﺭﺴﻭﻡ‬ ‫ﻫﻭ ﺠﺯ ‪‬‬ ‫ﺎ‪ ،‬ﻫﻲ ﻨﻔﺱ ﺴﻴﺎﺴﺎﺕ ﺤﺎﻻﺕ ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ‬ ‫‪‬ل ﻤﺴﺘﺨﺩﻤﻲ ﺭﻋﺎﻴﺔ ﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻗﺒ‬ ‫ﺍﻟﻤﺩﻓﻭﻋﺔ ﻤﻥ ِ‬ ‫ﺍﻷﻴﺩﺯ‪.‬‬ ‫‪‬ـل‬ ‫ﻗﺒ‬ ‫ﻭﺇﻥ ﺘﺤﻭﻴل ﻤﺴﺅﻭﻟﻴﺔ ﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ ﺇﻟﻰ ﻨﻘﻁﺔ ﺘﻘﺩﻴﻡ ﺍﻟﺨﺩﻤﺎﺕ‪ ،‬ﻤﻥ ﺨﻼل ﺇﺩﺨﺎل ﺍﻟﺭﺴﻭﻡ ﺍﻟﻤﺴﺩﺩﺓ ﻤﻥ ِ‬ ‫ﺍﻟﻤﺴﺘﺨﺩﻡ‪ ،‬ﻻﺒﺩ ﺒﺎﻟﻀﺭﻭﺭﺓ ﺃﻥ ﺘﺸﻤل ﺃﻨﻅﻤﺔ ﺇﻋﻔﺎﺀ ﻟﻠﻔﻘﺭﺍﺀ‪ .‬ﻭﺴﻭﻑ ﻴﻜﻭﻥ ﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺘﺤﻘﻴﻕ ﺘﻐﻁﻴﺔ ﻋﺎﻟﻤﻴﺔ ﻓـﻲ‬ ‫ﻻ‬ ‫ﻫﺫﺍ ﺍﻟﺸﺄﻥ ﺇﺫﺍ ﻤﺎ ﺘﻡ ﺇﻨﺸﺎﺀ ﺃﻨﻅﻤﺔ ﻟﻠﺩﻓﻊ ﺍﻟﻤﺴﺒﻕ ﻤﺜل ﺃﻨﻅﻤﺔ ﺍﻟﺘﺄﻤﻴﻥ ﺍﻟﺼﺤﻲ‪ ،‬ﺃﻭ ﺍﻟﺘﺄﻤﻴﻥ ﺍﻟﺼﺤﻲ ﺍﻻﺠﺘﻤﺎﻋﻲ ﺒﺩ ﹰ‬ ‫ﻤﻥ ﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺍﻟﺭﺴﻭﻡ ﺍﻟﺘﻲ ﻴﺴﺩﺩﻫﺎ ﺍﻟﻤﺴﺘﺨﺩﻡ ﻟﻬﺫﻩ ﺍﻟﺨﺩﻤﺎﺕ‪ .‬ﻭﺒﻴﻨﻤﺎ ﺘﺘﻘﺩﻡ ﺍﻟﺒﻠﺩﺍﻥ ﻨﺤﻭ ﺇﻨﺸﺎﺀ‪ ،‬ﺃﻭ ﺍﻟﺘﻭﺴﻊ ﻓﻲ‬ ‫ﺃﻨﻅﻤﺔ ﺍﻟﺘﺄﻤﻴﻥ ﺍﻟﺼﺤﻲ )ﺍﻟﺫﻱ ﻴﺘﻭﻓﺭ ﻟﻌﻤﻭﻡ ﺍﻟﻨﺎﺱ‪ ،‬ﺃﻭ ﻤﺭﺘﺒﻁ ﺒﺎﻟﻌﻤل‪ ،‬ﺃﻭ ﺃﻨﻅﻤﺔ ﻤﺸﺘﺭﺍﺓ ﺒﺸﻜل ﺨﺎﺹ‪ ،‬ﺃﻭ ﺃﻨﻅﻤﺔ‬ ‫ﺎ ﻤﻥ ﺃﻥ ﺍﻟﻌﻤﻠﻴﺎﺕ ﺍﻟﻁﺒﻴﺔ ﺍﻟﺘﻲ‬ ‫‪‬ﻌﺔ(‪ .‬ﻭﻴﺠﺏ ﺃﻥ ﺘﺘﺤﻘﻕ ﺒﺭﺍﻤﺞ ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﺠﺘﻤﻌﻴﺔ ﻤﺠﻤ‬ ‫ﺘﻘﻭﻡ ﺒﻬﺎ ﻤﺸﻤﻭﻟﺔ ﻀﻤﻥ ﻤﻀﻤﻭﻤﺔ ﺍﻟﻤﺯﺍﻴﺎ‪ .‬ﻭﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﺘﻲ ﺘﻭﺍﺠﻪ ﺼﻌﻭﺒﺔ ﻓﻲ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﺘﻤﺜل ﺘﻜﻠﻔـﺔ‬ ‫ﺍﻷﺩﻭﻴﺔ ﺍﻟﺠﺯﺀ ﺍﻷﻜﺒﺭ ﻤﻥ ﺍﻟﻤﺼﺭﻭﻓﺎﺕ ﺍﻟﺘﻲ ﻴﻨﻔﻘﻬﺎ ﺍﻟﻔﺭﺩ ﻤﻥ ﺠﻴﺒﻪ ﺍﻟﺨﺎﺹ )ﺘﻠﻙ ﺍﻟﺘﻲ ﻴﻘﻭﻡ ﺒـﺴﺩﺍﺩﻫﺎ ﺍﻟﻤﺭﻀـﻰ‬ ‫ﺃﻨﻔﺴﻬﻡ ﺒﺩ ﹰ‬ ‫ﻻ ﻤﻥ ﺍﻟﻨﻅﺎﻡ ﺍﻟﺼﺤﻲ ﺃﻭ ﺍﻟﺘﺄﻤﻴﻥ ﺍﻟﺼﺤﻲ( ﺴﻭﺍﺀ ﻟﻠﻔﺭﺩ ﺃﻭ ﻟﻠﻌﺎﺌﻠﺔ )‪ .(٧٩‬ﻭﻴﻤﻜـﻥ ﺃﻥ ﺘﺭﺘﻔـﻊ ﺘﻜـﺎﻟﻴﻑ‬ ‫ﺠﻤﻴﻊ ﺍﻷﺩﻭﻴﺔ ﺍﻟﺘﻲ ﻴﻨﻔﻘﻬﺎ ﺍﻟﻔﺭﺩ ﻤﻥ ﺠﻴﺒﻪ ﺍﻟﺨﺎﺹ ﺇﻟﻰ ﻤﺎ ﻴﺼل ﺇﻟﻰ ‪ ٪٦٥‬ﻤﻥ ﺇﺠﻤﺎﻟﻲ ﺘﻜﻠﻔﺔ ﺍﻷﺩﻭﻴﺔ ﻓﻲ ﺃﻓﺭﻴﻘﻴـﺎ‬ ‫ﺠﻨﻭﺏ ﺍﻟﺼﺤﺭﺍﺀ‪ ،‬ﻭﺇﻟﻰ ‪ ٪٨١‬ﻓﻲ ﺁﺴﻴﺎ )‪ .(٨٠‬ﺒﻴﻨﻤﺎ ﻤﻥ ﺍﻟﻨﺎﺩﺭ ﺃﻥ ﺘﺯﻴﺩ ﻫﺫﻩ ﺍﻟﻨـﺴﺒﺔ ﻓـﻲ ﺍﻟـﺩﻭل ﺍﻟـﺼﻨﺎﻋﻴﺔ‬ ‫ﻋﻥ ‪.(٨١) ٪٢٠‬‬ ‫ﻤﻥ ﺠﻬﺔ ﺃﺨﺭﻯ‪ ،‬ﻓﺈﻥ ﺍﻟﺘﺩﻓﻕ ﺍﻟﻤﺎﻟﻲ ﺍﻟﻤﻼﺌﻡ ﺃﻭ ﺍﻟﻤﻌﻘﻭل ﻓﻲ ﻜل ﻤﺴﺘﻭﻯ ﻤﻥ ﻤﺴﺘﻭﻴﺎﺕ ﺍﻟﻨﻅﺎﻡ ﺍﻟﺼﺤﻲ ﻤﻥ‬ ‫ﺎ‪ .‬ﻭﻓـﻲ‬ ‫ﺸﺄﻨﻪ ﺃﻥ ﻴﺤﺴﻥ ﺍﻻﺴﺘﺠﺎﺒﺔ ﻭﺍﻟﻔﺎﻋﻠﻴﺔ ﻀﻤﻥ ﻋﻤﻠﻴﺔ ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺎ ﺘﺨﺼﻴﺹ ﺍﻻﻋﺘﻤﺎﺩﺍﺕ ﺍﻟﻤﺎﻟﻴﺔ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻤﺤﻠﻲ‪ ،‬ﺒﻤـﺎ‬ ‫ﹰ‪ ،‬ﻴﺘﻡ ﻏﺎﻟﺒﹰ‬ ‫ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﺘﻲ ﺘﺘﺨﺫ ﻓﻴﻬﺎ ﺍﻟﻘﺭﺍﺭﺍﺕ ﻻﻤﺭﻜﺯﻴﺎ‬ ‫ﺎ ﺃﻥ ﻴﻜﻭﻥ ﻟﻪ ﺤﻀﻭﺭ ﻀﺎﻏﻁ ﻤﺅﺜﺭ ﻭﻴﺘﻤﺘﻊ ﺒﻤﻬـﺎﺭﺍﺕ‬ ‫ﻴﺘﻁﻠﺏ ﻤﻥ ﻤﺩﻴﺭ ﺒﺭﻨﺎﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻤﺎ ﺘﻜﻭﻥ ﺘﺠﻬﻴـﺯﺍﺕ ﻋﻴـﺎﺩﺍﺕ‬ ‫ﺇﻋﺩﺍﺩ ﻭﺘﻨﻔﻴﺫ ﺨﻁﻁ ﺍﻷﻋﻤﺎل‪ .‬ﻭﻓﻲ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﺘﻲ ﺘﻭﺍﺠﻪ ﺼﻌﻭﺒﺔ ﻓﻲ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﻏﺎﻟﺒﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ ﻀﻌﻴﻔﺔ ﻭﻓﻘﻴﺭﺓ ﺒﺼﻭﺭﺓ ﻋﺎﻤﺔ‪ ،‬ﺍﻷﻤﺭ ﺍﻟﺫﻱ ﻴﺅﺩﻱ ﺇﻟﻰ ﺨﻔﺽ ﻤﻌﻨﻭﻴﺎﺕ ﺍﻟﻌﺎﻤﻠﻴﻥ ﻓﻴﻬـﺎ‪.‬‬ ‫ﻭﻤﻥ ﺍﻟﻭﺍﺠﺏ ﺘﺸﺠﻴﻊ ﻋﻤﻠﻴﺔ ﺍﻟﻤﺭﻭﻨﺔ ﻓﻲ ﻭﻀﻊ ﻭﺘﻨﻔﻴﺫ ﻤﺨﺘﻠﻑ ﺍﻟﺨﻴﺎﺭﺍﺕ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﻤﺩﻓﻭﻋﺎﺕ ﻭﺍﻟﻤﺸﺘﺭﻭﺍﺕ ﻭﺍﻟﺘﻲ‬ ‫ﺘﺘﻼﺀﻡ ﻤﻊ ﺍﻟﻅﺭﻭﻑ ﺍﻟﻤﺤﻠﻴﺔ‪ ،‬ﻭﻴﺠﺏ ﺘﺠﺭﺒﺔ ﺍﻟﺨﻴﺎﺭﺍﺕ ﺍﻟﺨﺎﺼﺔ ﺒﻜل ﻤﻥ ﺠﺎﻨﺏ ﺍﻟﻁﻠﺏ )ﻤﺜل ﻗـﺴﺎﺌﻡ ﺍﻟـﺼﺭﻑ(‬ ‫ﻭﺠﺎﻨﺏ ﺍﻟﻌﺭﺽ )ﻤﺜل ﺍﻟﺤﻭﺍﻓﺯ ﺍﻟﺘﻲ ﺘﺼﺭﻑ ﻜﺠﺯﺀ ﻤﻜﻤل ﻟﻠﺭﺍﺘﺏ(‪.‬‬ ‫ﻭﺒﻴﻨﻤﺎ ﺘﺘﺠﻪ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﺤﻜﻭﻤﺎﺕ ﻭﺍﻟﺠﻬﺎﺕ ﺍﻟﻤﺎﻨﺤﺔ ﻨﺤﻭ ﺍﺘﺒﺎﻉ ﺍﻷﺴﺎﻟﻴﺏ ﺍﻟﺸﺎﻤﻠﺔ ﻟﻠﻘﻁﺎﻋﺎﺕ ﺒﻬﺩﻑ ﺘﻨﻅﻴﻡ‬ ‫ﺎ ﻭﺭﻋﺎﻴـﺔ ﻤﺭﻀـﺎﻫﺎ‬ ‫ﺍﻟﻤﻌﻭﻨﺎﺕ ﺍﻟﻤﻭﺠﻬﺔ ﻟﻠﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ‪ ،‬ﻓﺴﻭﻑ ﺘﻭﺍﺠﻪ ﺒﺭﺍﻤﺞ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﺤﺩﻴﺎﺕ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻟﺘﺄﻜﺩ ﻤﻥ ﺃﻨﻪ ﻴﺘﻡ ﺘﻘﻴﻴﻡ ﺍﻷﻨﺸﻁﺔ ﺍﻟﻌﻼﺠﻴﺔ ﻭﺍﻟﻭﻗﺎﺌﻴﺔ ﻀﻤﻥ ﺍﻟﻤﺭﺍﻤﻲ ﻭﺍﻷﻫﺩﺍﻑ ﺍﻟﻤﺤﺩﺩﺓ ﻟﻬـﺫﻩ‬ ‫ﺍﻟﺒﺭﺍﻤﺞ‪ .‬ﻭﻴﺘﻡ ﻤﻥ ﺨﻼل ﺍﻟﻨﻬﺞ ﺍﻟﻘﻁﺎﻋﻴﺔ ﺍﻟﺸﺎﻤﻠﺔ‪ ،‬ﺘﻭﺠﻴﻪ ﺍﻻﻋﺘﻤﺎﺩﺍﺕ ﺍﻟﻤﺎﻟﻴﺔ ﺇﻟﻰ ﻜﺎﻤل ﺍﻟﻨﻅﺎﻡ ﺍﻟـﺼﺤﻲ ﻭﻟـﻴﺱ‬ ‫‪‬ـل ﻭﺯﺍﺭﺍﺕ ﺍﻟـﺼﺤﺔ‪.‬‬ ‫ﻗﺒ‬ ‫ﻟﻤﺸﺭﻭﻋﺎﺕ ﺼﺤﻴﺔ ﻤﺤﺩﺩﺓ ﻋﻠﻰ ﺃﻥ ﻴﺘﻡ ﺘﺤﺩﻴﺩ ﺍﻷﻭﻟﻭﻴﺎﺕ‪ ،‬ﻀﻤﻥ ﺍﻟﻘﻁﺎﻉ ﺍﻟﺼﺤﻲ ﻤـﻥ ِ‬ ‫ﻭﻋﻠﻰ ﺍﻟﺭﻏﻡ ﻤﻥ ﺃﻥ ﺍﻟﻘﺼﺩ ﻤﻥ ﻭﺭﺍﺀ ﺫﻟﻙ ﻫﻭ ﺘﺤﺴﻴﻥ ﺍﻟﻜﻔﺎﺀﺓ ﻭﺍﻟﻔﺎﻋﻠﻴﺔ‪ ،‬ﺇﻻ ﺃﻥ ﻫﻨﺎﻙ ﺨﻁﻭﺭﺓ ﻤﻥ ﺃﻥ ﻴﺘﻌـﺭﺽ‬ ‫‪‬ﻌﻁﻲ ﻤﺴﺘﻭﻯ ﻤﺘﺩﻥ ﻤﻥ ﺍﻷﻭﻟﻭﻴﺔ ﻓـﻲ‬ ‫ﺎﻴ‬ ‫ﺎ‪ ،‬ﻭﺍﻟﺫﻱ ﻜﺎﻥ ﺩﺍﺌﻤﹰ‬ ‫ﺘﻤﻭﻴل ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﻴﺯﺍﻨﻴﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺒﺎﻟﺒﻠﺩﺍﻥ ﺍﻟﻨﺎﻤﻴﺔ‪ ،‬ﻟﻤﺯﻴﺩ ﻤﻥ ﺍﻟﺘﻘﻠﺹ‪.‬‬

‫ﺘﻁﻭﻴﺭ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﺒﺸﺭﻴﺔ‬

‫‪٤-٥-٣‬‬

‫ﺇﻥ ﺍﻟﻤﻨﺎﻗﺸﺎﺕ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺘﻘﺩﻴﻡ ﺍﻟﺘﺩﺭﻴﺏ ﻓﻲ ﻤﺠﺎﻻﺕ ﺍﻟﻘﻴﺎﺩﺓ ﻭﺍﻹﺩﺍﺭﺓ ﻭﺍﻟﺘﺨﻁﻴﻁ ﺍﻻﺴـﺘﺭﺍﺘﻴﺠﻲ ﻭﺍﻟـﺩﻋﻭﺓ‬ ‫ﻭﺇﺩﺍﺭﺓ ﺍﻟﺴﻠﻊ ﻭﺃﻨﻅﻤﺔ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﻤﺠﺎﻻﺕ ﺍﻟﻌﻤﻠﻴﺔ ﺍﻷﺨﺭﻯ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺈﺩﺍﺭﺓ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻭﻁﻨﻴﺔ ﻟﻤﻜﺎﻓﺤـﺔ‬ ‫ﺎ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ‪ ،‬ﻫﻲ ﺃﻤﻭﺭ ﺘﻘﻊ ﺨﺎﺭﺝ ﺍﺨﺘﺼﺎﺼﺎﺕ ﻫﺫﻩ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ‪ ،‬ﺤﻴﺙ ﻴﺠﺏ ﺃﻥ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﹰ‪ ،‬ﺘﻜﻭﻥ ﻤﻌﻨﻴﺔ ﺒﺘﻁﻭﻴﺭ ﺍﻟﻁﺎﻗﺎﺕ ﻭﺍﻹﻤﻜﺎﻨﺎﺕ ﺍﻟﺒﺸﺭﻴﺔ ﻓﻲ ﺍﻟﻘﻁﺎﻉ‬ ‫ﺘﺘﻡ ﻫﺫﻩ ﺍﻟﻘﻀﺎﻴﺎ ﻓﻲ ﺴﻴﺎﻕ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺃﻜﺜﺭ ﺸﻤﻭﻻ‬ ‫ﺍﻟﺼﺤﻲ‪ .‬ﻭﺴﻭﻑ ﻴﺘﻡ ﺍﻟﺘﺭﻜﻴﺯ ﻓﻲ ﻫﺫﺍ ﺍﻟﻘﺴﻡ ﻋﻠﻰ ﺘﺩﺭﻴﺏ ﺍﻟﻌﺎﻤﻠﻴﻥ ﺍﻟﺼﺤﻴﻴﻥ ﺍﻟﻘﺎﺌﻤﻴﻥ ﻋﻠﻰ ﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﺭﻀﻰ‬ ‫ﺎ‪.‬‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺘﻠﺒﻴﺔ ﺍﻻﺤﺘﻴﺎﺠﺎﺕ ﺍﻟﻤﺘﻭﻗﻌﺔ ﻤﻥ ﺍﻟﻌﻤﺎﻟﺔ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻟﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﺇﻟﻰ ﺤﺩ ﻤﺎ‪ ،‬ﻋﻥ ﻁﺭﻴﻕ ﺍﻻﺤﺘﻔﺎﻅ ﺒﺎﻟﻌﺎﻤﻠﻴﻥ ﺍﻟﺼﺤﻴﻴﻥ ﺍﻟﺤﺎﻟﻴﻴﻥ ﻭﺇﻋﺎﺩﺓ ﺘﺩﺭﻴﺒﻬﻡ‪ ،‬ﻭﻜﺫﻟﻙ‪ ،‬ﻭﺒـﺸﻜل‬ ‫ﺠﺯﺌﻲ‪ ،‬ﻋﻥ ﻁﺭﻴﻕ ﺘﻌﻴﻴﻥ ﻭﺘﺩﺭﻴﺏ ﻋﺩﺩ ﺇﻀﺎﻓﻲ ﻤﻥ ﺍﻟﻌﺎﻤﻠﻴﻥ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺘﺩﺭﻴﺏ ﺃﻋﻀﺎﺀ ﺒﺭﻨﺎﻤﺞ ﺭﻋﺎﻴـﺔ ﻤﺭﻀـﻰ‬ ‫ﺎ‪ ،‬ﻭﺫﻟﻙ ﻤﻥ ﺃﺠل ﻀﻤﺎﻥ ﻗﻴﺎﻡ ﻜل ﻤﻨﻬﻡ ﺒﺩﻭﺭﻩ ﻓـﻲ ﺇﺩﺍﺭﺓ ﺍﻟﻌﻨﺎﺼـﺭ ﺍﻟﻤﺨﺘﻠﻔـﺔ ﺍﻟﻤﻜﻭﻨـﺔ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﻠﺒﺭﻨﺎﻤﺞ‪ .‬ﻭﻴﺠﺏ ﺘﺩﺭﻴﺏ ﺍﻟﻌﺎﻤﻠﻴﻥ ﺍﻟﺼﺤﻴﻴﻥ ﻭﻓﻘﹰ‬ ‫ﺎ ﻟﻤﺠﺎﻻﺕ ﺍﻟﻌﻤل ﺍﻟﺨﺎﺼﺔ ﺒﻜل ﻤﻨﻬﻡ‪ .‬ﻓﻌﻠﻰ ﺴﺒﻴل ﺍﻟﻤﺜﺎل‪ ،‬ﻓﺈﺫﺍ ﻜﺎﻥ‬ ‫ﻤﻥ ﺍﻟﻤﻨﺘﻅﺭ ﻗﻴﺎﻡ ﻤﻘﺩﻤﻲ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻓﻲ ﻋﻴﺎﺩﺍﺕ ﺭﻋﺎﻴﺔ ﺍﻟﺤﻤل ﻭﺘﻨﻅﻴﻡ ﺍﻷﺴـﺭﺓ‪ ،‬ﺒﺘﻘـﺩﻴﻡ ﺨـﺩﻤﺎﺕ‬ ‫ﺎ‪ ،‬ﻓﻴﻨﺒﻐﻲ ﺃﻥ ﻴﺸﻤل ﺍﻟﺘﺩﺭﻴﺏ ﺍﻟﻤﻘﺩﻡ ﻟﻬﻡ ﺫﻟﻙ‪ .‬ﻭﻋﻠﻰ ﻨﺤﻭ ﻤـﺸﺎﺒﻪ‪،‬‬ ‫ﺎ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﺃﻴﻀﹰ‬ ‫ﺍ ﻗﻴﺎﻡ ﺍﻷﻁﺒﺎﺀ ﺒﺘﻘﺩﻴﻡ ﺃﻨﺸﻁﺔ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﺘﺜﻘﻴﻑ ﻭﺍﻟﺘﻭﻋﻴﺔ‪ ،‬ﻓﻴﻨﺒﻐﻲ ﺃﻥ ﻴﺘﻡ ﺘﻭﺴﻴﻊ ﻨﻁـﺎﻕ ﺘـﺩﺭﻴﺒﻬﻡ‬ ‫ﺇﺫﺍ ﻜﺎﻥ ﻤﻨﺘﻅﺭﹰ‬ ‫ﻟﻴﺸﻤل ﻫﺫﻩ ﺍﻟﻤﻬﺎﺭﺍﺕ‪.‬‬ ‫ﻭﺍﻟﺤﺎﺠﺔ ﻤﺎﺴﺔ ﻓﻲ ﻜﻠﻴﺎﺕ ﺍﻟﻁﺏ‪ ،‬ﻭﺍﻟﻤﻌﺎﻫﺩ ﺍﻟﺘﻌﻠﻴﻤﻴﺔ ﺍﻟﻤﺘﺨﺼﺼﺔ ﺍﻷﺨﺭﻯ‪ ،‬ﻷﺩﺍﺀ ﺩﻭﺭ ﺃﻜﺒﺭ ﻓﻲ ﻤﺠـﺎل‬ ‫ﺎ‪ ،‬ﻭﺍﻟﺫﻱ ﻴﺸﻤل ﺠﻤﻴﻊ ﺍﻟﺠﻭﺍﻨﺏ ﺍﻟﻭﻗﺎﺌﻴﺔ‪ ،‬ﻭﺠﻭﺍﻨـﺏ ﺍﻟﺭﻋﺎﻴـﺔ‬ ‫ﺍﻟﺘﺩﺭﻴﺏ ﺍﻟﺸﺎﻤل ﻓﻲ ﻤﺠﺎل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻟﺘﻭﻋﻴﺔ‪ ،‬ﺒﺎﻟﻨﺴﺒﺔ ﻟﻸﻁﺒﺎﺀ‪ ،‬ﻭﺍﻟﻤﻤﺭﻀﻴﻥ‪ ،‬ﻭﺍﻟﻌﺎﻤﻠﻴﻥ ﺒﺎﻟﻤﺨﺘﺒﺭﺍﺕ‪ ،‬ﻭﺍﻟﺼﻴﺎﺩﻟﺔ‪ ،‬ﻭﻤﻭﻅﻔﻲ ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ‪ ،‬ﻭﺫﻟﻙ‬ ‫ﺨﻼل ﺘﻠﻘﻴﻬﻡ ﻟﻠﺘﺩﺭﻴﺏ ﺍﻷﺴﺎﺴﻲ ﺍﻟﺨﺎﺹ ﺒﻬﻡ‪ .‬ﻜﻤﺎ ﻴﺠﺏ ﺃﻥ ﻴﺘﻡ ﺩﻤﺞ ﺍﻟﺘﺩﺭﻴﺏ ﻋﻠﻰ ﺃﺴﺎﻟﻴﺏ ﺍﻟﻤﺘﻼﺯﻤﺎﺕ‪ ،‬ﻭﺇﻤﻜﺎﻨﻴﺔ‬ ‫ﺎ‪ ،‬ﻭﺍﻷﺴﺱ ﺍﻟﻌﻠﻤﻴﺔ ﻭﺍﻟﻤﺯﺍﻴﺎ ﻭﺃﻭﺠﻪ ﺍﻟﻘﺼﻭﺭ ﻓﻲ ﻫﺫﺍ ﺍﻟﺨـﺼﻭﺹ‪ ،‬ﻭﺫﻟـﻙ‬ ‫ﺘﻁﺒﻴﻘﻬﺎ ﻋﻠﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﺃﺤـﺩ ﺍﻟﻤﻜﻭﻨـﺎﺕ‬ ‫ﻀﻤﻥ ﺍﻟﻤﻨﺎﻫﺞ ﺍﻟﺩﺭﺍﺴﻴﺔ ﺍﻟﻤﻌﻨﻴﺔ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺃﻥ ﻴﻤﺜل ﺍﻟﻌﻨﺼﺭ ﺍﻟﺨﺎﺹ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻷﺴﺎﺴﻴﺔ ﻟﻠﻤﻨﺎﻫﺞ ﺍﻟﺘﺩﺭﻴﺒﻴﺔ ﺍﻟﻁﺒﻴﺔ ﺍﻟﺘﻲ ﻴﺘﻠﻘﺎﻫﺎ ﺍﻟﻁﺒﻴﺏ ﺒﻌﺩ ﺍﻟﺘﺨﺭﺝ‪ ،‬ﻓﻲ ﻤﺠﺎل ﺍﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻭﻻﺒﺩ ﻤﻥ ﺘﻘﺩﻴﻡ ﺍﻟﺘﺩﺭﻴﺏ ﺃﺜﻨﺎﺀ ﺍﻟﻌﻤل ﻟﺠﻤﻴﻊ ﺃﻋﻀﺎﺀ ﻓﺭﻴﻕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﺒﻤﻥ ﻓـﻲ ﺫﻟـﻙ ﺍﻷﻁﺒـﺎﺀ‬ ‫ﺍﻟﺴﺭﻴﺭﻴﻴﻥ‪ ،‬ﻭﺍﻟﺼﻴﺎﺩﻟﺔ ﻭﺍﻟﻌﺎﻤﻠﻴﻥ ﻓﻲ ﺍﻟﺨﻁ ﺍﻷﻤﺎﻤﻲ ﻤﺜل ﺍﻟﻜﺘﺒﺔ ﻭﻤﻭﻅﻔﻲ ﺍﻻﺴﺘﻘﺒﺎل‪ .‬ﻭﻴﺠﺏ ﺃﻻ ﻴﻘﺘﺼﺭ ﺍﻟﺘـﺩﺭﻴﺏ‬ ‫ﺎ ﺍﻟﻤﻭﺍﻗـﻑ‬ ‫ﺎ‪ ،‬ﺒل ﻻﺒﺩ ﺃﻥ ﻴﺘﻨﺎﻭل ﺃﻴـﻀﹰ‬ ‫ﻋﻠﻰ ﺍﻟﺠﻭﺍﻨﺏ ﺍﻟﻁﺒﻴﺔ ﺍﻟﺒﻴﻭﻟﻭﺠﻴﺔ ﻟﻠﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻟﻤﻌﺘﻘﺩﺍﺕ ﺍﻟﺨﺎﺼﺔ ﻟﺩﻯ ﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻜﻤﺎ ﻴﺠﺏ ﻜﺫﻟﻙ ﺍﺴﺘﻜﺸﺎﻑ ﺍﻷﺴﺎﻟﻴﺏ ﺍﻟﻤﺒﺘﻜﺭﺓ ﻤﺜل ﺍﻟﺘﻌﻠﻡ ﻋﻥ‬ ‫ﺒﻌﺩ ﻭﺍﻟﺘﻌﻠﻡ ﺒﻤﺴﺎﻋﺩﺓ ﺍﻟﺤﺎﺴﻭﺏ‪.‬‬ ‫ﺎ ﻓﻲ ﺘﻘﺩﻴﻡ ﺃﻨﺸﻁﺔ ﺍﻟﺘﻌﻠـﻴﻡ ﺍﻟﻁﺒـﻲ ﺍﻟﻤـﺴﺘﻤﺭ ﻭﺘﺤـﺩﻴﺙ‬ ‫ﺍ ﻫﺎﻤﹰ‬ ‫ﻭﻴﻤﻜﻥ ﺃﻥ ﺘﻠﻌﺏ ﺍﻻﺘﺤﺎﺩﺍﺕ ﺍﻟﻤﻬﻨﻴﺔ ﺩﻭﺭﹰ‬ ‫ﺍﻟﻤﻬﺎﺭﺍﺕ‪ ،‬ﺨﺎﺼﺔ ﻟﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﻌﺎﻤﻠﻴﻥ ﺒﺎﻟﻘﻁﺎﻉ ﺍﻟﺨﺎﺹ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺘﺤﻘﻴﻕ ﺫﻟﻙ ﻤـﻥ ﺨـﻼل ﺍﻟـﺩﻭﺭﺍﺕ‬ ‫ﺍﻟﺘﺩﺭﻴﺒﻴﺔ ﻭﺍﻟﻤﺅﺘﻤﺭﺍﺕ‪ ،‬ﻭﺍﻟﻤﻘﺎﻻﺕ ﺍﻟﻤﻨﺸﻭﺭﺓ ﻓﻲ ﺍﻟﻤﺠﻼﺕ ﺍﻟﻁﺒﻴﺔ ﻭﺍﻟﺭﺴﺎﺌل ﺍﻟﺒﺭﻴﺩﻴﺔ ﺍﻟﺘﻲ ﺘﻜﻭﻥ ﻋﻠﻰ ﺸﻜل ﺭﺴﺎﺌل‬ ‫ﺇﺨﺒﺎﺭﻴﺔ ﻭﺩﻻﺌل ﻭﻜﺘﻴﺒﺎﺕ ﺍﻟﺘﻌﻠﻴﻡ ﺍﻟﺫﺍﺘﻲ‪.‬‬ ‫ﻭﻴﺠﺏ ﺃﻥ ﻴﺭﺘﻜﺯ ﺍﻟﺘﺩﺭﻴﺏ ﺍﻟﻤﺴﺘﻤﺭ )ﺍﻟﺘﺩﺭﻴﺏ ﺍﻟﻤﺠﺩﺩ ﻟﻠﻤﻌﻠﻭﻤﺎﺕ( ﺍﻟﻤﻘﺩﻡ ﻟﻠﻌﺎﻤﻠﻴﻥ ﻋﻠﻰ ﻨﺘـﺎﺌﺞ ﺃﻋﻤـﺎل‬ ‫ﺎ ﻭﺒﺭﺍﻤﺞ ﺘﻁﻭﻴﺭ ﻤﻬﺎﺭﺍﺕ ﺍﻟﻌـﺎﻤﻠﻴﻥ‪ .‬ﻭﻴﺠـﺏ ﺘﺤـﺴﻴﻥ‬ ‫ﺍﻟﺭﺼﺩ ﻭﺍﻟﺘﻘﻴﻴﻡ ﺍﻟﺨﺎﺼﺔ ﺒﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﻭﺫﻟﻙ ﻓـﻲ ﺍﻟﻘﻁﺎﻋـﺎﺕ ﺍﻷﺨـﺭﻯ ﻭﻀـﻤﻥ‬ ‫ﺍﻟﻤﻬﺎﺭﺍﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺠﺘﻤﻌﺎﺕ‪ ،‬ﻤﻥ ﺨﻼل ﺘﻌﺯﻴﺯ ﺍﻹﻤﻜﺎﻨﺎﺕ ﻭﺍﻟﻁﺎﻗﺎﺕ ﻭﺒﻨﺎﺀ ﺍﻟﻭﻋﻲ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺍﺴﺘﻜﺸﺎﻑ ﺍﻟﺩﻭﺭ ﺍﻟﺫﻱ ﻴﻤﻜﻥ ﺃﻥ ﻴﺅﺩﻴﻪ‬ ‫ﺎ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﺍﻷﻤﺎﻜﻥ ﺍﻟﺘـﻲ‬ ‫ﺍﻟﻌﺎﻤﻠﻭﻥ ﺍﻟﺼﺤﻴﻭﻥ ﻓﻲ ﺍﻟﻤﺠﺘﻤﻊ ﻓﻲ ﻤﺠﺎل ﺍﻟﺘﺩﺒﻴﺭﺍﺕ ﺍﻟﻌﻼﺠﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﺘﻭﻓﺭ ﻓﻴﻬﺎ ﻫﺫﻩ ﺍﻟﻜﻭﺍﺩﺭ‪.‬‬ ‫ﻭﻋﻠﻰ ﺍﻟﺭﻏﻡ ﻤﻥ ﺇﻫﻤﺎﻟﻬﺎ ﺒﺸﻜل ﻤﺘﻜﺭﺭ ﺒﺴﺒﺏ ﻨﻘﺹ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﻓﺈﻥ ﺍﻹﺸﺭﺍﻑ ﻭﺍﻟﻤﺘﺎﺒﻌﺔ ﻫﻤـﺎ ﻋـﺎﻤﻼﻥ‬ ‫ﺤﺎﺴﻤﺎﻥ ﻓﻴﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻟﺘﺩﺭﻴﺏ ﻭﻀﻤﺎﻥ ﺠﻭﺩﺓ ﺍﻟﺭﻋﺎﻴﺔ‪.‬‬

‫ﺩﻋﻡ ﺍﻟﻤﺨﺘﺒﺭﺍﺕ ﻹﺩﺍﺭﺓ ﺍﻟﺒﺭﻨﺎﻤﺞ‬

‫‪٥-٥-٣‬‬

‫ﺇﻥ ﺍﻟﺘﻜﻠﻔﺔ ﺍﻟﻌﺎﻟﻴﺔ ﻭﻋﺩﻡ ﺍﺴﺘﻤﺭﺍﺭ ﺘﻭﻓﺭ ﺍﻟﻤﺴﺘﻠﺯﻤﺎﺕ ﻭﺍﻟﻜﻭﺍﺸﻑ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻟﻼﺨﺘﺒﺎﺭﺍﺕ‪ ،‬ﻭﺍﻟﺨﺒﺭﺍﺕ‪ ،‬ﺘﻘﻠل‬ ‫ﺎ ﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﻤﺠﺘﻤﻌـﺎﺕ‪.‬‬ ‫ﺒﺸﻜل ﻜﺒﻴﺭ ﻤﻥ ﺠﺩﻭﻯ ﺒل ﻭﺘﻭﻓﺭ ﺍﻻﺴﺘﻘﺼﺎﺀﺍﺕ ﺍﻟﻤﺨﺘﺒﺭﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺤﺘﻰ ﻓﻲ ﺤﺎل ﺘﻭﻓﺭ ﻫﺫﻩ ﺍﻟﻤﻭﺍﺭﺩ‪ ،‬ﻓﺈﻥ ﺍﻷﻋﺩﺍﺩ ﺍﻟﻀﺨﻤﺔ ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﺭﺍﻓﻘﺔ ﺍﻟﻤﺘﻜﺭﺭﺓ ﺍﻟﺤﺩﻭﺙ‪ ،‬ﺘﺠﻌل ﻤﻥ‬ ‫ﺍ ﻏﻴﺭ ﻋﻤﻠﻲ ﻭﻻ ﻴﻤﻜﻥ ﺍﻟﺘﻌﻭﻴل ﻋﻠﻴﻬﺎ ﻓـﻲ ﻜﺜﻴـﺭ ﻤـﻥ‬ ‫ﻋﻤﻠﻴﺔ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﺍﻟﻤﺭﺘﻜﺯ ﻋﻠﻰ ﻤﺨﺘﺒﺭ ﻭﺍﺤﺩ‪ ،‬ﺃﻤﺭﹰ‬ ‫ﹰ‪ ،‬ﻤﻤﺎ ﻴﺅﺩﻱ ﺇﻟﻰ ﺘﺄﺨﺭ ﺍﻟﻤﻌﺎﻟﺠﺔ‬ ‫ﺎ ﻁﻭﻴﻼ‬ ‫ﺍﻷﻤﺎﻜﻥ‪ .‬ﺇﻀﺎﻓﺔ ﺇﻟﻰ ﺫﻟﻙ‪ ،‬ﻓﺈﻥ ﻤﻌﻅﻡ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﻤﺨﺘﺒﺭﻴﺔ ﺘﺴﺘﻐﺭﻕ ﻭﻗﺘﹰ‬ ‫ﺃﻭ ﻓﻘﺩﺍﻥ ﺍﻟﻤﺘﺎﺒﻌﺔ‪ .‬ﻤﻥ ﺠﻬﺔ ﺃﺨﺭﻯ‪ ،‬ﻓﺈﻥ ﺍﻟﻤﻌﻭﻟﻴﺔ ﻋﻠﻰ ﻨﺘﺎﺌﺞ ﺍﻟﻤﺨﺘﺒﺭ‪ ،‬ﺘﺯﻴﺩ ﻤﻥ ﺍﻟﻤﺸﻜﻠﺔ ﺒﺸﻜل ﺃﻜﺒﺭ‪ ،‬ﺤﻴـﺙ ﺇﻥ‬ ‫ﺃﻁﻘﻡ ﺍﻟﻜﻭﺍﺸﻑ ﺍﻟﺨﺎﺼﺔ ﺒﻨﻔﺱ ﺍﻟﻤﻴﻜﺭﻭﺏ ﺘﺨﺘﻠﻑ ﻤﻥ ﺸﺭﻜﺔ ﺼﺎﻨﻌﺔ ﺇﻟﻰ ﺃﺨﺭﻯ‪ ،‬ﻭﺇﺠﺭﺍﺀ ﻨﻔﺱ ﺍﻻﺨﺘﺒﺎﺭ ﻴﻤﻜﻥ ﺃﻥ‬ ‫ﻴﺨﻀﻊ ﻟﻌﺎﻤل ﺍﻟﺨﺒﺭﺓ ﻟﺩﻯ ﺍﻟﺘﻘﻨﻲ ﺍﻟﻘﺎﺌﻡ ﺒﺎﻹﺠﺭﺍﺀ ﺃﻭ ﺒﺎﻷﺴﻠﻭﺏ ﺍﻟﺫﻱ ﻴﺘﻡ ﺠﻤﻊ ﺍﻟﻌﻴﻨﺎﺕ ﺒﻪ‪ ،‬ﻭﻜﺫﻟﻙ ﺤﻔﻅ ﺍﻟﻌﻴﻨـﺎﺕ‬ ‫ﻭﺇﻤﻜﺎﻨﺎﺕ ﺍﻟﻨﻘل ﻟﺩﻯ ﺍﻟﻨﻅﺎﻡ ﺍﻟﺼﺤﻲ‪ .‬ﻭﻓﻲ ﻀﻭﺀ ﺃﻭﺠﻪ ﺍﻟﻘﺼﻭﺭ ﻫﺫﻩ‪ ،‬ﻴﺠﺏ ﻗﺼﺭ ﺍﻟﺩﻋﻡ ﺍﻟﻤﺨﺘﺒﺭﻱ ﻋﻠﻰ ﺍﻟﻤﻭﺍﻗﻑ‬ ‫ﺍﻟﺘﻲ ﺘﻜﻭﻥ ﻓﻴﻬﺎ ﻫﺫﻩ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﻀﺭﻭﺭﻴﺔ ﺒل ﻭﻻﺯﻤﺔ ﻻﺘﺨﺎﺫ ﻗﺭﺍﺭﺍﺕ ﺒﺭﻤﺠﻴﺔ ﺃﻭ ﺴﺭﻴﺭﻴﺔ )ﺇﻜﻠﻴﻨﻴﻜﻴﺔ(‪.‬‬ ‫ﻭﻴﺠﺏ ﺇﻨﺸﺎﺀ ﺃﻨﻅﻤﺔ ﻤﺨﺘﺒﺭﻴﺔ ﺫﺍﺕ ﺠﻭﺩﺓ ﻋﺎﻟﻴﺔ ﻓﻲ ﺃﻱ ﻤﺭﻓﻕ ﺘﺠﺭﻯ ﻓﻴﻪ ﺍﻟﺘﺸﺨﻴﺼﺎﺕ ﺍﻟﻤـﺴﺘﻨﺩﺓ ﺇﻟـﻰ‬ ‫ﺎ‪ ،‬ﺴﻭﺍﺀ ﻟﺘﺸﺨﻴﺹ ﺤﺎﻻﺕ ﻤﻨﻔﺭﺩﺓ ﺃﻭ ﻟﺘﻭﻓﻴﺭ ﺍﻟﺩﻋﻡ ﻟﻠﺘـﺩﺒﻴﺭ‬ ‫ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﻤﺨﺘﺒﺭﻴﺔ ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﻼﺠﻲ ﻟﻠﻤﺘﻼﺯﻤﺎﺕ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺘﻭﻓﻴﺭ ﺍﻟﺘﺩﺭﻴﺏ ﺍﻟﻤﻨﺎﺴﺏ ﻟﺠﻤﻴﻊ ﺍﻟﻌﺎﻤﻠﻴﻥ ﻓﻲ ﺍﻟﻤﺨﺘﺒـﺭ ﻭﺘﻘـﺩﻴﻡ ﺩﻻﺌـل ﺇﺭﺸـﺎﺩﻴﺔ‬ ‫ﻭﺍﻀﺤﺔ ﻟﻬﻡ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺄﻱ ﻤﻥ ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﻫﻲ ﺍﻟﺘﻲ ﻴﺠﺏ ﺇﺠﺭﺍﺅﻫﺎ ﻓﻲ ﺍﻟﻤﺨﺘﺒﺭ‪ ،‬ﻭﺘﻔﺴﻴﺭ ﺍﻟﻨﺘﺎﺌﺞ ﻭﺍﻷﻭﻗـﺎﺕ‬ ‫ﺍﻟﻤﺘﻭﻗﻌﺔ ﻻﻜﺘﻤﺎل ﺍﻻﺨﺘﺒﺎﺭﺍﺕ ﻭﻋﻭﺩﺓ ﺍﻟﻨﺘﺎﺌﺞ‪ .‬ﻭﻴﻨﺒﻐﻲ ﻜﺫﻟﻙ ﻭﻀﻊ ﺩﻻﺌل ﺇﺭﺸﺎﺩﻴﺔ ﺩﺍﺨﻠﻴﺔ ﺨﺎﺼﺔ ﺒﺎﻟﺠﻭﺩﺓ ﻭﺍﻻﻟﺘﺯﺍﻡ‬ ‫ﺒﻬﺎ‪ ،‬ﻭﺘﺸﺠﻴﻊ ﺍﻟﻤﺸﺎﺭﻜﺔ ﻓﻲ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﺨﺎﺭﺠﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ‪،‬‬ ‫ﺇﻥ ﻭﺠﻭﺩ ﺩﻋﻡ ﻤﺨﺘﺒﺭﻱ ﻫﻭ ﺃﻤﺭ ﻫﺎﻡ ﻟﻀﻤﺎﻥ ﺘﻨﻔﻴﺫ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻓﻌﺎﻟﺔ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺍ ﻀﻤﻥ ﺍﻟﻤﺭﺍﻓﻕ ﺍﻟﻤﺨﺘﺒﺭﻴـﺔ‪،‬‬ ‫ﻭﻴﻨﺒﻐﻲ ﺃﻥ ﺘﻜﻭﻥ ﻫﻨﺎﻙ ﺩﻻﺌل ﺇﺭﺸﺎﺩﻴﺔ ﻭﺍﻀﺤﺔ ﺘﺤﺩﺩ ﺍﻟﻤﻭﺍﻀﻊ ﺍﻟﺘﻲ ﺘﺘﻁﻠﺏ ﺘﻌﺯﻴﺯﹰ‬ ‫ﻭﻷﻱ ﻏﺭﺽ ﻴﺠﺏ ﺃﻥ ﻴﺘﻡ ﻫﺫﺍ ﺍﻟﺘﻌﺯﻴﺯ‪ .‬ﻭﻴﺠﺏ ﺇﻨﺸﺎﺀ ﻭﺘﻌﺯﻴﺯ ﺍﻟﻤﺨﺘﺒﺭﺍﺕ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻴﻴﻥ ﺍﻟﻭﻁﻨﻲ ﻭﺍﻹﻗﻠﻴﻤـﻲ‪،‬‬ ‫ﺎ ﻭﻤﺠﺩﻴﹰ‬ ‫ﻜﻠﻤﺎ ﻜﺎﻥ ﺫﻟﻙ ﻀﺭﻭﺭﻴﹰ‬ ‫ﺎ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺇﻴﺠﺎﺩ ﺍﻟﺩﻋﻡ ﺍﻟﻤﺨﺘﺒﺭﻱ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻤﺤﻠﻲ‪ ،‬ﻭﻴﻤﻜﻥ ﻟﻤﺜل ﻫـﺫﻩ‬ ‫ﺎ‪ .‬ﻭﻟﻜﻲ ﻴﻜﻭﻥ ﺫﻟـﻙ‬ ‫ﺎ ﻟﺘﻌﺯﻴﺯ ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﻤﻘﺩﻤﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺸﺒﻜﺔ ﻤﻥ ﺍﻟﻤﺨﺘﺒﺭﺍﺕ ﺍﻟﻌﻤل ﻤﻌﹰ‬ ‫ﻻ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ‪ ،‬ﻓﻴﻤﻜﻥ ﻟﻬﺫﻩ ﺍﻟﺸﺒﻜﺔ ﺘﺤﺩﻴﺩ ﺃﺩﻭﺍﺭ ﻭﻤﺠﺎﻻﺕ ﻭﺍﻀﺤﺔ ﻟﺘﻭﻟﻲ ﺍﻟﻤـﺴﺅﻭﻟﻴﺔ ﺤـﺴﺏ ﺍﻟﺘﻭﺼـﻴﺎﺕ‬ ‫ﻓﻌﺎ ﹰ‬ ‫ﺍﻟﻤﻭﻀﺤﺔ ﺃﺩﻨﺎﻩ‪.‬‬

‫ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ‬ ‫ﺇﺠﺭﺍﺀ ﻤﺴﻭﺤﺎﺕ ﻭﺒﺎﺌﻴﺔ ﻭﺇﻨﺫﺍﺭﻴﺔ ﻭﺴﺒﺒﻴﺔ ﻟﺭﺼﺩ ﺍﺘﺠﺎﻫﺎﺕ ﺍﻟﻤﺭﺽ ﻭﻓﻌﺎﻟﻴﺔ ﺍﻟﺘﺩﺨﻼﺕ‪.‬‬ ‫ﺘﺤﺩﻴﺙ ﻭﺘﻌﺩﻴل ﻤﺨﻁﻁﺎﺕ ﺍﻟﻤﺴﺎﺭ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﺘﻭﺼﻴﺎﺕ ﻭﺍﻟﺩﻻﺌل ﺍﻹﺭﺸﺎﺩﻴﺔ ﻟﻠﺘﺩﺍﺒﻴﺭ ﺍﻟﻌﻼﺠﻴﺔ ﻟﻠﻤﺘﻼﺯﻤﺎﺕ‪.‬‬ ‫ﺎ‪.‬‬ ‫ﺇﻨﺸﺎﺀ ﺃﻨﻅﻤﺔ ﻭﻁﻨﻴﺔ ﻟﺘﺤﻘﻴﻕ ﺍﻟﻜﻔﺎﺀﺓ ﻭﺍﻟﺠﻭﺩﺓ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻟﺘﺸﺨﻴﺹ ﺍﻟﻤﺨﺘﺒﺭﻱ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪.‬‬ ‫ﺘﻘﺩﻴﻡ ﺤﻠﻘﺎﺕ ﻋﻤﻠﻴﺔ ﺘﺩﺭﻴﺒﻴﺔ ﻓﻲ ﻤﺠﺎﻻﺕ ﺍﻟﺘﺸﺨﻴﺹ ﺍﻟﻤﺨﺘﺒﺭﻱ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﻘﻴﻴﻡ ﺍﻷﺩﺍﺀ‪ ،‬ﻭﺍﻟﻔﻌﺎﻟﻴﺔ ﻟﻘﺎﺀ ﺍﻟﺘﻜﺎﻟﻴﻑ ﻟﻼﺨﺘﺒﺎﺭﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﺍﻟﺠﺩﻴﺩﺓ‪.‬‬ ‫ﺘﺠﻤﻴﻊ ﺍﻟﻤﻌﻁﻴﺎﺕ ﻋﻥ ﺃﻨﻤﺎﻁ ﺍﻟﺤﺴﺎﺴﻴﺔ ﻟﻤﻀﺎﺩﺍﺕ ﺍﻟﻤﻴﻜﺭﻭﺒﺎﺕ ﻭﺍﻟﺘﻘﺩﻡ ﺒﺎﻟﺘﻭﺼﻴﺎﺕ ﺍﻟﻼﺯﻤﺔ ﻟﺫﻟﻙ‪.‬‬ ‫ﺘﺤﺩﻴﺩ ﺍﻟﺘﺸﺨﻴﺹ‪ ،‬ﻓﻲ ﺍﻟﻤﺭﺍﻜﺯ ﺍﻟﻤﺭﺠﻌﻴﺔ‪ ،‬ﻟﺘﻠﻙ ﺍﻟﺤﺎﻻﺕ ﺍﻟﺘﻲ ﻴﺨﻔﻕ ﻓﻴﻬﺎ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﻤﺘﻼﺯﻤﺎﺕ ﻭﻜﺫﻟﻙ‬ ‫ﻟﻸﻏﺭﺍﺽ ﺍﻟﻁﺒﻴﺔ ﺍﻟﺸﺭﻋﻴﺔ )ﻤﺜل ﺤﺎﻻﺕ ﺍﻻﻏﺘﺼﺎﺏ ﺃﻭ ﺍﻻﻨﺘﻬﺎﻙ ﺍﻟﺠﻨﺴﻲ(‪.‬‬ ‫ﹰ‪ ،‬ﻟﻠﻌـﺩﺍﻭﻯ ﺒـﺎﻟﻤﻜﻭﺭﺍﺕ ﺍﻟﺒﻨﻴـﺔ ﺃﻭ ﺍﻟﻤﺘـﺩﺜﺭﺍﺕ‪،‬‬ ‫ﺇﻨﺸﺎﺀ ﺃﻭ ﺘﻌﺯﻴﺯ ﺒﺭﺍﻤﺞ ﺍﻟﺘﺨﺯﻴﻥ‪ ،‬ﺃﻴﻥ ﻤﺎ ﻜﺎﻥ ﺫﻟﻙ ﻤﺠﺩﻴﺎ‬ ‫ﺎ‪.‬‬ ‫ﻭﺒﺨﺎﺼﺔ ﺒﻴﻥ ﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ ﻤﺜل ﺍﻟﻔﺘﻴﺎﺕ ﻭﺍﻟﻔﺘﻴﺎﻥ ﺍﻟﻨﺸﻁﻴﻥ ﺠﻨﺴﻴﹰ‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬

‫ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻹﻗﻠﻴﻤﻲ‬ ‫ﺇﺠﺭﺍﺀ ﻤﺴﻭﺤﺎﺕ ﺴﺒﺒﻴﺔ ﻟﺭﺼﺩ ﺍﺘﺠﺎﻫﺎﺕ ﺍﻟﻤﺭﺽ ﻭﻓﻌﺎﻟﻴﺔ ﺍﻟﺘﺩﺨﻼﺕ‪.‬‬ ‫ﺭﺼﺩ ﺃﻨﻤﺎﻁ ﺍﻟﺤﺴﺎﺴﻴﺔ ﻟﻤﻀﺎﺩﺍﺕ ﺍﻟﻤﻴﻜﺭﻭﺒﺎﺕ‪.‬‬ ‫ﺎ ﻓﻲ ﺍﻹﻗﻠﻴﻡ‪.‬‬ ‫ﺩﻋﻡ ﺃﻨﻅﻤﺔ ﻤﺭﺍﻗﺒﺔ ﺍﻟﻜﻔﺎﺀﺓ ﻭﺍﻟﺠﻭﺩﺓ ﻓﻲ ﻤﺠﺎل ﺍﻟﺘﺸﺨﻴﺹ ﺍﻟﻤﺨﺘﺒﺭﻱ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪.‬‬ ‫ﺘﻘﺩﻴﻡ ﺤﻠﻘﺎﺕ ﻋﻤﻠﻴﺔ ﺘﺩﺭﻴﺒﻴﺔ ﻓﻲ ﻤﺠﺎل ﺍﻟﺘﺸﺨﻴﺹ ﺍﻟﻤﺨﺘﺒﺭﻱ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬

‫ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻤﺤﻠﻲ‬ ‫ﺩﻋﻡ ﺍﻟﻤﺴﻭﺤﺎﺕ ﺍﻟﺨﺎﻓﺭﺓ‪.‬‬ ‫ﺘﻭﻓﻴﺭ ﺍﻻﺨﺘﺒﺎﺭ ﺍﻟﺴﻴﺭﻭﻟﻭﺠﻲ ﺍﻟﺭﻭﺘﻴﻨﻲ ﺍﻟﺨﺎﺹ ﺒﺩﺍﺀ ﺍﻟﺯﻫﺭﻱ ﻋﻨﺩ ﺍﻟﺤﻭﺍﻤل‪.‬‬ ‫•‬ ‫•‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺇﺩﺍﺭﺓ ﺍﻟﻤﺸﺘﺭﻭﺍﺕ ﻭﺍﻟﻠﻭﺠﻴﺴﺘﻴﺎﺕ‬

‫‪٦-٥-٣‬‬

‫ﻟﻀﻤﺎﻥ ﺍﻟﻌﻤل ﺒﺎﻟﻔﺎﻋﻠﻴﺔ ﺍﻟﻤﻁﻠﻭﺒﺔ‪ ،‬ﻻﺒﺩ ﺃﻥ ﻴﻜﻭﻥ ﻟﺩﻯ ﺍﻟﻌﺎﻤﻠﻴﻥ ﺍﻟﺼﺤﻴﻴﻥ ﺍﻷﺩﻭﻴﺔ ﻭﺍﻹﻤﺩﺍﺩﺍﺕ ﺍﻟﻼﺯﻤـﺔ‬ ‫)ﺍﻟﻘﻔﺎﺯﺍﺕ‪ ،‬ﺍﻟﻤﺤﺎﻗﻥ‪ ،‬ﺍﻟﻤﺴﺘﻠﺯﻤﺎﺕ ﺍﻟﻤﺨﺘﺒﺭﻴﺔ‪ ،‬ﺇﻟﺦ(‪ ،‬ﻭﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ‪ ،‬ﻭﺍﻷﺠﻬﺯﺓ ﺍﻟﻁﺒﻴﺔ )ﻁـﺎﻭﻻﺕ ﺍﻻﺨﺘﺒـﺎﺭ‪،‬‬ ‫ﺍﻹﻀﺎﺀﺓ ﺍﻟﻼﺯﻤﺔ ﻟﻼﺨﺘﺒﺎﺭ‪ ،‬ﻓﻭﺍﺼل ﻟﻠﻤﺤﺎﻓﻅﺔ ﻋﻠﻰ ﺨﺼﻭﺼﻴﺔ ﺍﻟﻤﺭﻀﻰ‪ ،‬ﻤﻨﺎﻅﻴﺭ ﻟﻠﻔﺤـﺹ ﺍﻟﻤﻬﺒﻠـﻲ‪ ،‬ﺃﺠﻬـﺯﺓ‬ ‫ﻟﻠﺘﻌﻘﻴﻡ‪ ،‬ﺇﻟﺦ(‪ .‬ﻭﻓﻲ ﻤﺎ ﻴﻠﻲ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻷﺭﺒﻌﺔ ﺍﻷﺴﺎﺴﻴﺔ ﺍﻟﻤﻜﻭﻨﺔ ﻟﻠﺩﺍﺌﺭﺓ ﺍﻟﻠﻭﺠﻴﺴﺘﻴﺔ ﺍﻟﺘـﻲ ﻴﺠـﺏ ﺃﺨـﺫﻫﺎ ﺒﻌـﻴﻥ‬ ‫ﺍﻻﻋﺘﺒﺎﺭ‪:‬‬ ‫ﺎ ﻤﻊ ﺍﻟﺤﻜﻭﻤﺔ ﺍﻟﻭﻁﻨﻴـﺔ ﻭﺒﺭﻨـﺎﻤﺞ‬ ‫ﺍﺨﺘﻴﺎﺭ ﺍﻹﻤﺩﺍﺩﺍﺕ ﺍﻟﺘﻲ ﻴﻨﺒﻐﻲ ﺃﻥ ﺘﻜﻭﻥ ﺒﺎﻟﻤﺴﺘﻭﺩﻋﺎﺕ )ﻫﺫﺍ ﻴﺘﻁﻠﺏ ﺘﻨﺴﻴﻘﹰ‬ ‫‪‬ل ﺍﻟﺴﻠﻁﺎﺕ ﺍﻟﺘﻨﻅﻴﻤﻴﺔ ﺍﻟﻭﻁﻨﻴﺔ ﺍﻟﻤﻌﻨﻴﺔ ﺒﺎﻷﺩﻭﻴﺔ ﻭﺍﻟﺴﻠﻊ ﺍﻟﻤﻁﻠﻭﺒـﺔ‬ ‫ﻗﺒ‬ ‫ﺍﻷﺩﻭﻴﺔ ﺍﻷﺴﺎﺴﻴﺔ ﻟﻀﻤﺎﻥ ﺘﺼﺎﺭﻴﺢ ﻤﻥ ِ‬ ‫ﻀﻤﻥ ﻗﻭﺍﺌﻡ ﺍﻷﺩﻭﻴﺔ ﻭﺍﻟﺴﻠﻊ ﺍﻷﺴﺎﺴﻴﺔ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻟﻠﺒﻼﺩ(‪.‬‬ ‫ﻭﺠﻭﺩ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻟﻠﻤﺸﺘﺭﻴﺎﺕ ﺘﺭﻤﻲ ﺇﻟﻰ ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺃﻥ ﺍﻹﻤﺩﺍﺩﺍﺕ ﻭﺍﻟﻤﺴﺘﻠﺯﻤﺎﺕ ﻗﺩ ﺘـﻡ ﺘﺄﻤﻴﻨﻬـﺎ ﺒﺄﺴـﻌﺎﺭ‬ ‫ﺘﻨﺎﻓﺴﻴﺔ ﻤﻘﺒﻭﻟﺔ ﻤﻥ ﺨﻼل ﻋﻤﻠﻴﺎﺕ ﻤﻔﺘﻭﺤﺔ ﻭﺍﻀﺤﺔ ﻭﺫﺍﺕ ﺸﻔﺎﻓﻴﺔ‪.‬‬ ‫ﻭﺠﻭﺩ ﻨﻅﺎﻡ ﺘﻭﺯﻴﻊ ﻴﻀﻤﻥ ﻭﺼﻭل ﺍﻹﻤﺩﺍﺩﺍﺕ ﻭﺍﻟﻤﺴﺘﻠﺯﻤﺎﺕ ﺇﻟﻰ ﺍﻟﻤﻭﺍﻗﻊ ﺍﻟﺘﻲ ﺘﺤﺘﺎﺠﻬﺎ‪ ،‬ﺒﺎﻨﺘﻅﺎﻡ )ﻤـﻊ ﺇﺩﺭﺍﻙ‬ ‫ﹰ‪ ،‬ﻭﺒﺸﻜل ﺸﺎﺌﻊ‪ ،‬ﻓﻲ ﻤﻌﺎﻟﺠﺔ‬ ‫ﺎ‪ ،‬ﺘﺴﺘﺨﺩﻡ ﺃﻴﻀﺎ‬ ‫ﺃﻥ ﻤﻌﻅﻡ ﺍﻷﺩﻭﻴﺔ ﺍﻟﻤﺴﺘﺨﺩﻤﺔ ﻓﻲ ﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ(‪.‬‬ ‫ﺇﺩﺍﺭﺓ ﺍﻟﺴﻠﻊ ﺒﺎﻟﺸﻜل ﺍﻟﺫﻱ ﻴﺘﺤﻘﻕ ﻤﻌﻪ ﺸﺭﺍﺀ ﻭﺼﺭﻑ ﻭﺍﺴﺘﻌﻭﺍﺽ ﺍﻟﻤﺴﺘﻠﺯﻤﺎﺕ ﻭﺍﻹﻤـﺩﺍﺩﺍﺕ ﻓـﻲ ﺍﻟﻭﻗـﺕ‬ ‫ﺍﻟﻤﻁﻠﻭﺏ ﻭﺒﺎﻟﺴﺭﻋﺔ ﺍﻟﻼﺯﻤﺔ‪.‬‬ ‫•‬

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‫ﺍ‬ ‫ﺎ ﻤﺘﻭﺍﻀﻌﺔ ﺠـﺩﹰ‬ ‫ﻭﻤﻥ ﺍﻟﺠﺩﻴﺭ ﺒﺎﻟﺫﻜﺭ ﺃﻥ ﺇﻤﻜﺎﻨﻴﺔ ﺍﻟﻭﺼﻭل ﺇﻟﻰ ﺍﻷﺩﻭﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻨﺎﻤﻴﺔ ﻭﺘﺅﺜﺭ ﻋﻠﻴﻬﺎ ﻋﻭﺍﻤل ﻤﺜل ﺍﻟﻘﺩﺭﺓ ﻋﻠﻰ ﺘﻭﻓﻴﺭﻫﺎ‪ ،‬ﻭﻀﻤﺎﻥ ﺍﺴﺘﻤﺭﺍﺭ ﻋﻤﻠﻴﺔ ﺍﻟﺘﻤﻭﻴـل‪،‬‬ ‫ﺎ ﻫـﻲ‬ ‫ﻭﻋﺩﻡ ﺜﺒﺎﺕ ﻋﻤﻠﻴﺔ ﺍﻟﺸﺭﺍﺀ‪ ،‬ﺍﻷﻤﺭ ﺍﻟﺫﻱ ﻴﺘﺭﺘﺏ ﻋﻠﻴﻪ ﺘﻜﺭﺍﺭ ﻨﻘﺼﻬﺎ‪ .‬ﻭﻤﻌﻅﻡ ﺃﺩﻭﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺃﺩﻭﻴﺔ ﺠﻨﻴﺴﺔ ﻭﻟﻴﺴﺕ ﻤﺭﺘﻔﻌﺔ ﺍﻟﺜﻤﻥ ﺒﺎﻟﺸﻜل ﺍﻟﺫﻱ ﻴﻤﻨﻊ ﺍﻟﺤﺼﻭل ﻋﻠﻴﻬﺎ‪ ،‬ﺇﻻ ﺃﻥ ﺍﻟﺘﻜﻠﻔﺔ ﻫﻲ ﺃﺤﺩ ﺍﻟﻌﻭﺍﻤل ﺍﻟﻬﺎﻤـﺔ‬ ‫ﺍﻟﺘﻲ ﺘﺴﻬﻡ ﻓﻲ ﻤﺴﺘﻭﻯ ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﻫﺫﻩ ﺍﻷﺩﻭﻴﺔ ﻓﻲ ﻤﻌﻅﻡ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﻨﺎﻤﻴﺔ‪ .‬ﻭﻓﻲ ﺍﻟﺤﻘﻴﻘﺔ ﻓﺈﻥ ﻤﻌﻅـﻡ ﺍﻷﺩﻭﻴـﺔ‬ ‫ﺎ‪ ،‬ﻟﻴﺴﺕ ﻤﺨﺼﺼﺔ ﺒﺸﻜل ﻤﺤﺩﺩ ﻟﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ ،‬ﻭﻟﻜﻨﻬﺎ ﺘـﺴﺘﺨﺩﻡ‬ ‫ﺍﻟﻤﺴﺘﺨﺩﻤﺔ ﻓﻲ ﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻟﻌﻼﺝ ﺃﻤﺭﺍﺽ ﺃﺨﺭﻯ‪ .‬ﻭﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻹﺠﺭﺍﺀ ﺘﺤﻠﻴل ﻟﺘﺤﺩﻴﺩ ﺍﻷﺴﺒﺎﺏ ﻭﺇﺯﺍﻟﺔ ﺍﻟﻤﺸﻜﻼﺕ ﺍﻟﺘﻲ ﺘـﺅﺩﻱ ﺇﻟـﻰ ﻋـﺩﻡ‬ ‫ﺎ‪ .‬ﻭﻗﺩ ﺘﺸﺘﻤل ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﺭﺍﻤﻴﺔ‬ ‫ﺍﻻﻨﺘﻅﺎﻡ ﻓﻲ ﺘﻭﻓﻴﺭ ﺇﻤﺩﺍﺩﺍﺕ ﺍﻷﺩﻭﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﺍﺴﺘﺨﺩﺍﻡ ﺍﻷﺩﻭﻴﺔ ﺍﻟﺠﻨﻴـﺴﺔ‬ ‫ﺇﻟﻰ ﺍﻟﺘﻭﺴﻊ ﻓﻲ ﻋﻤﻠﻴﺔ ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﺍﻟﻨﻁﺎﻕ ﺍﻟﻜﺎﻤل ﻷﺩﻭﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﺎﻟﻴﺔ ﺍﻟﺠﻭﺩﺓ ﻭﺍﻟﻤﺄﻤﻭﻨﺔ‪ ،‬ﻭﺍﻟﺸﺭﺍﺀ ﺒﻜﻤﻴﺎﺕ ﻀﺨﻤﺔ ﻭﺒﺄﺴﻌﺎﺭ ﺘﻔﺎﻀﻠﻴﺔ ﻟﻠﺤﺼﻭل ﻋﻠﻰ ﺍﻟـﺴﻌﺭ ﺍﻷﺩﻨـﻰ‪ ،‬ﻭﺇﻴﺠـﺎﺩ‬ ‫ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻟﻠﺘﻤﻭﻴل ﻭﺘﺭﺸﻴﺩ ﻋﻤﻠﻴﺔ ﻭﺼﻑ ﺍﻷﺩﻭﻴﺔ )ﻤﻥ ﺨﻼل ﺇﺩﺨﺎل ﺒﺭﻭﺘﻭﻜﻭﻻﺕ ﻤﻭﺤﺩﺓ ﻟﻌـﻼﺝ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ(‪.‬‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻴﻤﻜﻥ ﺍﻟﻨﻅﺭ ﻓﻲ ﺍﺘﺨﺎﺫ ﺁﻟﻴﺎﺕ ﻤﺘﺭﺍﻓﻘﺔ ﺃﺨﺭﻯ ﻟﺩﻋﻡ ﻭﺘﻌﺯﻴﺯ ﻋﻤﻠﻴﺔ ﺍﻟﻭﺼﻭل ﺇﻟـﻰ ﻭﺍﻟﺤـﺼﻭل ﻋﻠـﻰ‬ ‫ﺍﻷﺩﻭﻴﺔ‪ ،‬ﻭﺫﻟﻙ ﻤﻥ ﺇﻗﻠﻴﻡ ﻹﻗﻠﻴﻡ ﻭﻤﻥ ﺒﻠﺩ ﻵﺨﺭ‪ ،‬ﻭﻗﺩ ﻴﺸﻤل ﺫﻟﻙ ﺼﻴﺎﻏﺔ ﺍﻟﺴﻴﺎﺴﺎﺕ‪ ،‬ﻭﺍﻻﺒﺘﻜﺎﺭ ﻭﻭﻀـﻊ ﺍﻵﻟﻴـﺎﺕ‬ ‫ﺍﻟﺘﻨﻅﻴﻤﻴﺔ‪ .‬ﻭﻤﻥ ﺃﻤﺜﻠﺔ ﺍﻟﻘﻀﺎﻴﺎ ﺍﻟﺘﻲ ﻴﻨﺒﻐﻲ ﺍﻟﻨﻅﺭ ﻓﻴﻬﺎ‪ ،‬ﻤﺎ ﻴﻠﻲ‪:‬‬ ‫ ﺘﻌﻴﻴﻥ ﺠﻬﺔ ﻭﻁﻨﻴﺔ ﻤﺘﻌﺩﺩﺓ ﺍﻷﻨﻅﻤﺔ ﻴﻌﻬﺩ ﺇﻟﻴﻬﺎ ﺒﺈﺠﺭﺍﺀﺍﺕ ﺘﻨﺴﻴﻕ ﺍﻟﺴﻴﺎﺴﺎﺕ ﺍﻟﺨﺎﺼـﺔ ﺒﺎﺴـﺘﺨﺩﺍﻤﺎﺕ‬‫ﺍﻷﺩﻭﻴﺔ ﻭﻭﻀﻊ ﻭﺘﻨﻔﻴﺫ ﺍﻟﻘﻭﺍﻋﺩ ﻭﺍﻷﻨﻅﻤﺔ ﺍﻟﻤﻼﺯﻤﺔ ﻟﺫﻟﻙ؛‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ ﺇﻨﺸﺎﺀ ﻟﺠﺎﻥ ﻟﻸﺩﻭﻴﺔ ﻭﺍﻟﻌﻼﺠﺎﺕ ﻓﻲ ﺍﻟﻤﻘﺎﻁﻌﺎﺕ ﻭﺍﻟﻤﺴﺘﺸﻔﻴﺎﺕ؛‬‫ ﺍﻟﺘﺩﺭﻴﺏ ﺍﻟﻤﺭﺘﻜﺯ ﻋﻠﻰ ﺤل ﺍﻟﻤﺸﻜﻼﺕ ﻓﻲ ﻤﺠﺎل ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﺩﻭﺍﺌﻴﺔ ﻀﻤﻥ ﺍﻟﻤﻘﺭﺭﺍﺕ ﺍﻟﺩﺭﺍﺴﻴﺔ ﻓـﻲ‬‫ﺍﻟﻤﺭﺤﻠﺔ ﺍﻟﺠﺎﻤﻌﻴﺔ؛‬ ‫ ﺍﺴﺘﻤﺭﺍﺭ ﺘﻘﺩﻴﻡ ﺍﻟﺘﻌﻠﻴﻡ ﺍﻟﻁﺒﻲ ﺍﻟﻤﺴﺘﻤﺭ ﺃﺜﻨﺎﺀ ﺍﻟﻌﻤل ﺒﻭﺼﻑ ﺫﻟﻙ ﺃﺤﺩ ﺍﻟﻤﺘﻁﻠﺒـﺎﺕ ﺍﻟﻼﺯﻤـﺔ ﻟﻤـﻨﺢ‬‫ﺘﺭﺨﻴﺹ ﻤﺯﺍﻭﻟﺔ ﺍﻟﻤﻬﻨﺔ؛‬ ‫ ﺘﻭﻋﻴﺔ ﻭﺘﺜﻘﻴﻑ ﺍﻟﺠﻤﻬﻭﺭ ﺤﻭل ﺍﻷﺩﻭﻴﺔ ﻭﺍﻟﻌﻼﺠﺎﺕ ﺒﺎﺴﺘﺨﺩﺍﻡ ﺍﻟﻠﻐﺎﺕ ﺍﻟﻤﺤﻠﻴﺔ؛‬‫ ﺘﻘﺩﻴﻡ ﻤﻌﻠﻭﻤﺎﺕ ﺫﺍﺕ ﻁﺒﻴﻌﺔ ﻤﺴﺘﻘﻠﺔ ﻋﻥ ﺍﻷﺩﻭﻴﺔ‪ ،‬ﺇﻟﻰ ﺍﻷﻁﺒﺎﺀ ﺍﻟﺫﻴﻥ ﻴﻘﻭﻤﻭﻥ ﺒﻭﺼﻑ ﺘﻠﻙ ﺍﻷﺩﻭﻴـﺔ‪،‬‬‫ﻭﺘﻜﻭﻥ ﻫﺫﻩ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﻏﻴﺭ ﺘﻠﻙ ﺍﻟﺘﻲ ﻴﻘﺩﻤﻬﺎ ﺼﺎﻨﻌﻭ ﺍﻟﻤﺴﺘﺤﻀﺭﺍﺕ ﺍﻟﺩﻭﺍﺌﻴﺔ؛‬ ‫ ﺍﻹﺸﺭﺍﻑ ﻭﺍﻟﺘﺩﻗﻴﻕ ﻭﺍﻟﺤﺼﻭل ﻋﻠﻰ ﻤﻌﻠﻭﻤﺎﺕ ﺍﺭﺘﺠﺎﻋﻴﺔ ﻤﻥ ﻭﺍﺼﻔﻲ ﺍﻷﺩﻭﻴﺔ؛‬‫ ﺇﻨﻔﺎﻕ ﺍﻟﺤﻜﻭﻤﺎﺕ ﻟﻤﺒﺎﻟﻎ ﻜﺎﻓﻴﺔ ﻟﻀﻤﺎﻥ ﺘﻭﻓﺭ ﺍﻷﺩﻭﻴﺔ ﻭﺍﻟﻌﻼﺠﺎﺕ ﻭﺍﻟﻤﻬﻨﻴـﻴﻥ ﺍﻟﻌﺎﻤﻠﻴﻥ؛‬‫ ﺘﺠﻨﺏ ﺘﻘﺩﻴﻡ ﺤﻭﺍﻓﺯ ﻤﺎﻟﻴﺔ ﻤﻥ ﺍﻟﺸﺭﻜﺎﺕ ﺍﻟﺼﺎﻨﻌﺔ‪ ،‬ﺇﻟﻰ ﻭﺍﺼﻔﻲ ﺍﻷﺩﻭﻴﺔ ﺍﻟﺫﻴﻥ ﻴﻘﻭﻤـﻭﻥ ﺒﺎﺴـﺘﺨﺩﺍﻡ‬‫ﺃﺩﻭﻴﺔ ﺒﻌﻴﻨﻬﺎ‪.‬‬

‫‪ ٦-٣‬ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﻤﺤﺩﺩﺓ ﻟﻸﻭﻟﻭﻴﺎﺕ ﻤﻥ ﺃﺠل ﺍﻟﻘﻴﺎﻡ ﺒﺈﺠﺭﺍﺀﺍﺕ ﻓﻭﺭﻴﺔ‬ ‫ﺎ ﻓـﻲ‬ ‫ﻴﺘﻌﻴﻥ ﻋﻠﻰ ﺍﻟﺒﻠﺩﺍﻥ ﻜﺄﻭﻟﻭﻴﺔ‪ ،‬ﺘﻨﻔﻴﺫ ﻋﻤﻠﻴﺔ ﻨﻬﻭﺽ ﻟﺘﻭﻓﻴﺭ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻋﺩﺩ ﻤﻥ ﺍﻟﻤﻨﺎﻁﻕ ﺍﻟﺤﻴﻭﻴﺔ ﻭﺍﻟﺘﻲ ﻴﺘﻭﻓﺭ ﻋﻨﻬﺎ ﻤﻌﻠﻭﻤﺎﺕ ﻭﺒﻴﻨﺎﺕ ﻜﺎﻓﻴﺔ ﺤﻭل ﺘﺄﺜﻴﺭ ﻫﺫﻩ ﺍﻷﻤﺭﺍﺽ ﻭﺠﺩﻭﻯ ﻋﻤﻠﻴـﺔ‬ ‫ﺍﻟﺘﺼﺩﻱ ﻟﻬﺎ‪) .‬ﺍﻟﺠﺩﻭل ‪ ،٣‬ﺍﻷﻨﺸﻁﺔ ﺫﺍﺕ ﺍﻷﻭﻟﻭﻴﺔ ﺍﻷﻭﻟﻰ(‪ .‬ﻭﻗﺩ ﺘﻡ ﺘﻨﻔﻴﺫ ﻫﺫﻩ ﺍﻟﺘﺩﺨﻼﺕ ﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤـﻥ ﺍﻷﻤـﺎﻜﻥ‬ ‫ﺒﺎﻻﺴﺘﻌﺎﻨﺔ ﺒﺎﻟﻤﻭﺍﺭﺩ ﺍﻟﺒﺸﺭﻴﺔ ﻭﺍﻟﻤﺎﻟﻴﺔ ﺍﻟﻤﺘﻭﺍﻀﻌﺔ ﺍﻟﻘﺎﺌﻤﺔ‪ ،‬ﻭﻟﻜﻥ ﻟﻡ ﻴﺘﻡ ﺍﻟﻨﻬﻭﺽ ﺒﻬﺫﻩ ﺍﻟﺘﺩﺨﻼﺕ ﺒﻤﺎ ﻴﺤﻘﻕ ﺃﻗـﺼﻰ‬ ‫ﺘﺄﺜﻴﺭ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ‪ .‬ﻭﻗﺩ ﻴﻜﻭﻥ ﻤﻥ ﺍﻟﻤﻤﻜﻥ ﺘﻨﻔﻴﺫ ﺒﻌﺽ ﺍﻟﻤﻜﻭﻨﺎﺕ ﻓﻲ ﺇﻁﺎﺭ ﻤﻔﻬﻭﻡ "ﺍﻟﺘﺨﻁﻴﻁ‪ ،‬ﺜﻡ ﺍﻟﻌﻤل‪،‬‬ ‫ﺜﻡ ﺍﻟﺘﻘﻴﻴﻡ‪ ،‬ﺜﻡ ﺍﻟﻨﻬﻭﺽ"‪ ،‬ﻭﺫﻟﻙ ﻤﻥ ﺃﺠل ﺠﻤﻊ ﻤﺯﻴﺩ ﻤﻥ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ‪ ،‬ﻭﺍﻜﺘﺴﺎﺏ ﻤﺯﻴﺩ ﻤﻥ ﺍﻟﻤﻌﺭﻓﺔ‪ ،‬ﻭﺠﻤﻊ ﺍﻟﺒﻴﺎﻨﺎﺕ‬ ‫ﻤﻊ ﺘﻘﺩﻴﻡ ﺍﻟﺨﺩﻤﺎﺕ ﻓﻲ ﻨﻔﺱ ﺍﻟﻭﻗﺕ‪ .‬ﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﺘﺩﺨﻼﺕ ﺍﻟﺘﻲ ﻗﺩ ﺘﺘﻁﻠﺏ ﺍﻟﻜﺜﻴﺭ ﻤﻥ ﺍﻟﻤـﻭﺍﺭﺩ ﺍﻟﺒـﺸﺭﻴﺔ ﻭﺍﻟﻤﺎﻟﻴـﺔ‬ ‫ﺍﻹﻀﺎﻓﻴﺔ‪ ،‬ﻓﻴﻨﺒﻐﻲ ﻭﻀﻊ ﺍﻟﺨﻁﻁ ﺍﻟﻼﺯﻤﺔ ﻟﺘﻨﻔﻴﺫ ﻫﺫﻩ ﺍﻟﺘﺩﺨﻼﺕ ﺒﻁﺭﻴﻘﺔ ﻤﺘﺩﺭﺠﺔ ﻜﻠﻤﺎ ﺃﺘﻴﺤﺕ ﺍﻟﻤﻭﺍﺭﺩ )ﺍﻟﺠﺩﻭل ‪،٣‬‬ ‫ﺍﻷﻨﺸﻁﺔ ﺫﺍﺕ ﺍﻷﻭﻟﻭﻴﺔ ﺍﻟﺜﺎﻨﻴﺔ(‪ .‬ﻭﻴﺠﺏ ﺃﻥ ﻴﺘﻡ‪ ،‬ﻓﻲ ﻜل ﻋﻨﺼﺭ ﻤﻥ ﻫﺫﻩ ﺍﻟﻌﻨﺎﺼﺭ‪ ،‬ﺍﻷﺨﺫ ﻓﻲ ﺍﻟﺤﺴﺒﺎﻥ ﺩﻴﻨﺎﻤﻴﻜﻴﺎﺕ‬ ‫ﺎ‪ ،‬ﻭﺍﻟﺸﺒﻜﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﻭﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻷﻜﺜﺭ ﻗﺎﺒﻠﻴﺔ ﻟﻺﺼﺎﺒﺔ ﺒﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ‪،‬‬ ‫ﺴﺭﺍﻴﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﻗﺩ ﻴﺤـﻀﺭﻭﻥ ﺇﻟـﻰ ﺍﻟﻤﺭﻓـﻕ‬ ‫ﻭﺘﻭﻓﻴﺭ ﺍﻟﺨﺩﻤﺎﺕ‪ ،‬ﻤﻊ ﺇﺩﺭﺍﻙ ﺃﻥ ﺍﻷﺸﺨﺎﺹ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺼﺤﻲ ﻭﺘﻅﻬﺭ ﻋﻠﻴﻬﻡ ﺃﻭ ﻻ ﺘﻅﻬﺭ ﺃﻋﺭﺍﺽ‪ ،‬ﻭﺫﻟﻙ ﻓﻲ ﻋﺩﻴﺩ ﻤﻥ ﺍﻟﻤﺭﺍﻜﺯ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻤﻭﺠﻭﺩﺓ ﻓﻲ ﺍﻟﺒﻼﺩ‪.‬‬

‫ﺎ‬ ‫ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻋﺎﻟﻲ ﺍﻟﺠﻭﺩﺓ ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬

‫‪١-٦-٣‬‬

‫ﺎ‪ ،‬ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﺘﺎﻟﻴﺔ‬ ‫ﻴﻨﺒﻐﻲ ﺃﻥ ﺘﺘﻭﻓﺭ ﻓﻲ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﺍﻟﺸﺎﻤل ﻟﺤﺎﻻﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺫﻟﻙ ﻜﺤﺩ ﺃﺩﻨﻰ‪:‬‬ ‫‪ -‬ﺍﻟﺘﻭﺼل ﺇﻟﻰ ﺍﻟﺘﺸﺨﻴﺹ ﺍﻟﺼﺤﻴﺢ؛‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ ﺘﻘﺩﻴﻡ ﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻔﻌﺎﻟﺔ؛‬‫ﺎ‪ ،‬ﺒﻤﺎ ﻓﻲ ﺫﻟـﻙ ﻓﻴـﺭﻭﺱ‬ ‫ ﺘﻘﺩﻴﻡ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﺘﺜﻘﻴﻑ ﻭﺍﻟﻤﺸﻭﺭﺓ ﺍﻟﺼﺤﻴﺔ ﺤﻭل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ؛‬ ‫ ﺘﺸﺠﻴﻊ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﺎﺯل ﺍﻟﺫﻜﺭﻱ ﻭﺘﻭﺯﻴﻌﻪ ﻤﻊ ﺘﻭﻓﻴﺭ ﺍﻟﻤﻌﻠﻭﻤـﺎﺕ ﺍﻟﺨﺎﺼـﺔ ﺒﺎﺴـﺘﺨﺩﺍﻤﻪ ﺒـﺼﻭﺭﺓ‬‫ﺼﺤﻴﺤﺔ ﻭﺜﺎﺒﺘﺔ؛‬ ‫ ﺍﻟﺘﺤﻘﻕ ﻤﻥ ﺇﺒﻼﻍ ﺍﻷﺯﻭﺍﺝ ﻭﻤﻌﺎﻟﺠﺘﻬﻡ‪.‬‬‫ﺎ ﻫـﻭ ﺒﻤﺜﺎﺒـﺔ‬ ‫ﻭﻫﻨﺎﻙ ﺩﻻﺌل ﻭﺒﻴﻨﺎﺕ ﻜﺎﻓﻴﺔ ﻋﻠﻰ ﺃﻥ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﻤﺘﻼﺯﻤﺎﺕ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻌﺎﻟﺠﺔ ﻓﻌﺎﻟﺔ ﻭﻟﻬﺎ ﺘﺄﺜﻴﺭ ﻋﻠﻰ ﻭﺒﺎﺌﻴﺔ ﻫﺫﻩ ﺍﻷﻤﺭﺍﺽ ﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺃﻤﺎﻜﻥ ﺘﻘﺩﻴﻡ ﺍﻟﺭﻋﺎﻴﺔ‪ .‬ﻓﻌﻠـﻰ ﺴـﺒﻴل ﺍﻟﻤﺜـﺎل‪،‬‬ ‫ﻟﻭﺤﻅ ﻭﺠﻭﺩ ﺍﻨﺨﻔﺎﺽ ﻓﻲ ﻤﻌﺩﻻﺕ ﺍﻹﺼﺎﺒﺔ ﺒﻬﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ ﻓﻲ ﺃﻋﻘﺎﺏ ﺘﻨﻔﻴﺫ ﺍﺴـﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﻤﻜﺎﻓﺤـﺔ ﺍﻟﻤﺭﺘﻜـﺯﺓ‬ ‫ﻋﻠﻰ ﺃﺴﻠﻭﺏ ﺍﻟﻤﺘﻼﺯﻤﺎﺕ ﻭﺫﻟﻙ ﻓﻲ ﻋﺩﺩ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ ﺒﻤﺎ ﻓﻲ ﺫﻟﻙ ﺍﻟﺘـﺩﺨﻼﺕ ﺍﻟﺘـﻲ ﺘﻤـﺕ ﻟـﺩﻯ ﺍﻟﺒﻐﺎﻴـﺎ ﻓـﻲ‬ ‫ﺎ ﻓﻲ ﺒﻭﺭﻜﻴﻨﺎ ﻓﺎﺼﻭ‬ ‫ﻜﻭﺕ ﺩﻴﻔﻭﺍﺭ )ﺴﺎﺤل ﺍﻟﻌﺎﺝ( ﻭﺍﻟﺴﻨﻐﺎل ﻭﺠﻨﻭﺏ ﺃﻓﺭﻴﻘﻴﺎ‪ ،‬ﻭﻓﻲ ﻋﻴﺎﺩﺍﺕ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻜﻴﻨﻴﺎ )‪ .(٨٢ ،٥٠‬ﻭﻋﻠﻰ ﻤﺴﺘﻭﻯ ﺍﻟﻤﺠﺘﻤﻌﺎﺕ‪ ،‬ﻓﻘﺩ ﺃﻅﻬﺭﺕ ﺍﻟﺩﺭﺍﺴﺎﺕ ﺍﻟﺘﻲ ﺃﺠﺭﻴـﺕ ﻓـﻲ ﺃﻭﻏﻨـﺩﺍ )ﻤﺎﺴـﺎﻜﺎ(‬ ‫ﻻ‬ ‫ﻭﺠﻤﻬﻭﺭﻴﺔ ﺘﻨﺯﺍﻨﻴﺎ ﺍﻟﻤﺘﺤﺩﺓ )ﻤﻭﺍﻨﺯﺍ( )‪ .(٨٤ ،٨٣‬ﺤﺩﻭﺙ ﺘﺄﺜﻴﺭ ﻓﻲ ﻫﺫﺍ ﺍﻟﺨﺼﻭﺹ‪ .‬ﻭﻴﻌﺘﺒﺭ ﻫﺫﺍ ﺍﻷﺴﻠﻭﺏ ﻓﻌـﺎ ﹰ‬ ‫ﺒﺼﻔﺔ ﺨﺎﺼﺔ ﻓﻲ ﺤﺎﻻﺕ ﺍﻹﻓﺭﺍﺯﺍﺕ ﺍﻹﺤﻠﻴﻠﻴﺔ ﻟﺩﻯ ﺍﻟﺭﺠﺎل‪ ،‬ﻭﻓﻲ ﺤﺎﻻﺕ ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺘﻨﺎﺴـﻠﻴﺔ ﻟـﺩﻯ ﻜـل ﻤـﻥ‬ ‫ﺍﻟﺭﺠــﺎل ﻭﺍﻟﻨﺴــﺎﺀ )‪.(٩١ ،٨٥‬‬ ‫ﻭﻴﻤﻜﻥ ﺍﻟﻨﻬﻭﺽ ﺒﺎﻟﺘﺩﺍﺒﻴﺭ ﺍﻟﻌﻼﺠﻴﺔ ﻟﻠﻤﺘﻼﺯﻤﺎﺕ ﻷﻤﺭﺍﺽ ﺍﻹﻓﺭﺍﺯﺍﺕ ﺍﻹﺤﻠﻴﻠﻴﺔ ﻭﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﺇﻟـﻰ‬ ‫ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﺫﻱ ﻴﻐﻁﻲ ‪ ٪٩٠‬ﻋﻠﻰ ﺍﻷﻗل ﻤﻥ ﻤﻭﺍﻗﻊ ﻨﻘﺎﻁ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻷﻭﻟﻴﺔ‪ ،‬ﺫﺍﺕ ﺍﻟﺼﻠﺔ‪ ،‬ﻭﻋﻼﺝ ﺍﻟﻤﺭﻀﻰ ﺍﻟـﺫﻴﻥ‬ ‫ﻴﺤﻀﺭﻭﻥ ﻟﻬﺫﻩ ﺍﻟﻤﺭﺍﻜﺯ ﺒﻬﺫﻩ ﺍﻟﻤﺘﻼﺯﻤﺎﺕ‪ .‬ﻭﻻﺒﺩ ﻤﻥ ﺇﺩﺭﺍﻙ ﺃﻫﻤﻴﺔ ﻤﺎ ﻴﻠﻲ ﻋﻨﺩ ﺍﻟﺘﻨﻔﻴﺫ‪:‬‬ ‫ ﺍﻷﻨﻅﻤﺔ ﺍﻟﻠﻭﺠﻴﺴﺘﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻷﺩﻭﻴﺔ؛‬‫ ﺘﺩﺭﻴﺏ ﺍﻟﻌﺎﻤﻠﻴﻥ ﺍﻟﺼﺤﻴﻴﻥ؛‬‫ﻤﺭﺍﻋﺎﺓ ﺍﻟﺴﺭﻴﺔ؛‬ ‫‪-‬‬

‫ﺎ ﻟﻸﻨﻤﺎﻁ ﺍﻟﻭﺒﺎﺌﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ ﺍﻟﺘﻭﺜﻕ ﺍﻟﺩﻭﺭﻱ ﻤﻥ ﺼﺤﺔ ﻤﺨﻁﻁﺎﺕ ﺍﻟﻤﺴﺎﺭ ﺒﻐﺭﺽ ﺘﻌﺩﻴﻠﻬﺎ ﻭﻓﻘﹰ‬‫ﺎ ﻓﻲ ﻤﻭﻗﻊ ﻤﺎ؛‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ ﻭﺠﻭﺩ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻹﺒﻼﻍ ﺍﻷﺯﻭﺍﺝ ﻭﺍﻟﺘﻲ ﻴﺠﺏ ﺃﻥ ﺘﺸﻤل‪ :‬ﻗﻴﺎﻡ ﻤﻘﺩﻡ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟـﺼﺤﻴﺔ ﺒـﺈﺒﻼﻍ‬‫ﺍﻟﺯﻭﺝ؛ ﺃﻭ ﺘﺴﻠﻴﻡ ﺍﻟﻌﻼﺝ ﻟﻠﻤﺭﻴﺽ؛ ﺤﺴﺏ ﻤﺎ ﻫﻭ ﻤﻼﺌﻡ؛ ﻭﺍﺴﺘﺨﺩﺍﻡ ﺸﺒﻜﺔ ﺍﻹﻨﺘﺭﻨﺕ؛ ﻋﻨﺩﻤﺎ ﻴﺘﻁﻠـﺏ‬ ‫ﺎ‪ ،‬ﻭﺒﺨﺎﺼﺔ ﺒﺎﻟﻨـﺴﺒﺔ ﻟﻠﺭﺠـﺎل‬ ‫ﺍﻷﻤﺭ ﺫﻟﻙ؛ ﻭﺍﻟﻤﻌﺎﻟﺠﺔ ﺍﻟﻤﻘﺘﺭﺤﺔ ﻟﻠﺯﻭﺝ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺫﻴﻥ ﺘﻅﻬﺭ ﻟﺩﻴﻬﻡ ﺃﻋﺭﺍﺽ ﺍﻹﺼﺎﺒﺔ‪.‬‬

‫ﺇﺘﺎﺤﺔ ﺍﻟﺴﻠﻊ ﻭﺍﻷﺩﻭﻴﺔ ﺍﻷﺴﺎﺴﻴﺔ‬

‫‪٢-٦-٣‬‬

‫ﺇﻥ ﺇﺘﺎﺤﺔ ﻤﻀﻤﻭﻤﺔ ﺃﺴﺎﺴﻴﺔ ﻤﻥ ﺍﻟﺴﻠﻊ )ﺍﻷﺩﻭﻴﺔ‪ ،‬ﻭﺍﻟﻭﺴﺎﺌل ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﻭﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ( ﻋﻨﺼﺭ ﺤﺎﺴﻡ‬ ‫ﺎ‪ ،‬ﻭﻴﺠﺏ ﺍﻟﺤﻔـﺎﻅ ﻋﻠـﻰ ﺍﺴـﺘﻤﺭﺍﺭﻫﺎ‬ ‫ﻓﻲ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻭﺍﻟﻭﻗﺎﻴﺔ ﻭﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﻭﺘﺤﺴﻴﻨﻬﺎ‪ .‬ﻭﻻﺒﺩ ﺃﻥ ﻴﺘﻭﻓﺭ ﻟﺩﻯ ﻜل ﻤﺭﻓﻕ ﻟﻠﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻴﻘﻭﻡ ﺒﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻠﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺫﻩ‬ ‫ﺎ‪.‬‬ ‫ﺍﻷﻤـﺭﺍﺽ‪ ،‬ﻤﺨﺯﻭﻥ ﺍﺤﺘﻴﺎﻁﻲ ﻤـﻥ ﻫﺫﻩ ﺍﻟﺒﻀﺎﺌﻊ ﻭﺍﻟﺴﻠﻊ ﺍﻷﺴﺎﺴﻴـﺔ‪ ،‬ﻴﻜﻔﻲ‪ ،‬ﻜﺤﺩ ﺃﺩﻨﻰ‪ ،‬ﻟﻤﺩﺓ ‪ ٦٠‬ﻴﻭﻤﹰ‬

‫ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺘﻲ ﻴﺠﺏ ﺇﺠﺭﺍﺅﻫﺎ ﻟﻠﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻌﺎﻟﻴﺔ ﺍﻻﺨﺘﻁﺎﺭ ﻭﺍﻷﻜﺜﺭ ﻋﺭﻀﺔ ﻟﻺﺼﺎﺒﺔ‬

‫‪٣-٦-٣‬‬

‫ﺎ‪،‬‬ ‫ﻴﺠﺏ ﺍﻟﻘﻴﺎﻡ ﻭﺍﻟﻨﻬﻭﺽ ﺒﺎﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻭﺫﻟﻙ ﻟﺯﻴﺎﺩﺓ ﻓﺭﺹ ﺇﺘﺎﺤﺔ ﺍﻟﺭﻋﺎﻴﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻭﺫﻟﻙ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻌﺎﻟﻴﺔ ﺍﻻﺨﺘﻁﺎﺭ ﻭﺍﻷﻜﺜﺭ ﻋﺭﻀﺔ ﻟﻺﺼﺎﺒﺔ ﺒﻤﻥ ﻓﻲ ﺫﻟـﻙ ﺍﻟـﺼﻐﺎﺭ ﻭﺍﻟﺒﻐﺎﻴـﺎ‬ ‫ﺎ ﻭﺒﺎﻟﻨﻅﺭ ﺇﻟﻰ‬ ‫ﻭﺍﻟﻠﻭﺍﻁﻴﻴﻥ‪ ،‬ﻭﻤﺘﻌﺎﻁﻲ ﺍﻟﻤﺨﺩﺭﺍﺕ ﻋﻥ ﻁﺭﻴﻕ ﺍﻟﺤﻘﻥ‪ ،‬ﻭﻏﻴﺭﻫﻡ‪ ،‬ﻋﻠﻰ ﺤﺴﺏ ﺍﻟﻤﻌﺎﻴﻴﺭ ﺍﻟﻤﺤﺩﺩﺓ ﻤﺤﻠﻴﹰ‬ ‫ﹰ‪ ،‬ﻭﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﺘﺩﺨﻼﺕ ﺍﻟﻭﻗﺎﺌﻴﺔ ﺍﻟﻤـﺴﻨﺩﺓ ﺒﺎﻟﺒﻴﻨـﺎﺕ‬ ‫ﺍﻟﻘﻴﻡ ﺍﻟﺜﻘﺎﻓﻴﺔ ﺍﻟﻤﺤﻠﻴﺔ‪ .‬ﻭﻓﻲ ﺇﺤﺩﻯ ﺍﻟﻤﻘﺎﺭﻨﺎﺕ ﺍﻟﺘﻲ ﺘﻤﺕ ﻤﺅﺨﺭﺍ‬ ‫ﻭﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﺍﺤﺘﻠﺕ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ ﻟﻠﺒﻐﺎﻴﺎ ﺍﻟﻤﺭﺘﺒﺔ ﺍﻷﻭﻟﻰ ﻤﻥ ﺤﻴﺙ‬ ‫ﺎ‬ ‫ﻤﻌﺩل ﺍﻟﻔﻌﺎﻟﻴﺔ ﻭﺤﺠﻡ ﺍﻟﺘﺄﺜﻴﺭ‪ ،‬ﻭﺍﻟﻤﺭﺘﺒﺔ ﺍﻷﺨﻴﺭﺓ ﻤﻥ ﺤﻴﺙ ﺍﻟﺘﻜﻠﻔﺔ ﻭﺍﻻﻋﺘﻤﺎﺩ ﻋﻠﻰ ﺍﻟﻨﻅﺎﻡ ﺍﻟﺼﺤﻲ )‪ .(٩٢‬ﻭﺍﻨﻁﻼﻗﹰ‬ ‫ﺎ ﻟﺘﻁﺒﻴﻕ ﺍﻷﺴﺎﻟﻴﺏ ﺍﻟﻤﺒﺘﻜﺭﺓ ﻓﻲ ﺒﻌﺽ ﺍﻟﻤﻨـﺎﻁﻕ‪ ،‬ﻓـﺈﻥ‬ ‫ﺎ ﺒﺄﻜﺜﺭ ﺍﻷﺴﺎﻟﻴﺏ ﻓﺎﺌﺩﺓ ﻭﻓﺎﻋﻠﻴﺔ‪ ،‬ﻭﺴﻌﻴﹰ‬ ‫ﻤﻥ ﻤﺎ ﻴﻌﺭﻑ ﺤﺎﻟﻴﹰ‬ ‫ﺍﻟﻤﺠﺎﻻﺕ ﺍﻟﻤﻘﺘﺭﺤﺔ ﺍﻟﺘﻲ ﻴﺠﺏ ﺃﻥ ﺘﻌﻁﻲ ﺍﻷﻭﻟﻭﻴﺔ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﺒﻠﺩﺍﻥ ﻫﻲ‪:‬‬ ‫ﺎ ﻟـ ‪ ٪٩٠‬ﻋﻠﻰ ﺍﻷﻗل ﻤﻥ ﺍﻟﺒﻐﺎﻴﺎ‪ ،‬ﺴﻭﺍﺀ‬ ‫ﻴﺠﺏ ﺇﺘﺎﺤﺔ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﻭﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺒﺄﻥ ﻟﻬﺎ ﺃﻭﻟﻭﻴﺔ ﻓـﻲ ﺫﻟـﻙ ﺒـﺴﺒﺏ ﻜﻭﻨﻬـﺎ‬ ‫ﻻ ﺃﻭ ﻨﺴﺎﺀ‪ ،‬ﻭﺍﻟﻔﺌﺎﺕ ﺍﻷﺨﺭﻯ ﺍﻟﺘﻲ ﻴﺘﻡ ﺘﺤﺩﻴﺩﻫﺎ ﻤﺤﻠﻴﹰ‬ ‫ﻜﺎﻨﻭﺍ ﺭﺠﺎ ﹰ‬ ‫ﻤﻌﺭﻀﺔ ﺃﻭ ﻗﺎﺒﻠﺔ ﺃﻜﺜﺭ ﻤﻥ ﻏﻴﺭﻫﺎ ﻟﻺﺼﺎﺒﺔ ﺒﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ‪.‬‬ ‫ﺘﻘﺩﻴﻡ ﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺼﺤﻲ ﺍﻟﺸﺎﻤل‪ ،‬ﻓﻲ ﺍﻟﻤﺩﺍﺭﺱ‪ ،‬ﺤﻭل ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻤﺭﺘﺒﻁﺔ ﺒﻬﺎ‪ ،‬ﻭﺫﻟﻙ‬ ‫ﺎ ﻟﻜل ﻤﺠﻤﻭﻋﺔ ﻋﻤﺭﻴﺔ‪ ،‬ﻭﻴﺸﻤل ﺫﻟﻙ ﻤﺭﺍﺠﻌﺔ ﻭﺘﻁﻭﻴﺭ ﻭﺘﻘﺩﻴﻡ ﺍﻟﺘﺜﻘﻴﻑ ﺒﺎﻟﻁﺭﻕ ﺍﻟﻤﺴﺘﻨﺩﺓ‬ ‫ﺤﺴﺏ ﻤﺎ ﻴﻜﻭﻥ ﻤﻼﺌﻤﹰ‬ ‫ﺎ‪.‬‬ ‫ﺇﻟﻰ ﻤﻬﺎﺭﺍﺕ ﺍﻟﺤﻴﺎﺓ‪ ،‬ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﻤﺭﺽ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺴﻪ‪ ،‬ﻭﺴﺎﺌﺭ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻀﻊ ﻭﺘﻨﻔﻴﺫ ﺘﺩﺨﻼﺕ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﻤﺭﺘﻜﺯﺓ ﻋﻠﻰ ﺍﻟﻭﺴﺎﺌل ﺍﻹﻋﻼﻤﻴﺔ‪ ،‬ﺤﺴﺏ ﻤﺎ ﻴـﺘﻼﺌﻡ ﻤـﻊ ﺍﻟﻔﺌـﺎﺕ‬ ‫ﺍﻟﻌﻤﺭﻴﺔ )ﺍﻟﺠﻨﺱ ﻭﺍﻟﻌﻼﻗﺎﺕ‪ ،‬ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﺘﺜﻘﻴﻑ ﺤﻭل ﺍﻟﺤﻴﺎﺓ ﺍﻟﺠﻨﺴﻴﺔ‪ ،‬ﻭﺍﻻﺴﺘﺨﺩﺍﻡ ﺍﻟﺼﺤﻴﺢ ﻭﺍﻟﺜﺎﺒﺕ ﻟﻠﻌﻭﺍﺯل‬ ‫ﺍﻟﺫﻜﺭﻴﺔ‪ ،‬ﺇﻟﺦ(‪ ،‬ﺤﺘﻰ ﻴﺼل ﺇﻟﻰ ﻜﺎﻓﺔ ﺍﻟﺼﻐﺎﺭ ﻭﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﺍﻟﻤﺨﺘﻠﻔﺔ )ﻋﺒﺭ ﺤﺠﺭﺍﺕ ﺍﻟﻤﺤﺎﺩﺜﺔ ﺍﻟﻤﺒﺎﺸﺭﺓ‬ ‫ﻋﻠﻰ ﺸﺒﻜﺔ ﺍﻹﻨﺘﺭﻨﺕ‪ ،‬ﻭﻭﺴﺎﺌل ﺍﻹﻋﻼﻡ‪ ،‬ﻭﺍﻹﻋﻼﻨﺎﺕ‪ ،‬ﻭﺍﻟﻤﻠﺼﻘﺎﺕ ﻭﺍﻟﻁﻭﺍﺒﻊ ﺍﻟﺒﺭﻴﺩﻴﺔ‪ ،‬ﻭﺍﻟﻤﺴﺭﺡ‪ ،‬ﻤﻊ ﺍﻟﺘﺭﻜﻴﺯ‬ ‫ﻋﻠﻰ ﺍﻟﺴﻠﻭﻜﻴﺎﺕ ﺍﻟﺠﻨﺴﻴﺔ ﺍﻟﻤﺤﺴﻨﺔ‪ ،‬ﺇﻟﺦ(‪.‬‬ ‫ﻀﻤﺎﻥ ﺘﻭﻓﺭ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻟﻤﻨﺎﺴﺒﺔ ﻟﻌﻤﺭ ﺍﻟﻌﻤﻴل‪ ،‬ﻭﺒﺨﺎﺼﺔ ﻟﻠﻤﺭﺍﻫﻘﻴﻥ‪ ،‬ﻋﻥ ﻁﺭﻴـﻕ ﺍﻻﺤﺘﻔـﺎﻅ‬ ‫ﺒﻤﻘﺩﻤﻲ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺍﻷﻜﻔﺎﺀ ﻭﺘﻨﻔﻴﺫ ﺍﻟﺴﻴﺎﺴﺎﺕ ﺍﻟﺘﻲ ﺘﺘﻤﺤﻭﺭ ﺤﻭل ﻤﺼﻠﺤﺔ ﺍﻟﻌﻤﻴل‪ ،‬ﻭﺍﻟﺨﺎﺼـﺔ ﺒﺘـﻭﻓﻴﺭ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ‪.‬‬ ‫ﺘﺄﻴﻴﺩ ﻭﺩﻋﻡ ﺍﻟﺠﻬﻭﺩ ﺍﻟﺭﺍﻤﻴﺔ ﺇﻟﻰ ﻤﻜﺎﻓﺤﺔ ﺃﻤﺭﺍﺽ ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﻭﺍﻟﻘﻀﺎﺀ ﻋﻠﻰ ﺩﺍﺀ ﺍﻟﺯﻫﺭﻱ ﺍﻟﺨﻠﻘﻲ ﻤـﻥ‬ ‫ﺨﻼل ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻤﺘﻜﺎﻤﻠﺔ ﻟﻤﻜﺎﻓﺤﺔ ﺩﺍﺀ ﺍﻟﺯﻫﺭﻱ ﻭﺃﻤﺭﺍﺽ ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﻤﻊ ﺍﻷﺨﺫ ﻓﻲ ﺍﻻﻋﺘﺒﺎﺭ ﻤﺎ ﻴﻠﻲ‪:‬‬ ‫ﻼ ﺒﺸﻜل ﻤﺘﺯﺍﻴﺩ‪ ،‬ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ؛‬ ‫ ﺍﻟﻘﻀﺎﺀ ﻋﻠﻰ ﺩﺍﺀ ﺍﻟﺯﻫﺭﻱ ﺍﻟﺨﻠﻘﻲ ﺃﺼﺒﺢ ﺘﻨﻔﻴﺫﻩ ﺴﻬ ﹰ‬‫ ﻴﺘﻀﺎﺀل ﻤﻌﺩل ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻘﺭﻴﺢ ﻓﻲ ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﺒﻠﺩﺍﻥ‪ ،‬ﺇﻻ ﺃﻥ ﻫﻨﺎﻙ ﺤﺎﺠﺔ ﻟﻤﺯﻴﺩ ﻤﻥ ﺍﻟﻤﻌﻁﻴﺎﺕ ﻭﺒـﺫل‬‫ﺎ ﺒﻬﺎ؛‬ ‫ﺍﻟﻤﺯﻴﺩ ﻤﻥ ﺍﻟﺠﻬﺩ ﻓﻲ ﺍﻟﻤﻨﺎﻁﻕ ﺍﻟﺘﻲ ﻻﻴﺯﺍل ﺍﻟﻤﺭﺽ ﻤﺴﺘﻭﻁﻨﹰ‬ ‫ ﺨﻔﺽ ﺃﻤﺭﺍﺽ ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﻴﺸﻤل ﺍﻟﻌﺩﻴﺩ ﻤﻥ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺘﻲ ﻟﻬﺎ ﺃﻫﻤﻴﺘﻬﺎ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ ﺒـﺴﺭﺍﻴﺔ‬‫ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪.‬‬ ‫•‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺼﺤﻲ ﻭﺍﻟﻤﺸﻭﺭﺓ ﺍﻟﺘﻲ ﺘﺴﺘﻬﺩﻑ ﻤﻨﻊ ﻤﺯﻴﺩ ﻤﻥ ﺍﻟﺴﺭﺍﻴﺔ ﻟﻠﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ‬ ‫ﺎ‪ ،‬ﻭﺘﺸﻤل ﻤﺎ ﻴﻠﻲ‪:‬‬ ‫ﺍﻟﺒﺸﺭﻱ ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻷﺨﺭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻻﺨﺘﺒﺎﺭ ﺍﻟﻁﻭﻋﻲ ﺍﻟﺨﺎﺹ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻟﻜﺎﻓـﺔ ﺍﻟﻤﺭﻀـﻰ ﺍﻟﻤـﺼﺎﺒﻴﻥ‬‫ﺎ؛‬ ‫ﺒﻌﺩﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ ﺍﻟﺭﺒﻁ ﺒﻴﻥ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻤﻌﻨﻴﺔ ﺒﺎﻨﺘﻘﺎل ﻤﺭﺽ ﺍﻟﺯﻫﺭﻱ ﻤﻥ ﺍﻷﻡ ﺇﻟﻰ ﻁﻔﻠﻬﺎ ﻭﺘﺤـﺭﻱ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻷﺨـﺭﻯ‬‫ﺎ‪ ،‬ﻟﻠﺘﺤﻘﻕ ﻤﻥ ﺃﻥ ﺍﺤﺘﻤﺎل ﺍﻨﺘﻘﺎل ﺍﻟﺯﻫﺭﻱ ﺍﻟﺤﻘﻴﻘﻲ ﻗﺩ ﺘﻡ ﺍﻟﻜﺸﻑ ﻋﻨﻪ ﻭﺃﻥ ﺍﻟﻤﻌﺎﻟﺠﺔ ﻗﺩ ﺘﻡ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺘﻘﺩﻴﻤﻬﺎ ﺒﺎﻟﺘﺯﺍﻤﻥ ﻤﻊ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒـﺸﺭﻱ‪ ،‬ﺒﻐـﺭﺽ‬ ‫ﺨﻔﺽ ﻤﻌﺩﻻﺕ ﻭﻓﻴﺎﺕ ﺍﻷﻁﻔﺎل )ﺍﻟﻬﺩﻑ ﺍﻟﺨﺎﻤﺱ ﻟﻠﻤﺭﻤﻰ ﺍﻟﺭﺍﺒﻊ ﻤﻥ ﺍﻟﻤﺭﺍﻤﻲ ﺍﻹﻨﻤﺎﺌﻴﺔ ﻟﻸﻟﻔﻴﺔ(‪.‬‬ ‫ﺘﻴﺴﻴﺭ ﻭﺩﻋﻡ ﻭﺘﻌﺯﻴﺯ ﺍﻟﺠﻬﻭﺩ ﺍﻟﻌﺎﻟﻤﻴﺔ ﻟﻠﺘﻁﻌﻴﻡ ﻀﺩ ﺍﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩ "ﺏ"‪ ،‬ﺨﺎﺼﺔ ﻟﺩﻯ ﺍﻷﺸـﺨﺎﺹ ﺍﻟﻤـﺼﺎﺒﻴﻥ‬ ‫ﺎ‪ ،‬ﻭﻜﺫﻟﻙ ﺍﻟﻔﺌﺎﺕ ﺍﻟﻌﺎﻟﻴﺔ ﺍﻻﺨﺘﻁﺎﺭ ﻟﻺﺼﺎﺒﺔ ﺒﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ ،‬ﻭﻭﻀﻊ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ‬ ‫ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻠﻘﺎﺤﺎﺕ ﺍﻟﻤﺘﻭﻗﻊ ﻨﺠﺎﺤﻬﺎ ﻭﺍﺯﺩﻫﺎﺭﻫﺎ ﻤﺜل ﺍﻟﻠﻘﺎﺡ ﺍﻟﻤﻀﺎﺩ ﻟﻔﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒﺸﺭﻱ ﻭﻓﻴﺭﻭﺱ‬ ‫ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ ‪ -‬ﺍﻟﻨﻤﻁ ‪.٢‬‬ ‫ﺎ ﻭﺘﻨﻔﻴﺫ ﺍﻟﺘـﺩﺨﻼﺕ ﺍﻷﻓﻘﻴـﺔ ﺍﻟﺨﺎﺼـﺔ‬ ‫ﺇﻗﺎﻤﺔ ﺸﺭﺍﻜﺎﺕ ﻟﺘﻨﻔﻴﺫ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ /‬ﺍﻟﻌﺩﻭﻯ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ ،‬ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴـﺔ‪ ،‬ﻭﺴـﺎﺌﺭ‬ ‫ﺒﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻷﻭﻟﻴﺔ‪ ،‬ﻭﻭﻀﻊ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺇﻋﺩﺍﺩ ﺃﻁﺭ ﺍﻟﻌﻤل ﻤﻥ ﺃﺠل ﺍﻟﺘﻨﻔﻴﺫ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻷﻓﻘﻲ‪.‬‬ ‫ﻋﻠﻰ ﺍﻟﺒﻠﺩﺍﻥ ﺍﻟﺘﻤﺎﺱ ﻤﺴﺎﻋﺩﺍﺕ ﺘﻘﻨﻴﺔ ﻭﻤﺎﻟﻴﺔ ﺇﻀﺎﻓﻴﺔ ﻤﻥ ﻤﻨﻅﻤﺔ ﺍﻷﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ‪ ،‬ﻭﺍﻟﻭﻜﺎﻻﺕ ﺍﻷﺨـﺭﻯ‪ ،‬ﺤﺘـﻰ‬ ‫ﻴﻤﻜﻨﻬﺎ ﺘﺤﻘﻴﻕ ﺍﻷﻫﺩﺍﻑ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻭﺍﻟﺤﻔﺎﻅ ﻋﻠﻰ ﺠﻭﺩﺓ ﺍﻟﺭﻋﺎﻴﺔ‪.‬‬

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‫‪65‬‬

‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﺠﺩﻭل ‪ -٣‬ﻤﻭﺠﺯ ﻟﻠﺘﺩﺨﻼﺕ ﺍﻟﻤﻤﻜﻨﺔ ﻟﻠﺘﻨﻔﻴﺫ ﺍﻟﻔﻭﺭﻱ‬ ‫ﺍﻷﻫﺩﺍﻑ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ‬ ‫ﺍﻟﻤﺅﺸﺭﺍﺕ‬ ‫ﺍﻷﻭﻟﻭﻴﺔ ‪ ١‬ﺍﻷﻨﺸﻁﺔ‬

‫‪١‬ﺃ‪ -‬ﻨﺴﺒﺔ ﺍﻟﻤﻭﺍﻗﻊ ﺍﻷﻭﻟﻴﺔ ﺍﻟﺘﻲ ﺘﻘﺩﻡ ﺨﺩﻤﺎﺕ ‪١‬ﺃ‪ ٪٩٠ -‬ﻤﻥ ﺍﻟﻤﻭﺍﻗﻊ ﺍﻷﻭﻟﻴﺔ ﺍﻟﺘـﻲ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﻭﺍﻟﺘﻲ ﺘﻭﻓﺭ ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﺍﻟﺸﺎﻤل ﺘﻘﺩﻡ ﺨﺩﻤﺎﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺴﺘﻭﻓﺭ ﺍﻟﺭﻋﺎﻴـﺔ‬ ‫ﻟﻤﻌﺎﻟﺠﺔ ﺤﺎﻻﺕ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺍﻟﺸﺎﻤﻠﺔ ﻟﺤﺎﻻﺕ ﺍﻹﺼـﺎﺒﺔ ﺒﺎﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ ﺍﻟﻤﺘﺭﺍﻓﻘﺔ ﺒـﺎﻷﻋﺭﺍﺽ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺍﻟﻤﺘﺭﺍﻓﻘﺔ ﺒﺎﻷﻋﺭﺍﺽ‪.‬‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺒﺤﻠﻭل ﻋﺎﻡ ‪.٢٠١٥‬‬ ‫‪١‬ﺏ‪ -‬ﺒﺤﻠﻭل ﻋﺎﻡ ‪ ،٢٠١٥‬ﺘﺼل ﻨﺴﺒﺔ‬ ‫ﺍﻟﻨﺴﺎﺀ ﻭﺍﻟﺭﺠﺎل ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ ﺍﻟﺫﻴﻥ ﻴﺘﻡ ﺘﺸﺨﻴـﺼﻬﻡ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﻤﻌﺎﻟﺠﺘﻬﻡ ﻭﺘﻭﻋﻴﻬﻡ ﻓﻲ ﻤﺭﺍﻓﻕ ﺘﻘـﺩﻴﻡ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﺇﻟﻰ ‪.٪٩٠‬‬

‫‪ -١‬ﺍﻟﻨﻬﻭﺽ ﺒﺄﻋﻤﺎل ﺘـﺸﺨﻴﺹ‬ ‫ـﺔ‬ ‫ـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـ‬ ‫ـﺔ ﺍﻟﻌـ‬ ‫ﻭﻤﻌﺎﻟﺠـ‬ ‫ﺎ‪.‬‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ـﻲ‬ ‫ـﺩﺒﻴﺭ ﺍﻟﻌﻼﺠـ‬ ‫ـﺘﺨﺩﺍﻡ ﺍﻟﺘـ‬ ‫)ﺍﺴـ‬ ‫ﻟﻠﻤﺘﻼﺯﻤﺎﺕ ﺤﻴﺜﻤﺎ ﺘﻜﻭﻥ ﺍﻟﻤﻭﺍﺭﺩ‬ ‫ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﻤﺤﺩﻭﺩﺓ(‬ ‫‪١‬ﺏ‪ -‬ﻨﺴﺒﺔ ﺍﻟﻤﺭﻀﻰ ﺒﺎﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ ﻓﻲ ﻤﺭﺍﻓﻕ ﺼﺤﻴﺔ ﻤﻨﺘﻘﺎﺓ‪ ،‬ﻴﺘﻡ ﻓﻴﻬـﺎ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺘﺸﺨﻴﺼﻬﻡ ﻭﻤﻌﺎﻟﺠﺘﻬﻡ ﻭﺘـﻭﻋﻴﺘﻬﻡ ﺒـﺼﻭﺭﺓ‬ ‫ﺎ ﻟﻠﺩﻻﺌل ﺍﻹﺭﺸﺎﺩﻴﺔ ﺍﻟﻭﻁﻨﻴﺔ‪.‬‬ ‫ﺼﺤﻴﺤﺔ ﻭﻓﻘﹰ‬

‫‪ -٢‬ﻤﻜﺎﻓﺤﺔ ﺍﻟﺯﻫـﺭﻱ ﺍﻟﺨﻠﻘـﻲ ‪ -٢‬ﻨﺴﺒﺔ ﺍﻟﺤﻭﺍﻤل ﺍﻟﺘﻲ ﺘﺘﺭﺍﻭﺡ ﺃﻋﻤـﺎﺭﻫﻥ ‪٢‬ﺃ‪ -‬ﺃﻜﺜﺭ ﻤـﻥ ‪ ٪٩٠‬ﻤﻤـﻥ ﻴﻨـﺸﺩﻥ‬ ‫ﻜﺨﻁﻭﺓ ﻨﺤـﻭ ﺍﻟـﺘﺨﻠﺹ ﻤﻨـﻪ ﺒﻴﻥ ‪ ١٥‬ﻭ‪ ٢٤‬ﺍﻟﻼﺌﻲ ﻴﺫﻫﺒﻥ ﺇﻟـﻰ ﻋﻴـﺎﺩﺍﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺃﺜﻨـﺎﺀ ﺍﻟﺤﻤـل ﻷﻭل ﻤـﺭﺓ‪،‬‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﺃﺜﻨﺎﺀ ﺍﻟﺤﻤل ﻭﻫﻥ ﺇﻴﺠﺎﺒﻴﺎﺕ ﺍﻟﻤﺼل ﻭﺍﻟﻼﺌﻲ ﺘﺘﺭﺍﻭﺡ ﺃﻋﻤـﺎﺭﻫﻥ ﺒـﻴﻥ ‪١٥‬‬ ‫ﻭﺍﻟﻘﻀﺎﺀ ﻋﻠﻴﻪ‪.‬‬ ‫ﺎ‪ ،‬ﻴﺨﻀﻌﻥ ﻟﻠﺘﺤﺭﻱ ﺤـﻭل‬ ‫ﻭ‪ ٢٤‬ﻋﺎﻤﹰ‬ ‫ﻟﻠﺯﻫﺭﻱ‪.‬‬ ‫ﺇﺼﺎﺒﺘﻬﻥ ﺒﺎﻟﺯﻫﺭﻱ‪.‬‬ ‫‪٢‬ﺏ‪ -‬ﺘﻌﺎﻟﺞ ﺃﻜﺜﺭ ﻤﻥ ‪ ٪٩٠‬ﻤﻥ ﺍﻟﻨﺴﺎﺀ‬ ‫ﺍﻹﻴﺠﺎﺒﻴﺎﺕ ﺍﻟﻤﺼل ﻟﻠﺯﻫﺭﻱ ﺒـﺼﻭﺭﺓ‬ ‫ﺼﺤﻴﺤﺔ ﻭﻤﻨﺎﺴﺒﺔ ﺒﺤﻠﻭل ﻋﺎﻡ ‪.٢٠١٥‬‬ ‫‪٣‬ﺃ‪ -‬ﺒﺤﻠﻭل ﻋﺎﻡ ‪ ،٢٠١٠‬ﺘﻜﻭﻥ ﻫﻨﺎﻙ‬ ‫ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻭﺩﻻﺌل ﺇﺭﺸﺎﺩﻴﺔ ﻗﺎﺌﻤـﺔ‬ ‫ﺒﺎﻟﻔﻌل ﻤﻥ ﺃﺠل ﺍﻷﺸﺨﺎﺹ ﺍﻹﻴﺠﺎﺒﻴﻴﻥ‬ ‫ﻟﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺨﺎﺼـﺔ‬ ‫ﺎ‪.‬‬ ‫ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪٣‬ﺏ‪ ٪٩٠ -‬ﻤﻥ ﺍﻟﻤﻭﺍﻗﻊ ﺍﻷﻭﻟﻴﺔ ﻟﺘﻘﺩﻴﻡ‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﺘﻘﺩﻡ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﻔﻌﺎﻟﺔ ﻟﺤـﺎﻻﺕ‬ ‫ﺎ ﺒﻴﻥ‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪.‬‬ ‫‪ -٤‬ﺍﻟﻨﻬﻭﺽ ﺒﺘﺭﺼﺩ ﺍﻹﺼـﺎﺒﺔ ‪٤‬ﺃ‪ -‬ﻋﺩﺩ ﺍﻟﺩﺭﺍﺴﺎﺕ ﺤﻭل ﻤـﺩﻯ ﺍﻻﻨﺘـﺸﺎﺭ ‪٤‬ﺃ‪ -‬ﺩﻭﺭﺘﺎﻥ ﻋﻠﻰ ﺍﻷﻗل ﺒﺤﻠﻭل ‪٢٠١٥‬‬ ‫ﺎ ﻀـﻤﻥ ﺍﻟﺘﻲ ﺘﺘﻡ ﺒﺼﻭﺭﺓ ﻤﻨﺘﻅﻤﺔ ﻋﻠﻰ ﻓﺘﺭﺍﺕ ﻤـﻥ ﻟﺘﺭﺼﺩ ﻤﺩﻯ ﺍﻻﻨﺘﺸﺎﺭ‪.‬‬ ‫ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺴﻴﺎﻕ ﺍﻟﺠﻴل ﺍﻟﺜﺎﻨﻲ ﻤـﻥ ﻋﻤﻠﻴـﺔ ﺜﻼﺙ ﺇﻟﻰ ﺨﻤﺱ ﺴﻨﻭﺍﺕ )ﻓﻲ ﻤﻭﺍﻗﻊ ﺍﻟﺭﺼﺩ‬ ‫ـﺴﻜﺎﻨﻴﺔ‬ ‫ـﺎﺕ ﺍﻟـ‬ ‫ـﻲ ﺍﻟﻤﺠﻤﻭﻋـ‬ ‫ـﺎﻓﺭ ﺃﻭ ﻓـ‬ ‫ﺍﻟﺨـ‬ ‫ﺘﺭﺼﺩ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪.‬‬ ‫ﺍﻟﺨﺎﻓﺭﺓ(‪.‬‬ ‫ـﻲ‬ ‫ـﻼﻍ ﺍﻟﺭﻭﺘﻴﻨـ‬ ‫ـﺎﺀ ﺍﻹﺒـ‬ ‫‪٤‬ﺏ‪ -‬ﻤﻌﺩل ﺍﻟﻭﻗﻭﻋﺎﺕ ﺍﻟﺴﻨﻭﻴﺔ ﺍﻟﺘـﻲ ﻴـﺘﻡ ‪٤‬ﺏ‪ -‬ﺇﺭﺴـ‬ ‫ﺎ ﺒﺤﻠﻭل ﻋـﺎﻡ‬ ‫ﺍﻹﺒﻼﻍ ﻋﻨﻬﺎ ﻟﺤـﺎﻻﺕ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ )ﺘﺒﻠﻴﻎ ﻤﺘﻼﺯﻤﻲ ﺃﻭ ﺍﻓﺘﺭﺍﻀﻲ ﻭﻓﻘـﺎ ‪ ٢٠١٥‬ﻭﻀﻤﺎﻥ ﺍﺴﺘﻤﺭﺍﺭﻫﺎ ﻟﻤﺩﺓ ﻻﺘﻘل‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﻋﻥ ﺨﻤﺴﺔ ﺃﻋﻭﺍﻡ ﻤﺘﻭﺍﺼﻠﺔ‪.‬‬ ‫ﻟﻤﺴﺒﺒﺎﺕ ﺍﻟﻤﺭﺽ(‪.‬‬ ‫ـﺘﺭﺍﺘﻴﺠﻴﺎﺕ ‪ -٣‬ﻨﺴﺒﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻹﻴﺠـﺎﺒﻴﻴﻥ ﻟﻔﻴـﺭﻭﺱ‬ ‫ـﻭﺽ ﺒﺎﺴـ‬ ‫‪ -٣‬ﺍﻟﻨﻬـ‬ ‫ﺎ‬ ‫ـل ﺍﻷﻴﺩﺯ ﻭﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ـﻥ ﺃﺠـ‬ ‫ـﺔ ﻤـ‬ ‫ـﺭﺍﻤﺞ ﺍﻟﻭﻗﺎﻴـ‬ ‫ﻭﺒـ‬ ‫ﺍﻷﺸﺨﺎﺹ ﺍﻹﻴﺠﺎﺒﻴﻴﻥ ﻟﻔﻴـﺭﻭﺱ ﺍﻟﺫﻴﻥ ﻴﺘﻠﻘﻭﻥ ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺸﺎﻤﻠﺔ ﺒﻤﺎ ﻓﻲ ﺫﻟـﻙ‬ ‫ﺍﻟﺘﻭﻋﻴﺔ ﺒﺎﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ ﻭﺇﺒـﻼﻍ‬ ‫ﺍﻷﻴﺩﺯ‪.‬‬ ‫ﺍﻟﺯﻭﺝ‪.‬‬

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‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫)ﺍﻟﺠﺩﻭل ‪ ٣‬ﺘﺎﺒﻊ(‬ ‫ﺍﻷﻫﺩﺍﻑ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ‬ ‫ﺍﻟﻤﺅﺸﺭﺍﺕ‬ ‫ﺍﻷﻭﻟﻭﻴﺔ ‪ ١‬ﺍﻷﻨﺸﻁﺔ‬

‫ـﺄﻤﺭﺍﺽ ‪٥‬ﺃ‪ -‬ﻻ ﻭﺠﻭﺩ ﻟﺤﺎﻻﺕ ﺍﻟﻘﺭﻴﺢ ﺒﺤﻠـﻭل‬ ‫ـﺎﺒﺔ ﺒـ‬ ‫ـﺎﻻﺕ ﺍﻹﺼـ‬ ‫ـﺴﺒﺔ ﺤـ‬ ‫‪ -٥‬ﻤﻜﺎﻓﺤﺔ ﺃﻤﺭﺍﺽ ﺍﻟﻘﺭﺤـﺎﺕ ‪٥‬ﺃ‪ -‬ﻨـ‬ ‫ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ ﺍﻟﺒﻜﺘﻴﺭﻴﺔ ﺍﻟﻤﺅﻜـﺩﺓ ﺒـﻴﻥ ﻋﺎﻡ ‪ ٢٠١٥‬ﻀﻤﻥ ﺤﺎﻻﺕ ﺍﻹﺼـﺎﺒﺔ‬ ‫ﺍﻟﺘﻨﺎﺴﻠﻴﺔ‪.‬‬ ‫ﺒﺄﻤﺭﺍﺽ ﺍﻟﻘﺭﺤﺎﺕ ﺍﻟﺘﻨﺎﺴﻠﻴﺔ‪.‬‬ ‫ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ‪.‬‬ ‫‪٥‬ﺏ‪ -‬ﻨﺴﺒﺔ ﺍﻟﺤﻭﺍﻤل ﻤﻤﻥ ﺘﺘﺭﺍﻭﺡ ﺃﻋﻤﺎﺭﻫﻥ ‪٥‬ﺏ‪ -‬ﺍﻨﺨﻔﺎﺽ ﺍﻟﻨﺴﺒﺔ ﺍﻟﻤﺌﻭﻴﺔ ﺇﻟﻰ ﺃﻗل‬ ‫ﺒﻴﻥ ‪ ١٥‬ﻭ‪ ٢٤‬ﻋﺎﻤﺎ ﺍﻟﻼﺌـﻲ ﻴـﺫﻫﺒﻥ ﺇﻟـﻰ ﻤﻥ ‪ ٪٢‬ﻟﻠﺤﺎﻻﺕ ﺍﻹﻴﺠﺎﺒﻴـﺔ ﺍﻟﻤـﺼل‬ ‫ﻋﻴﺎﺩﺍﺕ ﺍﻟﺭﻋﺎﻴﺔ ﺃﺜﻨﺎﺀ ﺍﻟﺤﻤل ﻭﻫﻥ ﺇﻴﺠﺎﺒﻴﺎﺕ ﻟﻠﺯﻫﺭﻱ ﺒﻴﻥ ﻤﻥ ﻴﻨﺸﺩﻥ ﺍﻟﺭﻋﺎﻴﺔ ﺃﺜﻨﺎﺀ‬ ‫ﺍﻟﺤﻤل ﻭﺘﺘﺭﺍﻭﺡ ﺃﻋﻤـﺎﺭﻫﻥ ﺒـﻴﻥ ‪١٥‬‬ ‫ﺍﻟﻤﺼل ﻟﻠﺯﻫﺭﻱ‪.‬‬ ‫ﻭ‪ ٢٤‬ﻋﺎﻤﺎ‪.‬‬

‫ﺍﻷﻫﺩﺍﻑ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ‬ ‫‪٦‬ﺃ‪ -‬ﺒﺤﻠﻭل ﻋﺎﻡ ‪ ،٢٠١٠‬ﺍﻻﻨﺘﻬﺎﺀ ﻤﻥ‬ ‫ـﺴﻴﺎﺴﺎﺕ‬ ‫ـﺎﺕ ﻭﺍﻟـ‬ ‫ـﺔ ﺍﻻﺤﺘﻴﺎﺠـ‬ ‫ﻤﺭﺍﺠﻌـ‬ ‫ﻭﺍﻟﺘﺸﺭﻴﻌﺎﺕ ﻭﺍﻟﺘﻨﻅﻴﻤـﺎﺕ ﺍﻟـﺼﺤﻴﺔ‪،‬‬ ‫ﻭﻭﻀﻊ ﺍﻟﺨﻁﻁ ﺍﻟﻌﻤﻠﻴﺔ ﻓﻲ ﻨـﺼﺎﺒﻬﺎ‪،‬‬ ‫ﻭﺘﻨﻔﻴﺫ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﺨﺘﺎﺭﺓ ﻭﺍﻟﻤﻭﺠﻬـﺔ‬ ‫ﻟﻜل ﺒﻠﺩ ﻋﻠﻰ ﺤﺩﺓ‪.‬‬

‫ﺍﻟﻤﺅﺸﺭﺍﺕ‬ ‫‪٦‬ﺃ‪ -‬ﺍﻻﻨﺘﻬﺎﺀ ﻤﻥ ﻭﻀﻊ ﻭﺘﻨﻔﻴﺫ ﺍﻹﺠـﺭﺍﺀﺍﺕ‬ ‫ـﺼﺤﻴﺔ‬ ‫ـﺎﺕ ﺍﻟـ‬ ‫ـﺩ ﺍﻻﺤﺘﻴﺎﺠـ‬ ‫ـﺔ ﺒﺘﺤﺩﻴـ‬ ‫ﺍﻟﺨﺎﺼـ‬ ‫ﻭﺍﻟﺨﻁﻁ ﺍﻟﻭﻁﻨﻴﺔ ﻤﻥ ﺃﺠل ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ‬ ‫ﺎ ﺒﻤﺎ ﻓﻴﻬﺎ ﺍﻟﻌـﺩﻭﻯ ﺒﻔﻴـﺭﻭﺱ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻷﻴﺩﺯ‪ ،‬ﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﺴﻜﺎﻥ ﺍﻟﻤﻌﺭﻀﻴﻥ ﺒﺼﻭﺭﺓ‬ ‫ﺭﺌﻴﺴﻴﺔ ﻟﻤﺨﺎﻁﺭ ﺍﻹﺼﺎﺒﺔ ﺒﻬﺫﻩ ﺍﻷﻤـﺭﺍﺽ‬ ‫ﻭﺍﻟﻤﺴﺘﻀﻌﻔﻴﻥ ﻤﻨﻬﻡ‪.‬‬

‫ﺍﻷﻭﻟﻭﻴﺔ ‪ ٢‬ﺍﻷﻨﺸﻁﺔ‬ ‫ـﺎﺡ‪.‬‬ ‫ـﻥ ﺍﻟﻨﺠـ‬ ‫ـﻼﻕ ﻤـ‬ ‫‪ -٦‬ﺍﻻﻨﻁـ‬ ‫ـﻲ‬ ‫ـﺴﺘﻬﺩﻓﺔ ﻓـ‬ ‫ـﺩﺨﻼﺕ ﺍﻟﻤـ‬ ‫ﺍﻟﺘـ‬ ‫ـﺔ‬ ‫ـﺴﻜﺎﻨﻴﺔ ﻋﺎﻟﻴـ‬ ‫ـﺎﺕ ﺍﻟـ‬ ‫ﺍﻟﺘﺠﻤﻌـ‬ ‫ـﺔ‬ ‫ـﺭ ﻋﺭﻀـ‬ ‫ـﺎﺭ ﻭﺍﻷﻜﺜـ‬ ‫ﺍﻻﺨﺘﻁـ‬ ‫ﻟﻺﺼﺎﺒﺔ‪.‬‬

‫‪٦‬ﺏ‪ -‬ﻨﺴﺒﺔ ﺍﻟﺸﺒﺎﺏ )ﻓﻴﻤـﺎ ﺒـﻴﻥ ‪ ١٥‬ﻭ‪٦ ٢٤‬ﺏ‪ -‬ﺒﺤﻠﻭل ﻋﺎﻡ ‪ ٢٠١٥‬ﻴﻜﻭﻥ ﻗـﺩ‬ ‫ﺎ ﺃﺠﺭﻱ ﺩﻭﺭﺘﻴﻥ ﻋﻠﻰ ﺍﻷﻗـل ﻟﺘﺭﺼـﺩ‬ ‫ﻋﺎﻤﺎ( ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻭﺍﻟﺫﻴﻥ ﺘﻡ ﺍﻜﺘﺸﺎﻓﻬﻡ ﻋﻨﺩ ﺇﺠﺭﺍﺀ ﺍﻟﻔﺤﻭﺼـﺎﺕ ﻤﺩﻯ ﺍﻻﻨﺘﺸﺎﺭ ﺒﻴﻥ ﺍﻟﻤﺠﻤﻭﻋـﺎﺕ ﺫﺍﺕ‬ ‫ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﻟﺘﺤﺭﻱ ﺍﻹﺼﺎﺒﺔ ﺒﻬﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ‪ .‬ﺍﻟﺴﻠﻭﻜﻴﺎﺕ ﻋﺎﻟﻴـﺔ ﺍﻻﺨﺘﻁـﺎﺭ ﻭﺒـﻴﻥ‬ ‫ﺍﻟﺸﺒﺎﺏ‪.‬‬ ‫‪٧‬ﺃ‪ -‬ﺒﺤﻠﻭل ﻋﺎﻡ ‪ ٢٠٠٧‬ﻴﻜﻭﻥ ﻗﺩ ﺘـﻡ‬ ‫ﺍﺴﺘﻌﺭﺍﺽ ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺇﻋﺩﺍﺩ ﺍﻟﻤـﻭﺍﺩ‬ ‫ﺍﻹﻋﻼﻤﻴﺔ ﻭﺍﻟﺘﺩﺭﻴﺒﻴﺔ ﺒﻤﺎ ﻴﺘﻼﺀﻡ ﻭﺍﻟﻔﺌﺔ‬ ‫ﺍﻟﻌﻤﺭﻴﺔ ﻓﻲ ﺍﻟﻤﺩﺍﺭﺱ‪.‬‬ ‫‪٧‬ﺏ‪ -‬ﺒﺤﻠﻭل ﻋﺎﻡ ‪ ٢٠١٥‬ﺘﻜﻭﻥ ﻫﻨﺎﻙ‬ ‫ﺯﻴﺎﺩﺓ ﻓﻲ ﻋﺩﺩ ﺍﻟﻤﻌﻠﻤـﻴﻥ ﺍﻟﻤـﺩﺭﺒﻴﻥ‬ ‫ﺍﻟﻤﻨﺨﺭﻁﻴﻥ ﻓﻲ ﻤﺠﺎل ﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﻤﺒﻨﻲ‬ ‫ﻋﻠﻰ ﺍﻟﻤﻬﺎﺭﺍﺕ ﺍﻟﺤﻴﺎﺘﻴﺔ ﻟﻠﻭﻗﺎﻴـﺔ ﻤـﻥ‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴـﺭﻭﺱ ﺍﻷﻴـﺩﺯ‪ ،‬ﻭﺴـﺎﺌﺭ‬ ‫ﺎ‪.‬‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ـﻑ ﺍﻟـ‬ ‫ـﺫ ﺍﻟﺘﺜﻘﻴـ‬ ‫‪ -٧‬ﺘﻨﻔﻴـ‬ ‫ـﺸﺎﻤل ‪ -٧‬ﻨﺴﺒﺔ ﺍﻟﻤﺩﺍﺭﺱ ﺍﻟﺘﻲ ﻴﻌﻤل ﺒﻬﺎ ﻤـﺩﺭﺱ‬ ‫ﻭﺒﺎﻟﺨـﺩﻤﺎﺕ‬ ‫ﺍﻟﺠﻨـﺴﻴﺔ‬ ‫ﺒﺎﻟﺼﺤﺔ‬ ‫ﻭﺍﺤﺩ ﻋﻠﻰ ﺍﻷﻗل ﻴﻤﻜﻨﻪ ﺘﻘﺩﻴﻡ ﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﻭﻗﺎﺌﻲ‬ ‫ﺍﻟﺼﺤﻴﺔ ﺤﺴﺏ ﻤﺎ ﻴﺘﻼﺀﻡ ﻭﺍﻟﻔﺌـﺔ ﺍﻟﻤﺒﻨﻲ ﻋﻠﻰ ﺍﻟﻤﻬﺎﺭﺍﺕ ﺍﻟﺤﻴﺎﺘﻴﺔ ﻤـﻥ ﺃﺠـل‬ ‫ﺍﻟﻌﻤﺭﻴﺔ‪.‬‬ ‫ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ‪.‬‬ ‫ﺠﻨﺴﻴﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫)ﺍﻟﺠﺩﻭل ‪ ٣‬ﺘﺎﺒﻊ(‬ ‫ﺍﻷﻫﺩﺍﻑ ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ‬ ‫ﺍﻟﻤﺅﺸﺭﺍﺕ‬ ‫ﺍﻷﻭﻟﻭﻴﺔ ‪ ٢‬ﺍﻷﻨﺸﻁﺔ‬

‫ـﺯﻭﺝ ‪٨‬ﺃ‪ -‬ﻨﺴﺒﺔ ﺍﻟﻤﺭﻀـﻰ ﺒﺎﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ‪٨‬ﺃ‪ -‬ﺍﻻﻨﺘﻬﺎﺀ ﻤـﻥ ﺇﻋـﺩﺍﺩ ﺍﻟﺨﻁـﻁ‬ ‫ـﺔ ﺍﻟـ‬ ‫ـﺴﻴﻥ ﻤﻌﺎﻟﺠـ‬ ‫‪ -٨‬ﺘﺤـ‬ ‫ﻭﺍﻟﻤﻭﺍﺩ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﺩﻋﻡ ﻤﻥ ﺃﺠل ﺇﺒﻼﻍ‬ ‫ﺎ ﺍﻟﺫﻴﻥ ﺘﻡ ﺇﺤﺎﻟﺔ ﺃﺯﻭﺍﺠﻬﻡ ﻟﻠﻤﻌﺎﻟﺠﺔ‪.‬‬ ‫ﻭﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﻤﻌـﺎﻭﺩﺓ ﺍﻹﺼـﺎﺒﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺯﻭﺝ‪ ،‬ﻭﺇﺭﺴﺎﺀ ﺃﺴﺱ ﺘﻠﻘـﻲ ﻤﻘـﺩﻤﻲ‬ ‫ﺒﺎﻟﻌﺩﻭﻯ‪.‬‬ ‫ﺍﻟﺭﻋﺎﻴﺔ ﺍﻟﺼﺤﻴﺔ ﻋﻠﻰ ﺍﻟﺘﺩﺭﻴﺏ ﻭﺫﻟـﻙ‬ ‫ﺒﺤﻠﻭل ﻋﺎﻡ ‪.٢٠١٠‬‬ ‫‪٨‬ﺏ‪ -‬ﻤﻀﺎﻋﻔﺔ ﻨﺴﺒﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ‬ ‫ﻴﺼﻁﺤﺒﻭﻥ ﺃﺯﻭﺍﺠﻬﻡ ﻟﻠﻤﻌﺎﻟﺠﺔ‪.‬‬ ‫‪٩‬ﺃ‪ -‬ﺍﻟﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﺨﻁﻁ ﺍﻟﺨﺎﺼﺔ ﺒـﺎﻟﺘﻁﻌﻴﻡ ‪٩‬ﺃ‪ -‬ﺍﻻﻨﺘﻬﺎﺀ ﻤﻥ ﻭﻀﻊ ﺍﻟﺨﻁﻁ ﺍﻟﻌﻤﻠﻴﺔ‬ ‫ﻓﻲ ﻨﺼﺎﺒﻬﺎ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻟﺘﻁﻌﻴﻡ ﻀﺩ‬ ‫ﺍﻟﻌﺎﻟﻤﻲ ﻀﺩ ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩﻱ ﺍﻟﺒﺎﺌﻲ‪.‬‬ ‫ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﻜﺒـﺩﻱ ﺍﻟﺒـﺎﺌﻲ ﻭﺍﻟﺘﻁﻌـﻴﻡ‬ ‫ﺍﻟﻤﻀﺎﺩ ﻟﻔﻴـﺭﻭﺱ ﺍﻟـﻭﺭﻡ ﺍﻟﺤﻠﻴﻤـﻲ‬ ‫ﺍﻟﺒﺸﺭﻱ ﻭﺫﻟﻙ ﺒﺤﻠﻭل ﻋﺎﻡ ‪.٢٠٠٨‬‬ ‫ـﻭﻥ‬ ‫ـﺎﻡ ‪ ٢٠١٠‬ﺘﻜـ‬ ‫ـﻭل ﻋـ‬ ‫‪٩‬ﺏ‪ -‬ﻤﺭﺍﺠﻌــﺔ ﺍﻟﺨﻁــﻁ ﻭﺍﻟــﺴﻴﺎﺴﺎﺕ ‪٩‬ﺏ‪ -‬ﺒﺤﻠـ‬ ‫ﻭﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﺨﺎﺼـﺔ ﺒﺎﻻﻨﺘﻬـﺎﺀ ﻤـﻥ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻻﺭﺘﻴﺎﺩﻴﺔ ﻟﻠﺘﻁﻌﻴﻤﺎﺕ ﻗﺩ ﺒﺩﺃﺕ‬ ‫ﺍﻟﺘﻁﻌﻴﻡ ﺍﻟﻤﻀﺎﺩ ﻟﻔﻴﺭﻭﺱ ﺍﻟـﻭﺭﻡ ﺍﻟﺤﻠﻴﻤـﻲ ﻭﺠﺎﺭﻱ ﺍﻟﻌﻤل ﻋﻠﻰ ﺍﻟﻨﻬﻭﺽ ﺒﻬﺎ‪.‬‬ ‫ﺍﻟﺒﺸﺭﻱ ﻭﺍﻟﺘﻁﻌﻴﻡ ﺍﻟﻤﻤﻜﻥ ﺍﻟﻤﻀﺎﺩ ﻟﻔﻴـﺭﻭﺱ‬ ‫ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ‪.‬‬ ‫‪١٠‬ﺃ‪ -‬ﺘﻭﺍﻓﺭ ﺍﻟﻔﺤﺹ ﺍﻟﻁﻭﻋﻲ ﻟﻠﻜﺸﻑ‬ ‫ﻋﻥ ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺘﻘـﺩﻴﻡ‬ ‫ﺍﻟﺘﻭﻋﻴﺔ ﻓﻲ ﺠﻤﻴﻊ ﺍﻟﻤﻨﺎﻁﻕ ﺍﻟﺘﻲ ﺘﻘـﺩﻡ‬ ‫ﻓﻴﻬﺎ ﺍﻟﺭﻋﺎﻴـﺔ ﻟﻠﻤـﺼﺎﺒﻴﻥ ﺒﺎﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ ﻭﺫﻟـﻙ ﺒﺤﻠـﻭل ﻋـﺎﻡ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪.٢٠١٥‬‬ ‫ـﻰ‬ ‫ـﺴﺒﺔ ﺍﻟﻤﺭﻀـ‬ ‫‪١٠‬ﺏ‪ -‬ﻤـﻀﺎﻋﻔﺔ ﻨـ‬ ‫ﺎ ﺍﻟﺫﻴﻥ ﻴﺘﻠﻘﻭﻥ‬ ‫ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺘﻭﻋﻴﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ ﻭﺘﺘﻭﺍﻓﺭ ﻟﻬـﻡ‬ ‫ﺴﺒل ﺇﺠﺭﺍﺀ ﺍﻟﻔﺤﻭﺼـﺎﺕ ﺍﻟﻁﻭﻋﻴـﺔ‬ ‫ﻟﻠﻜﺸﻑ ﻋﻥ ﺍﻹﺼﺎﺒﺔ ﺒﻪ‪.‬‬ ‫‪ -١٠‬ﻨﺴﺒﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﺫﻴﻥ ﻴﺘﻡ ﺘﻘﻴﻴﻤﻬﻡ ﻤـﻥ‬ ‫ﺃﺠل ﺍﻟﻜﺸﻑ ﻋﻥ ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ‬ ‫ﺎ ﻭﺍﻟﺫﻴﻥ ﻴﺘﻠﻘﻭﻥ ﺍﻟﺘﻭﻋﻴﺔ ﻭﻴﺘﻭﻓﺭ ﻟﻬـﻡ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺇﺠﺭﺍﺀ ﺍﻟﻔﺤﻭﺼﺎﺕ ﺍﻟﻤﺤﺎﻁﺔ ﺒﺎﻟﺴﺭﻴﺔ ﻟﻠﻜﺸﻑ‬ ‫ﻋﻥ ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‪.‬‬ ‫ـﺫ‬ ‫ـﺩﺍﺩ ﻭﺘﻨﻔﻴـ‬ ‫ـﺴﻬﻴل ﺇﻋـ‬ ‫‪ -١٠‬ﺘـ‬ ‫ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﻌﺎﻟﻤﻴﺔ ﺍﻟﺘﻲ ﺘﻌﻤـل‬ ‫ﻋﻠﻰ ﺯﻴﺎﺩﺓ ﻨﺴﺒﺔ ﺘﻠﻘـﻲ ﺍﻟﺘﻭﻋﻴـﺔ‬ ‫ﻭﺇﺠﺭﺍﺀ ﺍﻟﻔﺤﻭﺼـﺎﺕ ﺍﻟﻁﻭﻋﻴـﺔ‬ ‫ﻟﻠﻤﺼﺎﺒﻴﻥ ﺒﻌﺩﻭﻯ ﻓﻴﺭﻭﺱ ﺍﻷﻴﺩﺯ‬ ‫ﻤﻥ ﺒـﻴﻥ ﺍﻟﻤـﺼﺎﺒﻴﻥ ﺒﺎﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ‪.‬‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪ -٩‬ﺩﻋﻡ ﺍﻟﺘﻭﺴﻊ ﻓـﻲ ﺍﻟﻠﻘﺎﺤـﺎﺕ‬ ‫ﺍﻟﻔﻌﺎﻟﺔ )ﺍﻟﺘﻁﻌﻴﻡ ﺍﻟﻔﻌـﺎل( )ﻀـﺩ‬ ‫ﺍﻻﻟﺘﻬﺎﺏ ﺍﻟﻜﺒﺩﻱ ﺍﻟﺒـﺎﺌﻲ‪ ،‬ﻭﻀـﺩ‬ ‫ﻓﻴﺭﻭﺱ ﺍﻟﻭﺭﻡ ﺍﻟﺤﻠﻴﻤﻲ ﺍﻟﺒـﺸﺭﻱ‪،‬‬ ‫ﻭﻀﺩ ﻓﻴﺭﻭﺱ ﺍﻟﻬﺭﺒﺱ ﺍﻟﺒﺴﻴﻁ(‪.‬‬

‫ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺭﺼﺩ ﻭﺠﻤﻊ ﺍﻟﻤﻌﻁﻴﺎﺕ‬

‫‪٤-٦-٣‬‬

‫ﻴﺘﻌﻴﻥ ﺃﻥ ﻴﻜﻭﻥ ﻟﺩﻯ ﺍﻟﺒﻠﺩﺍﻥ ﻤﻌﻠﻭﻤﺎﺕ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺘﻡ ﺍﻟﺤﺼﻭل ﻋﻠﻴﻬﺎ ﻤﻥ ﺨﻼل ﺘﻘﺩﻴﺭ ﺍﻟﻤﻭﻗﻑ ﺍﻟﺨـﺎﺹ‬ ‫ﺎ ﻭﺍﻟﺘﺼﺩﻱ ﻟﻌﺏﺀ ﻫﺫﻩ ﺍﻷﻤﺭﺍﺽ ﻭﺍﻻﺤﺘﻴﺎﺠﺎﺕ ﺍﻟﻤﻁﻠﻭﺒﺔ‪ .‬ﻭﺇﻥ ﺘﻭﻓﺭ ﻤﻌﻠﻭﻤﺎﺕ ﺩﻗﻴﻘﺔ ﻤﻥ‬ ‫ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺸﺄﻨﻪ ﺃﻥ ﻴﻌﻴﻥ ﻋﻠﻰ ﻋﻤل ﺍﻟﺘﺨﻁﻴﻁ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻲ ﻭﻴﻭﻓﺭ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﺘﻭﻋﻴﺔ ﻭﺘﺤﺩﻴﺩ ﺍﻷﻭﻟﻭﻴﺎﺕ ﺍﻟﻤﺭﺘﺒﻁﺔ‬ ‫ﺒﺎﻟﺘﺩﺨﻼﺕ‪ .‬ﻭﺤﻴﺙ ﺃﺼﺒﺢ ﺍﻟﺠﻴل ﺍﻟﺜﺎﻨﻲ ﻤﻥ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺭﺼﺩ ﺍﻟﺨﺎﺼﺔ ﺒﻔﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ ﺍﻟﻤﻨـﺎﻋﻲ ﺍﻟﺒـﺸﺭﻱ‬ ‫ﺎ‪ ،‬ﺴﻬل ﺍﻟﺘﻨﻔﻴﺫ ﺒﺸﻜل ﻤﺘﺯﺍﻴﺩ‪ ،‬ﻓﻴﻨﺒﻐﻲ ﻋﻠﻰ ﺍﻟﺒﻠﺩﺍﻥ ﻭﻀﻊ ﻨﻅﺎﻡ ﻟﻠﺘﺭﺼﺩ ﻴﺸﻤل ﺍﻟﺴﻠﻭﻜﻴﺎﺕ‬ ‫ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﻟﻤﺤﻔﻭﻓﺔ ﺒﺎﻟﻤﺨﺎﻁﺭ‪ .‬ﻭﻴﺠﺏ ﺘﺠﻤﻴﻊ ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﻭﺍﻟﻤﻌﻁﻴﺎﺕ ﻤﻥ ﻓﺌﺎﺕ ﺴﻜﺎﻨﻴﺔ ﻤﺨﺘﻠﻔﺔ ﺒﻤﻥ ﻓﻴﻬﻡ ﺍﻟﻤﺭﺍﻫﻘﻭﻥ ﺩﺍﺨـل‬ ‫ﻭﺨﺎﺭﺝ ﺍﻟﻤﺩﺍﺭﺱ ﻭﻜﺫﻟﻙ ﻤﻥ ﺍﻟﻌﺎﻤﻠﻴﻥ ﻓﻲ ﺠﻬﺎﺯﻱ ﺍﻟﺸﺭﻁﺔ ﻭﺍﻟﺠﻴﺵ‪.‬‬ ‫ﺃﺴﻠﻭﺏ ﺍﻟﺘﻨﻔﻴﺫ ﺍﻟﻤﺘﻜﺎﻤل‪ :‬ﺍﻟﻤﺴﺅﻭﻟﻴﺎﺕ ﺍﻟﻤﺸﺘﺭﻜﺔ‬ ‫‪٥-٦-٣‬‬

‫ﻟﻜﻲ ﻴﻤﻜﻥ ﺍﻹﺴﺭﺍﻉ ﺒﻭﺘﻴﺭﺓ ﻭﺼﻭل ﺍﻷﺸﺨﺎﺹ ﺇﻟﻰ ﺍﻟﺨﺩﻤﺎﺕ ﻭﺤﺼﻭﻟﻬﻡ ﻋﻠﻴﻬﺎ‪ ،‬ﻓﻤﻥ ﺍﻟﻀﺭﻭﺭﻱ ﺘﻀﺎﻓﺭ‬ ‫ﺃﻨﺸﻁﺔ ﺍﻟﺘﻨﻔﻴﺫ ﻤﻥ ﻗﺒل ﺍﻷﺠﻬﺯﺓ ﺍﻟﻤﺨﺘﻠﻔﺔ ﻋﻠﻰ ﻜﺎﻓﺔ ﻤﺴﺘﻭﻴﺎﺕ ﺍﻟﻨﻅﺎﻡ ﺍﻟﺼﺤﻲ‪ .‬ﻭﻴﻠﺨﺹ ﺍﻟﺠـﺩﻭل ﺭﻗـﻡ ‪ ٤‬ﺃﻫـﻡ‬ ‫ﺍﻷﻨﺸﻁﺔ ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺍﻟﻘﻴﺎﻡ ﺒﻬﺎ ﺒﺸﻜل ﻤﺘﻀﺎﻓﺭ ﻓﻲ ﻤﺎ ﺒﻴﻥ ﺒﺭﺍﻤﺞ ﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤـﺼﺎﺒﻴﻥ ﺒﻔﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ‬ ‫ﺎ‪ ،‬ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ ﻤﻥ ﺠﻬﺔ‪ ،‬ﻭﻭﺯﺍﺭﺍﺕ ﺍﻟﺘﻌﻠﻴﻡ ﻭﺍﻟﻌﻤل ﻤـﻥ ﺠﻬـﺔ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ‪ /‬ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺃﺨﺭﻯ‪ .‬ﻭﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ‪ ،‬ﻴﻤﻜﻥ ﺘﻌﻴـﻴﻥ ﻋﺩﺩ ﻤﻥ ﻤﻨﻔﺫﻱ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺼﺤﻴﺔ‪ ،‬ﻀﻤﻥ ﻫﺫﺍ ﺍﻷﺴﻠﻭﺏ‪ ،‬ﻟﻠﻭﻗﺎﻴﺔ‬ ‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪ ،‬ﻤﻊ ﺇﺠﺭﺍﺀ ﺍﻟﺘﻌﺩﻴل ﻭﺍﻟﺘﻜﻴـﻴﻑ ﺍﻟﻤﻼﺌﻡ ﻟﻠﻅﺭﻭﻑ ﺍﻟﻤﺤﻠﻴﺔ‪ .‬ﻭﻗﺩ ﻴﺸﻤل ﺫﻟﻙ‬ ‫ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻓﺌﺎﺕ ﺍﻟﻨﺴﺎﺀ ﻭﺍﻻﺘﺤﺎﺩﺍﺕ ﺍﻟﻤﺠﺘﻤﻌﻴﺔ ﻭﺍﻟﻤﺅﺴﺴﺎﺕ ﺍﻟﺩﻴﻨﻴﺔ‪.‬‬

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‫‪A59/11‬‬

‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺎ‬ ‫ﺍﻟﺠﺩﻭل ﺭﻗﻡ ‪ – ٤‬ﺩﻟﻴل ﻟﺘﻨﻔﻴﺫ ﺍﻟﺘﺩﺨﻼﺕ ﺒﺸﻜل ﻤﺘﻀﺎﻓﺭ – ﻟﻠﻭﻗﺎﻴـﺔ ﻤـﻥ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴ ﹰ‬ ‫ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‪.‬‬ ‫ﺍﻷﻨﺸﻁﺔ ﺍﻟﻤﺘﻀﺎﻓﺭﺓ‬ ‫ﺎ ﻷﻭﻟﻭﻴﺎﺘﻬﺎ‬ ‫ﺍﻷﻨﺸﻁﺔ ﺍﻷﺴﺎﺴﻴﺔ ﺍﻷﻭﻟﻴﺔ‪ ،‬ﻭﻓﻘ ﹰ‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬

‫ﺍﻟﺒﺭﻨﺎﻤﺞ‬

‫ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴـﺭﻭﺱ ﺍﻟﻌـﻭﺯ ﺍﻟﻤﻨـﺎﻋﻲ ﺍﻟﺒـﺸﺭﻱ • ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ‬ ‫• ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ ﻟﻠﻭﻗﺎﻴﺔ‬ ‫ﺎ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻩ‬ ‫ﻭﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻤﻥ ﺍﻹﺼﺎﺒﺔ ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ‬ ‫ﺘﻌﺯﻴﺯ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ‬ ‫ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﺍﻟﻌﺩﺍﻭﻯ‬ ‫ﺍﻟﻭﻗﺎﻴﺔ ﺍﻹﻴﺠﺎﺒﻴﺔ‬ ‫ﺎ ﻭﺭﻋﺎﻴـﺔ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻻﺨﺘﺒﺎﺭ ﺍﻟﻁﻭﻋﻲ‬ ‫ﻤﺭﻀﺎﻫﺎ‬ ‫ﺍﻟﺠﻴل ﺍﻟﺜﺎﻨﻲ ﻤﻥ ﺇﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺭﺼﺩ ﻤﻊ ﺍﺴـﺘﺨﺩﺍﻡ ﻤﺅﺸـﺭﺍﺕ‬ ‫ـﺩﺒﻴﺭ‬ ‫ـﺘﺨﺩﺍﻡ ﺍﻟﺘـ‬ ‫ـﺸﺠﻴﻊ ﺍﺴـ‬ ‫• ﺘـ‬ ‫ﺎ‬ ‫ﺍﻹﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﻌﻼﺠﻲ ﻟﻠﻤﺘﻼﺯﻤﺎﺕ‬ ‫ﺍﻟﺭﺼﺩ ﻭﺍﻟﺘﻘﻴـﻴﻡ‬ ‫ﺍﻟﺒﺤﺙ ﺍﻟﻤﻴﺩﺍﻨﻲ‬ ‫ـﻥ‬ ‫ـﺔ ﻤـ‬ ‫ـﺭﺍﺀﺍﺕ ﺍﻟﻭﻗﺎﻴـ‬ ‫ﺇﺠـ‬ ‫ﺎ ﺒﻴﻥ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻷﺸــﺨﺎﺹ ﺍﻟﻤــﺼﺎﺒﻴﻥ‬ ‫ﺒﻔﻴﺭﻭﺱ ﺍﻟﻌـﻭﺯ ﺍﻟﻤﻨـﺎﻋﻲ‬ ‫ﺍﻟﺒﺸﺭﻱ‬ ‫ﺘﺤﺭﻱ ﺩﺍﺀ ﺍﻟﺯﻫﺭﻱ ﺃﺜﻨـﺎﺀ‬ ‫ﺭﻋﺎﻴﺔ ﺍﻟﺤﻤل‬ ‫ﺍﻟﺠﻴل ﺍﻟﺜـﺎﻨﻲ ﻹﺠـﺭﺍﺀﺍﺕ‬ ‫ﺍﻟﺘﺭﺼﺩ‬ ‫ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻻﺨﺘﺒﺎﺭ ﺍﻟﻁﻭﻋﻲ‬ ‫ـﺔ‬ ‫ـﺩﻤﺎﺕ ﺭﻋﺎﻴـ‬ ‫ـﻤﻥ ﺨـ‬ ‫ﻀـ‬ ‫ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ‪.‬‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺩﻻﺌل ﺍﻹﺭﺸﺎﺩﻴﺔ‪ ،‬ﺘﻁﻭﻴﺭ ﻭﺘﻜﺎﻤل ﺍﻟﻤﻨﺎﻫﺞ ﺍﻟﺩﺭﺍﺴﻴﺔ‪ ،‬ﺍﻟﺘﺩﺭﻴﺏ‬ ‫ﻭﻀﻤﺎﻥ ﺍﻟﺠﻭﺩﺓ‬ ‫ﺎ ﻓـﻲ‬ ‫ﺍﻟﺘﺩﺒﻴﺭ ﺍﻟﻌﻼﺠﻲ ﻟﻠﻤﺘﻼﺯﻤﺎﺕ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻋﻴﺎﺩﺍﺕ ﺘﻘﺩﻴﻡ ﺨﺩﻤﺎﺕ ﺭﻋﺎﻴـﺔ ﺍﻟﻤﺭﻀـﻰ ﺍﻟﻤـﺼﺎﺒﻴﻥ ﺒﻬـﺫﻩ‬ ‫ﺍﻷﻤﺭﺍﺽ‬ ‫•‬ ‫ﺩﻟﻴل ﻭﺨﻁﺔ ﻤﻌﺎﻟﺠﺔ ﺍﻟﺯﻭﺝ‬ ‫ﺘﻌﺯﻴﺯ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﻭﺍﺯل ﺍﻟﺫﻜﺭﻴﺔ‬ ‫•‬ ‫ﺎ‬ ‫ﺘﺭﺼﺩ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‬ ‫ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﺴﺘﻬﺩﻓﺔ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫•‬ ‫ﻭﻤﻜﺎﻓﺤﺘﻬﺎ‬ ‫ﺍﻟﺭﺼﺩ ﻭﺍﻟﺘﻘﻴـﻴﻡ‬ ‫ﺽ(‬ ‫‪‬ﻡ‪ ،‬ﺜـﻡ ﺍﻨﻬـ ﹺ‬ ‫ﱢﺫ‪ ،‬ﻗـﻴ‬ ‫ﱢﻁ‪ ،‬ﻨﻔ‬ ‫ﺍﻟﺒﺤﺙ ﺍﻟﻤﻴﺩﺍﻨﻲ ﻭﺍﻟﺩﺍﺌﺭﺓ ) ﺨﻁ‬ ‫)‪(PDAS‬‬ ‫•‬

‫ﺍﻷﻴﺩﺯ ﻭﺍﻟﻌﺩﻭﻯ‬ ‫ﺒﻔﻴﺭﻭﺴﻪ‬

‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬ ‫•‬

‫ﺒﺭﻨﺎﻤﺞ ﺍﻟﻌﺩﺍﻭﻯ‬ ‫ﺎ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴ ﹰ‬

‫• ﺍﻟﺘﻭﻋﻴﺔ ﻭﺍﻟﺘﺜﻘﻴﻑ ﺍﻟﺸﺎﻤل ﺤﻭل ﺍﻟـﺼﺤﺔ ﺍﻟﺠﻨـﺴﻴﺔ ﻭﺘﻘـﺩﻴﻡ • ﻤﺭﺍﻜﺯ ﺍﻟﺼﺤﺔ ﺍﻟﻤﺩﺭﺴـﻴﺔ‬ ‫ﺍ‬ ‫ﺤﺴﺏ ﻤـﺎ ﻜـﺎﻥ ﻤﺘﻴـﺴﺭﹰ‬ ‫ﺍﻟﺨﺩﻤﺎﺕ ﺍﻟﺨﺎﺼﺔ ﺒﻬﺎ ﺤﺴﺏ ﻤﺎ ﻴﺘﻨﺎﺴﺏ ﻤﻊ ﺍﻟﻔﺌﺔ ﺍﻟﻌﻤﺭﻴﺔ‪ ،‬ﺒﻤﺎ‬ ‫ﺎ‬ ‫ﻭﻤﺠﺩﻴﹰ‬ ‫ﻓﻲ ﺫﻟﻙ ﺇﻨﺘﺎﺝ ﺍﻟﻤﻭﺍﺩ ﺍﻹﻋﻼﻤﻴﺔ ﺒﺎﻟﻠﻐﺎﺕ ﺍﻟﻤﺤﻠﻴﺔ‬ ‫• ﺍﻟﺘﺩﺨﻼﺕ ﻓﻲ ﻤﻭﺍﻗﻊ ﺍﻟﻌﻤل ﻤـﻊ ﺘﻌﻠـﻴﻡ ﺍﻟـﺯﻤﻼﺀ ﻭﺘـﻭﻓﻴﺭ • ﺍﻟﻌﻴـﺎﺩﺍﺕ ﺍﻟـﺼﺤﻴﺔ ﺍﻟﺘـﻲ‬ ‫ـﺎﺕ‬ ‫ـﺎ ﺍﻹﻤﻜﺎﻨـ‬ ‫ــﺘﻭﻓﺭ ﺒﻬـ‬ ‫ﺘـ‬ ‫ﺍﻟﻤﻌﻠﻭﻤﺎﺕ ﻟﻬﻡ‬ ‫ﻟﺘﺤﺭﻱ ﻭﻤﻌﺎﻟﺠﺔ ﺍﻟﻌـﺩﺍﻭﻯ‬ ‫ﺎ‬ ‫• ﺍﻟﻌﻴﺎﺩﺍﺕ ﺍﻟﺼﺤﻴﺔ ﻟﺘﺤﺭﻱ ﻭﻤﻌﺎﻟﺠﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

‫ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﺯﻫﺭﻱ ﺃﺜﻨﺎﺀ ﺭﻋﺎﻴﺔ ﺍﻟﺤﻤـل ﻭﺘﻘـﺩﻴﻡ ﺍﻟﺭﻋﺎﻴـﺔ • ﺍﻟﺠﻴل ﺍﻟﺜﺎﻨﻲ ﻤﻥ ﺇﺠـﺭﺍﺀﺍﺕ‬ ‫ﺍﻟﺘﺭﺼﺩ‬ ‫ﻟﻠﻤﺼﺎﺒﺎﺕ ﺒﻪ‬ ‫ﺘﻌﺯﻴﺯ ﺍﺴﺘﺨﺩﺍﻡ ﺍﻟﻌﻭﺍﺯل ﻤﻥ ﺃﺠل ﺍﻟﻭﻗﺎﻴﺔ ﺍﻟﻤﺯﺩﻭﺠﺔ‬ ‫ﺎ ﻟﻠﻤﺠﻤﻭﻋﺎﺕ‬ ‫ﺍﻟﺩﻻﺌل ﺍﻹﺭﺸﺎﺩﻴﺔ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ ﻭﻓﻘﹰ‬ ‫ﺍﻟﻌﻤﺭﻴﺔ‬ ‫ﺎ ﻓﻲ ﻤﺭﺍﻓﻕ ﺨـﺩﻤﺎﺕ‬ ‫ﻤﻌﺎﻟﺠﺔ ﻤﺭﻀﻰ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‬ ‫ﺍﻟﺭﺼﺩ ﻭﺍﻟﺘﻘﻴـﻴﻡ‬ ‫ﺽ(‬ ‫‪‬ﻡ‪ ،‬ﺜـﻡ ﺍﻨﻬـ ﹺ‬ ‫ﱢـﺫ‪ ،‬ﻗـﻴ‬ ‫ﱢﻁ‪ ،‬ﻨﻔ‬ ‫ﺍﻟﺒﺤﺙ ﺍﻟﻤﻴﺩﺍﻨﻲ ﻭﺍﻟﺩﺍﺌﺭﺓ )ﺨﻁ‬ ‫)‪(PDAS‬‬

‫ﺍﻟﺼﺤﺔ ﺍﻟﺠﻨﺴﻴﺔ‬ ‫ﻭﺍﻟﺼﺤﺔ ﺍﻹﻨﺠﺎﺒﻴﺔ‬

‫ﻭﺯﺍﺭﺍﺕ ﺍﻟﺘﻌﻠﻴﻡ‬ ‫ﻭﺍﻟﺸﺒﺎﺏ‬ ‫ﻭﺯﺍﺭﺍﺕ ﺍﻟﻌﻤل‬ ‫ﻭﺍﻟﺴﻴﺎﺤﺔ‪ ،‬ﺇﻟﺦ‪.‬‬

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‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﺍﻟﺩﻋﻭﺓ ﻭﺍﻟﻤﺴﺎﻨﺩﺓ‪ :‬ﺍﺴﺘﻨﻬﺎﺽ ﺍﻟﻘﻴﺎﺩﺓ ﺍﻟﺴﻴﺎﺴﻴﺔ ﻭﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﺎﻟﻴﺔ‬

‫‪-٤‬‬

‫‪ ١-٤‬ﺍﻟﺩﻋﻭﺓ ﻭﺍﻟﻤﺴﺎﻨﺩﺓ‬ ‫ﺎ ﻜﺎﻨﺕ ﺠﻭﺩﺓ ﺍﻟﺘﻜﻨﻭﻟﻭﺠﻴﺎﺕ ﻭﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﻤﻭﺠﻭﺩﺓ ﻭﺍﻟﻤﺘﻭﻓﺭﺓ‪ ،‬ﻓﻠﻥ ﺘﻜﻭﻥ ﻟﻬﺎ ﻓﺎﺌﺩﺓ ﻟﻠﻤﺠﺘﻤﻊ ﺍﻟـﺴﻜﺎﻨﻲ ﺩﻭﻥ‬ ‫ﺃﻴﹰ‬ ‫ﻭﺠﻭﺩ ﺍﻹﺭﺍﺩﺓ ﺍﻟﺴﻴﺎﺴﻴﺔ ﻭﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻼﺯﻤﺔ ﻟﻀﻤﺎﻥ ﺍﺴﺘﻤﺭﺍﺭ ﺘﻨﻔﻴﺫﻫﺎ ﻭﺘﻁﺒﻴﻘﻬﺎ‪ .‬ﺇﻥ ﺍﻟﻭﺼﻤﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﺍﻟﻤﺭﺍﻓﻘـﺔ‬ ‫ﺎ ﻭﺭﻋﺎﻴﺔ‬ ‫ﻼ ﺩﻭﻥ ﺍﻟﺘﻌﺭﺽ ﻟﻘﻀﻴﺔ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ‪ ،‬ﺘﻘﻑ ﺤﺎﺌ ﹰ‬ ‫ﻟﻺﺼﺎﺒﺔ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍ‬ ‫ﺎ ﺘﻌﺘﺒﺭ ﺃﻤﺭﹰ‬ ‫ﻤﺭﻀﺎﻫﺎ‪ ،‬ﻭﺒﺤﺜﻬﺎ ﻋﻠﻰ ﺍﻟﻤﻸ‪ ،‬ﻭﺍﺸﺘﺭﺍﻙ ﺃﻓﺭﺍﺩ ﺍﻟﻤﺠﺘﻤﻊ ﻓﻴﻬﺎ‪ .‬ﻭﻻﺯﺍﻟﺕ ﺍﻹﺼﺎﺒﺔ ﺒﻌﺩﺍﻭﻯ ﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻏﻴﺭ ﻤﻘﺒﻭل ﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻻﺠﺘﻤﺎﻋﻲ‪ ،‬ﻭﻟﻴﺴﺕ ﻫﻨﺎﻙ ﺴﻭﻯ ﻤﺠﻤﻭﻋﺎﺕ ﻤﺤـﺩﻭﺩﺓ ﻴﻜﻭﻨﻬـﺎ ﺍﻟﻤﺭﻀـﻰ ﻟﻤـﺴﺎﻨﺩﺓ‬ ‫ﺎ ﺃﻭ ﻜﺴﺏ ﺍﻟﺘﺄﻴـﻴﺩ ﺤﻭل ﺒﻌﺽ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻤﺘﻌﻠﻘﺔ ﺒﻤﻜﺎﻓﺤـﺔ ﻫـﺫﻩ ﺍﻷﻤـﺭﺍﺽ‬ ‫ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ‪ .‬ﻭﻴﺠﺏ ﺃﻥ ﺘـﺘﻡ ﺍﻟﺩﻋﻭﺓ ﻋﻠﻰ ﻜﻼ ﺍﻟﻤﺴﺘﻭﻴـﻴﻥ‪ ،‬ﺍﻟﻭﻁﻨﻲ ﻭﺍﻟﻌﺎﻟﻤﻲ ﻟﻭﻀـﻊ ﻤـﺴﺄﻟﺔ ﻤﻜﺎﻓﺤـﺔ‬ ‫ﺎ ﻋﻠﻰ ﺭﺃﺱ ﺒﺭﻨﺎﻤﺞ ﺍﻟﻌﻤل ﺍﻟﺼﺤﻲ‪ .‬ﻋﻼﻭﺓ ﻋﻠﻰ ﺫﻟﻙ‪ ،‬ﻓﺈﻥ ﻭﺠﻭﺩ ﻗﻴﺎﺩﺓ ﻗﻭﻴﺔ )ﻤﺩﻋﻭﻤﺔ ﻤﻥ‬ ‫ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫‪‬ل ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﻤﺩﻨﻲ(‪ ،‬ﻭﺭﺅﻴﺔ ﻭﺭﺴﺎﻟﺔ ﻭﺍﻀﺤﺘﻴﻥ‪ ،‬ﻭﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻭﺘﺩﺨﻼﺕ )ﻤﺭﺘﻜﺯﺓ ﻋﻠﻰ ﻗﺎﻋﺩﺓ ﻋﻠﻤﻴﺔ ﺼـﻠﺒﺔ(‬ ‫ﻗﺒ‬ ‫ِ‬ ‫ﻫﻲ ﺃﻤﻭﺭ ﻻ ﻏﻨﻰ ﻋﻨﻬﺎ ﻻﺴﺘﻠﻬﺎﻡ ﺭﻭﺡ ﺍﻟﻌﻤل ﻭﺍﻹﻨﺠﺎﺯ‪ .‬ﻭﻴﻨﺒﻐﻲ ﺃﻥ ﺘﺸﻤل ﺠﻬﻭﺩ ﺍﻟﺩﻋﻭﺓ ﺍﻟﻘﻴﺎﻡ ﺒﺎﻵﺘﻲ‪:‬‬ ‫ﺎ ﻭﺇﻋﺩﺍﺩ ﺤﺯﻡ ﻤﻀﻤﻭﻤﺔ ﻤﻥ ﺍﻟﺭﺴﺎﺌل؛‬ ‫ ﺘﻭﺜﻴﻕ ﺍﻟﻤﻭﻗﻑ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﹰ‬‫ ﺘﺤﺩﻴﺩ ﺍﻟﻌﻨﺎﺼﺭ ﻭﺍﻟﻤﻜﻭﻨﺎﺕ ﺍﻟﺭﺌﻴﺴﻴﺔ ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺃﻥ ﻴﻜﻭﻥ ﻟﻬﺎ ﺘﺄﺜﻴﺭ ﻋﻠﻰ ﺍﻟـﺴﻴﺎﺴﺎﺕ ﻭﺘﺨـﺼﻴﺹ‬‫ﺍﻟﻤﻭﺍﺭﺩ؛‬ ‫ ﺨﻠﻕ ﺘﺤﺎﻟﻔﺎﺕ ﻭﺸﺒﻜﺎﺕ ﻤﺘﻌﺩﺩﺓ ﺍﻟﺘﺨﺼﺼﺎﺕ ﻭﺍﻟﻘﻁﺎﻋﺎﺕ ﻟﻠﺘﺄﺜﻴﺭ ﻋﻠﻰ ﺼﺎﻨﻌﻲ ﺍﻟﻘﺭﺍﺭﺍﺕ‪.‬‬‫ﻭﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ‪ ،‬ﻴﻨﺒﻐﻲ ﺘﻌﺯﻴﺯ ﺍﻟﺩﻋﻭﺓ ﻟﻠﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﺘﺸﺭﻴﻌﺎﺕ ﺫﺍﺕ ﺍﻟﻘﺩﺭﺓ ﻋﻠﻰ ﺍﻟﺘﻨﻔﻴﺫ‪ ،‬ﺤﻴـﺙ‬ ‫ﺘﺠﺏ ﻤﺭﺍﺠﻌﺔ ﺍﻟﻠﻭﺍﺌﺢ ﻭﺍﻷﻨﻅﻤﺔ ﻭﺍﻟﺘﺸﺭﻴﻌﺎﺕ ﺍﻟﻘﺎﺌﻤﺔ ﻟﺘﻘﻴـﻴﻡ ﺍﻟﺠﻭﺍﻨﺏ ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺍﻻﺴﺘﻔﺎﺩﺓ ﻤﻨﻬـﺎ‪ ،‬ﻭﺍﻹﺴـﻬﺎﻤﺎﺕ‬ ‫ﺎ ﻭﺭﻋﺎﻴـﺔ‬ ‫ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺃﻥ ﺘﻘﺩﻤﻬﺎ ﻟﻠﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﻤﺭﺍﻤﻲ ﻭﺍﻷﻫﺩﺍﻑ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ﻤﺭﻀﺎﻫﺎ‪ .‬ﻭﻴﻨﺒﻐﻲ ﻜﺫﻟﻙ‪ ،‬ﺍﻟﻨﻅﺭ ﺒﻌﻴﻥ ﺍﻻﻋﺘﺒﺎﺭ ﻟﻌﻤﻠﻴﺔ ﺇﺼﻼﺡ ﺍﻟـﺴﻴﺎﺴﺎﺕ ﻭﺍﻟﺘـﺸﺭﻴﻌﺎﺕ ﺍﻟﺘـﻲ ﺘﻌﻴـﻕ ﺘﺤﻘﻴـﻕ‬ ‫ﺎ ﻟﻠﺒﻴﻨﺎﺕ ﻭﺍﻟـﺩﻻﺌل ﺍﻟﻌﻠﻤﻴـﺔ‬ ‫ﺎ ﻭﺭﻋﺎﻴﺔ ﻤﺭﻀﺎﻫﺎ‪ ،‬ﻭﺫﻟﻙ ﻭﻓﻘﹰ‬ ‫ﺍﻟﻤﺭﺍﻤﻲ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍﻟﺴﻠﻴﻤﺔ )‪.(٥١‬‬ ‫ﻭﻴﻤﻜﻥ ﻟﺠﻬﻭﺩ ﺍﻟﺩﻋﻭﺓ ﺍﻻﻨﻁﻼﻕ ﻤﻥ ﺍﻟﺨﺒﺭﺍﺕ ﻭﺍﻟﺩﺭﻭﺱ ﺍﻟﻤﺴﺘﻔﺎﺩﺓ ﻤﻥ ﺤﻤﻼﺕ ﺍﻟﺩﻋﻭﺓ ﺍﻟﻨﺎﺠﺤﺔ ﺍﻷﺨﺭﻯ‬ ‫ﻤﺜل ﺒﺭﺍﻤﺞ ﺍﻟﺘﻤﻨﻴﻊ‪ ،‬ﻭﺍﺴﺘﺌﺼﺎل ﺸﻠل ﺍﻷﻁﻔﺎل‪ ،‬ﻭﻭﻗﻑ ﺍﻟﺴل‪ ،‬ﻭﺩﺤﺭ ﺍﻟﻤﻼﺭﻴﺎ ﻭﻤﺒﺎﺩﺭﺓ ﺍﻟﺘﺤﺭﺭ ﻤﻥ ﺍﻟﺘﺒﻎ‪.‬‬

‫‪ ٢-٤‬ﺍﻟﻌﻤل ﻤﻊ ﻭﺴﺎﺌل ﺍﻹﻋﻼﻡ‬ ‫ﺍ ﻭﺃﻨﺒﺎﺀ ﺒﺎﻟﻨﺴﺒﺔ ﻟﻭﺴﺎﺌل ﺍﻹﻋﻼﻡ ﺍﻟﺘﻲ ﺘﻘـﻭﻡ‬ ‫ﻟﻘﺩ ﺃﺼﺒﺤﺕ ﺍﻷﻤﻭﺭ ﺍﻟﺨﺎﺼﺔ ﺒﺎﻟﺼﺤﺔ ﺍﻟﻌﻤﻭﻤﻴﺔ ﺘﻤﺜل ﺃﺨﺒﺎﺭﹰ‬ ‫ﺍﻵﻥ ﺒﺘﻐﻁﻴﺔ ﺍﻟﻘﻀﺎﻴﺎ ﺍﻟﺼﺤﻴﺔ ﻭﺍﻟﺘﻬﺩﻴﺩﺍﺕ ﺍﻟﺘﻲ ﺘﻨﻁﻭﻱ ﻋﻠﻴﻬﺎ ﺍﻷﻤﺭﺍﺽ‪ ،‬ﻭﺫﻟﻙ ﻋﻠﻰ ﻨﺤﻭ ﻏﻴﺭ ﻤﺴﺒﻭﻕ‪ .‬ﻭﻫﻨـﺎﻙ‬ ‫ﺎ ﺘﻐﻁﻴﺔ ﺃﻜﺜﺭ ﺇﻴﺠﺎﺒﻴﺔ ﻤﻥ ﻗﺒل ﻭﺴﺎﺌل ﺍﻹﻋﻼﻡ‪ ،‬ﺤﻴﺙ ﻴﺠـﺏ ﺃﻥ‬ ‫ﺤﺎﺠﺔ ﻷﻥ ﻴﺴﺘﻘﻁﺏ ﻤﺠﺎل ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻴﺘﻡ ﺍﻟﻌﻤل ﻤﻊ ﻭﺴﺎﺌل ﺍﻹﻋﻼﻡ ﺒﺸﻜل ﺍﺴﺘﺒﺎﻗﻲ‪ .‬ﻭﺘﻌﺘﺒـﺭ ﻗـﺼﺹ ﺍﻟﺘﺠـﺎﺭﺏ ﺍﻟﻨﺎﺠﺤـﺔ ﺍﻟﺘـﻲ ﺘﻠﻘـﻲ ﺒﺎﻟـﻀﻭﺀ‬ ‫ﻋﻠﻰ ﺍﻹﻨﺠﺎﺯﺍﺕ ﺍﻹﻴﺠﺎﺒﻴﺔ‪ ،‬ﻤﻥ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﻬﺎﻤﺔ ﻭﺍﻷﺴﺎﺴﻴﺔ ﻟﺨﻠـﻕ ﻋﻤﻠﻴـﺔ ﺘﻭﺍﺼـل ﻗـﻭﻱ‪ .‬ﻭﻴﺠـﺏ ﻭﻀـﻊ‬ ‫ﱢﻴﻥ ﻟﻠﻭﺴﺎﺌل ﺍﻹﻋﻼﻤﻴﺔ ﻤﻥ ﺃﺠل ﺍﻟﺘﺭﻭﻴﺞ ﻷﻫﺩﺍﻑ ﺍﻟﻤﺒـﺎﺩﺭﺓ‬ ‫ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻟﺘﻭﻁﻴﺩ ﺍﻟﻌﻼﻗﺔ ﺒﻴﻥ ﺍﻟﻤﻤﺜﻠﻴﻥ ﺍﻟﺭﺌﻴﺴﻴـ‬ ‫ﺒﻤﺎ ﻴﺸﺘﻤل ﻋﻠﻰ ﺍﻵﺘﻲ‪:‬‬

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‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫ﱢﻴﻥ ﻋﻠﻰ ﺘﻁﻭﻴﺭ ﻭﺴﺎﺌل ﺩﺍﻋﻤﺔ؛‬ ‫ ﺘﻌﺯﻴﺯ ﻗﺩﺭﺍﺕ ﺍﻹﻋﻼﻤﻴـ‬‫ﺎ ﻭﻤﻜﺎﻓﺤﺘﻬـﺎ ﻭﺭﻋﺎﻴـﺔ‬ ‫ ﺘﺤﺴﻴﻥ ﻭﻋﻲ ﻭﺇﺩﺭﺍﻙ ﺍﻟﺠﻤﻬﻭﺭ ﻟﻘﻀﻴﺔ ﺍﻟﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ﻤﺭﻀﺎﻫﺎ؛‬ ‫ ﺍﻟﻤﺴﺎﻋﺩﺓ ﻓﻲ ﺍﺴﺘﻨﻬﺎﺽ ﺍﻹﺭﺍﺩﺓ ﺍﻟﺴﻴﺎﺴﻴﺔ؛‬‫ ﺍﻟﻤﺴﺎﻋﺩﺓ ﻓﻲ ﺍﻟﺘﺄﺜﻴﺭ ﻋﻠﻰ ﺍﻟﻤﺠﺘﻤﻊ ﻭﺍﻟﺘﺠﻤﻌﺎﺕ ﺍﻟﺴﻜﺎﻨﻴﺔ ﻹﺯﺍﻟﺔ ﺍﻟﻭﺼﻤﺔ ﺍﻻﺠﺘﻤﺎﻋﻴﺔ ﻭﺘﻼﺸﻴﻬﺎ؛‬‫ﺎ ﻭﻋﺩﺍﻭﻯ‬ ‫ ﻨﺸﺭ ﺍﻟﺭﺴﺎﺌل ﺍﻟﻭﻗﺎﺌﻴﺔ ﻭﺭﻓﻊ ﺍﻟﻭﻋﻲ ﻓﻲ ﻤﺎ ﻴﺘﻌﻠﻕ ﺒﺎﻟﻨﺘﺎﺌﺞ ﺍﻟﻤﺩﻤﺭﺓ ﻟﻠﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ﺍﻟﺠﻬﺎﺯ ﺍﻹﻨﺠﺎﺒﻲ ﺍﻷﺨﺭﻯ‪.‬‬

‫‪ ٣-٤‬ﺇﻗﺎﻤﺔ ﺸﺭﻜﺎﺕ ﻓﺎﻋﻠﺔ‬ ‫ﻴﻨﺒﻐﻲ ﺘﺒﻨﻲ ﺃﺴﻠﻭﺏ ﻭﺍﺴﻊ ﺍﻟﻤﻨﻅﻭﺭ‪ ،‬ﻴﺘﺤﻘﻕ ﻤﻥ ﺨﻼﻟﻪ ﺍﻨﻀﻤﺎﻡ ﺸﺭﻜﺎﺀ ﻭﻗﻁﺎﻋﺎﺕ ﻤﺘﻌﺩﺩﺓ‪ ،‬ﺤﻴﺙ ﻟﻥ ﻴﻜﻭﻥ‬ ‫ﺎ ﺇﻻ ﻤﻥ ﺨﻼل ﺘﻀﺎﻓﺭ ﺍﻟﻘﻭﻯ ﻭﺘﻜﺎﻤل ﺍﻟﺠﻬﻭﺩ‪.‬‬ ‫ﺒﺎﻹﻤﻜﺎﻥ ﺘﺤﻘﻴﻕ ﺍﻟﻤﺭﺍﻤﻲ ﺍﻟﺨﺎﺼﺔ ﺒﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺍ ﺇﻗﺎﻤﺔ ﺘﺤﺎﻟﻔﺎﺕ ﻭﺍﺌﺘﻼﻓﺎﺕ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻤﺎ ﺒﻴﻥ ﺍﻟﻘﻁﺎﻋﻴﻥ ﺍﻟﻌـﺎﻡ ﻭﺍﻟﺨـﺎﺹ‪ ،‬ﻭﻭﻜـﺎﻻﺕ‬ ‫ﻟﺫﻟﻙ‪ ،‬ﻓﺈﻨﻪ ﻤﻥ ﺍﻟﻤﻬﻡ ﺠﺩﹰ‬ ‫ﺍﻟﻤﺴﺎﻋﺩﺓ ﺍﻟﻤﺘﻌﺩﺩﺓ ﻭﺍﻟﺜﻨﺎﺌﻴﺔ ﺍﻷﻁﺭﺍﻑ‪ ،‬ﻭﻭﻜﺎﻻﺕ ﺍﻷﻤﻡ ﺍﻟﻤﺘﺤﺩﺓ‪ ،‬ﻭﺸﺭﻜﺎﺕ ﺼﻨﺎﻋﺔ ﺍﻷﺩﻭﻴﺔ‪ ،‬ﻭﻭﺴـﺎﺌل ﺍﻹﻋـﻼﻡ‪،‬‬ ‫ﻭﻤﺅﺴﺴﺎﺕ ﺍﻟﻤﺠﺘﻤﻊ ﺍﻟﻤﻬﻨﻲ ﻭﺍﻟﻤﺩﻨﻲ‪ ،‬ﻭﺍﻟﻬﻴﺌﺎﺕ ﺍﻷﻜﺎﺩﻴﻤﻴﺔ ﻭﻏﻴﺭﻫﺎ ﻤﻥ ﺍﻟﺠﻬﺎﺕ ﺫﺍﺕ ﺍﻟﻌﻼﻗﺔ‪ .‬ﻭﻤﻥ ﺍﻟﻤﻌﺭﻭﻑ ﺃﻥ‬ ‫ﻭﺠﻭﺩ ﺍﻟﺸﺭﺍﻜﺎﺕ ﻴﻤﻜﻥ ﺃﻥ ﻴﻀﻴﻑ ﺇﻟﻰ ﺍﻟﺭﺅﻴﺔ ﻭﻴﺯﻴﺩ ﻤﻥ ﺍﻟﺯﺨﻡ ﻭﻴﻌﺯﺯ ﻤﻥ ﺍﻟﻔﻌﺎﻟﻴﺔ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻟﻠﺠﻬـﻭﺩ ﺍﻟﺭﺍﻤﻴـﺔ‬ ‫ﺎ ﻭﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺎ ﻤﻥ ﺨﻼل ﺘﻭﺤﻴﺩ ﺍﻟﻌﻨﺎﺼﺭ ﺍﻟﻌﺩﻴﺩﺓ ﻭﺍﻟﻤﺘﻨﻭﻋﺔ‬ ‫ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻭﺍﻟﻌﻤل ﺒﺘﻨﺎﻏﻡ ﻭﻓﺎﻋﻠﻴﺔ‪ ،‬ﻤﻊ ﺍﻟﺘﻘﻠﻴل ﻤﻥ ﺍﻻﺯﺩﻭﺍﺠﻴﺔ ﻏﻴﺭ ﺍﻟﻤﻁﻠﻭﺒﺔ ﻓﻲ ﺍﻟﺠﻬﻭﺩ‪.‬‬ ‫ﻭﺘﺸﺘﻤل ﺍﻟﻤﺠﺎﻻﺕ ﻭﺍﻟﻘﻀﺎﻴﺎ ﺍﻟﻤﺤﺩﺩﺓ ﺍﻟﺘﻲ ﻴﺘﻌﻴﻥ ﻋﻠﻰ ﺍﻟﺸﺭﻜﺎﺀ ﺃﻥ ﻴﻨﺒﺭﻭﺍ ﻟﻬﺎ ﻭﻴﻠﺘﻔﻭﺍ ﺤﻭﻟﻬﺎ‪ ،‬ﻤﺎ ﻴﻠﻲ‪:‬‬ ‫ﺎ‪ ،‬ﻭﺍﻟﻤﻀﺎﻋﻔﺎﺕ ﺍﻟﻨﺎﺸﺌﺔ ﻋﻨﻬﺎ‪ ،‬ﻤﺜل ﺍﻟﻘﻀﺎﺀ ﻋﻠﻰ ﺍﻟﺯﻫـﺭﻱ‬ ‫ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻨﻭﻋﻴﺔ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬‫ﺍﻟﺨﻠﻘﻲ ﻭﻤﻜﺎﻓﺤﺔ ﻭﺍﺴﺘﺌﺼﺎل ﺍﻟﻘﺭﻴﺢ؛‬ ‫ ﺯﻴﺎﺩﺓ ﺇﻤﻜﺎﻨﻴﺔ ﺍﻟﺤﺼﻭل ﻋﻠﻰ ﺍﻟﺘﻜﻨﻭﻟﻭﺠﻴﺎ ﺍﻟﻤﻨﺎﺴﺒﺔ‪ ،‬ﻭﺯﻴﺎﺩﺓ ﻨﻁﺎﻕ ﺍﺴﺘﺨﺩﺍﻤﻬﺎ ﻟﻠﻭﻗﺎﻴﺔ ﻤﻥ ﺍﻟﻌـﺩﺍﻭﻯ‬‫ﺎ‪ ،‬ﻭﺭﻋﺎﻴﺔ ﺍﻟﻤﺭﻀﻰ ﺍﻟﻤﺼﺎﺒﻴﻥ ﺒﻬﺎ ﻤﺜل ﺍﻹﺠﺭﺍﺀﺍﺕ ﺍﻟﺘﺸﺨﻴﺼﻴﺔ ﺍﻟـﺴﺭﻴﻌﺔ ﺍﻟﺨﺎﺼـﺔ‬ ‫ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺒﻬﺫﻩ ﺍﻷﻤﺭﺍﺽ‪ ،‬ﻭﺍﻟﻠﻘﺎﺤﺎﺕ ﺍﻟﻤﻀﺎﺩﺓ ﻟﻬﺎ‪ ،‬ﻭﺍﻟﻭﺴﺎﺌل ﺍﻟﺤﺎﺌﻠﺔ ﺍﻟﻨﺴﺎﺌﻴﺔ ﺒﻤﺎ ﻓﻴﻬﺎ ﻤﺒﻴﺩﺍﺕ ﺍﻟﻤﻴﻜﺭﻭﺒﺎﺕ؛‬ ‫ﺎ‬ ‫‪‬ﺎﻟﺔ ﻭﺍﻟﺴﻠﻊ ﺍﻷﺨﺭﻯ ﺍﻟﻼﺯﻤﺔ ﻟﻠﻭﻗﺎﻴـﺔ ﻤـﻥ ﺍﻟﻌـﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ ﺠﻨـﺴﻴﹰ‬ ‫ ﻀﻤﺎﻥ ﺇﺘﺎﺤﺔ ﺍﻷﺩﻭﻴﺔ ﺍﻟﻔﻌ‬‫ﻭﻤﻌﺎﻟﺠﺘﻬﺎ‪ ،‬ﺒﺄﺴﻌﺎﺭ ﺘﻜﻭﻥ ﻓﻲ ﺍﻟﻤﺘﻨﺎﻭل؛‬ ‫ ﺍﻟﺘﺩﺨﻼﺕ ﺍﻟﺘﻜﻤﻴﻠﻴﺔ ﻤﺜل ﺍﺘﻘﺎﺀ ﺴﺭﺍﻴﺔ ﻜل ﻤﻥ ﻓﻴﺭﻭﺱ ﺍﻟﻌﻭﺯ ﺍﻟﻤﻨﺎﻋﻲ ﺍﻟﺒﺸﺭﻱ ﻭﺍﻟﺯﻫﺭﻱ ﻤﻥ ﺍﻷﻡ ﺇﻟﻰ‬‫ﻁﻔﻠﻬﺎ‪ ،‬ﻤﻥ ﺃﺠل ﻀﻤﺎﻥ ﻭﻻﺩﺓ ﺍﻷﻁﻔﺎل ﻭﻫﻡ ﻏﻴﺭ ﻤﺼﺎﺒﻴﻥ ﺒﺄﻱ ﻤﻥ ﻫﺫﻩ ﺍﻟﻌﺩﺍﻭﻯ )‪.(٣٣‬‬ ‫ﻤﻥ ﺠﻬﺔ ﺃﺨﺭﻯ ﻓﺈﻥ ﺇﻗﺎﻤﺔ ﺘﻌﺎﻭﻥ ﻓﻲ ﻤﺎ ﺒﻴﻥ ﺍﻷﻗﺎﻟﻴﻡ ﻭﻜﺫﻟﻙ ﺇﻨﺸﺎﺀ ﺸﺒﻜﺎﺕ ﺇﻗﻠﻴﻤﻴﺔ ﺘـﺘﻀﻤﻥ ﺍﻟﺨﺒـﺭﺍﺕ‬ ‫ﻭﺍﻟﺘﺠﺎﺭﺏ ﺍﻟﻤﻜﺘﺴﺒﺔ ﻓﻲ ﻫﺫﺍ ﺍﻟﻤﺠﺎل‪ ،‬ﻭﺘﻘﺩﻴﻡ ﺍﻟﻤﺴﺎﻋﺩﺍﺕ ﻭﺘﻁﻭﻴﺭ ﻭﺘﻌﺯﻴﺯ )ﻤﺭﺍﻜﺯ ﺍﻻﻤﺘﻴﺎﺯ( ﺍﻹﻗﻠﻴﻤﻴﺔ ﺠﻤﻴﻌﻬﺎ ﺘﻤﺜل‬ ‫ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻫﺎﻤﺔ ﻭﺫﺍﺕ ﺼﻠﺔ ﺒﺘﻌﺯﻴﺯ ﻭﺘﻘﻭﻴﺔ ﺍﻟﺒﺭﺍﻤﺞ ﺍﻟﻭﻁﻨﻴﺔ‪.‬‬

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‫‪Annex‬‬

‫ﺍﻟﻤﻠﺤﻕ‬

‫ﺝ‪١١/٥٩‬‬

‫‪ ٤-٤‬ﺤﺸﺩ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﺎﻟﻴﺔ‬ ‫ﻟﻜﻲ ﻴﻤﻜﻥ ﺘﻨﻔﻴﺫ ﺍﻻﺴﺘﺭﺍﺘﻴﺠﻴﺔ ﻻﺒﺩ ﻤﻥ ﻭﺠﻭﺩ ﺁﻟﻴﺔ ﻟﺤﺸﺩ ﺍﻟﻤﺯﻴﺩ ﻤﻥ ﺍﻟﻤﻭﺍﺭﺩ‪ .‬ﻭﺒﺎﻟﻨﺴﺒﺔ ﻟﻠﺒﻠﺩﺍﻥ ﺍﻟﻨﺎﻤﻴﺔ ﺃﻭ‬ ‫ﺫﺍﺕ ﺍﻟﻤﻭﺍﺭﺩ ﺍﻟﻤﺤﺩﻭﺩﺓ‪ ،‬ﻓﺈﻥ ﻫﻨﺎﻙ ﻋﺩﺩ ﻤﻥ ﺍﻟﻤﺼﺎﺩﺭ ﺍﻟﺘﻲ ﻴﻤﻜﻥ ﺍﺴﺘﻜﺸﺎﻓﻬﺎ‪ .‬ﻓﻌﻠﻰ ﺴﺒﻴل ﺍﻟﻤﺜﺎل‪ ،‬ﻫﻨـﺎﻙ ﻤـﻭﺍﺭﺩ‬ ‫‪‬ﻡ ﺇﻟﻰ‬ ‫ﻤﺭﺘﺒﻁﺔ ﺒﺎﻟﺼﻨﺩﻭﻕ ﺍﻟﻌﺎﻟﻤﻲ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻷﻴﺩﺯ ﻭﺍﻟﺴل ﻭﺍﻟﻤﻼﺭﻴﺎ‪ ،‬ﻭﻴﻨﺒﻐﻲ ﻋﻠﻰ ﺍﻟﺒﻠﺩﺍﻥ ﺍﺴﺘﻐﻼل ﺍﻟﻔﺭﺼﺔ ﻭﺍﻟﺘﻘﺩ‬ ‫ﺎ‪ .‬ﻭﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻌـﺎﻟﻤﻲ‪،‬‬ ‫ﺍﻟﺼﻨﺩﻭﻕ ﺒﺎﻟﻤﻘﺘﺭﺤﺎﺕ ﺍﻟﺘﻲ ﺘـﺘﻀﻤﻥ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﻴﺘﻌﻴﻥ ﻋﻠﻰ ﺍﻟﻭﻜﺎﻻﺕ ﺍﻟﺩﻭﻟﻴﺔ ﺘﻜﺜﻴﻑ ﻤﻨﺎﻗﺸﺎﺘﻬﺎ ﻭﻤﺩﺍﻭﻻﺘﻬﺎ ﻟﺘﺴﻬﻴل ﺘﻭﻓﻴﺭ ﺍﻻﻋﺘﻤﺎﺩﺍﺕ ﻟﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟـﺔ‬ ‫ﺎ ﻋﺩﺩ ﻤﻥ ﺍﻟﻔﺭﺹ ﺍﻷﺨﺭﻯ ﺍﻟﺘﻲ ﺘﺘﻴﺢ ﺫﻟﻙ ﻤﺜل ﺍﻟﻤﺅﺴﺴﺎﺕ ﺍﻟﺘﻲ‬ ‫ﺎ ﻋﻥ ﻁﺭﻴﻕ ﻤﺜل ﻫﺫﻩ ﺍﻵﻟﻴﺎﺕ‪ .‬ﻭﻫﻨﺎﻙ ﺃﻴﻀﹰ‬ ‫ﺠﻨﺴﻴﹰ‬ ‫ﻟﻬﺎ ﻤﺼﻠﺤﺔ ﻓﻲ ﻤﻜﺎﻓﺤﺔ ﺍﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬ ‫ﺎ ﺒﺸﻜل ﻋﺎﻡ ﺃﻭ ﺒﺎﻟﻨﺴﺒﺔ ﻟﺘﺠﻤﻌﺎﺕ ﺴﻜﺎﻨﻴﺔ ﺃﻭ ﺘـﺩﺨﻼﺕ ﻤﺤـﺩﺩﺓ‪.‬‬ ‫ﻭﻋﻠﻰ ﺍﻟﻤﺴﺘﻭﻯ ﺍﻟﻭﻁﻨﻲ‪ ،‬ﺇﺫﺍ ﻜﺎﻨﺕ ﺍﻷﺴﺎﻟﻴﺏ ﺍﻟﺸﺎﻤﻠﺔ ﻟﻠﻘﻁﺎﻋﺎﺕ ﻤﻌﺘﻤﺩﺓ ﻜﺂﻟﻴـﺔ ﻟﻠﺤـﺼﻭل ﻋﻠـﻰ ﺍﻻﻋﺘﻤـﺎﺩﺍﺕ‬ ‫ﺍﻟﻤﻁﻠﻭﺒﺔ‪ ،‬ﻓﻴﻨﺒﻐﻲ ﻭﻀﻊ ﺍﺴﺘﺭﺍﺘﻴﺠﻴﺎﺕ ﺍﻟﺩﻋﻭﺓ ﻭﺍﻟﻤﺴﺎﻨﺩﺓ ﻤﻥ ﺃﺠل ﺘﺨﺼﻴﺹ ﺍﻻﻋﺘﻤﺎﺩ ﺍﻟﻤﻼﺌﻡ ﻟﻠﺒـﺭﺍﻤﺞ ﺍﻟﺨﺎﺼـﺔ‬ ‫ﺎ‪.‬‬ ‫ﺒﺎﻟﻌﺩﺍﻭﻯ ﺍﻟﻤﻨﻘﻭﻟﺔ ﺠﻨﺴﻴﹰ‬

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