Law on Reproductive Health

Translation by K. Imholz
June 2002

As published in the Official Journal of the Republic of Albania 15/2002 (May)


REPUBLIC OF ALBANIA
THE ASSEMBLY

LAW
Nr. 8876 dated 4 April 2002

ON REPRODUCTIVE HEALTH

 In reliance on articles 78, 81 point 1 and 83 point 1 of the Constitution, on the proposal of a group of deputies,

THE ASSEMBLY
OF THE REPUBLIC OF ALBANIA

D E C I D E D:


CHAPTER I
GENERAL PROVISIONS

Article 1

 This law regulates the organization, functioning and supervision of all activities that are carried on in the field of reproductive health, in private and public health institutions, protects the reproductive rights of the individual and the couple and assures that the reproductive rights of every individual will be protected in conformity with the national policies and laws and with other recognized international principles.

Article 2

 “Reproductive health” means general physical and mental well-being, as a whole, with the absence of problematic incapacities and illnesses, as well as every other basic conditioning provision that the reproductive system needs for the functions, processes and ability for a satisfactory and safe sexual life.  It means the ability of people to reproduce and their freedom to choose the manner and time of reproduction, as well as to be informed of where they can do this and where they can find such services.

Article 3

 Reproductive health care includes an entirety of methods, techniques and health services that affect the reproductive health of people, preventing and solving their problems, as below:
 a) services and counseling, informing, educating and communicating about family planning;
 b) services and education for care before birth, safe birth and care after birth, especially breast feeding;
 c) services and education for children, adolescents and health care for women;
 ç) prevention and treatment for sexually transmitted illnesses, HIV/AIDS, and infections and illnesses of the reproductive tract;
 d) safe abortion and the management of complications related to abortion;
 dh) informing, educating and counseling about sexuality and reproductive health;
 e) referral services for family planning, complications of pregnancy, abortion, infertility, infections of the reproductive tract, breast cancer and cancers of the reproductive system, menopause, sexually transmitted illnesses, including HIV/AIDS;
 ë) prevention and appropriate treatment of infertility.

Article 4

 1.  Sexual health is part of reproductive health and means the improvement of life and healthy sexual relations, giving information, counseling, and care related to reproduction and sexually transmitted illnesses.
 2.  Sexual health includes:
 a) normal development;
 b) equal and responsible sexual accepted alike by each partner;
 c) avoidance of illnesses and any incapacity, obligation, force and any harmful practice or conduct related to sexuality;
 ç) the realization of an optimal sexual life.

Article 5

 All individuals have the right to be informed, to be counseled, to receive education and necessary health and social service in order to have good sexual health, as well as to exercise their reproductive and sexual rights and responsibilities.

Article 6

 1.  Every woman, free and excluded from any form of discrimination, obligation or force, has the right to control and freely to decide about all questions related to her sexuality and her sexual and reproductive health.
 2.  Reciprocal respect of equal relations by woman and men during sexual relations and reproduction means respect, not violating the integrity of either persons, good understanding and the division of responsibilities for sexual behavior and its consequences.

 

Article 7

 Safe motherhood means the right for every woman to have the necessary care to have good health from pregnancy until the birth of the child.  The principal elements for assuring safe motherhood include access to high quality health care before birth, during and after birth, the prevention of undesired pregnancies, the prevention of unsafe abortion and of premature birth.

CHAPTER II
REPRODUCTIVE RIGHTS

Article 8

 1.  All individuals and couples have the right to decide freely, but respecting the desire of each partner, about the time, the number and interval of births, to be informed of the appropriate means for achieving them, and to ask for the highest standards of sexual and reproductive health.
 2.  This law guarantees decision-making to every individual about the exercise of reproductive rights according to their desire and interest free from discrimination, obligation and force.

Article 9

 Every individual has the right to choose his sexual relationships and to control his reproductive life.  The choice should be done of his own free will, which means:
 a) no woman is to be forced to be pregnant;
 b) every medical intervention relation to sexual and reproductive health is to be performed with the consent (acceptance) of the person on whom the intervention will be performed.

Article 10

 1.  All individuals and couples have the right to benefit from the use of safe, affordable and acceptable methods of family planning, according to their choice, as well as other methods chosen for the regulation of fertility.
 2.  All individuals and couples have the right to have suitable health care services in order to have a safe pregnancy and birth and a healthy child.
 3.  All individuals have the right to benefit from scientific progress and new technologies related to reproduction and sexuality, when they are safe and acceptable.

Article 11

 1.  A woman has the right to safe motherhood and to avoid unwanted pregnancy that may threaten her life.  The life of a woman should not be exposed to a risk related to pregnancy, birth and other obstacles related to sexual inequality.
 2.  The services of family planning are to be used and promoted as a means for avoiding unwanted pregnancies.
 3.  Every woman has the right to health protection during her pregnancy, to assistance during birth and to benefit from the application of methods and practices that minimize the risk to her health or the health of the fetus, the new-born and the child.

Article 12

 1.  Every individual has the right to health education.
 2.  The right to health education includes the possibility to get informed in a suitable manner and education in the field of reproductive and sexual rights.  The freedom of reproductive and sexual health is not to be limited by the influence of religion, philosophy, or culture and ideology.

Article 13

 1.  Every individual has the right to health care and basic necessary medical services, which are the basis for protecting his health and well-being as an individual, and enjoys the right to quality care for sexual and reproductive health.
 2.  Motherhood and the child have the right to health care and special support.
 3.  Every individual of reproductive age may ask for medical examinations and suitable treatment and rehabilitation for healthy reproduction.

Article 14

 1.  Health services and care for reproductive health are offered by the state medical services, by public and private juridical persons, and by persons who have the right the exercise this activity in conformity with the legislation in force, who are licensed by the Minister of Health for this kind of activity.
 2.  State medical services, public and private juridical persons, as well as persons who have the right to exercise this activity in conformity with the legislation in force, are obligated to preserve the confidentiality and anonymity of data they learn of because of the activity that they conduct.

Article 15

 1.  Sterilization means a surgical medical procedure by means of which the permanent stoppage of the ability of an individual to reproduce is carried out.
 2.  Sterilization is a lawful method for family planning and is performed only when:
 a) the patient gives written permission;
 b) the individual fulfils the age criterion.

 


Article 16

 Every individual has the right, in conformity with his own desires, to undergo surgical methods for sterilization.

Article 17

 Every individual has the right to protect his reproductive ability, appealing against actions, decisions, damages of third persons, when the rights related to reproductive health are violated.

Article 18

 Every individual is to be provided with information and health services, and to be given medical and social assistance by selected methods and techniques, in conformity with the individual particularities accepted and provided by law, in order to prevent unwanted pregnancy, bearing in mind the health condition, age and individual characteristics.

Article 19

 Adolescents and youth enjoy the right to information and services about reproductive health, to information and programs that aim at preventing unwanted pregnancies and abuses, and for everything that is related to their active sexual conduct, in conformity with their age.

Article 20

 1.  All individuals have the right to:
 a) infertility treatment, including the application of modern methods and technologies for reproduction;
 b) information about the content of supplementary reproductive technologies, their efficiency, the optimal periods for implementing them, the medical consequences and possible consequences, and information about the effectiveness of other methods for the treatment of infertility.
 2.  Couples and individuals will have the right to the application of reproductive technologies only in case of a mutual agreement.

CHAPTER III
ORGANIZATION OF THE SERVICE OF REPRODUCTIVE HEALTH

Article 21

 The Minister of Health determines the structures and services of reproductive health, the criteria, the rules for their functioning, as well as the policy and strategy of development for reproductive health.

Article 22

 The activity of the services for care to reproductive health include:
 a) care before, during and after birth;
 b) care for the grown and development of the child 0-6 years of age;
 c) care for the health of adolescents;
 ç) checking of and medical treatment for infectious sexually transmitted diseases HIV/AIDS;
 d) sexual education and information;
 dh) prevention of unwanted pregnancies through contraceptive methods of family planning;
 e) voluntary interruption of pregnancy;
 ë) being cured of sterility and the techniques of reproduction;
 f) the treatment of illnesses of the reproductive tract;
 g) the treatment of menopause.

Article 23

 1.  The service of reproductive health is organized in specialized public and private clinics, licensed in the three levels of health care on the basis of instructions of the Minister of Health.
 2.  The services of reproductive health in primary health care carry out the prevention, diagnosis, treatment of problems of reproductive health, health education and information, and following pathologies in the reproductive system.

Article 24

 1.  All pregnant women enjoy for free the periodic medical following of their pregnancy, the birth and after the birth, especially obligatory pre-natal and post-natal examinations, which are designated by act of the Minister of Health.
 2.  The number and type of obligatory examinations, and the period of performing them, are determined by instructions of the Minister of Health.
 3.  All pregnant woman have the right to have, without payment, obligatory examinations prescribed by the doctor and to receive for free a personal journal about the progress of the pregnancy.

Article 25

 1.  All children 0-6 years of age enjoy preventative health measures as well as free medical check-ups and follow-up.
 2.  The number of examinations and check-ups that are to be performed for children 0-6 years old, as well as the institutions that will perform them, are determined by the Minister of Health.


Article 26

 Contraceptive methods for family planning acceptable for use in the country are determined by instruction of the Minister of Health, included condoms, vaginal barrier methods, oral contraceptives, implants, injections, IUD, voluntary male and female sterilization and emergency contraception.  In addition, patients/clients are to receive detailed information about the risks and precedence of each method.

CHAPTER IV
MAKING DIAGNOSES BEFORE BIRTH

Article 27

 In the meaning of reproductive health, all woman are permitted to have diagnoses made before birth.

Article 28

 The particular methods, rules and conditions for making a diagnosis before birth will be determined by acts of the Minister of Health.

Article 29

Information is to be given about examinations that are performed in connection with making a diagnosis before birth in such a way that the woman will feel complete freedom of choice.

CHAPTER V
TECHNIQUES OF ASSISTED MEDICAL REPRODUCTION

Article 30

 Assisted medical reproduction has the purpose of meeting the request of an individual or a couple to have a child.  It aims at treating one or more medical instances of infertility, that make a couple not able to achieve a pregnancy in the natural way.

Article 31

 Assisted medical reproduction includes clinical and biological practices, which enable conception in vitro, the transfer of embryos and artificial insemination, as well as all other equivalent techniques that permit reproduction outside the natural process.

Article 32

 The techniques of reproduction are applied:
 a) when an individual has reached the age to marry;
 b) when the spouses have failed in attempts to have a child for a period of two years up to the moment when the transfer of the embryo and insemination is performed;
 c) in the presence of a licensed specialist doctor;
ç) only after the written consent has been received for each cycle by the interested individuals.

Article 33

The techniques of reproduction are used only in the cases when:
a) other methods of treatment of the infertility of the man or the woman are not productive or appropriate and do not guarantee the desired result;
b) they prevent the transmission to the child of genetic illnesses, or other illnesses that would produce premature death, mental retardation or serious invalidity;
c) they are considered as an alternative to a natural birth.

CHAPTER VI
ARTIFICIAL INSEMINATION

Article 34

 Artificial insemination means using semen from a donor and injecting it into a woman.  This is done when:
 a) her spouse is infertile;
 b) the donor is not the spouse of the woman.

Article 35

 Artificial insemination with the spouse is done by injecting semen of the male spouse into the female spouse.  Artificial insemination with the male spouse is used only if the inability of the couple to give birth does not come as the result of the reproductive ability of the husband.

Article 36

 The conditions and requirements for the performance of assisted reproductive technologies, artificial insemination, with the consequences of embryonic transplant, are determined by act of the Minister of Health.

Article 37

 During the use of assisted reproductive technologies, the selection of the sex of the future child is not permitted, except for cases when there is a possibility of inheriting illnesses connected with the sex.

 

Article 38

 The human embryo is prohibited from being used for any other kind of commercial, industrial or experimental purpose.

Article 39

1.  Men and women have the right to preserve sexual cells.
2.  The conditions and requirements for preserving and using sexual cells will be determined by act of the Minister of Health.

CHAPTER VII
ARTIFICIAL IN VITRO FECUNDATION

Article 40

 Artificial fecundation means the fertilization experimentally of female eggs with sperm of the man of a couple, outside the body of the woman.  Participation in it is conditioned by the written permission of the woman who donates the eggs and the man who donates the sperm.

Article 41

 Artificial fecundation is applied in one of the cases when:
 a) the woman shows tubal defects or damage;
 b) the man is infertile or the bearer of genetic diseases endangering life;
 c) the sperm of the male partner is unsuitable for the carrying out of a natural birth.

CHAPTER VIII
FINAL PROVISIONS

Article 42

 1.  Violations of the rules contemplated in the preceding articles of this law, when they do not constitute a criminal offense, are considered administrative violations and are punishable by the Minister of Health or by persons authorized by him as follows:
 a) for professional conduct in the field of reproductive health by doctors of this specialty without a license, by fine of from 250,000 to 100,000 lek;
 b) for the functioning of private health institutions without a license in the field of reproductive health, by a fine of from 50,000 up to 1,000,000 lek.
 2.  If violations contemplated in letters a and b of point 1 of this article are repeated, the following measures are taken:
 a) sequestration of equipment of the institution;
 b) taking away the right to conduct the profession;
 c) criminal complaint.

Article 43

 The Minister of Health is obligated to issued separate acts to determine the specifications in relation to:
 a) artificial insemination;
 b) techniques of assisted reproduction;
 c) surrogate adoption.

Article 44

 1. The Minister of Health is to assure services of reproductive health and sexual education for adolescents for free.
 2.  The Minister of Health, in collaboration with the Minister of Education, is obligated to issue particular acts to determine the specifications related to:
 a) education and health institutions for adolescents for sexual education;
 b) models of the programs of education for sexual education and the protection of reproductive health.

Article 45

 This law is effective three months after publication in the Official Journal.

Promulgated by decree nr. 3300 dated 19 April 2002 of the President of the Republic of Albania, Rexhep Meidani.