Title: South Asia Advocacy for Integrating Sexual and Reproductive Health and Rights in MDGS by
1Need for Integrating Sexual and Reproductive
Health and Rights in the MDGs A plea from South
AsiaMs. Indu Capoor, Founder-Director
Centre for Health Education, Training and
Nutrition Awareness , Ahmedabad, India
6th June 2007
2Making MDGs a Reality
- The eight MDGs are an unprecedented promise by
all world leaders to accelerate global efforts to
meet the needs of the worlds poorest by 2015.
However, universal access to reproductive health
services and focus on sexual and reproductive
health and rights was missing until recently. - None of the MDGs can be attained without
addressing SRHR. Due to absence of SRHR in MDGs,
SRHR has received less visibility, less
attention, lower priority and less funding.
3Links between SRHR, poverty and gender
disempowerment
- Sexual and reproductive health among young people
is a poverty issue and forced early marriage and
early pregnancy is an outcome. - Pregnant girls drop out of schools. Without
education and employment unmarried pregnant girls
are poorly prepared to take responsibility of
childcare and face diminishing prospects for
income generation. - Addressing early pregnancy and empower-ment women
for safe motherhood are necessary components for
reducing maternal mortality and improving child
health.
4While MDGs are a goal for the Global Commitment
Regional Disparities Exist
- Rachel
- Born in Europe
- Eats nutritious food
- Graduates from a good institution
- Is active in the job market
- Chooses her life partner
- Mother of two healthy children
Lives a healthy life!
- Reni
- Born in South Asia
- Often goes hungry
- Works 10-12 hours
- Is married at 10
- Conceives at 13
- Looses 3 children
- Gives birth to 4 children
- Receives no care
- Is often abused
- Dies at 21 years of age!
5The scenario in South Asia
- South Asia is the worlds most populous region. A
significant percentage of the population is
denied basic human needs-food, shelter, clothing
and education. (Per Capita Income ranges from USD
250 to 840) - A region of Class, caste, gender and race
inequalities, political crisis, terrorism and
turmoil. - One fifth of the population in South Asia is
between the ages of 15 and 24. This is the
largest number of young people ever to transit
into adulthood, both in South Asia and in the
world.
6The SRHR situation in South Asia
- About 74 million women are missing in South Asia.
They are the victims of social and economic
neglect from the cradle to the grave. The sex
ratio is 94/100 as compared to 106/100 at the
global level. - South Asia significantly contributes to the
global burden of maternal deaths (MMR ranges from
340-800). - More than 80 of adolescent girls and 85 of
pregnant women in South Asia suffer from anemia. - In 2004 36 of the total deliveries in South Asia
were attended by a skilled health personnel.
7The gap between policy and practice
- At policy level there has been some progress
SRHR related issues are reflected in the youth,
health, education policies. However, the reality
at the ground is different! The implementation of
the policies is the real challenge among other
things because the public health systems are
weak. - While funding for reproductive health and
education has increased, its access by
field-based civil society organizations has
become extremely difficult, due to the focus on
public-private-partnerships.
8Obstacles
- The increasing global opposition against sexual
and reproductive rights through budget
restrictions partlicularly the US government
(PEPFAR, GAG Rule) - Religious opposition to sexuality education,
access to contraceptives, abortion etc. - The culture of silence among women and girls in
South Asia
9What needs to be done?
- Build a strong and strategic advocacy
partnership. - Create new opportunities for people centered
advocacy at the local, national and regional
level. - Strengthen civil society and marginalized womens
capacity to effectively advocate for SRHR through
field based evidence. - Hold decision makers and service providers
accountable. - Conduct simultaneous advocacy and create linkages
at state, national, regional and international
level.
10Building Evidence and Ground for Advocacy
Capacity enhancement of CBOs and community to
articulate the denial of their rights
Listening to women narrate experiences of
accessing care from the public health System Lack
of infrastructure, supplies, absenteeism,
corruption
Documentation of denial to services in local and
national languages Developing policy briefs
Scanning the environment for advocacy
interventions and opportunities - community,
state policies and programme and the political
agenda and power from local to national level
11Advocacy efforts at various levels
Advocacy for Womens Access to Maternal Health
Services from the Public Health System
Dialogue with the community and elected
representatives for consensus building and
affirmative action
Voices of denial at the state level for state
policy action
National dialogue with policy makers, media,
donor agencies to showcase the evidence of
denial and demand for improved health services
Dialogue with the block and district public
health administrators and media
Opportunities, when ever available are seized at
all levels, to take community voices to the
policy makers
12Strong and tactful leadership required
- Global funding for the MDGs is not at the
promised level and you can lobby with your
government to put pressure on other donor
countries especially in the EU to contribute to
programmes that focus on a comprehensive
approach Infant Mortality, young Peoples issues
and maternal Health. - Maintain focus on controversial issues to support
the global fight for a gender and rights-based
approach and help secure sexual and reproductive
rights.
13Strong and tactful leadership required
- Pressurize your government to influence
negotiations during PRSPs so that the voice of
womens organizations, especially organizations
working on advocacy for SRHR are heard and that
womens rights-based programmes are funded. - Review budgets for gaps and increase aid
allocation to fund civil society organizations
for - Demand creation of health entitlements
- Ensuring accountability mechanisms
- Fund for enabling community feedback mechanisms.
14Strong and tactful leadership required
- Hold dialogues with civil society organizations
to understand the political and social realities
of countries being funded. - Local realities are complex, dynamic and
unpredictable, you can advocate for funding
sustainable civil society organizations that
could deepen the field understanding and link it
to practice where health service outreach is
poor.
15Let us join hands for a Healthy South Asia!
- Womens health is a personal and social state of
balance and well being - in which a woman feels strong, active,
creative, wise and worthwhile - where her body's vital power of functioning and
healing is intact - where her diverse capacities and rhythms are
valued - where she may decide and choose, express
herself and move about freely. - - from the 'Women and Health (WAH!) Programme
Approach Document, 1993