Society reaps the benefits when women enjoy better health care
Marleen
Temmerman, The Conversation, June 21, 2018
Weak
political commitment, inadequate resources and persistent discrimination
against women and girls: these are just some reasons that many countries still
don’t openly and comprehensively address sexual and reproductive health and
rights.
political commitment, inadequate resources and persistent discrimination
against women and girls: these are just some reasons that many countries still
don’t openly and comprehensively address sexual and reproductive health and
rights.
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AU-UN IST
photo/Stuart Price |
This is
borne out by figures. Each year in developing countries, including those in
Africa, more than 30
million women don’t give birth at a health facility. More than 45
million have inadequate or
no antenatal care. And over 200 million women want to avoid
pregnancy but don’t have
access to modern contraceptive methods.
The
United Nations’ Sustainable
Development Goals -– introduced in 2015 –- were created to address
many of these problems. The goals recognise that sexual and reproductive health
and rights are fundamental to people’s health and survival, to gender equality
and to the well-being of humanity.
United Nations’ Sustainable
Development Goals -– introduced in 2015 –- were created to address
many of these problems. The goals recognise that sexual and reproductive health
and rights are fundamental to people’s health and survival, to gender equality
and to the well-being of humanity.
But many
countries on the continent still have a long way to go before they make any
headway with these goals .
countries on the continent still have a long way to go before they make any
headway with these goals .
In a bid
to boost these fundamental rights, the Guttmacher-Lancet
Commission on Sexual and Reproductive Health and Rights was convened
in 2016.
to boost these fundamental rights, the Guttmacher-Lancet
Commission on Sexual and Reproductive Health and Rights was convened
in 2016.
I was one
of the experts from across the world who served on the commission to try and
find new ways to achieve universal sexual and reproductive health. Our main finding
– released this year – is that sexual and reproductive health services are
fragmented, often duplicated and inefficient.
of the experts from across the world who served on the commission to try and
find new ways to achieve universal sexual and reproductive health. Our main finding
– released this year – is that sexual and reproductive health services are
fragmented, often duplicated and inefficient.
As part
of the findings we’ve developed a set of evidence based interventions that’s
rooted in human rights. These are a direct response to the gaps identified by
the commission. It’s hoped that by plugging these gaps, we can contribute to
achieving the Sustainable Development Goals by 2030. After all, advancing
sexual and reproductive health rights -– particularly among women – will help
address the gender based disparities in health and other sectors.
of the findings we’ve developed a set of evidence based interventions that’s
rooted in human rights. These are a direct response to the gaps identified by
the commission. It’s hoped that by plugging these gaps, we can contribute to
achieving the Sustainable Development Goals by 2030. After all, advancing
sexual and reproductive health rights -– particularly among women – will help
address the gender based disparities in health and other sectors.
Our
findings
findings
The
commission’s findings address commonly recognised components of sexual and
reproductive health like contraceptive services, maternal and newborn care, and
the prevention and treatment of HIV/AIDS.
commission’s findings address commonly recognised components of sexual and
reproductive health like contraceptive services, maternal and newborn care, and
the prevention and treatment of HIV/AIDS.
But it
also addresses components that are often neglected or are addressed in
isolation. These areas are critical if people are to make autonomous decisions
about their health and lives, and include:
also addresses components that are often neglected or are addressed in
isolation. These areas are critical if people are to make autonomous decisions
about their health and lives, and include:
_ comprehensive
sexuality education;
sexuality education;
_ safe
abortions;
abortions;
_ the
prevention and treatment of sexually transmitted infections other than HIV;
prevention and treatment of sexually transmitted infections other than HIV;
_ counselling
and care for sexual health and well-being; and
and care for sexual health and well-being; and
_ preventing,
detecting and managing gender-based violence, infertility and reproductive
cancers.
detecting and managing gender-based violence, infertility and reproductive
cancers.
The
interventions come in different forms. One example involves incorporating
information on how to prevent sexually transmitted infections, contraception
and sexual well-being into adolescent health programming. This upholds young
people’s right to self-determination about their sexuality and results in
improved health outcomes.
interventions come in different forms. One example involves incorporating
information on how to prevent sexually transmitted infections, contraception
and sexual well-being into adolescent health programming. This upholds young
people’s right to self-determination about their sexuality and results in
improved health outcomes.
Another
intervention is offering contraceptive counselling as part of postpartum and
post-abortion care. Each year in developing regions, more than 200 million
women want to avoid pregnancy but don’t use modern contraception methods.
Giving them this access allows them to access contraceptives easily and reduces
the risk of unintended pregnancy.
intervention is offering contraceptive counselling as part of postpartum and
post-abortion care. Each year in developing regions, more than 200 million
women want to avoid pregnancy but don’t use modern contraception methods.
Giving them this access allows them to access contraceptives easily and reduces
the risk of unintended pregnancy.
This
intervention could reduce
unintended pregnancies by 75% from 89 million in 2017 to 22 million.
And it would only come at a cost of USD$ 9 per
person per year. This is a modest cost, considering that half of
this is already being spent to cover the costs of current levels of care.
intervention could reduce
unintended pregnancies by 75% from 89 million in 2017 to 22 million.
And it would only come at a cost of USD$ 9 per
person per year. This is a modest cost, considering that half of
this is already being spent to cover the costs of current levels of care.
Other
interventions may have to involve amending a country’s laws or policies. For
instance, in 2010 the Kenyan government passed laws
that allow abortions to happen under certain circumstances. But eight years
later health professionals are still reluctant to perform the procedure as they
fear legal consequences. Why? Because the penal code hasn’t yet been revised
and so they might still be held guilty of a crime.
interventions may have to involve amending a country’s laws or policies. For
instance, in 2010 the Kenyan government passed laws
that allow abortions to happen under certain circumstances. But eight years
later health professionals are still reluctant to perform the procedure as they
fear legal consequences. Why? Because the penal code hasn’t yet been revised
and so they might still be held guilty of a crime.
The
result of this gap between law and paperwork is that there were close to half a
million unsafe abortions in Kenya in 2012. At least 100 000 of those women
needed to be treated in hospital and roughly a quarter died due to
complications.
result of this gap between law and paperwork is that there were close to half a
million unsafe abortions in Kenya in 2012. At least 100 000 of those women
needed to be treated in hospital and roughly a quarter died due to
complications.
All of
this shows that while achieving universal access to sexual and reproductive
health and rights is ambitious it’s also achievable and affordable.
this shows that while achieving universal access to sexual and reproductive
health and rights is ambitious it’s also achievable and affordable.
A way
forward
forward
There are
several steps that governments need to take to tackle these issues. The first
is that governments, multilateral organisations and advocates should embrace
the commission’s recommended package of essential sexual and reproductive
health interventions and push for its inclusion in national and international
planning.
several steps that governments need to take to tackle these issues. The first
is that governments, multilateral organisations and advocates should embrace
the commission’s recommended package of essential sexual and reproductive
health interventions and push for its inclusion in national and international
planning.
It’s also
crucial for health ministries and service providers to consider how and where
to introduce these interventions into the health care system. They must also
work out how best to integrate sexual and reproductive health interventions
into other health care services.
crucial for health ministries and service providers to consider how and where
to introduce these interventions into the health care system. They must also
work out how best to integrate sexual and reproductive health interventions
into other health care services.
Many
developing countries are not currently equipped to provide the full spectrum of
interventions. But that does not preclude them from committing to achieving
universal access to sexual and reproductive health and rights and to making
continual and steady progress, regardless of their starting point.
developing countries are not currently equipped to provide the full spectrum of
interventions. But that does not preclude them from committing to achieving
universal access to sexual and reproductive health and rights and to making
continual and steady progress, regardless of their starting point.
* Dr Zeba
Sathar, who is the Population Council’s Country Director in Islamabad,
Pakistan, also contributed to writing this article.
Sathar, who is the Population Council’s Country Director in Islamabad,
Pakistan, also contributed to writing this article.
