Annual Ministerial Review 2010
The International Planned Parenthood Federation (IPPF) welcomes the theme of the 2010 Annual Ministerial Review. A new agenda of investment in women and girls, in their education, especially secondary education, in their health, especially their sexual and reproductive health including their maternal health, and investing in their empowerment and employment could be the catalyst for achieving the MDGs and sustainable social and economic development.
IPPF recognizes that sexual and reproductive health and rights (SRHR) are central to addressing obstacles related to women’s advancement worldwide, to reaching the internationally agreed goals and commitments in regard to gender equality and to equitable and sustainable development. Working through 148 Member Associations in 171 countries. IPPF is committed to implementing the Programme of Action (PoA) of the International Conference on Population and Development (Cairo), the Platform for Action (PfA) of the Fourth World Conference on Women (Beijing) and the Millennium Development Goals (MDGs) all of which strive to advance gender equality and empower women. IPPF supports the General Assembly’s resolution to create a new gender entity headed by an Under Secretary‐General. Although advances in gender equality and the empowerment of women have been made, much remains to be done. It is clear progress remains uneven and that this is reflected in the continuing imbalance in power between women and men.
To implement the internationally agreed goals and commitments relating to gender equality and the empowerment of women, it is necessary to ensure that SRHR is prioritized at all levels. This is because “sexual and reproductive ill health accounts for one-third of the global burden of disease among women of reproductive age and one-fifth of the burden of disease among the population overall”. Estimates suggest over half a million women die every year due to complications of pregnancy and childbirth – with 99 per cent occurring in developing countries, mainly South Asia and Africa. A further 10 million develop long-term physical, psychological, social and economic problems as a result of pregnancy and childbirth.
This lack of priority on SRH is highlighted in the lack of progress in reducing the rate of maternal mortality. Between 1990 and 2005, maternal mortality declined at less than 1 per cent per year globally – considerably below the 5.5 percent annual improvement needed to reach MDG5, which at this rate will not be met in Asia until 2076 and later still in Africa. Despite this, the goal can and must be achieved.
Many of the most obstructive barriers to gender equality and the empowerment of women are related to women’s SRHR and these obstacles disproportionately affect young women. Approximately 14.3 million adolescent girls aged 15 to 19 give birth each year and girls in this age group are twice as likely to die during pregnancy and childbirth as those over the age of 20. For young women aged 15 to 19 worldwide pregnancy-related complications are the leading cause of death. Women know what they want and how to achieve it, but are denied the means. An estimated 215 million women who want to delay pregnancy are unable to use an effective method of contraception, that’s 15 per cent of all women aged 15-49. Meeting the need for both family planning and maternal health services would have dramatic health outcomes. Unintended pregnancies would drop by more than two-thirds, from 75 million in 2008 to 22 million per year. Maternal deaths would decline from 550,000 to 160,000. Unsafe abortions would decline by 73 per cent from 20 million to 5.5 million (assuming no change in abortion laws), and the number of women needing medical care for complications of unsafe procedures would decline from 8.5 million to two million. It would cost a mere eight US dollars for every woman of reproductive age who wants to practice modern contraception to be able to do so. However, funding for family planning has halved from US$653m to US$394m between 1997 and 2006.
Young women are more vulnerable to HIV infection with only 38 per cent of girls and young women worldwide showing accurate and comprehensive knowledge about HIV and how to avoid transmission. Women and girls also bear a disproportionate burden of caring for others, and may also suffer greater discrimination when they are or are perceived to be living with HIV. Issues such as poverty, violence against women and girls, lack of access to land and property, conflict, homelessness or lack of stable housing, lack of access to comprehensive SRH services and information, combine to drive and/or exacerbate the impact of HIV on women and girls. Other structural barriers that make women more vulnerable such as the criminalization of HIV transmission that can prevent women from knowing their HIV status and access relevant services further exacerbating discrimination and violence. A comprehensive response to address the gender dimensions of the HIV epidemic can reverse some the recent gains and reduce the chances of achieving MDG6.
Barriers to gender equality and the empowerment of women start with discrimination at an early age. Disparities in the ways in which boys and girls are raised are often at the core of problems related to SRH as well as at the centre of development challenges. For example, girls may experience restrictions, and find their freedom of movement and association limited, while for boys, the opposite is often true. As such, the pre-determination of gender roles often restrict girls’ ability to compete equally with their male counterparts. Girls are often forced to marry at an early age and begin child bearing before they are either mentally or physically ready. According to UNFPA 82 million girls in developing countries between the ages of 10 and 17 will be married before they reach 18. Young women are particularly vulnerable to: early marriage; complications related to pregnancy; unsafe abortion; sexual violence and coercion; human trafficking for commercial sexual exploitation; female genital mutilation; the discontinuation of studies (often due to child marriage or adolescent pregnancy) and poverty. All of these issues are related to SRHR and are key determinants that impede progress in gender equality and empowerment. To help achieve gender equality, therefore, it is vital that young women be empowered to exercise their rights and take leadership roles in decision-making and income generation that affect their lives. In many parts of the world, young women will have less access to education, health services and fewer opportunities for employment in the formal labour market than young men. With access to education and training restricted, many young women are forced to work in the informal economy, hindering any advances for gender equality. In addition, many girls who become pregnant at a young age are forced to leave education. This has long-term implications for the young women as individuals, for their families and for their communities and re-entrenches prevailing gender stereotypes and roles. In these ways adolescent pregnancy, unsafe abortion, and exposure to sexually transmitted infections (STIs), including HIV and AIDS, can have a major impact on a young woman’s education and future employment opportunities. An estimated 215 million women who want to delay pregnancy are not using an effective method of contraception and that this figure represents 15 per cent of all women aged 15-49.
Another barrier is access to education. Educated women have more options than those without - education equates to more control over their lives. Educated women usually have fewer children, and the children they do have are often healthier and better educated. Increasing women’s economic opportunities - and control of assets - are a path out of poverty. It is vital that young women and girls have access to comprehensive and gender-sensitive sexuality education in both formal and informal educational settings. It provides knowledge and contributes to reducing gender stereotypes and violence against women. If a young woman delays childbearing until she has achieved her own educational goals, it has broad social and economic benefits, not just for her, and her family, but for society at large. Therefore, SRH services contribute toward improving women’s social position and their ability to participate equally in society.
The ICPD PoA highlighted the importance of placing SRH at the centre of efforts to advance gender equality and development. The Beijing PfA gave special attention to issues related to the sexual and reproductive rights of women, including access to family planning, maternal health and safe abortion services as a way to achieve gender equality. Access to these services is rooted within international human rights obligations and recognized by Treaty Monitoring Bodies (TMBs). A woman’s right to access contraceptive services is recognised by TMBs, with a lack of access to family planning understood to constitute a violation of the right to health. The UN Human Rights Council resolution on Preventable Maternal Mortality (11/8) recognises preventable maternal mortality and morbidity as a human rights issue.
Limited and uneven progress on MDG3 demonstrates the lack of priority afforded to gender equality by Member States. Although gender cross-cuts all MDGs, gender equality is to all intent and purposes isolated in one goal. Even if the MDG 3 targets are reached, it will not confirm progress on gender equality or the empowerment of women will be advanced. This is because MDG 3 fails to address many of the deep-rooted obstacles that impede women’s rights. We should recognise that while there are three MDGs related to health, and two related to gender, it is the goal that relates both to gender and health that is the most off-track (MDG5). Member States must:
- Ensure that MDG 5b target - universal access to reproductive health– is afforded the funding and political priority it deserves
- Develop effective strategies to ensure gender equity and gender-sensitive SRHR programmes and policies. These should be central to any new development framework that follows on from the ending of the current internationally agreed development goals in 2015. Member States should also recognize that the success of such a framework will require the meaningful engagement of civil society and the leadership in this process by young women. In addition, it will require the prioritization in policies and funding by Member States to meet MDG 5 and MDG 6
- Reprioritize family planning to ensure that the unmet need of 215 million women is met.
- Ensure adequate financial resources to implement effective interventions to improve the health and well-being of women. Ensure health systems prioritize women’s health and that women’s health is used as an indicator of the success of health systems.
- Meet the educational and service needs of adolescents, by providing access to comprehensive sexuality education.
- Implement measures to fully integrate women into the formal economy, in order to ensure women and men are treated equally in both formal and informal working environments
- Increase the mainstreaming of gender perspectives into all legislation, policies and programmes to ensure gender responsive budgeting.
- Develop institutional mechanisms that advance women’s human rights and to reform laws that discriminate against women or impede their ability to exercise their rights. As such it is necessary to enhance the monitoring of State’s compliance with international human rights obligations in the area of SRH.
Finally, it is incumbent upon Member States to do all that they can and to take the pro-active steps necessary to achieve gender equality and the empowerment of women. Without such progress, the MDGs will not be achieved.