As part of the main drivers of the BAM Group of Companies, this being the umbrella company within which Informative Newspaper operates, alongside sister brands Finite Magazine, Finite Lifestyle Club, Bam Promotions and Twin Talk, Informative Newspaper takes particular interest in social issues and causes created to advance the development of young girls and women and their participation in the global space.
To advance and cement the organization’s support for women and young girls, the Sexual and Reproductive Health and Rights is today, through this issue introduced. Its purpose is to advance knowledge and create further awareness on developments surrounding the said community sector and to help audiences stay updated on such, further guiding means of both action and reaction to these developments.
This week we discuss Contraception and family planning,
Family planning programmes are a key component of comprehensive SRH and they provide essential services, information and commodities to women. Family planning not only benefits women, it also helps families and communities: when women are able to manage the size of their families, they can ensure that all children go to school and households have more resources for food, shelter and health care.
According to global research conducted in 2014, 225 million women who wanted to prevent or delay pregnancy were not using an effective method of contraception51and a 2012 study on global trends on intended and unintended pregnancies showed that about 40% of all pregnancies globally are unintended, with the highest number of these being in Africa.52 Both married and unmarried women experience barriers to accessing contraception and to making informed decisions about family planning.
Lack of access to contraception puts women at risk of HIV and other STIs and leaves them powerless to make decisions about the most intimate aspects of their lives.
The adverse health consequences of unintended pregnancy include chronic illhealth and even death, while the social costs include increased poverty, disruption of education for girls and stigma and discrimination.
In addition to preventing unwanted, unintended pregnancies, family planning services, when integrated with HIV services, provide a crucial opportunity to discuss HIV with women, helping them assess their risk of HIV, including from sexual violence, how to prevent transmission and linking them to HIV testing and counselling services. It is also a critical, and often missed opportunity, to provide targeted services for women living with HIV.
The right to family planning and contraception is grounded in international and regional human rights, including the right to the highest attainable standard of health, the right to decide the number and spacing of one’s children, and the rights to privacy, information and equality and non-discrimination. SADC countries have ratified international and regional human rights treaties that oblige them to protect and promote these rights.
The CEDAW states that women have the right to determine the number, spacing and timing of their children and to have access to contraception and the information needed to exercise that right. The Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (the Maputo Protocol) includes the right to decide whether to have children, and the number and spacing, as well the right of women to control their fertility and to have access to family planning education. The Protocol also includes the right to be protected against HIV and STIs.
The Committee on Economic, Social and Cultural Rights and the CEDAW Committee have interpreted the right to health to include SRH and that contraceptive information and services are necessary to fulfil this right. The CSW adopted resolution 60/2 in 2016, calling on states to ensure that women can exercise their right to have control over and decide freely and responsibly on matters related to their sexuality, including their SRH, free of coercion, discrimination and violence.
In addition to their legal obligations under international human rights laws, SADC countries have also committed to achieving the SDGs, also known as the Global Goals. These goals aim to end extreme poverty, eliminate inequality and injustice and address climate change by 2030. Target 3.7 aims to ensure universal access to sexual and reproductive health care services, including family planning education and information, by 2030. The indicator for this target is the proportion of women of reproductive age who have their need for family planning satisfied with modern methods.
Family Planning 2020
Family Planning 2020 is a global partnership between governments, civil society, multilateral organisations, donors, the private sector and the research and development community to support women’s access to contraception and their rights to decide “freely and for themselves, whether, when and how many children they want to have”.
The campaign plans to expand access to contraception, information and family planning services to 125 million women and girls in 69 of the world’s poorest countries by 2020.
Focus countries include several SADC countries: the Democratic Republic of Congo (DRC), Lesotho, Madagascar, Malawi, Mozambique, South Africa, Tanzania, Zambia and Zimbabwe.
Human rights barriers to family planning and contraception
Harmful gender norms
Women and girls may be unable to access family planning because of family or spousal opposition, often based on religious reasons or social values. In many African countries, married women may themselves oppose contraception because they believe it is their duty to have children. Adolescent girls and young women may not be able to disclose that they are sexually active because of social norms and this may limit their ability and willingness to access contraception.
contraception and family planning
Many women struggle to access information about modern contraception and do not understand how contraception works or which method would work best for them. The lack of information does not only impede access because women do not demand access, but it also leads to misconceptions about the side effects and health risks associated with contraception which may deter women from asking for and using contraception. For example, some women believe that hormonal contraception may make them infertile or cause cancer.
In Africa, studies show that many married women do not use contraception if they have not resumed menstruation post-pregnancy, they are still breast-feeding or both because they do not believe they can get pregnant.
Women living with HIV and family planning
Family planning services rarely provide targeted services and information to women living with HIV, who have both the same and different family planning needs as other women. They have a higher risk of contracting STIs and need specific information about their options for contraception, including access to male and female condoms.
Women living with HIV have the right to become pregnant and have children. They should be able to decide whether they wish to have children and to plan their pregnancies, but they frequently cannot access accurate information that allows them to make informed decisions about pregnancy and children in the context of their HIV status. Some may be pressurised by health care workers, families and sexual partners to be sterilised and women living with HIV in some SADC countries have reported being sterilised without their informed consent.
Consequences of the lack of access to contraception and information include Health consequences of unintended pregnancy. Women who do not have access to contraception are unable to prevent or delay their pregnancies and many, especially vulnerable and marginalised women and adolescent girls, experience negative health consequences as a result. Providing access to all women in developing countries who have an unmet need for contraception would prevent: 54 million unintended pregnancies, 16 million unsafe abortions and 7 million miscarriages, 79 000 maternal deaths and 1.1 million infant deaths.
Lack of sexual autonomy
Lack of access to contraception undermines the ability of women to control their fertility and health, undermining their ability to enjoy a satisfying sex life.
What can parliamentarians do to advance access to family planning and contraception?
Undertake advocacy research: Parliamentarians can initiate research into the barriers to family planning, including the lack of education about contraception both inside and outside hospital and clinic facilities. This research should pay specific attention to the family planning needs of women living with HIV, female members of key populations and young women, as well as the specific barriers they face in accessing services and information. It is important for parliamentarians to understand the reasons why women in their countries are not accessing contraception as reasons will differ between countries.
Further, by understanding the dynamics in their own countries, parliamentarians could encourage evidence based policies and programming. Parliamentarians can investigate the availability of family planning in public health facilities and whether health care workers have been trained to advise and administer contraception, including to women living with HIV, female members of key populations and young women. They can also investigate the availability of CSE for adolescents and young people that includes information and education about family planning and contraception.
Parliamentarians can also initiate research into special programmes that promote access to contraception and information to marginalised and vulnerable women.
Enact and strengthen protective laws: Parliamentarians can draft and enact laws promoting access to family planning. They can ensure that laws:
• Promote equal, non-discriminatory access to family planning and contraception, ensure that women are able to make informed decisions about contraception and give their informed consent before using any form of contraception;
• Promote access to family planning and contraception for young women, women living with HIV, female members of key populations and other marginalised and vulnerable women;
• Prohibit any form of coercion in access to contraception, including sterilisation;
• Do not criminalise methods of preventing pregnancy, including abortion;
• Do not require spousal or parental consent to access contraception and contraceptive information;
• Respect the right to medical confidentiality for women and girls; and
• Promote access to CSE for adolescents and young men and women, including information about contraception
Ensure accountability for implementation of commitments: Parliamentarians can undertake legal audits to assess the extent to which laws and policies are consistent with their international and regional human rights commitments. They can also call for accountability to and reporting on efforts to meet related international and regional human rights commitments. They can meet with the relevant parliamentary committees to share information and concerns about discriminatory laws and assess what changes are necessary to advance access to family planning and contraception. They can meet with international and regional experts to discuss what law reform is necessary and advocate for legal and policy reform to ensure compliance. They can monitor and hold government ministries accountable for reporting on their progress towards amending discriminatory laws and enact protective ones, and they can encourage civil society to monitor whether protective laws are being implemented.
Where they find deficits, they can advocate for legal and policy reform to ensure compliance. Parliamentarians can encourage government to develop national plans of action, with clear targets, milestones, indicators and allocated budgets, to achieve SDG Target 3.7 on ensuring universal access to sexual and reproductive health care services. They can monitor and hold government ministries accountable for reporting on their progress towards achieving SDG Target 3.7.
Budget monitoring: Parliamentarians can advocate for adequate budgets to be allocated to advancing universal access to SRHR, including family planning and contraception and ensure that budgeted programmes for family planning and contraceptive methods are tailored to the needs of the community, taking into account conservative traditions and practices of certain social groups and communities and indicating clearly the scientific evidence available on reproduction and ways to control it safely. They can analyse budget allocations for SRH to assess that programmes will reach the women and girls who most need them. They can encourage various ministries (e.g. health, education, justice) to budget for relevant programmes and that human rights are fully integrated into programmes on contraception and appropriately costed to ensure implementation.
Be an opinion leader and influencer: Parliamentarians can become opinion leaders on the importance of access to contraception and family planning for all women who wish to enforce their human rights to decide on the number and spacing of their children. They can play a particularly important role in destigmatising women living with HIV who want to get pregnant by framing access to family planning as a human right for everyone. By speaking out, parliamentarians can encourage a human rights-based approach to family planning and more social acceptance of contraception and support for women to access and use them. They can use international or national human rights days, including World Contraception Day (26 September) to increase awareness about the negative consequences of unintended pregnancy and the importance of universal access to contraception. They can also work within Parliament and in Parliamentary forums and networks, to raise awareness and share lessons learned amongst fellow parliamentarians at regional and global levels.
Engage with civil society: Parliamentarians can engage with CSOs, including women’s groups, health care workers and other groups working on women’s reproductive health to increase awareness, understanding and information on SRHR including access to family planning and contraception. They can invite CSOs and the communities they work with, to provide expert information at parliamentary hearings on the barrier to access contraception, including for vulnerable groups, the harmful consequences of unintended pregnancies and challenges within the legal framework that prevent women, or particular groups of women from accessing contraception. Parliamentarians can play an important role in ensuring that the voices of women and girls, including those living with HIV, are included in discussions about their lives and that they can influence all aspects of contraceptive planning, including design, implementation and monitoring.
Represent their electorate: Parliamentarians should engage with and reflect the concerns of all their electorate, including women and girls. Parliamentarians can engage with key stakeholders within communities such as women, HIV support groups, health care workers, parents, traditional leaders and religious leaders, to increase awareness about human rights and family planning. In particular, parliamentarians can ensure that they include the voices on girls and young women at the centre of these conversations.
Work with the media: Parliamentarians can work with the media to raise awareness and to encourage responsible reporting on SRHR, including access to contraception. They can encourage the media to write stories that sensitively convey the consequences of unintended pregnancy, that portray the contraceptive needs of women and girls, including those living with HIV and key populations, accurately and without judgment and that provide relevant and reliable information about the public health benefits of contraception. They can encourage journalists to seek out women living with HIV and report their stories.
Next we discuss Safe Abortion
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