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: Human rights barriers to comprehensive cervical cancer prevention, screening and treatment
The 2012 Southern Africa Litigation Centre report on cervical cancer in Southern Africa concluded that very few SADC countries are effectively addressing cervical cancer, with few having comprehensive cervical cancer policies in place. In order to prevent unnecessary deaths, governments must ensure that women are able to access a comprehensive cervical cancer programme that includes primary prevention, screening, treatment, palliative care and makes adequate provision for the special needs of women living with HIV or those at higher risk of HIV. The HPV vaccine is not widely available for free in many SADC countries and other barriers to prevention, screening and treatment include a lack of trained health care workers and inadequate laboratory facilities.
In addition to the structural barriers, there are human rights issues that prevent women and girls from accessing care where it is available, including the following:
Lack of information about cervical cancer and misperceptions about the HPV vaccine
Research shows that there are low levels of knowledge about cervical cancer in Southern Africa.74
The lack of information amongst women and girls, parents and health care workers, creates obstacles to access services, even if they do exist, and reinforces negative attitudes on the part of health care workers about sexual and reproductive health care. Girls and young women are especially vulnerable to stigma and discrimination when they seek sexual and reproductive health care, including information on cervical cancer. Lack of information particularly undermines prevention efforts which depend on women and communities being aware of, and understanding their risks and what prevention and screening services are available.
Young women and girls also face particular challenges in accessing information about their risk of cervical cancer and HPV infection. There are many misconceptions about the HPV vaccine, including whether it is safe to administer and whether it promotes promiscuity. There are insufficient programmes that target parents and care givers about why it is important to vaccinate girls and the health benefits of the vaccine. Health care workers are often not trained to provide information and care to young women and girls and they lack the necessary skills to support this group of vulnerable women. In addition, age of consent laws may prevent girls from accessing services related to cervical cancer without the consent of their parents or guardians.
Stigma associated with sexual and reproductive health care, including cervical screening
Women in Southern Africa often face stigma when they seek out sexual and reproductive health care. Cervical screening and its association with STIs is often seen as an indication of sexual promiscuity, deterring women from asking for these services. Women may fear that when it is disclosed that they sought out cervical cancer screening, they will be abandoned by their partners and ostracised by their community.
Gender inequality
Women do not always have the power to access sexual and reproductive health care without the permission of their spouses or sexual partners. These concerns may be especially acute for women in rural areas and who live under customary laws.
What can parliamentarians do to advance prevention, screening and treatment for cervical cancer?
Parliamentarians can play a critical role in ensuring that the myths and misinformation about cervical cancer, arising in part from custom and tradition, are dispelled and women and girls, including those living with HIV, receive the right information at the right time in order to make informed decisions about their health.
Undertake advocacy research: Parliamentarians can initiate research into the human rights barriers to prevention, screening and treatment programmes for cervical cancer. Parliamentarians can investigate the barriers faced by women living with HIV and vulnerable women and ensure that their needs are adequately addressed. They can commission research on the potential to scale up access to the HPV vaccine and cervical cancer screening and treatment.
Enact and strengthen laws: Parliamentarians can draft and enact laws promoting access to comprehensive prevention, screening and treatment for cervical cancer. They can ensure that laws:
- Promote equal, non-discriminatory access to cervical cancer programmes and ensure that women are able to make informed decisions about their health, including access to the HPV vaccine;
- Promote access to cervical cancer programmes for women living with HIV and marginalised or vulnerable women;
- Do not require spousal or parental consent to access information about cervical cancer;
- Do not require spousal or parental consent to access the HPV vaccine;
- Respect the right to medical confidentiality for women and girls; and
- Promote CSE for adolescents and young men and women, including information about the risk of cervical cancer.
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 and do not hamper access to cervical cancer services. 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 cervical cancer programmes. 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 governments to develop national cervical cancer plans to address the need to improve services and work with the medical profession to ensure they are evidence based. They can monitor and hold government ministries accountable for reporting on their progress towards implementing these plans.
Budget monitoring: Parliamentarians can advocate for adequate budgets to be allocated for measures to advance universal access to SRHR, including cervical cancer programmes. The budget should include provision for medical equipment and technology required to track and diagnose cervical cancer at its early stages, and should monitor that equipment reaches hospitals or health care centres spread across the country. They can analyse budget allocations for SRH to assess that programmes include cervical cancer programming and that programmes will reach the most vulnerable women, including women living with HIV. 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 cervical cancer and are appropriately costed to ensure implementation.
Be an opinion leader and influencer: Parliamentarians can help raise awareness about cervical cancer, the HP virus and the links between HIV and HPV. They can become opinion leaders on the importance of access to the HPV vaccine and help to de-stigmatise adolescent sexuality so that girls can access to HP vaccination. By speaking out, parliamentarians can encourage a human rights-based approach to cervical cancer and more social acceptance of cervical cancer prevention and screening. They can actively support CSE, including for the girls that are due to receive the vaccine. They can attend events and deliver speeches to frame cervical cancer as a human rights issue. They can also work within Parliament and in Parliamentary forums and networks, to raise awareness amongst fellow parliamentarians. They can share lessons learned with other parliamentarians at regional and global level, including from outreach to communities on HIV.
Work with the media: Parliamentarians can work with the media to raise awareness and to encourage more reporting on cervical cancer. They can encourage the media to write stories that sensitively convey information about cervical cancer, the increased risk for women living with HIV, the need for adolescent girls to access the HPV vaccine and provide accurate information about screening and treatment for cervical cancer.
Next, we discuss: Key populations