Sexual and Reproductive Health Rights. Period!

In the context of understanding human rights, access to affordable sexual and reproductive services and health education, are fundamental human rights. The implications of denying this have been severe: an increase in sexually transmitted infections and diseases, unplanned pregnancies, unsafe abortions, and an increase in maternal mortality. Adolescent girls and young women are restrained from much needed access to information, which would enable them to have greater control over their bodies and decision-making, ultimately also challenging systemic oppression that seeks to control women’s bodies and sexual freedoms.

 

 Reproductive Rights in Africa

There has been peripheral progress when it comes to protecting African women and girls’ sexual and reproductive health rights (SRHR). Despite elaborated health policies, adopted declarations in the constitutions, action plans and frameworks, institutional reforms and some semblance of gender responsive budgets committed to addressing the need for high standard of health for every person, which includes the right to reproductive health care, many challenges remain when it comes to the implementation, especially pertaining to the highly controversial issue of abortion.

A 2017 factsheet on the legal status of abortion in Africa shows strict prohibition of abortion in 10 out of 54 countries, whereas an estimated 93% of women of reproductive age in Africa live in countries with restrictive abortion laws. South Africa, where abortion was legalised in 2006, still struggles with ‘shady backrooms’ and unauthorised clinics catering to half of all the abortions. This probably means that only very few women have the means to be able to obtain a safe, legal procedure.

In either case, the moot questions we need to ponder over are about the nature of public healthcare (less than 7% of public clinics and hospitals offered the procedure), availability (or lack thereof) of family planning services, like access to effective contraception and accurate information, state accountability (negligent), and above all, the still predominant societal attitude that stigmatises abortion in the attempt of preserving cultural morality (for instance, expulsion of pregnant girls from school and deny adolescent mothers the right to study in public schools) and harasses those trying to access safe abortion procedures. All these factors continue to push many girls and women to look for the easy/fast and hence unsafe routes.

And while the African states’ relatively unresponsive and hostile contexts pose one kind of challenge, the other most immediate threat comes from Donald Trump’s global gag rule, passed in 2017, which only further encourages continuation of regressive health regimes that restrict women’s broader right to decision making processes regarding their lives and bodies.

The reinstatement of the contentious ‘Mexico City Policy’ has attracted severe ire of African women’s rights groups, women’s funds, donors and NGOs alike. USAID, the body responsible for disbursing aid to groups, revised its policy that has already begun to affect the way organisations have been approaching reproductive health rights, and might possibly render many more organisations ineligible for funds, thus impacting critical work being undertaken at the grassroots level.

For instance, in Kenya, the Kisumu Medical and Education Trust in Kenya has lost the $2 million it expected in grants. Similarly, Marie Stopes International who has been providing contraceptives in Niger where just about 12% of women have access to modern contraceptives and prevent backdoor abortions, their funding will also be cut.

In Zimbabwe and Mozambique, the Mozambican Association for Family Development (AMODEFA) has been supporting local communities with family planning, reproductive health and maternal and child health care. It will lose 60 percent of its budget next year — leading to 10 of its 20 health clinics closing and 30 percent of its staff getting laid off.

Another article noted that women in conflict zones, or traumatised by war, would be hurt the most. In Nigeria, UNFPA has been working in camps helping women to receive contraceptives and other reproductive health related services. These will eventually come to an end with the very real threat of US defunding.

In other cases, like Egypt, a prominent organisation working closely on the issue of family planning and SRHR had to sign memorandums stating they will stop any ongoing work on safe abortion. An anonymous source tells us, “In Egypt, we had to sign some agreements that state we are not working and don’t plan to work in safe abortion in order to secure fund for other programs which serve distinct categories of women. We are in a battle of trying not to lose everything. Some organizations use hidden messages related to safe abortion through their SRHR campaigns. At the end, advocacy for new policies and strategies are the most negatively-affected aspect by Trump’s personal opinion!”

The move is particularly disappointing in the context of the Sustainable Development Goals (SDGs). For the first time these goals (introduced in 2015) include ‘global targets’ for addressing the issue of Sexual and Reproductive Health Rights (SRHR). The US being at the forefront of leading the financial and technical drive, passing of such an order has been viewed by many as a ‘stunning failure to protect the world’s most vulnerable.’

 The Way Forward

How are those in the movement, to go ahead and work, if such gag orders continue to define the parameters within which women can work, what issues are important and what aspects of an issue the organisations and grassroots must ‘invest’ in. Decades of work has gone into making reproductive health rights a reality, many gains made are now at risk, courtesy of growing and globalising networks of conservative and fundamentalist groups that are aggressively pushing back against women’s sexual and reproductive rights.

We have to address issues through the lens of rights and intersectionality for the concept of ‘leaving no one behind’ to succeed.

Governments must ensure that their laws, policies and practices are built on their human rights obligations and on the recognition of women’s dignity and autonomy. It only makes more sense for the member states to step up and commit to comprehensive conventions like the Maputo Protocol whose provisions categorically aims at eliminating injustices against women and girls in Africa. An encouraging example of this would be Rwanda who back in 2012 lifted reservations on abortion provisions in the Protocol. The act reaffirmed its own commitment to women’s SRHR and in compliance with its minimum obligations under international and regional human rights law.

The current socio-politico scenario is such that any effort to secure justice for sexual reproductive and health rights must go beyond top-down health provisions. There needs to be:

• better focus on enforcement, including strengthening institutional mechanisms, resources and increasing the human capacity needed to ensure enacted legislation promotes SRHR;
• holding perpetrators accountable; a functional redressal system to ensure comprehensive reporting of discrimination and violence
• encouraging different stakeholders to work together to devise plan of action, which is: a) inclusive, b) makes services affordable and accessible for women and girls, c) addresses the very structural inequalities that perpetuate discrimination and violence against girls and women, and d) ensures that African women have access to domestic remedies to effectively bring about change in their conditions.
• periodic monitoring/reporting and develop robust data collection to identify gaps and challenges

*Surbhi Mahajan currently works with The Hunger Project, India office, on the issues of women’s political representation and participation in local governance, deepening democracy, gender and development. Follow her at @surbhi_sarita.