1994 Cairo Agendamatters to women and girls

03Dec 2019
Kenneth Simbaya
The Guardian
1994 Cairo Agendamatters to women and girls

FROM 12-14 November, this year, the governments of Kenya and Denmark and United Nations Population Fund (UNFPA) co-organized the International Conference on Population and Development (ICPD)25,dubbed:-

-Nairobi Summit on ICPD25—a high-level conference to mobilize the political will and financial commitments we urgently need to finally and fully implement the ICPD Programme of Action (PoA).

Our Correspondent KENNETH SIMBAYA interviewed EngenderHealth President and Chief Executive Officer (CEO) TRACI BAIRD, who attended the conference with the intent of getting her reflection of the summit and some key takeaways from the summit. Read on…

QUESTION: What have you learnt from ICPD25 Conference?

ANSWER: I always like to celebrate the progress that we make in the hard work that we do, and there were nice moments of celebration at the Nairobi Summit – for example, in the release of FP2020’s video about the history and progress in family planning in the past 25 years. 

However, despite progress in improving SRHR, we have a long way to go in order ensure that everyone, everywhere, benefits from policies, services, community support, and their own ability to make their choices and achieve their health and life goals. 

Fortunately, at the Nairobi Summit I saw great examples of country leadership, ownership, and accountability; the critical engagement of civil society; and the voices of feminist movements, youth movements, and groups of indigenous and disabled women, among others, ensuring that they are involved and part of the global solutions as we make good on the commitments of the Summit.

My final takeaway is that we cannot disconnect SRHR and gender equality: we must advance on each to achieve the other.

Q:  Is it possible to end unnecessary maternal deaths in pregnancy and childbirth by 2030 without access to safe abortion?

A: No. The 25 million unsafe abortions that occur in the word every year contribute to about 8% of maternal deaths, as well as to significant levels of disability.

We will not be able to fully address maternal health – or ensure that people can exercise their human rights to health and bodily autonomy – without safe abortion. We know that no contraceptive method is 100% effective, not all girls and women have access to contraception (although of course that is one of the goals of the Nairobi Summit), and not all sex is planned or consensual.

We also know that limiting access to safe abortion does not reduce abortions – it just forces people to resort to unsafe abortion. Safe abortion must be available -- we cannot end preventable maternal deaths without access to safe abortion.

Even beyond that goal, as a matter of basic human rights, women need to be able to choose whether, with whom, and when to have children; safe abortion is part of that choice. 

In advance of the Nairobi Summit, EngenderHealth endorsed the Global Declaration on Abortion, joining dozens of organizations around the globe in a call for a comprehensive, rights-based approach to comprehensive abortion access.

Q:  Which are better, providing safe abortion services or treating serious morbidities resulting from complications of unsafe abortion? 

A: It is important to note here that EngenderHealth always operates within the confines of the laws and regulations in every country and community in which we work, and we are highly aware that legal frameworks around abortion vary from country to country.

That said, I would respectfully argue that the question is framed around a false dichotomy. Those who are shaping health systems and approaches to health service delivery should not be thinking in an “either/or” framework. Instead, we should strive to provide every single individual with the best medical care.

We should strive to ensure that all people can benefit from scientific progress, including access to safe abortion technology and a range of modern contraceptive methods.

We also need to ensure that this access is equitable, and that all people, irrespective of their education, economic status, or geography can benefit from health information and comprehensive sexual and reproductive health care. With that approach, we can eliminate serious morbidities resulting from unsafe medical procedures, and end preventable maternal deaths.

Q: What has been EngenderHealth’s support to Tanzania? And to what extent has that support helped the country move closer to ICPD PoA, specifically on maternal deaths and gender equality?

A: Our support has focused on working with the government as per the allowable policies and guidelines in the country.  Our support has enabled millions of Tanzanian women the ability to choose whether, when, and how many children to bear over their lifetimes. 

Our work has supported the government to update policies, guidelines, and training curricula; training of master trainers; and the establishment of quality improvement and quality assurance processes throughout the country. 

In collaboration with the government, we have established programs for family planning special days and family planning outreach services that have enabled millions of Tanzanian women to access family planning services, making services available, accessible, and affordable (free), and of high quality. 

We have also supported the government to integrate FP services into other government services, including HIV and Immunization. 

Finally, we have also worked with the government to demonstrate that assistant medical officers are equally capable of providing tubal ligations through mini-laparoscopy in Tanzania, leading to a change in the national guidelines.

Under our Men as Partners work and our current work on gender, through the government, we continue to engage men and women in dialogue, and support women and men to establish positive relationships so men are engaged in decisions (where warranted). 

In the work we do to address gender-based violence, we have worked with individuals and communities to address the fundamental gender dynamics that are at the heart of why gender-based violence occurs in the first place. 

We have worked hand-in-hand with the government of Tanzania to establish a national response to GBV, ensuring that women are screened and that health facilities, police, and justice provide one-stop services to reduce the burden survivors of violence. 

Finally, more recently, we have worked with the government to revise guidelines for the provision of post-abortion care services for all women. 

We have also worked with the government to train master trainers and provide training for hundreds of health care providers throughout the country to ensure that women who seek post abortion care services receive immediate and effective support. 

As is the case in all our programs, we have integrated FP in the PAC services we provide, so women and girls who are treated for abortion complications also receive counseling on effective contraception methods and their method of choice from the same PAC provider.

We are committed to bringing high quality services closer to women wherever they are.  Our collaboration with the Tanzanian government has enabled us to do just that.  We look forward to continuing to collaborate with the government and to ensure that there is zero unmet need, zero preventable maternal deaths, and zero gender-based violence and harmful practices against women and girls. 

Q:What will it take to achieve zero unmet need for family planning, zero preventable maternal deaths, zero gender based violence and harmful practices against women and girls?

A: The “zero goals” – zero unmet need for contraceptive counseling, information, and services; zero preventable maternal deaths and morbidities; zero sexual or gender-based violence or harmful practices against women and girls; and zero gender discrimination – are ambitious goals that are acting as a call to action for organizations and government agencies around the world. Making progress on these goals will take coordinated action, information sharing, and multi-sector partnerships.

Many governments – including Tanzania – have already clearly stated their commitments to these goals, and connected those commitments to national development plans. To achieve those commitments, governments will need to work closely with partners, including nongovernmental organizations, international nongovernmental organizations, foundations, and private sector actors.

Citizens will need track their government’s actions and progress toward the commitments made on behalf of the populations they represent.

EngenderHealth envisions a gender-equal world where all people achieve their sexual and reproductive health and rights, and we believe that progress on the zero goals will be accelerated by the engagement of all stakeholders, and all communities, in this effort. We must especially listen to and fully engage with the important voices and work of groups that have not equally benefitted in the progress that has been made in SRHR since Cairo.

Young people, indigenous people, people with disabilities, and sexual and gender minorities are among those who have not equally benefited, and they must so the Summit goals can be achieved by and for everyone.