How can Sexual and Reproductive Health & Rights be ensured for hard-to-reach and vulnerable groups?
Young people, people living with disabilities, and people living in fragile settings continue to be among the least able to realise their sexual and reproductive health and rights (SRHR), and are vulnerable to discrimination, violence and illness. Safeguarding SRHR for these very groups lies at the heart of the 2030 Agenda vision for sustainable development.
The 15th International Dialogue on Population and Sustainable Development closed in Berlin on November 24th, with delegates delivering a message of resilience in challenging political times, and the protection of the sexual and reproductive health and rights of young people, people living with disabilities and people living in fragile settings. The two-day conference allowed for an exchange between stakeholders from government, civil society organisations and multilateral institutions, as they discussed how to make the 2030 Agenda for Sustainable Development ambition to ‘leave no one behind’ a reality in the lives of the most vulnerable people on the planet.
Every person should have a choice
In his welcome remarks, Andreas Proksch, the Director General of the Deutsche Gesellschaft für Internationale Zusammenarbeit (GIZ), encouraged delegates to seek innovative solutions as they worked towards the common goal of making sexual and reproductive health and rights a reality for all, everywhere, especially for women and girls.
“Every person should have a choice of when, with whom, how many and in what spacing to have children – or not to have children at all,” Proksch explained. “No woman should die as a result of preventable causes such as unsafe abortion or due to complications during pregnancy and in childbirth.”
Klaus Brill, Vice President of Global Healthcare Programs at Bayer AG encouraged delegates to embrace private-public partnership in the pursuit of human rights and acknowledged the uphill battle faced by many of those gathered. Continued perseverance, he said, would eventually see the true advancement of SRHR for the world’s neediest people.
In Africa, one in every ten girls between 15 and 19 is a teenage mother
The morning’s opening remarks were delivered by Thomas Silberhorn, Parliamentary State Secretary for the German Federal Ministry for Economic Cooperation and Development (BMZ). He outlined Germany’s global projects aimed at achieving the 2030 Agenda for Sustainable Development, including their work in Africa, where one in ten girls aged 15 to 19 becomes a mother. “In addition to exposing the girls to health risks, such pregnancies often put an end to their educational journey. And these girls have hardly any chance of working in a decent profession later on in life,” he said. To offer girls and women a chance at a better life, Germany works to reach young people through peer education projects, among others, and more than a million now have access to comprehensive sexuality education.
Accelerating progress for the most vulnerable
The Dialogue’s keynote speaker, Natalia Kanem, the Executive Director of the United Nations Population Fund (UNFPA), applauded the significant progress seen over the nearly 25 years since the ICPD. “the chance of a woman dying due to pregnancy and childbirth complications have fallen by almost half,” she said. “And for the first time in history, we have more than 670 million women and girls in developing countries who have access to modern contraceptives.
But she called for delegates to accelerate progress for young people, people living with disabilities and women and girls who are most vulnerable during violent conflict and natural disasters. “Too many continue to be left behind and it is increasingly an unequal world,” she warned.
Kanem offered the example of obstetric fistula “which is a tragic manifestation of our collective failure as a society and as a health system to protect the reproductive rights of the poorest, most excluded women and girls”. This is a traumatic injury ruptures the womb and is both preventable and treatable, but it persists because of weak health systems, poverty, gender inequality, early marriage and early child bearing.
It’s taboo to speak about SRHR for people with disabilities
This set the stage for a conversation with experts about what it actually means to leave no one behind. In a session with Silvia Quan, an advocate for persons with disabilities from the the International Disability Alliance, Sarah Keogh, an expert in the barriers faced by young people, from the Guttmacher Institute and Sandra Krause, the Director of the Women’s Refugee Committee, and member of the Inter-agency Working Group on Reproductive Health in Crisis. The trio discussed a number of possible ways to overcome challenges encountered in the implementation of the SRHR-related SDGs for young people, people with disabilities and those living in fragile settings.
“Dealing with SRHR of persons with disabilities has been overlooked for decades,” said Quan. “When we speak about persons with disabilities, it is usually a taboo, so is speaking about SRHR. So joining the two together, SRHR for people with disabilities, it is a major taboo. There are too many harmful stereotypes, particularly that people – mainly young people or women and girls with disabilities – are asexual or hypersexual. These myths have helped create very poor solutions.”
Quan outlined the difficulties in convincing power-holders that persons with disabilities have the right to choose. Sarah Keogh added that 10 to 14 year-olds are at a critical age for laying the foundations of positive sexual and reproductive health, and they too find themselves outside the thinking of policymakers and health systems. Sandra Krause, meanwhile, reflected on the importance of reaching people in fragile settings as a key to successfully implementing the 2030 Agenda.
In conflict-affected settings “the biggest concern for very young adolescents is security. They are fearful of sexual violence and sexual exploitation and abuse, outright abduction and sex trafficking,” Krause said. Safe spaces are essential in order for education, including SRHR education, to take place.
Following this talk, there was a vibrant Q&A session in which innovative, inclusive solutions were shared and delegates debated the intersectionality of gender and disability in relation to SRHR issues. The delegates then broke into smaller groups for a rotating discussion on how to advance SRHR for hard-to-reach and vulnerable groups within the UN system through the High-Level Political Forum (HLPF), the Commission on Population Development (CPD), the Human Rights Council (HRC), and the monitoring bodies of the Convention on the Rights of Persons with Disabilities (CRPD
Young voices speak out
Day Two opened with a spotlight on young voices, through an interview with Ana Rizescu, Coordinator at YouAct, the European Youth Network on Sexual and Reproductive Rights, and Levi Singh, the National Coordinator of Siyakwazi Youth Network in South Africa. Rizescu outlined the threats faced by youth SRHR advocates in Poland, Turkey and Russia, and the rise of right wing movements worldwide that threaten access to services and information.
Singh echoed Rizescu’s concerns, adding that in some regions “it is quite dangerous to undertake activism. “Any sort of activism, even SRHR related, can be viewed as holding anti-government views, so it’s quickly suppressed.”
The delegates were then encouraged to share innovative solutions for advancing SRHR-related SDGs for hard-to-reach and vulnerable groups during four rounds of participatory poster presentations. During these sessions, experts and advocates from around the world presented their work,sharing best practices, while also listening to delegates suggestions for how to improve that work or overcome challenges.
Honouring the achievements of SRHR advocates
The event closed with a red-carpet awards ceremony, which was held to celebrate the achievements of SRHR advocates. Among the award winners were the Nepal Disabled Women’s Association, IPPF Humanitarian – and Yamaan, a local foundation in Yemen. Yamaan’s win brought delegates to their feet in a display of solidarity. In his acceptance speech, Executive Director Ashraf Badr spoke of the ongoing blockade and violence. “People are in a very, very bad situation and they need all the support the international community can provide,” he said. “Sexual and Reproductive Health is important and it can easily be integrated into any support offered to any country in fragile contexts or humanitarian situations.”
Saroja Coelho, December 2017
Articles on previous International Dialogue conferences:
- International Dialogue: Accountability to advance SRHR commitments
- International Dialogue 2015: Advancing sexual and reproductive health and rights in the new era of sustainable development
- International Dialogue 2014: ICPD and Beyond: Investing in Health and Rights
- International Dialogue 2013: Youth and Employment – Realizing the demographic dividend