Meeting the Reproductive Needs and Rights of Women and Girls: The Legacy of ICPD is in the Details
Guest post by Mary Beth Hastings, Vice President of Center for Health and Gender Equity (CHANGE)
The task of translating the International Conference on Population and Development’s (ICPD) Programme of Action (PoA) into meaningful change for women and girls globally includes some important detail work. Several years ago, my organization – the Center for Health and Gender Equity (CHANGE) – set out to better define the meaning of key PoA terms. Our guiding question was: “What constitutes comprehensive, rights-based sexual and reproductive health (SRH) care?” We found some useful literature and human rights documents to point us in the right direction, but most importantly, we wanted to make sure our answer was grounded in the lived experiences of women and girls.
Community-based health workers in Bahir Dar, Ethiopia met with CHANGE to share their comprehensive approach to sexual and reproductive health and rights. Photo by S. Sippel/CHANGE
Getting Real on Rights: Experience from Two Country Consultations on Applying a Rights-Based Approach to Family Planning Programming
Guest post by Shannon Harris
Given the many challenges that countries face in providing family planning (FP) services, how can a client-centered, rights-based approach to programming help governments meet their obligations to respect, protect, and fulfill clients’ rights to meet their reproductive needs and desires? This question framed two recent country consultations in India and Kenya to explore the feasibility and desirability of applying the voluntary, rights-based FP (VRBFP) conceptual framework. Were country-level FP stakeholders—program managers, policymakers, and providers—even interested in such an approach?
With funding from the Bill & Melinda Gates Foundation, the Futures Group and EngenderHealth partnered with the Population Foundation of India and the National Council for Population and Development in Kenya to host national and regional stakeholder consultations, as well as conduct FP site visits to explore these questions. Despite diverse cultural, policy and program environments, stakeholders in both countries expressed tremendous interest in using a rights-based approach. Stakeholders found the program vision described in the VRBFP framework appealing and relevant to their programs because of its emphasis on the individuals and communities served by the FP program, while simultaneously acknowledging the importance of the policy environment and supply-side factors.
Members of the Futures Group/EngenderHealth rights framework team visit a community motivator in India’s Bihar State to identify the realities and challenges related to protecting and fulfilling human rights in FP at the community level—specifically to identify the conditions and practices that either uphold or violate human rights. (Photo by H. Connor/EngenderHealth)
Family Planning for All: The Importance of Contraceptive Access and Choice following Fistula Repair
Guest Post by Carrie Ngongo (Project Manager, Fistula Care Plus)
People often assume that women who’ve undergone an obstetric fistula repair are not interested in using family planning (FP). After all, most lost a baby during the obstructed labor that led to their injury. However, recent studies (see here and here) indicate that fistula clients are often interested in using FP if they learn about available methods and services during their post-repair recovery period. When fistula surgeons and counselors make assumptions about women’s desires, they miss the opportunity to provide needed services and to offer reproductive choices to women who may have been disadvantaged and marginalized as a result of their injury.
Photo by R. Raj Kumar/EngenderHealth
Ensuring Human Rights–Based Goals in the Post-2015 Development Agenda
This week, the Center for Reproductive Rights (CRR) published Substantive Equality and Reproductive Rights: A Briefing Paper on Aligning Development Goals with Human Rights Obligations, a new resource offering guidance on how governments can ensure that principles of substantive equality, including human rights principles and obligations, are reflected in the post-2015 development agenda.
Substantive equality calls for states to respect, protect, and fulfill human rights, ensure equality for all, and promote accountability for rights violations. The paper contends that violations of reproductive rights are primarily manifestations of discrimination, poverty, and violence. Therefore, where women’s rights to equality and nondiscrimination are not fulfilled, their ability to access reproductive health services and make meaningful choices about their reproductive lives is limited.
Keeping Complexity in a Human Rights–Based Approach to Family Planning: Is It Worth It?
Submitted by Shannon Harris, on behalf of the team led by Futures Group and EngenderHealth that developed the Voluntary, Rights-Based Family Planning Framework
Human rights–based family planning (FP) programming—what does it mean? Where do you start to translate it into practice? How comprehensive do you need to be? It is easy to become daunted by a long list of inputs and activities, such as those listed in the voluntary, rights-based family planning framework developed by a team led by Futures Group and EngenderHealth. The recent 2020 Vision newsletter refers to the overwhelming nature of existing guidance documents for ensuring that FP programs are rights-based and offers a simplified starting point. But will simplification of a complex set of challenges lead to the transformation in FP programming that our field needs?
We welcome the dialogue started by Population Action International (PAI) about how to move forward to protect and fulfill human rights within FP programs. This conversation is needed; multiple voices and views add richness to the discussion. PAI suggests starting with three priorities: voluntarism, informed choice, and achieving a diverse method mix. Certainly, we have to start somewhere, and these three elements are essential to rights-based FP— programs must be vigilant in preventing instances of coercion and in ensuring full, free, and informed contraceptive choice.
However, these program elements are not sufficient to ensure equitable access to services for all nor to ensure that the services are of high quality. They also do not address community factors that impede access to and use of FP. And they do not address the issue of accountability. These are critical considerations for reaching and fulfilling the human rights of the 220 million women with an unmet need for FP.
Strengthening the Links Between Human Rights and Family Planning: An Update from Addis
Guest Post by Shannon Harris
There is greater interest and investment in family planning (FP) programs now than in the last 20 years. With this increased attention and funding, programs are also benefiting from an increased commitment to ensuring that vulnerable and hard-to-reach populations are being better served and that women are receiving high-quality services and expanded contraceptive choice. As FP reemerges as a global priority, there is more attention to the human rights that underlie providing contraceptive services to all individuals. The recently published Family Planning 2020 (FP2020) first annual progress report highlights the new Conceptual Framework for Voluntary, Rights-Based Family Planning, a tool designed to ensure that public health programs oriented toward increasing voluntary FP access and use respect, protect, and fulfill human rights in the way they are designed, implemented, and evaluated.
Walking Together: Strengthening Health Facility and Community Links to Improve Access and Choice
Guest post by Molly Tumusiime, Program Associate (Community Engagement), EngenderHealth/Uganda
The Right to Health asserts that people are entitled to access reproductive health services, including family planning (FP), that are acceptable to them and of the highest possible quality. However, there are many barriers to individuals’ realizing this right at many levels. While policy change and provider training can support increased FP access and use and better ensure contraceptive choice, interventions at the policy and service delivery levels alone are insufficient. Community-level barriers also impede service utilization and should be addressed in participatory and cooperative ways.
In 2010, EngenderHealth began piloting site walk-throughs (SWTs) in Bangladesh, Ethiopia, Ghana, Tanzania, and Uganda. This promising approach—rooted in the core human rights principles of participation, empowerment, and accountability—catalyzes community participation in health and strengthens the accountability of service providers to communities. In addition, SWTs foster linkages and collaborative partnerships between health providers and community members in addressing barriers to informed choice and service access and in improving the quality and acceptability of services.
Photos by E. Brazier/EngenderHealth
Expanding Choice through the Introduction and Scale-Up of the Standard Days Method® in India
Guest post by Lauren VanEnk, Program Officer, Institute for Reproductive Health at Georgetown University (IRH)
Photo credit: Institute for Reproductive Health (IRH) at Georgetown University
For decades, India’s national family planning (FP) program has emphasized female sterilization, resulting in limited contraceptive method options for those with an unmet need for FP, especially for spacing pregnancies. However, following the 1994 International Conference on Population and Development (ICPD), which recommended high-quality services and a range of methods, the Government of India adopted a national population policy in 2000 that shifted its FP program’s focus from achieving target-driven demographic goals to ensuring reproductive health and rights, including voluntary and informed choice.
Hot Topic: Rights and Choice at the International Conference on Family Planning
From November 12–15, an estimated 4,000 government officials, policymakers, program managers, researchers, academics, and youth advocates will gather in Addis Ababa, Ethiopia for the 3rd Annual International Conference on Family Planning (ICFP).
The theme of this year’s conference—cohosted by The Bill and Melinda Gates Institute for Population and Reproductive Health and Ethiopia’s Ministry of Health—is “Full Access, Full Choice,” echoing the Family Planning 2020 (FP2020) initiative’s call to ensure that rights and contraceptive choice are central to meeting the commitment made at the London Summit on Family Planning to reach an additional 120 million women with access to contraception by 2020.
Developing Country Leaders and Advocates Urge Improved Commodity Security to Ensure Rights
Ms. Anuradha Gupta, Additional Secretary of India’s Ministry of Health and Family Welfare and Mission Director of the National Rural Health Mission (NRHM) / Photo credit: RHSC
Last week, the Reproductive Health Supplies Coalition (RHSC) held their 14th annual meeting in Delhi, India. The meeting, cohosted by India’s Ministry of Health and Family Welfare, convened more than 200 participants from civil society, the private sector, and governments to work collaboratively toward strengthening the core principles of commodity security—method choice, quality, and equity—to increase access to affordable, high-quality family planning (FP). (more…)