Written Statement to the 2010 United Nations Economic and Social Council (ECOSOC) Annual Ministerial Review by the International Planned Parenthood Federation (IPPF) The International Planned Parenthood Federation (IPPF) welcomes the theme of the 2010 Annual Ministerial Review which this year focuses on "Implementing the internationally agreed goals and commitments in regard to gender equality and the empowerment of women". IPPF recognizes that sexual and reproductive health and rights are central to addressing obstacles related to women’s advancement worldwide, to reaching the internationally agreed goals and commitments in regard to gender equality and to equitable and sustainable development. Working through 148 Member Associations in 171 countries IPPF is committed to implementing the Programme of Action (PoA) of the International Conference on Population and Development (Cairo), the Platform for Action (PfA) of the Fourth World Conference on Women (Beijing) and the Millennium Development Goals (MDGs) all of which strive to advance gender equality and empower women. IPPF also supports the General Assembly’s resolution to create a new gender entity headed by an Under Secretary‐General. Although some advances in gender equality and the empowerment of women have been made, much remains to be done. It is clear that progress remains uneven and that this is reflected in the continuing imbalance in power between women and men in all spheres of society. To implement the internationally agreed goals and commitments relating to gender equality and the empowerment of women, it is necessary to ensure that sexual and reproductive health and rights are prioritized at all levels from community to global. This is because “sexual and reproductive ill health accounts for onethird of the global burden of disease among women of reproductive age and one fifth of the burden of disease among the population overall”. 1 Indeed, in excess of half a million women die every year due to complications of pregnancy and childbirth – with 99 per cent of these deaths taking place in developing countries. In addition, a further nine million women will suffer complications that result in lifelong pain, disability and socioeconomic exclusion. 2 This lack of priority on sexual and reproductive health is highlighted in the lack of progress in reducing the rate of maternal mortality. Between 1990 and 2005, maternal mortality has declined at less than 1 per cent per year globally – considerably below the 5.5 percent annual improvement needed to reach the MDG target. At this rate, MDG 5 will not be met in Asia until 2076 and many years later in Africa. 3 IPPF recognizes that many of the most obstructive barriers to gender equality and the empowerment of women are related specifically to women’s sexual and reproductive health and rights and that these obstacles disproportionately affect young women. Approximately 14.3 million adolescent girls aged 15 to 19 give birth each year and girls in this age group are twice as likely to die during pregnancy and childbirth as those over the age of 20. For young women aged 15 to 19 worldwide pregnancyrelated complications are the leading cause of death. Approximately 2.5 million adolescents have unsafe abortions every year, and 14 per cent of all unsafe abortions in low and middleincome countries are among women aged 15 to 19 years. “Evidence shows that access to family planning alone could prevent as many as one in every three maternal deaths by allowing women and girls to delay
ADDING IT UP, The Benefits of Investing in Sexual and Reproductive Health Care, Guttmacher/UNFPA (2009) at http://www.guttmacher.org/pubs/addingitup.pdf 2 See DfID, Millennium Development Goal 5 at http://www.dfid.gov.uk/GlobalIssues/MillenniumDevelopmentGoals/5Improve maternalhealth/ 3 Cited in ‘Global Maternal Mortality Fact Sheet’, White Ribbon Alliance, 2009
motherhood, space births, avoid unsafe abortions, and stop childbearing when they have reached their desired family size”.4 Young women are more vulnerable to HIV infection with only 38 per cent worldwide showing accurate and comprehensive knowledge about HIV and how to avoid transmission. Women and girls also bear a disproportionate burden of caring for others, and may also suffer greater discrimination when they are, or are perceived to be living with HIV. Issues such as poverty, violence against women and girls, lack of access to land and property, conflict, homelessness or lack of stable housing, lack of access to comprehensive sexual and reproductive health services, drive and/or exacerbate the impact of HIV on women and girls. There are other structural barriers that make women more vulnerable such as the criminalization of HIV transmission that can drive women away from knowing their HIV status and access relevant services. The lack of a comprehensive response to address the gender dimensions of the HIV epidemic can reverse some the recent gains and reduce the chances of achieving MDG6. Barriers to gender equality and the empowerment of women start with discrimination at an early age. Disparities in the ways in which boys and girls are raised are often at the core of problems related to sexual and reproductive health as well as at the centre of development challenges. For example, girls may experience restrictions, and find their freedom of movement and association limited, while for boys, the opposite is often true. As such, the predetermination of gender roles often restrict girls’ ability to compete equally with their male counterparts. Girls are often forced to marry at an early age and begin child bearing before they are either mentally or physically ready. According to UNFPA 82 million girls in developing countries between the ages of 10 and 17 will be married before they reach 18.5 Young women are particularly vulnerable to: early marriage; complications related to pregnancy; unsafe abortion; sexual violence and coercion; human trafficking for commercial sexual exploitation; female genital mutilation; the discontinuation of studies (often due to child marriage or adolescent pregnancy) and poverty. All of these issues are related to sexual and reproductive health and rights and are key determinants that impede progress in gender equality and empowerment. To help achieve gender equality, therefore, it is vital that young women be empowered to exercise their rights and take leadership roles in decisionmaking and income generation that affect their lives. In many parts of the world, young women will have less access to education, health services and fewer opportunities for employment in the formal labour market than young men. With access to education and training restricted, many young women are forced to work in the informal economy, hindering any advances for gender equality. In addition, many girls who become pregnant at a young age are forced to leave education. This has longterm implications for the young women as individuals, for their families and for their communities and reentrenches prevailing gender stereotypes and roles. In these ways adolescent pregnancy, unsafe abortion, and exposure to sexually transmitted infections (STIs), including HIV and AIDS, can have a major impact on a young woman’s education and future employment opportunities.6 An estimated 215 million women who want to delay pregnancy are not using an effective method of contraception and that this figure represents 15 per cent of all women aged 1549. Another barrier to gender equality is linked to access to education. Educated women clearly have more options than those without – to employment, marriage and childbearing – which equates to more control over their lives. In addition, educated women usually have fewer children, and the children they do have are often healthier and better educated themselves. Increasing women’s economic opportunities and their control of assets is a vital path out of poverty and high fertility and 4
Call to Action: Maternal and Child Health at The G8 Summit. Action Canada for Population and Development
Gender Equality, Giving special attention to girls and adolescents, UNFPA at http://www.unfpa.org/gender/girls.htm
See UNFPA, Reproductive health and employment: Implications for young people at: http://www.unfpa.org/upload/lib_pub_file/29_filename_rhemployment.pdf
towards gender equality. As such it is vital that young women and girls have access to comprehensive and gendersensitive sexuality education in both formal and informal educational settings. It is also important to ensure universal access to a comprehensive package of sexual and reproductive health services and provide counselling, information and quality care. It is evident that scaling up access to family planning, including contraception would dramatically reduce the number of unintended and unplanned pregnancies. In addition, it is clear that, if a young woman delays childbearing until she has achieved her own educational goals, it has broad social and economic benefits, not just for her, and her family, but also for society at large. Therefore, sexual and reproductive health services contribute toward improving women’s social position and their ability to participate equally in society.7 Both the Beijing PfA and the ICPD PoA highlighted the importance of placing sexual and reproductive health and rights at the centre of efforts to advance gender equality and make development a reality. The Beijing PfA also gave special attention to a variety of issues related to the sexual and reproductive rights of women, including access to family planning, maternal health and safe abortion services as a way to achieve gender equality. It should be noted that access to these services is not only rooted within international human rights obligations but recognized as such by Treaty Monitoring Bodies (TMBs). In addition, a woman’s right to access contraceptive services is recognised by TMBs, with a lack of access to family planning being understood to constitute a violation of the right to health. Limited and uneven progress on MDG3 demonstrates the lack of priority afforded to gender equality by Member States. Although gender crosscuts all of the MDGs, gender equality and the empowerment of women is to all intent and purposes isolated under one goal. However, it is important to recognize that even if the targets in MDG 3 are reached, it will not mean that progress on gender equality or the empowerment of women will be enough. This is because MDG 3 fails to address many of the deeprooted obstacles that impede women’s rights in the family, society and the broader economy. Indeed we should recognise that while there are three MDGs related to health, and two related to gender, it is the goal that relates both to gender and health that is the most offtrack (MDG5). Member States must: • •
Ensure that the MDG 5b target universal access to reproductive health which is a key component on the path to gender equality – is afforded the funding and political priority it deserves Develop effective strategies to ensure gender equity and gendersensitive sexual and reproductive health and rights programmes and policies. These should be central to any new development framework that follows on from the ending of the internationally agreed development goals in 2015. Member States should also recognize that the success of such a framework will require the meaningful engagement of civil society and the leadership in this process by young women. In addition, it will require the prioritization in policies and funding by Member States to meetMDG5 and MDG 6 Reprioritize family planning so as to ensure that the unmet need, especially of young women, is met. Ensure adequate financial, human and technical resources so as to implement effective interventions to improve the health and wellbeing of women.
For further information see: ADDING IT UP, The Benefits of Investing in Sexual and Reproductive Health Care, Guttmacher/UNFPA (2009) at http://www.guttmacher.org/pubs/addingitup.pdf
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Meet the educational and service needs of adolescents, by providing access to comprehensive sexuality education, which has the added benefit of breaking down traditional gender stereotypes. Implement measures to fully integrate women into the formal economy, in order to ensure women and men are treated equally in both formal and informal working environments Increase the mainstreaming of gender perspectives into all legislation, policies and programmes to ensure gender responsive budgeting. Develop institutional mechanisms that advance women’s human rights and to reform laws that discriminate against women or impede their ability to exercise their rights. As such it is necessary to enhance the monitoring of State’s compliance with international human rights obligations in the area of sexual and reproductive health.
Finally, without proactive steps being taken by Member States to achieve gender equality and empowerment of women it is clear that the Beijing PfA, the ICPD PoA and the MDGs will not be achieved.