United Nations, New York – Over the past three decades, significant progress has been made in the global approach to sexual and reproductive health and rights. Maternal mortality rates have fallen by almost a third, the number of women using modern contraceptive methods has doubled, and more than 160 countries have enacted national contraceptive methods. violence.
A new report from UNFPA, the United Nations sexual and reproductive health agency, traces the trajectory that has led to this progress and increased freedom and autonomy for millions of people. But it has also become clear how little these improvements are impacting the world's poorest and most marginalized people, whose rights and choices remain largely out of reach.
These different realities are often caused by hidden inequalities and discrimination within health systems and economic, social and political systems. Achieving equity therefore requires exposing inequalities so that inclusive solutions can be imagined and implemented.
Below, we explore where and how inequality manifests itself in our society, lifting up some communities while holding others back, and how to combat inequality and create peace and prosperity for all. Read about what you can do to secure your future.
1. Inequalities in sexual and reproductive health and rights are wherever.
In Ashgabat, Turkmenistan, Alya* and her husband were told it was “undesirable” to have a baby. reason? They were both blind.
Women and girls with disabilities often face sexual and reproductive health discrimination, limited access to services, and exclusion from comprehensive sexuality education. In some cases, forced sterilization may be performed.
The special challenges that Alia and other women with disabilities face during pregnancy and childbirth reinforce one of the report's key themes: access to health and rights varies widely across regions, countries and people. be.
Disability status is just one aspect of identity that impacts the right to health. Geography is another story, with African women about 130 times more likely to die from pregnancy complications than European women. For women and girls from ethnic minorities, disparities in access to health care were also found in all countries surveyed for the UNFPA report.
2. Progress in sexual and reproductive health for all has stalled and in many ways is collapsing.
For almost 20 years, the annual decline in global maternal deaths has been zero, meaning no progress has been made. Meanwhile, today a quarter of women report that they can't say no to sex with their husband or partner.
This means that despite investment, advocacy and numerous bills, women's ability to make decisions about their bodies is declining. And while the barriers to health have rapidly lowered for the most advantaged, they remain firmly in place for the least advantaged.
“Even in wealthy countries, maternal mortality rates are high in communities that continue to face racial and other prejudice in their daily lives,” UNFPA Executive Director Dr. Natalia Kanem said in a statement on World Health Day. ” he said. She said: “We can and must do better.”
3. Sexual and reproductive health and rights are becoming politicized and polarizing.
With half the world going to the polls this year, many leaders have decided to make sowing division the cornerstone of their political strategy.
Some policymakers are weaponizing fears about migration and low and high birth rates to override agreements on sexual and reproductive health and rights. On the other hand, some countries have made their legal systems less inequitable, for example by decriminalizing female genital mutilation or restricting the rights of LGBTQIA+ people.
Harmful stereotypes about women, girls, and people with diverse sexual orientations and gender identities are too often propagated and have dangerous consequences to justify gender inequality and homophobia. Masu. Ephraim*, a refugee from Syria who was struggling to access sexual health care in his new country, explained to UNFPA: We are not recognized and do not have any rights. ”
4. But there is hope. Where inequalities exist, community leaders help fill gaps in services.
Gender inequality, racism, and misinformation are deeply embedded in many health systems. A study by the United Nations Population Fund found that in the Americas, women of African descent are more likely to die during childbirth, due in part to racist abuses in the health sector.
For these reasons, as well as other reasons such as cost and distance to facilities, African women may avoid going to hospitals for health care. “It was not the environment I wanted,” Shirley Maturana Obregon, from Colombia, told UNFPA about her birth plans.
Instead, she gave birth using a partera, a traditional midwife and knowledge practitioner ancestral to Colombia's African communities.
Partera is a community in Colombia that remains largely cut off from the country's formal health system, requiring expensive travel across dangerous and conflict-affected terrain to seek medical attention. , providing culturally sensitive care.
Maturana Obregon said giving birth in Partera was beautiful and unforgettable. She then became a traditional midwife herself. “We are there to make women's dreams come true,” she said.
5. Progress is achievable, but we must reject division and embrace cooperation.
Above all, UNFPA's report shows that we cannot divide and conquer in the process of ensuring universal health and rights. Rather, we need to find political consensus, tailor solutions to local communities, and mobilize emergency resources to achieve our goals.
Grassroots leaders are essential to this movement. Sara Cee Sabaneh, who works against female genital mutilation and child marriage in Ivory Coast, says programs aimed at eliminating harmful practices are designed by people working in the communities they target. He says there is. “Safe Spaces, Her Husband's Club and other interventions are bringing real change and shining a light on places where young girls thought they had no rights,” she told UNFPA. Ta.
Such efforts are having a tangible impact, but more support is needed. Spending an additional $79 billion in low- and middle-income countries by 2030 would avert 400 million unplanned pregnancies, save 1 million lives, and generate $660 billion in economic impact. right. Around 40 per cent of maternal and newborn deaths and more than a quarter of stillbirths could be prevented by training more midwives.
Capital saves lives, but lack of investment puts lives at risk.
The truth is, inequality exists everywhere we look, and once its devastating consequences become clear, we cannot ignore it. Dr Natalia Kanem, UNFPA Executive Director, said: “In the interests of human rights, gender equality, justice and the world, we have every reason to act.
The only way to achieve a future of dignity and rights for all is by working together. ”
