A teenage mother and her toddler in Bonpland, a rural municipality in the northern province of Misiones in Argentina. Latin America has the second highest regional rate of early pregnancies in the world, after sub-Saharan Africa. Credit: Fabiana Frayssinet/IPS

By Fabiana Frayssinet
BUENOS AIRES, Jul 8 2016 (IPS)

In plain and simple language, an Argentine video aimed at teenagers explains how to get sexual pleasure while being careful. Its freedom from taboos is very necessary in Latin American countries where one in five girls becomes a mother by the time she is 19 years old.

“For good sex to happen, both partners have to want it and this is as much about being sure they want it, as about being in the mood or ‘hot’ with desire,” said psychologist Cecilia Saia who made the video “Let’s talk About Sex” (Hablemos de sexo), aimed at adolescents and preadolescents and posted on social networks.

The video was produced by Fundación para Estudio e Investigación de la Mujer (FEIM – Foundation for Women’s Studies and Research) as part of a Take the Non-Pregnancy Test campaign. It was also distributed to teenagers so they “would be able to take free and informed decisions about becoming mothers and fathers.” “Keeping children in the education system or bringing them back into it would be effective interventions to prevent teenage pregnancy. In the same way, creating conditions within the education system to ensure that pregnant teenagers or adolescent mothers can continue their education, would be another intervention with a positive impact” - Alma Virginia Camacho-Hübner.

During the campaign, teenagers of both sexes were given boxes similar in appearance to pregnancy test kits, containing information about teenage pregnancy and the myths surrounding how it is caused, as well as condoms and instructions on how to use them, Mabel Bianco, the president of FEIM, told IPS.

The campaign was broadcast on YouTube and other social networks, with candid messages in the language used by adolescents. “This meant we could reach a large numbers of 14-to-18-year-olds, an age group that such campaigns usually find hard to reach,” she said.

According to FEIM, in Argentina 300 babies a day, or 15 percent of the total, are born to mothers aged under 19.

“This percentage has shown a sustained increase over the last 10 to 15 years, and the proportion of births to girls under 15 years of age has also risen,” Bianco said.

Argentina exemplifies what is happening in the rest of Latin America, which is the world region with the second highest teenage fertility rate, after sub-Saharan Africa. The national rate in Argentina is 76 live births per 1,000 women aged 15-19 years, according to United Nations’ demographic statistics.

In order to call attention to this problem and to the general need to promote the equal development of women, Investing in Teenage Girls is the theme of this year’s World Population Day, to be celebrated July 11.

The United Nations Population Fund (UNFPA) states that one in five women in the Southern Cone of South America (Argentina, Brazil, Chile, Paraguay and Uruguay) will become a teenage mother, in an area where over 1.2 million babies a year are born to adolescents.

“Early pregnancy and motherhood can bring about health complications for mother and baby, as well as negative impacts over the course of the lives of adolescents,” says a UNFPA report about fertility and teenage motherhood in the Southern Cone.

The report says that “when pregnancy is unplanned, it is a clear indication of the infringement of teenagers’ sexual and reproductive rights and hence of their human rights.”

Alma Virginia Camacho-Hübner, UNFPA sexual and reproductive health adviser for Latin America and the Caribbean, told IPS that teenage pregnancy has implications for individual patients, such as maternal morbidity and mortality associated with the risks involved with unsafe abortions, among other factors.

Prematurity rates and low birthweights are also several-fold higher, especially among mothers younger than 15.

For health services, the costs of prenatal care, childbirth, postnatal care and care of the newborn are far higher than the cost of interventions to prevent pregnancy and promote health education.

“For society as a whole, from a strictly economic point of view, in countries that enjoy a demographic dividend, early motherhood represents an accelerated loss of that demographic dividend,” Camacho-Hübner said from the UNFPA regional headquarters in Panama City.

This is because “instead of increasing economic productivity by having a larger economically active proportion of the population, a rise in early motherhood causes a rapid rise in the dependency ratio, that is the proportion of the population that is not economically active and requires support from family or society,”she said.

The Southern Cone study found that dropping out of school usually preceded getting pregnant.

“Therefore, keeping children in the education system or bringing them back into it would be effective interventions to prevent teenage pregnancy. In the same way, creating conditions within the education system to ensure that pregnant teenagers or adolescent mothers can continue their education, would be another intervention with a positive impact,” Camacho-Hübner said.

In her view, teen pregnancy and motherhood are an issue of inequality which mainly affects women in lower socio-economic strata.

“It is teenagers from the poorest families and with the least education, living in underprivileged geographical regions, that are most prone to becoming adolescent mothers,” she said.

“Becoming mothers at an early age reinforces conditioning and the inequalities in the process by which teenagers who are, and who are not, mothers, effect the transition into adulthood,” she said.

“The main consequence of pregnancy is the interruption of schooling, although in many cases they have already dropped out by the time they become pregnant. But they do not go back to school afterwards because they have to look after the baby,” Bianco said.

“This makes for a poorer future, as these girls will have access to lower-paid jobs and will be able to contribute less to the country’s development. On the personal level, they will have to postpone their adolescence, they cannot go out with friends, go dancing and other typical teen activities,” she said.

Federico Tobar, another UNFPA regional adviser, said that “in addition to strengthening health, education and social services, there must be investment to promote demand, with interventions to motivate young people to build a sustained life project.”

“This involves incorporating economic incentives as well as symbolic remuneration, and also concrete childcare support for teenage mothers so that they can finish school and avoid repeated childbearing, which is frequently seen in these countries,” he told IPS.

Among other positive experiences, Tobar mentioned the Uruguayan initiative “Jóvenes en red” (Young People’s Network) which includes returning to school and work, and promotion of sexual and reproductive health.

“I believe it is important to invest in the education of teenage women, including comprehensive sex education and the capacity to decide whether or not they wish to have children. It is not a question of eliminating all pregnancy in adolescence, but of making it a conscious choice rather than an accident,” Bianco said. 

Edited by Estrella Gutiérrez. Translated by Valerie Dee.

By Jo Baker
LONDON, Jan 7 2016 (IPS)

It is a grim fact that prisoners in most countries suffer from poorer health than non-prisoners, and that their right to health is not always protected. But for certain groups these rights can be even more elusive. Such is the case for women.

Jo Baker

For me, this was starkly illustrated during a visit to the clinic of a large women’s jail in the southern Philippines. Here, a very thin woman lay curled and still on a narrow wooden bench. Her hands were cradling her taut, bloated stomach, her eyes tightly closed. The nurse explained that she was an addict, arrested while heavily pregnant for drug possession (a sentence that keeps the country’s women’s jails lamentably stocked), and that her baby had died days earlier in a government hospital because of a condition related to her drug use, after a complicated labour. Being understaffed and short on medicine and beds in the prison, the best treatment she could offer the woman on her return, as she faced her withdrawal, post-labour pain, grief, separation from family, and possible years awaiting trial, were paracetamol, kind words and a bench. Hers would be a particular and gendered kind of purgatory.

In speaking with imprisoned women and healthcare practitioners across five countries, our research team commonly found harmful responses and barriers to healthcare that existed because the inmates were women. These included women who were imprisoned in Jordan while recovering from brutal gender-based violence (including honour crimes and rape), without adequate treatment or rehabilitation; women who prepared for and recovered from childbirth in dirty rooms with little more than substandard prison rations, water and soap; and women who were isolated and punished because of attempts to self-harm or commit suicide. “One girl used the edge of a seafood shell on her wrists,” recounted an inmate in the Philippines. “They scolded her. If you want to die, go ahead, do it now!”

These responses are of course unlikely to be particular only to these countries.

International standards (including the Bangkok Rules) now recognize that because women commonly face certain risk factors and backgrounds, they require a gender-specific framework for healthcare. More women than men suffer from particular diseases, including HIV, hepatitis and some cancers. They have differing sexual and reproductive health (SRH) needs, including those relating for example, to birth, abortion and the menopause. They are more susceptible to particular mental health problems. Studies have found self-harm in prison to be up to ten times higher among women than among men, and suicide to also be proportionally higher. This list goes on.

Women (especially those in conflict with the law) are also, crucially, more likely to have been victims of sustained gender-based violence and sexual abuse. Yet prisons, which are increasingly taking in women, are rarely equipped to respond to these forms of trauma. As I was told quietly by one prison healthcare worker, gesturing to a courtyard of around 20 women. “Almost all the women here are mothers, and a lot have maltreatment and molestation in their histories. I can look around and count more than ten women who have been raped. Some have been prostituted by their families. Then drug use comes in and makes it a vicious cycle.”

These and other cultural factors lead to a different sense of shame, which can also work as a barrier to healthcare. For example inmates in Jordan, Zambia and the Philippines told me that they often avoided reporting urinary tract infections and SRH problems to male health staff. Yet some prisons for women don’t employ female doctors, and these issues remain unrecognized, and sometimes debilitating.

My research findings with DIGNITY (see our comparative study here) therefore stress the urgent need for every prison and place of detention to follow a framework for healthcare that is gender-responsive and trauma-informed – one that treats women’s specific health needs, and trains staff accordingly. In just a few facilities did we find gestures towards this.

But not all gender-sensitive health responses are medical. The traditional prison model – designed as a harsh criminal justice response to violent men – remains the basis for many institutions detaining groups that are neither violent, nor male. In the facilities where women told me of harsh disciplinary structures, negative relationships between staff and inmates, and their isolation from caring relationships, they tended to report very low morale, forms of depression, and other signs of serious struggle, such as self harm and hunger strike. This was markedly different in facilities (such the one described here in Albania) that connected the women with the outside community – particularly their children – and gave them tools to cope, learn, communicate and prepare for the future.

Meanwhile, exercise is known to be important to health and morale, and is a right of prisoners under international law (see the Mandela Rules). Yet only in one of five countries, the Philippines, were detained women encouraged and able to exercise every day. In the other countries, exercise and sports facilities of some kind were common only in prisons for men.

Many of our findings on health fell in line with those observed by the former UN Special Rapporteur on Violence Against Women in her 2013 report on women’s incarceration, and they indicated clear and harmful examples of discrimination. Yet in reviewing issues raised by UN treaty body reports, we found women’s health to largely be a gap: UN experts are not giving this area consideration.

The human rights of these women entitle them to better, and must be championed, internationally and in their own countries. As once said by Dostoevsky, society must be judged by the way that it treats its prisoners. Or rather, and as told to me by one mother and survivor of domestic violence, sentenced to life in a Zambian prison: “If you’ve offended, certain things you must accept. But I don’t deserve to pass through some of these things. I came to prison healthy. I’m not intending to leave sick.”

(End)

Excerpt:

So extreme are gender inequalities in South Sudan that a young girl is three times more likely to die in pregnancy or childbirth than to reach the eighth grade – the last grade before high school – according to Plan International, one of the oldest and largest children’s development organisations in the world.

A vast majority of South Sudanese girls will have been victims of at least one form of gender-based violence in their young lives, but those living in Eastern Equatoria State face a particularly abhorrent practice which is a tradition among at least five of the state’s 12 tribes – being given away as ‘blood money’.

Dina Disan Olweny, Executive Director of the non-governmental Coalition of State Women’s and Youth Organisations, is one of the rights activists pushing for an end to harmful traditions and injustices facing young girls in South Sudan. Credit: Miriam Gathigah/IPS

“When a person kills another person, the bereaved family expects to be given ‘blood money’ as compensation,” Dina Disan Olweny, Executive Director of the non-governmental Coalition of State Women’s and Youth Organisations, told IPS.

Most tribes demand compensation when a life has been taken in one of the regular conflicts over cattle and pasture, revenge killings and other inter-village conflicts, and although 20 to 30 goats is what many tribes demand in form of compensation, Olweny explained that “most families can either not afford or are unwilling to pay so much, and prefer to give away one of their girls as compensation.”

According to child protection specialist, Shanti Risal Kaphle, “a young girl is taken as a commodity that can be given in lieu of someone’s lost life, or as ‘blood money’, to keep the family and community in peace.”

Kaphle explained that the girl’s life is negotiated “without her information and consent and is subject to violence, abuse and exploitation.”

The practice of girl child compensation has not escaped the eye of the government, which set an estimated 500 dollars as the amount for compensation for a life, but tribe people still prefer to be given a girl, saying that the figure set by the government is too little.“A young girl is taken as a commodity that can be given in lieu of someone’s lost life, or as ‘blood money’, to keep the family and community in peace” – child protection specialist Shanti Risal Kaphle

Experts say that a girl is also preferred as compensation by a bereaved family because she can either be married to one of their own without having to pay a bride price, or she can be married off when she turns 12 and attract a herd of goats.

Many of the girls handed over as compensation are often as young as five years. They are expected to forget their birth families and start afresh, severing all contacts with their natural families once the exchange has been concluded.

At this point their lives can take a dramatic turn for the worse through multiple abuse. These girls may be “subjected to child labour, and to sexual, physical and emotional abuse – to escape this hell, more of them now prefer to commit suicide,” said Olweny.

Residents here say that customary laws which perpetuate and rubber stamp these forms of abuse are seen to play a vital role in conflict resolution because they are considered cheap, accessible and the decisions are made on the basis of customs they are familiar with.

Kaphle said that customary laws and decisions are also perceived as more amicable and less time-consuming.

However, girl child compensation is just one of a multitude of abuses that the girl child in South Sudan faces.

The state of Western Bahr El Ghazal, for example, has a notorious tradition of widow compensation which has seen many young girls denied an opportunity to go to school because they are forced into early marriages.

Linda Ferdinand Hussein, Executive Director of the non-governmental organization Women’s Organisation for Training and Promotion, explained how this tradition works.

“When a man’s wife dies for whatever reasons, the man can demand to be given back the bride price that he had paid.” This price varies from one family to the next “but most families are unwilling to pay back the bride price so they give the man one of the deceased wife’s younger sisters as compensation.”

Four years after South Sudan won its independence and became the world’s youngest nation, child protection specialists like Hussein are raising the alarm. “Gender-based violence against young girls continues to be perpetrated in a variety of ways in both peacetime and during conflict,” she said.

A report released Jun. 30 by the United Nations Mission in the Republic of South Sudan (UNMISS) revealed that the Sudan People’s Liberation Army (SPLA) and associated armed groups recently carried out a campaign of violence against the population of South Sudan, which was marked by a “new brutality and intensity” and included the raping and then burning alive of girls inside their homes.

A report released last year by leading humanitarian organisation CARE, titled ‘The Girl Has No Rights’: Gender-Based Violence in South Sudan, highlighted the extreme injustices faced by young girls in the country.

These injustices continue to serve as obstacles towards accessing education and later exploiting the opportunities that life presents for those who have gone through school.

According to Plan International, 7.3 percent of girls are married before they reach the age of 15 years and another 42.2 percent will have been married between the ages of 15 and 18. And, although 37 percent of girls enrol in primary school, only around seven percent complete the curriculum and only two percent of them proceed to secondary school.

Edited by Phil Harris

Zimbabwe struggles to contain maternity deaths. Here in this southern African nation, the number of women dying in childbirth continues to rise. Credit: Jeffrey Moyo/ IPS

By Jeffrey Moyo
HARARE, Jan 30 2015 (IPS)

For 47-year-old Albert Mangwendere from Mutoko, a district 143 kilometres east of Harare, the Zimbabwean capital, transporting his three pregnant wives using a wheelbarrow to a local clinic has become routine, with his wives delivering babies one after the other.

But these routines have not always been a source of joy for Mangwendere.

“Over the past twenty years, I have been ferrying my pregnant wives to a local clinic using a wheelbarrow because I have no (full size) scotch cart and we have lost 12 babies in total while traveling to the clinic,” Mangwendere told IPS.

Mangwendere’s case typifies the deepening maternity crisis in this Southern African nation.An estimated 3,000 women die every year in Zimbabwe during childbirth and at least 1.23 percent of gross domestic product (GDP) is lost annually due to maternal complications – United Nations issue paper on 'Maternal Mortality in Zimbabwe', 2013

An estimated 3,000 women die every year in Zimbabwe during childbirth and at least 1.23 percent of gross domestic product (GDP) is lost annually due to maternal complications, according to Maternal Mortality in Zimbabwe, a United Nations issue paper released in 2013.

In fact, the United Nations found that maternal mortality worsened by 28 percent between 1990 and 2010. The major causes were bacterial infection, uterine rupture (scar from a previous caesarean section tearing during an attempt at birth), renal and cardiac failure, as well as hyperemesis gravidarum (condition characterised by severe nausea, vomiting and weight loss during pregnancy).

This year, the government has allocated 301 million dollars to the health sector for a country of 13.5 million, according to the local NewsDay publication, which concluded: “This is to say that the government intends to spend on average just over 22 dollars on an individual this year. Compare this with 650 dollars for South Africa, 90 dollars for Botswana, 390 dollars for Botswana and 200 dollars for Angola.”

On top of a barely adequate public transportation system, user fees for delivering pregnant women that are charged in healthcare centres are also at fault, say civil society activists.

“In 2012, the government crafted and adopted a policy that saw user fees for maternity services being scrapped,” Catherine Mukwapati, director of the Youth Dialogue Action Network, a grassroots organisation, told IPS.

“But despite this policy, some facilities still charge indirect service fees, which is scaring away many pregnant women from hospitals and clinics, leaving them in the hands of less skilled midwives.”

Zimbabwe’s local authority clinics say they have resisted scrapping maternity fees despite the official directive, claiming that they are not reimbursed as promised by the government.

28-year-old Chipo Shumba pictured here holds her only child after she lost six others while giving birth over the past few years, a crisis health experts in Zimbabwe say is on the rise. Credit: Jeffrey Moyo/IPS

“Council clinics have no choice but to charge the council-subsidised 25 dollars for maternity since they haven’t received money from government,” Harare city director of health services, Stanley Mungofa, told IPS.

The actual cost of providing maternity services in council clinics has been pegged at 152 dollars, Mungofa said. At public hospitals like Parirenyatwa in Harare, the cost of a normal delivery is 150 dollars while a caesarean section costs as much as 450 dollars.

In a bid to lower the high maternity fees of public hospitals and council clinics, a group of donors pledged 435 million dollars for the nation’s health system for the period 2011-2015. The fund – the so-called Health Transition Fund – was led by the health ministry and managed by the U.N. Children’s Fund (UNICEF).

Importantly, the Health Transition Fund is helping to retain skilled workers by raising low wages. Underpaid doctors make up a large part of the country’s “brain drain” and there are now just 1.6 doctors for every 10,000 people.

Maternal fees may not apply in Zimbabwe’s countryside, where many like Mangwendere and his wives live, but other obstacles present an equally insurmountable barrier to obtaining care. Clinics and referral hospitals are often far away from people needing help, a major cause of maternity deaths there.

Finally, the tentacles of systemic corruption have reached into the health care systems. According to Transparency International, one local hospital was found to be charging mothers-to-be five dollars every time they screamed while giving birth.

A staggering 62 percent of Zimbabweans reported having paid a bribe in the previous year, the group stated in its 2013 report on global corruption.

Zimbabwe’s health sector was one of the best in sub-Saharan Africa in the 1980s, but it nearly collapsed when an economic crisis caused hyper-inflation of more than 230 million percent in 2008. Over the following years, chronic under-investment made a bad situation worse.

The increase in maternal mortality is being witnessed despite the U.N. Millennium Development Goal (MDG) for maternal health, under which countries should reduce the maternal mortality ratio by three-quarters between 1990 and 2015.

A 2012 status report on the MDGs asserted that Zimbabwe was unlikely to meet its mandate of reducing the maternal mortality ratio to 174 per 100,000 live births.

In research conducted in 2013 to address causes of maternal death, Zimbabwe’s Ministry of Health and Child Care blamed excessive bleeding after childbirth and unsafe abortion as the major causes of death, although no information was provided to back the claim.

“Statistics on maternal deaths often leave out sad realities of these similar deaths in unreachable remote areas where pregnant women and infants die daily without these cases being recorded anywhere,” said Helen Watungwa, a midwife at a council clinic in Gweru, the capital of the Midlands province, 222 kilometres outside the capital.

“But in any case, with the limited resources we have as nurses, we are doing all we can to save lives both of delivering mothers and infants,” Watungwa told IPS.

“It is truly a miracle that we continue to survive a series of pregnancies while battling to give birth often on the way to the clinic, bleeding heavily without any skilled persons to attend to us, with only our husband tottering with each one of us to the village healthcare centre using a wheelbarrow,” 28-year-old Mavis Handa, one of Mangwendere’s wives, told IPS.

Edited by Lisa Vives/Phil Harris    

Fatema,15, sits on the bed at her home in Khulna, Bangladesh, in April 2014. Fatema was saved from being married a few weeks earlier. Local child protection committee members stopped the marriage with the help of law enforcement agencies. Credit: UNICEF

By A. D. McKenzie
LONDON, Jul 23 2014 (IPS)

Heightening their campaign to eradicate violence against women and girls, United Nations agencies and civil groups have called for increased action to end child marriage and female genital mutilation.

At the first Girl Summit in London Wednesday, hosted by the U.K. government and UNICEF, delegates said they wanted to send a strong message that there should be “zero tolerance” for these practices.

“Millions of young girls around the world are in danger of female genital mutilation and child marriage – and of losing their childhoods forever to these harmful practices,” Susan Bissell, UNICEF’s Chief of Child Protection, told IPS.“Millions of young girls around the world are in danger of female genital mutilation and child marriage – and of losing their childhoods forever to these harmful practices” – Susan Bissell, UNICEF's Chief of Child Protection

“FGM is an excruciatingly painful and terrifying ordeal for young girls. The physical effects can last a lifetime, resulting in horrific infections, difficulty passing urine, infertility and even death.”

Bissell said that when a young girl is married “it tends to mark the end of her education and she’s more likely to have children when she’s still a child herself – with a much higher risk of dying during pregnancy or childbirth”.

“Without firm and accelerated action now, hundreds of millions more girls will suffer permanent damage,” she added in an e-mail interview.

At the summit, the United Kingdom announced an FGM prevention programme, launched by the government’s Department of Health and the National Health Service (NHS) England. Backed by 1.4 million pounds, the programme is designed to improve the way in which the NHS tackles female genital mutilation and “clarify the role of health professionals which is to ‘care, protect, prevent’,” the government said.

According to British Prime Minister David Cameron, some 130,000 people are affected by FGM in the United Kingdom, with “60,000 girls under the age of 15 potentially at risk”, even though the practice is outlawed in the country.

The prevention programme will now make it mandatory for all “acute hospitals” to report the number of patients with FGM to the Department of Health on a monthly basis, as of September of this year.

U.N. officials said that the Girl Summit was a significant development because it marked the importance of the issues addressed.

“International leaders came together in one place and said enough is enough,” Bissell said.

While it is difficult to measure the impact of intensified campaigns on the reductions in child marriage and female genital mutilation/cutting over the past few years, the United Nations and other organisations have noted that the numbers of girls affected are in fact decreasing.

In the Middle East and North Africa, the percentage of women married before age 18 has dropped by about half, from 34 percent to 18 percent over the last three decades, UNICEF says.

In South Asia, the decline has been especially marked for marriages involving girls under age 15, dropping from 32 percent to 17 percent.

“The marriage of girls under age 18, however, is still commonplace,” Bissell told IPS.

“In Indonesia and Morocco, the risk of marrying before age 18 is less than half of what it was three decades ago. In Ethiopia, women aged 20 to 24 are marrying about three years later than their counterparts three decades ago,” she added.

Regarding female genital mutilation/cutting, Kenya and Tanzania have seen rates drop to one-third of their levels three decades ago through a combination of community activism and legislation, while in the Central African Republic, Iraq, Liberia and Nigeria, prevalence of FGM has dropped by as much as half, Bissell said.

However, officials stressed that with population growth, it is possible that progress in reducing child marriage will remain flat unless the commitments made at the Girl Summit are acted upon. Flat progress “isn’t good enough”, Bissell told IPS.

Recently released U.N. figures show that, despite the declines, child marriage is widespread, with more than 700 million women alive today who were married as children. UNICEF says that some 250 million women were married before the age of 15.

The highest percentage of these women can be found in South Asia, followed by East Asia and the Pacific which is home to 25 percent of girls and women married before the age of 18, UNICEF says.

Statistics also indicate that girls who marry before they turn 18 are less likely to remain in school and more likely to experience domestic violence. In addition, teenage mothers are more at risk from complications in pregnancy and childbirth than women in their 20s; some 70,000 adolescent girls die every year because of such complications, according to the United Nations.

The statistics on female genital mutilation are also cause for international concern, with the United Nations Population Fund (UNFPA) saying that about 125 million girls and women have been subjected to the practice, which can lead to haemorrhage, infection, physical dysfunction, obstructed labour and death.

According to UNFPA, female genital mutilation/cutting and child marriage are human rights violations that both help to perpetuate girls’ low status by impairing their health and long-term development.

UNFPA Executive Director Dr. Babatunde Osotimehin told IPS that a number of states have adopted legislation against female genital mutilation/cutting but that some perpetrators are still operating with “impunity”.

Participating in the London summit, Osotimehin said that certain governments were facing challenges within their own countries because of long-held cultural beliefs, but like Bissell, he said that the picture is not completely bleak, because civil society and grassroots organisations are amplifying their campaigns.

“Our message for girls who are affected by these practices is that they have support – moral, psychological, physical and emotional support,” he told IPS. “We also want to send a message that those who are affected should advocate to try and stop these practices.”

Meanwhile, U.N. officials said it was significant that the summit saw commitment from the African Union and the deputy prime Minister of Ethiopia, as well as from the United States Agency for International Development (USAID) and the U.K. Department for International Development (DfID). The Government of Canada and several other financial supporters also made commitments.

For the executive director of UN Women, Phumzile Mlambo-Ngcuka, the pledges show support for the message of “zero tolerance” of child marriage and FGM that her organisation wishes to send. They are also a strong signal that the practices can be ended in a generation, she told IPS.

Teen mothers give birth to 81 out of every 1,000 children in Nepal. Credit: Mallika Aryal/IPS

By Mallika Aryal
CHAMPI, Nepal, Jul 11 2013 (IPS)

Radhika Thapa was just 16 years old when she married a 21-year-old boy three years ago. Now, she is expecting a baby and is well into the last months of her pregnancy. This is not the first time she has been with child – her first two pregnancies ended in miscarriages.

“The first time I conceived I was just 16, I didn’t know much about having babies, nobody told me what to do,” Thapa tells IPS in between assisting customers at the vegetable store she runs with her husband in the small town of Champi, some 12 km from Nepal’s capital, Kathmandu.

"When girls get pregnant their education stops, which means a lack of employment opportunities and poverty." -- Bhogedra Raj Dotel
“The second time I wasn’t ready either, but my husband wanted a baby so I gave in,” she admitted.

After the second miscarriage, Thapa’s doctors urged her to wait a few years before trying again, but she was under immense pressure from her in-laws, who threatened to “find another woman for her husband if she kept losing her babies”.

What might seem like a horror story to some has become an accepted state of affairs in Nepal, the country with the highest child marriage rate in the world.

On average, two out of five girls are married before their 18^th birthday. The legal age for marriage in Nepal is 18 years with parental consent, and 20 without, a law that is seldom observed, least of all in rural parts of the country.

Studies show that child marriages occur most frequently among the least educated, poorest girls living out in the countryside.

According to the 2011 Nepal Demographic and Health Survey (NDHS), 17 percent of married adolescent girls between 15 and 19 years are either pregnant or are mothers already. In fact, research shows that adolescent mothers give birth to 81 out of every 1,000 children in Nepal.

The survey also shows that 86 percent of married adolescents do not use any form of contraception, meaning that few girls are able to space their births.

Disturbed by trends in countries like Nepal, the UNFPA spotlighted teen pregnancy as the theme for this year’s World Population Day, observed annually on Jul. 11.

“Globally there are 16 million girls aged 15-19 who give birth each year – they never had the opportunity to plan their pregnancy. It is a developmental issue that goes beyond health,” Vallese stressed.

In reality, teen pregnancy can be a matter of life and death. Adolescent girls under the age of 15 are up to five times more likely to die during childbirth than women in their 20s.

The number one cause of death among girls aged 15-19 relates to complications in childbirth. Young mothers are at a high risk of suffering from complications such as obstetric fistula and uterine prolapse.

Furthermore, “the first child born to a mother aged 12-20 is at greater risk of being stunted or underweight, suffering from anaemia or even of dying before the age of five,” says Vallese.

Less visible, but equally troubling, is the host of social complications that teen mothers must navigate.

“When girls get pregnant their education stops, which means a lack of employment opportunities and poverty,” says Bhogedra Raj Dotel of the government’s family planning and adolescent sexual reproductive health division.

According to the UNFPA, 37 percent of married adolescent girls are not working and 76 percent of those who are employed are not paid in cash or kind for the work they do.

Menuka Bista, 35, is a local female community health volunteer in Champi, assisting about 55 households in her area. Bista has been advising Thapa, to ensure that the girl has a safe pregnancy.

“Radhika (Thapa) is educated, she knows she needs to go to the doctor and eat nutritious food for her baby to be safe, but she doesn’t make decisions about her body: her husband and in-laws do,” Bista told IPS.

This observation finds echo in research carried out by various experts: according to Dotel, husbands and in-laws make all the major decisions about a woman’s reproductive health, from what hospital she visits to where she will deliver her child.

For this reason, Vallese believes it is important to train husbands and family members on reproductive health and rights.

Another problem, experts say, is that almost all national policies have been designed with the assumption that adolescent pregnancies affect only married women, with little acknowledgement of the fact that unmarried teenaged girls also engage in sexual activities, said Vallese.

The penetration of the Internet and mobile phones into every aspect of daily life, coupled with a massive wave of migration of young rural men into urban areas, has created “a significant teenage population that engages in pre-martial sex,” she stressed.

Whether the teenaged girls are married or unmarried, sex education plays a major role in decreasing the number of pregnancies.

Sex education is a part of the national school curriculum from Grade 6 upwards, but teachers are not trained, and are uncomfortable talking about it. When the subject comes up in a classroom, most teachers simply skip that chapter, or defer to a health worker to explain the process of reproduction.

“There’s a general (perception) that teaching about sexual health makes girls promiscuous, but we have found it to be exactly the opposite,” says Shova KC, chair of a local cooperative that works with women in Champi.

Public health experts, meanwhile, have criticised the government for not implementing existing policies that could spare thousands of young girls from the trauma of complicated pregnancies so early on in life.

For instance, “more than 500 youth friendly service centers have been set up but progress is about more than just ticking boxes,” UNFPA Assistant Representative Latika Maskey Pradhan, told IPS.

In the future, she said, advocates must keep a close eye not only on how policies are designed but also on how they are implemented.

Dhaka maternity hospitals encourage exclusive breastfeeding. Credit: Sujan-map/IPS

By Naimul Haq
DHAKA, Oct 30 2012 (IPS)

Bangladesh’s achievement in raising exclusive breastfeeding rates for infants under six months from 43 percent to 64 percent, over the last five years, is said to be the result of a determined campaign by government and non-governmental organisations (NGOs).

At the Shaheed Suhrawardy Medical College and Hospital in the national capital, Razia Khatun, 36, is being assisted with feeding her eight-day-old infant. “I was told to start breastfeeding within the first hour of my child’s birth but failed and so I am back here for help.”

Shahida Banu, a trained staff nurse at the hospital, told IPS: “Razia had clogged ducts because her milk wasn’t draining completely, but this could be rectified by steady massaging.”

Peyara Begum, 29, a mother from the city’s Gabtoli area with similar problems, says, “The nurses here attend to you the moment you enter and there are smiling faces all around – and that makes all the difference.”

Prof. Soofia Khatoon, head of the paediatric department of the hospital, told IPS, “Mothers tend to switch to substitutes when they face such minor problems as cracked or flat nipple, low  output and overflow – we have been able to reverse this trend just by speaking to the mothers and encouraging them.”

Many of the nurses employed at the hospital trained at the Bangladesh Breastfeeding Foundation (BBF) which has, since 1989, been running intensive programmes to promote exclusive breastfeeding.

“Exclusive breastfeeding along with awareness building on improving the health of undernourished mothers is the best way to address child malnutrition in Bangladesh,” says BBF chairman Dr. S.K. Roy.

“The challenge now is to take the breastfeeding rate to even higher levels and thereby drastically reduce child malnutrition which is a problem in Bangladesh,” Roy told IPS in an interview.

An internationally acclaimed scientist working on child health, Roy said BBF’s main role was to function as a catalyst to build the capacity of the government, NGOs, the private sector and other stakeholders.

A survey carried out by the National Institute of Population Research and Training attributes the raising of exclusive breastfeeding levels to 64 percent by 2011 to “several intensive programmes that focus on maternal and newborn care and child health.”

Bangladesh’s achievement seems especially impressive when compared with the low exclusive breastfeeding average in South Asia for infants under six months, languishing at 39 percent.

“We have a high level of commitment and support from the government, which is why we have been able to form a nationwide  network for our advocacy programmes in a relatively short time,” Roy said.

In 2010, Bangladesh enforced a directive for extending maternal leave to six months from the previous four for working women to allow them to exclusively breastfeed their newborn.

“This is a sign of the seriousness with which the government is taking the issue as a key to achieving the United Nations millennium development goal that calls for reducing child mortality rates,” Khurshid Jahan, a senior BBF member, told IPS.

“Many don’t realise that exclusive breastfeeding can address  stunting and low weight problems,” Jahan said. “If every mother practices breastfeeding we would have a healthier and more productive  population,” she added.

Workers like Jahan credit the Baby-Friendly Hospital Initiative (BFHI) – a global programme sponsored by the World Health Organisation and the United Nations Children’s Fund (UNICEF) – that assists hospitals in giving mothers confidence and skills to initiate and continue breastfeeding.

About 1,200 government hospitals and health facilities now have centres under the BFHI, while another 500 clinics run by NGOs have similar facilities where mothers are nudged towards exclusive breastfeeding.

In rural areas, mother support groups (MSGs) are at work counselling new mothers and weaning them away from old wives’ myths and traditions that are not friendly to breastfeeding.

When new mothers get back home from the hospital after delivery they are often surrounded by women who insist on feeding the babies prelacteals such as honey or mustard oil, ignoring the naturally protective value of colostrum.

Prof. M. A. K. Azad Chowdhury, head of neonatology department at the Dhaka Shishu (Children’s) Hospital, told IPS, “MSGs work to bring back confidence in mothers who fail to breastfeed their babies. People tend to look for alternative sources of milk in such a situation.”

Infants exclusively breastfed are likely to be exposed less to contaminated foods and this helps reduce the incidence and severity of infectious diseases, Chowdhury said.

After six months, infants should receive nutritionally adequate and safe complementary foods while continuing to be breastfed for up to two years of age or beyond.

UNICEF representative in Bangladesh, Pascal Villeneuve, told IPS, “While we reflect on the successes, we must also note that many babies under six months old in Bangladesh are still not exclusively breastfed.”

Villeneuve said there is work to be done to increase awareness regarding the benefits of exclusive breastfeeding and provide  support to nursing mothers at home, community or workplace.

Each year, 16 million girls aged 15-19 give birth. 50,000 of them die from complications related to pregnancy and childbirth. And 95 percent of those births occur in developing countries.

Latin America and Sub-Saharan Africa lead the world in this department, with 80 and 120 births, respectively, per 1,000 adolescent females in 2009. But young girls’ bodies are not ready for childbirth, and getting pregnant before the age of 18 is a risk to both mother and child, as a UNICEF report, “Progress for children”, has shown. In fact, childbirth is the leading killer of adolescent girls in Africa.

Better access to and more effective use of contraceptives would help prevent 272,000 maternal deaths worldwide each year, according to a recent Johns Hopkins Bloomberg School of Public Health study. But in ensuring that girls can access and know how to use contraception, education is key, despite various cultural challenges that educating girls often faces.

Studies have shown that keeping girls in school improves their sexual and reproductive health. A recent released report by Save the Children shows that the higher a mother’s level of education, the lower children’s under-five mortality rate.

Laura Laski, chief of the sexual and reproductive health technical division at the United Nations Population Fund (UNFPA), told IPS that some families “believe that more education will not contribute to what (young girls) would…become later in life”.

Cultural barriers

Winifride Mwebesa, senior director of family planning and reproductive health at Save the Children, told IPS about cultural barriers in Sub-Saharan Africa. “Very often, poor families find themselves obliged to marry their children. The tradition has been that as soon as the girl menstruates she needs to get married because you don’t want the shame of having a pregnancy in the house before she is married.”

According to the World Health Organisation (WHO), in the developing world 90 percent of adolescent pregnancies are those of married girls.

Early marriage is a problem in Sub-Saharan Africa because it’s rooted deeply in the traditional values of the community. “Over 30 percent of girls in developing countries marry before 18 years of age; around 14 percent do so before the age of 15,” said Laski. Then, community expectations that girls soon have children prevents them from going to school.

In Latin America, early marriage is not as big a problem as in Sub-Saharan Africa. The report “Jóvenes y derechos” by Family Care International shows that in Latin America, factors related to a higher rate of teenage births have more to do with poverty, sexual abuse, absence of parents, culture and education levels.

María Faget, regional consultant in Latin America and the Caribbean for Family Care International, told IPS that “sexual context is still something not in the open”. Talking about the topic with parents or friends is difficult, and there is a reigning culture mandating that “young people do not need or should not be looking for contraception”, Faget explained.

Efforts in this region focus on providing “friendly services” and a welcoming environment for young people because sometimes, confidentiality is a problem. “These services are open and many times they are opened within hospitals and so young people do not go because they are afraid they are going to meet people, people they know,” said Faget.

In Sub-Saharan Africa, “friendly services” are also trying to be implemented. They include the training of  health personnel to provide accurate information to young people without interfering with their own values.

Education as the foundation

In both Sub-Saharan Africa and Latin America, the solution is strongly linked to the improvement of girls’ education.

Mali is a clear example. The percentage of female attendance in primary school between 2005-2010 (latest data) was 55 percent. But this number falls to 24 percent in secondary school, according to UNICEF data.

The number of girls in school is very low and the teenage pregnancy rate is extremely high – 190 births per 1,000 women – as the “Countdown to 2015 report” shows. The number is even higher than  the Sub-Saharan Africa average of 120 births per 1,000 women.

Often, families won’t take their girls to school because they are so far away . But Save the Children is working to build community schools there, as well as to create a girls-friendly environment –  also important in a family’s decision to let girls go to schools. “We build community schools that are friendly to girls, that have separate latrines,” Mwebesa told IPS.

Family Care International was part of a plan called Plan Andino para la Prevención del Embarazo en Adolescents (Plan Andino to Prevent Pregnancies Among Adolescents) that worked in six countries: Bolivia, Chile, Ecuador, Perú, Venezuela and Colombia.

Of those countries, Colombia has seen major improvement. “Colombia has made enormous effort in  friendly health programs,” explained Faget. In 2010, it launched an important communication campaign, “Por el derecho a una sexualidad con sentido,” that had a strong rights component.

Organisations agree that in these reproductive health and sexual education programmes, including young people’s voices is critical. After all, youth are the bridge between health and education systems and what is really needed.

Save the Children relies on youth participation to help develop materials related to sexual education. “We may have an idea of the content that needs to be in, but the format has to be decided by young people,” said Mwebesa.

Family Care International also believes in the importance of youth involvement, because youth can shift attitudes and they can have a big impact in changing culture, explained Faget.

In addition to keeping girls in school, young people need to have access to family planning and receive age-appropriate sex education, which Laski descrbied as “comprehensive sexuality education (where) girls and boys are educated about not only about their sexuality but (also) about…relationships and how to protect and promote human rights”.

A nurse attends to an expectant mother at Walgak Primary Health Care Centre in South Sudan's Jonglei State. Credit: Charlton Doki/IPS

By Charlton Doki
JUBA, Jul 9 2012 (IPS)

One year after the formation of South Sudan, the country’s women say that independence has not resulted in the positive political, economic and social changes that they had hoped for.

Women activists worry that even after separation from Sudan on Jul. 9, 2011, when South Sudan became the world’s newest country and Africa’s 54th nation, the government has not done enough to improve the lives of its women.

But as people across the country celebrate the first anniversary of independence from Sudan, after a 21-year civil war, the year has been fraught with crises.

The country is in the midst of an economic crisis after South Sudan’s decision in January to shut down oil production, which accounts for 98 percent of the its revenue, following a dispute with Sudan over fees charged to use its pipelines.

There is also dire food insecurity here. In June, the United Nations World Food Programme said that more than half of the country’s 8.2 million people would need food aid by the end of the year.

In the country’s Upper Nile state, the Jamam refugee camp is on the verge of a humanitarian crisis. The camp is home to some of the 200,000 refugees who, according to the U.N., have fled the conflict in Sudan’s Blue state.

However, Médecins Sans Frontières has warned that the mortality rate among children at the camp was 2.8 per 10,000 per day. This figure is above the emergency threshold of two per 10,000.

Amidst all of this both women leaders and activists admit that they had high expectations of the country’s first year. Some feel that the reality of independence has failed to live up to the hype and euphoria.

“We had high expectations, but I think they are not unrealistic and should not be pushed aside. Women are doing badly politically, economically, socially and education wise. The government needs to take measures to address the challenges facing women so that they can truly enjoy life in their new independent country,” Lorna Merekaje, of the South Sudan Domestic Election Monitoring and Observation Programme, told IPS.

Others disagree.

The Central Equatoria state Governor’s advisor on conflict resolution, Helen Murshali Boro, said that women’s concerns would be addressed.

“There is freedom of speech to allow women to express themselves and this means women’s concerns will not go off the radar until they are addressed in the coming years of our country’s independence,” she said.

Though the reality still remains far different.

“Like in the past when South Sudan was still part of Sudan, today women live in poverty,” said Lona James Elia, executive director of a local women’s rights agency, Voice For Change.

The National Baseline Household Survey (NBHS), conducted in 2009 and released in June 2012, indicates that over half of South Sudan’s 8.2 million people live below the poverty line on less than a dollar a day. The majority of the poor are women.

Elia added that South Sudan is still unable to provide maternal health services to the country’s women, especially in rural areas.

According to the U.N. Children’s Fund only 19 percent of births are attended by a skilled health worker. According to the NBHS, 30 percent of the population has no access to basic health services.

The few available health facilities lack supplies and qualified personnel to provide the required services. And in some rural areas women cannot receive maternal and antenatal care because they live too far from the nearest maternity clinic. Thirty-seven percent of poor households have to travel for more than an hour to reach their nearest most-used health facility, according to the NBHS.

“Women are still dying while giving birth. They are still not accessing maternal health services. A woman is not supposed to die because she is giving birth to a new life, a new baby. This is not acceptable,” Elia told IPS.

According to the National Bureau of Statistics, in 2011 the country recorded that 2,054 out of every 100,000 women died during childbirth. The high mortality rate has not changed much a year later, according to the U.N. Population Fund (UNFPA).

In June, Kate Gilmore, assistant secretary-general and deputy executive director (Programme) of the UNFPA, told reporters in Juba that maternal mortality rates in South Sudan remained the worst in the world.

“The latest evidence that we have is that using standard figures in every 100,000 births there are over two thousand women who die from preventable causes in South Sudan. In Afghanistan, which surely is one of the most troubled countries in the world, it is half that. Across Africa it is five hundred,” she had said.

Elia said the government needed to invest in maternal health services to ensure that women could participate in developing the country.

“A mother should not have to travel all the way from Gondokoro to Juba to deliver a baby because there is no hospital in her home city,” Elia said. Gondokoro is about 20 km from Juba and also within Central Equatoria state. She added that because the nearest health care centre was too far, some women died along the way.

However, government spokesman Barnaba Marial Benjamin said that the government had worked hard to improve living standards.
“We have initiated projects, including building schools and health centres, which will benefit all South Sudanese citizens, including women,” he told IPS.

In addition, the government has implement an affirmative action policy that ensures 25 percent women’s representation in all government jobs at national, state and county levels.

“You see after independence the president appointed six women to the cabinet and about nine to 10 assistant ministers. I think with about 16 women in the national government, the government has responded positively,” said Boro.

Currently there are four female ministers out of a total of 29, and eight female assistant ministers from a total of 27.

However, activists say that this has not directly affected the lives of the country’s women.

“When you look at the middle-class women and those at the grassroots they are still not in positions where they can make decisions that benefit women,” Merekaje told IPS.

Boro admitted that women still occupy low entry positions in the work field.

“Although these days you see more women coming to work in the morning, at the end of the day they go home with peanuts because they work in the less-paid, low positions,” Boro said.

Elia said that women were unable to find employment because the majority are illiterate and do not have the vocational skills required by employers. According to the National Bureau of Statistics, 88 percent of South Sudanese women are illiterate. In addition, the U.N. says that only one percent of girls complete primary school.

“Women are the most illiterate and because, despite the independence of our country, women at the grassroots level still remain the most underprivileged segment of society as they have to depend on men for survival,” Elia told IPS.

Jerisa Yide is one such example. The 65-year-old grandmother earns a living breaking stones and rocks into gravel, which she sells to builders.

“I used to crash stones before independence to enable me to pay my grandchildren’s school fees. We are now independent, but we are even paying more fees for our children to go to school,” said Yide.

Primary and secondary school education are not free in South Sudan. And as a result of the shut down on oil production, the government introduced an austerity budget in January where it scrapped free university education.

Yide said that when she voted for independence she expected the government to provide better services, including education and health.

Selina Modong agreed that not much had changed. She said that the cost of living in Juba had increased since independence. As a result of the economic crisis, inflation has soared to a staggering 80 percent in May.

“I was eating one meal per day before independence. Today I still eat one meal per day and sometimes we hardly eat good food these days,” Modong said.

“I think independence has not changed anything for us poor people,” Modong concluded.

Elia said that everyone should participate in ensuring that the women’s agenda is addressed.

“If you want this independence to benefit everyone, the issue of women should not be for women alone. It should be for everybody. Let us ensure that our daughters have a bright future. That they will get the education they want, that they will get the employment they want and that they will get the health services they deserve to build healthy families for themselves,” said Elia.

A young professional in India’s burgeoning IT hub Gurgaon, a major satellite city of national capital New Delhi, Manideepa Moitra works as a software content writer not just to make a living but to secure a career in the demanding sector that catapulted India on the global outsourcing  industry map.

Manideepa, 28, who got married early this year, says she has no plans to conceive in the foreseeable future.

“Parenthood is not in our scheme of things now and we cannot even say when is a suitable time to start a family. It is simply because I am busy with my career, and there is no support system here after we relocated from Kolkata, leaving our parents there,” says Manideepa.

“It is a conscious choice to give more priority to our career now, and my husband agrees that we will not have a child in the coming years.”

It is becoming common in India for urban women to focus on their career first, according to a survey released earlier this month by India’s leading industry body, the Associated Chambers of Commerce (ASSOCHAM).

The ASSOCHAM Social Development Foundation (ASDF) carried out a random survey of about 1,200 married, young full-time working women without children and about 800 stay-at-home mothers in the 24-30 age group years in cities.

It found that more than half (650) of married, young working women said they have shelved plans to start a family. They said career advancement and higher education is their priority, and they cannot sacrifice this to raise kids.

“Ambitious working women in India are not willing to give up their career for the sake of family as they are apprehensive about dealing with stress and emotional distress associated with issues of work/life balance,” says D.S. Rawat, secretary general of ASSOCHAM.

The findings about urban women professionals are significant in a country where the average childbearing age for women is very low in rural areas, and the maternal mortality rate is still a high 212 per 100,000 births, according to the Registrar General of India.

According to Dr Ranjana Kumari, Director of New Delhi-based Centre For Social Research, there is a perceptible shift in the approach to childbirth in urban areas, and many metropolitan women are choosing to delay both marriage and childbirth.

“There are a range of external conditions that enable women to make the choice to delay childbirth. These include high education levels, support from their family and community, good and secure employment, and comfortable living conditions,” she tells IPS.

“Priorities are definitely changing for urban women. As women become higher educated and more economically independent and secure, they gain more self-confidence and dignity, and are more empowered to make life decisions including choosing when and if to marry and have children.”

Of the women interviewed in the ASSOCHAM report, about 10 percent said they work to lead a better lifestyle and need to accumulate enough wealth before they start a family and cope with the rising costs of childcare. About 20 percent of the women surveyed said they and their husbands had taken the decision mutually.

Young professionals like Manideepa Moitra say motherhood is an impediment on the career path.“If I take a break from career for two three years, it is very difficult to come back and have the same position.”

However, some women studies groups and experts are not willing to draw any broad conclusion from such studies.

“Having a child, when to have one and when not to have one is and should be a woman’s right, in consultation with her partner at best, but, this in fact is seldom the case in countries like India where women’s ability to exercise choice in decision-making remains restricted, and there are enough studies to show that,” Dr. Indu Agnihotri, Director of New Delhi-based Centre for Women’s Development Studies (CWDS), tells IPS.

“Any such report has to be seen in the context of hard data and facts. The work participation rate for women in India is very low and even more so for urban India,” she says.

Dr Agnihotri says that the last round of National Sample Survey Office (NSSO) data shows that the proportion of women workers nationally is on average as low as 25 percent. NSSO is an organisation in the Ministry of Statistics and Programme Implementation of the Indian government.

But, says Dr Agnihotri, “deeper analysis undertaken by my colleagues in the CWDS showed that actually only 15 percent of women were in paid work. The work participation rate for women in national capital Delhi for the year 2007-8 stood at 7.1 percent in the age group of 15 and above.

“So the real issue is unemployment, unavailability of work and loss of existing work, since I think in the last round of recession some 27 million women lost their jobs but there is no discussion on that.”

According to CWDS, the story of India’s growth is one of jobless growth along with high levels of poverty where women are disproportionately high in numbers among the poor, and in the most low end and insecure jobs, mostly in the informal sector. She says they have poor wage rates and little bargaining position.

According to her, given the few jobs that women have even at the level of those surveyed, and the insecurity prevailing, the private sector largely follows an unstated policy of sacking a woman employee when informed of a pregnancy, and maternity leave is almost never granted in the climate of hire and fire.