The UNFPA released a report detailing how women were suffering widespread mistreatment during childbirth across Eastern Europe and Central Asia. Credit: UNFPA

By Ed Holt
BRATISLAVA, Mar 30 2026 (IPS)

Government and medical professionals must implement systematic changes to deal with a “crisis” of obstetric violence (OV) across Eastern Europe and Central Asia (EECA), experts and rights campaigners have said.

The call comes as the United Nations Population Fund (UNFPA) released a report on March 12 detailing how women were suffering widescale mistreatment during childbirth across the region.

“This report is a wake-up call. All stakeholders must make sure that women’s rights are respected and protected in all facilities in the health system and beyond,” Tamar Khomasuridze, UNFPA Sexual and Reproductive Health Adviser for Eastern Europe and Central Asia, told Inter Press Service (IPS).

The report, Respectful Maternity Care: Women’s Experiences and Outlooks in Eastern Europe and Central Asia, highlighted what the UNFPA said was a “pervasive yet often hidden OV crisis that violates women’s fundamental human rights and dignity”.

The survey, which was based on online responses from over 2,600 women who gave birth recently and conducted across 16 countries and territories in the region, found that 67 percent of respondents reported at least one form of mistreatment, including non-consensual medical procedures, verbal and physical abuse, and significant breaches of privacy.

Nearly half (48.1 percent) of women underwent obstetric procedures – such as episiotomies, Caesarean sections, or the administration of oxytocin – without their informed consent.

Meanwhile, about 24 percent of surveyed women reported experiencing verbal abuse, including yelling and humiliation, and 1 in 10 endured physical or sexual abuse during labour or gynaecological examinations. For example, 12 percent of the surveyed women reported being physically restrained during labour, such as being tied to the bed or subjected to aggressive physical contact under the pretext of facilitating delivery. Just over 10 percent experienced different forms of sexual abuse, ranging from inappropriate touching to more severe forms of assault (disrespectful manipulation of the genitals).

The survey also revealed a massive lack of awareness of OV among women in the region – almost 54 percent of surveyed women said women were unfamiliar with the term “obstetric violence”. And of those that knew they were victims of OV, very few reported such incidents – only two percent of those mistreated officially reported their experience, often due to a lack of trust in accountability mechanisms or fear of retaliation.

Previous research into the extent of OV in the region is limited and experts say it is difficult to gauge whether the situation in the region has changed in recent years.

But campaigners say the report underlines that it remains a serious problem.

“Obstetric violence has always existed, but for a long time it remained invisible, normalised, and embedded within what was perceived as ‘standard medical practice’. The major shift over the past decade is not necessarily in the prevalence of the phenomenon but rather in its increased visibility at the public, legal, and institutional levels, including its inclusion on the global agenda of human rights and public health,” Alina Andronache, a gender public policy expert at the Partnership for Development Center (CPD) in Moldova, who helped author the UNFPA report, told IPS.

“The report outlines a mixed picture: recognition and visibility of the phenomenon are increasing, yet the prevalence of experiences of abuse, coercion, and lack of consent remains alarmingly high,” she added.

Rights activists say that the phenomenon is closely linked to the wider issue of prevalent attitudes to women in the region.

“The report clearly shows that obstetric violence is not merely an issue of inadequate medical practices but is deeply embedded in broader social and cultural structures—particularly gender discrimination, power imbalances between the patient and medical staff, rigid institutional hierarchies, and norms that socialise women to accept authority without questioning it, including in highly intimate and vulnerable contexts such as childbirth,” said Andronache.

She highlighted the report’s finding that 58.4 percent of respondents believe that a mother must accept any intervention for the benefit of the child, even if it may harm her, while 19.6 percent consider that doctors may take a decision without a woman’s consent to protect the child.

“These perceptions reflect a profound internalisation of the idea that women’s bodily autonomy can be suspended during childbirth in favour of a medical authority perceived as unquestionable. This internalisation has two major consequences: it legitimises abusive or coercive practices, which are no longer perceived as violations of rights but as ‘necessary’ or ‘medically justified’ interventions, and it  directly contributes to underreporting and to the difficulty of recognising obstetric violence as such. If women are socialised to believe that they do not have the right to refuse, to ask questions, or to negotiate interventions, then their experiences are not necessarily identified as abuse but rather as a ‘normal’ part of childbirth,” she explained.

The report includes a call to action that outlines critical steps to address systemic problems with OV in the EECA states. These include legislation to protect women against OV; human rights-centred training for all healthcare personnel to shift clinical attitudes and ensure dignity is maintained at the point of service, as well as implementing monitoring and other measures to ensure accountability; and strengthening education and wider awareness of OV.

The UNFPA says its call to action has been endorsed by all countries in the survey and other stakeholders and will become part of action plans on OV at the national level.

But it is unclear how easy it will be to effect meaningful change, especially in a region where some countries have very conservative social cultures and wider problems with women’s rights.

The report showed that among respondents from Central Asian countries, such as Kazakhstan, Kyrgyzstan and Uzbekistan, around two thirds of women were unaware of OV. The report says this is due, in part, to traditional norms surrounding women’s roles and childbirth, which may make women less open to discussions about obstetric abuse.

Khomasuridze admitted that there were “of course sensitivities in different countries” in the region but was confident that with the help of various stakeholders, including civil society organisations, women’s rights groups and patient groups, changes would be implemented.

Andronache said that in countries where strongly conservative political policies and societal attitudes are prevalent, it was crucial that “the message be adapted to the context”.

“In more conservative societies, the approach should not be perceived as confrontational or ideological but rather framed as an issue of safety, dignity, and quality of care for both mother and child. Emphasising health, respect, and communication may be more readily accepted than a discourse focused exclusively on rights,” she said.

She added that it was essential that women be made aware of OV during their engagement with healthcare professionals – prenatal courses should be accessible and include, alongside medical information, clear explanations about women’s rights, informed consent, and what respectful care entails. ‘Meanwhile, information must reach those who need it most, she said — particularly in rural areas and in communities with more limited access to education.

“This requires simple messages, delivered in accessible languages and through channels that women already trust, including healthcare providers, community leaders, or other women sharing their experiences,” Andronache said.

“Awareness is built not only through the dissemination of information, but also through the creation of a space in which women feel able to ask questions, understand what is happening to them, and recognise when their rights are not being respected,” she added.

However, even in places where there is more awareness, serious problems with OV remain.

The study found that awareness of OV is higher in Eastern European countries, in part because advocacy initiatives regarding women’s rights during childbirth have contributed to increased visibility of the issue. Yet OV is widespread in some of these states.

In the survey the highest dissatisfaction rates with their childbirth experience were recorded among respondents from the Western Balkans (Albania, Serbia and Kosovo).

In 2022, a study by lawyers in Serbia found that women in the country are regularly subjected to various forms of violence at maternity clinics and hospitals, including not just verbal abuse and humiliation at the hands of staff, but violent physical examinations and invasive procedures without consent.

In January 2024, Marica Mihajlovic, a Roma woman, claimed that during labour her doctor jumped on her stomach, slapped her and racially abused her. Her baby died soon after birth.

A 2023 report on OV in Moldova included testimony from scores of OV victims, some of whom were left with serious physical and mental health issues afterwards.

As well as having to deal with the physical and mental damage of their experiences, victims of OV in the region also often face significant barriers to any redress for their suffering.

“Women who are aware of obstetric violence and would like to take action encounter, in reality, a form of distance—not only physical, but also emotional and institutional. In theory, reporting mechanisms should be ‘within reach’: easy to understand, accessible, and safe. In practice, in many countries this distance is far too great,” explained Andronache.

She said many women who want to report OV struggle with difficult and bureaucratic systems for doing so. Many are also put off by feelings that reporting what happened to them will not change anything or, worse, “that they would be placed in a position of having to prove their suffering, of being questioned, or even invalidated”.

“In the absence of clear and credible accountability mechanisms, reporting is not perceived as a solution, but as a long, uncertain, and emotionally draining process,” Andronache said.

Some also find that after a difficult or traumatic experience, they simply do not have the emotional resources to engage in a formal process. “They seek calm, recovery, and the ability to care for their child. The question ‘is it worth going through this?’ becomes very real,” said Andronache.

While the report identifies the scale of the OV crisis in the region and changes needed to reverse, or at least lessen it, fundamental improvement is not expected to come overnight, regardless of how enthusiastically governments embrace the UNFPA’s recommendations.

“Some changes can be implemented relatively quickly—for example, establishing clear and accessible reporting mechanisms, informing women, introducing more transparent procedures, or providing basic training for medical staff. These depend largely on political will and organisational capacity and can be achieved within a relatively short timeframe.

“However, the more difficult aspect is the transformation of mindsets—both within the medical system and in society at large. A deeper transformation to a system in which women feel safe to speak out and which responds with accountability and respect is a long-term process that may take a decade or more. At its core, this is a cultural shift, not merely a regulatory one,” said Andronache.

Khomasuridze agreed.

“We and our partners have a long way to go. Progress depends on action at the national level and we are very well positioned in [EECA] countries to accelerate progress, working with government, professional societies, civil societies, women’s groups, and patients’ groups to make sure that this transformative agenda is implemented,” she said.

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In Japan, the youth group donated the proceeds from their recycling to single-mother families with hospitalized children through the NPO Keep Mama Smiling. Credit: Karuta Yamamoto.

By Karuta Yamamoto
TOKYO, Japan, Mar 6 2026 (IPS)

From the beginning, this project was a collaboration between student teams in Japan and Korea. Although we live in different countries, we shared one common question: How can young people reduce waste while supporting families facing food insecurities?
Our journey began with a problem we could see clearly in our communities.

In Japan, food insecurity often hides behind quiet dignity. According to a recent survey by Save the Children Japan, over 90 percent of low-income households with children reported struggling to afford enough food, with many families forced to cut back on even basic staples such as rice due to rising prices.

The Japan and Korean team of all 11 students presented ‘The Co-creation of Youth from Waste to Hope’ at the 9th Tokyo International Conference on African Development (TICAD 9) Thematic Event. Credit: Ticad 9

The Japanese team leader, Karuta Yamamoto, and the Korean team presented ‘What we want in Africa for the future’ at the Seoul National University, Seoul, Korea, during TICAD 9.

Japan and Korea Team Leader, Karuta Yamamoto and Emma Shin, in an interview with UNFPA Seoul. Credit: Karuta Yamamoto

The Korean team set up a shop at a bazaar at Arumjigi, Seoul, Korea. Credit: Karuta Yamamoto

Single-parent households—most led by mothers—face especially high levels of food hardship and are often compelled to make painful decisions about how limited budgets are spent. For some families, this means choosing between symbolic moments of celebration and everyday nutrition. A ¥3,000 Christmas cake may represent joy for one household, but for another, that same amount must stretch to five kilograms of rice—enough to feed a family for several days.

At the same time, vast amounts of edible food are wasted in Japan. Official statistics show that millions of tons of food are discarded annually in Japan, much of it still edible. Seasonal items such as Christmas cakes, which cannot be sold after December 25, are frequently thrown away. This contrast—waste on one side and hunger on the other—reflects the global challenge addressed by SDG 12: Responsible Consumption and Production.

As students in Japan and Korea, we asked ourselves, “What role can we play in closing this gap?”

We knew that awareness alone would not change habits. enough. Instead of telling people to feel guilty about food waste, we decided to take action together.

We began locally, but with shared purpose.

In Japan, students at Dalton Tokyo Senior High School noticed that mandarin oranges—one of the country’s most common fruits—often go uneaten, with peels and seeds discarded. In Korea, students identified a different issue: more than 150,000 tons of used coffee grounds are discarded each year, contributing to landfill emissions and greenhouse gas emissions.

Different materials.

One shared goal.

Rather than seeing waste as the end of a product’s life, we saw it as a beginning.

Research shows that citrus peels contain essential oils that can be used in soaps and cleaning products. Studies in Korea also demonstrate that spent coffee grounds can be processed into sustainable biomaterials suitable for eco-friendly design and 3D printing. Plantable seed paper—made from recycled paper embedded with seeds—is another example of how waste can be transformed into something regenerative.

Inspired by these ideas, our student teams turned theory into action.

Japanese students created handmade soaps using discarded citrus peels.

Handmade soaps using discarded citrus peels. Credit: Karuta Yamamoto

The soaps ready for sale. Credit: Karuta Yamamoto

Korean students developed 3D-printed clip-on vases incorporating recycled coffee grounds, encouraging people to reuse empty bottles and cups instead of discarding them.

The Korean students developed 3D-printed clip-on vases incorporating recycled coffee grounds. Credit: Karuta Yamamoto

They also produced plantable seed paper from recycled materials, allowing waste to literally grow into flowers and herbs.

Korean students produced plantable seed paper from recycled materials. Credit: Karuta Yamamoto.

These products were not sold as charity goods. Instead, they were shared as examples of responsible consumption—showing that waste can have a second life through our design. Through this work, we directly supported SDG 12: Responsible Consumption and Production, which calls for reducing waste through recycling and reuse, and SDG 13: Climate Action, by lowering emissions through upcycling.

At the same time, the funds raised had a clear purpose.

The profits were used to support families facing food insecurity. In Japan, we donated to single-mother families with hospitalized children through the NPO Keep Mama Smiling (see main photo for the opinion piece).

They also provided essential cooking ingredients to the Karuizawa Food Bank. By connecting environmental action with helping families in need, our project also supported SDG 2: Zero Hunger.

The group provided cooking ingredients to the Karuizawa Food Bank. Credit: Karuta Yamamoto

Through this experience, we learned that caring for the planet and caring for people are not separate goals. Waste reduction and hunger relief became connected in one youth-led effort—turning environmental responsibility into community solidarity.

But our collaboration did not stop in Japan and Korea.

Through a partnership with the OneSmile Foundation—an organization that transforms digital smiles into donations—we connected our local initiatives to a global challenge. During workshops, we learned that school meal donations in Lesotho had stopped the previous year. Without reliable meals, many students were struggling to focus in class.

Together, our Japanese and Korean teams raised over 300,000 Japanese yen.

The Japanese and Korean teams celebrate their fundraising efforts. Credit: Karuta Yamamoto

Working with local partners in Lesotho, we organized a community-based food support initiative at Rasetimela High School, which serves 863 students. School feeding programs play a critical role in Lesotho, and recent disruptions have left many students more vulnerable to hunger.

Students at Rasetimela High School in Lesotho receive donations of food. Courtesy: Rasetimela High School

Ninety-one of the most vulnerable students were selected through transparent criteria, including those supported by social welfare programs and those who had previously relied on international assistance. Each selected family received staple foods such as rice and corn flour to make a local staple called pap. Distribution was organized near the school to ensure safety and allow parents to collect the supplies securely.

This cross-border effort—connecting students, NGOs, local leaders, and communities—reflects the spirit of SDG 17: Partnerships for the Goals.

Although we live in different countries, climates, and cultures, this experience reshaped how we understand global cooperation. The students in Lesotho were not distant beneficiaries. We became peers in a shared world.

They became peers in a shared world. Courtesy: Rasetimela High School

As young people, we often believe our impact is limited because we do not control large resources. This project challenged that belief. We learned that we can create change by designing solutions, raising awareness, and working together.

We even tried to measure what we called a “Happiness Index” by counting the smiles of students who received support. Those smiles reminded us that sustainability is not only environmental or economic—it is human.

Our experience shows that youth are not just future leaders. We are active contributors today. When creativity meets collaboration, waste can become opportunity, and local action can grow into global solidarity.

Turning waste into hope is not an abstract idea.
It is a choice—and young people are already making it.

Edited by Dr Hanna Yoon

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The maternity ward at Kharkiv City Multifunctional Hospital No.25. Credit: UNFPA/Ukraine

By Ed Holt
BRATISLAVA, Jan 7 2026 (IPS)

“It was an emergency caesarean section when the life of the pregnant woman was at risk. We did the operation with just flashlights and no water, and against a backdrop of constant explosions,” says Dr Oleksandr Zhelezniakov, Director of the Obstetrics Department at Kharkiv Regional Clinical Hospital, in eastern Ukraine.

He is recalling what he says was “one of the most difficult” medical procedures he has been involved in since the start of Russia’s full-scale invasion of his country.

But it was far from the only time he has had to work in extreme conditions while his city is pounded by Russian shelling. In fact, he says, it has become routine for him and his colleagues.

“The current reality is that, given we are in a frontline city, we work like this almost every day, because the alarms never stop and we hear explosions almost every day,” he tells IPS.

“You just do what you have to do to save a life, to save the future. In such moments, you only think about saving a life. We work [in these conditions] because life must always prevail,” he says.

Staff look at the beginnings of construction of a bunkerised facility at Kharkiv City Multifunctional Hospital No. 25. Credit: UNFPA/Ukraine

Zhelezniakov’s hospital has, like many other medical facilities in Ukraine, been repeatedly attacked and damaged since the start of the war. The World Health Organisation (WHO) had documented more than 2,700 attacks on Ukrainian healthcare facilities since February 24, 2024.

These have included attacks on more than 80 maternal healthcare facilities – with devastating consequences for maternal health, as recently released data has shown.

According to analysis by the United Nations Population Fund (UNFPA) released in December, there has been a sharp rise in the risk of dying in pregnancy or childbirth in Ukraine as the conflict grinds on.

The agency says repeated strikes on hospitals and the breakdown of essential services are forcing women to give birth in increasingly dangerous conditions, and health workers have warned that a combination of violence, chronic stress, displacement and widespread disruption of maternity care is driving a surge in pregnancy complications and preventable deaths.

Its analysis of national data shows a 37-percent increase in the maternal mortality rate from 2023 to 2024 – the most recent full year of national data available. In 2023, Ukraine recorded 18.9 maternal deaths per 100,000 live births. In 2024, that figure rose to 25.9. The organisation says most of these are preventable deaths, reflecting a health system operating under extreme strain.

It said it had also seen sharp increases in severe pregnancy and childbirth complications. Uterine ruptures — among the most dangerous obstetric emergencies — have risen by 44 per cent. Hypertensive disorders of pregnancy have increased by more than 12 per cent, while severe postpartum haemorrhage has risen by nearly 9 per cent – from 2023 to 2024. Delays in accessing care, stress, displacement and disrupted referral pathways are key contributing factors.

Meanwhile, the situation in frontline regions is particularly acute. In Kherson, premature births are almost double the national average, and the region has the highest stillbirth rate in the country, according to UNFPA.

It cites contributing factors including stress, insecurity and difficulties in accessing care, which can lead to preterm labour and premature rupture of membranes.

Another indicator of system strain is the Caesarean section rate. Nationally, the rate now exceeds 28 per cent, already above recommended levels. In frontline regions, the figures are among the highest in Europe: 46 per cent in Kherson and approximately 32 per cent in Odesa, Zaporizhzhia and Kharkiv. These high rates often reflect the need for doctors and women to time deliveries around short windows of relative safety and can additionally show an increased pregnancy complication rate that requires surgical intervention, according to UNFPA officials.

“Attacks [on healthcare, including maternity and neonatal facilities] have had measurable and severe consequences for maternal health. Ukraine is entering another winter under conditions that sharply increase risks for pregnant women, newborns and the health workers who care for them,” Isaac Hurskin, Head of Communications, UNFPA in Ukraine, told IPS.

In early December, a maternity hospital in Kherson, a facility supported by UNFPA, was struck by artillery fire. During the strike, hospital staff moved women in labour and newborns into a bunkered maternity ward—one of many such facilities constructed by the government with help from groups like UNFPA to protect mothers and babies during active hostilities.

While everyone survived the attack and a baby girl was born in the bunker during the shelling, Hurskin said it was “a stark illustration of the conditions under which pregnancy and childbirth are now taking place — conditions no woman or health worker should ever have to face”.

But the devastation wrought by the war in Ukraine is also impacting wider reproductive health.

IPS has spoken to women in Ukraine who have admitted they are avoiding getting pregnant because of concerns about their ability to access maternal healthcare safely but also the conditions in which they may have to raise an infant.

“Women in conflict-affected areas have specific reproductive needs. It is very hard to meet them when a maternity hospital gets bombed on a regular basis, or when energy infrastructure is targeted, limiting the functionality of hospitals and forcing pregnant women to unequipped hospital shelters. A woman considering getting pregnant needs to make a decision based on these factors – whether a hospital is safe, whether she can have access to services, and whether she is able to care for the child afterwards, with no electricity, heating, or water at home,” Uliana Poltavets, International Advocacy and Ukraine Program Coordinator at Physicians for Human Rights (PHR), told IPS.

“This is a trend which is being observed,” added Zhelezniakov. “Women fear not only for their lives and the lives of their unborn children during childbirth under shelling but also an uncertain future—a lack of safe housing, work, and normal conditions for raising a child. This is a rational fear in the irrational conditions of war. It is one of the reasons for the sharp decline in the birth rate.”

But he added that conversely, the effects of the war were impacting women’s ability to conceive.

“Chronic stress, high cortisol levels, anxiety, and sleep disorders directly affect hormonal balance and reproductive function. Constant stress also leads to hormonal imbalances (dysfunction of the hypothalamic-pituitary-ovarian axis). This causes an increase in cases of secondary infertility, premature ovarian failure, and endometriosis. We are already seeing an increase in the number of pathological menopauses in young women,” he said.

These threats to fertility and maternal health come at a time when Ukraine is facing a demographic crisis.

According to UNFPA, since 2014, when Russia illegally annexed Crimea and supported separatist paramilitary movements in eastern Ukraine, the country has lost an estimated 10 million people through displacement, mortality and outward migration. Fertility has fallen to below one child per woman — one of the lowest rates globally.

It says that rising maternal deaths, increasing complications and pervasive uncertainty about the safety of childbirth reinforce one another, with long-term consequences for families, communities and national recovery.

“This is not only a humanitarian emergency. It is a demographic crisis with implications that will extend far beyond the end of hostilities. Protecting maternal health is central to Ukraine’s long-term recovery and future stability,” said Hurskin.

Indeed, examples from other recent conflicts where there has been widescale destruction of healthcare have shown the long-term effects of war on maternal and reproductive healthcare long after they have finished, from problems with rebuilding damaged and destroyed facilities, ongoing displacement, and continued shortages of medical staff just some of the barriers to women being able to access services.

“Look at Syria, for example. The healthcare system is being built back up, there is rebuilding of facilities, things are improving, but it will take decades to get back to where it was before. And maternal healthcare tends to be deprioritised both during and after a conflict – resources tend to go to other areas such as emergency and trauma care. Women in Syria will have problems with accessing maternal healthcare for years and years to come,” an expert on healthcare in war zones working for an international human rights group, who spoke on condition of anonymity for security reasons, told IPS.

Zhelezniakov admits that a worsening of the demographic crisis in Ukraine is inevitable.

“The expectation is that it will get worse. The destruction of the maternal health care system only exacerbates existing problems caused by the war: the migration of women and children abroad, loss of life, economic instability, and psychological pressure,” he says.

But he adds that even now measures can be taken to improve maternal healthcare, including strengthening primary care, improving digitalisation (e-health systems), investment in prevention, mental health support programmes, environmental improvement, legislative regulation, and raising awareness of reproductive health to reduce mortality and disability, among others.

Developing international cooperation by creating “medical hubs” in relatively safe regions with the support of international partners, such as UNFPA and WHO, to ensure services, would also help.

“Even during active hostilities, we can and must work to adapt the system,” he says.

He also vows that, no matter what happens, he and other medical staff will not stop their work, recalling the emergency caesarean section performed by flashlight as shells rained down on Kharkiv.

“The birth of a child in such conditions is always a miracle and a powerful motivator to continue working, despite everything,” he says.

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Strong health systems start with midwives. Credit: Unsplash

By Shreya Komar
UNITED NATIONS, Aug 15 2025 (IPS)

Asia-Pacific’s midwives are a healthcare lifeline capable of delivering nearly 90 percent of essential maternal and newborn services. Yet the region grapples with severe shortages, underinvestment, and systemic neglect.

The newly released State of Asia’s Midwifery 2024 Report, released by the United Nations Population Fund (UNFPA), reveals that despite midwives’ lifesaving potential, many countries lack enough workers, face poor training and support systems, and struggle with weak policy backing. The findings underscore an urgent need to elevate midwives from auxiliary roles to central pillars of health systems across the region.

Drawing on data from 21 countries in the UNFPA Asia-Pacific (AP) region, the report was intended to assist countries in the region to meet the challenges of the health-related SDGs and the Every Woman Every Newborn Everywhere (EWENE) agenda, a global initiative focused on accelerating the reduction of preventable maternal and newborn deaths.

The report shows hundreds of thousands of maternal and newborn deaths in 2023 across the Asia-Pacific that timely midwife interventions could have largely prevented. The region faces a shortage of approximately 200,000 midwives, contributing to an annual toll of roughly 66,000 maternal deaths alone. These stark figures expose both the human cost and the systemic failure to invest in this essential healthcare workforce.

According to the report, at least five Asia-Pacific countries, including Lao PDR, Mongolia, Pakistan, Papua New Guinea (PNG) and Timor-Leste, are estimated to face needs-based midwife shortages, with Pakistan and PNG experiencing the most severe gaps.

The report projects that Pakistan and PNG will still face shortages by 2030, even if they maintain current rates of midwife graduation and full employment. Other countries, such as Afghanistan, Myanmar, and Viet Nam, are also likely to experience ongoing shortages; however, limited data prevents precise estimates of these shortages.

Beyond shortages, the report points to alarming gaps in education quality, regulatory frameworks, and leadership pathways for midwives. Many countries still struggle with limited pre-service training, scarce continuing education opportunities, weak licensing systems, and fragmented governance. Retention suffers as poor pay, inadequate infrastructure, and lack of professional recognition push midwives away, especially from rural and underserved areas.

The report also emphasizes how placing midwives in leadership roles can strengthen decision-making on policies that directly affect maternal and newborn health, improve supervision and mentoring, and ensure midwifery perspectives shape regulation, training, and service delivery.

Countries like Afghanistan, Iran, and Malaysia show how midwife-led governance can integrate professional expertise into national health strategies, ultimately enhancing the quality, reach, and effectiveness of sexual, reproductive, maternal, newborn and adolescent health (SRMNAH) services.

Since 2021, nine countries have increased midwife availability (Bangladesh, Cambodia, Iran, Lao PDR, Maldives, Nepal, PNG, Sri Lanka and Viet Nam), four have seen decreases (Indonesia, Malaysia, Pakistan and the Philippines), and two show no significant change (Mongolia and Timor-Leste). It shows that while some nations are making progress, regional gains are uneven, and shortages can worsen without sustained investment and retention strategies.

The WHO estimates that countries with fewer than 25 doctors, nurses and midwives per 10,000 people will struggle to provide adequate primary healthcare, a threshold that, while general, offers a benchmark for minimum workforce density.

Acting on this information is imperative because midwives are the most cost-effective, accessible answer to achieving safe motherhood and newborn survival goals. As the World Health Organization notes, when well-trained and integrated, midwives can address roughly 90 percent of essential reproductive and newborn health needs. Still, the world faces a global shortfall of nearly 900,000 midwives, and many in Asia endure poor working conditions, low pay, and limited career paths. Thus, saving lives demands investing in midwifery education, fair compensation, regulation, leadership, and full integration into health systems.

Midwife supervisor Arafin Mim, who oversees a team serving over 32,500 Rohingya refugees on the remote island of Bhasan Char in Bangladesh, captures the importance of her work simply.

“I feel this profession from the corner of my heart. It’s about making a connection with a pregnant woman, building a relationship during her pregnancy.”

Mim’s dedication illustrates the commitment and resilience midwives bring to some of the world’s most challenging environments.

In UNFPA’s recent opinion piece, the Regional Director Pio Smith shares a vivid image of midwives delivering in remote Bangladesh during climate crises to describe their resilience.

“When non-stop rain caused flooding in her village, the maternity ward, pharmacy, and storage room were submerged by water. She still continued to deliver babies, without electricity, even supporting emergency cesarean sections as needed with the doctors on call.”

The report urges governments and partners to close needs-based midwife shortages by expanding education in line with ICM standards, improving faculty and curricula, and ensuring equitable deployment. It recommends updating policies so midwives can work to their full scope, using data-driven workforce planning to create sanctioned posts, and adopting fair recruitment, deployment, and retention strategies.

Finally, it calls for empowering midwives with leadership roles in SRMNAH governance, regulation, and service improvement.

UNFPA’s Executive Director, Dr. Natalia Kanem, reminds us in a statement that “midwives are instrumental to navigating these challenges: They can provide up to 90 percent of essential services for sexual and reproductive health and bring their expertise and counsel to women wherever they are.”

Country examples such as Bangladesh, Nepal, and Cambodia offer hopeful signs. Bangladesh’s midwife-led birthing centers, Nepal’s rural midwifery deployments, and Cambodia’s regulatory reforms are exemplary, but much more action and investment are needed.

Midwives must be valued and supported as key professionals with quality education, fair pay, robust licensing, leadership opportunities, and a seat at health policymaking tables. This will result in fewer maternal and infant deaths, stronger newborn health, and more resilient healthcare systems.

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Delegates at AFPPD’s Sub-Regional Parliamentarians’ Meeting on Women Empowerment and Investment in Young People, which focused on the ICPD Program of Action and 2030 Agenda. Credit: People’s Majlis of the Republic of Maldives

By Cecilia Russell
MALÉ & JOHANNESBURG, Jun 26 2025 (IPS)

A meeting of parliamentarians in Malé, the Maldives, pledged to provide an enabling environment for emerging women leaders by supporting them and promoting a political culture rooted in mutual respect, inclusivity, and equal opportunity.

This was one of the main features of the Malé Declaration, agreed to by more than 40 participants from parliaments, governments, international organizations, NGOs, youth organizations, and academia across 15 countries during the AFPPD’s Sub-Regional Parliamentarians’ Meeting on Women Empowerment and Investment in Young People, which focused on the ICPD Program of Action and 2030 Agenda for sustainable development, aiming to address youth and women empowerment.

The meeting was co-hosted by the People’s Majlis of the Maldives and the Asian Forum of Parliamentarians on Population and Development (AFPPD), with support from the United Nations Population Fund (UNFPA) through the Japan Trust Fund (JTF).

The lawmakers agreed to commission evidence-based research on barriers to women’s political participation. The research will “examine the social, cultural, economic, and institutional impediments to women’s pursuit of political office and leadership roles in the member states in Asia, including the Maldives,” the declaration said, with the outcomes serving as a foundation for targeted policy interventions and legislative reforms to enhance women’s political engagement.

Dr. Anara Naeem, MP, Huraa Constituency/Maldives

In an interview ahead of the meeting, Dr. Anara Naeem (MP, Huraa Constituency/Maldives) told IPS that advocating for women’s rights started when they were young and parliamentarians had an active role in ensuring that women are encouraged to become involved in the economy.

Reacting to a question on the UNFPA research, which shows that 40 percent of young women are not engaged in employment, education, or training (NEET), she noted many core challenges, including high youth unemployment despite free education up to a first university degree. The country, like others, had to deal with gender stereotypes that prioritized women’s domestic role over careers—and with social participation barriers, “stereotypes limit women’s public engagement.”

Policymakers, Naeem said, were focusing on addressing these using multiple strategies, including promoting postgraduate scholarships and vocational training (tourism, tech, and healthcare aligned with job markets), encouraging women into STEM and non-traditional fields via mentorship, and integrating leadership and career advancement programs to address the glass ceiling.

Parliamentarians were also looking at innovative ways to boost the public sector hiring of women and incentivize private sector partnerships through tax benefits, flexible work, and career progression pathways.

“We also host community dialogues (haa saaba) and engage religious leaders to shift mindsets,” Naeem said.

AFPPD’s Sub-Regional Parliamentarians’ Meeting on Women Empowerment and Investment in Young People, held in Malé, Maldives. Credit: People’s Majlis of the Republic of Maldives

Speakers at the AFPPD’s Sub-Regional Parliamentarians’ Meeting on Women Empowerment and Investment in Young People, held in Malé, Maldives. Credit: People’s Majlis of the Republic of Maldives

The Maldivian government was working to enforce gender equality laws (anti-discrimination, parental leave, and addressing the glass ceiling) and allocate a budget for childcare, job programs, and women’s grants, including the enforcement of paid maternity leave for up to six months and no-pay leave for a year in all government offices. It was also encouraging the private sector to do likewise.

However, the success of these plans requires “coordinated action across government, the private sector, NGOs, and communities to create relevant jobs, dismantle cultural barriers (including the glass ceiling), provide critical support (childcare, robust maternity leave), and enable flexible pathways for young women’s economic and social participation.”

Parliamentarians also committed to working with the relevant Maldivian authorities to undertake a thorough “review and enhancement of national school curriculum to align it with job matrix. This initiative shall integrate principles of gender equality, women’s rights, civic responsibility, leadership, and sustainable youth development, fostering transformative educational content to instill progressive values from an early age.”

Naeem said lawmakers were also playing a special role in addressing issues affecting the youth like drug use and mental health, where they were “combining legislative action, oversight, resource allocation, and public advocacy.”

This included updating drug laws to target traffickers, decriminalizing addiction, and prioritizing treatment. While parliamentarians were lobbying for increased funding for rehab centers and the training of psychologists and medication subsidies, they were using national media to create awareness and holding local dialogues.

“Our key focus in law reform includes better rehab frameworks, funding oversight, public awareness partnerships, building support systems, minimizing service delivery gaps, and reducing relapse—shifting towards prevention and recovery in the Maldivian context,” Naeem said.

Participants at the meeting recommitted themselves to working with all stakeholders to advance the ICPD PoA and achieve the 2030 Agenda and reaffirmed the 2024 Oslo Statement of Commitment.

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Study Tour on Gender Equality and Women's Empowerment in Bosnia and Herzegovina. Credit: AFPPD

By Cecilia Russell
SARAJEVO & JOHANNESBURG, May 30 2025 (IPS)

Jelena Pekić, MP of the Federation of Bosnia and Herzegovina (House of People) and Deputy Speaker of the Canton Sarajevo Assembly, Lana Prlić, MP of the Federation of Bosnia and Herzegovina (House of Representatives) and Marina Riđić, Assistant Representative, UNFPA Bosnia and Herzegovina, spoke to IPS ahead of the Study Tour on Gender Equality and Women’s Empowerment in Bosnia and Herzegovina.

The study visit program arranged for members of the AFPPD group as well as for parliamentarians from Eastern Europe, held on May 29 and 30 in Sarajevo, gives lawmakers from the region and abroad the opportunity to participate in an event where they can exchange experiences and learn from each other.

“The main objectives of this important gathering are deeply connected to our shared vision of fostering genuine equality and empowering women at every level of society,” explains Riđić. “It is an opportunity to build stronger collaborations between parliamentarians, civil society organizations, and experts, creating synergies and mutual understanding essential for sustainable progress. By connecting gender equality to broader issues of population dynamics and sustainable development, we emphasize the holistic approach needed to achieve lasting impact.”

Here are edited responses from MPs Pekić and Prlić and UNFPA’s Riđić.

IPS: What are the main objectives of the Parliamentarians’ conference in Bosnia and Herzegovina?

Jelena Pekić, MP of the Federation of Bosnia and Herzegovina (House of People) and Deputy Speaker of the Canton Sarajevo Assembly, and Lana Prlić, MP of the Federation of Bosnia and Herzegovina (House of Representatives).

Pekić and Prlić: The main objectives of the Parliamentarians’ conference in Bosnia and Herzegovina are, first, to have the opportunity for the MPs to come here and meet the people during the study tour on gender equality and women’s empowerment. MPs will meet representatives from all levels in Bosnia and Herzegovina, from state to local levels of government and Parliaments, as well as agencies and committees, UNFPA, and media. All of this couldn’t be possible without the local office of UNFPA, which worked hard in past months to organize this study tour.

Marina Riđić, Assistant Representative, UNFPA Bosnia and Herzegovina.

Riđić: As a woman from Bosnia and Herzegovina currently working with UNFPA, I see the Parliamentarians’ efforts on gender equality and women’s empowerment as a powerful platform to drive meaningful change in our region. The main objectives of this important gathering are deeply connected to our shared vision of fostering genuine equality and empowering women at every level of society. Through facilitating rich exchanges of experiences and peer learning among parliamentarians from Eastern Europe and Central Asia (EECA), we aim not only to showcase Bosnia and Herzegovina’s robust legal and institutional frameworks but also to learn from each other’s successes and challenges. Bosnian and Herzegovinian Members of Parliament have already benefited immensely from the collaborative efforts with the Asian Forum of Parliamentarians on Population and Development (AFPPD), enhancing their knowledge and strengthening their resolve to champion gender-responsive policies. This conference further reinforces their capacity to design and implement initiatives that genuinely reflect and address the realities women face every day.

Moreover, it is an opportunity to build stronger collaborations between parliamentarians, civil society organizations, and experts, creating synergies and mutual understanding essential for sustainable progress. By connecting gender equality to broader issues of population dynamics and sustainable development, we emphasize the holistic approach needed to achieve lasting impact.

Personally, this conference represents a significant step forward in our collective journey towards true equality, highlighting the critical role parliamentarians play in transforming legislative visions into concrete actions that empower women and girls in Bosnia and Herzegovina and across the EECA region.

IPS: What are the challenges and successes regarding women’s representation in parliament and in other spheres of government? 

Pekić and Prlić: There was a study regarding challenges that women are facing as politicians, done by the Westminster Foundation for Democracy a couple of years ago, and the focus was on violence against women in politics. The study revealed the primary reasons women are reluctant to enter politics and why those who have been successful in the field have chosen to leave. Violence against women in politics commonly takes the form of emotional and verbal abuse; the perception is that violence is the cost of doing politics, and often a reason why women don’t do politics, or they leave politics. The Election Law of Bosnia and Herzegovina in 2013 raised the mandatory quota for women on candidate lists to 40 percent.

It is important to have affordable and accessible social services, including childcare, in order for women to participate fully in the economy. While legislation may have been passed, budgets often fall behind. How are parliamentarians working toward ensuring that both the legislation and budgets work in harmony so that women can fully participate in the workplace?

Riđić: Bosnia and Herzegovina has made notable strides in advancing gender equality, particularly through the adoption of strong legal frameworks such as the Gender Equality Law and the Election Law’s Gender Quota. These measures signal a commitment to increasing women’s representation in parliament and other spheres of government.

However, the gap between policy and practice remains a major challenge. Despite progressive legislation, systemic barriers continue to limit women’s full participation in decision-making roles. Entrenched gender and social norms still define leadership as predominantly male, discouraging women from stepping into public and political life. On top of that, the heavy load of unpaid care work borne by women restricts their ability to invest time and energy into political careers or high-responsibility positions.

There is also a critical need to create more pathways for women to grow into leadership roles.

Structured training programmes, peer support, and mentorship initiatives can make a real difference in equipping women to navigate institutional hurdles and thrive in political and public arenas.

The study tour offers an opportunity to reflect on both the progress and the setbacks. It allows us to share how Bosnia and Herzegovina is addressing these issues—what has worked, where we’ve fallen short, and what more needs to be done to ensure that our governance systems truly reflect the diversity and potential of our society.

Dr. Kiyoko Ikegami, Vice-Chair and Secretary General of APDA, with
Hon. Jelena Pekić, MP Bosnia and Herzegovina. Credit: AFPPD

Riđić: In Bosnia and Herzegovina, where more than half a million women are outside the labor market, the economic consequences are significant. With a population of just over three million, the scale of this untapped potential is alarming. That’s why we are not only looking at legislation but also at how to build political will for gender-responsive budgeting.

Importantly, we recognize that such work cannot be done by the public sector alone. We are also working to strengthen dialogue with the private sector, helping businesses understand the return on investment in human capital when they support inclusive and family-oriented work environments. Learning from Central Asian experiences is another key pillar of this tour, helping us apply practical and proven models in our context.

Ensuring that legislation and budgets work in harmony is at the heart of what we are exploring during the Parliamentarians’ study tour in Bosnia and Herzegovina. While our country has adopted key laws supporting gender equality and family-friendly policies, the reality is that without dedicated and sustained budget allocations, these policies often remain aspirational.

Parliamentarians are now increasingly aware of the need to bridge this implementation gap.

Through the support of partners like UNFPA and AFPPD, they are engaging in cross-country dialogue and peer learning to understand how to advocate more effectively for budget lines that support affordable childcare and other essential social services. Evidence from UNFPA’s unpaid care work studies, labor market projections, and gender equality programming underscores that without these services, women’s participation in the workforce will remain limited.

IPS: How are parliamentarians working toward ensuring that both the legislation and budgets work in harmony so that women can fully participate in the workplace?

Pekić: Making a law and passing it in the Parliament is just the beginning of a solution for certain issues in society, as you said in your question; law enforcement depends on the executive part of the system and budget, of course. That is why, personally, when proposing some of the laws and solutions, I consult the executive branch as well as the NGOs that closely work on those questions.

For example, in Sarajevo Canton, we have devoted a lot of attention to programmes and measures aimed at empowering families, with a special focus on childcare—from subsidies for kindergartens and extended school stays to maternity allowance for women during maternity leave lasting 12 months. All of these are measures that require significant financial resources, but with careful prioritization and planning of financial flows, their implementation is possible and sustainable.

IPS: Could you elaborate on any projects enabling young women’s entry into both the workplace and spheres of government? How have parliamentarians been supporting these projects?

Pekić: As a Member of Parliament of Bosnia and Herzegovina, I am deeply committed to advancing initiatives that empower young women to enter both the workforce and spheres of government.

Here, I would especially highlight employment programs by the government for young people and women through co-financing employment or starting their own businesses, as well as programs such as employment and education of the women who left the safe house—women who were victims of the violence. And when it comes to programmes empowering women to enter spheres of government, non-governmental organizations play an important role by providing numerous mentorship and education programs.

Riđić:  When we speak about enabling young women to enter the workforce and public life, we must begin with a broader picture because true empowerment doesn’t start at the job interview or ballot box. It starts much earlier, through inclusive education, health services, community belonging, and opportunity.

That’s why UNFPA, in partnership with parliamentarians, supports a range of initiatives that build foundations for young women to succeed. Through our youth empowerment programmes, social cohesion and peacebuilding efforts, and intergenerational dialogue initiatives, we are helping to create safer, more inclusive communities where young women can envision—and claim—their place in the public and professional spheres.

Innovative digital tools and platforms have been developed to amplify young people’s voices in local communities and support their engagement in decision-making processes. These tools encourage civic participation and nurture leadership skills from an early age. Our work also extends to strengthening the social and healthcare systems. Initiatives promoting HPV vaccination and healthy lifestyle education in primary schools are not only improving health outcomes: they are teaching girls to value their bodies, understand their rights, and grow with confidence. Programmes focused on social protection and rural outreach have helped ensure that young women from marginalized communities, including Roma, women with disabilities, and those from remote areas, have the support they need to pursue education and employment opportunities.

While these may not always appear as direct employment interventions, they are essential building blocks. Without systems that ensure dignity, inclusion, and safety, meaningful and sustained participation in the economy or politics remains out of reach. UNFPA’s demographic work and policy advocacy are deeply rooted in identifying and scaling measures that support sustainable solutions.

MPs and delegates walk through Sarajevo on their Study Tour on Gender Equality and Women’s Empowerment in Bosnia and Herzegovina. Credit: Delegates in session during the Study Tour on Gender Equality and Women’s Empowerment in Bosnia and Herzegovina, held on May 29 and 30 in Sarajevo. Credit: AFPPD

IPS: Could you elaborate on one or more specific projects that address gender-based violence? How have parliamentarians been supporting these projects?

Prlić: Recently we adopted in the Parliament of the Federation of Bosnia and Herzegovina a new law with the main goal of protecting women and families against violence, and very soon we are expecting to adopt the new changes to the Criminal Law, which will be harmonized with the mentioned law previously adopted, as well as with the Istanbul Convention, The Council of Europe Convention on preventing and combating violence against women and domestic violence, which is the first instrument in Europe to set legally binding standards specifically to prevent gender-based violence, protect victims of violence and punish perpetrators.

By adopting these two laws, there is a legal framework set to criminalize some of the acts that were not in the past, as well as give more tools to the police, judiciary, and medical workers to protect victims and punish perpetrators to make society safer and to make women safer in their homes.

Delegates in session during the Study Tour on Gender Equality and Women’s Empowerment in Bosnia and Herzegovina held on May 29 and 30 in Sarajevo. Credit: AFPPD

Riđić: Addressing gender-based violence (GBV) remains a core priority for UNFPA and a central theme in our cooperation with parliamentarians. The study tour will include discussions on national and regional projects aimed at preventing GBV and providing support for survivors. In Bosnia and Herzegovina, the work involves tackling both traditional forms of violence and emerging challenges like technology-facilitated abuse.

Parliamentarians have played a critical role in advancing legislative reforms and supporting institutional responses. Notably, they have been instrumental in the development of a legislative roadmap on protection from digital violence, a growing concern in today’s digital world. UNFPA’s “bodyright” campaign has contributed to public discourse and legal advocacy in this area.

Investment in healthcare services to support GBV survivors has been secured under the framework of the Istanbul Convention, with parliamentarians helping to ensure these commitments are reflected in national budgets. Equally important has been our collaborative work with survivors of conflict-related sexual violence and programs addressing perpetrators as part of a comprehensive approach to justice, healing, and prevention.

These efforts show that fighting GBV is not limited to reactive responses but requires long-term, structural engagement, and that’s why sustained parliamentary support is vital for ensuring that every law, budget, and service reflects the dignity and rights of women and girls in Bosnia and Herzegovina and beyond.

Note: The Study Tour on Gender Equality and Women’s Empowerment in Bosnia and Herzegovina is organized by the Asian Forum of Parliamentarians on Population and Development (AFPPD) and supported by the United Nations Population Fund (UNFPA) and the Japan Trust Fund (JTF).

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Tulia Akson, Tanzanian Parliament Speaker and President of the Inter-Parliamentary Union (IPU) at a recent meeting organized by Asian and African Parliamentarians. Credit: Kizito Makoye/IPS

By Kizito Makoye
DAR ES SALAAM, Mar 3 2025 (IPS)

Speaker of the Tanzanian Parliament and President of the Inter-Parliamentary Union (IPU), Tulia Akson, has called for bold and immediate investments in young people to unlock the demographic dividend and accelerate sustainable development across Africa and Asia.

Speaking at the African and Asian Parliamentarians’ Meeting on Population and Development in Dar es Salaam on Monday, February 24, Akson emphasized that youth empowerment must be at the center of national policies to ensure that rapid population growth translates into economic prosperity rather than a crisis.

“We must take deliberate and coordinated measures to harness the demographic dividend by empowering our youth and ensuring their active participation in economic development,” Akson told parliamentarians gathered from across Africa and Asia.

The conference, organized by the Asian Population and Development Association (APDA) in collaboration with the African Forum of Parliamentarians on Population and Development (FPA) and Tanzania’s Parliamentary Association on Population and Development (TPAPD), provided a platform for legislators to discuss legislative and policy reforms needed to advance population and development goals.

The event also drew support from the United Nations Population Fund (UNFPA) and the Japan Trust Fund (JTF), underscoring the urgency of population-centered development strategies.

A Demographic Window of Opportunity

Africa’s population is projected to double to two billion by 2050, with young people making up the majority. Experts argue that if this youthful population is equipped with quality education, healthcare, and economic opportunities, it could drive unprecedented economic transformation. However, failure to act could lead to social unrest, increased poverty, and economic stagnation.

According to UNFPA, 42 percent of Africa’s population is under the age of 50, a figure that presents both an opportunity and a challenge. While life expectancy has improved and maternal mortality has declined, critical gaps remain in access to education, employment, and reproductive health services.

“Young people constitute a significant proportion of our population, and their neglect is a ticking time bomb that could hinder progress,” Akson warned.

Tanzania, she said, has made strides in youth empowerment through initiatives such as free education from primary to secondary school, expanded student loan schemes, and a national skills development program that equips young people with vocational and technical expertise.

“We have also launched youth entrepreneurship funds to support start-ups and small businesses and expanded digital education programs to enhance ICT proficiency among our youth,” Akson said.

Despite such efforts, structural barriers persist, limiting young people’s access to quality jobs and economic opportunities.

Sexual and Reproductive Health: A Key Pillar of Development

Delegates at the African and Asian Parliamentarians’ Meeting on Population and Development in Dar es Salaam. Credit: APDA

Akson also stressed the importance of investing in sexual and reproductive health education to ensure young people, particularly girls, can make informed choices about their futures.

“We risk derailing our development trajectory if we fail to invest in young people’s sexual and reproductive health and rights,” she said.

The UNFPA has consistently underscored that access to reproductive health services is essential for economic and social progress. While contraceptive use has increased in many countries, adolescent pregnancies, gender-based violence, and harmful practices such as child marriage and female genital mutilation (FGM) remain widespread.

UNFPA Tanzania Country Representative Mark Schreiner noted that despite progress, “maternal mortality rates remain unacceptably high, with only a few African countries on track to meet the SDG target of 70 deaths per 100,000 live births by 2030.”

Similarly, although more women are using modern contraception voluntarily, millions of adolescent girls still lack access to critical reproductive health services due to social stigma, policy gaps, and inadequate funding.

Schreiner called for urgent investments in comprehensive sexuality education (CSE) and youth-friendly health services to empower young people with knowledge and protect them from unintended pregnancies, sexually transmitted infections (STIs), and harmful cultural practices.

“Comprehensive sexuality education and investment in young people’s health, including sexual and reproductive health, must be prioritized to accelerate progress toward universal health coverage,” Schreiner said.

Parliamentarians agreed to take immediate action to empower youth at a recent meeting organized by Asian and African parliamentarians. Credit: Kizito Makoye/IPS

Parliamentarians’ Role in Advancing the Population Agenda

As policymakers, parliamentarians hold significant influence over national budgets and legislative reforms that impact population policies. Akson urged her colleagues to use their constitutional mandates to push for policies that address youth unemployment, gender-based violence, and reproductive health access.

“With the deadline for the SDGs fast approaching, we must act swiftly and decisively to remove the barriers that hinder young people’s development,” she said.

Japan’s Ambassador to Tanzania, Yoichi Mikami, commended lawmakers for their commitment to addressing population challenges, stating, “Any solution on population issues must be based on an understanding of each individual. The role of parliamentarians, therefore, as representatives of their citizens, is critically important.”

Joseph Komwihangiro, Country Director for Pathfinder International, a global civil society organization providing sexual and reproductive health services, echoed this sentiment.

“Population data is at the heart of everything we do. It helps policymakers improve service delivery and address the most pressing challenges facing communities,” he said.

He urged parliamentarians to ensure that population data translates into inclusive policies that prioritize the needs of vulnerable groups, including women, girls, and marginalized communities.

Global Crises Threatening Progress

The meeting also highlighted how global crises—including armed conflicts, climate change, and emerging health threats—are disproportionately affecting vulnerable populations and threatening the realization of sustainable development goals.

“It is profoundly concerning that escalating global crises such as extreme weather conditions and emerging health challenges are disproportionately affecting vulnerable populations and derailing development efforts,” Akson said.

She cited the words of Tanzania’s founding father, Julius Nyerere: “The purpose of development is the people. You cannot develop things; you develop people.”

Akson emphasized that true and meaningful development must be people-centered, urging lawmakers to craft policies that align with their citizens’ unique realities, cultures, and aspirations.

Strengthening Partnerships for Development

With just five years left to achieve the 2030 Agenda, UN Secretary-General António Guterres has called for “a surge in implementation, massive investment, and more effective partnerships” to drive progress across key SDGs, including health, education, gender equality, and economic development.

Akson echoed this call, stressing that gender equality must be at the core of all development efforts.

“We cannot expect to achieve the SDGs without dismantling gender barriers and empowering all women and girls,” she said.

The Dar es Salaam Monday meeting concluded with a call for strengthened international cooperation to maximize progress, particularly in reforming the outdated global financial architecture that has left many developing countries struggling with debt and underfunded social programs.

As the meeting’s outcome document is prepared for submission to the upcoming TICAD9 summit in Japan in August 2025, lawmakers pledged to champion legislative and policy reforms that will accelerate the realization of the ICPD Programme of Action and the Addis Ababa Declaration on Population and Development.

“Let’s be hopeful about the future that our empowered youths can create,” Akson said, closing the conference with an optimistic tone.

For many African and Asian countries, the future is blight with challenges. But as Akson and fellow parliamentarians have underscored, investing in youth, advancing reproductive health rights, and enacting inclusive policies will be critical in shaping a sustainable and equitable future.

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Dr. Natalia Kanem, UNFPA’s Executive Director. Credit: UNFPA

By Naureen Hossain
UNITED NATIONS, Sep 26 2024 (IPS)

On the heels of the Summit of the Future and the sidelines of the United Nations High-Level Meeting Week, governments and philanthropies pledged to commit at least USD 350 million to boost family planning, sexual and reproductive health and supplies on the national and global level. As enshrined in the newly-adopted Pact for the Future, seeking new international finance models is critical to solving the issues that the world faces today. The decision to pledge forward is a demonstration of commitment to ongoing health issues.

On September 24, the United Nations Population Fund (UNFPA), the Bill and Melinda Gates Foundation, Family Planning 2030 (FP2030) and the Children’s Investment Fund Foundation (CIFF) invited prominent figures across the private, development and government sectors to promote political will on the matter of sustainable investments towards sexual and reproductive health (SRH). 

“Investing in reproductive health supplies is a ‘best buy’ for development, empowering women, improving maternal and newborn health outcomes, and uplifting economies,” said Dr. Natalia Kanem, UNFPA’s Executive Director.

When speaking on UNFPA’s partnerships with the co-organizers, Kanem remarked: “What we’re doing is transforming lives. The life of a girl in her community, the life of an adolescent in her city, and empowering communities and families to be able to harness and take control of their futures.”

“So much of our world has been made possible by family planning,” said Dr. Samukeliso Dube, Executive Director of FP2030. “By enabling more women to shape their lives and futures, family planning has helped women to finish their education, join the workforce, ascend to leadership positions, and achieve their dreams.”

Donor countries, such as the United Kingdom, Canada, Norway, and Spain, announced pledges to the UNFPA Supplies Partnership, which delivers modern contraceptives and maternal health supplies to women and girls in low-income countries. Through this partnership, UNFPA has helped to prevent 1.6 million child deaths, 254,000 maternal deaths, and 2.6 million unsafe abortions. The contributions to UNFPA could potentially save up to 9000 women and girls worldwide. As Anneliese Dodds, UK Minister for Development and Women and Inequalities, remarked, investing in SRH was “critical to making sure that women have the power.”

Speakers representing their countries’ governments pledged their support through domestic financial investments. The governments of Madagascar, Nepal, and the Kyrgyz Republic, for example, announced domestic financial commitments that would invest in SRH services in their countries.

Madagascar announced a contribution of USD 15 million to procure health supplies through UNFPA. Their minister of public health, Zely Arivelo Randriamanantany, added that their goal was to increase access to contraceptives by over 50 percent. Arzu Rana Deube, foreign minister of Nepal, announced the government’s commitment of USD 600,000 to purchase high-quality contraceptives. Renat Mavlyanbai Uulu, Advisor to the Minister of Health, of the Kyrgyz Republic, announced a commitment of USD 119,000 to domestic resources for family planning commodities.

Feri Anita Wijayanti, a registered midwife from Indonesia. Credit: UNFPA

As UNFPA Chief of Sexual and Reproductive Health and Rights Ayman Abdelmohsen told IPS, the commitments to domestic financing are significant; it shows that in “allocating from their own resources… and [making] budgetary allocations,”  these governments will prioritize SRH without relying on foreign donors. It is in line with UNFPA’s compact agreements with 44 countries, through which countries will build up their capacity to provide comprehensive reproductive health through their own resources.

Despite the predicted growth in contraceptive access and maternal health by 2030, the current financing gap why this is still far off in the future. The gap currently sits at at least USD 1.5 billion in the world’s poorest countries.

Throughout the event, the speakers emphasized the ‘transformative’ power of SRH in countries. That to invest in SRH is to invest in girls’ and women’s’ agency over the health and life choices. In guaranteeing women’s sexual and reproductive health, it pays forward in protecting families and communities. In terms of financing, every dollar spent on family planning can yield more than 8 dollars in benefits for families and societies.

Investing in healthcare also goes forward to the practitioners within the sector. As Feri Anita Wijayanti, a registered midwife from Indonesia, explained to the panel, many communities rely on the expertise of midwives, whose responsibilities extend “far beyond delivering babies,”  for they are at the frontlines to address other health issues.

“Every second in every corner of the world, midwives work tirelessly to protect the lives of women and babies, and to provide sexual and reproductive health services,” she said. Midwives have the power to save an estimated 4.3 million lives each year by 2025. We urge you to invest in us, to believe in the transformative power of midwives and to begin by investing in sexual and reproductive health.”

The commitments made by countries and the private sector are a step forward in closing the considerable financing gap. They come at a time where senior leadership within the UN, namely the Secretary-General, has called for countries to explore innovative and sustainable financing to address global inequalities. The commitments made at this event demonstrate that despite the challenges to SRH, there is political will in support of, and it can be mobilized to ensure this care for all.

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Students joined APDA-affiliated parliamentarians at a two-day workshop on mental health. Credit: APDA

By Cecilia Russell
SRI JAYAWARDENEPURA KOTTE & ATHENS, Mar 25 2024 (IPS)

Sri Lankan lawmaker Hector Appuhamy, in conversation with IPS ahead of a two-day conference aimed at educating  and involving university students in mental health issues, said parliamentarians were concerned about gaps in the programmes and financing for youth mental health. They were looking beyond the country’s health budget for support in ensuring that youth were able to access mental health facilities in a supportive environment.

IPS: According to my research, Sri Lanka has one of the highest suicide rates in the world. While the revised mental health policy for 2020–2030 identifies the needs of adolescents and youth, it would seem there are few policies and programmes that deal specifically with the issue for youth. How are parliamentarians addressing this issue?

Hon. Hector Appuhamy, MP, Sri Lanka

Hector Appuhamy: Suicide rates in Sri Lanka have indeed been a concerning issue, with the country historically having one of the highest rates globally. According to the World Health Organization (WHO), Sri Lanka’s suicide rate was estimated at 14.6 per 100,000 population in 2016. While addressing this issue, it’s imperative to recognize that mental health policies and programs tailored specifically for youth are crucial in mitigating such challenges.

As parliamentarians, we understand the urgency of addressing mental health issues among youth, including the risk of suicide.

Even though the mental health policy for 2020–2030 recognizes the needs of young people, there aren’t enough programs in place to help them properly. In response, parliamentarians are working on different ways to tackle this issue.

The new statistics have made government officials and parliamentarians take a closer look at mental health services in Sri Lanka, especially for young people. They’ve realized that there aren’t enough programs or resources to help young people with their mental health. So, parliamentarians are trying to find out why this is happening and what needs to change. They’re doing assessments to find the gaps and come up with new policies and programs to help young people with their mental health.

Parliamentarians are also working with different groups, like the government, charities, and mental health experts, to find solutions. They’re trying to develop programs that specifically address the needs of young people. By working together, they hope to make sure that young people’s mental health is a priority and that they get the help they need.

The proposed program isn’t just about fixing things now—it’s about planning for the future too. Parliamentarians want to make sure that young people in Sri Lanka have the support they need for their mental health, both now and in the years to come.

IPS: Only a small proportion of the 5% of national expenditure that is spent on health, is used for mental health. One of the shortcomings is the resource gap. What ways, including involving the private sector, are parliamentarians working on to ensure that the funds and programmes become available for youth mental health?

Appuhamy: Addressing the resource gap in mental health services, particularly for youth, necessitates a multi-faceted approach involving collaboration with both public and private sectors.

Organizations including APDA, UNDP, and UNICEF always support Sri Lanka through diverse programs. Recognizing this imperative, we are to initiate discussions aimed at devising strategies to secure funding and attract support from these and many other organizations. This novel initiative seeks to garner their attention and enlist their support in fortifying the resilience of our youth, given their established track record of extending aid where it is most needed.

By underscoring the pivotal role of mental health services for young people, we endeavor to ensure a substantial allocation of the health budget towards mental health initiatives. In line with these efforts, discussions are underway to implement the following initiatives:

Public-Private Partnerships (PPPs): Promote partnerships between the government and private sector entities, such as corporate organizations and philanthropic foundations, to support youth mental health programs. These partnerships can involve financial contributions, in-kind donations, or expertise sharing to enhance the effectiveness and reach of mental health services.

Corporate Social Responsibility (CSR) Initiatives: Parliamentarians will collaborate with private sector companies to develop CSR initiatives focused on youth mental health. Through CSR programs, companies can allocate resources, including funding, employee volunteering, and in-kind support, towards addressing mental health challenges among young people in their communities.

Incentives for Private Sector Investment: Parliamentarians may propose incentives, such as grants, subsidies, or preferential access to government contracts, to encourage private sector investment in youth mental health programs. These incentives can attract private sector participation and stimulate innovation in mental health service delivery.

By employing these strategies and fostering collaboration between the public and private sectors, parliamentarians aim to bridge the resource gap and ensure that funds and programs are available for youth mental health initiatives in Sri Lanka.

IPS: WHO suggests that supportive environments, education and awareness, the involvement of youths in policy development, peer support with trained peers, and the collection of reliable data are all crucial to assisting with youth mental health How are lawmakers ensuring that a comprehensive social package is available to address mental health in youth?

We acknowledge the significance of a comprehensive approach to addressing mental health issues among youth, a stance echoed by the World Health Organization (WHO). In Sri Lanka, the existence of a youth parliament comprising young participants endowed with diverse insights and innovative ideas underscores the potential reservoir of knowledge within this demographic. As parliamentarians, we are committed to adapting our strategies by actively involving youth in decision-making processes.

In our capacity as parliamentarians, we are strategizing to actively engage young individuals in the formulation of mental health policies and programs. By integrating youth voices and perspectives into policymaking endeavors, we endeavor to ensure that mental health initiatives are contextually relevant, responsive, and inclusive of the unique needs and preferences of young people.

We are trying to push for more education and awareness campaigns to increase understanding of mental health issues among youth, families, educators, and communities. These campaigns aim to destigmatize mental illness, promote early intervention, and provide information about available resources and support services.

As parliament members, we prioritize the collection of reliable data on youth mental health to inform evidence-based policies and programs. This includes monitoring mental health indicators, prevalence rates, service utilization, and outcomes to assess the effectiveness of interventions and identify areas for improvement.

By implementing these strategies and collaborating with stakeholders, lawmakers strive to create a supportive and inclusive environment that promotes the mental health and well-being of youth in Sri Lanka. Through ongoing efforts and investments, they aim to build a sustainable framework that addresses the complex and evolving mental health needs of young people.

IPS: What outcomes do you expect from your two-day conference aimed at educating university students about mental health issues?

Appuhamy: Our strategy entails convening approximately 40 students from diverse universities across the nation for a comprehensive two-day conference, structured as a residential program. This initiative, aimed at educating university students about mental health issues, is anticipated to yield numerous beneficial outcomes:

Firstly, the conference aims to enhance awareness and deepen understanding among university students regarding various facets of mental health. Topics to be covered include identifying mental health issues, coping mechanisms, triggers for such issues, relevant laws and regulations, avenues for seeking assistance, and contact information for relevant authorities. These crucial insights will be imparted to students through interactive sessions facilitated by esteemed resource persons, including university professors, a consultant psychiatrist, a chief inspector of police, a deputy solicitor general, and motivational speakers.

Furthermore, the program seeks to achieve several objectives, including:

Reduced Stigma: By providing accurate information and fostering open discussions, the conference aims to reduce the stigma surrounding mental issues. This can help create a more supportive and accepting environment where students feel comfortable discussing their mental health concerns and seeking assistance when needed.

Improved Help-Seeking Behaviors: The conference will equip students with knowledge about available mental health resources and support services, empowering them to seek help proactively for themselves or their peers who may be struggling with mental health challenges.

Enhanced Coping Skills: Through workshops, presentations, and interactive sessions, students will learn practical strategies for managing stress, building resilience, and promoting mental well-being. These skills can empower students to navigate the pressures of university life more effectively.

Inspiration for Advocacy and Action: By hearing from experts, advocates, and individuals with lived experience, students may be inspired to become mental health champions within their university community and beyond. This can lead to increased advocacy efforts, initiatives to improve campus mental health services, and broader societal change.

Long-term Impact: The knowledge and skills gained during the conference have the potential to have a lasting impact on students’ mental health and well-being throughout their academic journey and beyond. By investing in mental health education and awareness at the university level, we aim to create a culture of support and resilience that benefits students for years to come.

IPS: How are parliamentarians encouraging universities’ leadership (both academic and student) to ensure that mental health programs are available to students?

Appuhamy: We are cognizant of the fact that our current engagement with universities may not be sufficient to address mental health issues among students. Consequently, we are planning to open discussions with higher-ranking officials to elevate the prominence of this matter. Through these dialogues, we aim to shed more light on the challenges faced by students regarding mental health and identify priority areas for intervention. By fostering open communication with university authorities, we seek to enhance our understanding of the specific needs and concerns of students, thus enabling us to tailor our approach more effectively and address mental health issues comprehensively within the university setting.

As parliamentarians, we are proposing to engage directly with university leadership, including academic administrators, deans, and student affairs officials, to discuss the importance of mental health and encourage proactive measures to support student well-being. This may involve meetings, forums, and consultations to share best practices and identify areas for improvement.

It is a plan to exercise legislative oversight to ensure that universities are fulfilling their responsibilities in addressing mental health issues among students. They may conduct hearings, inquiries, or audits to assess the effectiveness of mental health programs and hold universities accountable for meeting established standards. So that they can manage the issues arising due to harassment happening with the universities, which leads to problems in student’s mental health capacity.

Overall, parliamentarians play a vital role in advocating for the availability of mental health programs at universities by engaging with university leadership, allocating resources, fostering collaboration, and promoting student involvement. By working together, they can create supportive environments where students have access to the resources and support, they need to thrive academically and emotionally.

IPS: Is there anything else you would like to add?

In closing, I would like to emphasize the critical importance of prioritizing mental health at all levels of society, including within educational institutions like universities. Mental health issues among students not only impact academic performance but also have profound implications for overall well-being and future success.

As parliamentarians, educators, healthcare professionals, and community leaders, we have a collective responsibility to ensure that mental health programs and support services are accessible, inclusive, and effective. By investing in mental health education, destigmatization efforts, and proactive intervention strategies, we can create environments where students feel valued, supported, and empowered to prioritize their mental well-being.

Additionally, it’s essential to recognize that addressing mental health requires a holistic and multi-sectoral approach. Collaboration between government agencies, academic institutions, healthcare providers, NGOs, and community organizations is essential to creating comprehensive solutions that address the diverse needs of students and promote a culture of mental well-being.

I encourage continued dialogue, collaboration, and advocacy to advance mental health initiatives in Sri Lanka and beyond. Together, we can make meaningful strides towards creating a society where mental health is valued, supported, and prioritized for all individuals, including our youth.

Note: The two-day conference was supported by the AFPPD and funded by the Japan Trust.
Fund”.

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Dr Rintaro Mori, Regional Adviser, Population Ageing and Sustainable Development at UNFPA, told the conference it was crucial to invest to improve social security, health, and well-being. Credit: APDA

By Cecilia Russell
BANGKOK & JOHANNESBURG, Jul 19 2023 (IPS)

Countries with falling population growth face twin dilemmas: Ensuring their aging population live healthy and fulfilling lives and removing barriers to parenthood.

This was the focus of a recent workshop in Thailand reviewing the ICPD30 process and preparation for the Summit for the Future slated for next year (2024).

The workshop was opened by Professor Keizo Takemi, MP Japan and Chair of AFPPD, who contextualized the issue.

“In the Asia Pacific region, a profound shift awaits us. By 2050, one in four individuals will be about the age of 60, with a majority of them being women. The empowerment and the well-being of these women become essential for their meaningful and independent participation in the socio-economic development.”

The meeting sought to highlight what is required from lawmakers to ensure a dynamic and balanced aging society where older people will be physically, mentally, and economically self-reliant as possible, with a sustainable healthcare system.

Dr Rintaro Mori, Regional Adviser, Population Ageing and Sustainable Development at UNFPA, in an interview with IPS, said parliamentarians’ role included “macro level policy planning to prepare for the coming population aging and low fertility including both economic and human rights perspectives.”

Their role was to lead the governments’ reform policies and systems of the country to adjust for “the emerging population trend, such as pension reform and education sector reforms to accommodate all ages,” and “investing in early and later years to take preventative measures to improve social security, health, and well-being.”

Mori said this was possible using a life-cycle approach with a strong emphasis on prevention:

“Prevention is the most cost-effective way to promote healthy and active aging. Life-long investment in social security, health promotion, and psychological well-being (relationship) is the key.”

Parliamentarians and experts met in Bangkok to discuss the ICPD30 process and preparation for the Summit for the Future 2024. Credit: APDA

Boosting fertility was crucial for countries facing declining and aging populations. Dr Victoria Boydell from the University of Essex in the UK said it is vital to remove barriers to parenthood but not through the trend of reducing access to sexual and reproductive health services.

According to research by UN Women and the International Labour Organization, 1.6 billion hours a day are spent in unpaid care work – representing 9 percent of global GDP, and women carry out at least two and a half times more unpaid household work than men. These factors needed to be considered by lawmakers.

Boydell said policy responses to boost fertility and remove barriers to parenthood included supporting early childhood development, enrollment in quality childcare from an early age, compensation for the economic cost of children through the allocation of benefits, tax exemptions, and other subsidies.

Other practices include fostering employment, especially amongst mothers, for example, part-time and flexible working conditions, promoting equal pay, equal sharing of paid and unpaid work, and allocating benefits to low-income families.

Regarding SRH services, there could be an increase in access to infertility treatment, fertility targets and policies to support the higher number of children, cash or tax exemptions, and access to contraception and abortion. Choice was a key right that needed protection.

In a case study, Chalermchai Kruangam, an MP from Thailand, said it was expected that a growing number of older people would need institutional long-term care – with considerable costs to the fiscus. It was, therefore, crucial to encourage governments and stakeholders to support modifications of living arrangements for older people and provide access to knowledge and training on new technologies, particularly digitalization and information technology. This would ensure that older people remained independent for longer periods, especially if supported health facilities near their homes.

Willie Mongin, an MP from Malaysia, said governments needed to formulate and implement necessary measures to ensure that social systems are ready to meet the older adult’s needs, improve their lives and the well-being of their families and communities – so they can live their lives with dignity. With the World Bank, Malaysia was formulating a strategic plan or blueprint to address an aging population’s impact, including economic growth, productivity, social protection, and health care.

Mori told IPS it was important to note that “older persons are a quite diverse population. Some of the wealthiest persons are among the older population. The health status of older persons is quite different depending upon the individual. Any country should have basic social security infrastructure based on the needs and demands of the population, not solely on the age of a person.”

He also said governments should take into account the older persons’ diversity in their plans to, for example, encourage them to remain in the workplace beyond traditional retirement ages.

“The health, skills, and knowledge of older individuals are diverse, and governments should not plan such economic and labor market policies based on the assumption that older persons are homogenous, Mori said. Recently in Japan, trends show that small and frontline jobs seem to be suitable for older persons (Sakamoto 2022).

Note: The workshop was organized by the Asian Population and Development Association (APDA) and supported by the United Nations Population Fund (UNFPA)

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A demonstration in the city of Córdoba, capital of the province of the same name in central Argentina, in favor of legal, safe and free abortion and women's rights. The color green has identified the movement in favor of the legalization of abortion, which was passed by Congress in late 2020. CREDIT: Catholics for Choice

By Daniel Gutman
BUENOS AIRES, Jun 23 2023 (IPS)

Viviana Mazur is a doctor at the Santojanni Hospital in Mataderos, a working-class neighborhood in Buenos Aires. She has witnessed the advances in women’s rights in Argentina, where until 2020 abortion was only allowed on two grounds, while it is now available on demand up to 14 weeks of pregnancy.

“Today what we see at the hospital is that most women come in for a consultation very early; in many cases they do so as soon as their period is late. This makes it possible to resolve almost all abortions with medication, in the woman’s own home, with medical advice and monitoring,” she said."(Medical abortion) is less traumatic and less risky for the woman and it's less costly for the public health system." -- Viviana Mazur

Mazur, who is also coordinator of Sexual Health in the Buenos Aires city government, said there are many advantages of medication abortion over the traditional surgical procedures.

“It’s less traumatic and less risky for the woman and it’s less costly for the public health system,” she told IPS.

In Argentina, as a result of years of struggle by the women’s rights movement, since January 2021 abortion has been decriminalized. In the last stage of the fight, mass demonstrations by women – and also men – wearing green headscarves, which has become a pro-choice symbol in Latin America, filled the streets.

Since then, Law 27,610 on Access to Voluntary Interruption of Pregnancy allows any woman to have an abortion up to the 14th week of pregnancy free of charge and without having to explain the reasons for her decision.

Until the law came into force, access was severely restricted: a Supreme Court ruling in effect since 2012 authorized what was called Legal Termination of Pregnancy, only in the case of rape or if the pregnancy endangered the woman’s life or health.

Argentina’s Minister of Health Carla Vizzotti (C) holds the green headscarf that is the symbol for the feminist movement that fought for the successful legalization of abortion in Argentina. CREDIT: Ministry of Health

More abortions recorded in 2022

In 2022, the first full year in which the law allowing abortion on demand was in force, 96,664 abortions were performed in the public health system of this South American country of 46 million inhabitants, according to official data. This marked a significant increase over 2021, when the total was 73,847, partly due to the rise in abortions in the public health system.

“More than 85 percent of abortions in 2022 were performed with medication,” Valeria Isla, the national director of Sexual and Reproductive Health, told IPS.
.
“The good news is that today these are safe practices taking place within the health system. In any case, since until recently most abortions were clandestine, we believe it is too early to draw conclusions with respect to the number. The figures have yet to stabilize,” she added.

Isla explained that her office provides training to health personnel from all over the country on how to perform abortions and that medications are distributed, as well as equipment for manual vacuum aspiration, which is a less risky medical procedure in a doctor’s office than dilation and curettage, which is performed in an operating room.

In this sense, since 2022 the incorporation of mifepristone into the Argentine health system, in addition to misoprostol, which has been used for years to perform medical abortions, has been a great step forward.

The combination of mifepristone and misoprostol, called “combipack”, makes abortions more efficient and less painful for women, and in fact the combination of these two drugs for pregnancy termination is one of the techniques recommended by the World Health Organization (WHO) since 2005.

Last year, the WHO ratified both as essential drugs for providing quality health services and backed their efficacy and safety for abortion.

Isla explained that since last year the national government has been distributing mifepristone in public hospitals thanks to a donation from the United Nations Population Fund (UNFPA).

Since March of this year, mifepristone has been fully available also for the Argentine private health system, since the governmental National Administration of Medicines, Food and Medical Technology (Amnat) authorized its sale in pharmacies.

This has allowed the “combipack” to be used in recent months in the private health system as well, where women now also have easier access to abortion.

“The incorporation of mifepristone has been very important on a day-to-day basis to make abortion easier for women, because it means less misoprostol is used, side effects are reduced and the whole process can be carried out at home, with prior and subsequent checkups,” Florencia Grazzini, a social worker at a primary care clinic in the municipality of Lanús, on the outskirts of Buenos Aires, told IPS.

Grazzini began providing support to women who needed access to abortion long before the legalization of voluntary termination of pregnancy. She worked for years at the Kimelú counseling center, formed by feminist activists and serving the southern area of Greater Buenos Aires.

She said that while access to abortion has now been greatly facilitated, for some women termination of pregnancy is still a stigma.

“Despite the fact that with the law there is no need to gjve a reason for abortions up to 14 weeks of pregnancy, the justification for the decision continues to appear in the record of the consultations,” Grazzini pointed out.

She added that, “We are working so that people can share how they feel about their situation, but we don’t want them to feel that they need to explain in order to access an abortion.”

She said the women are told that they do not need to explain why they wish to have an abortion, although psychological assistance is provided to those who request it.

Abortion, however, sometimes encounters resistance from health professionals themselves. This was reflected in May, when the Ministry of Health updated the Protocol of Care and urged the “elimination of all requirements that are not clinically necessary for the safe practice of abortion.”

Specifically, it called for the elimination of waiting or reflection periods and the requirement of parental or partner consent.

A rally at the Ministry of Health in Buenos Aires, where feminist activists showed their green scarves and demonstrated in favor of women’s rights. CREDIT: Ministry of Health

The need for support

More data that shows that the legalization of abortion has not eliminated all the actual barriers is provided by Socorristas en Red (roughly, “Helpers Online Network”), a women’s organization that provides nationwide support for women who need an abortion.

In 2022, the network received 13,292 calls from women who wanted to terminate their pregnancies.

Only 10 percent of them had abortions in the public health system and the rest had abortions that they arranged elsewhere. The organization provided them with psychological assistance, information, instructions, WhatsApp messages, phone calls, and virtual and face-to-face company by “socorristas” or helpers. With all this they found greater comfort than in the health system.

This picture is completed by the visible inequality in access to abortion in different areas of the country.

Although the number of public hospitals and health centers that perform abortions reached 1793 in 2022 – against less than 1000 in 2021 – in some provinces the supply is very limited. For example, in the northern provinces of Santiago del Estero and Chaco there are only eight and nine health institutions, respectively, that perform abortions.

“In some places there is resistance from officials and a lack of knowledge among fellow workers about outpatient treatment with medications,” Ana Morillo, a social worker in the province of Córdoba, in the center of the country, told IPS.

Morillo, who is an activist and member of the Network of Professionals for Choice and the organization Catholics for Choice, said the advocacy work of the women’s rights movement has made Cordoba one of the provinces with the greatest access to abortion, since there are 180 hospitals and health centers that perform the procedure.

“The greatest inequalities are between cities and rural areas, where it is much more difficult to access an abortion. These are the disparities in the country on which we still have to work the hardest,” she said.

Parliamentarians attending the Global Conference of Parliamentarians on Population and Development Toward the 2023 G7 Hiroshima Summit. Credit: APDA

By Cecilia Russell
JOHANNESBURG, May 9 2023 (IPS)

Parliamentarians from more than 30 countries agreed to send a strong message to the G7 Hiroshima Summit in Japan later this year, focusing on human security and support of vulnerable communities, including women, girls, youth, aging people, migrants, and indigenous people, among others.

The wide-ranging declaration also called on governments to support active political and economic participation for women and girls, enhancing and implementing legislation that addresses gender-based violence (GBV) and eradicating harmful practices like child, early, and forced marriages. During discussions and in the declaration, a clear message emerged that budgetary requirements for Universal Health Care (UHC) should be prioritized and the exceptional work done by health workers during the pandemic be recognized.

In his keynote address, Japan’s Prime Minister Kishida Fumio reminded delegates that Covid-19 had exposed the “fragility of the global health architecture and underscored the need for UHC.”

Kishida said that the central vision of the G7 Hiroshima Summit was to emphasize the importance of addressing human security – through building global health architecture, including the “governance for prevention, preparedness, and response to public health crises, including finance. We believe it is important for the G7 to actively and constructively contribute to efforts to improve international governance, secure sustainable financing and strengthen international norms.”

Apart from contributing to resilient, equitable, and sustainable UHC, health innovation was needed to promote a “more effective global ecosystem to enable rapid research and development and equitable access to infectious disease crisis medicines … and to support aging society,” Kishida said.

Former Prime Minister of Japan Fukuda Yasuo, Chair of APDA, and Honorary Chair of JPFP said this conference and its declaration would follow in a tradition of delivering strong messages to the G7 that improving reproductive health was crucial to the development and the future of a planet which now had 8 million people living on it.

“International Community is becoming increasingly confrontational and divided, and there is the emergence of a national leader who is threatening the use of nuclear weapons. No nuclear weapons have been used in the nearly 80 years since Hiroshima and Nagasaki. We must work together to prevent the use of nuclear weapons, which can take many precious lives and people’s daily lives. In this instance, I would like you to search for the path toward appeasement and not division. We must keep all channels of dialogue open so as to ease tension,” Fukuda asked of the conference.

While calling on parliamentarians to work together to address challenges, Fukuda also expressed concern about the widening inequities caused by Covid-19 and climate change and noted: “This network of parliamentarians on population and development has been a vital resource for parliamentarians who share the same concern for not only their own countries but for the entire planet and future generations.”

Kamikawa Yoko, MP Japan, Chair of JPFP, said that with a world population of 8 billion, it was essential to “realize a society where no one is left behind … and Japan would share its experiences of being on the frontlines of an aging society with declining birth rates. “We are living in an aging society … and given these challenges in Japan, we will try to share with you our experience and lessons through our diplomacy while trying to deepen our discussions and exchanges to seek solutions.”

Japan’s Foreign Affairs Minister Hayashi Yoshimasa said it was essential for all to cooperate during the “Anthropocene era, when human activities have promised to have a major impact on the global environment, global issues that transcend national borders, such as climate change, and the spread of infectious diseases, including Covid-19 are becoming more and more prevalent.”

He reminded the delegates that at the center of Japan’s economic growth post World War II was mainly through health promotion and employment policies.

Delegates of the Global Conference of Parliamentarians on Population and Development Toward the 2023 G7 Hiroshima Summit agreed to send a strong message on human security to the Summit. Credit: APDA

Director of the Division for Communications and Strategic Partnerships of UNFPA, Ian McFarlane, said it was not about the “numbers of people but the rights of the people that matter. It’s not about whether we are too many or too few, but whether women and girls can decide if, when, and how many children to have.”

A recent UNFPA report indicated that nearly half of the women across the globe could not exercise their rights and choices, their bodily autonomy, and expressed hope that policies in the future continue to focus on humanity and universal human rights.

Despite being close to the 30th anniversary of the International Conference on Population and Development (ICPD), the conference heard that much still needed to be done regarding women’s rights.

New Zealand MP and co-chair of AFPPD Standing Committee on Gender Equality and Women Empowerment, Angela Warren-Clark, reminded the audience that women still only held 26 percent of parliamentarian seats globally. While women make up 70 percent of the workforce in the health sector, only 25 percent have senior leadership positions.

“It is women in this pandemic who bore the increased burden of unpaid work at home as schools were closed, and it is girls and the poorest families who were taken out of school and forced into early marriages … We believe that if women had an equal say in decision-making during the pandemic, some of these mistakes would have been avoided.”

Baroness Elizabeth Barker, MP from the United Kingdom, told parliamentarians their role was to ensure that “no person on earth, from the head of G7 country to a poor person in a village, can say that they do not know what gender equality is. And they do not know what gender violence is.”

Barker suggested they use international standards, like the Istanbul Convention on Violence Against Women, to compare countries. “And you know that if your country doesn’t come out very well, they really don’t like it.”

She pointed to two successes in the UK, including stopping virginity testing and tackling the practice of forced marriages. She also warned the delegates that there was a right-wing campaign aimed at destroying human rights gained, and they chose different battlegrounds. The overturning of abortion rights in the United States in the Roe vs. Wade case was an example, as was the anti-LGBTQ legislation in Uganda.

Hassan Omar, MP from Djibouti, gave a host of achievements in his country, including ensuring that women occupy 25 percent roles in politics and the state administration and the growing literacy of women numbers in his country.

Risa Hontiveros, MP Philippines, painted a bleak picture of the impact of Covid in her country.

Hontiveros said GBV increased during Covid and extended to the digital space.

“The Internet has become a breeding ground for predators and cyber criminals to prey on children, especially young women, and girls. The online sexual abuse and exploitation of children … has become so prevalent in the Philippines that we have been tagged as the global hotspot.”

In a desperate attempt to provide for their families, even parents produced “exploitative material of their own children and sold them online to pedophiles abroad.”

To address these, she filed a gender-responsive and inclusive Emergency Management Act bill, which seeks to address the gender-differentiated needs of women and girls, because they were “disproportionately affected in times of emergencies.”

Former MP from Afghanistan Khadija Elham’s testimony united many in the conference and even resulted in proposals from the floor to include a condemnation of the Taliban’s women’s policies.

Elham said GBV had increased since the Taliban took over – women were forced to wear a burqa in public, they were not allowed to work, and those who wish to “learn science or (get an) education are forced to continue their studies and hidden places like basements.”

If their secret schools are exposed, they face torture and imprisonment. During the last two months, 260 people, including 50 women, were publicly whipped – a clear violation of their human rights. Women’s representation in political life has been banned, and women are no longer allowed to work in NGOs – and it has been “550 days since women could attend high schools and universities.”

She called on the international community, the United Nations, to pressure the Taliban to restore women’s work and education rights.

Nakayama Maho, Director of the Peacebuilding Program at the Sasakawa Peace Foundation, announced new research on factors contributing to men’s propensity to GBV. The research found that the higher a man’s educational attainment, the lower the level of violence. There were also lower levels of violence with “positive” masculinity – such as a man being employed, married, and capable of protecting his family. Men who experienced violence during times of conflict tended to support violence to instill discipline, or protect women and communities.

Dr Roopa Dhatt, Executive Director of Women in Global Health, summed up this critical session by saying, “Equal leadership for women in all fields is a game changer, particularly in politics and health.”

Japan’s Health, Labour and Welfare Minister, Kato Katsunobu, noted during his closing address that the G7 countries “share the recognition that investment in people is not an expense, but an investment… and as you invest in people you can create a virtuous cycle between workers well-being and social and economic activities.”

He said Japan had a lot to offer concerning aging populations.

“Japan has been promoting the establishment of a comprehensive community-based care system so that people can continue to live in their own way in their own neighborhood until the end of their lives and is in the position to provide knowledge to the G7 countries and other countries who will be facing (an aging population) in the future.”

Dr Alvaro Bermejo, Director-General of IPPF, commended the conference and said he was “thankful” that the conference declaration would tell G7 governments to set an example. “Marginalized and excluded populations are at the heart of human security and can only be achieved in solidarity, and that message from this conference is clear.”

Professor Takemi Keizo, MP Japan, Chair of AFPPD, summed up the proceeding by saying that parliamentarians as representatives of the electorate were vital to creating a “positive momentum in this global community and overcoming so many difficult issues.”

Takemi elaborated on some issues facing the world now, including climate change and military conflicts, but as parliamentarians, there was the opportunity to “build up the new basis of the global governance, which can be very beneficial.”

NOTE: Global Conference of Parliamentarians on Population and Development Toward the 2023 G7 Hiroshima Summit was organized by the Asian Population and Development Association (APDA), the Asian Forum of Parliamentarians on Population and Development (AFPPD), and the Japan Parliamentarians Federation for Population (JPFP).

It was supported by the Ministry of Foreign Affairs of Japan (MOFA), United Nations Population Fund (UNFPA), Japan Trust Fund (JTF), and Keidanren-Japan Business Federation in cooperation with the International Planned Parenthood Federation (IPPF).

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Nelly García is 65 years old, and for 30 years she has been selling flowers at a market in Lima because she was unable to return to her profession as a nurse technician after taking a break from work to raise her children when they were young. She says sadly that “if the government does not care about children, it cares about us even less. They must think ‘let these old people die because they’re no good for anything anymore’.” CREDIT: Mariela Jara/IPS

By Mariela Jara
LIMA, Feb 6 2023 (IPS)

Latin America and the Caribbean is no longer a young region and it will be one of the regions with the largest aging populations by 2050, which poses great challenges due to the social inequalities the countries face, but also opportunities to overcome them.

“Currently in the region an estimated 8.1 percent of the population is over 65 years of age, and this percentage is projected to increase to 17 percent by 2050, higher than the global average,” said Sabrina Juran, a regional technical advisor on population and development for Latin America and the Caribbean of the United Nations Population Fund (UNFPA).

In 2022, the region was home to 658 million people, of whom some 52 million were older adults, creating great challenges for the countries in terms of work, health and pensions, in a context in which according to international organizations the economic slowdown will deepen in the region in 2023.

“I am 65 and employers already saw me as too old to hire at 35, and I did not manage to get another job as a nurse technician,” says Nelly García, who moved to the capital, Lima, with her parents when she was 10 years old from her hometown of Huancayo, a city in Peru’s central Andes highlands.

The case of García illustrates the labor problems faced by many older adults in Latin America, especially women whose job opportunities are often hindered by motherhood and their responsibilities to care for family members.

“Imagine at this age what chance of insurance or pensions exist for people like me or people who are even older and work in the informal sector,” she told IPS with bitterness, adding that “if the government does not care about children, it cares about us even less. They must think ‘let these old people die because they’re no good for anything anymore’.”

García lives in Breña, a working-class district of 75,000 people that is one of the 43 districts in the department of Lima. Since she failed to find work in any hospital 30 years ago, she has been selling flowers.

She had taken a break from her work as a nurse technician to raise her four children. When she sought to return to her profession, the doors of the hospitals slammed shut on her. “I was already seen as old at the age of 35,” she repeated several times.

She has social health insurance from her husband, who is about to retire from a book import company. “But his pension will be less than 200 soles (52 dollars); that will not even cover the electricity bill,” she lamented.

Peru, a South American country of 33 million people, is facing a severe economic, political and social crisis, with a poverty level that climbed during the pandemic to a national average of 30 percent, although in rural areas it is 45 percent.

There are more than four million people over 60 according to official figures, only one third or 35 percent of whom were in a pension system. And although 89 percent have access to public health insurance, coverage and quality do not go hand in hand

“I try to save up for when I’m older, although the truth is I don’t think I’ll reach the age of 75 because in my family we suffer from heart disease. But I’m not going back to the public health insurance system,” García said emphatically.

She talked about her experience of the system: “It’s an ordeal, you have to go to the hospital at dawn to make an appointment, they order tests for several months later and who knows when you’ll get the results back. If I go through the same thing now, I’ll surely die before they call me, so when it’s my time, I hope to leave in peace.”

García is referring to the Social Health Security, a public system that covers 35 percent of people over 60, which draws harsh criticism for its poor facilities, shortage of medical personnel and poor quality of care.

A group of Peruvian women take part in a demonstration for the rights of the elderly in Lima. Latin America and the Caribbean will become one of the regions with the most aging populations by 2050 due to advances in medicine and the decrease in the birth rate. Life expectancy at birth was 72 years in 2022. CREDIT: Wálter Hupiú/IPS

An irreversible path

On Jan. 12, the Division for Inclusive Social Development of the United Nations Department of Economic and Social Affairs (DESA) presented the World Social Report on demographic change, which ratifies the global tendency that the population over 65 is growing faster than younger age sets and that people are living longer.

Greater life expectancy at birth due to the advancement of medicine and the decline in the fertility rate, which stands at 2.1 births per woman, are factors contributing to this trend.

Sabrina Juran of UNFPA told IPS from Panama City, where the U.N. agency’s regional headquarters is located, that the birth rate in Latin America is 1.85 and regional population growth is below 0.67 percent per year, both of which are lower than the global rates.

She said that according to the latest U.N. projections, there would be around 695.5 million inhabitants in the region in 2030 with a peak of 751.9 in mid-2050, after which the population would constantly decrease until reaching 649.2 million in 2100.

Sabrina Juran, a regional technical advisor on population and development for Latin America and the Caribbean of the United Nations Population Fund (UNFPA), poses for a picture at the organization’s headquarters in Panama. By 2050, 17 percent of the regional population will be over 65, the agency projects. CREDIT: UNFPA LAC

Juran explained that further reductions in mortality are expected to lead to a global average longevity of about 77.2 years in 2050 and 80.6 years regionally. Life expectancy at birth in Latin America and the Caribbean was 72.2 years in 2022, three years less than life expectancy in 2019 due to the impact of the COVID-19 pandemic.

This scenario means governments in the region must focus on meeting greater demands for healthcare, employment, housing, and pensions.

Juran said the growth of the working-age population – from 38.7 percent in 1990 to 51 percent today – can help boost per capita economic growth, known as the “demographic dividend”, which offers to maximize the potential benefits of a favorable age distribution.

“But this increase in the working-age population will not remain constant: it will peak in 2040 at 53.8 percent before decreasing,” she said. “This means there is a window of opportunity to be taken advantage of.”

The region faces steep inequalities. According to the U.N. Food and Agriculture Organization (FAO) on Jan. 18, 22.5 percent of the population – in other words, at least 131.3 million people – were unable to afford a healthy diet.

“Countries must invest in the development of their human capital, guaranteeing access to healthcare, quality education at all ages, and promoting opportunities for productive employment and decent work,” Juran remarked.

She added that they must take measures to adapt public programs to the growing number of older people, establishing universal healthcare and long-term care systems, and improving the sustainability of social security and pension systems.

“At UNFPA we advocate measuring and anticipating demographic changes in order to be better prepared for the consequences that arise,” said the regional advisor.

She said the commitment is “to a world where people have the power to make informed decisions about whether and when to have children, exercise their rights and responsibilities, navigate risks and become the foundation of more inclusive, adaptable and sustainable societies.”

Achieving this demographic resilience, Juran said, starts with a commitment to count not only the number of people, but also their opportunities for advancement and the barriers that stand in their way, which requires transforming discriminatory norms that hold back individuals and societies.

Delegates at the 'Intergenerational Dialogue of the Asian Parliamentarians and Youth Advocates on Meaningful Youth Engagement' discussed how meaningful dialogue amplify young people’s issues and lead to laws and policies which benefit them. Credit: APDA

By Cecilia Russell
Johannesburg, Jun 7 2022 (IPS)

Young people are often the first to rebuild their communities. However, youths’ diverse challenges cannot be addressed without meaningful dialogue, says Klaus Beck, Regional Director of UNFPA APRO ai.

He was speaking during the hybrid conference ‘Intergenerational Dialogue of the Asian Parliamentarians and Youth Advocates on Meaningful Youth Engagement’ on June 2 and 3, 2022.

Beck noted young people were severely affected during the COVID-19 pandemic because many were forced out of jobs due to the economic recession. Many other young boys and girls had missed school – some dropping out altogether. There was an impact on anxiety and depression and increased suicide. With almost a billion young people aged 10 to 24 years living in the mid to low and middle-income countries in Asia and accounting for 60% of the world’s population – this is a very powerful group that needs to be taken seriously.

“We know that young people are among the first to step up to help their communities rebuild. During the COVID 19 pandemic, young people were mobilized to respond to the crisis by working as health workers, advocates, volunteers, scientists, social entrepreneurs, and innovators,” Beck said. “We cannot address the diverse challenges in needs and support their leadership without partnering with them. It is, for this reason, that the engagement of young people in policy and programs is crucial.”

Meaningful youth engagement should include the poorest and the most marginalized. Beck said policymakers must have a systematic method for conducting open and inclusive dialogue. Many youth participants at the conference elaborated on this theme.

Ayano Kunimitsu, an MP from Japan, said youth made impressive contributions on the frontlines and through initiatives during the pandemic, even though they often faced structural barriers due to cultural norms and the digital divide.

Parliamentarians should ensure “opportunities are given to young people to exercise their potential and that youth voices are reflected into national policies and strategies,” she said.

Young people were often the first to respond during a crisis, yet were often marginalized, an ‘Intergenerational Dialogue of the Asian Parliamentarians and Youth Advocates on Meaningful Youth Engagement’ co-hosted APDA and Y-PEER heard. Credit: APDA

Dr Jetn Sirathranont, MP from Thailand, represented the host country. While there were negative impacts due to the pandemic, Thailand changed its Criminal Code in February 2021 and passed a law that allowed women to unconditionally terminate their 1st term pregnancies.
Abortion is allowed under certain circumstances up to 20 weeks, he said.

He said though intergenerational discussions, youth were involved in developing youth policy and legislation alongside Parliamentarians.

Virasak Kohsurat, MP for Thailand and the former Minister of Social Development and Human Security, said the country’s constitution required that one-third of all members in a committee looking at draft bills be drawn from NGOs working for and with that group of the population. Likewise, with Senate committees, he said.

He suggested a combination of “deep listening” and being patient, polite, and open was an essential strategy for success in meaningful youth engagement.

When the subject matter could get emotive and controversial, for example, global warming and education, this strategy would keep the conversation on track.

During a discussion of the best way for young people to engage with parliamentarians, one delegate suggested that UN agencies could contribute to ensuring all, including marginalized rural communities, was included. The dialogue was crucial and should not leave anybody behind.

Rebecca Tobena, a youth delegate from Papua New Guinea, agreed, especially in a country like hers with a clear hierarchy and where women and youth are on the bottom rung.

Irene Saulog, a member of the House of Representatives in the Philippines, said the UN estimated that 30 percent of the world’s students, both at schools and universities, amounting to 1.5 billion people in 188 countries, were excluded from face-to-face learning during the pandemic.

This closure of school affected the youths’ well-being.

“The young generation experienced significant psychological impacts of social distancing and quarantine measures,” Saulog said.

The young generation experienced significant psychological impacts of social distancing and quarantine measures during the COVID-19 pandemic, yet their contribution and creativity was praised during an ‘Intergenerational Dialogue of the Asian Parliamentarians and Youth Advocates on Meaningful Youth Engagement’ held virtually and in Bangkok, Thailand. Credit: APDA

The lack of face-to-face learning exacerbated inequality because students from marginalized sectors were less likely to have access to online education.

She quoted the International Labour Organization and the Asian Development Bank report, which estimated that an estimated 220 million employed young people ages 15 to 24 years old only have temporary jobs in the Asia Pacific.

“This results in them depending on taking informal jobs to earn a living, risking their health.”

Saulog noted that in the Philippines, 28 percent of the population of 30 million Filipino citizens were between 10 to 24 years old.

“With the right policies and investments, our country is poised to reap the benefits of a large number of youths … it was worth passing legislation that benefitted the youth.”

Youth made and are making major contributions, Saulog said. She wanted the audience to know that “we are delightfully surprised by your creativity”, especially in the digital age where the solutions created were “beyond our imaginations”.

Nepalese youth representative Safalta Maharjan noted that while youth were considered the country’s “future,” they were not prioritized.

Maharjan said youth should have the right to participate in the decision-making of a family, community, and public institutions on matters that concern them. The participation of youth in decision making was notably lacking in the rural areas

“Many youths in rural areas are uneducated, and this needs to be prioritized,” she said.

Thai Children and Youth Council members Dusadee Thirathanakul and Issara
Paanthong gave a joint presentation in which they said the National Child and Youth Development Promotion Act underpinned youth policy in Thailand, and during COVID-19 young people were involved in ensuring that students’ futures were not jeopardized. Youth also shared campaigns via social media and ran a civil rights campaign.

Rajasurang Wongkrasaemongkol shared details of a youth-led campaign, including AI, to improve the use of wearing masks and correctly. The project received high praise from participants – and reinforced the message of the effectiveness of youth-led projects.

The Intergenerational Dialogue of the Asian Parliamentarians and Youth Advocates on Meaningful Youth Engagement, held in Bangkok, Thailand, and virtually, was co-hosted by APDA, and Y-PEER. UNFPA supported the dialogue.
IPS UN Bureau Report

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Chiring Tamang holds the family’s new baby while his wife Priya looks on. She delivered the girl at home in their village in Nepal’s Sindhupalchowk district in February 2021. Credit: Marty Logan / IPS

By Marty Logan
Kathmandu, Nepal, Jul 21 2021 (IPS)

One year after Nepal’s Ministry of Health (MoH) appealed to international organisations in the country to urgently supply a drug used to stop excessive bleeding after childbirth, a UN agency has delivered $1 million worth of contraceptives to prevent another shortage.

The 1.6 million cycles of oral contraceptive pills and 776,000 units of injectable contraceptives and syringes will prevent roughly 75 000 unintended pregnancies, 22 000 unsafe abortions and 80 maternal deaths, according to the UN Population Fund (UNFPA).

As it was last year at this time, Nepal is at the tail end of a lockdown designed to break a runaway number of Covid-19 cases. Between April and May 2021, daily cases went from 150 to more than 8,000—fuelled by outbreaks in neighbouring India. Intensive care unit beds were unavailable in most hospitals in the capital Kathmandu and some cities on the southern border with India, and patients attached to oxygen tanks were forced into hospital parking lots. Crematoriums had to be expanded to accommodate the dead.

More than 9 500 people have died, and 667 000 had been infected as of 18 July, according to official figures, which are widely considered to underestimate the true impact.

“This support is very timely as Nepal was on the verge of facing a shortage of the injectable contraceptives and oral pills,” said Dr Tara Nath Pokhrel, Director of the Family Welfare Division (FWD) of the MoH. “These supplies will greatly help the federal, provincial and local governments to address the increasing family planning needs during the COVID-19 pandemic,” he added in a UNFPA press release.

Last year’s urgent need was misoprostol, a drug used for medical abortion and to stop excessive bleeding of new mothers, also known as postpartum haemorrhage (PPH). The condition is the leading cause of death among women who give birth at home, a number that skyrocketed after the first case of Covid-19 was detected in January 2020. Deliveries in health facilities fell by more than 50% during the 2020 lockdown, according to The Lancet journal.

The shortage affected only the three-pill package of misoprostol used to prevent PPH, not medical abortion kits. It was December before UNFPA could deliver nearly 500 000 doses to the government, a one-year supply.

Maintaining a steady supply of misoprostol has been a challenge for the Government of Nepal since it took over the programme from a project sponsored by the US government in 2010. Initially, it was able to turn to international partners to source the drug outside of the country, but it soon absorbed the purchasing into its procurement system.

However, in 2014 the government’s corruption agency charged eight ministry of health employees with importing poor quality misoprostol into the country at inflated prices.

Eventually, they were acquitted, along with private-sector suppliers, but the high-profile case put a ‘chill’ on further buying by government officials, a former employee of the project told IPS. “If the person needed to justify (misoprostol procurement) maybe they were thinking, ‘this created lots of tension in the past, so let’s not go for procurement’.

Shortages resulted. Then in 2015, earthquakes rocked Nepal, killing nearly 9,000 people. That disaster was followed by a months-long blockade of road routes from India after Nepal’s politicians approved a controversial new Constitution. Supply chains became twisted and unreliable.

In 2017, following Nepal’s first elections under a federal governance system, some health responsibilities were transferred from central authorities to provincial or local officials, including the purchase and distribution of misoprostol. But local governments appeared unprepared.

“In general, local governments did not have sufficient time and resources to strengthen their procurement capacity on lifesaving maternal and neonatal health commodities,” a spokesperson for UNFPA noted in a statement. “It also depended on how much priority each local government had given to the health sector in general.”

Before Covid-19 hit, the misoprostol programme was in place in 56 of Nepal’s 77 districts, but in January 2020, a survey of 12 of the 56 districts found that none had the drug, says Surya Bhatta, executive director of One Heart Worldwide, an international NGO working in Nepal.

“I think misoprostol is one of the most discussed matters in our office,” he adds. “We talk about this a lot with local leaders, pregnant mothers, female community health volunteers during their monthly meetings, and with service providers in the health facilities. Even for the managers, in larger government forums, there is a lot of discussion happening, but the implementation side has a lot of holes to fill.”

During the 2020 lockdown, misoprostol shortages and PPH deaths of women who gave birth at home generated many headlines. This year there have been no reports of misoprostol shortages, Dr Punya Poudel of the FWD told IPS. However, maternal deaths remained above average for the second year running. From mid-March 2020 to mid-June 2021, there were 258 maternal deaths, compared to 51 in the same period pre-Covid, according to preliminary statistics.

Nepal’s maternal mortality rate of 239 per 100,000 births is equivalent to roughly 1,200 deaths annually.

In the agency’s press release, UNFPA Representative to Nepal Lubna Baqi urged the government and partners to make reproductive health a priority.

“Nepal has continued to struggle with shortages in supplies due to competing priorities and demands, but it is time for the government and development partners to turn their attention to preventing unwanted pregnancies and unsafe abortions by investing in family planning and comprehensive sexuality education.”

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Studies have shown that the longer a girl stays in school, the less likely she is to be forced into child marriage. With many schools currently shut down and girls are not going to school, an increase in child marriage is expected. Credit: Ahmed Osman/IPS

By Samira Sadeque
UNITED NATIONS, Jul 3 2020 (IPS)

An additional 5.6 million child marriages can be expected because of the coronavirus pandemic, which resulted in a short-term increase in poverty and the shutdown of schools. 

The current pandemic is also expected to have a massive impact on the projected growth of harmful practices on women’s bodies.

According to a recent report released by the United Nations Population Fund (UNFPA), titled “Against My Will: State of World Population 2020”, an additional two million cases of female genital mutilation (FGM) will occur by 2030. 

“A big protective factor in preventing child marriage is education,” Richard Kollodge, Senior Editorial Adviser of the report, told IPS. “Studies have shown that the longer a girl stays in school, the less likely she is to be forced into child marriage. [Now] if schools are shut down and girls are not going to school, that’s a loss of a protective factor and that could contribute to an increase in child marriages.”

Other contributing factors include people’s inability to go to work, which in turn is affecting livelihoods. In such circumstances, some parents might feel encouraged to marry off their daughter as it’s one less mouth to feed or because they believe it might be safer, Kollodge said. 

It is significant then that this year UNFPA began its 10-year agenda to end harmful practices by 2030 in every country. IPS spoke with Tharanga Godallage, a results-based management advisor at UNFPA, on how the current pandemic affects this agenda and how it exacerbates the crises of FGM and child marriage across the world. 

Tharanga Godallage, a results-based management advisor at UNFPA.

Inter Press Service (IPS): You report says, “Getting to zero harmful practices will require much faster progress. It demands a society-wide effort, where everyone who has a role in stopping these practices steps up to do so.” What steps can different actors in a society take to address this issue?

Tharanga Godallage (TG): The “harmful practices” are a multi-stakeholder commitment because no single stakeholder can solve this problem. It’s actually not only a country level problem — they exist across borders. For FGM in particular, cross-border stakeholder advocacy is really important.

In the eradication of FGM, and overall, the most important factor is strong political commitment from the government. The second one is law enforcement because we need to create new laws and policies if you really want to have sustained change. 

The third one is the involvement of multiple ministries, because this is not a single-ministry show. The approach is to have the whole government involved. 

Our observation and recommendation is to look at it in a more holistic way, especially the sustainable change. 

There’s also the need for a change in social norms, which is the most critical and the most difficult as well. That’s why you need a huge advocacy campaign. 

Social norm is the root cause of most of these cases, and that needs community level engagement, including leaders, who have a bigger role to play, and formal and informal community leaders.

And then there’s a socio-economic link to child marriage, and FGM, and son preference. We need to bring the policy makers and stakeholders together and have all these translated to policy change. 

IPS: Your report says “If the pandemic causes a two-year delay in FGM-prevention programmes, researchers projected that two million female genital mutilation cases would occur over the next decade that would otherwise have been averted.” Can you break down how such a delay would lead to two million lives affected? 

TG: Based on the historical trend and projections, we knew that the estimated FGM cases by 2030 without COVID-19 impact would be around 34 million. 

Then we looked at the reduction of scale-up programmes and the new cases to determine how many cases those adjustments would lead to, and we projected 36 million. 

Overall, this COVID-19 impact has been observed in two ways: one is the effect on scaling up prevention programmes, as we will not be able to do prevention programmes the way we planned, and then there might be new cases coming up on top of that. 

IPS: What factors are you counting when accounting for this change in the projected number owing to COVID-19? 

TG: The restrictions on group gatherings and travel have reduced availability of technical staff and delay of starting international programmes or prevention programmes.

The second one is economic impact. In the economic impact, according to the data we found, there was a 10 percent reduction on GDP overall and then because of the GDP [drop] there was an increase in poverty.

Usually we know increased poverty has 32 percent impact on child marriage, it’s very closely related. Hence, because of the economic factor, and the short-term poverty increase because of COVID-19 that was factored into the modelling, there will now be an additional 5.6 million child marriages.  

IPS: Your report says “Ending harmful practices by 2030 in every country and community—an objective of UNFPA, will require rapid changes in mindsets that still sanction violence against women and girls and deny their rights and bodily autonomy.” How has this target been affected by the pandemic, and how do you aim to go forward in these circumstances?  

TG: So far we have done our internal analysis of overall challenges. So, community mobilisation related research is going to be a very big challenge especially as we are trying to see how to [address that], especially the commitments relating to community mobilisation like social norms change and the comprehensive sexual education programmes (i.e.informal education). Those kinds of programmes will be heavily affected, and data generation is going to be a challenge. 

People are used to the new normal now and people have come up with alternative strategies: call centres, telemedicine, and e-meetings. These are new innovative alternatives so maybe over time we might come to a new normal in our approaches to address these issues. 

A dated photo of a mother and her child from West Point, a low-income neighbourhood of Monrovia, Liberia. Advocates worry that there will be numerous kinds of impact on women’s access to sexual and reproductive health facilities around the world as countries and cities are under lockdown under the COVID-19 pandemic. Credit: Travis Lupick/IPS

By Samira Sadeque
UNITED NATIONS, Apr 7 2020 (IPS)

A little over half of women across the globe are able to freely make choices about their sexual and reproductive health, according to a latest report based on data from 57 countries. 

However, as much of the world has gone into lockdown because of the coronavirus pandemic, with countries implementing social distancing and restricting the free movement of people, experts are concerned that even this small gain in sexual and reproductive health may suffer negatively.

“Globally, as COVID-19 has taken hold, access to sexual and reproductive health care services, from routine services and testing for STIs to antenatal care, contraception, and abortion, has suffered significantly,” Françoise Girard, president of the International Women’s Health Coalition (IWHC), told IPS.

“Sexual and reproductive health services are always vulnerable to falling to the bottom of the priority list because decision-makers (male, white, heterosexual, older, affluent) are not the people who will suffer from lack of access,” she told IPS.

The “Ensure universal access to sexual and reproductive health and reproductive rights” report was launched by the United Nations Population Fund (UNFPA) at the end of last week to highlight the various levels of access (or lack thereof) women have to sexual and reproductive health facilities. This includes a woman’s agency to choose her options for herself. 

UNFPA has three pillars to measure the level of autonomy women have in making their decisions regarding their sexual and reproductive health:

• the person involved in making decisions about healthcare for the women,
• the person making decisions on the contraception used, and
• if the woman is able to say no to her husband/partner if she does not want to have sex. 

The data for the report includes primarily sub-Saharan African countries on its list of 57 countries. The report states that “gaps still exist in women’s autonomy, even where high levels of individual decision-making are observed in some dimensions”.

While improvements need to be made, it’s especially difficult under the current circumstances. Advocates worry that there will be numerous kinds of impact on women’s access to sexual and reproductive health facilities around the world as countries and cities are under lockdown under the coronavirus threat.

“Sexual and reproductive health services are always vulnerable to falling to the bottom of the priority list because decision-makers (male, white, heterosexual, older, affluent) are not the people who will suffer from lack of access,” Girard said.

A question of access

Emilie Filmer-Wilson, Human Rights Adviser at UNFPA, says there’s a “myriad of factors” that determine a woman’s ability to access these facilities: on an individual level, institutional level, and community level. 

One of the most key determinants for a woman’s decision-making ability at this time is her education level, as well as that of her partner’s, Filmer-Wilson told IPS, adding that that will now be especially impacted given many are out of school at the moment. 

Beyond education, they are also expecting to see a risk at the institutional level, she says, that helps determine one’s ability to make the decisions and whether the institutions are affordable, accessible, and of good quality. 

For accessibility, she says, they usually take into account the geographic distance. But given the current situation of social distancing as a crucial measure to contain the coronavirus pandemic, this poses a difficult challenge. 

“In this context, it’s not only geographic, it’s also [that] there are issues that will impact that distance. Distance would be one of the risks that are involved in just going to a healthcare service center,” she told IPS. “So if these at the institutional, service levels are impacted, it’s going to [be] much harder for women.”

Girard of IWHC has noted similar concerns.

“Misguided attempts to control COVID infection – for example, by banning partners or doulas from accompanying women in labour – have also played a role, showing how little decision-makers value and understand women’s health and needs.”

Question over data

Meanwhile, the issue of access also means there are certain communities that will be disproportionately affected. 

“Already marginalised communities suffer the most,” says Girard. “Poor women, black women, indigenous women, rural women, LGBTQI+ individuals, adolescent girls, people with disabilities already struggle to access comprehensive health care services and social protection systems; the COVID-19 pandemic has exacerbated these existing inequalities. In the United States, COVID is affecting African-American communities particularly hard.”

In order to measure this impacts, it’s crucial to have proper data. However, data collection at a time of social isolation is further limiting opportunities for researchers to collect the information and generate data on how the pandemic is affecting the stakeholders. 

“We need to have the data pre-COVID and post-COVID in order to make this kind of comparison,” Mengjia Liang, Technical Specialist (Population and Development Branch) at UNFPA, told IPS. “

“Agencies that manage those international household surveys [are] very likely to delay their household planning survey as well,” she added. 

In essence, given the current circumstances, data collection in general might be taking a backseat, even though it’s at the core what helps researchers measure these impacts of something like the pandemic on women’s access to sexual and reproductive health facilities. 

The lack of data will be yet another salt to the wound.

** In the original story IPS incorrectly quoted Liza Kane-Hartnett, communications officer at the International Women’s Health Coalition (IWHC) instead of Françoise Girard, IWHC president.

The $683 million will be used for efforts towards women’s reproductive and sexual health rights across 57 countries, of which about $300 million will be directed towards UNFPA’s projects in Arab state regions, including countries such as Syria, Yemen, Iraq, Sudan, and Somalia. Credit: Abdurrahman Warsameh/IPS

By Samira Sadeque
UNITED NATIONS, Feb 7 2020 (IPS)

The United Nations Population Fund (UNFPA) is appealing for $683million in their mission to address sexual and reproductive health services for women and girls in conflict areas in the world. 

At the Humanitarian Action Overview 2020, launched on Thursday, the sexual and reproductive health agency highlighted the urgency with which the issue should be treated. 

With more than 168 million people currently requiring humanitarian assistance in the world, UNFPA projects 45 million women, girls and young people will be affected by some kind of conflict this year. 

For women and girls, sexual and health reproductive health rights have often come as secondary priority in crisis situations, but experts say it’s time to make them a primary concern. 

“[These] types of service have long time been forgotten,” Arthur Erken, Director of UNFPA Division of Communications and Strategic Partnerships (DCS), told IPS. “It should not be an afterthought, it should be part and parcel of [the whole concern].”  

“We’re focusing on women and what they’re going through because they’re on the front lines,”  Ann Erb Leoncavallo of UNFPA told IPS. “They’re trying to take care of their children, they’re getting pregnant, they’re having babies, they’re getting bombed, they’re suffering from floods, high waters, you name it.”

Leoncavallo added that many of the women in areas of conflict might head single-parent households or have their own trauma. “They get depression, they get traumatised because they faced increased of gender-based violence,” she said.  

The $683 million will be used for efforts towards women’s reproductive and sexual health rights across 57 countries, of which about $300 million will be directed towards  UNFPA’s projects in Arab state regions, including countries such as Syria, Yemen, Iraq, Sudan, and Somalia. 

In order to help women reach out for help, unlearn their shame and stigma, UNFPA is currently working with a “safe space” for many women to take a break from their everyday activities. 

The “women and girl safe spaces” is dedicated space in the refugee camps where women can come and meet with other women, share notes, relax, and have a safe environment to discuss concerns and ask for help, Erken explained.

“It’s safe, men are not allowed,” Erken said, adding that the purpose of the space is to put a lot of attention to calming women, giving them breathing space, and often counselling services.

He says there doesn’t seem to be any stigma about women coming into these spaces, pointing out refugee camps in Jordan that have the facility. He learned from some of the service providers the women do visit, when their kids are in school and their husband occupied. 

Dr. Afrah Thabet Al-Ademi, a UNFPA medical doctor in Yemen who works with women who have escaped conflict, says education has a role to play in destigmatising these services for refugee population.

A staggering $100.5 million is being requested specifically for the crisis in Yemen, the highest on the list provided by UNFPA.

“A lot of women who are not educated, who feel targeted, and feel stigma to talk about their needs or family planning,” Al-Ademi told IPS. 

She recalls one time when she was meeting with a woman who had just given birth and who had covered her baby with a headscarf. 

“When she exposed the baby, I found that she covered the baby with a newsletter, she didn’t have clothes,” Al-Ademi told IPS. 

As a result, UNFPA in Yemen is now developing a kit specifically for mothers of new borns, to be put in “health facility for any woman who comes in for deliver”.

“The clothes is like a dignity for her,” said Al-Ademi.

The “Mama Kit” has clothes for the baby, pads for the mother, blankets, and diapers, among other things for the newborn. 

UNFPA is also allocating funds for Democratic Republic of Congo, Syria, Sudan, Bangladesh, and Venezuela to assist with sexual and reproductive health for the women in those countries.

Students in Primary Seven at Zanaki Primary School in Dar es Salaam, Tanzania during an English language class. Credit: Sarah Farhat/World Bank.

By Thalif Deen
UNITED NATIONS, Aug 16 2019 (IPS)

The UN Population Fund (UNFPA) is convinced that the world’s 1.8 billion adolescents and youth– a quarter of the global population—have a key role to play in helping implement the UN’s 2030 Development Agenda.

In an interview with IPS, UNFPA Deputy Executive Director (Programme) Dereje Wordofa, said “young people are at the centre of sustainable development”.

“If we do not work with, and for them, there is no way we can achieve the sustainable development goals by 2030, or UNFPA’s three transformative results,” he warned.

Through “My Body, My Life, My World!”, UNFPA is also contributing to each of the five priorities of the UN’s overall Youth Strategy, “Youth 2030”.

“If we make coherent, tailored, large-scale reforms and investments, especially in health (including sexual and reproductive health), skills development, and employment, those nations can achieve a huge demographic dividend from their healthy, empowered young populations"

Dereje Wordofa, UNFPA Deputy Executive Director (Programme)

“These are engagement, participation and advocacy, informed and healthy foundations, economic empowerment through decent work, and peace and resilience,” he pointed out.

Speaking during International Youth Day on August 11, UN Secretary-General Antonio Guterres complained schools are “not equipping young people with the skills they need to navigate the technological revolution.”

Last year, he also stressed the importance of young people in addressing the challenges confronting the contemporary world, including peace, impacts of climate change and growing inequalities.

“The best hope [to address these] challenges is with the new generations. We need to make sure that we are able to strongly invest in those new generations,” said Guterres, urging the international community to be fully engaged in addressing a key problem of youth unemployment.

Asked how realistic was UNFPA’s strategy in poverty-stricken communities struggling to survive on less than $1.25 a day, Wordofa told IPS: “Having lived and worked in many countries affected by poverty and deprivation, including in my own Ethiopia, I couldn’t agree with you more”

He said Sustainable Development Goal 1 (SDG 1) is a lynchpin for all the other SDGs, and in all sectors of development “we are contributing towards reducing poverty. I believe empowered young people will play a vital role here too”.

“At UNFPA, we firmly believe that one of the most essential routes to achieving sustainable development lies in educating and empowering young people to make decisions about their health and wellbeing, giving them the tools to take charge of their lives, to drive development, and to sustain peace”.

“We must recognize that adolescents and young people make up the majority of the population in many economically poor nations,” he declared.

“ If we make coherent, tailored, large-scale reforms and investments, especially in health (including sexual and reproductive health), skills development, and employment, those nations can achieve a huge demographic dividend from their healthy, empowered young populations,’ said Wordofa, who earlier served as the International Regional Director, Eastern and Southern Africa, at SOS Children’s Villages and Regional Director for Africa at the American Friends Service Committee.

In this context, he pointed out that UNFPA’s “My Body, My Life, My World!” is a human-centric approach: “we are emphasizing how all the different issues affecting adolescents and youth today are interlinked and inseparable”.

“For example, without rights and choices over their bodies, it is not possible for young people to have full control over their lives and actively shape their communities and end poverty. So we must continue to address the complex determinants that affect young people’s health and wellbeing,” he noted.

UNFPA Deputy Executive Director (Programme) Dereje Wordofa.

Excerpts from the interview:

IPS: How best would you describe the UNFPA’s new strategy on adolescents and youth? 

WORDOFA: UNFPA’s vision is to create a world where every young person can make their own choices and enjoy their rights. The strategy titled “My body, my life, my world!” is our new rallying cry for every young person to have the knowledge and power to make informed choices about their bodies and lives, and to participate in transforming their world.

The strategy puts young people – their talents, hopes, perspectives and unique needs – at the very centre of sustainable development, and offers a new approach to collaborate with, invest in, and champion young people around the world. It encompasses everything that was called for and promised by world leaders at the International Conference on Population and Development (ICPD) back in 1994 in Cairo.

“My Body, My Life, My World!” provides a new narrative for all of UNFPA’s youth work, building on the organization’s strategic plan and the UN’s “Youth 2030” strategy, and putting young people’s sexual and reproductive health and rights at the core of what we do both in development and humanitarian settings.

In addition to the crucial need for young people to enjoy their right to sexual and reproductive health, the strategy also includes their fundamental right to participate in sustainable development, humanitarian action and sustaining peace.

By working with and for young people, we will deliver across the three spheres that matter to them – their body, life, and world. This will be essential if we are to finally fulfil the promise of the ICPD of rights and choices for all adolescents and youth.

IPS: Are you working on a deadline for its implementation?

WORDOFA: UNFPA seeks to achieve its three transformative goals by 2030; namely zero unmet need for family planning, zero maternal deaths and zero violence and harmful practices against women and girls. “My Body, My Life, My World!” will be a key accelerator to achieving these three goals.

IPS: Do you think the world’s 1.8 billion adolescents and youth now remain largely marginalized in decisions relating to reproductive health, marriage and child-bearing?

WORDOFA: Yes! It is a sad fact that far too many young people are still a long way from being able to exercise their reproductive rights, despite being promised them by world leaders twenty-five years ago at the International Conference on Population and Development in Cairo.

The numbers are staggering: 21 per cent of girls worldwide are married before age 18. Tens of thousands of girls get married every day. And every day in developing countries, 20,000 girls under age 18 give birth: this amounts to 7.3 million births a year.

The choices young people make—or are forced to make—determine their lives now, their futures as adults, and the health of future generations. A single choice, for example, to stay in school may protect against early pregnancy, child marriage, gender-based violence and HIV infection.

Yet many young people will not be able to make that choice. Poverty, humanitarian crises, race, ethnicity, gender and cultural traditions are just some of the barriers that may stand in the way.

IPS: What role can civil society play in promoting the Youth strategy in the developing world?                   

WORDOFA: Making a real difference in the lives of young people rests on shared leadership and shared responsibility. Youth-led and youth-serving organizations, governments, community leaders, UN entities, civil society, academia, the private sector and the media all have essential roles to play.

As UNFPA, we take pride in being a trusted ally and partner for youth leaders, organizations and networks. We systematically invest in strengthening national and regional youth-led networks, and pioneering models for youth leadership and participation in many countries.

Adolescents and youth both benefit from our programmes, and as our close partners, offer vital contributions to shaping their design and implementation.

For “My Body, My Life, My World!” we are excited to strengthen and broaden our partnership base and collaborate with youth-led organizations, community-based organizations, but also iNGOs, to scale up joint implementation efforts with young people.

IPS: How will your young professional network – the Tangerines – described as the first of its kind in the UN system, be deployed in promoting your new strategy?

WORDOFA: The Tangerines played an important role in formulating and shaping the strategy. We will continue to provide a safe space and promote an organizational culture that encourages young professionals within UNFPA to be closely linked to the implementation of “My Body, My Life, My World!” We know we need to start by walking the talk.

At the conception phase of the Strategy, we conducted a global survey with Tangerine members and consulted with our Executive Director, Dr Natalia Kanem, and the UN Secretary General’s Youth Envoy to explore how UNFPA was delivering for young people and what could be strengthened.

We are planning to collaborate closely with the Tangerines for the global launch and promotion of the Strategy, as well as when thinking about how we can reach young people and operationalize the strategy.

The writer can be contacted at thalifdeen@ips.org

Teenagers hanging out in Kazakhstan. In Kazakhstan the lack of sexuality education has led to 91 percent of young people aged between 15 and 19 not having accurate and full knowledge on HIV and AIDS. Courtesy: Gulbakyt Dyussenova/ World Bank

By Tharanga Yakupitiyage
UNITED NATIONS, Jun 25 2019 (IPS)

Young people around the world are facing increasingly insurmountable, persistent barriers as they try to achieve their full potential and secure a prosperous future. However, Central Asia and the Asia-Pacific have already begun working to ensure that no one is left behind.

In collaboration with the United Nations Population Fund (UNFPA) and the Asian Population and Development Association (APDA), parliamentarians across Asia gathered to address and act on the pressing issues that youth face today, including access to health and employment.

“The demographic dividend in countries in the region provides an opportune moment to continue to invest in youth for the benefit of all society,” UNFPA’s Representative in Kazakhstan Giulia Vallese told IPS.

Approximately 60 percent of the world’s youth live in Central Asia and the Asia-Pacific region.

Discussing sustainable development issues such as health care and employment access, parliamentarians met in a series of two meetings; the first being the “Leaving No One Behind” meeting in Kazakhstan in October 2018 and the “Act Today, Shape Tomorrow” gathering in Tajikistan in March 2019.

It is through such multi-stakeholder platforms and collaborations where success can be achieved, noted Vallese.

“It was important to bring together these different stakeholders to promote a shared understanding of closely interlinked root causes of issues and challenges faced by young people and increase appreciation of the urgent need for cross-sectoral, inter-ministerial, and multi-stakeholder approaches to help resolve the issues and challenges faced by young people in the region,” she said.

“Both conferences demonstrated the positive impact and the catalytic effect of multi-stakeholder partnerships for development. They allowed under the leadership of the respective host countries, Kazakhstan and Tajikistan, for the exchange of ideas on the role of national multi-stakeholder partnerships, which actually is the essence of implementing such a complex agenda as the International Conference on Population and Development (ICPD) programme of action and contribute to delivering on Agenda 2030,” she added.

Adopted by 179 governments in 1994, the landmark ICPD agenda marked the first paradigm shift which put people’s rights at the heart of all sustainable development.

In Kazakhstan, among the major issues discussed by participants was access to health information and services.

For instance, the lack of sexuality education has led to 91 percent of young people aged between 15 and 19 not having accurate and full knowledge on HIV and AIDS.

UNFPA also found that among those who reported having had symptoms of sexually transmitted infections, only 37 percent sought medical help.

Adolescents younger than 18 require parental consent to receive medical services.

In Tajikistan, access to employment and education particularly for youth and women remain limited.

According to the World Bank, inactive youth who are neither employed nor in school make up approximately 40 percent of the total youth population. Almost one third of those who are employed are in unpaid, informal jobs compared to 15 percent of adults.

Women have not fared well either as the female labour force participation rate was just 27 percent compared to 63 percent among males in 2013. Almost a quarter of women are in unpaid employment compared to 13 percent of men.

While education can help determine job outcomes, completion rates of secondary education may be falling in the Central Asian nation. For instance, more young women are not completing secondary school or technical education, the World Bank found.

Speaking to IPS, Deputy Speaker of Tajikistan’s Parliament Honorary Khayrinisso Yusufi said that youth are the “main creative force of the future” and stressed the need for investments to develop their potential.

“Developing the potential of young people, shaping their public engagement, strengthening their quality of education and health care, their participation in labour markets, and engaging in development processes reflect the aspirations of peoples and the policies of our countries to achieve the SDGs and create a better world for everyone,” she said.

And Central Asian countries such as Tajikistan and Kazakhstan are already on their way to empower youth.

During the conference in Dushnabe, Deputy Minister of Education and Science of Tajikistan Dr. Latofat Naziri told participants of the importance of actively engaging youth in order to help build their envisioned futures and involvement in society. With that in mind, study groups and clubs are being organised at the school level aimed at developing youth’s entrepreneurship skills.

Others, including Yusufi, pointed to the focus on strengthening the status of young people, especially girls. Among Tajikistan’s priorities are presidential quotas for girls’ higher education, and already the number of young parliamentarians and women in the country has increased, Yusufi told IPS.

After the meeting in Astana, participants adopted the Astana Declaration which promises to make primary health care, especially sexual and reproductive health services as well as sexuality education, more youth-friendly and accessible.

UNFPA has already begun working on this front, establishing Youth Peer Education which trains youth to help their peers and share accurate information about healthy life skills. Youth-friendly health centres have also been established in order to provide comprehensive and confidential services.

Vallese urged that such work should continue, and protective laws and policies are essential to support human rights of youth.

“Young people need to be part of the national dialogue for sustainable development…investing in young people is critically important to ensure future societies are economically dynamic and vibrant, as well as peaceful, inclusive and sustainable while providing opportunity for all,” she told IPS.

Yusufi also highlighted the role of parliamentarians, legislation, and collaborations to achieve such a vision.

“I am sure that the activity shown by the forum participants in discussing the problems and prospects of youth policies in our countries will be productive in the legislative field. We will be able to more effectively pursue a policy of modernisation, improve education, health, protect the environment, effectively apply technologies and support youth initiatives,” she said.

“We parliamentarians, reaffirmed the key role of parliaments and parliamentary networks in establishing a multi-state partnership with a view to sustainable development and a better future for humanity,” Yusifi concluded.

As this year marks the 25th anniversary of the ICPD, civil society and governments will gather in Kenya for the Nairobi Summit to advance the ICPD’s goals.  

Kazakhstan boys swim in muddy water of Syr Darya river. Parliamentarians from Kazakhstan are advocating for youth employment opportunities, healthcare services, and educational possibilities at a regional, national and global level. Credit: Ninara/CC By 2.0

By Carmen Arroyo
UNITED NATIONS, Oct 23 2018 (IPS)

Parliamentarians from 36 countries met this weekend in Astana, Kazakhstan, to discuss the future of youth in Central Asia and the Asia-Pacific region. The gathering called “International Conference on Investing on Youth: Leaving No One Behind” took place on the Oct. 19 to 20, and the goal was to advance the Sustainable Development Goals (SDGs), set by the United Nations, with regards to youth.

Keizo Takemi, Member of Parliament (MP) from Japan and chair of the Asian Forum of Parliamentarians on Population and Development (AFPPD), told IPS: “We would like to reach a broad consensus among the participants that investment in youth is a core part of the investment of human capital.”

Kazakhstan and the Asian Population and Development Association (APDA) have long been concerned with the future of youth in Asian countries. Parliamentarians from the region have turned to this issue, advocating for youth employment opportunities, healthcare services, and educational possibilities at a regional, national and global level.

Given that 60 percent of the world’s youth lives in Central Asia and the Asia-Pacific region, their concern with youth is justified. According to World Bank data, the majority of young people in these regions is literate, and healthy. Thus, the parliamentarians at Astana focused mainly on three issues: healthcare information and access, civil participation and increased employment opportunities for the youth.

Two hundred participants attended the conference at the Rixos President Astana Hotel. The two-day event was organised by the Parliament of Kazakhstan, the ministry of social development in Kazakhstan and the APDA, funded by the U.N. Population Fund (UNFPA) through the Japan Trust Fund.

Event’s agenda

Of the 200 participants that attended the conference, 90 were from Kazakhstan and 110 from abroad. Among them, there were parliamentarians, international experts and representatives from U.N agencies, NGOs, academia and the private sector.

The two-day event opened with the remarks of G. I. Issimbayeva, deputy chairperson of the Mazhilis of the Parliament of the Republic of Kazakhstan, and closed with Takemi and Issimbayeva’s comments.

During the conference, there were four main sessions which included panels. The first three sessions took place on Friday. The first one focused on education and employment, featuring speakers such as Ato Brown, World Bank country manager, and Madina Abylkasymova, from the ministry of labour and social protection of population in Kazakhstan.

The second one talked about health, with speakers like Keizo Takemi and Soyoltuya Bayaraa, from UNFPA. The last session of the day concentrated on youth participation in civil, political and social affairs, with representatives such as Tatyana Lebedeva, Russia’s MP, and Bakhtyar Maken, Republic of Kazakhstan’s MP.

Finally, the fourth session occurred on Saturday, and it dealt with opportunities for youth in globalisation, with Vitalie Vremis U.N. Development Programme as moderator.

Takemi, Chairman at AFPPD, talked at the conference on improving universal access to health information and services for youth. He shared with IPS his thoughts on how health relates to gender. “There are many gender-related issues on investment in youth and in access to healthcare services. We, at AFPPD, have always kept a comprehensive framework on population related issues, including gender empowerment, investment in youth and active ageing,” he said.

UNFPA is another crucial organiser of the meeting. It has supported the region’s parliamentarians in investing in youth, by raising awareness through gatherings. In 2016 UNFPA, AFPPD and APDA launched the “G7: Global Conference of Parliamentarians on Population and Development,” where the participants committed to improve quality of education and health services, employment and gender equality among the youth.

All these issues remain intertwined, explained Takemi. “Each building block is related to each other. Therefore, when we highlight investment in youth, simultaneously we must take into account gender and ageing.”

No one left behind – including the youth

These gatherings aim to advance the SDGs and translate them to the national context. “The SDGs means that no one is left behind. That broad consensus can be the basis on which many MPs bridge national boundaries,” stated Takemi.

Specifically, the “International Conference on Investing on Youth” wanted to increase awareness of the need for a cross-sectoral and inter-ministerial approach to resolve the problems identified by the parliamentarians.

It also aimed to include policies related to the youth in their implementation of the SDGs at a national level. Those policies would vary depending on the country and the overall situation of their youth. With the World Bank’s Human Capital Project, countries can keep track of their youth’s needs. Takemi said: “I really hope the heads of the states recognise where they are through resources of the human capital through the World Bank.”

But one type of policy is not enough. A multilateral approach is needed. Takemi stated: “In order to achieve SDGs by 2030 we should have cross sectoral policy concept. Each goal and target can’t be achieved by isolated players and sectors.” He continued: “Investment in youth, education, vocational training, employment policies should be combined through a cross-sectoral conceptual framework, such as investment in human capital.”

Takemi concluded: “I myself recognise investment in youth should be the core of the investment in human capital.”

Manes Feston, flanked by her children, holds her four-month-old son Fedson. He was one of triplets but his siblings died because of a lack of welfare support. High fertility rates can be seen in much of Africa with four or more births per woman. Generally, these countries are poorer with limited access to quality healthcare and contraception. Credit: Travis Lupick/IPS

By Tharanga Yakupitiyage
UNITED NATIONS, Oct 21 2018 (IPS)

Reproductive choice can transform the world and our goals towards a sustainable society, a new report says.

Every year, the United Nations Population Fund (UNFPA) examines the state of the world population. In this year’s report, the agency focuses on the power of reproductive choice and the role it can play to promote social and economic development.

“Choice can change the world,” UNFPA’s executive director Natalia Kanem said in the report’s foreword.

“It can rapidly improve the well-being of women and girls, transform families, and accelerate global development,” she added.

While progress has been achieved, the international community still has a ways to go, UNFPA’s Washington D.C. director Sarah Craven told IPS.

“There is no country in the world where reproductive rights and choices are enjoyed by all people at all times,” she said.

The State of the World Population 2018 report examines global fertility trends and how they are influenced by choice or the lack thereof.

High fertility rates can be seen in much of Africa with four or more births per woman.

Generally, these countries are poorer with limited access to quality healthcare and contraception.

UNFPA found that over 20 percent of women in the region want to avoid a pregnancy but have an unmet need for family planning.

At the same time, almost 20 million—or 38 percent—of the region’s pregnancies each year are unintended.

Practices such as early marriage, which is associated to an early start to child bearing, is also common.

In sub-Saharan Africa, approximately 38 percent of women are married by the age of 18. In Niger, 76 percent of girls marry by the age of 18.

Child marriage, which is accompanied with the end of education and the lack of opportunities for employment and thus reduced earnings in adulthood, denies girls’ decision-making power and their right to choose.

It also hinders progress on the Sustainable Development Goals (SDGs) such as the elimination of poverty, achievement of good health and well-being, and access to decent work.

Countries with high fertility have faster population growth, which poses challenges for governments already struggling to make progress on the SDGs and to provide education, healthcare, and employment opportunities.

On the other hand, while there are trends towards lower birth rates as a result of greater access to services, some women are having fewer children due to constraints rather than choice.

“The gap between desired and actual family size suggests that women and men are not fully able to realise their reproductive rights,” the report states.

For instance, the culture of overwork in East Asia has made it difficult for many to have both a career and a family.

In South Korea, almost 20 percent of employed women worked more than 54 hours a week in 2014.

The East Asian nation has a fertility rate of 1.17 births per woman, below the recommended replacement level of 2.1 and the level needed to sustain the current size of the population.

In Japan, which also has concerning fertility levels, the demanding work environment has even led to “karoshi,” or death by overwork.

In 2013, journalist Miwa Sado died of a heart failure and investigators found that she had logged 159 hours of overtime work one month before she died.

In 2015, 24-year-old Matsuri Takahashi committed suicide. It emerged that she worked for over 100 hours of overtime at her advertising job and had barely slept in the period leading up to her death.

In an effort to address this problem, both countries have started to put policies in place to restrict work hours.

However, women with children also often face discrimination in the labour market, which can be seen in countries such as South Korea and Japan where mothers predominately hold low-salary positions and have limited career options, resulting in vast gender wage gaps.

With fewer children and young adults, the labour force has been shrinking contributing to weaker economies.

At the same time, as older people account for larger shares of the population, governments face challenges to cover health-care costs and social security systems, further weakening economies.

Among the recommendations in the report is to provide universal access to quality reproductive healthcare, including access to modern contraceptives, make available sexuality education, and achieve gender equality.

“Choice can be a reality everywhere. This is something that governments should prioritise,” Craven told IPS.

In high fertility countries, there is a need for education on reproductive rights and employment opportunities for rural women while low fertility countries should implement family-friendly policies such as child care services and parental leave.

Questions and challenges remain as to how governments should achieve such policies as the debate over reproductive choice in many countries is often grounded in religious beliefs.

In the United States, a new set of proposed rules will expand religious exemptions, allowing employers to deny health care access such as reproductive health coverage and access to contraception.

In Saudi Arabia, child marriage is still widespread and often justified by clerics.

Craven expressed concern over any policy that restricts individuals to access information and services, and highlighted the importance of reproductive choice.

“You will not achieve the SDGs if you don’t also achieve reproductive rights of your citizens,” she said.

Kanem echoed similar sentiments in the foreword of the report, stating: “The way forward is the full realisation of reproductive rights, for every individual and couple, no matter where or how they live, or how much they earn…the real measure of progress is people themselves: especially the well-being of women and girls, their enjoyment of their rights and full equality, and the life choices that they are free to make.”

A basket of condoms passed around during International Women’s Day in Manila. Without publicly funded family planning services or information, we can only expect to see higher rates of unintended pregnancies, unsafe abortions, and infant mortality in the U.S. Credit: Kara Santos/IPS

By Tharanga Yakupitiyage
UNITED NATIONS, Jul 11 2018 (IPS)

It has been five decades since the international community affirmed the right to family planning but women still remain unable to enjoy this right, which is increasingly under attack around the world.

For World Population Day, held annually on Jul. 11, the United Nations Population Fund (UNFPA) has focused its attention on “Family Planning is a Human Right,” and aptly so.

This year marks the 50th anniversary of the 1968 International Conference on Human Rights where family planning was, for the first time, understood to be a human right.“Chipping away at women’s access to information is a direct attack on their access to healthcare, and the right to make informed autonomous decisions about their lives and their bodies,” said Human Rights Watch’s Senior Researcher Amanda Klasing.

“Parents have a basic human right to determine freely and responsibly the number and spacing of their children,” the Tehran Proclamation from the conference states.

The historic meeting also linked the right to the “dignity and worth of the human person.”

“Family planning is not only a matter of human rights; it is also central to women’s empowerment, reducing poverty, and achieving sustainable development,” said UNFPA’s Executive Director Natalia Kanem.

However, in developing countries, more than 200 million women still lack safe and effective family planning methods largely due to the lack of information or services.

The World Health Organization (WHO) recently found that clinical guidelines are followed in less than 50 percent of cases in poorer nations, resulting in “deficient” family planning.

In such circumstances and without access to contraception, women and girls often turn to dangerous methods such as ingesting or inserting vinegar, which can cause bodily damage.

UNFPA found that in one country, the stiff plastic wrapper of an ice popsicle is used as a replacement for condoms which could result in genital lacerations.

While such practices have generally decreased, countries like Yemen where conflict has restricted access to family planning are seeing more women using unsafe, traditional methods of contraception.

In other places such as the United States, family planning is deliberately under attack.

Just a year after implementing the global gag rule, which cuts off international family planning funds to any foreign nongovernmental organization who advocate or even give information about abortion, the Trump administration is now turning inwards and targeting its own.

Title X is a USD300 million government programme dedicated to helping the four million low-income women who wish to access birth control and other family planning services

However, new proposed regulations echo a sense of a “domestic gag rule” by restricting people’s access to family planning care. One such proposal forbids doctors from counselling patients with unplanned pregnancies about their reproductive options and instead advocates coercing pregnant patients towards having children regardless of their own wishes.

The scenario can already be seen playing out across the country.

Recently in California, the Supreme Court reversed a law that required crisis pregnancy centres, which often trick women into believing they provide family planning services, to provide full disclosure.

The Supreme Court found that it “imposes an unduly burdensome disclosure requirement that will chill their protected speech.”

“It’s clear the U.S. government is taking more and more swipes at a fundamental aspect of the right to health—the right to information,” said Human Rights Watch’s Senior Researcher Amanda Klasing.

“Chipping away at women’s access to information is a direct attack on their access to healthcare, and the right to make informed autonomous decisions about their lives and their bodies,” she continued.

Withholding such essential resources and information from women also heightens the risk of ill-health or even death for newborns.

According to the Guttmacher Institute, women with unintended pregnancies, which is often higher among the poor, often receive worse prenatal care and poor birth outcomes. When women are able to decide when to have children and space out their pregnancies, their children are less likely to be born prematurely or have low birth weights.

Already, a study found that U.S. babies are three times more likely to die compared to 19 countries in the Organization for Economic Co-operation and Development largely due to high poverty rates and a weak social safety net.

Without publicly funded family planning services or information, we can only expect to see higher rates of unintended pregnancies, unsafe abortions, and infant mortality in the U.S.

And now with President Donald Trump’s Supreme Court nominee Brett Kavanaugh, who has a history of undermining women’s reproductive freedom, we may even see worse including the dismantling of the historic Roe v. Wade case which legalised abortions.

If we are to achieve the Sustainable Development Goals, including ensuring universal access to sexual and reproductive health care and meeting all family planning needs, the international community should not forget its affirmation at the 1968 International Conference on Human Rights.

“Investments in family planning today are investments in the health and well-being of women for generations to come,” Kanem concluded.

Over the next decade, China will be home to the world's largest elderly population, while India -- because of its demographic dividend – will require jobs for the world's largest workforce. Credit: Neeta Lal/IPS

By Amna Khaishgi
SEOUL/NEW DELHI, Oct 28 2017 (IPS)

Experts on population ageing converged in Seoul this week to discuss how to make reaching one’s “golden years” a happy and sustainable process across the world.

They gathered at the Global Symposium on Ageing 2017. The two-day symposium on Oct. 23-24 was aimed at “Promoting Resilience and Sustainability in an Ageing World”.“Having never encountered ageing on a global scale before, humanity is still grappling with this issue through a trial and error approach." --Yasuo Fukuda, Chair of APDA

Organized by the United Nations Population Fund (UNFPA) and Statistics Korea (KOSTAT), it brought together thought leaders in the field of ageing, including policy makers, academics, civil society, the private sector, and representatives of international agencies, to review past developments, current challenges, and future actions.

“Population ageing is no longer a phenomenon of developed countries. The pace of population ageing is progressing most quickly in developing countries. By 2050, around 80 percent of people aged 60 or older will live in what are now low- or middle-income countries,” said Dr. Natalia Kanem, executive director of UNFPA.

“Ageing is the outcome of great achievements in health and nutrition, in social and economic development, and it reflects a better quality of life around the globe. It is a triumph of development. We must now turn our focus from merely helping people reach old age to helping them reach a happy old age,” she added.

Countries like Bangladesh, China, India, Indonesia, Japan, Malaysia, Manoglia, Nepal, Philippines, Republic of Korea, Sri Lanka, Thailand and Vietnam participated in the symposium and shared their experiences. UNFPA also announced the establishment of its permanent liaison office in Seoul to work on population ageing.

During the two-day symposium, participants reviewed the progress of the Madrid International Plan of Action on Aging (MIPAA), which was adopted at the Second World Assembly on Ageing by government representatives from all over the globe in 2002.

MIPAA continues to serve as one of the main guiding frameworks for UNFPA’s work of stock-taking on global ageing. It recognizes ageing as a global trend and relates this to social and economic development and human rights. MIPAA promotes a “society of all ages” and assures the wellbeing of a large and growing number of older persons.

The symposium also debated how population aging might affect social and economic development, and discussed whether government policies regarding education, health, and woman’s empowerment are really supporting their ageing population.

One in nine persons across the world is aged 60 or older. This is projected to increase to one in five by 2050.

On the eve of the conference, the Asian Population and Development Association (APDA) also issued a ‘Policy brief on Ageing in Asia’.

“We live in a world in which globally the population is ageing, and a demographic transition taking place,” said Yasuo Fukuda, a former Prime Minister of Japan and Chair of APDA, in his introduction.

“Having never encountered ageing on a global scale before, humanity is still grappling with this issue through a trial and error approach, and despite multitudinous research on the topic, a one-size-fits-all solution has yet to be found,” he said.

“This report too is limited in its scope, and is by no means a compendium of the vast amount of research that has been done on ageing and social security, and does not offer definitive solutions,” Fukuda added. “What it does aim to do is to clearly set out issues surrounding this topic and present critical views that can help Asian countries develop better policies for population ageing.”

While sharing the details and findings of the policy brief, Fukuda said that it is necessary to strengthen the gathering of statistics, in particular the census system, and to establish family registration systems in order to identify the paid subscribers and beneficiaries of social security, and to avoid a breakdown in the system resulting from the so-called tragedy of the commons. He also emphasized that there need to promote research and implement policies to stem very low fertility and so avoid too rapid a decline in population.

According to the Policy Brief, issued by APDA, the world’s ratio of population ageing will increase from 9.3 percent to 16.0 percent from 2020 to 2050. In Asia, the ratio will more than double, from 8.8 percent to 18.2 percent. In more developed regions and less developed regions, the ratios will rise from 19.4 percent to 26.5 percent and from 7.4 percent to 14.4 percent respectively.

“Asia’s population, however, is estimated to age rapidly thereafter so that by 2050, the ratio in six countries and areas will be 30 percent or over, which is considered the ratio at which point a country can be described as a super-ageing society, 20-30 percent in 11 countries and areas, 10-20 percent in 25 countries and areas, and less than 10 percent in nine countries and areas (and less than 7 percent in five of these nine),” the brief said.

“The projections show that around 90 percent of Asian countries will be either ageing or super-ageing societies by 2050. Ageing in Asia is particularly characterized by the rapid pace of ageing in East Asian countries,” the report said.

“Whereas it took more than 40 years for the ratio of population ageing to double from 7 percent to 14 percent in Western countries, it took less than 25 years in countries such as South Korea, Singapore, and Japan.”

According to the report, the projections of the ratio of population ageing in 51 countries and areas in Asia in 2020, the ratio is estimated to be 15 percent or over in five countries and areas (including Japan, South Korea, and Singapore), 10-15 percent in eight countries and areas (including Thailand, China, and Sri Lanka), 7-10 percent in seven countries (including North Korea, Vietnam, and Malaysia), 5-7 percent in 11 countries and areas (including India, Iran, and Indonesia), and less than 5 percent in 20 countries and areas (including Cambodia, Mongolia, Pakistan, and Iraq).

The data show that in 2020, 20 countries and areas will reach the 7 percent mark, which is considered the benchmark indicator of an ageing population, while 31 countries and areas will fall short of the 7 percent mark. Countries and areas with a young population structure will make up about 60 percent of all countries and areas in this region.

Natalia Kanem, Acting Executive Director the United Nations Population Fund (UNFPA). Credit: UN Photo/Mark Garten

By Tharanga Yakupitiyage
UNITED NATIONS, Jul 28 2017 (IPS)

The demographic dividend: though not a new concept, it is one of the major buzzwords at the UN this year. But what does it really mean?

There are 1.8 billion young people between the ages of 10 and 24 around the world, the most in the history of humankind.

In Africa alone, approximately 60 percent of its population is currently under 25 years old and this figure is only expected to rise.

With this change in demographics comes more working-age individuals and thus the potential to advance economic growth and sustainable development, known as the demographic dividend.

However, this will not happen on its own.

Investments are required in areas such as education and sexual and reproductive healthcare in order to provide youth with opportunities to prosper, major components of the globally adopted 2030 Agenda for Sustainable Development.

The UN Population Fund’s (UNFPA) new acting executive director Natalia Kanem, who assumed her new role after the unexpected death of former executive director Babatunde Osotimehin, sat down with IPS to discuss the issues, challenges, and goals towards achieving the demographic dividend and the Sustainable Development Goals (SDGs).

Q: What is the demographic dividend and why is it so important?

A: The demographic dividend is the economic boost that happens in a country when you have more people in productive working ages employed and contributing to the economy compared to the categories of young people or elderly who are dependents in economic terms.

For many of the countries which dwell in poverty today, we are seeing this transition that was predicted to happen.

Through the success in healthcare and sanitation, society has been able to increase life expectancy—people are getting older so we are getting lower death rates.

At the same time, we are getting lower birth rates, which are happening in some of these countries, and that means the working-age population is going to have fewer mouths to feed, fewer shoes to put on the school-aged child’s feet.

Many things have to also happen at the same time—it’s not just simply lowering the birth rate.

You have to equip people to be able to be productive members of a society, and this means education is very important. Adolescent girls in particular should be equipped to reach their potential by providing education of certain types of skills or training.

All of this is going to add up to much more societal progress, potential of young people fulfilled, and human rights being enjoyed.

Q: Where does this fit in and how does it inform UNFPA’s work under your leadership? Does it signal a paradigm shift?

A: We do feel that it is a paradigm shift, and what we are doing at UNFPA is making it accessible so that governments understand its relevance.

The mandate of UNFPA is to promote universal access to sexual and reproductive health and reproductive rights, and we feel that a woman’s choice is at the center of all of this.

Right now, as girls get married young and are having coerced sexual activity young, they are really not able to decide for themselves about how many children they want, when they want to have them, and how they would like to space them.

By giving women the choice to exercise their reproductive wishes and educating them—all of these things are going to ignite the potential of young people.

These people have potential, they want to work, they want to be educated, they want to contribute—so let’s make it easier for them, let’s not hide sexual and reproductive health information.

Not every method is going to work for every person, so we really look at human rights across the spectrum of choice.

We also have a lot of experts who have been very strategic in thinking through what really makes a difference, and we can say emphatically that investment in sexual and reproductive health way outweighs the costs—you at least double your money, and if you do the whole package, you can actually get 122 times the investment.

There is nothing on the planet that gives you that kind of payback.

Q: Why isn’t it enough to just equip youth with skills and jobs?

A: The young person exists in a societal environment like we all do, and girls tend to get left out of that picture.

In the past, when we were thinking of farmers, we didn’t realize that more than half of the farmers were women. So we were giving all of the agricultural resources to the wrong people.

And here we are saying the adolescent girl is half of the world and she also needs to be deliberately included.

The cards will be stacked against her if we don’t protect her so she doesn’t fall into the trap of sexual and reproductive dis-ease—so she’s pregnant before she wants to be, she is having her kids too close together, she is physically exhausted, and if she doesn’t finish her education, all of these things work together.

So that’s why we keep harping on this balance of all of these different elements.

The Republic of Korea is the classic example of how its gross domestic product (GDP) grew over 2,000 percent in the 50 odd years when they were investing in voluntary family planning coupled with educating the population and preparing them for the types of jobs that were going to be available.

South Korea’s population pyramid went from looking like a triangle, where there wasn’t enough working age people to take care of those at the bottom, to where there were fewer children per family and greater ability to invest more into nutrition and education and all of the things families want for their children.

And it’s not just fewer families alone, because if you have fewer families but she doesn’t have an education, then it won’t work. You need the packaged deal.

We are ultimately talking about a social revolution which sees young people as an asset to their family, community, and country.

Q: How accepted is the correlation between growth and issues that may not be so obvious such as sexual and reproductive health or child marriage? Has there been pushback on that?

A: First of all, there was lack of recognition. It seems like the dots are very far apart until you paint the picture, but we have been explaining that better.

The regional report card atlas which we just launched earlier this month for the African Union Summit is very telling. We looked at those same parameters for every single African country, one of which was early marriage, and it varies so much.

In some countries, it can be up to 70 percent of girls getting married before the age of 17. In Rwanda it’s under 10 percent, and they have very good family planning which they’ve been working on for a while.

Uganda is a very good example of how pushback was transformed.

President Museveni came in as a strong proponent of big families and said that they need a big population in order to have more workers. But after a lot of discussion, he saw that Uganda already has a big population but it wasn’t enough.

So later, the President started advocating strongly for voluntary family planning services and services like midwives because again, the woman has to be sure that when she does get pregnant she and her baby are going to survive.

Uganda has now transformed its economy and is starting to see that demographic dividend boost.

Q: Where do the resources come from for countries to invest in youth?

A: Many countries are looking to invest their own resources in this proposition because the return on investment argument is highly persuasive.

We have also garnered the interest of development banks. The World Bank is working very closely with UNFPA on the Sahelian Women’s Economic Development and Demographic Dividend (SWEDD) program. It’s only been active for a little while now but it is wildly successful because it looks at rural women in countries of the Sahel.

There is also a huge role for the private sector.

Government is very important because of policies and setting the tone and norms and laying down the expectations.

But the reality is that the private sector employs 90 percent of people in the developing world.

This coupling of the public government side and the private investment side is very crucial to ensure rights, freedoms, services, and accurate information—all of that together is needed for development and for this bonus that we call the demographic dividend.

Q: How are the recent funding cuts by the United States affecting UNFPA’s work? Is it hindering progress on the demographic dividend and/or the sustainable development goals?

A: First of all, I would like to say that UNFPA is moving forward.

We are steadfastly committed to our three goals: Zero preventable maternal deaths, zero unmet need for family planning, and the elimination of harmful practices including violence that affect women and girls.

We are very focused on these three goals in our work with governments, civil society, private sector, and other actors in over 150 countries to honor the legacy of our late boss as well as those who preceded him.

There are still 214 million women who want family planning and don’t have modern contraception.

We have a funding gap that stands at about 700 million dollars from now to 2020, and we have been looking for additional funding because we need to reach more and more women and girls without cutting the programs we already have.

The United States’ defunding was such a disappointment in terms of our good standing in the world and our regret that the decision was based on an erroneous claim.

Ultimately, I think our regret on the decision is certainly monetary because we were using that money very effectively in humanitarian core operations.

But we also regret it because of the stature of the U.S. in the fight to make sure that there is gender equality as well as reproductive health and rights.

We are really looking forward to continuing a dialogue and hopefully keeping an open door because the U.S. and U.S. Agency for International Development (USAID) have been very good partners with UNFPA.

The time is now for young women to be protected from it being their fault that they got raped, for them feeling shame when they have been assaulted.

Let’s turn that around so that men and boys, women and girls live peacefully with the resources they want and need to survive and thrive.

No one of us can do it alone and I think that UNFPA is a good partner, and that we deserve to be supported.

*Interview edited for length and clarity.

Credit: Curt Carnemark / World Bank. CC BY-NC-ND 2.0

By Lyndal Rowlands
UNITED NATIONS, Apr 7 2017 (IPS)

When Bimla Chandrasekharan saw that women who gave birth to baby girls were being sent out of the house by their angry husbands and mothers-in-law she realised a basic biology lesson was needed.

“We start educating them on this XY chromosome,” Chandrasekharan who is Founder and Director of Indian women’s rights organisation EKTA told IPS. “(But) we don’t say XY chromosome, we do it with tomatoes and limes. ‘Tomato tomato’ it becomes a girl, ‘tomato lime’ it becomes a boy.”

It is just a start but this lesson helps to show fathers that they in fact determine the sex of their children.

According to the UN Population Fund (UNFPA), there are now 117 million girls who are ‘missing’ worldwide because of sex selective abortion and infanticide.

The problem ballooned in India and China in the 1990s, partly due to increased access to ultrasounds. But according to the UNFPA the problem has also now spread to new regions including Eastern Europe and South-East Asia.

A new UNFPA program to address the problem in Armenia, Azerbaijan, Georgia, Viet Nam, Bangladesh and Nepal will draw on the experiences of both India and China in addressing the problem.

“Son preference is a practice that affects many societies around the world,” Luis Mora, Chief of the UN Population Fund’s Gender, Human Rights & Culture Branch told IPS.

“What we have seen over the last three decades is that the practice that initially was considered a sort of exception in China and India … has moved to other countries.”

Yet while the increase in sex selection has coincided with access to technologies like ultrasound, both Mora and Chandrasekharan agree that banning ultrasounds alone won’t fix the problem.

“In a patriarchal society there is always a preference for a male child,” says Chandrasekharan.

This is why EKTA challenges patriarchy and teaches mothers and fathers why they should want to have daughters just as much as they want sons.

Some of the reasons why sons are preferred over daughters are economic. In India parents have to pay a dowry for daughters. In many countries only sons can inherit property, daughters cannot.

But there are other reasons too.

As Chandrasekharan points out, some mothers fear bringing daughters into a world where they are likely to experience sexual harassment and abuse, a lifetime of unpaid housework, and marriage as young as 12 or 13.

Chandrasekharan, is an active member of a national campaign called Girls Count, which aims to fight sex selection in India, and receives funding from both UNFPA and UN Women.

She says that within Girls Count there are “two streams.”

“One stream of people believe in strict enforcement of the law,” says Chandrasekharan, “The other stream is challenging patriarchy, I belong to that stream,” She adds that she also believes in the law, but doesn’t think that laws alone work.

As Chandrasekharan points out India’s Preconception and Prenatal Diagnostic Technique Act was introduced in 1994, banning prenatal scanning and revealing the sex to parents, yet this law has not stopped sex-selective abortions.

Yet Chandrasekharan is also careful to say that challenging patriarchy doesn’t mean that her organisation is anti-men. Patriarchy is a system, she says that has consequences for both men and women, but mostly benefits men.

“We are not against you as an individual we are talking about a system,” she tells the men and boys she works with.

Mora also agrees that it is not possible to end sex selection without addressing gender inequality.

“The evidence we have (of what) what really works is changing social norms and gender norms that under-value girls and at the same time giving opportunities to girls and women.”

This includes giving rights, equal access to education, employment and land, says Mora. “These are the practical things that make a sustainable change.”

This is also why EKTA introduces role models to the community, to show that not all women will spend their lives doing unpaid housework.

EKTA’s most recent role model came from the local community herself. At a young age she met a family member who told her that she had flown to meet them by plane.

Even though the girl came from a marginalised Dalit family, she told her family that she wanted to be the ‘engine driver’ of a plane, since she didn’t yet know the word for pilot.

Last year, says Chandrasekharan, she became a full-fledged pilot and returned to speak to the community as part of EKTA’s role models program.

UNFPA’s new program in the six selected countries is funded by the European Union, however many other UNFPA programs are now in jeopardy, after the United States’ decision to withdraw all of its funding from the agency on Monday.

IPS spoke to Chandrasekharan during the annual UN Commission on the Status of Women.

Excerpt:

Mothers and babies wait for health screening at a US funded health clinic in Uganda. Credit: Lyndal Rowlands / IPS.

By Tharanga Yakupitiyage
UNITED NATIONS, Apr 5 2017 (IPS)

The U.S. has withdrawn all of its funding to the UN Population Fund (UNFPA), an agency that works on family planning and reproductive health in over 150 countries.

The decision is based on what the UNFPA says is an erroneous claim that it “supports, or participates in the management of, a program of coercive abortion or involuntary sterilisation (in China).”

The claim was made by the U.S. State Department in a letter on Monday announcing the cuts, but has been described repeatedly as baseless, by those who know the UNFPA’s work.

According to the UNFPA, it does not promote abortions and instead “accords the highest priority to voluntary family planning to prevent unintended pregnancies to eliminate recourse to abortion.”

In a statement released in response to the funding cuts, the UNFPA said that “we have always valued the United States as a trusted partner and leader in helping to ensure that every pregnancy is wanted, every childbirth is safe, and every young person’s potential is fulfilled.”

The U.S. is one of the largest contributors to UNFPA having provided over $75 million in 2015 alone, the third highest contribution from a government after the United Kingdom and Sweden. The U.S. is also the second largest funder of UNFPA’s humanitarian operations. Like other UN agencies, UNFPA is funded by governments voluntarily.

Though UNFPA does work in China, both Kowalski and Jalan told IPS that the accusation is baseless and is simply an “excuse” to stop funding an organization working on sexual and reproductive rights.

International Women’s Health Coalition’s Director of Advocacy and Policy Shannon Kowalski told IPS that the cuts will have “devastating consequences” for girls and women around the world.

Female genital mutilation (FGM) traditional surgeon in Kapchorwa, Uganda speaking to a reporter. The women in this area are being trained by the civil society organisation REACH in how to educate people to stop the practice. Credit: Joshua Kyalimpa/IPS

By Desmond Latham
JOHANNESBURG, Aug 6 2016 (IPS)

After years of wrangling and debates among African leaders, the movement to end female genital mutilation (FGM) is gaining real momentum, with a new action plan signed this week by Pan African Parliament (PAP) representatives and the U.N. Population Fund (UNFPA) to end FGM as well as underage marriage.

The UNFPA has already trained over 100,000 health workers to deal specifically with aiding victims of FGM, while tens of thousands of traditional leaders have also signed pledges against the practice.

The agreement followed a PAP Women’s Caucus meeting with UNFPA representatives in Johannesburg on July 29-30.

Kicking off the meeting, PAP President Roger Dang said, “PAP is determined to help and be part of stakeholders to come up with solutions to this practice. This is in line with the mandate of PAP to defend and promote gender balance and people living with disability.”

The PAP is the legislative organ of the African Union, and has up to 250 members representing the 50 AU Member States.

In some African countries, girls as young as eleven and twelve are forced to marry much older men. This has led to an increase in serious health problems, including cervical cancer and a host of social problems.

UNFPA East and Southern Africa Deputy Regional Director Justine Coulson said if the current trend continues, the number of girls under 15 who had babies would rise by a million – from two to three million.

“If we do nothing, in the next decade over 14 million girls under 18 years will be married every year,” she said.

There are believed to be at least seven million child brides in Southern Africa alone. While underage marriage and childbirth is a major health risk, the Pan African Parliament UNFPA workshop also heard how FGM had led to an increased likelihood girls and women would be exposed to sexually transmitted diseases such as HIV/AIDS.

The cause of this can be traced back to contaminated cutting instruments, hemorrhages requiring blood transfusions, and injurious sexual intercourse causing vaginal tearing and lesions.

Globally, an estimated 200 million girls and women alive today have undergone some form of FGM. In Africa, FGM is practiced in at least 26 of 43 African countries, with prevalence rates ranging from 98 percent in Somalia to 5 percent in Zaire.

The buy-in of African political leadership is crucial if this latest move is to succeed, with up to 140 million women and girls in sub-Saharan Africa who’ve been forced to submit to the practice of cutting their genitals. The aim is to influence people on the ground as well as effect legislation banning the practice.

The procedure intentionally alters or injures a girl or woman’s organs for non-medical reasons. There are no health benefits in the process and it can cause severe bleeding, problems urinating, cysts, infections and a host of childbirth complications.

There are four types of genital mutilation. Type 1 is a clitoridectomy which is where the clitoris is cut out. Type 2 is known as excision which is the totally removal of the clitoris and inner folds of the vulva. Type 3 is infibulation, which is the tightening of a a vaginal opening while, Type 4 is all other harmful procedures which includes piercing, cauterising, scraping and stitching the vagina.

The PAP also agreed to work with the UNFPA in seeking to overturn the practice of marrying off children under the age of sixteen.

In June, the UNFPA worked with Southern African Development Community Parliamentary Forum representatives at a meeting in Swaziland which voted through a Model Law on eradicating child marriage.

Coulson said moves such as these seen in SADC are beginning to show tangible results.

“Girls and women of Africa need your support to end female genital mutilation. We need to act now. All it requires is our engagement, passion and dedication to uphold the human rights of women and girls,” she told attendees at the workshop.

Now the PAP has setup a working group which will oversee the moves towards a similar law. The areas of priority include laws and legislation, engaging the community, mobilising resources, advocacy and implementing the plan at regional and national levels.

Dang also called on men to step up and join the fight against FGM, saying, “We have double responsibility to defend girls against this human rights violation.”

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.

Melody Kemp/IPS

By Lyndal Rowlands
UNITED NATIONS, Jul 7 2016 (IPS)

From forced sterilisation to sexual abuse, young women and men with disabilities are much more likely to have their sexual and reproductive health rights violated than other people.

However despite the increased risks they face, young people with disabilities are also much less likely to get the sexual health education that they need.

Sometimes this is because well-meaning caregivers fail to realise the sexual desires and needs of people with disabilities, Malin Kvitvaer who works for the Swedish Association for Sexuality Education (RFSU) told IPS.

“They see only the deafness and forget that there is a young person there too,” said Kvitvaer who works on a special project aimed at improving sexual education in sign language and is herself deaf.

Parents and caregivers can forget that young people with disabilities also have questions about their bodies and thinks about sex, just like any other teenager, said Kvitvaer.

Even where young people with disabilities do have access to sexual health education, it can be incomplete or inadequate due to access barriers, Kvitvaer added.

“There are many instances where the teacher, not being fluent in sign language, does not know how to teach sexuality education in sign language and either teaches a very compromised version, or skips it altogether,” she said.

Communication barriers can have an even greater impact, when abusers take advantage of the fact that it is harder for young Deaf people to report abuse.

“In the history of the Deaf community there is a history of young Deaf girls – boys too, but mostly girls – who were subjected to sexual abuse by the adult men around them, such as teachers, Deaf priests and so on.”

“Many times they also knew that the girls’ families did not speak Sign language and so they wouldn’t be able to tell (their families) about the abuse,” said Kvitvaer who was also the Swedish youth delegate to the United Nations in 2011.

We Decide, a new initiative launched last month by the UN Population Fund (UNFPA) aims to address the gaps in sexual and reproductive health services, education and information which disproportionately effect young people with disabilities.

Leyla Sharafi. Gender and youth specialist at UNFPA told IPS that adolescents and youth around the world struggle to access appropriate sexual and reproductive health services and that for young people with disabilities the barriers are even greater.

“Young people with disabilities are at higher risk of experiencing sexual violence and face greater barriers when accessing sexual and reproductive health services and education,” Sharafi told IPS.

“UNFPA and the We Decide program is advocating that all young people with disabilities enjoy their human rights, including living a life free of violence and discrimination.”

Sharafi added that the program was designed in collaboration with young people with disabilities, taking into consideration their wants and needs.

To this end, Kvitvaer notes that sexual education should not just focus on the negative aspects of sex, but also the positive aspects.

“I also think it is important to not only focus on problems that sex can cause – such as unwanted pregnancies, STDs, but also that sex is a good thing when consensual and that is just as ok to want to have sex, as it is to not want to have sex.”

This week marks the 10-year anniversary of the UN Convention on the Rights of Persons with Disabilities (CRPD) which Sharafi notes “is one of the only conventions that explicitly talks about access to sexual and reproductive health.”

CS Sicily Kariuki visits a maternity center at Kilifi Hospital supported by UNFPA Kenya. Photo Credit: @unfpaken

By Sicily K. Kariuki, CBS and Siddharth Chatterjee
KILIFI COUNTY, Kenya , Jul 1 2016 (IPS)

The Ministry of Public Service, Youth and Gender Affairs in partnership with the United Nations Population Fund (UNFPA) is establishing and strengthening sexual and gender based violence (SGBV) recovery centres in the country. One such center was launched at the Kilifi County Hospital on 01 July 2016 in collaboration with the Kilifi County Government.

It must rank as among the most confounding realities that SGBV, though acknowledged globally as one of the most pervasive violations of human rights in the world, is also one of the least prosecuted crimes.

It is a crime that cuts across all races, income-levels and religions and it continues to be largely visited upon one half of humanity.

When four in every ten women in Kenya have suffered one form of violence or another from a close partner, it must be clear that the silence on violence against women and children must end now.  It is the time to stop seeing SGBV as an issue for gender activists, but as a prerequisite for sustainable development.

Evidence abounds about the tremendous wide-ranging effects of violence against women and children. These are effects that remain not only with individual women and children directly violated, but they can pass from one generation to another.

When four in every ten women in Kenya have suffered one form of violence or another from a close partner, it must be clear that the silence on violence against women and children must end now
Violence against women and girls is an extreme manifestation of gender inequality and systemic gender-based discrimination. The right of women and children to live free of violence depends on the protection of their human rights and a strong chain of justice.

The patriarchal system in many parts of the world combined with absence of rights at the household level have made women and girls vulnerable to sexual, physical, emotional, spiritual, and intellectual violence.

These dated attitudes manifest themselves though practices such as child marriage, female genital mutilation, wife inheritance and disinheritance of women and girls.  They are pervasive attitudes that have propagated the false paradigm that women are mere chattels, fated to rank second to men and boys.

Kenya has enacted various laws related to on violence against women.  These include the Sexual Offences Act (2007), the FGM Act (2011) and the National Policy towards Prevention and Response to SGBV (2014).  Considerable programmes have been established for facilitating enforcement of those laws.

As much as punishment of crimes is crucial, other programmes must be put in place, especially towards victim support.

Survivors of sexual violence such as rape must for instance have rapid access to a health clinic that can administer emergency medical care, including treatment to prevent HIV and unintended pregnancies and counseling. A woman who is beaten by her husband must have someplace to go with her children to enjoy safety, sanity and shelter.

Victims of violence must have confidence that when they file reports with the police report, she will receive non-accusatory justice and the perpetrator will be punished.

Despite initial challenges, considerable momentum has gathered towards putting the above in place, not only be large agencies and government, but also by grassroots players.  It is extremely heartening for instance to hear of groups of women such as Komeni group, who are taking leadership towards the elimination of child marriage in Pokot. Through their merry-go-round club, they have put up a shelter for girls escaping from forced early marriage and are collaborating with the local administration to arrest and prosecute offenders.

The clarion call is for more hands to be put on deck.  The Ministry is keen to work with such community initiatives and to provide national leadership in coordination of the SGBV programme.  This includes the comprehensive 5P approach; Prevention, Protection, Prosecution, Programming and Partnership, that will facilitate the achievement of Gender Equality (SDG 5).

Some of the key issues highlighted in the 5P are awareness creation in communities on SGBV, hotlines for survivors to report, and the establishment of SGBV Centers for survivors and survivors’ protection through prosecution of perpetrators.

The launch of these centres will help to link the community, hospitals and the different sectors that offer SGBV response services such as legal, psychosocial and security.

Going forward, the longer term view must obtain if the country is to begin to defang the structural drivers of gender violence.  The status of women’s health, their participation in the economy and their education levels must be priority in the development agenda.  Where gender gaps in these areas prevail, women will always be subjected to violence.

The entire gamut of development actors must now come together to ensure that every home is safe and free of every form of violence.

This is the only way to ensure truly sustainable peace and progress in which everyone of us has a stake.

Let’s speak out loudly and call for an end to the scourge of sexual and gender based violence.

Excerpt:

Two women selling fruit, grains and vegetables in the Little Haiti street market in Santo Domingo, the capital of the Dominican Republic. They allowed their picture to be taken but preferred not to talk about their situation. Fear is part of daily life for Haitian immigrants in this country. Credit: Dionny Matos/IPS

By Ivet González
SANTO DOMINGO, Feb 5 2016 (IPS)

A middle-aged woman arranges bouquets of yellow roses in a street market in Little Haiti, a slum neighbourhood in the capital of the Dominican Republic. “I don’t want to talk, don’t take photos,” she tells IPS, standing next to a little girl who appears to be her daughter.

Other vendors at the stalls in the street market, all of them black women, also refuse to talk. “They’re afraid because they think they’ll be deported,” one woman whispers, as she stirs a pot of soup on a wood fire on the sidewalk.

That fear was heightened by the last wave of deportations, which formed part of the complicated migration relations between this country and Haiti – the poorest country in the Americas, with a black population – which share the island of Hispaniola.

According to official figures, the Dominican Republic’s migration authorities deported 15,754 undocumented Haitian immigrants from August 2015 to January 2016, while 113,320, including 23,286 minors, voluntarily returned home.

“This process has a greater impact on women because when a son or a daughter is denied their Dominican identity, the mothers are directly responsible for failing to legalise their status,” said Lilian Dolis, head of the Dominican-Haitian Women’s Movement (MUDHA), a local NGO.

“If the mother is undocumented then the validity of her children’s documents is questioned,” she told IPS.

“And in the case of Haitian immigrant women, it’s not enough to marry a Dominican man even though the constitution grants them their husband’s nationality,” said Dolis, whose movement emerged in 1983. “That right is often violated.”

The latest migration crisis broke out in 2013 when a Constitutional Court ruling set new requirements for acquiring Dominican citizenship.

The aspect that caused an international outcry was the fact that the verdict retroactively denied Dominican nationality to anyone born after 1929 who did not have at least one parent of Dominican blood, even if their births were recorded in the civil registry.

This affected not only the children of immigrants, but their grandchildren and even great-grandchildren.

Tens of thousands of Dominicans of Haitian descent were left in legal limbo or without any nationality, international human rights groups like Human Rights Watch complained.

In response to the international outrage, the Dominican government passed a special law on naturalisation that set a limited period – May 2014 to February 2015 – for people born to undocumented foreign parents between 1929 and 2007 to apply for citizenship.

Antonia Abreu, one of the few street vendors who agreed to talk to IPS about the harsh reality faced by Haitian immigrants in the Dominican Republic, at her street stall where she sells flowers in the Little Haiti neighbourhood in Santo Domingo. Credit: Dionny Matos/IPS

But only 8,755 people managed to register under this law.

At the same time, the authorities implemented a national plan for foreigners to regularise their status, from June 2014 to June 2015.

Under this plan, 288,466 undocumented immigrants, mainly of Haitian descent, applied for residency and work permits. But only about 10,000 met all the requirements, and only a few hundred were granted permits.

Since August, the police have been carrying out continuous raids, and undocumented immigrants are taken to camps along the border, to be deported to Haiti.

“Most Haitian women work outside the home; very few can afford to be homemakers,” said Antonia Abreu, a Haitian-Dominican woman who has sold floral arrangements for parties, gifts and funerals in the Little Haiti market for 40 years.

Abreu, known by her nickname “the Spider”, said “women sell clothes or food, they apply hair extensions, they’re domestic employees and some are sex workers. Many are ‘paleteras’ (street vendors selling candy and cigarettes) who suffer from police abuse – the police take their carts and merchandise when they don’t have documents.”

“Those who work as decent people have integrated in society and contribute to the country,” she told IPS.

Among the unique mix of smells – of spices, open sewers, traditional foods and garbage – many women barely eke out a living in this Haitian neighbourhood market, selling flowers, prepared foods, fruit and vegetables, clothing, household goods and second-hand appliances.

The small neighbourhood, which is close to a busy commercial street and in the middle of the Colonial City, Santo Domingo’s main tourist attraction, has been neglected by the municipal authorities, unlike its thriving neighbours.

No one knows exactly how many people live in Little Haiti, which is a slum but is virtually free of crime, according to both local residents and outsiders.

Most of the people buying at the market stalls in the neighbourhood are Haitian immigrants, who work in what are described by international rights groups as semi-slavery conditions.

The street market is also frequented by non-Haitian Dominicans with low incomes, in this country of 10.6 million people, where 36 percent of the population lives below the poverty line, according to World Bank figures from 2014.

A Haitian immigrant in the rural settlement of Mata Mamón in the Dominican Republic, where she works as a ‘bracera’ or migrant worker in agriculture. Haitian women who work on plantations in this country are invisible in the statistics as well as in programmes that provide support to rural migrants, activists complain. Credit: Dionny Matos/IPS

“Undocumented immigrants can’t work, study or have a public life,” Dolis said. “They go directly into domestic service or work in the informal sector. And even if they have documents, Haitian-Dominican women are always excluded from social programmes.”

In this country with a deeply sexist culture, women of Haitian descent are victims of exclusion due to a cocktail of xenophobia, racism and gender discrimination, different experts and studies say.

“They are made invisible,” said Dolis. “We don’t even know how many Haitian-Dominican women there are. The census data is not reliable in terms of the Dominican population of Haitian descent, and the UNFPA (United Nations Population Fund) survey is out-of-date.”

The activist was referring to the last available population figures gathered by the National Survey on Immigrants carried out in 2012 by the National Statistics Office with UNFPA support.

At the time, the survey estimated the number of immigrants in the Dominican Republic at 560,000, including 458,000 born in Haiti.

The lack of up-to-date statistics hinders the work of Mudha, which defends the rights of Haitian-Dominican women in four provinces and five municipalities, with an emphasis on sexual and reproductive rights.

The movement is led by a group of 19 women and has 62 local organisers carrying out activities in urban and rural communities, which have reached more than 6,000 women.

Mudha says the Dominican authorities have never recognised the rights of women of Haitian descent. “They’ve always talked about immigration of ‘braceros’ (migrant workers), but never ‘braceras’ – that is, the women who come with their husbands, or come as migrant workers themselves,” Dolis said.

Since the mid-19th century Haitians have worked as braceros in the sugarcane industry, the main engine of the Dominican economy for centuries. But today, they are also employed in large numbers in the construction industry, commerce, manufacturing and hotels.

Edited by Estrella Gutiérrez/Translated by Stephanie Wildes