Thank you for inviting me to participate in this important symposium. It gives me great pleasure being here with you today to discuss and exchange ideas on how to improve women’s and children´s health and lives.
Women´s and children´s health are indeed interlinked. A self-determined woman who has the right and possibility to plan and decide over her life, body and pregnancy will be a strong person and also a healthy mother. When women are healthy and empowered by having access to education, information and reproductive health services we see the positive effect also on children´s health, particularly for the newborn child.
Now, what have we learnt so far at a global level when it comes to women´s health, needs and rights? Let me elaborate on three things in this speech:
- What does the world look like for women and girls today?
- What have the world´s leaders agreed to do so far?
- What needs to be done beyond 2015?
If we have a look at women´s access to reproductive health around the world, the maternal mortality rate is finally dropping, due to all the great global and national efforts that have been carried out the last couple of years. This proves we are on the right track.
Maternal mortality as a consequence of the political resistance against gender equality
But at the same time, changes are uneven and too slow. You all know the hard statistics. Over 350.000 women still die every year in pregnancy and childbirth. 99 % of these deaths occur in the developing world, despite the fact that almost all deaths are preventable. Pregnancy related complications are also the most common causes of death for 15-19 year old females.
This is simply unacceptable. Maternal mortality is not an incurable disease - it is a tragic receipt of the failure of a state that has ignored to respond properly to women´s and girl´s health needs. It is a sign of the lack of political will and determination to find solutions to increase access to sexual and reproductive health services, including skilled birth attendants.
Maternal mortality is also a consequence of the political resistance against women´s empowerment and gender equality. Women and girls are too often denied equal access to education and health, which leads to severe and fatal consequences, particularly for teenage girls.
The lack of financial resources is not always the biggest problem. I would like to say that it is rather the continuous discrimination of women and girls and the denial of their rights that keep preventable maternal mortality at an unacceptable high level. Women and adolescent girls are deprived of their rights and even hindered, to have access to comprehensive sexuality education or family planning. This strongly impairs their ability to plan their lives, prevent unwanted pregnancies and determine their own future.
Today, more than 220 million women who want to avoid unwanted pregnancies, lack access to voluntary family planning, even though evidence shows that maternal mortality would drop by 25-35%, if the unmet need for contraceptives was met.
Lack of access to sexual and reproductive health
As many as 8-25% of girls in some sub-Saharan African countries drop out of school, due to unplanned and unwanted pregnancies, and the lack of access to sexual and reproductive health services and information. This needs to change. We now also have the largest generation of young people ever, 1.8 billion youth - and their needs and rights cannot continue being ignored. It is central to remove the barriers that keep girls out of school, and that later on also keep women out of the labour market. If we don’t do that, we will never achieve women´s empowerment and gender equality, which is key also to successfully improve health and achieve poverty eradication, both at the individual and societal level.
Gender based discrimination and violence against women and girls are other impeding factors. We see far too many examples of countries that are denying women and girls their basic human rights. In Morocco for instance, girls and women that are victims of rape are forced to marry their perpetrators, who are then freed from their crime.
In other countries, such as Nicaragua, we see the fatal effects of the criminalization and total ban on abortion, where women are bleeding to death because they are denied medical care when they have life threatening pregnancy complications. Why? Because saving a pregnant woman´s life at the cost of the fetus, is now a crime in Nicaragua. So what happens in practice? Of course both the mother and child die.
One would think that these examples are picked from another century, but unfortunately they are even new governmental initiatives from these last couple of years. So where is the world heading? Development is not always going forward, that is clear. What is also clear is that we need to strengthen women and girls rights, in order also to strengthen their health and wellbeing.
Cairo Conference on Population and Development: Time to measure the results
So what have the world´s leaders agreed to do, to achieve universal access to reproductive health?
The Cairo Conference on Population and Development (ICPD) held in 1994, managed to put the emphasis on the respect for human rights, as essential to improving the lives of individuals. The ICPD plan of action was adopted by 179 governments. Delegates from all regions and cultures agreed already 20 years ago, that reproductive health is a basic human right and that the empowerment of women is key to improving the quality of life for everyone.
Three quantitative goals were set up to be achieved by 2015:
- The reduction of infant, child and maternal mortality.
- The provision of universal access to education, particularly for girls.
- The provision of universal access to a full range of reproductive health services, including family planning.
These goals were also reinforced in the Millennium Development Goals that were formulated in 2000, particularly in MDG5 on maternal health. The ICPD goals are also essential for meeting the other MDGs to reduce poverty, hunger, disease and to achieve gender equality by 2015.
Now, it is time to measure the results and assess how the leaders of the world are fulfilling their commitments. It comes as no surprise unfortunately that MDG5 - to reduce maternal mortality by 75% and achieve universal access to reproductive health by 2015, is the one MDG lagging most behind. Once more, the discrimination and unequal access to health and rights for women and girls linger on. Why that is still the case? Why is it that these questions, particularly around women´s health and rights, are not prioritized?
Several important regional and global initiatives have been launched though to come to terms with this gap. The Muskoka initiative, Every woman Every child, FP2020, to mention a few. The know-how expertise and also a strengthened financial support are in place, but are governments doing what they should do? Are they really fulfilling their commitments to improve women and girls health and rights?
It is time to deliver results and hold governments to account for not implementing the Cairo plan of action and not achieving the MDG5. The countdown to 2015 is on. The opportunity is now, to take a step forward in development and meet the unmet needs of women and girls, by respecting and implementing their human rights. We are at a crucial cross road to evaluate what is missing in the MDGs and what needs to be done to meet the goals, particularly those goals that are lagging behind.
What will happen after the deadline of 2015? And what can we do better?
There are intense global discussions going on right now what the future goals for development will look like beyond 2015. Following up on the Rio+20 meeting this year on Sustainable Development, the current idea is to integrate the old MDG framework and merge it into a new framework that would also include specific global sustainable development goals. These goals would be based on the three pillars of sustainable development from an economic, social and environmental perspective. Social inclusion, equity, human rights and inclusive economic growth are concepts that keep coming back in the discussions on how to finally eradicate poverty and achieve a sustainable development. Here it will be crucial to see holistically how the different goals are interlinked, to be successful in achieving the future goals. We all know that investment in maternal health care and family planning also is highly cost effective in terms of poverty reduction. Every dollar spent on family planning, for instance, saves at least 4 US-$ that would otherwise be spent treating complications from unwanted and unintended pregnancies.
The UN system task team on Sustainable development, points out clearly in their report “The future we want for all” to the Secretary General, that the empowerment of women and girls and the protection of their rights, should be center-pieces of the post 2015 agenda. This is crucial to eradicate poverty and reach a sustainable development.
However, we know that gender equality and women´s empowerment will not happen if women and girls are denied their right to sexual and reproductive health services. How can women be empowered, if they are denied even having the power to decide over their own lives and bodies?
This is why it is so important to integrate the goal, core messages and key recommendations of the ICDP Plan of Action into the new framework. We cannot fail women and girls this time around. To become strong voices and advocate for the advancement of MDG5 and women and girls rights, we need to establish strong collaborations with likeminded countries and organizations that are also fighting to improve women´s health and lives.
At my organization RFSU, we do it together with our excellent Swiss colleagues from Santé Sexuelle and 15 other leading European organizations in the consortium called Countdown2015Europe, which are campaigning for universal access to reproductive health. We are strongly convinced that sexual and reproductive health and right are part of the solution, and not only part of the problem. Healthy, educated and empowered women and girls, men and boys - will be agents of change for a social, economic and environmentally sustainable development.
We firmly believe that the new development framework has to include concrete goals and targets to finally achieve MDG5 and in particular achieve universal access to sexual and reproductive health, as set out in the Cairo Plan of Action. For poverty alleviation to be inclusive and sustainable, gender disparities in education, early and forced marriage and unwanted teenage pregnancies, need to be addressed as matters of priority.
The new framework also need to have clear targets and goals to reduce gender based violence, discrimination and violations of human rights, to achieve the goals of gender equality and women´s empowerment. Strong accountability mechanisms and human rights institutions will be crucial to include, ensuring that the human rights perspective will be implemented in practice this time around.
The political reality of today is that resistance is unfortunately growing strong when it comes to acknowledging gender equality and women´s needs and rights. That is why it becomes so crucial to join efforts. Switzerland can be an important actor to stand up for women and children´s health and right onwards. I very much look forward to continuing these discussions with you. We can indeed improve the health and rights of women, girls and children, if we do it together.
*Ann Svensén is a communications specialist with 25 years of experience in strategic communication, policy advocacy, resource mobilization, branding and CSR. She has 23 years’ experience within the area of Sexual and Reproductive Health and Rights. She is the Director of External Relations in RFSU, the Swedish member association to International Planned Parenthood Federation, IPPF. She is currently on the Board of Directors to the Guttmacher Institute. Contact: ann.svensen@rfsu.se
