Peruvian Women Still Denied Their Right to Abortion

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Women’s Health

Yomira Cuadros faced motherhood at an early age, as well as the obstacles of a sexist society like Peru’s, regarding her reproductive decisions. In the apartment where she lives with her family in Lima, she expresses faith in the future, now that she has finally started attending university, after having two children as a result of unplanned pregnancies. CREDIT: Mariela Jara/IPS

Yomira Cuadros faced motherhood at an early age, as well as the obstacles of a sexist society like Peru’s, regarding her reproductive decisions. In the apartment where she lives with her family in Lima, she expresses faith in the future, now that she has finally started attending university, after having two children as a result of unplanned pregnancies. CREDIT: Mariela Jara/IPS

LIMA, Nov 18 2022 (IPS) – No woman in Peru should have to die, have her physical or mental health affected, be treated as a criminal or have an unwanted pregnancy because she does not have access to abortion, said Dr. Rocío Gutiérrez, an obstetrician who is the deputy director of the Manuela Ramos Movement, a non-governmental feminist center that works for gender rights in this South American country.

In this Andean nation of 33 million people, abortion is illegal even in cases of rape or fetal malformation. It is only legal for two therapeutic reasons: to save the life of the pregnant woman or to prevent a serious and permanent health problem.

Peru thus goes against the current of the advances achieved by the “green wave”. Green is the color that symbolizes the changes that the women’s rights movement has achieved in the legislation of neighboring countries such as Uruguay, Colombia, Argentina and some states in Mexico, where early abortion has been decriminalized. These countries have joined the ranks of Cuba, where it has been legal for decades.

“I didn’t tell my parents because they are very Catholic and would have forced me to go through with the pregnancy, they always instilled in me that abortion was a bad thing. But I started to think about how pregnancy would change my life and I didn’t feel capable of raising a child at that moment.” — Fatima Guevara

But Latin America remains one of the most punitive regions in terms of abortion, with several countries that do not recognize women’s right to make decisions about their pregnancies under any circumstances. In El Salvador, Honduras, Nicaragua, the Dominican Republic and Haiti it is illegal under all circumstances, and in some cases draconian penalties are handed down.

In the case of Costa Rica, Guatemala, Peru and Venezuela, meanwhile, abortion is allowed under very few conditions, while there are more circumstances under which it is legal in Bolivia, Brazil, Chile and Ecuador.

“In Peru an estimated 50,000 women a year are treated for abortion-related complications in public health facilities,” Dr. Gutiérrez told IPS. “This is not the total number of abortions in the country, but rather the number of women who reach public health services due to emergencies or complications.”

The obstetrician spoke to IPS from Buenos Aires, where she participated in the XV Regional Conference on Women, held Nov. 7-11 in the Argentine capital.

Gutiérrez explained that the cases attended are just the tip of the iceberg, because for every abortion complicated by hemorrhage or infection treated at a health center, at least seven have been performed that did not present difficulties.

Multiplying by seven the 50,000 cases treated due to complications provides the shocking figure of 350,000 unsafe clandestine abortions performed annually in Peru.

The doctor regretted the lack of official statistics about a phenomenon that affects the lives and rights of women “irreversibly, with damage to health, and death.”

Gutiérrez said that another of the major impacts is the criminalization of women who undergo abortions, due to mistreatment by health personnel who not only judge and blame them, but also report them to the police.

Obstetrician Rocío Gutiérrez (C), deputy director of the feminist Manuela Ramos Movement, stands with two fellow activists holding green scarves – representing the struggle for reproductive rights - during the XV Regional Conference on Women held this month in the city of Buenos Aires. CREDIT: Courtesy of Rocío Gutiérrez

Obstetrician Rocío Gutiérrez (C), deputy director of the feminist Manuela Ramos Movement, stands with two fellow activists holding green scarves – representing the struggle for reproductive rights – during the XV Regional Conference on Women held this month in the city of Buenos Aires. CREDIT: Courtesy of Rocío Gutiérrez

Under article 30 of Peru’s General Health Law, No. 26842, a physician who attends a case of presumed illegal abortion is required to file a police report.

Gutiérrez also referred to the fact that unwanted pregnancies have numerous consequences for the lives of women, especially girls and adolescents, in a sexist country like Peru, where women often do not have the right to make decisions on their sexuality and reproductive health.

Healing the wounds of unwanted motherhood

By the age of 19, Yomira Cuadros was already the mother of two children. She did not plan either of the pregnancies and only went ahead with them because of pressure from her partner.

In 2020, according to official data, 8.3 percent of adolescents between the ages of 15 and 19 were already mothers or had become pregnant in Peru.

Cuadros, whose parents are both physicians and who lives in a middle-class family, said she never imagined that her life would turn out so differently than what she had planned.

“The first time was because I didn’t know about contraceptives, I was 17 years old. The second time the birth control method failed and I thought about getting an abortion, but I couldn’t do it,” Cuadros told IPS.

At the time, she was in a relationship with an older boyfriend on whom she felt very emotionally dependent. “I had made a decision (to terminate the pregnancy), but he didn’t want to, he told me not to, the pressure was like blackmail and out of fear I went ahead with the pregnancy,” she said.

Making that decision under coercion hurt her mental health. Today, at the age of 26, she reflects on the importance of women being guaranteed the conditions to freely decide whether they want to be mothers or not.

Peruvian activists go topless to demand the right to legal abortion, during a demonstration in the streets of the capital on Mar. 8, 2018. CREDIT: Mariela Jara/IPS

Peruvian activists go topless to demand the right to legal abortion, during a demonstration in the streets of the capital on Mar. 8, 2018. CREDIT: Mariela Jara/IPS

In her case, although she had the support of her mother to get a safe abortion, the power of her then-partner over her was stronger.

“Becoming a mother when you haven’t planned to is a shock, you feel so alone, it is very difficult. I didn’t feel that motherhood was something beautiful and I didn’t want to experience the same thing with my second pregnancy, so I considered terminating it,” she said.

Finding herself in that unwanted situation, she fell into a deep depression and was on medication, and is still in therapy today.

“I went from being a teenager to an adult with responsibilities that I never imagined. It’s as if I have never really gone through the proper mourning process because of everything I had to take on, and I know that it will continue to affect me because I will never stop being a mother,” she said.

She clarified that “it’s not that I don’t want to be a mother or that I hate my children,” and added that “as I continue to learn to cope, I will get better, it’s just that it wasn’t the right time.”

She and her two children, ages nine and seven, live with her parents and brother in an apartment in the municipality of Pueblo Libre, in the Peruvian capital. She has enrolled at university to study psychology and accepts the fact that she will only see her dreams come true little by little.

“Things are not how I thought they would be, but it’s okay,” she remarked with a newfound confidence that she is proud of.

Gutiérrez said more than 60 percent of women in Peru have an unplanned pregnancy at some point in their lives, and argued that the government’s family planning policies fall far short.

The National Institute of Statistics and Informatics reported that the total fertility rate in Peru in 2021 would have been 1.3 children on average if all unwanted births had been prevented, compared to the actual rate of 2.0 children – almost 54 percent higher than the desired fertility rate.

“There are a set of factors that lead to unwanted pregnancies, such as the lack of comprehensive sex education in schools, and the lack of birth control methods and timely family planning for women in all their diversity, which worsened during the pandemic. And of course, the correlate is access to legal and safe abortion,” said Gutiérrez.

She lamented that little or no progress has been made in Peru in relation to the exercise of sexual and reproductive rights, including access to safe and free legal abortion, despite the struggle of feminist organizations and movements in the country that have been demanding decriminalization in cases of rape, artificial insemination without consent, non-consensual egg transfer, or malformations incompatible with life.

University student Fátima Guevara decided to terminate an unwanted pregnancy when she was 19 years old. Four years later, she is sure that it was the right decision, in terms of her plans for her life. The young woman told her story at a friend's home, where she was able to talk about it openly, in Lima, Peru. CREDIT: Mariela Jara/IPS

University student Fátima Guevara decided to terminate an unwanted pregnancy when she was 19 years old. Four years later, she is sure that it was the right decision, in terms of her plans for her life. The young woman told her story at a friend’s home, where she was able to talk about it openly, in Lima, Peru. CREDIT: Mariela Jara/IPS

The obscurity of illegal abortion

The obscurity surrounding abortion led Fátima Guevara, when she faced an unwanted pregnancy at the age of 19, to decide to use Misoprostol, a safe medication that is included in the methods accepted by the World Health Organization for the termination of pregnancies.

“I didn’t tell my parents because they are very Catholic and would have forced me to go through with the pregnancy, they always instilled in me that abortion was a bad thing. But I started to think about how pregnancy would change my life and I didn’t feel capable of raising a child at that moment,” she told IPS in a meeting at a friend’s home in Lima.

She said that she and her partner lacked adequate information and obtained the medication through a third party, but that she used it incorrectly. She turned to her brother who took her to have an ultrasound first. “Hearing the fetal heartbeat shook me, it made me feel guilty, but I followed through with my decision,” she added.

After receiving proper instructions, she was able to complete the abortion. And today, at the age of 23, about to finish her psychology degree, she has no doubt that it was the right thing to do.

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How Collective Action Can Move the Needle on Gender Equality

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Active Citizens, Conferences, Development & Aid, Education, Gender, Global, Headlines, Health, Human Rights, TerraViva United Nations, Women & Climate Change, Women’s Health

Opinion

Delegates take a group photo at the Young Leaders & Alumni Workshop at the Women Deliver 2019 Conference in Vancouver, Canada. Credit: Isabella Sarmiento

NEW YORK, Mar 18 2022 (IPS) – During this year’s sixty-sixth session of the Commission on the Status of Women (CSW66), we are eager to see the global community pivot towards more inclusive approaches to advocacy. It’s imperative to put the spotlight on women’s rights and youth-led organizations in communities that are often left out of key discussions. By handing the mic over to advocates across all backgrounds and ages, we can shift to a model that enables all advocates to take a lead role in policy-making and ultimately translate promises and rhetoric into real impact and accountability.

Since the emergence of the COVID-19 pandemic, the ways that the global community works together to push for inclusive progress toward gender equality — progress that fully and effectively engages and equally benefits everyone — are fundamentally changing. Private conversations between the organizations and people with the resources and privilege to access the halls of power have given way to hybrid events and videoconferences that are open to a more diverse, intergenerational set of stakeholders than ever before. This significant shift began to open the doors to more inclusive partnerships.

Also, during these past two years, a global reckoning called on us all to meaningfully transform our advocacy, practices, and programs. International development organizations, including our own, took a long, overdue look in the mirror, and in some cases, began the deep learning and unlearning needed to acknowledge the persistent power imbalances that plague our sector at large. It’s a first step in living up to the values of equity and inclusion — not just on paper, but in practice.

As the world as we know it changed, we were hard at work changing, too. We began actively leveraging our power and influence more intentionally than ever before to center the work and expertise of women’s rights and youth-led organizations in low- and middle-income countries (LMICs). Now, we are digging deeper to find and use new tools that enable advocates to co-create and co-lead by themselves so that our work and the Women Deliver 2023 Conference (WD2023) is more inclusive, diverse, consultative, and accessible than ever before.

Young gender equality advocates kick off the Youth Zone at the Women Deliver 2019 Conference in Vancouver, Canada. Credit: This Is It Studios

In “calling us in” and championing our ability to foster more inclusive partnerships across all of our programs, we are taking action to effectively and authentically advocate for, with, and alongside girls and women everywhere, in all their intersecting identities, to catalyze lasting progress on gender equality.

Transforming ourselves is of course a continuous process. Each day, we are learning to do better and to be better. We hope that our key learnings, below, can support our development colleagues, wherever they find themselves on their journey.

1. Accessibility and inclusion must lead the way — in-person and virtually.

    According to expert studies, organizations and individuals from LMICs are often under-represented at global health convenings. From day one, it’s urgent to intentionally engage those who have historically been excluded. In planning WD2023, we have leveraged the lessons of the past two years and from prior Women Deliver Conferences. We used an open application to select one-third of our Conference Advisory Group — a diverse panel with a balance of technical expertise. Our advisors represent 30 organizations — 10 individuals are from youth or youth-led organizations and 35 are from LMICs. We have done this to ensure that the Conference is co-created from the start by organizations and individuals representing the intersectional identities of the girls and women we work with and for.

    We meet regularly via videoconference with our Advisory Group to co-create the Conference’s Global Dialogue, theme, programming, and more, with support from social impact design experts at IDEO.org. IDEO also supports us as we carry out targeted discussions with specific stakeholder groups, including Women Deliver Young Leaders and Alumni, Deliver for Good Country Coalitions, and Conference Sponsors and Funders.

    In planning how to shape the dialogue, foster collaboration, and drive collective action before, during, and after the Conference, we’re working with our partners to ensure that all Conference advocacy spaces, be they digital or physical, are accessible to all. This includes low-bandwidth options, closed captioning, interpretation in multiple languages, and International Sign Language. On-site, we will also provide trauma-informed specialists, breastfeeding/nursing stations, child safeguarding support, and mental health specialists.

Mme Safiétou Diop, President of Réseau Siggil Jigeen speaking at a press conference during the launch of the Deliver for Good Senegal Campaign in Dakar, Senegal in 2019.

2. Move from meaningful youth engagement to co-leadership and intergenerational action.

    It’s time to follow the lead of young people, shift away from top-down approaches, and actively provide resources for robust youth co-leadership. According to global consensus, young people have a fundamental right to actively and meaningfully engage in all matters that affect their lives. For international development organizations, this means offering space, support, and compensation that youth need and deserve to co-create a more-gender equal future — a future from which they have the most to gain and to lose.

    We created the 14-person Young Leaders Program Alumni Committee, with an honorarium for their valuable expertise, to advise us on strategy and implementation of the Young Leaders Program and ideate youth co-creation opportunities. This committee provides invaluable guidance to ensure the Young Leaders Program models meaningful youth engagement and co-leadership, and effectively meets the needs of Young Leaders on the ground.

    Women Deliver also hosts Multi-Country Workshops to foster capacity strengthening, knowledge sharing, and coordinated advocacy on sexual and reproductive health and rights (SRHR) and gender equality. Starting in 2021, these workshops are now designed and led by a Young Leader Planning Committee representing the regions where the workshops take place. They are in the driver’s seat as they craft workshop content and programming, while Women Deliver provides logistical support and the virtual space to gather. This co-created process has led to more targeted — and impactful — workshops that cater to Young Leaders’ specific needs and build capacity in the issue areas where it’s most needed.

Delegates taking a group photo on stage at the Deliver for Good Campaign side event “Leveraging National Movements for Global Change” at the Women Deliver 2019 Conference in Vancouver, Canada.

3. Elevate diverse voices and support organizations working on the ground.

    Incusion and participation have to be integrated into the mission of development work, not a one-off tactic or strategy. Diverse, resilient feminist and women’s rights organizations and movements are – and must always be positioned as – the key drivers of change for gender equality and women’s rights across the globe.

    Over the past two years, we have stepped back to shift power across every aspect of our organization’s activities, policies, programs, and behaviors, into the hands of the youth and women’s rights groups most impacted by our work. For example, in 2020, in partnership with Girl Effect, as well as with young people themselves, we worked to understand how youth in India, Malawi, and Rwanda use digital platforms to learn about their sexual and reproductive health (SRHR). This project was designed and executed by more than 160 adolescent girls and young women, who worked hand in hand with researchers on the ground in India, Malawi, and Rwanda to conduct interviews within their own communities, as well as to design questions, discuss results, and generate recommendations. Moving forward, we must involve girls and women in all aspects of data collection and evidence generation that impacts them. This will ensure that the local knowledge and skills needed to drive sustainable change in their own communities, regions, and countries are an integral part of effective advocacy and decision-making.

    We’re now handing the pen directly to Young Leaders and spotlighting the work of youth-led organizations during key advocacy moments. Last year, the Deliver for Good Campaign organized its first ever Continental Conversation — an idea conceived by partners in Kenya and Senegal — as a way to work together towards gender equality in the region. What was first envisioned as a one-off peer-to-peer sharing opportunity via videoconference became understood as a vital, first-of-its-kind Continental Conversation to bridge divides — some of which had never been crossed. Together, the Campaign’s country partners shared their own experiences, lessons, challenges, and successes in advancing gender equality, laying the groundwork for a cross-regional peer-to-peer learning model with the power to accelerate progress on girls’ and women’s health and rights in Kenya, in Senegal, and around the world.

    Over the past year, we have also co-convened multi-sectoral coalitions with diverse partners representing the intersectional identities of girls and women. For example, as part of the SRHR & Climate Justice Coalition, we’re working on collective action and coordinated advocacy in partnership with more than 60 representatives from a wide range of civil society organizations. The Coalition is working to advance SRHR and gender equality in the context of climate change from an intersectional and climate justice approach.

    The Coalition emerged from the need to break down silos between the SRHR and Climate Justice organizations and movements, facilitate knowledge sharing, jointly mobilize, and amplify the voices and priorities of grassroots organizations. These organizations are led by girls and women, the LGBTQIA+ community, and Indigenous people from LMICs, particularly those most affected by climate change and without continuous access to high-quality SRH services. The Coalition is currently raising awareness of the interlinkages of SRHR and climate change in order to ensure SRHR is a key part of climate change conversations and action strategies ahead of key policy moments, such as CSW66 and COP27.

4. Collect and present data that accurately represents the diverse needs of all girls and women.

    Sustainable progress — and lasting change — will take all of us. Over the past two years, we’ve focused on connecting advocates working across different issue areas and collecting gender-disaggregated data. The data is broken down into the many factors that shape people’s lives, including race and ethnicity, sexual orientation, disability status, and socioeconomic class in order to drive collective action, the mainstay of transformative change. We also need to engage with data scientists from regions most impacted by this research.

    Last year, we partnered with Focus 2030 to carry out a survey of 17 countries on six continents — representing half of the world’s population. An overwhelming majority said they support gender equality, believe that women should be fully engaged in charting our path forward, and expect leaders – political and in business – to take meaningful action to bridge the gender divide. In centering the voices of citizens, we were able to effectively advocate for bigger, bolder commitments by governments and the private sector, ahead of the Generation Equality Forum.

As Women Deliver evolves and grows, we will continue to call upon our partners and funders, including in the private sector, to ensure that the international development world champions and secures robust, feminist funding and resources for women’s rights organizations, youth, and other marginalized communities. We hope you will join us in leveraging the changes set into motion during the pandemic and the global reckoning in our sector. Let’s work together to bridge existing divides and form inclusive partnerships — between countries, sectors, and generations.

The authors are Kathleen Sherwin (CEO/President), Divya Mathew (Director, Policy & Advocacy), Julia Fan (Senior Manager, Youth Engagement), Gretchen Gasteier (Manager, Conference), Rachel Elliott (Senior Associate, Communications) of Women Deliver

IPS UN Bureau

 

Youths Trailblazing Paths in Sexual and Reproductive Health Ahead of ICFP Family Planning Conference

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Youth Thought Leaders

Youth activists Peace Umanah, from Nigeria and Aurelia Naa Adjeley Sowah-Mensah from Ghana ensure that young people are made aware of their Sexual and Reproductive Health Rights. Credit: ICFP

Nairobi, Kenya, Mar 16 2022 (IPS) – Travelling in northern Nigeria, Peace Umanah noticed teenage girls with multiple children – they would be walking with one strapped to their back, holding another by hand and with a protruding belly.

“These were worrisome sights that got me thinking about whether these young girls knew about contraceptive choices or if they were not given information to make beneficial decisions.”

The same question weighed heavily on young Aurelia Naa Adjeley Sowah-Mensah from Ghana, who grew up in a community where teenage pregnancies are common – mirroring the situation in many developing countries.

These questions set the young women on a trailblazing path to change the trajectory of adolescent and teenage pregnancies in their countries.

The pair have joined forces with other young people, world leaders and actors in Sexual and Reproductive Health and Rights (SRHR) to give young people in every corner of the world much-needed tools to navigate their sexuality. They hope to remove SRHR-related challenges to enable young women to benefit from socio-economic growth and development opportunities.

“Through the International Conference on Family Planning (ICFP) Youth Trailblazer Award, young leaders in the field of family planning and SRHR aged 18-35 years old were invited to submit creative short videos that integrate this year’s conference theme,” says Jose G Rimon II, director of the Bill and Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health.

Jose G Rimon II, director of the Bill and Melinda Gates Institute for Population and Reproductive Health at the Johns Hopkins Bloomberg School of Public Health. Credit: ICFP

Rimon II, who is also the chair of ICFP’s International Steering Committee, tells IPS the videos “also highlighted youth perspectives, experiences, and voices in family planning and SRHR”.

The videos reflected the conference’s theme: ‘Universal Health Coverage and Family Planning: Innovate, Collaborate, Accelerate’.

Sowah-Mensah and Umanah were among 50 youth leaders working in family planning and SRHR awarded scholarships to attend ICFP this year in Pattaya City, Thailand, on November 14-17, 2022.

Other award winners include Tanaka Chirombo from Malawi, Alison Hoover from Atlanta, USA, and Muhammad Sarim (Saro) Imram from Pakistan.

Awardees are from countries in Africa, Asia, Europe, North and South America, selected from a pool of more than 300 youth worldwide who applied for the Youth Trailblazer Award. The award recognises youth leadership and innovation in family planning and SRHR.

“Selected youth demonstrated strong ideas and commitment, creative thinking that pushed the field forward and challenged norms, and successfully conveyed a clear and powerful message,” says Rimon II.

Youth Trailblazer Award winners will be integrated throughout the ICFP, the world’s largest scientific conference on family planning and reproductive health, to amplify and highlight the voices of young leaders globally, he adds.

“Awardees will actively participate in planning activities for the ICFP, including integral participation on the ICFP subcommittee(s) of their choice, engagement as speakers and moderators at sessions, as well as other conference engagement opportunities that will magnify the voices, perspectives, and experiences of the youth.”

Youth participation will bring to life ICFP’s stance that countries’ universal health coverage packages should include youth-friendly family planning and SRH products and services.

“As of 2021, the modern contraceptive prevalence rate shows only 17 percent of all women of reproductive age in Nigeria use contraceptives,” Umanah says.

In the absence of youth-friendly services, myths and misconceptions influence young people’s understanding of contraceptives. She says they sometimes use lime, soda, antibiotics, and salt to prevent unplanned pregnancies.

Adolescent and teenage pregnancies are the most pressing issues. Consequences include life-threatening health complications and the risk of missing out on lifelong learning and earning opportunities.

According to government statistics, one in every five girls in Kenya between the ages of 15 to 19 is either pregnant or already a mother. Complications during pregnancy and childbirth are a leading cause of death for 15- to 19-year-old girls in this East African nation.

As a youth champion engaging adolescents and young people, Umanah says the cohort needs safe spaces free of stigma and judgment, where they can find answers and solutions to their SRHR needs.

“For young women and girls, being able to speak up and be heard is critical. Social media tools, such as 9ja Girls Now, gives girls a platform to get connected across distances,” Umanah observes.

“9ja Girls is a Facebook platform and a safe space where girls learn and ask questions about love, life and health and find answers.”

Sowah-Mensah is an SRHR mentor of adolescent girls and young women under the Girl Boss initiative with the Youth Action Movement (YAM) of the Planned Parenthood Association of Ghana.

Without support, Sowah-Mensah says, “some girls exchange sex for food or money, ending up in unplanned pregnancies. To avoid stigma, they turn to unsafe ways (to terminate the pregnancy), such as grinding and consuming glass bottles or drinking a mixture of sugar and alcohol. Some lose their lives.”

A dedicated ICFP Youth Pre-conference will take place November 11-13 to support youth leaders and their programmatic work, advocacy, and research.

Rimon II says youth involvement is the “best way to ensure diverse voices are heard and strategies are developed that are sustainable, inclusive, culturally competent and representative of sexual and reproductive health and rights at the global level.”

SRHR youth experts such as Sowah-Mensah and Umanah agree.

Sowah-Mensah says young people are the demographic majority and a powerful instrument for development because they have many innovative ideas.

“But a large percentage of our leaders are not young and are thus unable to address young people’s most pressing needs for SRHR services. You have one generation making bodily autonomy decisions on behalf of a totally different generation,” she says.

The awardees assert that the status quo must change to achieve a desirable outcome. Umanah says, “In designing solutions to challenges that face adolescent girls and young women, their concerns and voices should be the loudest. They should lead conversations towards desired solutions.”

ICFP is supported by the Bill and Melinda Gates Institute for Population and Reproductive Health at Johns Hopkins University and more than two dozen other public, private, and non-profit sponsors, including the World Health Organization and United Nations Population Fund.

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IPS UN Bureau Report

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Delivering On the Promise of Health For All Must Include Gender Equality and SRHR

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Civil Society, COVID-19, Development & Aid, Gender, Global, Headlines, Health, Human Rights, Humanitarian Emergencies, Inequity, Labour, Poverty & SDGs, TerraViva United Nations, Women’s Health

Opinion

Health workers are at the frontlines in the fight against the new Corona Virus. Credit: John Njoroge

NEW YORK, Sep 29 2021 (IPS) – Gender-responsive universal health coverage (UHC) has the proven potential to transform the health and lives of billions of people, particularly girls and women, in all their intersecting identities. At tomorrow’s kick-off to the 2023 UN High-Level Meeting (HLM) on UHC, Member States and stakeholders will review progress made on the 2019 HLM’s commitments and set a roadmap to achieve UHC by 2030. We, as the co-convening organizations of the Alliance for Gender Equality and UHC, call on Member States to safeguard gender equality and sexual and reproductive health and rights (SRHR) as part of UHC implementation, especially in light of the gendered impacts of the COVID-19 pandemic.

To move forward, it is crucial to remember our cumulative past promises. In 2019, Member States adopted a Political Declaration that contained strong commitments to ensure universal access to SRHR, including family planning; mainstreaming a gender perspective across health systems; and increasing the meaningful representation, engagement, and empowerment of all women in the health workforce. Further, 58 countries put forward a joint statement that argued that investing in SRHR is affordable, cost-saving, and integral for UHC. These commitments were the result of the advocacy and hard work of civil society organizations, including members of the Alliance for Gender Equality and UHC, and set out a clear path on the steps needed to make gender-responsive UHC a reality.

However, following the 2019 HLM, the deadly and devastating COVID-19 pandemic drastically changed how individuals around the globe could access essential health services. Fundamental human rights, including hard-won gains made for UHC, SRHR, and gender equality, are now at risk as health and social services are strained and political attention is diverted. The protracted pandemic underscores how gender-responsive UHC is more important than ever.

We call on Member States to renew the commitments made in 2019 and affirm that delivering on the promise of health for all is only possible by way of gender-responsive UHC.

To truly deliver gender-responsive UHC, we offer the following five recommendations:

1. Design policies and programs with an intersectional lens that places SRHR and girls and women — in all their diversity — at the center of UHC design and implementation. To be effective, UHC must recognize and respond to the needs of women in all their intersecting identities, including by explicitly addressing the ways in which race, ethnicity, age, ability, migrant status, gender identity, sexual orientation, class, and caste multiply risk and impact health outcomes. What’s more, COVID-19 has deepened inequalities for marginalized populations, and special attention is needed, now more than ever, to deliver UHC for those pushed furthest behind.

2. Ensure UHC includes comprehensive SRH services, and provide access to SRH services for all individuals throughout the life course. These services must be free of stigma, discrimination, coercion, and violence, and they must be integrated, high quality, affordable, accessible, and acceptable. The World Health Organization (WHO) provides guidance in the UHC Compendium of interventions and supporting documents for what this can look like. The pandemic has given way to multiple interruptions to SRHR care. For example, an estimated 12 million women may have been unable to access family planning services due to the pandemic. COVID-19 response and recovery and UHC implementation must address these issues.

3. Prioritize, collect, and utilize disaggregated data, especially gender-disaggregated data. UHC policy and planning can only be gender-responsive when informed by data that are disaggregated by gender and other social characteristics. In the current pandemic, not all countries are reporting disaggregated data on infections and mortality from COVID-19 to the WHO, and most countries have not implemented a gendered policy response. In June 2021, only 50% of 199 countries reported data disaggregated by sex on COVID-19 infections and/or deaths in the previous month.1 The number of countries reporting sex-disaggregated statistics has also decreased over the course of the pandemic. Without this information, decision-makers are unable to base policies on evidence affirming how to address the health needs of all genders — a critical lesson for UHC.

4. Foster gender equality in the health and care workforce and catalyze women’s leadership. The approach to the health and care workforce in the pandemic has frequently not applied a gender lens, ignoring the fact that women are 70% of the global health workforce and powerful drivers of health services. Gender inequities in the health workforce were present long before the pandemic, with the majority of female health workers in lower-status, low-paid roles and sectors, often in insecure conditions and facing harassment on a regular basis. Moreover, although women have played a critical role in the pandemic response — from vaccine design to health service delivery — they have been marginalized in leadership on pandemic decision-making from parliamentary to community levels. In fact, 85% of national COVID-19 task forces have majority male membership. Urgent investment in safe, decent, and equal work for women health workers, as well as equal footing for women in leadership and decision-making roles, must be central to the delivery of UHC.

5. Back commitments to advancing SRHR, gender equality, and civil society engagement in UHC design and implementation with necessary funding and accountability. Now is the time to invest in health and the care economy, particularly in UHC. Governments everywhere are facing fiscal constraints from the pandemic. UHC is a critical part of investing in and building back resilient health and social systems to avoid catastrophic spending on future pandemics and global health emergencies. UHC must be designed intentionally, with appropriate accountability mechanisms, to reduce inequalities between and within countries — and especially gender inequality, which undermines social and economic rights and resilience.

We, along with our civil society partners in the Alliance for Gender Equality and UHC, stand ready to work hand-in-hand with governments, the UN, and all stakeholders to act on these recommendations on the road to the 2023 HLM on UHC. At this point in the COVID-19 pandemic, there is no time to waste in making the promise of health for all a reality, and this can only be achieved through gender-responsive UHC that centers gender equality and SRHR.

The authors are Ann Keeling of Women in Global Health, Divya Mathew of Women Deliver, Deepa Venkatachalam of Sama Resource Group for Women and Health, and Chantal Umuhoza of Spectra Rwanda. These four organizations are the co-conveners of the Alliance for Gender Equality and Universal Health Coverage.

1 Global Health 50/50 (globalhealth5050.org)

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South Korea’s Women Fire Back

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Civil Society, Featured, Gender, Gender Violence, Global, Headlines, Human Rights, IPS UN: Inside the Glasshouse, Poverty & SDGs, TerraViva United Nations, Women’s Health

Opinion

UNFPA Executive Director Dr. Natalia Kanem, KOICA President Lee Mikyung and UN Women Executive Director Phumzile Mlambo-Ngcuka (from left) launched a partnership in 2018 that Ms. Lee characterized as “a key foundation and platform for solidarity and collective engagement for gender equality.” The new tripartite agreement– between UNFPA, the Korea International Cooperation Agency (KOICA) and UN Women—has combined the strengths of the three partners to improve the lives of women and girls and accelerate the achievement of gender equality, as expressed in Sustainable Development Goal (SDG) 5.
Credit: UNFPA/Tara Milutis

SEOUL, South Korea, Sep 1 2021 (IPS) – A strong movement of feminism is sweeping South Korea. While women feel empowered to stand their ground, the men are retaliating.

When South Korean archer An San won two gold medals in just two days during the recent Tokyo Olympics, the response the 20-year-old received at home was a mixed. Some men were angered and said her medals should be taken away. Why? Because her short hair was a sign that she was a ‘man-hating’ feminist.

As bizarre and surreal as it may sound, the attack on An is a bleak reminder of the deep-rooted gender stereotypes in the economically advanced, yet deeply sexist South Korea – and the enormous pressure on women and girls to look and act ‘feminine’. It’s also another episode of the escalating culture war between the country’s increasingly outspoken feminists – and antifeminists seeking to silence their voices.

Lowest in the ranks

South Korea is the world’s 10th largest economy, a tech giant that is home to Samsung, the world’s largest smartphone maker, and a cultural powerhouse whose K-pop stars like BTS enjoy global followings. But despite all the economic and technological advances, the deep-seated patriarchy and gender discrimination remained little changed.

South Korea is ranked at the 102nd in the world in terms of gender parity, according to the World Economic Forum. The gender pay gap in the country is the widest among the advanced economies of the OECD member nations.

It has consistently ranked as the worst place to be a working woman in the Economist magazine’s Glass Ceiling Index. Women account for 19 per cent of parliamentary seats, almost on par with North Korea.

Hawon Jung

Women are under enormous pressure to look perfect at all times and all costs – as shown in the country’s reputation as the world’s capital of plastic surgery. On the busy streets of Seoul, it’s not difficult to find plastic surgery adverts screaming ‘being pretty is everything!’ and rail-thin K-pop starlets presented as role models for teenage girls and young women. The stars’ extreme diet regimens are widely shared on social media and avidly followed by many.

Typical beauty ideals in South Korea for women include pale yet glowing skin, a youthful ‘babyface’, long and luminous hair, wide eyes, a thin nose, and pin-thin body (nearly 17 per cent of South Korean women in their 20s are underweight, compared to less than 5 per cent for their male counterparts, according to a study in 2019).

The pressure begins early: more than 40 per cent of female elementary school students wear makeup, and the number goes up to over 70 per cent for middle schoolers.

Escape the Corset

But women started to fight back. A powerful wave of feminist movement has taken the country by storm in recent years, allowing many women to speak up against sexual discrimination, assault, and objectification like never before.

Since 2018, women have rallied together to bring down many sexual predators, including a popular presidential contender, in one of the most successful cases of #MeToo in Asia.

Tens of thousands took to the streets for months in 2018 to call for tougher crackdown on the so-called ‘spycam porn’ crimes that secretly film women in public space from workplaces to public toilets and share the footage on the internet.

They successfully campaigned to end the abortion ban. The so-called ‘Escape the Corset’ movement was part of that awakening, meant to defy the pressure to follow the rigid beauty ideals.

Women and girls who joined the campaign cut their hair short, destroyed their makeup, refused to wear tight, revealing, or uncomfortable clothes to instead opt for something more comfortable and practical. Since then, short hair has become something of a political statement among many young feminists.

The wave of awakening, however, has also drawn a strong pushback by men who thought – like many around the world – that the women had gone too far, and many labelled feminists as ‘man haters’ who should be punished.

More than 40 per cent of female elementary school students wear makeup, and the number goes up to over 70 per cent for middle schoolers.

The backlash has reached a fever pitch since May when members of many online forums popular among men started to cry ‘misandry’ over a adds that use an image of a pinching finger, a universal gesture to indicate something small.

Online crusade

In a campaign likened by many as a McCarthyian witch-hunt, they claimed whoever created the image must be feminists and out to ridicule the size of their genitals. Despite having no possibility of any political plot, many of the accused companies and government institutions – including the national police agency and the defense ministry – bent down quickly, apologized for hurting the men’s feelings and removed the images from their posters.

These online mobs even enjoyed political backing; Lee Jun-Seok, a young member of the rightwing People’s Power Party, rose to prominence by amplifying the conspiracy theory over the ‘misandrist’ finger gesture, and eventually became the leader of the party in July.

Feeling supported by a powerful politician and emboldened by groveling apologies from companies and the government, the online mobs moved on to their next target—the star Olympian whose appearance didn’t fit into their ideal of traditional femininity.

‘Why did you cut your hair?’ An was asked on her social media, to which she replied, ‘’coz it’s convenient’. The answer was not enough.

A campaign to extract an apology from An for being a feminist began, with some even demanding that the Korea Archery Association take away the gold medals from the ‘man hater’.

But women fought back again. Lawmakers, activists, entertainers, and thousands of ordinary women rallied behind An, many sharing the photos of their short hair on social media as a show of support.

And as the cyber-bullying targeting An raged on, many women across the country watched as An won yet another gold – becoming the first archer in Olympic history to win three golds at a single Game.

Hawon Jung is a journalist and former Seoul correspondent for the AFP news agency. She is the author of ‘Flowers of Fire,’ a book about South Korea’s #MeToo campaign.

Source: International Politics and Society (IPS), published by the Global and European Policy Unit of the Friedrich-Ebert-Stiftung, Hiroshimastrasse 28, D-10785 Berlin.

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‘Let’s Talk About Sex’ Discussion Highlights Risks to Women

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Civil Society, Crime & Justice, Development & Aid, Economy & Trade, Gender, Gender Violence, Global, Headlines, Health, Human Rights, Humanitarian Emergencies, Poverty & SDGs, TerraViva United Nations, Women’s Health

Nordic Talk moderator Katja Iversen shown here with Natasha Wang Mwansa, Emi Mahmoud, Dr Natalia Kanem and Flemming Møller Mortensen during a recent Nordic Talks webinar. Credit: Shuprova Tasneem

DHAKA and NEW YORK, Jun 4 2021 (IPS) – Every two minutes, a girl or woman dies from pregnancy or childbirth-related complications, including unsafe abortions. Every year, around 12 million girls are married while in their childhoods. An additional 10 million are now at risk of child marriage due to the Covid-19 pandemic.

In this context, the most recent Nordic Talk—a high-level debate on bodily autonomy and sexual and reproductive health and rights (SRHR) as a cornerstone of gender equality, aptly titled “Let’s Talk About Sex” — could not have come at a better time.

Moderator Katja Iversen, Dane of the Year (2018) and former CEO of Women Deliver, kicked off the discussion by focusing on the close link between bodily autonomy, gender equality, economic growth, and a healthy planet.

In an exclusive interview with IPS, Iversen said it was clear that “bodily autonomy for girls and women—in all their rich diversity—is political, social, economic and health-related.”

Women needed to have power and agency over their “bodies, fertility, and future, living a life free of violence and coercion in both the private and public sphere. It ties into norms, structure, systems – and if we want equity and health for all, we need to address all of it.”

Emi Mahmoud, two-time World Champion Poet and Goodwill Ambassador for the UNHCR, set the tone for the Nordic Talk with her emotive poetry reflecting women’s experiences in patriarchal societies, asking: “What survivor hasn’t had her struggle made spectacle?”

The three other panellists agreed that the right to control their bodies was a fundamental aspect of women’s rights and that gender equality was an essential part of the sustainable development agenda.

As Dr Natalia Kanem, Executive Director of the UNFPA, explained that “(women’s) freedom over her own body means freedom of choice”, and that all the data points towards how investment in SRHR could be the first step to empowering women to “ultimately contribute to sustainable development.”

It was critical that SRHR was adequately resourced – but warned these would be in short supply because of the COVID pandemic recovery plans.

“Part of the financing challenge is what we abbreviate as political will. It actually does not cost a lot for the agenda for SRHR to be a reality by 2030. It would take $26 billion a year to end the unmet need for contraception and to stop mothers dying at birth, many of whom were too young to be pregnant, but resources are going to be a challenge now with Covid having affected the world economies.”

While Flemming Møller Mortensen, Danish Minister for International and Nordic Development and Nordic Cooperation, expressed optimism regarding resources for SRHR now that “the US is back on track” and the global gag rule had been revoked. He was worried about a growing conservatism and pushback against women’s rights, particularly in the pandemic’s wake.

Iversen told IPS the cuts in various countries could be devastating.

“UNFPA estimates that with the $180 million the UK wants to withdraw from the Supplies Partnership, UNFPA could have helped prevent around 250,000 maternal and child deaths, 14.6 million unintended pregnancies and 4.3 million unsafe abortions. We will need foundations and other donor countries to step up, and we will need national government step up and step in and ensure that their national budgets reflect and fill the SRHR needs.”

She expressed concern that women on COVID-19 decision-making bodies were unrepresented.

“Less than 25% of national COVID-19 decision-making bodies have women included. It is too easy to cut resources from people who are not at the decision-making tables,” she said. “We urgently need to get a lot more women into leadership, including of the COVID-19 response and recovery efforts. All evidence shows that when more women are included in decision-making, there is a more holistic approach and both societies and people fare better.”

This call for inclusivity, not just for women but for the youth, was strongly echoed by adolescent sexual and reproductive health rights expert Natasha Wang Mwansa.

“So many commitments have been made by so many countries, yet there is no meaningful progress or accountability, and young people are not involved when making these decisions,” Mwansa said. “Young people are here as partners, but we are also here to take charge. From making choices over our own bodies to choices on our national budgets, we are ready to be part of these decisions.”

To deal with challenges in providing access to SRHR, Kanem stressed the importance of gender-disaggregated data for planning. She added that despite the hurdles, she was hopeful about the future because “young people and women are not waiting to make the case and show solidarity and understanding when it comes to racism or issues of discrimination and equity that divide us.”

Iversen echoed this optimism in her IPS interview.

“It gives me hope that comprehensive sexual and reproductive health services are included in the roadmap for Universal Health Coverage, in the Global Action Plan for Healthy Lives and Well-being, and latest in the Generation Equality Forum blueprint,” she said.

“Civil society has played a key role in ensuring this with good arguments, data and a lot of tenacity. But words in the big global documents about Health For All is one thing; gender equality and women’s rights, if it has to matter, it has to manifest in concrete action.”

The conversation rounded off with recommendations and commitments from the panellists: Mwansa stressed more investments in youth-run organisations and more social accountability from decision-makers; Mortensen asked for governments to be held accountable and for youth voices to be heard; and Kanem reaffirmed the UNFPA’s goal to put family planning in the hands of women as a means of empowerment, to end preventable deaths in pregnant women and girls, and change fundamental attitudes to end gender-based violence.

In her final comments to IPS, Iversen also stressed the importance of SRHR as a means of empowerment.

“Study after study shows that it pays to invest in girls, women and SRHR – socially, economically and health-wise. But we cannot look at SRHR alone; we need a full gender lens to the COVID response and recovery and development in general,” she said.

“And if we want to see positive change, we have to put girls and women front and centre of coronavirus response and recovery efforts, just as we, in general, need to see many more women in political and economic leadership.”

The Nordic Council of Ministers supports the Nordic Talks, and “Let’s Talk about Sex” was organised in partnership with UNFPA, the Danish Ministry of Foreign Affairs, Generation Equality, the Danish Family Planning Association, and Mind your Business, as a lead up to the Paris Generation Equality Forum.

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