Investment needed to accelerate progress on sexual and reproductive health and rights

By Bobby Ramakant, CNS
June 6, 2013
The author writes for Citizen News Service - CNS, manages the Global Stop-TB eForum, and is supported by the Lilly MDR TB Partnership to provide on-site coverage from the 4th Union Asia Pacific Region Conference on Lung Health in Hanoi, Viet Nam. Email: bobby@citizen-news.org, website: www.citizen-news.org

In the region of Asia and the Pacific - though there has been continued progress towards fulfilling the International Conference on Population and Development (ICPD) Programme of Action (PoA) – progress in sexual and reproductive health and rights and gender equality is unacceptably slow and inconsistent, calling for urgent prioritization and investment. The Asia Pacific Alliance for Sexual and Reproductive Health and Rights (APA) launched a latest publication at Women Deliver 2013 to strengthen investments for sexual and reproductive health and rights (SRHR) in Asia and the Pacific. This publication, "Resource Flows for Sexual and Reproductive Health and Rights in Asia and the Pacific: Gaps and Opportunities" highlights the striking disparities both between and within countries in this region.

"Cairo placed an emphasis on improving the lives of individuals and increasing respect for their human rights. Sexual and reproductive health and rights (SRHR) and gender equality are essential for building just and equitable societies and economies. To achieve this, addressing inequalities is imperative - certain groups are more vulnerable and excluded - especially women and adolescents girls, unmarried young women, migrants, ethnic or sexual minorities, as well as key affected populations in the HIV epidemic," said Rose Koenders, Executive Director, APA.

Funding for SRHR need to target the most vulnerable and marginalized groups to ensure equitable and sustainable development in this region. These groups face the biggest barriers to accessing services, and national strategies and programs are required to address their specific needs.

It is estimated that USD billion 25.24 is needed from the international donor community for the region to fulfil the ICPD PoA in 2015 alone. This will leave a shortfall of USD billion 6.7, according to the publication. Civil society has a crucial role to play to monitor governments and hold them to account, and to deliver reproductive health and family planning services and information for all, in particular for women and girls.

At the same time, in Asia and the Pacific the lines between donor and recipient countries are blurring. Resource flows from emerging donors are a growing area for development cooperation. India, China and Thailand are currently providing the largest source of development aid in the region. This type of development cooperation has potential for increasing the level of support for SRHR in Asia and the Pacific, although reliable and transparent funding data remains a challenge.

This makes effective cooperation with emerging economies necessary as both providers and recipients of development aid and sexual and reproductive health interventions. In addition, the majority of the world’s poor are currently residing in many of these same middle-income countries. In cognizance of the trends, APA recently strengthened its network by including two new emerging economy countries into its membership, India and Indonesia, to more effectively ensure its goal of sexual and reproductive health and rights in the region.

Francesca Barolo Shergill, Manager (Innovations and New Partnerships), Population Foundation of India, spoke with Citizen News Service - CNS at Women Deliver 2013 in Malaysia. Francesca said: "We have been working with the APA on tracking the support that donors are giving to sexual and reproductive health in middle income countries. The current funding in India on sexual and reproductive health from international donors is a very minimal part of the health funding (it is only 3 per cent). Adding severity to funding of SRHR is the fact that India is one of the countries that, is graduating to become off-list of donors for support for sexual and reproductive health and rights."

Francesca points out that "While at national level statistics and indicators of unmet needs of family planning or total fertility rates might be improving, we still need to remember there are pockets or populations in the country that still do not have access to services. They still need specific investment to make sure they have an equitable access to SRHR services. So, while you have a total fertility rate in the country which is going down (almost 2.5) we still have the most populous state in the country where women have an average of more than 3 children. So, there is still a real felt need to invest more in these areas."

Francesca shared that along with the APA, they are planning to do a study to understand the flow of investment in India so that they have the evidence to push for better monitoring of the investment, not only to see if sufficient money is allocated for SRHR but especially how it is spent, what impact it is giving and to ensure that civil society organizations have their role to play in the process. "We strongly believe that civil society organizations have a major role to play in this and we really hope that the donors and the government feel and give the same importance in doing transparent fund tracking of resources especially in the low- and middle- income countries in Asia and the Pacific" said Francesca.

"It is very important for us to keep focusing on communities like the young people in the country to have accessible services before they are married or before they get pregnant. We must make sure that communities such as young people have access to comprehensive sexuality education and freedom to access these services which will eventually help them in counselling, to understand what they want to do, how they feel about their sexuality, among other issues."

The Government of India took a major step forward by launching its new strategy in February 2013, formally called the "A Strategic Approach To Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) In India." "The government of India has acknowledged the fact that it is important to work with the adolescents. They want to do it in an integrated manner and we welcome these steps" said Francesca.

Francesca believes there is a lot more that needs to be done to meet the SRHR needs of key affected women and girls such as adolescents and young girls. "They still tend to get married too young. We still have one third of the women in the country who are getting married before they are of 18 years, getting pregnant, and having multiple pregnancies. We need to focus on the service component but we also need to focus on the fact that girls have the right to marry only when they are ready. And they have the right to get education and to live a full life."

In September 2013, governments will gather to set new priorities for population and development policy in the region at the 6th Asian Pacific Population Conference, a platform for the regional results of a review of the ICPD PoA. These results will be carried forward to a UN General Assembly on the ICPD beyond 2014 next year.

Now is the time to place the sexual and reproductive health and rights of women and girls at the centre of population and sustainable development.

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Posted on: June 06, 2013 09:22 AM IST