We welcome the focus on the theme – Realizing the future we want: integrating population issues into sustainable development, including the post-2015 development agenda and the issues that can be raised within it.
We also welcome the Open Working Group’s final outcome document with 17 proposed goals and 170 targets adopted in July 2014 that signifies the effort going into the formulation of a broader and more detailed development framework, especially the inclusion of standalone goals on achieving gender equality and the empowerment of women and girls, ending poverty and hunger, and ensuring healthy lives.
Recognising and ensuring sexual and reproductive health and rights is an integral part of achieving the goals – old or new, and ensuring a world that is just, equitable, inclusive, and sustainable, where women and girls are empowered. In the years 2012-2014, 183 member states engaged in submitting national progress reports on the achievement of the ICPD Programme of Action (PoA). The reports of member states formed the basis of the global report – Framework of Actions for the follow-up to the Programme of Action of the International Conference on Population and Development (United Nations, 2014a) and the resulting report – Summary of Framework of Actions for the follow-up to the Programme of Action of the International Conference on Population and Development Beyond 2014 – Report of the Secretary-General (United Nations, 2014b). All member states unequivocally stated that there remains an unfinished agenda of the ICPD PoA after 20 years. Hence, this unfinished agenda, reflected in the findings of the two global reports mentioned above, is an agenda that puts women’s equality, sexual and reproductive health and rights at the centre of development, and should be incorporated into the post-2015 agenda.
The call for a human rights-based approach to promoting women’s sexual and reproductive health and rights should be heeded, while reiterating that this agenda is inter-linked to all development agendas: gender equality, human rights, poverty, inequality, migration, health, climate change, population dynamics, conflicts, disasters, food and nutrition security, and access to resources (Asian-Pacific Resource & Research Centre for Women 2013a).
Despite the achievements in the Asia Pacific region, the benefits have not trickled down. Over 900 million people still live in poverty, while many are hungry and malnourished. Reducing poverty and inequalities remain key challenges that prevent equitable access to sexual and reproductive health services. Women who are poor, less educated, from remote areas face difficulties in accessing services. Structural drivers of inequalities and multiple forms of discrimination based on gender, age, class, caste, race, ethnicity, culture, religion, sexual orientation, gender identity, health status and abilities add to these difficulties (Thanenthiran S., Racherla S.J.M., and Jahanath S., 2013). If women’s realities and needs are not given due consideration and integrated into the new agenda, women will continue to be left behind and their rights will go unrealised.
The region has one of the largest youth populations in the world. They are more vulnerable when their sexual and reproductive health and rights are compromised. They require youth-friendly health services to make informed choices, free from violence, coercion, early marriage, unintended pregnancies and infection (Asian-Pacific Resource & Research Centre for Women 2013a). Equally important is access to education, employment opportunities, and participation (Asian-Pacific Resource & Research Centre for Women, 2012). Young people’s concerns should be central in the post-2015 agenda. They are effective advocates of rights and must be mobilised to achieve the post-2015 agenda (Asian-Pacific Resource & Research Centre for Women 2013a).
Migration has increased because of employment needs, natural disasters, conflicts, famine, and development projects. It impacts men, women and people of diverse sexuality in different ways. It can perpetuate gender roles and relations, while entrenching inequalities and increasing women’s vulnerability to violence and exploitation. Marriage migration poses risks for women moving to foreign countries, whose rights may be violated and support systems lost (Thanenthiran S., et.al., 2013). The key role that migration plays in the region cannot be ignored in the post-2015 agenda. The protection of migrant rights, including their sexual and reproductive health and rights, must be ensured.
The region is increasingly susceptible to climate change, mainly impacting vulnerable groups including women. It can impact women’s sexual and reproductive health and rights by constraining access to services, and increasing maternal health risks and exposure unhygienic conditions. Further, sexual and reproductive health services may not be prioritised in relief efforts (Asian-Pacific Resource & Research Centre for Women, 2014).
Likewise, religious extremism limits sexual and reproductive health and rights; for instance with contraception use, safe abortion services, comprehensive sexuality education, child marriage, female circumcision, and violence (Thanenthiran S., et.al., 2013).
Protection from all forms of violence, including domestic violence and rape, remains an integral component of the post-2015 agenda. A human rights framework, including the right to be free from discrimination, coercion and violence, and the principles of bodily integrity, dignity, equality, and respect for diversity are critical factors for inclusion (Asian-Pacific Resource & Research Centre for Women, 2013a).
The region continues to have high maternal deaths, morbidities and adolescent birth rates. Unsafe abortion largely contributes to maternal deaths. Few countries have made provisions for legal and safe abortion services. Maternal deaths and complications during pregnancy and birth are often associated with high levels of anaemia. Adolescent pregnancies are also caused by early, forced and child marriages. Despite improvements in contraceptive prevalence rates in many countries, unmet need for contraception continues to be high. Women shoulder the burden of contraception. Women, including a significant proportion that are adolescents, are affected by HIV and are at risk of other sexually transmitted infections. Persons of diverse sexual orientation and gender identities continue to be marginalised and face stigma and discrimination (Ibid, 2013a). Their needs should be prioritised in the post-2015 development agenda.
Improving weak health systems and greater resource allocation within the health sector can enhance sexual and reproductive health services. Access to rights-based continuum of quality healthcare across home, community and health facilities, including access to contraception, emergency obstetric care, skilled attendants at birth, and antenatal and postnatal care should be improved and universal access to these services should be prioritised (Ibid, 2013a). These services should be easily accessible to all adolescent girls and women irrespective of their marital status.
In practice, the post-2015 agenda has to be able to comprehensively address universal access to sexual and reproductive health, beyond family planning. Any approach must recognise that these are inextricably linked with gender equality, and that power over women, and their bodies and sexuality endangers health throughout the lifecycle (Universal Access Project, 2014).
We demand a post-2015 development agenda that creates transformational change in achieving gender equality and women’s human rights. It should ensure that:
Sexual and reproductive rights are fundamental human rights and human rights must underpin the post-2015 agenda.
Sexual and reproductive health goal(s) and targets are a given.
Universal access to comprehensive, high quality sexual and reproductive health services are guaranteed.
Non-discrimination includes sexual orientation and gender identity.
The impact of religious extremism on women and girls’ sexual and reproductive health is addressed including elimination of discriminatory laws and policies.
Financing for human rights and gender equality, including sexual and reproductive rights, which requires gender budgeting throughout the goals, targets and indicators.
Those most marginalized are at the centre, while ensuring truly democratic processes together with transparent decision-making and accountability.
Address development holistically. For example, ending poverty will only happen by providing access to education, including comprehensive sexuality education, and including sexual and reproductive health service.
Asian-Pacific Resource & Research Centre for Women 2012. Youth SRHR Movements: Claiming the post-2015 development agenda. ARROW for Change. vol. 18 no. 2 2012. http://www.arrow.org.my/uploads/20121130071740_v18n2.pdf
Asian-Pacific Resource & Research Centre for Women 2013a. Sexual and reproductive health and rights for all – now! http://www.arrow.org.my/publications/SRHR_for_All_Now.pdf
Asian-Pacific Resource & Research Centre for Women 2013b. Labour migration, gender, and sexual and reproductive health and rights. ARROW for Change. vol. 19 no. 1 2013. http://www.arrow.org.my/uploads/20121218025358_v19n1.pdf
Asian-Pacific Resource & Research Centre for Women 2014. Identifying Opportunities for Action on Climate Change and Sexual and Reproductive Health and Rights in Bangladesh, Indonesia, and the Philippines. Working Papers. http://arrow.org.my/download/Scoping%20Study%20-%20Climate%20Change%20and%20SRHR.pdf
Thanenthiran S., Racherla S.J.M., and Jahanath S. (2013). Reclaiming and Redefining Rights: ICPD + 20: Status of Sexual and Reproductive Health and Rights in Asia Pacific. ARROW http://www.arrow.org.my/publications/ICPD+20/ICPD+20_ARROW_AP.pdf
Universal Access Project 2014. Briefing Cards: Sexual and Reproductive Health and Rights (SRHR) and the Post-2015 Development Agenda. https://d3n8a8pro7vhmx.cloudfront.net/genun/pages/122/attachments/original/1407607969/SRHR_Briefing_Cards_FINAL.pdf?1407607969
UN 2014a. Framework of Actions for the follow-up to the Programme of Action of the International Conference on Population and Development Beyond 2014: Report of the Secretary-General. United Nations 12 February 2014. http://www.unfpa.org/sites/default/files/pub-pdf/ICPD_beyond2014_EN.pdf
UN 2014b. Framework of Actions for the follow-up to the Programme of Action of the International Conference on Population and Development Beyond 2014 – Report of the Secretary-General http://icpdbeyond2014.org/uploads/browser/files/sg_report_on_icpd_operational_review_final.unedited.pdf