Published by the 50/50 by 2030 Foundation, University of Canberra

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Sexual and reproductive rights: unfinished business

by | Sep 17, 2019 | The Agenda

“Imagine a 10 year old girl standing at a crossroads. Which direction will she go in? If she is able to stay in school, it can set on her the path of health and wellbeing throughout her life. If on the other hand she’s forced to marry she becomes pregnant too soon, she, still a child herself, can face a cascade of challenges throughout her life that will jeopardise her life, her health, her wellbeing, and of course family, her society, and ultimately our world – our prospects for prosperity.” 

Dr Natalia Kanem’s powerful lecture  – Unfinished business: the pursuit of rights and choices for all – went right into the heart of the matter as she took the audience through both the harrowing statistics, as well as the remarkable gains in sexual and reproductive health globally in the past 50 years since the United Nations sexual and reproductive health agency (UNFPA) began operations. 

… more than 200 million women who want to prevent a pregnancy don’t have access to modern contraceptives.

Currently, more than 200 million women who want to prevent a pregnancy don’t have access to modern contraceptives. Every day, 820 women die from complications of pregnancy and childbirth that are preventable. And many of the 300,000 women who die every year, are not women at all, as Dr Kanem pointed out. “They are children, they are girls.” 

“Reaching young people early is critical. The adolescent girl is at the centre of our world at the UNFPA because course corrections are much more difficult.”

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In the landmark International Conference on Population and Development (ICPD) in Cairo 25 years ago, 178 delegates representing every nation around the world agreed to a program of action, which recognised sexual and reproductive health and rights as a matter of fundamental foundations for a thriving, just and sustainable society.

“Achieving the goals of that program of action is our mandate for UNFPA and it still continues to guide our path today in over 150 countries where we serve. Our work is actually informing and delivering on that promise of Cairo. Reaching out to women and young people working in concert with others to make choice real.”

Ultimately, choice is about life and death

Choice, as she noted, “is about knowing how your own body functions, it’s about bodily integrity, having the power and the ability – the means to say no. Or to say yes. It’s about having the power and the means to make your own decisions regarding whether, when and with whom to have children. And that power affects other choices in life. It’s definitional, it means that care during pregnancy will be there for you through childbirth and for the newborn.” 

“Ultimately, [choice] is about life and death.”

Even though it is sometimes hard to remember it at turbulent times such as these when pushback against women’s rights appears to be increasing, and countries around the world are winding back the hard-won gains – there is also much to celebrate. 

Since the meeting in Cairo, hundreds of millions of women have gained the power to exercise their right to contraception and to decision-making, while deaths during pregnancy and childbirth have dropped by 44% – a huge achievement by anyone’s standards. Last year UNFPA humanitarian assistance reached nearly 15 million people, mostly women and girls. 

[Violence against women & girls] is one of the most widespread human rights violations in the world, and it’s ignored

But as Dr Kanem’s lecture title suggested, the work is far from finished, and she had some strong words to say about violence against women, arguing that it “is probably one of the most widespread human rights violations in the world, and it’s ignored, and it’s swept under the carpet.”

“It’s also one of the clearest manifestations of power imbalances, and gender imbalances in our societies, which is why it often goes unreported,” she continued. 

Globally, 20% of girls under the age of 18 are already married or in a union

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Child marriage is still a significant issue globally, with 20% of girls under the age of 18 already married or in a union. What’s more, the number doubles in the least developed countries. “Even where child marriage may be against the law, if the law doesn’t have teeth, the girls has no choice, the custom prevails, and there you have the laws going unenforced.”

The UN is recording some of the highest numbers ever of the displacement of women and girls due to war and natural disasters

The UN is recording some of the highest numbers ever of the displacement of women and girls due to war and natural disasters. In addition, the fertility rates in the pacific region are rising, signaling the need to improve access to health services.  

Referencing the findings from the UNFPA’s State of the World Population Report 2019, Dr  Kanem also highlighted some alarming global statistics. “In our survey of 51 countries around the world, just over half of married women reported that they can take their own decisions about sexual intercourse with their husband or partner, whether they can use contraception, or whether or not they can even leave the house to access health care.”

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Photo: Dr Natalia Kanem, Executive Director of UNFPA in discussion with Jane Alver (50/50 by 2030 Foundation Steering Committee); & Dr Pia Rowe (BroadAgenda Editor, University of Canberra)

Where does this leave us now? And what can we do by the year 2030? 

Focusing on the ‘three zeros’, she outlined the UNFPA’s aspirations: To zero the unmet need for family planning and to make it accessible everywhere; to zero the preventable maternal deaths, and finally, to have zero gender based violence. 

“UNFPA wants to persevere with all of this, until every woman and girl everywhere is healthy, empowered and has control over her own future.” 

Noting the progress over the years, she argued, “slow and steady work is important, but now we want to accelerate that and make it rapid – and not wait another 50 years for incremental change.”

“Despite our best intentions, so far we have left some women behind, and this is why we need new energy, so we can decide how we can do better. And we all have a role to play.”



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