Sexual and Reproductive Health and Rights

• The concept of reproductive health is relatively new.
• Emerged following ICPD Cairo Egypt, 1994. ICPD also heralded women’s sexual and reproductive rights, and constituted the framework for the development of the UN MDGs in 2000.

• Defined in relation to the positive definition of health in WHO constitution as: A state of complete physical, mental, and social well-being, and not merely the absence of disease or disorder of the reproductive tracts, system and processes.
• Adopts a holistic approach to the management of reproductive problems.
• Of global concern, impacting on crucial areas .e.g. Health, Population, Development, Economy, Status of women, and the environment.
• Tracks the individual from the womb to the tomb (cradle to the grave) being a major determinant therefore of the physical, mental, and social status of the future generation.
• Most important component of general health, and therefore a prerequisite to the social, economic, and human development of any nation.
• The burden of reproductive health lies most on women and young people.

Anticipating and meeting women’s health needs from infancy through old age,

Emphasizing health-seeking behavior and appropriate services to meet women’s health needs throughout their lives, and recognizing the right of all women to make informed decisions about their health.

• Safe Motherhood
• Family planning
• Infertility — prevention and management.
• Infant and child survival, growth and development.
• Prevention and management of STIs & HIV/AIDS.
• Abortion — including the prevention and management of unsafe abortion.
• Management of Reproductive tract malignancies, and other non- infectious conditions of the reproductive system such as genital fistula, cervical cancers and complications of female genital mutilation.
• Adolescent reproductive health and sexuality.
• Human sexuality.
• Traditional practices harmful to women
• Gender discrimination — gender inequity and inequality.
• Reproductive health problems associated with menopause & andropause.

Right- based approach adopted as a universal policy consensus, at ICPD Cairo, 1994, representing a paradigm shift in emphasis from family planning and demography to the right of the individual. The Concept of Women’s Sexual and Reproductive Right (WSRR) emerged and became recognized as an integral aspect of universal human right.

The rights-based approach to reproductive health includes:

• Placing of the health and well-being of individuals at the center of programme policy design.
• Recognition of the importance of gender equity and equality, and
• Building on the existing international human rights treaties.

Reproductive Rights:

This implies the right of couples to decide freely and responsibly on the number, timing, and spacing of their children and have the information, education and means to do so; attain the highest standards of reproductive health; and make decisions about reproduction free of discrimination, coercion and violence.

Sexual Right:

This implies the right of all people to decide freely and responsibly on all aspects of their sexuality; be free of discrimination, coercion and violence in their sexual lives and decisions; and expect and demand equality, full consent, mutual respect and shared responsibility in sexual relationships

Components of Women’s Sexual & Rep. Rights:

IPPF developed from 4 international human right treatise – a set of concerns patterned after the universal human right, which became known as the component of women sexual and reproductive rights.

These includes

1. Right to Life.
2. Right to liberty and security of the person.
3. Right to equality and to be free from all forms of discrimination.
4. Right to privacy.
5. Right to freedom of thought.
6. Right to information and education.
7. Right to choose whether or not to marry and to found and plan a family.
8. Right to decide whether and when to have children.
9. Right to healthcare and protection.
10. Right to benefits of scientific progress.
11. Right to freedom of assembly and political participation
12. Right to be free from torture and ill treatment

Unsafe motherhood

• Evident from high maternal mortality and morbidity.
• Ninety –nine percent (99%) of maternal death occur in sub-Saharan Africa.

Unsafe abortion:

• Approximately 20 million induced abortions occur annually (95% of which occur in developing countries), causing the death of about 80,000 women.

Traditional harmful practices

• Female genital mutilation
• Early marriage
• Widowhood rites and widows right infringement
• Female disinheritance.
• Gender inequality

Women trafficking.

Violence against women

• Development of right-based reproductive health policies e.g. Free ANC delivery and family planning services for all.
• Legislation in favour of safe motherhood and against harmful traditional practices e.g. FGM.
• Social and economic empowerment of women through free education, skills acquisition, and small loans schemes.
• Effective community interventions to abolish traditional harmful practices.
• Strengthening primary health services and restructuring secondary and tertiary services to meet RH demands.
• Development of rights based code of ethics and incorporation into the curriculum of medical education.
• Domestication of provisions of international conventions related to WSRR e.g CEDAW
• Reminder to men and boys of their RH responsibilities to women and girls.

Domestic abuse is defined as any incident or pattern of incidents of controlling, coercive, threatening, degrading and violent behavior, including sexual violence, usually by a partner or ex-partner, but also by a family member or carer.

The facts

• Not just physical and sexual violence; often psychological, emotional or economic abuse too
• Mainly perpetrated by men, against women, but also occurs against men by women and in same-sex relationships
• 2 million people suffer domestic abuse each year in UK
• CLEEN Foundation reports 1 in 3 respondents admitting to being a victim of domestic violence.
• A nationwide increase in the past 3 years from 21% to 30% in 2013.
• In 2016/17, 82 women and 13 men were killed by their partner or ex-partner in UK.
• Around 30 women a week attempt suicide and 3 women kill themselves each week, as a result of being subjected to domestic abuse in UK.
• 140,000 children live in households where serious domestic abuse takes place in UK

Types of abuse

• Sexual abuse and rape (including within a relationship)
• Physical violence
• Financial abuse
• Taking control over someone’s everyday life, eg where they go, what they wear
• Monitoring or controlling someone’s emails, text messages or social media accounts
• Threats to kill or harm
• Harassment and stalking

In 2015 the UK government created a new offence of Coercive or Controlling Behaviour.

Coercive control

• Extreme psychological and emotional abuse
• An on-going pattern of behaviour
• The victim feels isolated, intimidated, and in fear.
• Can include:
• Making unreasonable demands
• Monitoring their whereabouts using GPS, and constantly checking up on them
• Isolating them from friends and family
• Putting them down in front of others
• Forcing them to commit crime
• Threatening them, their family or pets
• Online and digital abuse

• Financial abuse is often the first sign of further emotional or domestic abuse, and can prevent people from leaving a relationship. It can include:
• Spending someone’s money or property without their consent, or borrowing money and never repaying it
• Controlling how much money someone is given, such as giving them a small allowance and making them beg for more
• Forbidding someone from having a bank account
• Forcing someone to take out a loan, or taking out a loan or credit card in someone’s name and racking up debts or deliberately ruining their credit rating
• Squandering or gambling away family resources
• Preventing someone from getting a job or education

Some indicators that someone might be in an abusive relationship:

• They stop socializing and withdraw into themselves – they might leave their job or college
• They seem nervous or frightened of their partner’s reaction to things they’ve done. They might refuse to appear in photos in case their partner sees them on social media
• They don’t have control over their money
• Their partner gets jealous a lot and constantly checks up on them
• Their partner belittles them in public
• They have unexplained injuries, or wear clothes that cover up their body

• If someone is in immediate danger, call the police.
• If you are worried about children caught up in the abuse, contact the National Human Right Commission/ police.
• If you are worried about someone you know, try talking to them about what’s happening. If they will open up to you, encourage them to seek help, and let them know where help is available.
• Provide practical support and listen during discussion.
• Avoid being judgmental, avoid statement like really, so you people have argument now