Zimbabwe could save up to US$3 billion in treatment of HIV and Aids and downstream costs if the country can scale up its Voluntary Medical Male Circumcision (VMMC), a health official has said.
Report by Christopher Mahove
Ministry of Health and Child Welfare, HIV and Aids and TB Specialist, Owen Mugurungi, said if the VMMC was to make an impact in the country, there was need for a rapid scaling up of the programme among the 15 to 49 age groups to above the 80% mark, which translated to 1,9 million men.
“If we do that, we will be able to reduce the rate of HIV infection from the current 130 000 new infections to less than 50 000 per year by 2020,” said Mugurungi.
“What it means is we would have also prevented close to 750 000 new HIV infections throughout the country and we would have invested around between US$100-US$120 million, but in terms of treatment and downstream costs, we will probably save US$2,9 billion.
“So you can see from an investment perspective, of saying where should we put our money, this is one of the high return areas in which we should be able to put our money.”
He said at community level, there were also even more benefits for partners of circumcised men and others, as it contributed to more than 75% prevention of HIV and Aids transmission to spouses.
Circumcision, Mugurungi said was also crucial in the elimination of the human papiloma virus, which affected the male organ and was the major cause of cervical cancer in women.
“This is because we know that if we circumcise all men, 60% of them are more likely to have reduced risk and if they have reduced risk, they are also less likely to transmit the disease, so that cascades to situations where even at community level, there is higher or better prevention,” he said.
Mugurungi said although the male circumcision programme had started on a slow note in 2009 in terms of uptake, the trend was slowly improving, with high hopes that the country would be able to reach its target.
“….but we are happy that in 2010, we circumcised the whole year, about 15 000, and already this year, 2013, during this previous campaign, which just happened during the holiday, we have circumcised more than 15 000.
“We are happy that we have achieved in less than six weeks what we achieved in 12 months. If that is anything to go by, we are happy to say that at least people are beginning to take it up and we will be able to circumcise more,” Mugurungi noted.
He said there was need for extensive educational campaigns to take the correct message to the people.
There are also other benefits that have for a long time been associated with circumcision, among them the prevention of genital ulcerations and general personal hygiene.
Mugurungi said studies done in South Africa, Kenya and Uganda had shown evidence that HIV infection rate among circumcised males was 60% lower than in those who were not.
Before the introduction of the male circumcision programme only a handful of private health institutions were offering the service and mostly for reasons other than as an HIV intervention measure.
In Africa, the vulnerability of women and girls to HIV remains high, with women constituting 59% of people living with HIV.
19 May 2013
Written by Sonke Gender Justice Network
Sonke Gender Justice Network, the MenEngage Africa Network and the Women’s Health Research Unit at the University of Cape Town are proud to host the second MenEngage Africa Training Initiative course: ‘Masculinities, Leadership and Gender Justice in Sub-Saharan Africa’, to be held from 16-26 September 2013 at the University of Cape Town in South Africa. This follows the highly successful pilot course that took place in August 2012.
To apply for this training course, complete the online application at:www.menengage.org/mati2013application.
For further information, please go towww.mengage.org/mati2013course or refer to the attached document.
About the course
‘Masculinities, Leadership and Gender Justice in Sub-Saharan Africa’ is a short, intensive, ten-day residential course which seeks to expand the skills and knowledge of women and men in the Sub-Saharan Africa region to scale up work on engaging men and boys in gender equality, and build a network of leaders and gender justice advocates. In so doing, it aims to strengthen existing work on the greater involvement of men and boys in the prevention and response to sexual and gender-based violence, sexual and reproductive health and rights, HIV and AIDS, fatherhood, LGBTI rights and other issues pertaining to gender equality.
The course will incorporate a mix of thematic and skills-building sessions – covering both theoretical and practical components – as well as a site visit and daily opportunity for reflection. Thematic sessions will address the topics mentioned above, while the skills building sessions will specifically address leadership (including youth leadership), organisational development, research methods, advocacy, resource mobilisation and monitoring and evaluation.
As part of the training, participants are expected to submit a ‘Project for Change’ proposal, which will be refined during the course and, most importantly, implemented within their respective organisations once the course is completed. The Project for Change is a project or programme that is applicable to engaging men for gender equality. It can focus on sexual and gender based violence, HIV and AIDS, sexual and reproductive health or, LGBTI rights to name a few potential thematic areas. The project can be an existing one that needs to be expanded or strengthened, or a new initiative that must be implemented upon completion of the course. Through the implementation of the Project for Change, it is hoped that participants will be able to practically employ the additional skills and knowledge gained from this training.
To assist participants with the implementation of their Projects for Change, the course incorporates a six month Mentorship Programme. This mentorship component is a critical aspect of the training as it seeks to provide participants with ongoing support and guidance as they implement their projects at the conclusion of the training. Participants can elect their own mentor or have one appointed for them. Ultimately, certification for the MenEngage Africa Training Initiative (MATI) will be based on satisfactory implementation of the Project for Change and thorough engagement in the Mentorship Programme.
The organisers trust that this course will contribute to the strengthening of both individual and organisational capacities, and it is with great pleasure you are hereby invited to apply to attend.
Summary of the first course
From 20-30 August 2012, the first MenEngage Africa Training Initiative course ‘Masculinities, Leadership and Gender Justice in Sub-Saharan Africa’ took place at the University of Cape Town in South Africa. It brought together 23 participants (14 males and 9 females) from 13 African countries. Course content was delivered by global and regional experts and leaders in the fields of gender, human rights and social justice, for example, on topics such as ‘Why Engage Men?’ and ‘Gender, Culture, Tradition and Religion.’ Evaluations from the first course indicated that participants found the training very useful and it increased their knowledge and skills by 41 %. This is a positive outcome demonstrating that the modules on the course were effective in transferring knowledge and skills to participants on how to work with men and boys for gender equality.
The course is intended for gender activists, programme staff and project managers from women’s rights, children’s rights, sexual and reproductive health and rights, HIV and AIDS, and LGBTI organisations, youth leaders, government officials, UN Agency representatives, donors, academics and media advocates.
Who is eligible?
The ideal candidate will:
- Work in a field where they can influence gender justice and gender equality through their positions within non-governmental organisations (NGOs), community-based organisations (CBOs), government, UN agencies, donors, academic institutions, faith based organisations, juridical systems or other relevant organisations in Sub-Saharan Africa
- Have a minimum of 3-5 years work experience in gender, advocacy, human rights, social justice and/or sexual and reproductive health and rights issues
- Demonstrate commitment and interest in strategies and programmes aimed at engaging men for gender equality within Sub-Saharan Africa
- Have proven and demonstrable leadership experience/skills
- Have a basic understanding of gender issues, particularly around gender justice
- Demonstrate an understanding, commitment and willingness to be part of an intense ten day residential course
- Have an innovative proposal for a ‘Project for Change’, to be implemented on completion of the course
- Have the support of their organisation for both participation in the course and implementation of their Project for Change (where applicable)
- Hold a Bachelor’s degree in international relations, human rights, health rights, gender or other relevant fields (practical experience will be taken into account in lieu of an educational background)
- Be fluent in English
- Have interest/experience in running training courses
There are no registration fees. Applicants are requested to cover all travel-related costs in full. Accommodation and course costs will be covered by the hosts.
A very limited number of scholarships to cover the full cost of participation are available. The hosts encourage ALL interested parties to apply.
To apply, please go to http://www.menengage.org/mati2013application to fill out the on-line application form.
Applications are to be completed by no later than 31 May 2013. Once completed, you will receive an email confirming receipt of your application. Successful candidates will be notified by no later than 1 July 2013.
For further information, kindly contact Tanya Charles at firstname.lastname@example.org
9 May 2013
On May 5th, International Day of the Midwife, AAI Commends Increased Accountability to Maternal Health in Malawi.
By Agnes Mizere
As midwives around the world celebrated the ‘International Day of the Midwife’ on Sunday, Malawian chiefs continued their daily campaign to save the lives of expectant mothers to further reduce the country’s maternal mortality rate.
Malawi’s maternal mortality rate has reduced from 675 out of 100,000 to 450 out of 100,000.
With the deadline for the Millennium Development Goals (MDG) rapidly approaching in 2015, the message that “the world needs midwives more than ever” is becoming more urgent including in Malawian villages.
Previously many village women were relying on Traditional Birth Attendants (TBA) during labour and delivery until they were stopped from assisting them. Instead village women are being encouraged to deliver their babies in hospitals and clinics under the supervision of midwives.
Under the Presidential Initiative on Safe Motherhood and Maternal Health, Senior Chief Kwataine explained how chiefs are determined to make sure “no woman dies while giving birth” and that plans are underway for more women to graduate as community midwives to replace TBAs in different villages.
He was speaking after a sensitization meeting in Traditional Authority Mwambo’s area in Zomba where 19 traditional leaders exchanged notes on how best to tackle maternal health.
Among other things, the chiefs agreed to form village committees to target those at grass-root level and another one at T/A level. The idea was to encourage villagers to send expectant mothers to hospitals or clinics.
“If approached TBAs should tell the expectant woman to go to hospitals or clinics where there is trained personnel. The TBAs are not supposed to put their hands on any woman who is pregnant. Gone are those days, we don’t need them to deliver babies so TBAs should find another job. We want young blood, women with a credit in MSCE to graduate as community midwives to replace TBAs in different villages,” stressed Kwataine when asked.
He emphasized the need for pregnant women to deliver safely as the main reason why the traditional leaders as owners and custodians of culture were now playing a leading role to ensure women do not die during childbirth.
According to Kwataine, the rate rose to 1120 per 100,000 some years back but with their Presidential Initiative on Safe Motherhood and Maternal Health, the messages are going down to Traditional Authorities, village heads and “those responsible for the pregnancies including their husbands.”
He also mentioned the need to stop girls under the age of 18 from getting married as statistics show them being vulnerable and facing potential complications during childbirth
5 May 2013
By Daniel Wasonga
Non-communicable diseases (NCDs) are not passed from person to person, and include those such as cancer, diabetes and hypertension. They may be of long duration and slow in progression, or in some instances, result in rapid death. NCDs are categorized mostly by their non-infectious causes and not their duration. Like all diseases that develop slowly and worsen over a long period of time, NCDs require chronic care management.
Expectant mothers, especially those beyond the first 42 days, are uniquely vulnerable to NCDs and require proper maternal care at home or in healthcare facilities. Exposure of these women to any disease is detrimental to their health and that of their unborn babies. Chronic diseases increase the health risks of expectant mothers and without adequate care, maternal mortality will rise beyond the current undesirable levels, especially in the developing economies.
NCDs disproportionately affect the low and middle income countries, where 80% (29 million) of deaths related to these diseases occur. Women in general already bear the burdens of NCDs, which are compounded by myths and misconceptions. Social and cultural taboos often prohibit women from opening up about issues such as family planning and unwanted pregnancies, which impairs the few efforts being made at improving these conditions. Furthermore, the constant “blame game” has not really helped in bringing stakeholders together in finding solutions for the specific issue of maternal mortality related to NCDs.
The cost of treatment is high. For expectant mothers who are the sole breadwinners in their households, getting proper care for NCDs may be difficult. This is especially the case in Africa, where cancer, cardiovascular disease, chronic respiratory disease and diabetes are leading causes of death in women. Worldwide, these diseases kill 18 million women yearly.
The impact of these diseases on society as a whole is enormous – maternal mortality goes beyond its consequences on individuals. The loss of women who are at their prime would leave an economic and social gap in society. Ignoring this aspect of the link between maternal mortality and NCDs is a mistake our decision makers and policy formulators should not make.
The overwhelming emphasis on reproductive and maternal health has pushed the special focus on NCDs to the periphery, an approach that is not effective. Maternal mortality remains the least achieved of the Millennium Development Goals (MDGs) and multi-faceted solutions promise better returns. A comprehensive approach to women’s health that goes beyond the maternal focus is essential and much more sensible. The current interventions are too rigid and limited to the MDGs with little or no focus on post-MDG initiatives.
Although some achievements have been made in Africa on reversing maternal mortality, the progress has been limited and unequally distributed within and among countries. The upcoming Conference of African Ministers of Health should focus on compounding the gains made within countries and ensuring there is no disconnect between government and initiatives taken at the grassroots level. In the push towards achieving the MDGs, Africa needs renewed commitments from the governments and feasible, effective monitoring and evaluation mechanisms. Best interventions should also be shared between countries to underline the collective efforts in eradicating maternal mortality.
23 April 2013
25 April 2013
AAI has distilled the key messages of the Civil Society African Common Position Paper on ICPD into 12 brief points for easy reading.
We will continue seeking endorsements in the coming weeks and have already had over 100 CSOs in Africa and worldwide sign on!
Join us and give more power to the people!
1. Human Rights
The document is fundamentally based on human rights. This means that the main objective of all development policies and programmes and their implementation must be to respect, protect and fulfil human rights for all.
1.1. Demography and population growth: The document clearly addresses the potential abuses of demographic and population growth policies and strategies that ignore the human rights of individuals. It also demands that all population growth and structure, and demographic work is approached with a human rights and gender responsive lens. It requests guarantees that policies to address high fertility and rapid population growth will focus on enlarging, not restricting, individual choices and opportunities. Clear policy guidelines must be developed and implemented so as to ensure that human rights and gender responsive lens is used through to clinic level so that abuse and misinterpretation does not occur.
1.2. All vulnerable people included: The document identifies vulnerable and key affected populations that require better inclusion and more focussed policies, programming and implementation in order to realize their full socio-economic and civil and political rights and freedoms. It acknowledges the role of both the vulnerable and the role of the already empowered and that they need to engage in promoting equality, equity and empowerment for all.
1.3. Duty-bearers and rights-holders: Both duty-bearers and rights-holders are identified throughout the document as a means to better identify the needs and entitlements of the former, and the obligations and duties of the latter. It also speaks to where capacity is lacking in order to empower the latter to hold the former accountable.
2. Accountability and Transparency
The document highlights the need for accountability which can be gained from collective transparency, open dialogue and greater focus on implementation and action with the attainment of human rights for all as the ultimate goal.
2.1. Reporting: To report in a timely manner, accurately and transparently on progress made. To ensure that monitoring and accountability mechanisms adopt a systemic and sustained human rights approach towards the implementation of the ICPD, Maputo Plan of Action (MPOA) and other relevant commitments;
2.2. Quality of data: To improve the quality of reporting by improving data, increasing quality and quantity of responses in reporting documents, using a collaborative process with civil society for the completion of reports, and ensuring appropriately disaggregated data is available and included in reporting.
2.3. Dialogue between government and Civil Society Organisations (CSOs): Use open dialogue between government, civil society and policy organs, to create more discussion around current status, national responses and challenges surrounding the attainment of universal access to sexual and reproductive health and rights (SRHR) and health services on the continent.
3. Focus on Implementation
The document highlights the need for a “less talk, more action” stance. This includes a focus on implementation of budget, human resource development and improved national ownership rather than policy and/or commitment development.
3.1. Budget allocation and spending: To boost funding for health, especially SRHR, by implementing the commitment made in Abuja to dedicate 15% of national budget to health. In addition, the document calls for implementation of the MPOA commitment to allocate 15% of health budget to family planning commodities. It is important to also identify alternative funding sources. There is a need to improve monitoring and evaluation and financial controls of existing budgets and expenditures;
3.2. Focus on African capacity: To allocate budget and implement capacity building for health systems strengthening through improved human resources. This is for health staff as well as national institutions, community systems and Ministry of Health staff. It is necessary to mount evidence-informed and rights-based responses, whilst also working on retaining existing staff, improving the existing quality of training and promoting South-South cooperation.
3.3. Leadership and national ownership: To commit to an all-inclusive and accountable leadership that ensures integration of SRHR into national development instruments. Leaders must also create space for national debate on priorities, strategic investments, social protection and legal measures. Leaders are required to create and adhere to good governance practices in all aspects of health systems strengthening.
4. Future forward
The document highlights the possibilities available to us as well as the need for innovative, modern and cutting edge knowledge, attitudes, decisions and strategies to be used in strengthening African health systems.
4.1. Technology: Use of innovative technologies, up to date knowledge, scientific and evidence-based decision-making to ensure that health systems are modern, sustainable, and intelligent. Decisions must be based on cutting edge philosophies and forward-looking thinking. We should be including newly developed yet proven safe services and commodities.
4.2. Quality and acceptability of services and commodities: ensure that sexual and reproductive health services and commodities are high-quality, available, accessible, and acceptable to all people. Ensure that the widest range of services and commodities and innovative technologies are provided as part of the modern health system.
4.3. Protect the population’s human rights: Prioritise human rights in sexual and reproductive health programmes by guaranteeing that services are designed to respond to individual’s health needs. This includes overcoming barriers faced by marginalized groups. This must be done through service provision that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure and thus looks to an African future for health systems based on human rights.
SIGN-ON! Civil Society African Common Position Paper on The International Conference on Population Development.
This section provides recommendations that addresses key matters that affect gender equality, equity and empowerment for all
- Persons with disabilities,
- Lesbian, Gay, Bisexual, Transgender and Intersex Persons (LGBTI),
- Persons living with HIV (PLHIV),
- Older persons,
- Orphans, and
- Migrant populations.
6.1. Gender Equality, Equity and Empowerment of all women
6.1.1. Ensure human rights based approach and that women’s and girl’s perspectives and rights are observed in all national SRHR policies and laws, and that all legal and institutional barriers to women realising full equality, equity and empowerment are removed as a matter of urgency,
6.1.2. To advocate for comprehensive societal affirmative action that promotes gender equity and equality in all spheres of life, including in the labour market. This includes addressing all policies that do not favour the ability of women to engage successfully in socio-economic activities, as well as committing to and financing the economic, political and social empowerment of women and girls through deliberate national programs which also include increasing women’s access to capital, land and credit facilities,
6.1.3. Continuous development and implementation of effective monitoring and evaluation mechanisms that aimed at evaluating progress toward national gender programmes, including but not limited to the improvement of data quality collection and analysis.
6.1.4. Ensure that there is creation and implementation of the legal and institutional framework that protects the rights of woman and young girls from harmful traditional practices such as inability to inherit and Female Genital Mutilation (FGM).
6.1.5. Commit to addressing the definition of gender which is currently limited to the binary of male and female which excludes different identities. Therefore, there must be the promotion of a comprehensive and all inclusive definition so as to support the equality of all women regardless of sexual orientation or gender identity,
6.1.6. Create platforms for continuous, comprehensive, consultative, capacity building for all stakeholders including Civil Society Organisations (CSOs) on gender and its role within SRHR,
6.1.7. Provide quality education, including comprehensive sexuality and life skills education at early levels for all children to promote empowerment of both girls and boys as a means to promoting equality, equity and empowerment and ensuring boys and men also play a role in realising equality for women,
6.1.8. Expand decision-making opportunities for women by ensuring their meaningful participation in all stages of design, monitoring and implementation of sexual and reproductive rights policies and programs at national, regional and international levels.
6.2. Persons with Disabilities
6.2.1. Ensure the development, implementation and financing of policy and strategies that eradicate all discriminatory practices against persons with disabilities and protect the rights of persons living with disabilities;
6.2.2. Meaningful engagement of persons with disabilities at policy and implementation level in order to develop non-discriminatory and comprehensive programs that are inclusive of their SRHR needs;
6.2.3. Create deliberate policy and implementation plans that address the sexual and reproductive health needs of persons living with disabilities and ensure universal access to accessible, acceptable, affordable and quality SRHR services, information and commodities whilst ensuring respect for persons with disabilities privacy and confidentiality in accessing services, and their capacity to make free and informed choices regarding their sexual and reproductive lives from childhood to old age in all their diversity;
6.2.4. Continuous development and implementation of effective monitoring and evaluation mechanisms that aimed at evaluating progress toward national gender programmes, including but not limited to the improvement of data quality collection and analysis;
6.2.5. Embark on awareness campaign programmes to dispel myths and misconceptions about the sexual and reproductive needs of people with disabilities and ensure that persons living with disabilities also enjoy healthy and fulfilling sexual lives;
6.2.6. Ensure the empowerment of persons living with disabilities by creating opportunities for economic development and self- reliance. Provide more possibilities for employment, credit facilities and land;
6.2.7. Create strategies that ensure the protection of women and girls living with disabilities against intimate partner violence and sexual violence;
6.2.8. Engage private and public structures to ensure that implementation of the regulations on the rights of persons with disabilities are fully adhered to;
6.2.9. Train health care workers on disability related health care, including service provision that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure.
6.3. Youth (including pre-adolescents)
6.3.1. Ensure that all aspects of the Convention on the Rights of the Child are recognised and implemented including the protection from child marriage and other forms of harmful practices as well as promote and implement laws, policies and programs that eliminate harmful practices such as early and forced marriage, rape, sexual and gender based violence, female genital mutilation, honor killings, and all other forms of violence against adolescents and youth;
6.3.2. Ensure that investments in health (including sexual and reproductive health), jobs, education and skills in youth development are made to position Africa to reap the rewards from the imminent demographic dividend;
6.3.3. Increase empirical evidence on how to address youth and pre-adolescent issues by strengthening research in academic institutions and greater inclusion of youth in the design, monitoring and implementation of policy, programming and implementation;
6.3.4. Ensure that cultural and religious barriers such as parental and spousal consent, and early and forced marriages, should never prevent access to family planning, safe and legal abortion, and other reproductive health services – recognizing that young people have autonomy over their own bodies, pleasures, and desires.
6.3.5. Provide quality education, including comprehensive sexuality and life skills education at early levels for all children to promote empowerment of both girls and boys as a means to promoting equality, equity and empowerment and ensuring boys also play a role in realising equality for girls; as well as remove any and all barriers to accessing quality education and ensure recognition, strengthening and utilisation of ICT in adolescents’ and youth development;
6.3.6. Create and sustain comprehensive, objective, and accurate sexuality education and information that is accessible and affirming for all children and youth in and out of schools, that includes but is not limited to the promotion of sexual and reproductive rights, gender equality, self-empowerment, knowledge of the body, bodily integrity and autonomy, and relationship skills development; are free of gender stereotypes, discrimination, and stigma; and are respectful of children’s and adolescents’ evolving capacities to make choices about their sexual and reproductive lives.
6.3.7. Prioritize sexual and reproductive rights issues in health systems strengthening and development programs so that integrated, high-quality services are available, accessible, and acceptable to all young people, particularly those most underserved. These services include but are not limited to comprehensive information on sexuality and contraception services and supplies (including emergency contraception, post exposure prophylaxis, male and female condoms); pregnancy care (antenatal and post natal care, skilled birth attendance, referral systems, and emergency obstetric care); safe abortion services and post-abortion care; access to assisted reproductive technologies; prevention, treatment, and care of sexually transmitted infections and HIV; prevention, treatment and care of reproductive cancers.
6.3.8. Greater recognition on the need for psychosocial support for adolescents and youth especially those in conflict areas;
6.3.9. Recognise and provide for the increased need for provision of SRH services and commodities in conflict and post conflict areas, where education of sexual and reproductive rights in post conflict regions must be aimed at reducing gender-based violence;
6.3.10. Protect young people’s human rights in sexual and reproductive health programs by guaranteeing that services are designed to respond to individual’s health needs and overcome barriers faced by marginalized groups, including through service provision that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure.
6.3.11. Ensure that programs show respect for adolescents’ and young peoples’ privacy and confidentiality in accessing services, and their capacity to make free and informed choices regarding their sexual and reproductive lives including parenthood, from childhood to old age in all their diversity; and pay special attention to marginalized groups of adolescents and young people, including those with disabilities, living with HIV and AIDS, and of all sexual orientations and gender identities as well as those in conflict areas;
6.3.12. Ensure routine monitoring of potential disparities in universal access to sexual and reproductive health information and services for adolescent and young people through regular collection and analysis of quality data;
6.3.13. Decriminalize abortion, and create and implement policies and programs that ensure young women have access to safe and legal abortion, pre- and post-abortion services, without mandatory waiting periods, requirements for parental and spousal notification and/or consent or age of consent.
6.4. Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) persons
6.4.1. Ensure human rights based approach and that lesbian, gay, bisexual, transgender and intersex persons perspectives and rights are observed in all national SRHR policies and laws, and that all legal and institutional barriers to LGBTI realising full equality, equity and empowerment are removed as a matter of urgency;
6.4.2. Ensure that the right to health, especially SRHR, is made available to all people regardless of sexual orientation or gender identity and that services are provided by sensitized and trained health care workers who provide health care that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure and privacy and confidentiality;
6.4.3. Increase empirical evidence on how to address LGBTI specific issues by strengthening research in academic institutions and greater inclusion of LGBTI in the design, monitoring and implementation of policy, programming and implementation;
6.4.4. Create deliberate policy and implementation plans that address the needs of sexual minorities as a necessary element to ensure universal access to quality SRHR services and commodities that are affordable, accessible and acceptable;
6.4.5. Ensure that there are national strategies and legislation to reduce stigma and discrimination toward LGBTI, and ensure the enforcement of these laws in accessing services and information;
6.4.6. Continuous development and implementation of effective monitoring and evaluation mechanisms that aimed at evaluating progress toward programmes aimed at providing human rights based equality, equity and empowerment of all people regardless of their sexual orientation or gender identity, including but not limited to the improvement of data quality collection and analysis.
6.5. Persons living with HIV (PLHIV)
6.5.1. Ensure human rights based approach and that perspectives and rights of people living with HIV are observed in all national SRHR policies and laws, and that all legal and institutional barriers to PLHIV realising full equality, equity and empowerment are removed as a matter of urgency;
6.5.2. Ensure that the right to health, especially SRHR, is made available to all people living with HIV and that services are provided by sensitized and trained health care workers who provide health care that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure and privacy and confidentiality;
6.5.3. Ensure routine monitoring of potential disparities in universal access to sexual and reproductive health information and services for people living with HIV through regular collection and analysis of quality data;
6.5.4. Create an enabling legal environment that will encourage pregnant women to under-go HIV testing, provide treatment care and support and ensure availability of antiretroviral therapy for all HIV pregnant women, especially those in rural areas;
6.5.5. Urgently put in place policy, programming and implementation strategies to ensure prevention of mother to child transmission;
6.5.6. Address HIV-related stigma and discrimination through education and awareness campaign programme;
6.5.7. Promote voluntary HIV counselling and testing in all public hospitals, including primary health care services;
6.5.8. Ensure that HIV prevention services form part of family planning services;
6.5.9. Allocate funds targeted to HIV that protect and empower young people, especially young women. In particular, guarantee funding for the provision of comprehensive sexual and reproductive health services that include comprehensive sexuality education; prevention, counselling, voluntary testing, treatment and care of HIV, as well as other sexually transmitted infections and reproductive cancers; and universal access to female and male condoms, microbicides and other female initiated prevention technologies and vaccines
6.6. Other especially vulnerable persons, including older persons, orphans and vulnerable children and refugees, asylum seekers and internally displaced persons and migrant populations.
6.6.1. Ensure human rights based approach and that perspectives and rights of vulnerable people are observed in all national SRHR policies and laws, and that all legal and institutional barriers to vulnerable people realising full equality, equity and empowerment are removed as a matter of urgency;
6.6.2. Ensure that the right to health, especially SRHR, is made available to all vulnerable people and that services are provided by sensitized and trained health care workers who provide health care that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure and privacy and confidentiality;
6.6.3. Ensure routine monitoring of potential disparities in universal access to sexual and reproductive health information and services for vulnrable people through regular collection and analysis of quality data;
6.6.4. Create awareness of the SRHR needs of older persons and develop policies and programmes that respect the sexual and reproductive health needs of older persons and include them in the process of decision-making as well as train health care providers to provide sexual and reproductive health services that are appropriate and acceptable to the needs of older persons;
6.6.5. Create national structures and laws that adequately evaluate andaddress pension payments and other support to older persons, especially those who are abandoned by their families and communities, and streamline the payment of pensions to retirees;
6.6.6. Assist African States interested in establishing support structures for abandoned old persons especially those who are also victims of discrimination (accused of witchcraft or other).
6.6.7. Create and support existing systems and structures which care for orphans and vulnerable children (OVC), ensuring quality services, education and other provisions are made to ensure their human rights are respected;
6.6.8. Ensure the provision of AAAQ SRH services, information and commodities in a timely manner including mental health treatment, care and support for all orphans and vulnerable children;
6.6.9. Facilitate the enactment and implementation of the Convention on the Rights of the Child in all countries to protect children and young people, especially orphans, from all forms of violence and harmful practices including early and forced marriages.
6.6.10. Ensure the provision of comprehensive sexuality education for orphans that promote sexual and reproductive rights, gender equality, self-empowerment, knowledge of the body, bodily integrity and autonomy, and relationship skills development; are free of gender stereotypes discrimination, and stigma; and are respectful of children’s and adolescents’ evolving capacities to make choices about their sexual and reproductive lives;
6.6.11. Guarantee universal access to comprehensive essential sexual and reproductive health services by providing sufficient and sustainable financing to achieve the training, deployment, and retention of necessary health workers; ensure equitable access and good quality services;
6.6.12. Ensure universal access to free (eliminating all forms of levies & user fees at all levels), quality, and comprehensive education at all levels in a safe and participatory environment.
6.6.13. Commit to researching and better understanding the health needs and SRHR needs of refugees, asylum seekers and internally displaced persons and migrant populations and ensure their inclusion in the development of policies, programming and implementation of health care.
6.6.14. Ensure that there are national strategies and legislation to reduce stigma and discrimination toward refugees, asylum seekers and internally displaced persons and migrant populations, and ensure the enforcement of these laws in accessing services and information.
To download the full document click here: AAI AUC Ford Civil Society African Common Position Paper on ICPD 2013 April
SIGN-ON! Civil Society African Common Position Paper on The International Conference on Population Development.
5. Health morbidity & mortality
5.1.1. Renew commitment to reducing maternal mortality and morbidity as a matter of urgency and allocating financial resources to ensure the development and implementation of policy and clear policy guidelines that guarantee universal access to the provision of family planning and contraceptive services , with free or subsidized care for those in need and those most marginalised;
5.1.2. Understand and demonstrate that safe motherhood is a human rights issue and as such needs to be positioned as a key concern in national dialogue on sexual and reproductive health and requires a strong rights approach at all levels of the ministry of health;
5.1.3. Ensure the development and implementation of policy and clear policy guidelines that guarantee universal access to an integrated service package, including but not limited to: mental health care; the provision of SRH services and commodities, improved ante-natal care, and response and care for obstetric emergencies;
5.1.4. Incorporate evidence-based clinical protocols that improve the referral system, strengthen transport and communication networks, promote community mobilization, build bridges between health care providers and social networks, improving the clinical and communication skills of providers at the health care level, improving access to skilled health providers, increasing access to referral services, and prevention of unwanted pregnancy and care of post abortion complications;
5.1.5. Educate and empower women and men to present at health care provider for pre-natal care at an earlier stage of pregnancy and more regularly, as well as to adhere to medical advice to ensure a healthy pregnancy;
5.1.6. Provide, without fear of prosecution, criminalisation, discrimination or intimidation, quality and prompt post abortion care and counselling to women who have undergone unlicensed, incomplete and/or illegal abortions and who require medical attention;
5.1.7. Remove all obstacles, including payment of fees, for women seeking medical attention during pregnancy and ensure free or subsidized care for those in need and those most marginalised especially rural based women;
5.1.8. Research and better understand the role and knowledge of traditional birth attendants and traditional or indigenous medicine and ensure that where applicable the benefits can be maximised and the dangers minimised.
5.2. Child survival and health
5.2.1. Mobilize political leadership to end preventable child deaths as a matter of urgency;
5.2.2. Implement evidence based country plans that sharpen government led action plans, track and sustain progress against 5 year milestones and align development support with national strategies;
5.2.3. Build on mechanisms to monitor and report progress, compile and disseminate annual progress reports, and promote transparency and accountability through regional and global forums;
5.2.4. Ensure the availability and accessibility of immunization services for all children;
5.2.5. Build capacity of parents and caregivers on health issues for children and babies including but not limited to when to seek medical attention, which foods are most nutritious, needs of sero-discordant families, the strengths and weaknesses of breast and bottle feeding, and accessing uncontaminated water for drinking and protecting children from infectious diseases like malaria and pneumonia with vaccines, bed nets, and antibiotics.
5.2.6. Research and better understand the role and knowledge of traditional or indigenous medicine for child survival and health and ensure that where applicable the benefits can be maximised and the dangers minimised.
5.2.7. Provide accessible, affordable, acceptable quality health services and information and support, including mental health services to HIV positive mothers and fathers before, during and after the birth process to ensure the prevention of mother to child transmission of HIV.
5.2.8. Urgently put in place policy, programming and implementation strategies to ensure prevention of mother to child transmission, especially by designing and implementing PMTCT programmes that are directed at community level in terms of applicability, language, local traditions and misconceptions;
5.2.9. Create an enabling legal environment that will encourage pregnant women to under-go HIV testing, provide treatment care and support and ensure availability of antiretroviral therapy for all HIV pregnant women, especially those in rural areas;
5.3. Non-Communicable Diseases
5.3.1. Improve information and research on non-communicable diseases (NCDS) and develop policies and programmes that are up to date and will address the challenges posed by non-communicable disease;
5.3.2. Increase public awareness and education of non-communicable diseases, including life-style, environmental and occupational related NCDs, such as Type 2 diabetes, hypertension (high blood pressure), and cancer and to implement campaigns to use prevention methods as much as possible.
5.3.3. Ensure the better screening and proper management and control of non-communicable diseases by providing timely and AAAQ diagnosis, treatment and information;
5.3.4. Equip health care centres and train health care workers to provide services for complications arising from non-communicable diseases;
5.3.5. Allocate appropriate resources towards address the challenges pose by non-communicable diseases;
5.3.6. Create awareness among people especially those in rural communities on environmental cleanliness.
To download the full document click here: AAI AUC Ford Civil Society African Common Position Paper on ICPD 2013 April
SIGN-ON! Civil Society African Common Position Paper on The International Conference on Population Development.
4. Sexual and Reproductive Health and Rights (SRHR)
4.1.1. Prioritize sexual and reproductive rights in health systems strengthening and development programs so that integrated, high-quality services are available, accessible, and acceptable to all people, especially women and youths, and other marginalised groups as indicated below and particularly those most underserved.
4.1.2. Protect the population’s human rights in sexual and reproductive health programs by guaranteeing that services are designed to respond to individual’s health needs and overcome barriers faced by marginalized groups, including through service provision that is free from stigma, coercion, discrimination and violence, based on full and informed consent, and that affirms the right to pleasure.
4.1.3. Programs must ensure respect for privacy and confidentiality of people in accessing services, and the capacity to make free and informed choices regarding their sexual and reproductive lives from childhood to old age in all their diversity; and pay special attention to marginalized groups.
4.1.4. These services include but are not limited to: comprehensive information on sexuality and contraception services and supplies (including emergency contraception, post exposure prophylaxis, male and female condoms); pregnancy care (antenatal and post natal care, skilled birth attendance, referral systems, and emergency obstetric care); safe abortion services and post-abortion care; access to assisted reproductive technologies; prevention, treatment, and care of sexually transmitted infections and HIV; prevention, treatment and care of reproductive cancers.
4.2. Safe & Legal Abortion
4.2.1. To make evidence based policy changes that recognise the cost-benefits surrounding providing women with access to safe and legal abortions on demand.
4.2.2. To immediately repeal all laws criminalizing, penalizing and/or restricting access to abortion services whilst formulating new laws and policies as a means to allow better access.
4.2.3. To specifically repeal laws that restrict young women from accessing safe abortion services on ground of requiring parental or spousal consent, age of consent or mandatory waiting periods.
4.2.4. To ensure women seeking abortion care are not subjected judicial and non-judicial persecution, including imprisonment or even harassment and degrading treatment in the health systems or by state authorities and institutions.
4.2.5. To implement right based laws and public policies that guarantee and uphold women’s access to safe abortion services without restriction.
4.2.6. To remove all non-legal and non-policy barriers to women gaining access to safe abortions on demand.
4.2.7. To ensure that healthcare workers and the health system are trained, sensitized and equipped with the necessary knowledge, equipment and resources to provide safe abortion services, including pre and post abortion services.
4.3. Freedom from forced sterilisation
4.3.1. Develop, promote and implement policies and clear policy guidelines with regard to sterilisation that protect the rights of women and men, including LGBTI men and women, based on a human rights framework and ensuring informed consent and free choice.
4.3.2. Monitor and document state and non-state violations around SRHR, and especially with regard to forced sterilisation.
4.3.3. Develop laws and policies that are be based on the right to health including freedom from non-consensual medical treatment or experimentation and develop laws and policies that will protect patients from non-consensual medical treatment
4.3.4. Provide on-going human rights training for health care providers, particularly in the context of forced medical treatment.
4.3.5. Establish accountability systems to monitor and ensure adherence of health care workers to human rights based laws on forced sterilisation, experimentation and non-consensual or non-informed medical treatments.
4.4. Accessibility, Acceptability and Affordability and Quality of SRHR services and commodities
4.4.1. Ensure the development and implementation of policy and clear policy guidelines that guarantee universal access to the provision of SRH services and commodities, with free or subsidized care for those in need and those most marginalised;
4.4.2. Inclusion and allocation of a specific SRH commodities budget within the country health budget;
4.4.3. Commit to and conduct effective monitoring and documentation of implementation strategies to minimise potential disparities and ensure universal access;
4.4.4. Support and promote an enabling environment that allows for continuous consultation, meaningful engagement and development across different and relevant sectors;
4.4.5. Commit to set up systems and structures for management, supply and timely distribution of SRH commodities so as to ensure no stock outs and no expired stock.
4.4.6. Commit to and finance the training, deployment, and retention of necessary health workers;
4.4.7. Ensure Inter and Multi-sector collaboration, learning and sharing within regional and sub-regional mechanisms of best practices and lessons learned on SRH commodity management;
4.4.8. Educate and inform citizens of their rights and responsibilities, so that they are better able to make informed decisions on their health choices, and better able to demand accessible, acceptable, affordable and quality SRHR services and commodities;
4.4.9. Recognise the role of the female condom as the only female initiated tool to prevent HIV, STI’s and unplanned pregnancies, and ensure access to quality and affordable female condoms are a reality for all women, as well as commit to funding for training and support for Female Condom Programming;
4.4.10. Recognise the need for further research into the role of anal and vaginal sexual lubricants for use as a tool to prevent HIV, STI’s and unplanned pregnancies, as well as its safety for users and compatibility with various other ingredients and condom varieties. Commit to making access to quality and affordable lubricants a reality for all people, as well as commit to funding for training and support for condom compatible lubricant use;
4.4.11. Train all health care workers, as well as procurement and head office ministry staff on new and evolving SRHR commodities especially with regard to HIV treatment and prevention technologies, this includes but is not limited to understanding the current vaginal and rectal micro-biocide and pre exposure prophylaxis fields in general and their specific programming implications for women and girls.
To download the full full document click here: AAI AUC Ford Civil Society African Common Position Paper on ICPD 2013 April
SIGN-ON: Civil Society African Common Position Paper on The International Conference on Population Development: 3. Population Growth and Structure
3.1. Fertility, mortality and population growth
3.1.1. Ensure that population growth and structure, and demographic work is approached with a human rights and gender responsive lens;
3.1.2. Guarantee that policies to address high fertility and rapid population growth, focus on enlarging, not restricting, individual choices and opportunities;
3.1.3. Ensure that clear policy guidelines are developed and shared and implemented so as to ensure that human rights and gender responsive lens is implemented through to clinic level and that abuse and misinterpretation is impossible.
3.1.4. Improve data collection, quality and analysis to ensure that targeted and evidence based policies are developed, implemented and then closely monitored and evaluated for necessary adjustments.
3.2. Demographic Dividends
3.2.1. To commit to researching, understanding, and investing in the possible dividends to be gained from the pending youth bulge;
3.2.2. To ensure that the population is able to contribute and benefit from potential gains of the demographic dividend by ensuring the following criteria are met:
22.214.171.124. Youth have universal access to quality education, including but not limited to alphabetical and numerical literacy, secondary and tertiary education, comprehensive sexuality education and citizenship and human rights education. This must be equally provided to all, without gender or geographical, religious or other discrimination.
126.96.36.199. Youth have access to programmes which provide entrepreneurship and profit-generating activities training and provided with structural support to implement business ideas;3
.2.2.3. Youth are enabled to make informed and educated decisions on their health, including sexual and reproductive health and rights, and able to access quality health services and information;
3.2.3. Reinforce universal and country specific policies with proven results to spur future job creation and economic growth.
3.2.4. Ensure accountable and transparent leadership to manage demographic change.
DOWNLOAD THE AFRICAN COMMON POSITION PAPER HERE: AAI AUC Ford Civil Society African Common Position Paper on ICPD 2013 April
Health Minister Aaron Motsoaledi has described the launch of the new triple combination antiretrovirals as a revolution.
Johannesburg — The Minister of Health, Dr Aaron Motsoaledi says the roll-out of the Fixed Dose Combination (ARV) during the 2013/14 financial year as announced last year is on track.
The Minister will formally launch the programme on the 8th of April 2013 at Phedisong 4 Clinic – Ga-Rankuwa, north of Pretoria.
“We will be starting with newly diagnosed HIV positive persons eligible for treatment, HIV positive pregnant women and breast-feeding mothers” said Motsoaledi.
Other Patients currently on ARV’s will be switched to the Fixed Dose Combination after clinical assessment by their health care providers.
There are about 1.9 million patients on ARV treatment in South Africa.
5 April 2013
By South African Departmment of Health