South Africa’s District Health Barometer, which kicked off in Pretoria yesterday (Monday October 28th), revealed an inconsistent picture of the progress to combat maternal mortality.
Although the overall number of maternal deaths has decreased by 57.6 per 100,000 births in the last four years, the country is still way off the 2015 targets that have been set by the UN’s Millennium Development Goals.
And according to Health-e, a more detailed look at the new data shows some regions are in a desperate position. One example is the Central Karoo district of Cape Town, which has seen stillbirths more than double in the last year.
The Barometer explained that the worsening problems in Central Karoo give an insight into the inadequate provision of healthcare during the latter stages of pregnancy.
It read: “The stillbirth rate is a good indicator of care during the third trimester [of pregnancy] and intra-partum period [labour].”
The Western Cape was also found to have the highest rates of infant diarrhoea in the whole of the country, but interestingly it had the lowest number of infants to die from the disease – perhaps indicating a strong infant healthcare system.
29 October 2013
Despite the United Nations’ zero-tolerance policy against sexual violence, gender-based crimes have broken out across several of the world’s latest conflict zones. Included on that list are South Sudan, the Democratic Republic of Congo, northern Uganda, Somalia and the Central African Republic.
Describing rape as “a weapon of war”, UN Secretary-General Ban Ki-moon told the Security Council last month that sexual violence occurred wherever conflicts raged, “devastating survivors and destroying the social fabric of whole communities”.
“It was a crime under international human rights law and a threat to international peace and security,” he said.
Since most of the heinous crimes are taking place in conflict zones overseen by UN peacekeeping missions, the preeminent international organization is issuing Women Protection Advisers (WPAs) to specifically curb sexual violence in war zones. For starters, they will be deployed with peacekeeping missions in South Sudan, the Central African Republic, Ivory Coast, DRC, Mali and Somalia.
“First-ever scenario-based training programme”
The secretary-general said that UN Women and the Department of Peacekeeping Operations (DPKO) have developed, on behalf of the UN Action Network, the “first-ever scenario-based training programme for peacekeepers”. Noteworthy is the fact that some UN peacekeepers have in the past, along with aid workers, been accused of sexual violence – specifically in South Sudan, DRC, Ivory Coast and Haiti.
The UN will also set up a team of experts on “the rule of law and sexual violence in conflict”, described as an important tool for strengthening national justice systems and legal frameworks. The team has already provided technical advice to governments in the Central African Republic, Colombia, Ivory Coast, DRC, Guinea, Liberia, Somalia and South Sudan.
DRC situation is “unacceptable”
More recently, in late June, the United Nations described as “unacceptable” several cases of rape of young girls in DRC. Nine young girls, aged between 18 months and 12 years, were admitted to a hospital in South Kivu with marks of violence on their bodies and very serious internal wounds, resulting in the death of two.
“Such violence and abuse is unacceptable and must be brought to an end,” said Roger Meece, head of MONUSCO, the UN peacekeeping mission in DRC. “These abuses are said to be related to harmful traditional practices perpetrated by individuals who kidnap young children from their communities.”
There were also widespread reports of 135 women and girls allegedly raped by government soldiers in Minova in eastern DRC back in 2012.
Safety and dignity of survivors
The UN should take urgent action to ensure that WPAs be trained before their deployment and encouraged to work collaboratively with already operational humanitarian structures, said Marcy Hersh, a senior advocate for women and girls’ rights at Refugees International. Additionally, they should be held accountable to fundamental and non-negotiable ethical and safety criteria for investigating sexual violence in conflict, which preserves the safety and dignity of survivors.
Hersh said the recently unanimously passed Security Council Resolution 2106 includes language that is in accordance with these recommendations in its calls for the timely deployment of WPAs, their adequate training, and their coordination across multiple sectors.
By Thalif Deen
22 July 2013
Antiretroviral medication was distributed on Tuesday to Gauteng clinics experiencing a shortage of supplies, health MEC Hope Papo said.
“We understand that a shortage of drugs places a heavy burden on patients who have to make many trips to the clinics,” Papo said in a statement.
“We are also sensitive to the fact that patients my develop drug resistance if they do not take their medication regularly. It is for this reason that we are taking every possible step to stabilise drug supply in the province.”
Papo said a total of 50,000 units of Lamivudine was delivered to the Helen Joseph hospital on Tuesday morning, and it would be delivered to clinics in Ekurhuleni, on the East Rand.
More stock was expected to be distributed on Wednesday, Papo said.
In a statement, the department said the Daveyton East clinic, which had inadequate ARV supplies, was among the first clinics to receive stock.
On Tuesday, the Health Professionals’ Sector of SA National Aids Council (Sanac) expressed concern at the shortage of ARV medication in the province.
“It is sad to note that some of the patients in East Rand clinics are reported to have gone for a week without their antiretroviral drugs,” Sanac said in a statement.
“This, we believe, compromises compliance, as antiretroviral drugs can prolong life only when taken correctly and timely.”
Sanac said it would be difficult to fight the epidemic if problems of medication supply were still happening.
“We wish to urge the Gauteng department of health to strengthen its procurement and distribution systems so that such an occurrence does not happen in future.”
Department spokesman Simon Zwane said the shortage was caused because of capacity at the suppliers, and that the department was looking at ways of improving capacity at the depots.
By The Sowetan
10 July 2013
South Africa has more people living longer with HIV, which is attributed to the country’s anti-retroviral (ARV) treatment programme. The National HIV Household Survey for 2012 shows about 6.4 million people in South Africa are living with HIV, or about 12.3% of the population.
These figures are up from 5.6 million or 10.3% of the population, in 2008. Over 2 million people are on ARV treatment.
Dr Khangelani Zuma of the Human Sciences Research Council presented some of the survey’s findings at the 6th South African Aids Conference in Durban.
“When we looked deeper into the results is that the prevalence of HIV has increased among people who are 25 years and above, but among those that are 15 years to 24 years HIV prevalence has gone down, which means actually fewer youth is HIV positive. But more people who are 25 and above are HIV positive which has a steady increase that could be attributed to the success of ARV therapy,” says Zuma.
A more worrying finding is that condom use among the youth between 15 to 24 years, and among adults aged 25 to 49 has significantly declined.
The Health Department’s Dr Yogan Pillay says they’re extending condom distribution.
“The department is currently working on condom distribution plans at district level which is far more targeted for both male and female condoms because we recognise that while we need combination prevention, condoms work,” says Pillay.
Pillay adds: ” We buy a lot of condoms, 500 male condoms are not enough but 12 million female condoms. The question is who is using it and for those that are not using it why aren’t they using it and what can we do about it. Those are critical questions that we need to answer.”
20 June 2013
By The SABC
6th SA AIDS Conference: Invitation to an Evening Cocktail Event – What is the current role of the business sector in the response to HIV & AIDS? AAI and SABCOHA
INVITE YOU TO:
An evening cocktail event
HIV & AIDS Workplace programmes: What is the current role of the business sector in the response to HIV & AIDS?
Thursday, 20 June 2013, 18:00 – 19:30, Hilton Hotel, 12 Walnut Road, Durban (opposite ICC Durban)
As part of the 6th SA AIDS Conference in Durban 18-20 June 2013.
A panel of experts from:
- AIDS Accountability International
- The De Beers Group
- The International Labour Office
- South African Business Coalition on HIV/AIDS
- The South African Clothing and Textile Workers Union
will speak about the current role in 2013 of the business sector in the response to HIV and AIDS.
To view the invitation please click below:
Please click here to RSVP online: http://www.amiando.com/VZTTHUA.html
or email email@example.com
Uganda’s maternal deaths have been reducing at an annual rate of 5.1% in the past 10 years, a just released World Health Organisation (WHO) report has said.
It however, pointed out that the country is still lagging behind in the reduction of maternal deaths which by 2010, stood at 310, over twice the 150 target set by the UN to be realized by 2015.
It is eighth among the African countries that are making progress in reducing maternal mortality with Rwanda leading the pack with an annual reduction of 8.7% between 2000 and 2010.
The report titled ‘Count down to 2015: maternal, newborn and child survival’ was released at the ongoing Women Deliver global conference that has attracted 5000 participants from 145 countries to the Malaysian capital Kuala Lumpur.
The participants include representatives of international Development Agencies, funding organisations, philanthropists, government representations, NGOs and Media. They are meeting to share best practices, identify opportunities and challenges to improving maternal health and universal access to reproductive health and rights.
The report is an update on the situation in by 2013 features country profiles featuring core indicators selected by the Commission on information and accountability for women and children’s health.
The count down to 2015 is a global movement of academics, governments, international agencies, professional organizations, donors and NGOs. It uses country specific data to track stimulate and support country progress towards achieving the child related development goals especially MDG 4 on reduced child mortality and 5 on improving maternal health.
It pointed out that maternal and child mortality has been dropping over the past two decades globally, but in some countries particularly in Sub-Saharan Africa where fertility remains high, progress has been slower. It said that child deaths are increasingly concentrated in the first month of life. New born deaths now account for 40% or more of all child deaths in 35 of the countdown countries.
“These countries must be prioritized for collective global, regional and national action,” the report said…,” it said of maternal health. “Improving newborn survival, including reducing still births, must be a major focus of policies and programmes,” it added for the child deaths.
It said that under-nutrition coupled with infectious diseases contributed to almost half of all child deaths. Levels of stunting which is a form of growth failure resulting from chronic under-nutrition remain unacceptably high in virtually all the 75 countries.
The report also asked that nutrition must continue to be emphasized as an essential ingredient of maternal, new born and child programmes,” it said. It also called for more efforts to deal with the high fertility levels and the unmet need for family planning.
“Significant challenges remain before us. High population growth remains a looming obstacle to progress in countries where health systems are least equipped to respond to escalations in demand, and pervasive inequities must be addressed if we are to fulfill the promise of MDG 4 and 5 for millions of women and children…,” it stated.
But it said that it is a report of hope showing some successes which show that commitment, investment and coordinated action can yield concrete results. It asked others to learn from the success stories.
Uganda’s maternal mortality ratio has been reducing from 600 in 1990 to 530 in 2000 and by 2010 was at 310. In East Africa its rate of reduction is behind Rwanda’s which reduced at a rate of 8.7% between 2000 and 2010.
It was followed by Tanzania with a 4.6 decline rate, Kenya with a 2.9% decline rate and Burundi whose maternal mortality reduced at a 2.6% rate in the past decade.
3 June 2013
By Samuel Mungadze
A NATIONAL Strategic Plan for HIV, tuberculous (TB) and sexually transmitted infections has been adopted on Friday, during South African National Aids Council (Sanac) meeting in Secunda, Mpumalanga, which was chaired by Deputy President Kgalema Motlanthe.
The National Strategic Plan has a target to have 3-million people on antiretroviral (ARV) treatment by 2015. South Africa currently has 1.9-million people on treatment.
The plan also aims to eliminate the transmission of HIV infection from mother to child by 2015 and to reduce AIDS-related maternal deaths. The country has in the recent past seen significant changes in the rate of mother-to-child HIV transmission.
Between 2008 and 2012, the rate of mother-to-child HIV transmission dropped from 8% to 2.7%. There was a leap in the percentage of HIV-infected women receiving ARV therapy between 2011 and 2012, from 87.3 % to 99%.
Similarly, 99 % of all infants born to HIV-infected women receive prophylactic ARV medication to reduce the risk of early mother-to-child HIV transmission in the first six weeks.
In this plan “Sanac aims to reduce TB incidence and mortality caused by TB in people living with HIV by 50 % in 2015″, read the statement from the council.
Sanac also approved plans to launch an HIV prevention programme aimed at sex workers. Details of the project were, however, not released with the council saying it would do so closer to the launch.
The National Strategic Plan is one of the many plans the government is implementing. Early, this month, Health Minister Aaron Motsoaledi announced the introduction of fixed-drug combination ARV therapy.
Patients living with both HIV and TB, have started being treated on the new therapy.
Fixed-drug combination therapy is a combination of three crucial antiretroviral medications in one tablet, taken only once a day.
This eliminates the need for patients to take three or more pills at various intervals per day.
19 April 2013
From the Business Day Live
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
After the March 2013 launch of AAI’s Country Coordinating Mechanisms (CCMs) Community Consultation Report entitled “Who is really affecting the Global Fund decision making process?” AAI has begun conducting advocacy around the findings. The objective is to use the research as an accountability tool, acting as a best-practice and gaps analysis evidence base for improving the meaningful participation processes of women, girls and those marginalized by their sexual orientation in Global Fund processes.
Download the full report: Who is really affecting the Global Fund decision making processes? A Community Consultation Report
Download the survey report: Who is really affecting the Global Fund decision making processes? A Quantitative Analysis of CCMs
Download the media release: AIDS Accountability International on the Global Fund
To achieve this, AAI conducted its Global Fund Advocacy Week at the Global Fund Secretariat in Geneva, Switzerland, from 15-19 April 2013, since engaging Fund Portfolio Managers and Senior Technical Advisors on gender and key populations is critical for holding both the CCMs and the Global Fund Secretariat accountable for their obligations to marginalized populations. AAI also endeavoured to connect with other partners in Geneva, such as the World Young Women’s Christian Association (World YWCA), the International Labour Organization (ILO) along with funding partners and independent stakeholders.
On Monday 15 April 2013, AAI began its Global Fund Advocacy Week in Geneva by meeting with Nyaradzayi Gumbonzvanda (General Secretary) and Hendrica Okondo (Global Programme Manager SRHR & HIV Focal Point for Africa) at the World Young Women’s Christian Association (World YWCA). The discussion focused on reducing the distance for dialogue between young girls and policy makers, creating spaces of “conversational accountability” and “intergenerational dialogues” so that young girls can have the opportunity to engage with decision makers, but in less technical forums. Leadership was also a topic of strategic thinking, with AAI and the YWCA brainstorming around how to redefine leadership so that it does not rest on the pillars of education or income.
The following day, AAI met with a team of senior technical specialists at the Global Fund Secretariat. Speaking with Linda Mafu (Head, Political and Civil Society Department), Sara Davis (Senior Specialist in Human Rights and Equity), Motoko Seko (Gender and Human Rights Specialist) and Mauro Guarinieri (Senior Advisor, Community Systems Strengthening and Civil Society), AAI pushed for greater accountability towards Human Rights in Global Fund processes. It was agreed during the meeting that viewing human rights through a public health lens can often be highly effective in certain contexts where the rights and women, girls and LGBT people can be politically and culturally sensitive. This supports the research findings in AAI’s CCM Report. AAI and the Global Fund also discussed the new CCM guidelines (2010) which say that CCMs should demonstrate effort to include key affected populations in the country dialogue process. In terms of the way forward, it was raised that Fund Portfolio Managers might benefit from capacity building on how to engage better with civil society outside of the CCM, as well as on human rights and key populations issues.
Continuing with Global Fund Advocacy Week, AAI met with two Fund Portfolio Managers (FPMs), Richard Cunliffe (Botswana, Swaziland) and Viviane Hughes-Lanier (Niger). At these two meetings, AAI consulted with the FPMs about how best to strengthen Africa’s CCMs through improved participation of marginalized groups. The result was a recommendation from the Secretariat to build the capacity of civil society to become principal or sub-recipients, train key populations CCM members on how to influence a meeting, and train the CCM Chairs and Co-Chairs on how to run a meeting that includes discussions of strategic thinking around human rights considerations.
At the end of the week, solid plans had been made to move forward with the project in a manner that continues to involve the Secretariat in Geneva. This way, AAI can increase its impact in pushing for greater accountability to women, girls and SOGI groups from both the CCMs in country, and the FPMs and Technical Specialists at the Global Fund in Geneva.
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