(Photo courtesy of MamaYe)

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

http://www.carmma.org/update/inextricable-link-between-non-communicable-diseases-ncds-and-maternal-mortality?utm_source=CARMMA+Mailing+List&utm_campaign=b8294967dc-CARMMA_Newsletter_April_20135_2_2013&utm_medium=email&utm_term=0_9e3fb35732-b8294967dc-113587333

Complications from Unsafe Abortion Harm Women and Drain Health Resources

Findings from the first national study on the incidence of unintended pregnancy and abortion in Rwanda show that nearly half (47%) of all pregnancies in the country are unintended. The report, Unintended Pregnancy and Induced Abortion in Rwanda: Causes and Consequences, was issued by the National University of Rwanda School of Public Health (NURSPH) and the Guttmacher Institute, which jointly conducted the study.

These unintended pregnancies are occurring despite the county’s remarkable progress in increasing contraceptive use over the last decade. In 2010, 44% of married or cohabiting Rwandan women were using a modern method of contraception, compared with just 4% in 2000. However, the increase in contraceptive use has not kept pace with the growing desire for smaller families and does not extend to the increasing proportion of unmarried young women who are sexually active.

In 2010, an estimated 19% of married women (250,000) and 56% of unmarried sexually active women 15-29 years old (40,000) had an unmet need for contraception—they wanted to avoid pregnancy but were not using a contraceptive method.

The findings were presented in Kigali on March 23 at a Family Planning Day event organized by NURSPH. The event brought together key stakeholders, including Ministry of Health officials, UN representatives, leading NGOs working on health issues and reproductive health advocates, who reviewed the most recent evidence on unintended pregnancy and unsafe abortion and developed a set of policy recommendations to better address the reproductive health needs of Rwandan women. Among these recommendations were expanding provision of postabortion care; making emergency contraception widely available throughout the country; better integrating family planning services and postabortion care; and educating women and medical and law-enforcement professionals about the conditions under which abortion is legal in Rwanda.

“The study’s findings indicate that Rwanda must build on the strong progress made over the last decade and further strengthen its family planning policies and programs,” said Paulin Basinga, formerly with NURSPH and lead author of the report. “Expanding the range of contraceptive options available to women and targeting those women who are at highest risk of unintended pregnancy are especially important if we are to reduce the rate of unplanned pregnancies in the country.”

The researchers found that approximately 22% of all unintended pregnancies end in induced abortion. Rwanda’s abortion rate—25 per 1,000 women of reproductive age—is significantly lower than that of Eastern Africa (38 per 1,000), and lower than that for the African continent as a whole (29 per 1000). Although the abortion rate is relatively low, abortion still places a heavy burden on Rwandan women and the health care system because virtually all abortions occur outside of the formal health system where safety cannot be assured.

In 2009, 24,000 of the approximately 60,000 women who had an abortion suffered complications that required medical treatment. Of these, just 17,000 received adequate treatment in a health facility; thus, 30% of the women who needed care did not receive it. According to the study, this was most likely a result of insufficient access to postabortion care and reluctance on the part of women to seek treatment, which could potentially expose them to harsh judgment or even prosecution for engaging in a stigmatized and illegal act.

Poor Rwandan women, in urban and rural areas, are far more likely to experience complications (54–55%) than wealthier women in both rural (38%) and urban areas (20%). According to experts surveyed, poor women are most likely to self-induce or rely on untrained providers such as traditional healers. Abortions from these sources have the highest estimated rate of complications—61–67%.

“The Rwandan government has already started to take action to improve access to postabortion care and we hope these findings provide further guidance on how to strengthen efforts to ensure that all Rwandan women receive the care they need,” said co-author Ann Moore of the Guttmacher Institute.

For more information:

Click here for the full report Unintended Pregnancy and Induced Abortion in Rwanda: Causes and Consequences, also available in French

Click here for the fact sheet Abortion in Rwanda, also available in French

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.

Deadline to Apply: May 4, 2013

The Youth Coalition for Sexual and Reproductive Rights (YCSRR) is an international organization of young people (ages 15-29 years) committed to promoting adolescent and youth sexual and reproductive rights at the national, regional and international levels. We are students, researchers, lawyers, health care professionals, educators, development workers, and most importantly, we are all dedicated activists.

In 2014-2015, the International Conference on Population and Development Programme of Action (ICPD PoA) and the Millennium Development Goals (MDGs) will be reviewed. The coming months and years offer significant opportunities for progressive youth advocates to influence the next development agenda, and, ultimately, ensure that youth SRHR is at the heart of the agenda.

Throughout 2012 and 2013, the YCSRR will be holding a series of regional trainings for young SRHR advocates. In 2012, we successfully held two trainings in the Asia-Pacific and the Latin America and Caribbean regions and another one in 2013 in Africa with over 70 young people.

Expanding to other regions, the YCSRR will conduct the third training of this series in the Middle East and Northern Africa region to build knowledge of youth activists on the ICPD and MDG review processes on regional and international levels, and assess how their commitments have been implemented at the country level. During the training, participants will strengthen their capacities to effectively lobby their governments and national delegations on issues related to the ICPD PoA and the MDGs, while also increasing their knowledge of issues concerning young people’s sexual and reproductive health and rights. Through these trainings, the YCSRR will provide ongoing technical assistance to participants and their organizations throughout the follow-up to the training. During the follow-up, participants will collaboratively work to develop national action plans to hold governments accountable to commitments made to youth SRHR in the ICPD and MDGs agenda.
When: June 16th – 19th, 2013
Where: Egypt
Training Goals

1. Build the capacities of young leaders to incorporate youth SRHR issues in the ICPD 2014 Review process, MDG 2015 Review and national poverty reduction strategy (PRS) processes.   2. Mobilize young people to advocate for youth SRHR in their respective national, regional and international ICPD and MDG review processes.

Training Learning Objectives
* Increase understanding of young people’s SRHR and its links to gender equality and poverty reduction.

* Increase knowledge of ICPD PoA, Beijing Platform for Action, and MDG commitments, their review processes and implementation through national-level processes.

* Strengthen advocacy skills of young people to influence policy at national, regional and international levels in the lead up to ICPD and MDGs review processes.

The YCSRR welcomes Letters of Interest from progressive youth-led and youth focused organisations who meet the eligibility criteria below to nominate two young people from your organisation to participate in the training. All organisations applying must support the YCSRR’s principles and values.

The YCSRR seeks Letters of Interest from youth organisations who are:

* Based in MENA

* either working on regional or national level in the region.

* Working with, or strongly connected to, young people between the ages 18 and 27.

* Have strong connections with national youth organisations and networks.

* Have a working knowledge of English (training will be conducted in English).

* With demonstrable experience working in the area of sexual and reproductive health and rights or related field.

* Planning to work on the ICPD, MDGs and PRS related advocacy initiatives & programmes in the lead up to 2014 and 2015.

* Have the institutional capacity to support its representatives to the training in the follow up at the national level.

* Willing and able to commit staff time and other resources to coordinate the preparation and follow-up to the training in the form of getting involved in and developing national-level advocacy initiatives in the lead up to the ICPD review in 2014.

Please note: Selected organizations will collaborate with each other in the post-training follow-up process and longer-term engagement in supporting the YCSRR’s progressive youth SRHR advocacy in dialogues leading up to the review processes in 2014/2015.

Interested and qualified organisations must complete the application form, clearly responding to all questions. In the application form (accessible here), please also identify 2 nominees from your organization who will participate in the training. For any inquiries, please contact admin@youthcoalition.org. Please submit completed application forms by May 4th, 2013 at 5pm EST.

Please click here to access the application form.

youth coalition for sexual and reproductive rights
admin@youthcoalition.org / www.youthcoalition.org
facebook: www.facebook.com/YouthCoalition twitter: @youth_coalition
tel: +1 613 562 3522 / fax: +1 613 562 7941

working internationally for sexual and reproductive rights.

Goodluck Jonathan, President of Nigeria

23 April 2013

ABUJA - Nigeria’s President, Goodluck Jonathan, agreed to help lead the Global Fund’s efforts to raise funds this year, a critical role in the partnership to fight AIDS, tuberculosis and malaria all over the world.

President Jonathan met with Mark Dybul, Executive Director of the Global Fund, on Monday to discuss joint efforts to control these deadly infectious diseases in Africa’s most populous nation and globally.

Dr. Dybul praised President Jonathan’s effective leadership and personal commitment to expanding health services, embodied by Nigeria’s “Save One Million Lives” initiative that is aiming to dramatically increase access to basic quality health services, particularly for women and children.

President Jonathan accepted an invitation be a Co-Chair in this year’s replenishment efforts by the Global Fund. Other Co-Chairs include UN Secretary-General Ban Ki-moon and heads of state from developed countries, emerging economies and the private sector.

“Working together, we can make tremendous gains, said Dr. Dybul. “With the existing science, our understanding of the epidemiology and our collective experience in combating the diseases, we now have an opportunity to control them. If we do not, the long-term costs will be incalculable.

During his first visit to Nigeria as Executive Director of the Global Fund, Dr. Dybul also met with the Minister of Health, Prof. Chukwu Onyebuchi and Minister of State for Health, Dr. Muhammad Pate, and other key stakeholders, partners and implementers to discuss opportunities to further strengthen collaboration.

Mr. Aig-Imoukhuede, Chairman of Friends Africa, said: “The upcoming replenishment of the Global Fund is its most critical replenishment and ought to be given the highest levels of support for the fight against these diseases to be won.”

Dr. Dybul announced that the Global Fund is providing up to US$ 288 million in additional funding to help accelerate programs to prevent and treat HIV and malaria in Nigeria. This new funding is being made available under a new funding model, and Nigeria is one of 47 countries accessing new funding through renewals, grant extensions and redesigned programs in 2013.  The Global Fund’s latest HIV grants are targeting pregnant women and “most-at-risk” populations such as women and girls, sex workers, people who use drugs, men who have sex with men, while the TB grants support expansion of diagnosis and treatment capacity including treatment of multidrug-resistant TB.

Malaria grants are aiming to achieve nationwide coverage of mosquito nets through mass campaigns and routine distribution, while at the same time increasing availability of antimalarial medicines and diagnostic tests.

Despite promising advances in recent years, such as declining AIDS and TB mortality and a sharp increase in the use of insecticide-treated nets, Nigeria faces serious health challenges. Over the last 12 months, Nigeria and the Global Fund signed agreements in worth a total of US$ 560 million to support programs that will help significantly expand prevention, diagnosis and treatment of the three diseases.

Dr. Dybul appealed to President Jonathan to expand domestic investment in health even further.

Nigeria has the second-largest number of people living with HIV in the world after South Africa. But only 30 percent of those needing treatment are on antiretroviral therapy and only 16 percent of pregnant HIV-positive mothers are getting prophylactic treatment to prevent them from passing on the virus to their babies.

The country also has the second-highest child and maternal mortality in the world, in absolute numbers, and accounts for nearly one-third of deaths from malaria globally. While TB mortality has fallen significantly since 2003, case detection rates are still among the lowest in the world.

For more information, please contact:

ANDREW HURST
Head of Media and Translations
Mobile: +41795616807
E-mail: andrew.hurst@theglobalfund.org

26 April 2013

Global Fund News Release

http://www.theglobalfund.org/en/mediacenter/newsreleases/2013-04-23_President_of_Nigeria_Joins_Global_Fund_Efforts_to_Broaden_Fight_Against_HIV,_TB_and_Malaria/

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!

SIGN ON to endorse this document here

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.

For more information, the full Civil Society African Common Position Paper and contact details click here

6.    Key populations

This section provides recommendations that addresses key matters that affect gender equality, equity and empowerment for all

1. Women,
2. Persons with disabilities,
3. Youth,
4. Lesbian, Gay, Bisexual, Transgender and Intersex Persons (LGBTI),
5. Persons living with HIV (PLHIV),
6. Older persons,
7. Orphans, and
8. 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

5. Health morbidity & mortality

5.1. Women’s health and safe motherhood

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

Watch MP Maurice Williamson’s witty speech supporting the Marriage Amendment Bill.

http://tvnz.co.nz/national-news/williamson-s-big-gay-rainbow-speech-makes-world-headlines-5410324/video?vid=5409813

http://www.youtube.com/watch?v=VRQXQxadyps

الزملاء الأعزاء,

لقد انتهينا للتو من تحديد الموقف العام للمجتمعات المدنية الإفريقية بشأن المؤتمر الدولي للسكان والتنمية!

كما هو معروف لدى العديد منكم، اعترفت المسائلة الدولية بشأن الإيدز ومفوضية الاتحاد الإفريقي في عام 2012 بالحاجة لتمثيل أكبر لمنظمات المجتمع المدني الإفريقية في المؤتمر الدولي حول عملية التنمية السكانية.

وقد تقرر  وضع ورقة تحديد للموقف العام من المؤتمر الدولي بشأن التنمية السكانية لكي تعكس وتشمل وجهات النظر والتوصيات والخبرات من أصحاب الشأن في إفريقيا.

يتضمن الموقف الإفريقي العام من المؤتمر الدولي بشأن التنمية السكانية مجموعة من التوصيات الموجهة للحكومات الوطنية لكي تعالج قضايا السكان والتنمية. وسوف تشكل هذه الورقة جزءاً من المؤتمر الإقليمي حول السكان والتنمية في شهر أيلول/ سبتمبر في أديس أبابا، حيث سيتبنى الوزراء المكلفون بقضايا السكان التقرير  القاري حول المؤتمر الإفريقي بشأن التنمية السكانية في 20 موقف إفريقي عام حالما يتم تقييمه من قبل مفوضية الاتحاد الإفريقي ووزراء الاتحاد الإفريقي المكلفين بقضايا السكان.

وعند التصديق على هذه المواقف، سوف تؤخذ النسخة النهائية لورقة تحديد الموقف العام إلى الجمعية العمومية في عام 2014 في استعراض المؤتمر الدولي بشأن التنمية السكانية بصفتها الوثيقة الرئيسية التي تعكس الموقف الإفريقي من المؤتمر الدولي بشأن التنمية الإفريقية.

نتقدم بالشكر الجزيل لمؤسسة فورد في جنوب إفريقيا على ما قدمته من مساندة في هذا العمل.

التسجيل

للتسجيل والموافقة على الموقف العام للمجتمعات المدنية الإفريقية، الرجاء ألضغط على أيقونة الرد أو إرسال رسالة بريد إلكتروني إلى phillipa@aidsaccountability.org

سوف يتم تضمين الموافقات من جميع أنحاء العالم، مع أنه سيتم إدراج الأفراد والمنظمات في إفريقيا في قائمة منفصلة عن تلك القائمة المخصصة للدول غير الإفريقية.

الاسم:

المنصب/ المسمى الوظيفي:

المنظمة:

الجنسية

البلد:

البريد الإلكتروني:

الموقع الإلكتروني:

رقم الهاتف:

نتقدم بالشكر الجزيل لكل من ساهم في  صنع هذا التوجه الحقيقي للأصوات الإفريقية.

نوجه عنايتكم لما يلي: قد تتضمن الأوراق أخطاء بسيطة أو أخطاء غير مقصودة. الرجاء إرسال بريد إلكتروني إلى phillipa@aidsaccountablity.org

مع خالص التقدير والاحترام

فيليبا

فيليبا تاكر

المدير التنفيذي

المسئولية الدولية عن الإيدز

102 Greenmarket Place, 54 Shortmarket Street
Cape Town 8000
South Africa

رقم الهاتف: +27 (0)21 424 2057

موبايل رقم:+27 (0)82 225 1598

البريد الإلكتروني: phillipa@aidsaccountability.org