Sandeep Prasad on UNFPA’s 2013 State of World Population Report

During the Ottawa launch of the 2013 UNFPA State of World Population Report, Executive Director of ACPD (now Action Canada), Sandeep Prasad spoke to the role Canada could be playing to addressing adolescent pregnancy overseas.

This is not a theoretical report.  It sets out the commitments relating specifically to adolescent girls that were made in 1994 by 179 governments, including Canada, to guarantee their rights to sexual and reproductive health and what countries must do to respect, protect and fulfill these rights.  The ICPD Programme of Action commits government to make information and services available to help protect girls and young women from unwanted pregnancy and to educate young men to respect women’s self-determination.

The report makes clear that solutions cannot be targeted at changing the behaviour of girls; rather they must be targeted at expanding the choices that girls have in their lives.  It requires a multi-tiered approach that involves addressing the underlying determinants and drivers of adolescent pregnancy, including gender inequality, poverty, sexual violence, early and forced (or “child”) marriage, exclusion from educational or job opportunities, and negative attitudes and stereotypes about adolescent girls, as well as, more proximate causes such as the lack of availability of sexual and reproductive health services and the legal, social and economic barriers that interfere with adolescents’ access to them.

These are complex issues but fortunately this year’s State of World Population report sets out a roadmap to the solutions required.

Issues related to adolescent pregnancy are linked to several stated priorities for the Canadian government, in particular: maternal mortality, sexual violence and early marriage.  About 70,000 adolescent girls die each year from pregnancy and childbirth related causes.  The report also notes that adolescent pregnancy occurs, in the developing world, primarily in the context of early marriages or as a result of sexual violence.

While we welcome the government’s attention to a number of issues that are fundamentally intertwined with adolescent pregnancy through its various commitments, it has much more to do to show itself as a leader on these issues.

And here are some thoughts on what that “more” needs to include:

1. The report lays out very clearly the role that laws and policies can play in both driving the conditions that lead to adolescent pregnancy and we also see how addressing these can lead to realizing the human rights of adolescents.  The government needs to use its representation abroad and its seat at the table as a development partner to actively engage in policy dialogue geared at changing laws and policies.  This includes not only measures to ban early and forced marriage but also the paramount need to criminalize marital rape.  There are still 89 countries in the world in which marital rape is perfectly legal and there is a strong correlation between the countries where this is legal and those where early marriage is prevalent.  We know 9 in 10 adolescent pregnancies occur in the context of marriage, but how many occur as a result of rape within marriage?These representations need to also focus on achieving the reform of laws and policies which restrict adolescent access to contraception and abortion services, including the criminal prohibitions of abortion and spousal and parental consent requirements to access these services.

2. The new DFATD needs to commit to implementing the UN Technical Guidance on operationalizing human rights-based approaches to maternal mortality as a donor and in its multilateral engagements.  Moving beyond a statement of principles, the Technical Guidance has the potential to radically change the way countries design and implement sexual and reproductive health policies. It is a technical guidance focused on ministries of health on how to actually implement a human rights based approach to policies and programmes related to maternal mortality and morbidity, showing what is needed at every stage of the project cycle.  This took a great deal of work by civil society at the international level to bring about, including a substantial amount by ACPD.  We are pleased that UNFPA and other UN agencies agreed one year ago to implement the Technical Guidance and we are excited about the pilot projects happening in 5 countries involving government, civil society and UN agencies.

3. Invest further funding for comprehensive sexuality education and sexual and reproductive health services for adolescents.  On comprehensive sexuality education, if we are committed to a gender transformative approach that this report recommends, then this is a key intervention to bring this about.  Not the way sexuality education is being delivered now in many places – these programmes need to focus on, among many other things, eliminating gender norms.  These norms in and of themselves are harmful to girls, boys, and transgender youth and also perpetuate gender inequality and violence.  On funding for sexual and reproductive health, the Canadian government has fallen short of the mark.  For example, despite the investment in the Muskoka Initiative, the government’s figures show that in FY 2011-2012 it spent about $6.9 million on family planning overseas – much less than the $17.8 million it spent in 2005.  In terms of overall funding for sexual and reproductive health, Muskoka has had a positive impact, but the government’s spending falls far short of the target of allocating 10% of ODA to sexual and reproductive health.  Keeping in mind that the government is far behind in fulfilling its overall ODA commitment of 0.7% of GDP, we would estimate that it would take another commitment of the size of 4 new Muskoka initiatives devoted to sexual and reproductive health for the government to be fulfilling its fair share.

4. The government must rescind its Ministerial declarations prohibiting its funding being used to provide safe abortion services.  The government’s response to this has been two-fold: 1) we can’t provide services that contravene national law and 2) other donors will fund these services so we don’t have to.  On the first point, there is plenty of scope for the government to support safe abortion services as part of a comprehensive and integrated package of sexual and reproductive health services – 24 out of the 33 priority countries for international development permit abortion in circumstances of rape, risk to mental health or without restriction as to reason.  On the second point, we need to learn a lesson from our neighbours to the South. The Helms Amendment in the United States (banning the provision of abortion services as a form of family planning in all US-funded development initiatives) has led to denials of lawful care related to abortion. This includes the denial of lawful safe abortions, post-abortion care, and referrals, counselling and information with regard to abortion services.

5. Lastly and yet crucially, the government must invest in human rights accountability for these issues.  That entails advocating for a strong human rights-based accountability framework in the post-2015 agenda, including not just outcome indicators, but also structural and process indicators.  But even more crucially it requires an investment invoice accountability through building the advocacy capacity of civil society in country, particularly women’s organizations and youth-led organizations.  We know from recent attention to these matters the drastic underfunding that exists for these organizations.

Those are our 5 recommendations related to how Canada can improve its efforts directed at improving the lives of adolescent girls.  To conclude, and with a view to strengthen Canada’s efforts abroad, we must question the Governments’ policy, or lack therefore, refusing to fund safe abortion services abroad. This begins with holding the Government accountable to upholding its human rights obligations. We must do this by carefully monitoring the impact of this policy on women’s access to information and services. There must be accountability for these impacts.

I urge you all to read this year’s State of World Population report and the roadmap that it sets out to realize the human rights of girls and I look forward to questions.

Posted on 2013-10-30
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