Reproductive health: Rights in an age of inequality
Expanding options for the poorest women by empowering them to enjoy their right to make their own decisions about the timing and spacing of pregnancies is one important pathway towards their economic security and independence.
Our world is increasingly unequal. But this inequality is not only about money. It’s also about power, rights and opportunities. And it has many dimensions that feed on each other. One dimension of inequality that has received too little attention is in the enjoyment or denial of reproductive rights and the effects of that on half of humanity.
This is the focus of the UNFPA flagship report, The State of World Population 2017. Consider this: In most developing countries, the poorest women have the least power to decide whether, when or how often to become pregnant. The poorest women also have the least access to quality care during pregnancy and childbirth.
This inequity has lasting repercussions for women’s health, work life and earnings potential and for their contribution to their nations’ development and elimination of poverty.
As a medical doctor myself and as a former Representative of UNFPA in Tanzania, I have seen first hand the devastating and needless suffering caused by fistula, and heard the most heartbreaking stories.
More than two million women still have this condition and cannot afford or cannot reach treatment.
Contraception, too, is often out of reach for the poor, particularly those who are less educated and living in rural areas. And this puts women and adolescent girls at greater risk of unintended pregnancy.
An unintended pregnancy can set in motion a lifetime of missed opportunities and unrealized potential, trapping a woman and her children in an endless cycle of poverty. The economic slide can continue for generations.
We also know that many emergencies and humanitarian crises are fueled by inequalities. And inequalities and the vulnerabilities engendered by them are magnified in times of crisis.
A woman or adolescent girl who cannot enjoy her reproductive rights is one who cannot stay healthy, cannot complete her education, cannot find decent work outside the home and cannot chart her own economic future.
Inequality in reproductive health and rights disenfranchises untold millions of women. It also bolsters social and economic systems that enable a privileged few to rise to the top and stay there, while dragging the vast majority to the bottom, robbing individuals of their rights and denying whole nations the foundations for development.
Countries seeking to tackle economic inequality should start by addressing related and underlying inequalities, such as in reproductive health.
Reproductive health and rights are critical but under-appreciated variables in the solution to economic inequality and can propel countries towards achieving the top United Nations Sustainable Development Goal: eliminating poverty.
Expanding options and choices for the poorest women by empowering them to enjoy their right to make their own decisions about the timing and spacing of pregnancies is one important pathway towards their economic security and independence. It is also a pathway towards more balanced economies and societies. And if poor women are disadvantaged, poor adolescents, especially girls, are even more so. Investments in adolescent girls are critical.
A recent study in The Lancet showed that improving the physical, mental and sexual health of adolescents, at a cost of about $4.60 per person per year, would yield more than 10 times as much in benefits to society. Moreover, the highest returns would be in the lowest income countries that are suffering the greatest burden of adolescent death. Innovation and creative solutions are needed to reach the furthest behind first. As Helen Keller once stated: “Although the world is full of suffering, it is also full of the overcoming of it.” Stopping the present downward spiral of inequality will require a new vision for inclusive societies, where all human potential is realized.
This is the vision that informed the goals of the UNFPA Strategic Plan, 2018-2021, which is the first of three Plans to get us to the Sustainable Development Goals 2030 target. Working with other United Nations agencies, partners and governments, UNFPA is committed to a future where zero is the only acceptable number: zero maternal deaths, zero unintended pregnancies and zero gender-based violence and harmful practices, including female genital mutilation and child marriage.
We, therefore, call today for action on multiple fronts to tackle all forms of inequality of sexual reproductive health and rights from the root, laying the foundation for an alternative–equitable–future. A future where all women govern their own lives with equal access to sexual and reproductive health care, where they are free from unintended pregnancies.
A future where all women, men, girls and boys may understand and enjoy their rights and have the knowledge and the power to set their own course in life.
So, to close, inequality is indeed about power–about the few who have it and the many who do not. Worlds Apart–the 2017 UNFPA State of World Population report–is a clarion call for putting power in the hands of women to control their reproductive choices and their futures. With that power in women’s hands, Worlds Apart no longer holds. With that power, instead of separation and inequality, fairness prevails–and a more equitable world for women and girls is the reward.
Dr. Kanem is the Executive Director of United Nations Population Fund (UNFPA)