Category Archives: SRHR

500 days and counting: Progress for girls and women means progress for all

August 18 marks 500 days remaining before the Millennium Development Goals expire at the end of 2015. Some countries are on track to meet those goals and some are not, and central to the difference is their relative levels of investment in women and girls.

The MDGs emerged from an historic summit of world leaders to mark the new millennium nearly 15 years ago. Since then, countries that worked to boost girls’ education, women’s rights and comprehensive maternal, sexual and reproductive health care saw benefits not just for gender equality and longer lives for women and children but in other areas as well — against poverty and hunger, against diseases including HIV and AIDS, and toward a more sustainable environment. Investment in girls and women turned out to be the most cost-effective way to advance on all the goals.

Women Deliver was organized to point out this connection. At three global conferences of activists and decision-makers from around the world — in London in 2007, in Washington, D.C. in 2010 and in Kuala Lumpur in 2013 — it provided statistics and case studies that proved the truth of its slogan, “Invest in women — it pays!” Every year brought more proof and better examples of investments in girls and women in which everybody won. So today, as the international community begins final MDG assessments and considers future plans, we are proud to announce that the next triennial Women Deliver conference will be held on May 17-19, 2016 in Copenhagen, Denmark.

Like the previous three gatherings, this one will bring together advocates, policymakers, journalists, young people, researchers and leaders of the private sector and civil society to showcase what it means and how it works when women and girls become the focus of development efforts. It will document the great results around the world where investment in women rose.

The Women Deliver 2016 Conference will also be the first major global conference after the post-2015 development framework, so far called the Sustainable Development Goals, is decided. It will be a first chance for strategizing on ways to turn the MDG spurs for growth into the plowshares of a livable planet, to make startup programs sustainable over the long term, to bring pilot programs to national scale — in short, to firm up long-term support, ensure that girls and women are kept at the center of the new development plans from the beginning, and include them in operations and evaluations at every stage into the future.

Copenhagen was chosen because Denmark is a leader and champion for progress in sexual and reproductive health and rights. The Danish International Development Agency has already launched a new Strategic Framework for Gender Equality, Rights and Diversity to assist women and girls in seizing opportunities and resources to take full control over their own lives. The Ministry of Foreign Affairs of Denmark is fully in support of Women Deliver’s call for additional global commitment on behalf of girls and women.

The post-2015 development framework is being developed as we write, and Women Deliver is working  to ensure that decision makers prioritize maternal, sexual and reproductive health and rights, especially in countries where inequality prevails and where it would help development most.

Closing the gender gap in agriculture alone, for example, could lift up to 150 million people out of hunger. Investing $8.1 billion a year in voluntary family planning would reduce pregnancy-related deaths by 79,000 and newborn deaths by 1.1 million every year. Increasing girls’ school attendance by only 10 percent raises a country’s GDP by 3 percent. And eliminating barriers to employment for girls and women could raise labor productivity in some countries by 25 percent.

These are the facts of life in the 21st century. Imagine a world where no woman dies giving life, where no baby is born with HIV, where every girl can attend school and get a quality education, and where everybody has a chance to fulfill their potential. The post-2015 process can move us closer to that day — if it prioritizes the health, rights, and well-being of girls and women.

In these last 500 days, Women Deliver will build on the momentum generated by our previous gatherings to see that it happens. We will insist that adolescents and young people, who predominate in most developing areas, should get special focus. We will make sure that women are present at the tables where decisions are made. And we will continue playing a critical role in fueling the global movement for maternal, sexual and reproductive health and rights.

We will see you all in Copenhagen!

Aug. 18, 2014, marks the 500-day milestone until the target date to achieve the Millennium Development Goals. Join Devex, in partnership with the United Nations Foundation, to raise awareness of the progress made through the MDGs and to rally to continue the momentum. Check out our Storify page and tweet us using #MDGmomentum.

By Jill Sheffield and Katja Iversen

18 August 2014

Source: https://www.devex.com/news/500-days-and-counting-progress-for-girls-and-women-means-progress-for-all-84064

The Evidence Is In: Decriminalizing Sex Work Is Critical to Public Health

During the 2014 International AIDS conference, The Lancet medical journal released a series of articles focused exclusively on HIV and sex work. One study by Kate Shannon et al., demonstrates that decriminalization of sex work could reduce HIV infections by 33 to 46 percent over the next decade. Shannon’s team showed that “multi-pronged structural and community-led interventions” are essential to promoting the human rights of sex workers, as well as improving their access to HIV prevention and treatment. Dr. Chris Beyrer, the researcher who coordinated this Lancet series, told AIDS conference participants that“[e]fforts to improve HIV prevention and treatment by and for people who sell sex can no longer be seen as peripheral to the achievement of universal access to HIV services and to eventual control of the pandemic,” drawing an irrefutable line between the social, legal, and economic injustices sex workers face and their subsequent vulnerability to HIV.

 

The Lancet series authors join many other prominent public health voices in identifying the decriminalization of sex work as vital to preventing the spread of human immunodeficiency virus (HIV) and of acquired immune deficiency syndrome (AIDS). For two decades, sex workers rights’ activists throughout the world have pushed human rights, public health, and HIV and AIDS response leaders to recognize that they, along with people who inject drugs and men who have sex with men, are “key populations” without whom an effective HIV and AIDS response is impossible. In 2012, the World Health Organization (WHO) declared that “all countries should work toward decriminalization of sex work and elimination of the unjust application of non-criminal laws and regulations against sex workers.” In South Africa (with the largest population of people living with HIV in the world), the National AIDS Council is urging its government to decriminalize sex work—a demand that advocates and health policy professionals are making in dozens of other countries as well. Amnesty International, Human Rights Watch, and the UN’s Global Commission on HIV and the Law all endorse this position. The latter points out “the impossibility of governments stigmatizing people on one hand, while simultaneously actually helping to reduce their risk of HIV transmission or exposure on the other.”

 

Sex work has been decriminalized in New Zealand and one province (New South Wales) in Australia leaving sex work businesses subject to standard occupational health and safety regulations. Law enforcement treats the sale of sex as it does any other business, without any intrusion or interruption unless existing laws are being violated.

 

Decriminalization has resulted in higher rates of condom use and enables sex workers to organize community-based health practices that demonstrably improve health and reduce HIV risk. It also makes it possible for sex workers to report and for the police to address illegal acts as they occur, such as assault, theft of services, employment of minors, or client coercion. In this decriminalized setting, sex workers can be strong allies in the fight against trafficking, intimate partner violence, and child abuse since they can report incidents to the police and social service agencies without putting themselves at risk of arrest.

 

So, why is the HIV-AIDS field only just beginning to recognize the connection between the decriminalization of sex work and HIV? And why is the trend toward criminalizing populations involved in the sex trades increasing in the United States—moving in the opposite direction from other countries? The following are three contributing factors.

 

Conflating Sex Work With Trafficking

 

Public debate around sex work in the United States increasingly focuses on people who have been trafficked or otherwise coerced into the sex trade. Anti-trafficking advocates conflate sex work (people choosing to sell sexual services from among employment options available to them) with trafficking (people being forced into the sex industry against their will). Laws that criminalize all people selling sex (voluntarily or involuntarily) violate the rights of the former and undermine efforts to identify and assist the latter. The Global Commission on HIV and the Law states unequivocally that, “Sex work and sex trafficking are not the same. The difference is that the former is consensual, whereas the latter is coercive.”

 

A commentary by Steen et al. in the recent Lancet series notes that “repressive and counterproductive police action,” including the arrest and incarceration of trafficking victims for the purposes of “rescue,” has overtaken far more effective responses in several countries. The understandable, but destructively over-simplified, mandate to “rescue and restore” sex workers is also being imposed in public health settings where providers are now charged with identifying and intervening with potential victims of trafficking in the sex trade. Certainly, health-care providers have a duty to watch for and help patients in abusive situations of all kinds. They also have a duty to understand the complexities of human experience, respond to patient-identified needs, and maintain that patients are experts of their own lives, whatever that may look like.

 

Lack of Access to Health Care for Sex Workers

 

Providing access to health-care services targeted to consumers’ needs is a vital part of any country’s HIV response. Without it, those most in need of prevention, care, and treatment are least likely to get it.

 

In a 2010 survey, 53 percent of medical students said they were not adequately trained to address their patients’ sexual issues comfortably. Far fewer professional medical curricula explicitly prepare students to understand that they will encounter sex workers as patients who, like all other patients, are individuals with a wide range of experiences, backgrounds, and needs that can best be treated with patient-centered care.

 

When sex workers receive demeaning and unprofessional treatment in health-care settings, they see health-care providers as an extension of the larger system that criminalizes them. A survey by the New York City-based Persist Health Project found that few sex workers disclosed their occupation to their health-care provider; only one study participant reported a positive experience after doing so. As one respondent explained, “I think for security reasons, I don’t usually disclose. Mainly because I don’t trust doctors … I sort of treat them like law enforcement.” Another noted that most health-care providers “have no clue who you are, no clue about your background, you can’t read them or know that they’re not going to try to lecture you or give you a stink-eye.”

 

St. James Infirmary, a peer-based occupational safety and health clinic for sex workers in San Francisco, corroborates these findings. Of their incoming patients, 70 percent had never previously disclosed their occupation to a medical provider for feared of bad treatment. Providing sex-worker friendly health care requires training health-care workers appropriately and supporting services designed specifically with and for the communities they serve.

 

Violence Risk Exacerbated by Criminalization

 

People usually envision a sex worker as someone soliciting on the street, but only about 20 percent of U.S. sex workers are street-based. The vast majority see clients in other venues including massage parlors, brothels, apartments they share with other sex workers, or a client’s hotel room. Many connect with clients online.

 

HIV risk is high among street-based sex workers who experience high levels of violence at the hands of clients and abusive law enforcement personnel. One important way they reduce this risk is assessing a potential client before getting into his car—looking for signals that he might be violent and relaying his license number to a colleague in case the worker disappears. This assessment time is also used to negotiate price and condom use. Law enforcement crack-downs compel sex workers to complete their negotiations quickly (in order to avoid arrest), depriving them of the time needed for assessment and negotiation.

 

Street-based sex workers have little or no protection if a client becomes violent or refuses to use a condom. Of the street-based workers surveyed in The Lancet study by Shannon et al., 25 percent reported being pressured by clients to have sex without a condom. Those working in remote areas (such as industrial parks) to escape local policing were three times more likely to report being pressured into having sex without a condom than the study population overall. The recent Lancet series data also shows that, in some countries, up to one-third of sex workers do not carry an adequate supply of condoms due to “condoms as evidence” policies that allow police to seize a sex worker’s condom supply and use it as evidence of their intent to engaged in sex work—a widely-used policy in several U.S. cities. 

 

Getting From Here to There 

 

Punitive laws against sex work are in place in 116 countries, including the United States, creating, according to the Open Society Foundations, “a state-sanctioned culture of stigma, discrimination, exploitation, and police and client violence against sex workers.”

 

Decriminalizing sex work in the United States is a long and challenging process, but there is a path to follow. The 1988 ban on federal funding for syringe exchange remained in place for 20 years and, after briefly lifting it in 2009, the Obama administration agreed to its reinstatement in 2011 at Congress’ insistence. Advocacy pressure to overturn it continues.

 

Thanks to the efforts of dedicated researchers and activists during the two decades between 1988-2009, public health professionals, medical institutions and virtually everyone working in the HIV-AIDS field learned why harm reduction practices are essential. Services to people who use drugs began to improve, although they are still inadequate, primarily because they are grossly under-funded. Progress has been made.

 

The U.S. National Institutes of Health (NIH) issued a consensus statement that addressed the need for syringe exchange but also observed that “[p]rograms targeting sex workers have been highly efficacious in other countries, but [in the U.S., programs] will encounter cultural and political barriers.” The public silence maintained on this issue for the last 17 years is emblematic of those barriers.

 

But sex workers’ rights organizations in most U.S. cities, though heavily marginalized, have not been silent. They are struggling to end “condoms as evidence” practices, train health-care providers, find or establish sex worker-friendly health-care services, and demand their rightful place as invaluable allies in ending human trafficking and preventing the spread of HIV. Like the harm reductionists who set up the first syringe exchange sites in the United States, they need the support of mainstream sexual and reproductive health advocates willing to learn from them and join them. Like the early harm reductionists, they need the rest of us to bring our money, skills, and political support this human rights struggle.

 

We can’t stop HIV in the United States without sustainable and long-term solutions to end the arrest, detention, and incarceration of sex workers in the United States, as well as end the violations against sex workers within the correctional system. A meta-analysis of more than 800 other studies and reports, published in the recent Lancet series, listed abuse experienced by sex workers as including “homicide; physical and sexual violence, from law enforcement, clients, and intimate partners; unlawful arrest and detention; discrimination in accessing health services; and forced HIV testing.” It added “protection of sex workers is essential to respect, protect, and meet their human rights, and to improve their health and well-being.”

 

Expert voices in support of community-led, sex worker-centered health care in the fight against HIV are becoming more and more numerous. When will the mainstream HIV and AIDS organizations and women’s health advocacy communities join loudly in this demand?

 

by Anna Forbes and Sarah Elspeth Patterson

13 August 2014

Source: http://rhrealitycheck.org/article/2014/08/13/evidence-decriminalizing-sex-work-critical-public-health/

Young people demand sexual and reproductive health rights

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The first time Alfred went to a HIV voluntary testing centre, the healthcare provider did not treat him well. As a gay man, his story is not so rare.

“He [healthcare worker] asked me are you a man or a woman? I answered I am a man. Then he asked me about my parents,” said Alfred, who lives on the Caribbean island of Saint Lucia.

“He just looked at me and treated me as if I was a disgrace to my parents. I decided not to go to the health centre after that. Because I do not want to go to a place where I am judged based on my sexual orientation. I am gay and I have sex. So what? ”

Challenges for youth to accessing sexual and reproductive health

Key populations in the HIV epidemic, such as men who have sex with men, sex workers and transgender people, have the same sexual and reproductive health rights as anyone else— the right to have sexual relations free from coercion, to have children and to protect themselves from infection.

Last week’s International AIDS Conference in Melbourne, Australia was an opportunity for young people, especially youth from key populations, including young people living with HIV, to discuss the barriers and challenges they face in accessing sexual and reproductive health services.

During a session moderated by the Athena Network and the International HIV/AIDS Alliance, one young panelist Violet Lindiwe, 23, from Malawi, said: “In my community, when you attend HIV testing and family planning, healthcare professionals are likely to judge you because they think you misbehaved and that’s why you are there.”

Myo Minn Htet, a young man from Indonesia, added: “Culture and religious beliefs make it very difficult to talk about sex and to go to sexual and reproductive health services. Moreover discrimination against young key populations make their access to these services more difficult.”

The legal age to attend health centres is also one of the barriers identified by young people. Annie Zamina from Malawi said: “In my country though the legal age to have sex is 16, you cannot go a clinic and ask for contraceptive pills without your parents’ approval. It seems that while the law says you’re old enough to have sex, you are still too young to use contraception or to protect yourself from HIV.”

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Young people vulnerable to HIV infection and unwanted pregnancies

According to the UN, globally young people account for 40% of all new HIV infections. Each day, more than 2,400 young people become infected with HIV, and some 5 million young people aged 15–24 live with HIV.

Apart from HIV infection, poor access to sexual and reproductive health and sex education opens the door to many other consequences, such as unintended pregnancies and dropping out of school.

Violet said: “When you listen to me, you may think I have a PhD but in fact, I stopped school when I became pregnant. I have to care for me and my son now. And this is what happens to young women in my community when they get pregnant when still students.”

Integrated services

According to the World Health Organization, linking sexual and reproductive health with HIV services is an approach that has the potential to increase universal access to prevention, treatment, and care services.

This is what Link Up— a programme to improve the sexual and reproductive health and rights of young people—is trying to achieve. The project works with young people living with and affected by HIV in Bangladesh, Burundi, Ethiopia, Myanmar, and Uganda and is implemented by a consortium of organisations, including the International HIV/Aids Alliance, Global Youth Coalition against Aids, and the Athena Network.

Sexual and reproductive health rights

Reproductive rights only become tangible when reproductive health services that offer a high quality of care are made widely available. Availability includes both affordability and easy access, which also implies a range of services under one roof.

Like Alfred, Rebeccah, a young woman living with HIV from Zimbabwe, was also treated badly the first time she went to a clinic to receive counselling about contraception. She said: “The nurse said she was surprised I was still having sex considering my ‘condition’. And she told me I should abstain from sex since I am HIV positive. I cried a lot in her office and decided not to go to that clinic anymore.”

But Rebeccah, like many other young people, is now getting to grips with her rights. “As a young woman living with HIV, I am sexually active and I have the right to go a clinic for family planning services,” she said. “My status should not be an argument to be denied this service. And I really hope people should not use our status, our sexual orientation or sex work as argument to deny access to healthcare because we need, no, we demand access to comprehensive sexual and reproductive health services.”

Nina Benedicte Kouassi is a member of the Key Correspondents network, which focuses on marginalised groups affected by HIV to report the health and human rights stories that matter to them. The network is supported by the International HIV/AIDS Alliance.

Feature image credit: Sheikh Rajibul Islam/International HIV/AIDS Alliance

In-post image credit: Julie Mellin/GYCA

By Nina B. Kouassi

30 July 2014

Source: http://stayingalivefoundation.org/blog/2014/07/young-people-demand-their-sexual-and-reproductive-health-rights/

Urban population boom poses massive challenges for Africa and Asia

The UN predicts that two-thirds of the world will live in cities by 2050, with 90% of growth taking place in the global south

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Two-thirds of the world's population will live in cities by 2050, posing unique infrastructural challenges for African and Asian countries, where 90% of the growth is predicted to take place.

The planet's urban population – which overtook the number of rural residents in 2010 – is likely to rise by about 2.5 billion to more than 6 billion people in less than 40 years, according to a UN report. Africa and Asia "will face numerous challenges in meeting the needs of their growing urban populations, including for housing, infrastructure, transportation, energy and employment, as well as for basic services such as education and healthcare", it adds.

Future development targets should focus on creating inclusive cities with adequate infrastructure and services for all residents, said John Wilmoth, director of the UN's population division. "Managing urban areas has become one of the most important development challenges of the 21st century," he said. "Our success or failure in building sustainable cities will be a major factor in the success of the post-2015 UN development agenda."

The report says rapid urbanisation will bring opportunities for governments to improve access to important services. "Providing public transportation, as well as housing, electricity, water and sanitation for a densely settled population is typically cheaper and less environmentally damaging than providing a similar level of services to a predominantly rural household," it says.

Africa is projected to experience a 16% rise in its urban population by 2050 – making it the most rapidly urbanising region on the planet – as the number of people living in its cities soars to 56%.

The report predicts there will be more than 40 megacities worldwide by 2050,each with a population of at least 10 million. Delhi, Shanghai and Tokyo are predicted to remain the world's most populous cities in 2030, when each is projected to be home to more than 30 million people.

"Several decades ago most of the world's largest urban agglomerations were found in the more developed regions, but today's large cities are concentrated in the global south," the UN says. "The fastest growing urban agglomerations are medium-sized cities and cities with fewer than 1 million inhabitants, located in Asia and Africa."

The world's 3.4 billion-strong rural population will start to decline as urbanisation becomes more common, the report says. The UN projects that rural populations will increase in only a third of countries between 2014 and 2050, as states with large rural communities will take longer to urbanise. "In general, the pace of urbanisation tends to slow down as a population becomes more urbanised," the report says.

The UN cautions that sustainable urbanisation requires cities to generate better income and employment opportunities, and "expand the necessary infrastructure for water and sanitation, energy, transportation, information and communications; ensure equal access to services; reduce the number of people living in slums; and preserve the natural assets within the city and surrounding areas".

Urbanisation has historically taken place in wealthy countries, but such expansion is now happening most rapidly in upper-middle-income countries, where gross national income per capita is between $1,046 and $4,125.

Source: http://www.theguardian.com/global-develop​ment/2014/jul/10/urban-population-growth-africa-asia-united-nations

Post-2015 Agenda: Organized Chaos or Hot Mess?

Sexual and Reproductive Health in Trouble as Goals Move Forward 

UN flag on Crumpled paper texture

The latest version of the zero draft report from the Open Working Group developing the Sustainable Development Goals (SDGs) hit the internet late Monday evening. This is the final draft that member states will have a chance to respond to before the final report is produced and shared with the Secretary General prior to the United Nations General Assembly in September. It is fairly similar to the last draft in that it still has the same 17 goals, with small semantic differences. Overall, there are fewer targets, but both the targets and the process are becoming increasingly convoluted.

 

This draft misses the integration, aspiration, transformation and sustainability that were meant to drive the post-2015 agenda.  We see important targets missing in this lengthy draft, but we have yet to really see the difficult trade-offs that a final set of implementable goals would require.

 

How have sexual and reproductive health and rights fared?

 

Sexual and reproductive health has disappeared from the Health Goal. While a target on sexual and reproductive health was previously included under both the Health and Gender goals, it now only appears under the Gender goal as “ensure universal access to sexual and reproductive health and reproductive rights in accordance with the Programme of Action of the ICPD and the Beijing Platform for Action.” This is problematic for two reasons:

 

1.    Without SRH under the health goal, family planning is in jeopardy of not being recognized in this new development framework. SRHR is a major component of overall health not only for women and girls, but also for men and boys. It is therefore critical to be included within a discussion of health.

 

2.    The qualifier of ICPD and Beijing is unnecessary and weakens the human rights frame of the target. Nowhere else in the Open Working Group’s draft document is such a caveat introduced. As such, it undermines the principle of arriving at a forward-looking set of SDGs. There is no need to qualify universal access to sexual and reproductive health or reproductive rights. With a reference to ICPD and Beijing already in the introduction, we hope to see this qualifier removed.

 

What are other notable points?

 

  • It is good to see that in proposed Goal 6  (Ensure availability and sustainable use of water and sanitation for all), the following target remained: “By 2030, achieve adequate sanitation and hygiene for all, paying special attention to the needs of women and girls.” This is critical to mainstreamed access to reproductive health.
  •  
  • Comprehensive sexuality education also remains absent from the latest document and should be inserted, ideally under the education goal.
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  • Equity has been and will continue to be a prevailing narrative in the post-2015 agenda.

 

What’s next?

 

In New York for the Open Working Group session last week, you could see will, desire, and investment on the faces of delegates, civil society, co-chairs. But you could also see the fatigue. This has been a long and intensive exercise that has lasted nearly two years already. Now is the time point to put words down on paper and respond to drafts in order to rescue the jumbled mess that the draft goals have become.

 

The final round of informal discussions by the Open Working Group takes place July 14 to 18. The co-chairs (from Kenya and Hungary) will incorporate this final feedback from member states into a final report submitted to the Secretary General in August. A report will simultaneously be submitted by the Intergovernmental Committee of Experts on Sustainable Development Financing. The Secretary General will then take these inputs, among others, and produce his own report, and full negotiations are expected to start in January 2015. The co-chairs of the post-2015 summit (September 21 to 23) are Denmark and Papua New Guinea.

 

By A. Tianna Scozzaro, Population and Climate Associate - 

3 July 2014

Source: http://www.populationaction.org/blog/2014/07/03/post-2015-agenda-organized-chaos-or-hot-mess/#sthash.VKfcdhBU.dpuf

UN warns some MDG targets may be missed

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There is a risk that Millennium Development Goals aimed at improving child and maternal mortality and expanding access to sanitation will be missed, the United Nations has warned.

 

With a little over a year to go to ensure the eight MDG targets are met, the UN this week issued a progress report, which showed that goals on poverty reduction, improving drinking water sources, improving the lives of slum dwellers and achieving gender parity in primary schools had already been met.

 

Progress was also being made on MDGs covering hunger, debt relief and malaria, tuberculosis and HIV treatment.

 

‘However, some MDG targets related to largely preventable problems with available solutions, such as reducing child and maternal mortality and increasing access to sanitation, are slipping away from achievement by 2015, despite major progress,’ the UN said.

 

‘The report calls on all stakeholders to focus and intensify efforts on the areas where advances have been too slow or not reached all.’

 

More reliable statistics were needed for monitoring development, the report said. It noted that the number of member states submitting progress reports on HIV/Aids increased from 102 in 2004 to 186 in 2012, helping galavanise global efforts. Funding for HIV programmes more than tripled in this period and 9.5 million people living with HIV were accessing antiretroviral treatment in 2012.

 

UN member states are currently considering a new set of development goals that can replace the MDGs in 2015. These are likely to be agreed in September next year.

 

UN secretary general Ban-Ki Moon said: ‘Our efforts to achieve the MDGs are critical to building a solid foundation for development beyond 2015. At the same time, we must aim for a strong successor framework to attend to unfinished business and address areas not covered by the eight MDGs.

 

‘Tackling growing inequality, in rich and poor countries alike, has become the defining challenges of our times. Our post-2015 objectives must be to leave no one behind.’

By Vivienne Russell

9 July 2014

http://www.publicfinanceinternational.org/news/2014/07/un-warns-some-mdg-targets-may-be-missed/

 

Poverty, child, maternal deaths high in India: UN report.

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United Nations: India continues to battle poverty, child and maternal deaths, according to a United Nations report on the Millennium Development Goals that said while several key global targets have been met, more sustained effort is needed to cover disparities by the 2015 deadline.

The 'Millennium Development Goals Report 2014', launched by UN Secretary-General Ban Ki-moon here yesterday, said many global MDG targets on reducing poverty, increasing access to improved drinking water sources, improving the lives of slum dwellers and achieving gender parity in primary schools have already been met.

Many more goals are within reach by their 2015 target date, the report said, adding that if current trends continue, the world will surpass MDG targets on malaria, tuberculosis and access to HIV treatment.

The report is the most up-to-date "global scorecard" on efforts to achieve the eight mostly anti-poverty goals agreed by world leaders at a UN summit in 2000.

It, however, said that some MDG targets related to largely preventable problems with available solutions, such as reducing child and maternal mortality and increasing access to sanitation, are slipping away from achievement by 2015, despite major progress.

"We know that achievements have been uneven between goals, among and within regions and countries, and between population groups," Ban said, adding that unless imbalances are addressed through bolder and more focused interventions, some targets will not be met, including in key areas such as childbirth, maternal mortality, universal education, and environmental sustainability.

The overwhelming majority of people living on less than 1.25 dollars a day belong to Southern Asia and sub-Saharan Africa, with one third of the world's 1.2 billion extreme poor living in India alone in 2010.

While Southern Asia has made "strong and steady" progress in reducing child deaths by more than halving its under-five mortality rate, yet nearly one in every three deaths still takes place in the region.India also had the highest number of under-five deaths in the world in 2012, with 1.4 million children dying before reaching their fifth birthday.

Despite progress in all world regions, the maternal mortality ratio in developing regions ? 230 maternal deaths per 1,00,000 live births in 2013 ? was 14 times higher than that of developed regions, which recorded only 16 maternal deaths per 1,00,000 live births in 2013.

Highlighting the extreme differences in maternal mortality among countries, the report said that almost one-third of all global maternal deaths are concentrated in the two populous countries – India and Nigeria.

India has an estimated 50,000 maternal deaths (17 per cent) while Nigeria has an estimated 40,000 maternal deaths (14 per cent).

The report further stated that despite a large increase in sanitation coverage, with an additional two billion people gaining access to an improved sanitation facility, it seems unlikely that the MDG target of 75 per cent coverage will be met by 2015.

"In 2012, a billion people still resorted to open defecation, a practice that needs to be brought to an end, as it poses a huge risk to communities that are often poor and vulnerable already," the report added.

"Open defecation is most prevalent in Southern Asia, Oceania and sub-Saharan Africa. The vast majority ? 82 per cent ? of people practicing open defecation now live in middle-income, populous countries, such as India and Nigeria," it said, adding that nearly 60 per cent of the one billion people practicing open defecation live in India.

With the 2015 deadline for achieving the landmark goals less that 550 days away, the report said many of MDGs have been met or are within reach. Among the targets that have been met is that the world has reduced extreme poverty by half.

In 1990, almost half of the population in developing regions lived on less than 1.25 dollars a day. This rate dropped to 22 per cent by 2010, reducing the number of people living in extreme poverty by 700 million.

Efforts in the fight against malaria and tuberculosis have shown results with an estimated 3.3 million deaths from malaria being averted between 2000 and 2012 due to the substantial expansion of malaria interventions.

The intensive efforts to fight tuberculosis have saved an estimated 22 million lives worldwide since 1995.

"If the trends continue, the world will reach the MDG targets on malaria and tuberculosis," it said.

Access to an improved drinking water source became a reality for 2.3 billion people and the target of halving the proportion of people without access to an improved drinking water source was achieved in 2010, five years ahead of schedule.

In 2012, 89 per cent of the world's population had access to an improved source, up from 76 per cent in 1990.

Hunger also continues to decline, but immediate additional efforts are needed to reach the MDG target, the report said.

The proportion of undernourished people in developing regions decreased from 24 per cent in 1990?1992 to 14 per cent in 2011?2013. However, progress has slowed down in the past decade.

"Meeting the target of halving the percentage of people suffering from hunger by 2015 will require immediate additional effort, especially in countries which have made little headway, the report added.

Launching the final push towards the United Nations targets, Ban appealed to member states that the global post-2015 objective must be to "leave no one behind".

Ban said the world is "at a historic juncture, with several milestones before us."

Citing gains made in the fight against malaria and tuberculosis and access to HIV treatment, Ban underscored that the report makes clear "the MDGs have helped unite, inspire and transform…And the combined action of Governments, the international community civil society and the private sector can make a difference."

"Our efforts to achieve the MDGs are critical to building a solid foundation for development beyond 2015. At the same time, we must aim for a strong successor framework to attend to unfinished business and address areas not covered by the eight MDGs," said the UN chief.  

PTI

 

First Published: Tuesday, July 08, 2014, 08:44

Source: http://zeenews.india.com/news/health/health-news/poverty-child-maternal-deaths-high-in-india-un-report_28670.html

World leaders review progress on Maternal health

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Prime Minister Erna Solberg of Norway, Co-chair of the MDG Advocates Group, and Graça Machel, Chair of The Partnership for Maternal, Newborn & Child Health (PMNCH), joined world leaders and the reproductive, maternal, newborn and child health (RMNCH) community to review progress toward achieving the  Millennium Development Goals focused on women and children’s health, and to identify targets for healthy women and children for the post-2015 sustainable development agenda.

 

The high-level panel of the MDG Advocates—a group of eminent personalities working to focus attention on the need to deliver on the vision for the Millennium Development Goals (MDGs) and to end poverty by 2030—met in Johannesburg at the 2014 PMNCH Partners’ Forum, cohosted by the Government of South Africa, PMNCH, Countdown to 2015, A Promise Renewed, and the independent Expert Review Group.  The Panel discussed several new reports released at the Forum, including the Countdown to 2015 report for 2014, which tracks progress in the  75 countries that account for the vast majority of maternal and child deaths, and the Success Factors for Women’s and Children’s Health report, which analyzes 10 countries that have made rapid progress toward the MDGs.

 

“Globally, we have made good progress on the MDGs,” said Prime Minister Solberg. “But more can and must be done. With fewer than 550 days until the Millennium Development Goals deadline, time is of the essence to scale up our efforts on behalf of women, children and adolescents.”

 

The leaders called for the new sustainable development agenda to be rights-based, equity focused and to place healthy women, children and adolescents at its core.  Leaders called for the new framework, which will be debated by the UN General Assembly in September, to focus on ending preventable maternal, newborn and child mortality, and to  ensure sexual and reproductive rights, including universal access to quality sexual and reproductive services.

 

Since 1990, both maternal and child mortality have halved and 50 million more children go to school each year. But many challenges remain and further rapid progress on health outcomes will require addressing the multiple determinants of health. For instance, every year 14 million girls are forced into marriage, and in many countries, women and girls still do not have access to adequate education.

 

“Across the world, the rights of women and girls continue to be grossly violated. The burden of poverty on women is ever present.” said Graça Machel.  “Every woman should have access to resources and gain space to assert her aspirations. Nobody should die in child birth. All girls should go to school with their brothers and master the tools for a productive life. ”

 

The Panel also previewed the PMNCH Partners’ Forum Communiqué, which will focus on working across sectors—including education, infrastructure, and economic development—to ensure a comprehensive, broad-based approach to improving women’s and children’s health. The Communique, which was endorsed by the MDG Advocates, called for this comprehensive response to be enshrined in specific new global development goals.

 

“We proved that Innovative Financing can help us to reach the MDGs” said Philippe Douste-Blazy, United Nations Special Advisor on Innovative Financing for Development. “New partners are uniting in South Africa to commit energy and resources towards innovation and saving lives.”

 

Dr. Carole Presern, Executive Director of PMNCH,  said, “Today, we leave with renewed energy to make sure that women, newborns, children and adolescents do not die from easily preventable causes; that sexual and reproductive health and rights are respected and that everyone, everywhere should be able to look forward to a healthy, happy and productive life..”

 

Source: http://www.spyghana.com/world-leaders-review-progress-maternal-health/

International leaders and public health experts call for women and children to be at the centre of the post-2015 development agenda

More than 800 leaders and public health experts from around the world opened a landmark two-day meeting in Johannesburg to review new data and call for accelerated action to improve maternal, newborn and child health. The Partnership for Maternal, Newborn & Child Health (PMNCH) 2014 Partners' Forum was opened by Graça Machel, Chair of PMNCH and African Ambassador for Committing to Child Survival: A Promise Renewed, who is making her first public appearance since the end of her mourning period after the death of her husband, Nelson Mandela.

"The world has made remarkable progress to improve health and expand opportunities over the past 14 years. Despite all efforts, there is still much more to be done," said Graça Machel. "Women and children have not been covered adequately. We must ensure that all women, adolescent girls, children and newborns, no matter where they live, are able to fulfill their rights to health and education, and realize their full potential."

In support of the UN Secretary-General's Every Woman Every Child movement, the Partners' Forum builds on two months of high-level meetings in Toronto, Prague, and Washington, DC, where global leaders and health experts met to discuss strategies to promote the health of women and children. At this Forum, leaders discussed steps to assist countries that have lagged behind in efforts to improve reproductive, maternal, newborn and child health, and made specific recommendations for how to maintain the focus on women and children within the post-2015 development agenda. Notably, participants also pledged their financial and policy support and a range of new resources to support the implementation of the new Every Newborn action plan (ENAP), a roadmap to improve newborn health and prevent stillbirths by 2035.

"We are privileged as a country to host this important meeting about the urgent need to improve women's and children's health. This global gathering gives us the opportunity to learn from each other's successes and challenges, and to identify new approaches," said Dr. Aaron Motsoaledi, South African Health Minister. The Government of South Africa is a Forum co-host, together with PMNCH, Countdown to 2015, A Promise Renewed and the independent Expert Review Group.

Despite improvements, 289,000 women still die every year from complications at birth and 6.6 million children do not live to see their fifth birthday, including nearly 3 million newborns. At least 200 million women and girls are unable to access family planning services that would allow them to control when they have children.

The world has been especially slow in improving health outcomes for newborns. Globally, each year, 2.9 million newborns (first 28 days of life) die and 2.6 million are stillborn (die in the last three months of pregnancy or during childbirth). Recent data published in The Lancet Every Newborn Series indicate that 15,000 babies are born and die every day without ever receiving a birth or death certificate. The accompanying analysis found that 3 million maternal and newborn deaths and stillbirths in 75 high burden countries could be prevented each year with proven interventions that can be implemented for an annual cost of only US$1.15 per person.

Responding to this crisis, partners at the Forum launched the ENAP, endorsed by the World Health Assembly in May 2014. The action plan is based on concrete evidence to further reduce preventable newborn deaths and stillbirths. Signalling their support for the full and prompt implementation of the plan, Forum attendees announced 40 new commitments. These commitments are in support of the UN Secretary-General's Every Woman Every Child movement and come from a diverse group of stakeholders, including governments, civil society organizations and the private sector.

"There is absolutely no reason for so many newborns to die every year when their lives can be saved with simple, cost-effective solutions," said Dr. Flavia Bustreo, Assistant Director-General for Family, Women's and Community Health at the World Health Organization. "The WHO remains committed to support countries and work with partners as the plan gets implemented, and to the accountability agenda, which includes reporting on progress achieved every year until 2030."

New data is critical to inform discussions about changing this reality. Today, partners at the Forum released the Countdown to 2015 Report for 2014, which presents the latest assessment of progress in the 75 countries that account for 95 percent of all maternal and child deaths each year. The report finds that in several countries, more than half of the mothers and children in the poorest 20 percent of the population still receive two or fewer of the eight interventions deemed essential for preventing or treating common causes of maternal and child death, including vaccinations, skilled birth attendance, pneumonia and diarrhea treatment, and access to family planning. The analysis shows that, in these 75 countries, a median of 39 percent of deaths of children under age five occur during the first month of life, underscoring a need for improved access to quality skilled delivery care for mother and baby around the time of birth, when most stillbirths and maternal and newborn deaths occur.

"We have affordable interventions that we know work. There's no excuse for not bringing them to the women and children who need them," said Dr. Mickey Chopra, Chief of Health at UNICEF and co-Chair of Countdown to 2015. "The health and well-being of our next generation, and the right of millions of children to live happy, productive lives, is at stake."

One other report was also launched at the 2014 PMNCH Partners' Forum: Success Factors for Women's and Children's Health Report spotlights 10 "fast track" countries making considerable progress in reducing maternal and child deaths, showing that rapid progress is possible despite significant social and economic challenges. The report showed the benefits of investing in high-impact interventions such as skilled care at birth, immunization, and family planning.

Delegates at the Forum emphasized the importance of ensuring that future efforts focus on countries that are making slow progress, and on poor and marginalized populations, including newborns and adolescents. Delegates also urged political leaders to work across different sectors—including education, skills and employment, water supply and sanitation, nutrition, energy, roads, and women's empowerment—to ensure an integrated approach to improving the health of women and children.

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PMNCH

The Partnership for Maternal, Newborn & Child Health (PMNCH) is a partnership of 625 organizations from across seven constituencies: governments, multilateral organizations, donors and foundations, nongovernmental organizations, healthcare professional associations, academic, research and training institutions, and the private sector. Hosted by the World Health Organization and launched in 2005, the vision of the Partnership is the achievement of the Millennium Development Goals, with women and children enabled to realize their right to the highest attainable standard of health in the years to 2015 and beyond.

Government of South Africa

The Government of South Africa recognizes that success in achieving better health outcomes as a country depends on partners' collective ability to build relationships and work across sectors. We are highly committed to improving the lives of women and children, and the reduction of maternal and child mortality remains a critical area of focus in South Africa. In 2012, South Africa launched the Campaign on the Accelerated Reduction of Maternal and Child Mortality in Africa (CARMMA) strategy, setting goals of reducing maternal and neonatal mortality by more than half between 2013/2014 and 2018/19.

Countdown to 2015

Countdown to 2015 is a global movement to track, stimulate and support country progress towards the health-related Millennium Development Goals, particularly goals 4 (reduce child mortality) and 5 (improve maternal health). Established in 2003, Countdown is supra-institutional and includes academics, governments, international agencies, professional associations, donors, nongovernmental organizations and other members of civil society, with The Lancet as a key partner. The Countdown Secretariat is hosted by the Partnership for Maternal, Newborn & Child Health. Countdown focuses specifically on tracking coverage of a set of evidence-based interventions proven to reduce maternal, newborn and child mortality in the 75 countries where more than 95% of maternal and child deaths occur. Countdown produces periodic publications, reports and other materials on key aspects of reproductive, maternal, newborn and child health, using data to hold stakeholders to account for global and national action. At the core of Countdown reporting are country profiles that present current evidence to assess country progress in improving reproductive, maternal, newborn and child health.

A Promise Renewed

Committing to Child Survival: A Promise Renewed is a global movement to end preventable child deaths. Under the leadership of participating governments and in support of the United Nations Secretary-General's Every Woman Every Child strategy, A Promise Renewed brings together public, private and civil society actors committed to advocacy and action for maternal, newborn and child survival. A Promise Renewed emerged from the Child Survival Call to Action, convened in June 2012 by the Governments of Ethiopia, India and the United States, in collaboration with UNICEF. The more than 700 government, civil society and private sector participants who gathered for the Call to Action reaffirmed their shared commitment to scale up progress on child survival, building on the success of the many partnerships, initiatives and interventions that currently exist within and beyond the field of health. A Promise Renewed is represented on the Forum steering committee by USAID and UNICEF.

Independent Expert Review Group (iERG)

The UN Commission on Information and Accountability for Women's and Children's Health was established by WHO at the request of the United Nations Secretary-General to accelerate progress on the Global Strategy for Women's and Children's Health. Starting in 2012 and ending in 2015, the iERG is reporting regularly to the United Nations Secretary-General on the results and resources related to the Global Strategy and on progress in implementing this Commission's recommendations.

30 June 2014

By All Africa

Source: http://allafrica.com/stories/201406300590.html?viewall=1

Invest in Adolescents and Young People for a Better Future

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The Partnership for Maternal, Newborn and Child Health (PMNCH) Partners’ Forum begins on June 30th in South Africa. The annual conference brings together global partners in the maternal, newborn, and child health communities to discuss trends, challenges, and opportunities in ensuring the wellbeing and empowerment of the world's children and women. With the Millennium Development Goals set to expire in 2015, this year’s conference will have a particular focus on envisioning the post-2015 development framework. Ahead of the event, Women Deliver launched a new infographic and co-hosted a Google+ Hangout with Girls’ Globe and young leaders to reignite a conversation about the importance of investing in the health and rights of adolescents and young people.

The new infographic brings attention to the current global status of today’s youth. It highlights the barriers that young people, particularly young women, face in fully realizing their rights and makes the case for meaningful youth participation in the development processes. The infographic joins six others in a series, all devoted to a variety of girls’ and women’s health and rights issues.

The Google+ Hangout was moderated by Julia Wiklander from Girls’ Globe and Women Deliver Young Leader Yemurai Nyoni from Zimbabwe and Kelly Thompson from the International Federation of Medical Students’ Associations, among others, joined the discussion. Participants shared their perspectives on why governments must recognize the human rights, including the sexual and reproductive rights, of young people, as well as include youth voices in the design and implementation of programs that affect their lives.

View the infographic here.

Source: http://www.womendeliver.org/updates/entry/invest-in-adolescents-and-young-people-for-a-better-future