Integration of Sexual and Reproductive Health and Rights into the Post 2015 Development Agenda

Background

 

Youth in Africa continue to be the key to ensuring the continent’s success in economic growth through investments in education, employment and health. Making up approximately 70 percent of the African population under the age of 30, young adolescents and young adult’s sexual and reproductive health and rights (SRHR) remains a critical element of a healthy youth population in Africa. Since 1990, the maternal mortality ratio (deaths per 100,000 live births) has gone down by approximately 45%, according to 2013 data; in 1990 there were about 380 deaths per 100,000, as comparted to 2010 last year. However, despite this progress, the number of maternal deaths is still unacceptably high; in 2013, almost 300,000 women lost their lives from pregnancy and childbirth related conditions (United Nations, 2014). 

Despite these elevated risks and increased need for SRHR, Youth-friendly reproductive health services often remain in pilot form in Africa and are almost always dependent on the support of non-governmental development partners. These services have not been consistently scaled up by the public sector, and there is a dire need for this to be prioritized (African Union, 2013). Furthermore, one in four young women (aged 15–19 years) has had their first child or is currently pregnant (Filmer and others 2014). Some young women give birth even earlier, before the age of 15, which is more common in West and Central Africa, the region which accounts for the largest proportion (6%) of births before age 15 (UNFPA 2012). By 2017, the number of births to girls under the age of 15 in sub-Saharan Africa is expected to be nearly twice as high as it is today. 

While maternal mortality is going down the unmet need for contraction in Africa is on the rise. In fact, excluding North Africa, the unmet need for contraception on the continent has gone up from 31 million in 2008 to 36 million in 2012 (African Union , 2012) . The connection between education and health is also vital - almost 25% of young girls in Africa (excluding North Africa) drop out of school because of unintended pregnancies (African Union, 2011).

One of the most significant challenges related to the sexual and reproductive health and rights of young women in Africa is child marriage. Globally, 11% of girls are married before they reach their 15th birthday, which places these young women at tremendous risk in terms of their health, education and security. (United Nations Children's Fund, 2014) According to 2005-2012 data from UNICEF in sub-Saharan Africa 39% of girls are married by the time they are 18-years-old, and 13% are married by the time they are 13(United Nations 2014). In West and Central Africa, these numbers are even higher, with 41% of girls married by 18 and 16% married by 15. These numbers also demonstrate an increase from previous years, where 2000-2009 data shows 23% of young girls 15-19 currently married in sub-Saharan Africa and 27% in West and Central Africa (United Nations, 2014).

HIV continues to remains one of Africa’s biggest health concerns that affects young people. About 80% of young women living with HIV live in sub-Saharan Africa, where women acquire HIV about five to seven years earlier than men (Joint United Nations Programme on HIV/AIDS, 2014). In fact, young women aged 15-24 in Sub-Saharan Africa are twice as likely to be HIV positive, compared with their male peers. (United Nations Children's Fund, 2014) Human rights issues related to gender-based violence, a lack of access to health services, and limited access to education for young women are some of the main reasons why adolescents and young women carry a disproportionate HIV burden in Africa. Further, the lack of government accountability is another significant reason, where policies do not translate into action. (Joint United Nations Programme on HIV/AIDS, 2014)

Another challenge faced by African youth today is the lack of access to quality education. One of the most important components of development in the context of the demographic bonus is an educated workforce. Today, high illiteracy levels remain one of Africa’s biggest challenges.  In sub-Saharan Africa, the number of young people who reached the final grade in school (as a proportion of those who started) worsened from 58% in 1999 to 56% in 2010. Comparatively, this proportion improved from 79% (1999) to 87% (2010) among the Arab States” (United Nations Educational, Scientific and Cultural Organization, 2014).

Gross enrollment is also a relevant indicator of the relative health of a country’s education system. Globally, the gross enrolment ratio for lower secondary schooling increased from 72% to 82% over the period 1999–2011, though there is still a large gap; 57 million children of primary school age were out of school in 2011 and hence denied their human right to a quality education. 

In addition, just 64% of boys and 61% of girls are enrolled in secondary school. In the least developed countries, this number is halved to 36% of boys and 30% of girls. There are still eight countries where at least one in five children is not expected to enrol in primary school (United Nations Educational, Scientific and Cultural Organization, 2014). All eight of these countries are in sub-Saharan Africa.  

In addition to the above, addressing youth unemployment on the African continent remains critical for the attainment of development. The Youth Decade Plan of Action 2009-2018 has a target on reducing Youth unemployment in Africa by 2% per annum (African Union, 2011). This is extremely important for harnessing Africa’s Demographic Dividend, particularly since current evidence shows that 3 out of 5 people who are unemployed in Africa are below the age of 35 (African Union , 2012). Projections for 2050 predict that the number of working-age adults in Africa, in relation to the number of dependents (typically meaning those people younger than 15 or older than 64), has the potential to rise to 1.7:1, up from 1:1 in 1985 (Filmer & Fox, 2014). However, this is only possible if fertility continues to decline, and Africa’s workforce continues to grow. 

Current trends in Africa show that Youth in sub-Saharan Africa are less likely to be unemployed than Youth in North Africa. While previous data showed Youth employment increasing in both regions, more recent analysis demonstrates that Youth unemployment has fallen slightly in the sub-Saharan region, from 11.8% in 2010% to 11.7 in 2011, but has risen in North Africa, from 20.1% to 23.3% over the same time period (African Union, 2011). Projections for 2015 show that unemployment is predicted to continue to rise in North Africa, reaching 23.8 in 2015 (International Labour Organisation, 2010). Disaggregated by sex, however, highlights that Youth unemployment among women in North Africa is expected to fall from 37.1% in 2011 to 36.2% in 2015. Among young men, unemployment is predicted to rise from 17.8% to 18.8% over the same period. (International Labour Organisation, 2010)

Lastly, youth participation in decision making forms the bedrock of ensuring that youth needs are provided within the post 2015 development agenda. In the last 10 years, it has become clear that Youth-led organizations and other groups led by young people have the power to influence policy and bring about social, political and economic change to improve their circumstances (United Nations Population Fund, 2013).

However, voting trends among African Youth remain relatively apathetic compared to those in older age categories. As with Afrobarometer data from 2005-2006 electoral participation of young people in Africa age 15-29 is consistently lower, in every county, than participation among those age 30 and higher. The highest rates of electoral participation are among those aged 50 and higher. In fact, Youth electoral participation has fallen since 2005-2006, from 59% to 56%, on average.  (African Union, 2011) (Afrobarometer, 2014)

Addressing the above youth challenges requires addressing the following:

Transparency 

One of the major problems that contribute to current state of sexual reproductive health and rights in Africa has been the lack of transparency at national level to appropriate address youth needs. This lack of transparency has led to African leaders in New York not adequately accounting to the youth constituency despite national and regional policies that support the provision of universal access to sexual and reproductive health and rights. An example of this disconnect is that of Nigeria which has an existing national policy on Sexual Reproductive Health (SRH) but consistently opposed any mention of SRH at regional and global level through out the negotiation process of the Post 2015 development agenda. It is through such inconsistences in policy formulation and implementation that continue to adversely affect young people’s universal access to sexual and reproductive health services. 

It is for this reason that advocacy efforts targeted at improving policy development and implementation must target governments at country level. This advocacy must further be aimed at increasing youth related data on sexual and reproductive health and rights forming a vital starting point for dialogue. 

Dialogue

In order to address some of the problems raised above also requires increased dialogue at national level between civil society, national governments and other implementing partners. This dialogue must be aimed at discussing progress made in the implementation of sexual and reproductive health and rights related goals and targets. 

Action

There continues to be lack of action that is required in addressing youth SRHR issues on the continent. In order to address youth African youth issues in the post 2015 development agenda, government, civil society require to make practical, implementable and sometimes innovative suggestions:

 • There is need to ensure a human rights approach to all development work, with the inclusion of engaged youth throughout the process, and using only 4 Cs policy (comprehensive, coherent, coordinated and cross-sectorial), at all times based on quality data only. 

• Address structural drivers such as gender inequality and poverty (including access to basic services) as a matter of urgency. 

• Ensure that finance for development programmes are innovative yet stable, whilst ensuring all stakeholders fulfil commitments to financial allocations and increasing representation of Africans in financial and economic decision-making spaces globally. 

• Ensure a progressive approach to allowing youth’s bodily integrity and the opportunity to make their own health decisions, whilst expanding access to treatment for mental illness, substance abuse, sexual and reproductive health and rights, and non-communicable diseases in youth friendly environments. 

• Ensure that Youths have universal access to quality education, including but not limited to alphabetical and numerical literacy, secondary and tertiary education, comprehensive sexuality education and citizenship and human rights education, including life skills such as leadership, creative thinking, strategic planning and problem solving. This must be equally provided to all, without gender or geographical, religious or other discrimination. 

• Ensure Youth engagement in ensuring good governance, transparency and accountability and anticorruption monitoring. Governments need to make sure that Youths are engaged in the design and implementation of any emergency responses to security threats and are at all times physically and adequately protected by the government.

 

Long-term Objective

 

The overall long term objective of this project is to improve universal access to sexual and reproductive health and rights in Africa through influencing the new global development framework. 

 

Mid-term Objective

 

The mid-term objective of this project is to increase input and influence from civil society on the implementation of the Sustainable Development Goals at country level. 

 

Short-term Objectives

 

The short-term objectives of this project are to:
•    Build capacity of civil society on Sustainable Development Goals; 
•    Create opportunities for dialogue between national governments and civil society at country level on the implementation of Sustainable Development Goals; 
•    Influence the implementation process of Sustainable Development Goals based on SRHR goals, targets and indicators at country level; 
•    Propose and inform African strategy for African civil society engagement beyond September 2015;
•    Discuss the integration of the Sustainable Development Goals in line with existing regional commitments such as Maputo Plan of Action, African Youth Charter, African Common Position and the Agenda 2063;
•    Demonstrate the (unmet) need for universal access to human rights based on existing evidence and data analysis on health, education, employment etc.;
•    Hold leaders accountable post the commitment on the SDGs. Identify opportunities for implementation of youth and SRHR related goals post Sept 2015;
•    Increase accountability to youth SRHR issues in the post 2015 development agenda through provision of data to be used for advocacy.  

 

Timeframe

 

The project's phase 1 began in late 2015 and phase 2 began January 2016 and ends on December 2016.

 

The Project Partners

 

AIDS Accountability International, Ford Foundation, United Nations Population Fund (UNFPA) and ARROW. 

 

Linkages

 

Please note that this project has linkages to the other following projects:

African Health Policy Review

ICPD and Beyond 2015

ARCPD Reflections

Monitoring the Maputo Plan of Action: An Assessment of SRHR in Africa

Monitoring the Maputo Plan of Action: A Strengthening of SRHR in Africa

The African Youth Task Force on Post 2015

 

Contact Details

 

Bob Mwiinga Munyati
Researcher 
bob@aidsaccountability.org 

102 Greenmarket Place, 54 Shortmarket Street 
Cape Town 8000 
South Africa
Tel: +27 (0)21 424 2057
www.aidsaccountability.org