A feminist critique of legal approaches to adolescent sexual and reproductive health rights in Eastern and Southern Africa: Denial and divergence versus facilitation

The Ministerial Commitment on Comprehensive Sexuality Education and Sexual and Reproductive Health Services for Adolescents and Young People in Eastern and Southern Africa (ESA), or the ESA Commitment, was affirmed December 7, 2013, by 21 countries located across this region during the 17th International Conference on AIDS and Sexually Transmitted Infections in Africa. The ESA Commitment speaks to the numerous practices and challenges of school age populations stemming from interplay among education, health, and contextual issues varying by country. Analysis of this policy is approached using methodology drawn from Bartlett and Vavrus (2014, 2017) and using a lens of policy borrowing, particularly focused on incorporating agency, process, impact, and timing (Steiner-Khamsi, 2000, 2010). This analysis seeks to understand the ESA Commitment and national curriculum subsequently implemented in Zambia by situating these actions among broader international, regional, and national discourse in the area of sexual and reproductive health and education for young people between 1994 and 2016. Through analysis considering its effectiveness in terms of implementation, scalability, and sustainability, its ability to enable progress towards improving the lives of young people, especially through increased knowledge of HIV/AIDS prevention, is examined and recommendations are presented.

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Gender equity and sexual and reproductive health in Eastern and Southern Africa: a critical overview of the literature

Global Health Action ◽

10.3402/gha.v7.23717 ◽

2014 ◽

Vol 7 (1) ◽

pp. 23717 ◽

Cited By ~ 22

Author(s):

Eleanor E. MacPherson ◽

Esther Richards ◽

Ireen Namakhoma ◽

Sally Theobald

Keyword(s):

Reproductive Health ◽

Gender Equity ◽

Southern Africa ◽

Sexual And Reproductive Health ◽

Eastern And Southern Africa ◽

Critical Overview

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Sexual and Reproductive Justice for LGBTQI Youth in Policy Responses Across Eastern and Southern Africa

10.1093/acrefore/9780190264093.013.1363 ◽

2021 ◽

Author(s):

Ingrid Lynch ◽

Finn Reygan

Keyword(s):

Young People ◽

Reproductive Health ◽

Sexual And Reproductive Health ◽

Gender Diversity ◽

Minority Youth ◽

Reproductive Justice ◽

Policy Narratives ◽

Sexual And Gender Minority ◽

Eastern And Southern Africa ◽

And Gender

Both significant progress and profound backlash have occurred in the inclusion of sexual and gender diversity across eastern and southern Africa. This includes the decriminalization of homosexuality in Mozambique in 2015 and the introduction of the Anti-Homosexuality Act (later annulled) in Uganda in the preceding year. Simultaneously there is increased pressure on Ministries of Education to engage more robustly with sexual and reproductive health and rights (SRHR) education in education systems across the region. Emerging regional research points to a narrow, heteronormative focus in comprehensive sexuality education; access barriers to sexual and reproductive health services; and pervasive school-related gender-based violence, including homophobic and transphobic violence. Civil society organizations (CSOs) play a key role in developing best practice in advancing the SRHR of sexual and gender minority youth and are therefore a valuable resource for government SRHR policies and programmatic responses. The regional SRHR education policy landscape is underpinned by two policy narratives: that of young people’s SRHR as a public health concern and a focus on young people’s human rights. These policy narratives not only underpin SRHR policy in the region but also in many instances are drawn on in CSO advocacy when positioning the SRHR of lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI) young people as an important policy concern. These two dominant policy narratives, however, have a narrow focus on young people’s risks and vulnerabilities, may inadvertently perpetuate stigma and marginalization of LGBTQI youth, and may limit youth voice and agency. These narratives also do not sufficiently engage local sociocultural and structural conditions that drive negative SRHR outcomes for young people in the region. Research, advocacy, and policy development toward the full realization of the SRHR of sexual and gender minority youth can address some of the limitations of health and rights-based policy narratives by drawing on a sexual and reproductive justice framework. Such a framework expands the policy focus on health risks and individual rights to include engagement with sociocultural and structural constraints on young people’s ability to exercise their rights. A sexual and reproductive justice framework provides a more robust toolkit when working toward full inclusion of sexual and gender diversity in regional school-based SRHR policy and programs.

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Ejercicio de derechos a la salud sexual y reproductiva entre mujeres de 20-29 años en Panamá y factores asociados.[Sexual and reproductive health rights exercise among women aged 20-29 in Panama and associated factors.]

Revista Médica de Panamá - ISSN 2412-642X ◽

10.37980/im.journal.rmdp.2020x1516 ◽

2021 ◽

Vol 40 (03) ◽

Author(s):

Fermina Chamorro Mojica ◽

Faride Rodriguez ◽

Selvis Stocel ◽

Ruth De León

Keyword(s):

Family Planning ◽

Hiv Prevention ◽

Reproductive Health ◽

Associated Factors ◽

Sexual And Reproductive Health ◽

Prevención Del Vih ◽

Conjugal Violence ◽

Modern Contraceptives ◽

Professional Care ◽

Health Rights

Introducción: Los derechos a la salud sexual y reproductiva (DSSR) son básicos, y la capacidad de las mujeres para ejercerlos influye en lograr objetivos de desarrollo. Objetivos: Estimar indicadores de DSSR en mujeres de 20-29 años identificando factores asociados. Métodos: Con datos de la Encuesta Nacional de Salud Sexual y Reproductiva 2014-2015 se analizaron 1206 casadas/unidas (982 con demanda de planificación familiar, 1082 con hijos, y 978 usuarias de anticonceptivos), midiéndose la violencia conyugal en el último año, conocimiento sobre prevención del VIH, demanda satisfecha con anticonceptivos modernos, atención profesional al parto y autonomía. Se utilizó la regresión logística multivariada para probar asociaciones. Resultados: Padeció violencia conyugal 13.0%, tenía conocimiento sobre prevención del VIH 38.8%, satisfacía su demanda de planificación familiar con métodos modernos 62.0%; recibió atención profesional al parto 81.1%; y mostró autonomía 10.3%. Las oportunidades relativas ajustadas (ORa) de violencia conyugal eran mayores en mujeres que la justificaban ORa=1.92;IC95%:1.09-3.39); el conocimiento sobre prevención del VIH aumentaba con la escolaridad (ORa=1.13;IC95%:1.04-1.22); la satisfacción de la demanda con métodos modernos era menor si justificaban la violencia conyugal (ORa=0.42; IC95%:0.20-0.85) y mayor en aquellas con una mayor percepción de empoderamiento (ORa=2.33;IC95%:1.15-5.00). Las ORa de atención profesional en el último parto disminuyen cuando aumentaba la edad (ORa=0.72;IC95%:0.62-0.84), y era menor si experimentaron matrimonio infantil (ORa=0.43;IC95%:0.19-0.95). Las ORa de mayor autonomía resultaron menores en casadas (ORa=0.22;IC95%:0.10-0.47) y amas de casa (ORa=0.53;IC95%:0.28-0.98). Conclusiones: El ejercicio de DSSR y sus factores asociados constituyen desafíos al diseño de políticas públicas.AbstractIntroduction: Sexual and reproductive health rights (SRHR) are basic, and women capacity to exert them influence achieving development goals. Objectives: Estimate indicators of SRHR in women aged 20-29 years, identifying associated factors. Methods: A total of 1206 married/cohabitant women (908 with need for family planning, 1082 with children and 978 contraceptive users) were analyzed with data from National Sexual and Reproductive Health Survey 2014-2015. It was obtained the proportion of conjugal violence victims in the last year, with knowledge about VIH prevention, family planning needs satisfied by modern contraceptive methods, with professional care at delivery and with autonomy. Multivariate logistic regression was used to test associations. Results: The 13.0% of women suffered conjugal violence, 38.8% had knowledge about HIV prevention, 62.0% used modern contraceptives for satisfying family planning needs, 81.1% received professional care at delivery, and 30.7% made informed decisions about SRH. Adjusted odds ratio (AOR) for conjugal violence were greater when women justified violence (AOR=1.92;95%CI:1.09-3.39); knowledge about HIV prevention increases with schooling (AOR=1.13;95%CI:1.04-1.22); family planning met with modern contraceptives methods was lower, if they justified violence (AOR=0.42;95%CI 0.20-0.85) and higher in women with a higher empowerment perception (AOR=2.33;95%CI:1.15-5.00). The AOR for professional care at last delivery decrease with increasing age (AOR=0.72;95%CI:0.62-0.84) and was lower if they experienced child marriage (AOR=0.43;95%CI:0.19-0.95). The AOR for autonomy was lower in married women (AOR=0.22;95%CI:0.10-0.47) and housewives (AOR=0.53;95%CI:0.28-0.98). Conclusions: The exert of SRHR and its associated factors challenge public policies design.

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