Women’s empowerment in West Africa: Increasing access to reproductive health services and rights is crucial

In this guest blogpost Marie Stopes International (MSI) responds to our call for contributions on the state of women’s empowerment in West Africa. We asked: What specific aspects of the gender agenda are identified as priorities in the region? Susan Sandars, MSI West Africa Policy Advisor, emphasises how universal access to reproductive health services and rights is essential for women’s empowerment and gender equality.

MSI counselling West AfricaLast month in New York representatives of 193 countries met to agree 17 Sustainable Development Goals (SDGs) that aim to end poverty, fight inequality and promote prosperity, while protecting the environment, by 2030. Whilst praising the agreement reached, the United Nations Secretary General, Ban Ki-moon, highlighted that these goals could not be achieved without ensuring gender equality and women’s empowerment.[1]

Marie Stopes International (MSI) believes that investing in universal access to contraception and providing women with choice regarding their reproductive health is critical to achieving women’s empowerment.[2] So what do these Goals actually mean for women and girls who want to access reproductive health services? The good news is that there is a Goal on both health (Goal 3) and gender equality (Goal 5) which include targets to:

  • “Ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes” (target 3.7).
  • “Ensure universal access to sexual and reproductive health and reproductive rights.” (target 5.5)”.

However, much depends on the next year – if and how governments integrate the SDGs into national plans, policies and budgets and how these plans are then implemented. The SDGs are a framework of indivisible goals, yet with 17 goals and 169 targets there is a real risk that countries will ‘cherry pick’ the issues they want to focus on and sexual and reproductive health will not be a priority.

The challenges in translating the SDGs into real, tangible change for West African men, women and children are significant in light of poor human development scores across the region. Strong economic growth, investments in development aid and reductions in infant mortality have not yet resulted in improved conditions and meaningful development for the most vulnerable people.

There is clearly a lot of work to be done, yet despite displaying some of the lowest health and development indicators in the global country list, West Africa is in a strong position. Partnerships involving the public and private sectors, civil society and the media will be crucial to the success of the SDGs. West African countries can draw from their successes in developing multi-sectoral strategies to build resilience, tackle malnutrition and combat food insecurity, for example the Zero Hunger Challenge, the Global Alliance for Resilience – Sahel and West Africa (AGIR) and the Scaling up Nutrition movement.

But there are also lessons to be learnt. Prioritising access to sexual and reproductive rights can be a question of life or death for many women particularly across the Sahel, and if this is not a strong enough argument, it is also clear that access to contraception is a corner stone of social and economic development. Enabling women to take control over the choice of when and how many children they have is a critical aspect of both women’s empowerment and gender equality.

A number of initiatives recognise this, for example the 2013 Regional Roadmap of AGIR Sahel and West Africa says: “Demographics and the changing dynamics between urban and rural, agricultural and non-agricultural populations will largely determine development, and food and nutrition security in the coming decades. Public policies regarding reproductive health and family planning are therefore crucial (emphasis in original).” Yet to date few of the multi-sectoral initiatives that have been developed include the provision of reproductive health services. Lack of family planning is mentioned as a causal factor, if at all. Where interventions are proposed they focus on information, education and communication rather than service delivery, e.g. in the Scaling up Nutrition Framework for Action, AGIR-National Resilience Priorities, the ECOWAS Zero Hunger Initiative for West Africa.

Why is this? One argument that I often hear is that West African women don’t want to use contraception. Big families are common here, people explain to me, and there are various social, economic, cultural and religious reasons for this. While there are certainly elements of truth in this, a quick look at reproductive health data shows a different reality. According to the World Bank, approximately 30% of women in West Africa have an unmet need for contraception, meaning that they would like to be able to space their births by two years but cannot access it.

The demand is there and the fact that in 2014 MSI provided approximately 500,000 women in the West African countries where it operates (Burkina Faso, Ghana, Mali, Nigeria, Niger, Senegal and Sierra Leone) with sexual and reproductive health services is proof of that. MSI experience is that there are not currently enough resources to meet this demand. The accessibility and availability of family planning services is very limited, particularly in poor communities and rural areas. As such women are not empowered to make choices about their reproductive health, leading to consecutive pregnancies which put them, as well as their children, at high risk of health and nutrition problems.

Another reason is that sexual and reproductive health and rights issues do not have a voice at the food security and resilience policy debates and discussions that are taking place, for example in the AGIR framework, both at the regional and national level.

MSI hopes that in the run up to the Sahel and West Africa Week (26-30 October) where the importance of women’s empowerment and gender equality vis-à-vis food security and resilience will be discussed, more people interested in these topics will join in the debate and share their experiences and views. We are looking forward to hearing from you.

Susan Sandars is West Africa Policy Advisor for Marie Stopes International. Based in Dakar, Senegal, she provides technical support to MSI’s programmes throughout the region in their policy and advocacy work, which is focused on overcoming barriers to sexual and reproductive health services.



[1]
http://www.un.org/apps/news/story.asp?NewsID=51987#.VgmIu-ztmko

[2] The UN define women’s empowerment as resting on the following five components: women’s sense of self-worth; women’s right to have and to determine choices; their right to have access to opportunities and resources; their right to have the power to control their own lives, both within and outside the home; and their ability to influence the direction of social change to create a more just social and economic order, nationally and internationally.

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