Feature: Let’s talk about sex

Ensuring women’s human right to healthy sexual and reproductive lives

The International Conference on Population and Development (ICPD) held in Cairo in 1994, hosted by the United Nations, brought together governments, inter-governmental agencies, world leaders, civil society and activists to discuss the link between population and development, specifically women’s role in alleviating poverty. During the conference, it was made clear that until women and girls have full enjoyment of their rights, in family life and society, the development of communities and countries would be held back. The conference concluded with a Programme of Action (PoA) that outlined key areas for governments and world leaders to address in order to ensure women and girls can live full and fulfilling lives. The goals include commitments on increasing access to education for women and girls, reducing child and maternal mortality and ensuring women’s health, especially their sexual and reproductive health.

The ICPD set a target for the PoA—governments are to achieve the goals by 2015. With less than five years to go, the world is far from reaching the ambitious goals set in the PoA. Women still die needlessly from childbirth complications, young women lag behind their male peers in education and far too many girls entering their reproductive years face numerous dangers from violence to HIV, early marriage to risk of cervical and breast cancer.

Reproductive health and rights

The outcomes of the ICPD offer the most comprehensive definitions of sexual and reproductive health and rights (SRHR). Although some theories on SRHR remain contentious, the definitions set at the ICPD have gone on to inform the work of countless organisations, including the World YWCA.

The ICPD defined reproductive heath as:

“…a state of complete physical, mental and social well-being in all matters relating to the reproductive system and to its functions and processes. It implies that people have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this is the right of men and women to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility, which are not against the law, and the right of access to health-care services that will enable women to go safely through pregnancy and childbirth.” [1] 

In 2003, the World YWCA Council adopted a resolutions on Reproductive Health and Sexuality calling on the YWCA movement to promote and work towards the provision of extensive access to quality education, resources, information, discussion and counseling for women and girls regarding their reproductive right.

Many YWCAs have implemented programmes on reproductive health like the acclaimed YWCA Encore Breast Cancer programmes available across the USA, Australia, New Zealand and Japan that provide women with support as they recover from breast cancer surgery.

In Ghana, the YWCA run reproductive health services that reached over 60,000 schoolgirls and women of reproductive-age through mobile health clinics funded by the Centre for Development and Population Activities (Cedpa).

Violence, HIV and the link to sexual rights

Sexual rights protect women and men’s right to decide when, where, how and with whom they choose to have sexual experiences. Furthermore, people—including young people —have the right to all information on the importance of responsible sexual behaviour and how to effectively prevent sexually transmitted infections (STIs) and HIV.

But talking about sex with a partner can have serious consequences for many women—whether it is a discussion on how many children to have, introducing condoms to the relationship or declining sex. Simply trying to access sexual rights in a context of harmful traditions or legislation that do not protect women often increases their vulnerability to violence and HIV infection. There are many forms of violence against women (VAW) and there is no fixed, exhaustive list. VAW includes violence in the family and community such as battering, marital rape and emotional abuse like isolation and humiliation. It also includes harmful traditional practices like female genital mutilation, child and forced marriage, forced sexual initiation, acid throwing, sexual harassment and intimidation at work or schools, trafficking and forced sterilisation. [2]

In 2007, the World YWCA further committed to advancing women’s rights by including actions on SRHR in the Nairobi 2007 Call to Action on HIV and AIDS launched at the International Women’s Summit on Women’s Leadership on HIV and AIDS [3]. In regions where the HIV prevalence is high, access to sexual and reproductive heath tools like condoms have a dual effect: they enable women to plan their families and also offer protection from HIV and STIs. The female condom offers women an additional choice for contraception and protection. In the 2006 AIDS epidemic update, UNAIDS reported that in Thailand a third of new infections were among married women. In Cambodia, 40% of married women surveyed reported fear that their husbands would infect them with HIV [4]. In a recent survey in East Africa, 40% of married individuals with HIV have uninfected partners [5]. For serodiscordant couples (where only one partner is HIV-positive), condoms use is crucial to ensure healthy and pleasurable sexual relationships.

Comprehensive programming for women and girls

On numerous occasions, the World YWCA has called for increased access and distribution of the female condom. But condoms are not the only solution to preventing HIV. With over 70 member associations running programmes on HIV and SRHR, the World YWCA understands that a comprehensive approach is essential to an effective response to HIV. Early in 2009, the World YWCA convened a consultation to strengthen the global strategy on SRHR and HIV and AIDS including condom programming. The revised strategy offers four goals for the YWCA movement to focus its action: create a safe and inclusive space for women and girls; provide comprehensive prevention including comprehensive condom programming (CCP); develop leadership and strengthen capacity, especially with young women as champions and leaders on SRHR, HIV and an end to VAW; and ensure documentation and quality monitoring and evaluation of YWCA programmes.

The strategy will be shared during the World YWCA regional training institutes to be held through 2009 and early 2010 and will inform regional level SRHR plans.

[1] United Nations Department of Public Information * DPI/1618/POP--March 1995

[2] 1993 UN General Assembly Declaration on the Elimination of Violence against Women

[3] Hosted by the YWCA the International Women’s Summit on Women’s Leadership on HIV and AIDS was the first international conference to focus on women’s leadership and HIV and AIDS

[4] 2006 Report on the Global AIDS Epidemic. UNAIDS

[5] 2008 Report on the Global AIDS Epidemic. UNAIDS