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Let’s not turn the clock back on reproductive health and rights

by Siddharth Chatterjee | United Nations
Thursday, 7 March 2019 15:30 GMT

Young girls with U.S. and Kenya flags wait to greet U.S. Ambassador to Kenya Robert Godec as he visits a President's Emergency Plan for AIDS Relief (PEPFAR) project for girls' empowerment in Nairobi, Kenya, March 10, 2018. REUTERS/Jonathan Ernst

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In many parts of the world girls and women still lack knowledge about their bodies and rights, and lack access to the information and tools that can help them take charge of their fertility

Siddharth Chatterjee is the United Nations Resident Coordinator to Kenya.

Enabling women to choose when and whether to have children is pivotal to social and economic development.

But efforts to give girls and women access to sexual and reproductive health services now risk being undermined by the US Government’s reinstatement and amendments to the Mexico City Policy first introduced by Ronald Reagan in 1984.

For more than 100 years International Women’s Day has been marked on 8 March, celebrating women’s social, economic, political and cultural achievements. Huge progress has been made in that time, not least in the area of sexual and reproductive health and rights. There is no place for complacency though.

In many parts of the world girls and women still lack knowledge about their bodies and their rights, and they lack access to the information and tools that can help them take charge of their fertility.

Unsurprisingly, these parts of the world are also those with the highest rates of population growth, and the highest levels of poverty. A woman in the Democratic Republic of Congo will give birth to an average 5.9 children in her lifetime compared to the 1.5 of a woman in Germany.

In Kenya we are already seeing the domino effect of the Global Gag Rule(Mexico City Policy) with increased teenage pregnancies and a spike in unsafe abortions. Between June 2016 and July 2017, 378,397 adolescents in Kenya aged 10 to 19 got pregnant. Adolescent girls in the worst affected parts of Kenya have lost their ability to make informed choices.  It is a crisis of health, education and opportunity.

The original policy demanded that recipients of US family planning aid should not use those funds for abortion-related activities, but the US Government’s amendments expand its reach to include all US health assistance – an estimated US$8.8bn per year. Additionally, recipients must certify that they do not use their own, non-US funds to provide abortion services or counseling or to advocate for liberalisation of abortion law.

This is having far-reaching consequences. Human Rights Watch says that women and girls will have less access to contraception, resulting in more unplanned pregnancies and unsafe abortions, increasing maternal deaths in parts of the world where rates are already high. Outside of reproductive health, programs that lose US funding may have to cut child vaccination, HIV and other vital programs.

In 2016 international donors directed some US$26bn to health in the developing world, up from around US$2.5bn in 2000, an increase that recognises that health has benefits for human rights, security and the global economy.

This is especially so for women, who bear the health, social and economic impacts of early and unplanned pregnancies. The link between family size and poverty is real. A woman who can choose the timing and number of her children almost always chooses to have a smaller family, which in itself bestows health benefits on the whole household.

Delaying pregnancy beyond adolescence leads to a stark reduction in maternal and infant deaths, and reduces the blight of child marriage. It means a girl is more likely to finish her education before embarking on parenthood, increasing her employment prospects and her contribution to the wider economy. It frees more of her time and resources to focus on the health, nutrition and education of her children, increasing their own future prospects.

Studies have shown, that women’s reproductive health, unlocks a country’s full economic potential.

And it’s money well spent. The United Nations Population Fund (UNFPA) says that for every additional dollar spent on contraception, the cost of pregnancy-related care falls by US$2.20.

At the 1994 International Conference on Population and Development (ICPD) in Cairo, Egypt,  179 governments agreed that women’s right to make their own choices about reproduction is central to the welfare of communities, economies, countries and the world, as well as to individual well-being.

It would be a cruel irony if, 25 years later, as we prepare this year in November for the ICPD in Nairobi, Kenya, the impact of a policy from the world’s wealthiest nation were to turn back the clock for the health of those who are the poorest.

Let’s stand together on the uplifting annual occasion of International Women’s Day and appeal to the US to show leadership, compassion and responsibility by reconsidering this legislation.