The unmet need for sexual & reproductive health and rights in Asia and the Pacific

Across countries in Asia and the Pacific, the unmet need for sexual and reproductive health services remains vast. Donors and governments need to improve health systems and respect sexual rights.

These were the messages at a satellite session held during the NGO Forum in Berlin, co-hosted by the Asia Pacific Alliance (APA) and the Asian-Pacific Resource and Research Centre for Women (ARROW). The session brought together NGO representatives to make the case for increased resources for sexual and reproductive health and rights in countries of Asia and the Pacific.

Moderated by Dr. Gill Greer, Director-General of the International Planned Parenthood Federation (IPPF), the session began with an overview of major sexual and reproductive health challenges in Asia, based on research compiled by ARROW to monitor progress on the International Conference on Population and Development (ICPD) commitments. Sivananthi Thanenthiran explained that despite economic progress, maternal mortality rates in some countries remain abysmal and fall well short of the targets set it in MDG 5. Across Asia and the Pacific, governments allocate only a tiny fraction of expenditure on health.

From the Women's Health Foundation, Indonesia, Atashendartini Habsjah presented research that looked at how decentralisation had catastrophically failed to improve access to services. Contraceptive prevalence remains low, many services are dangerously under-resourced and the number of health workers had reduced. Most startling was evidence of coercion during recruitment of potential family planning acceptors, a clear abuse of human rights and rejection of ICPD principles.

From the Australian Reproductive Health Alliance, Jane Singleton discussed recent advocacy achievements and success in helping to change AusAID's family planning guidelines. Jane underlined the importance of working with passionate parliamentarians to force change and spoke about high fertility in Timor Leste, and very poor maternal health in Papua New Guinea as examples of urgent need.

As Chair of APA, Sumie Ishii (also from the Japanese Organisation for International Cooperation in Family Planning) gave an update on political developments in Japan and explained how this may impact on resource flows from the region's most important bilateral donor, Japan. Working with governments to advance ICPD and ensure funding for sexual and reproductive health services remains critical.

Joanna Spratt from Family Planning International New Zealand spoke about the value in supporting civil society efforts to improve health at the community level in Pacific Island countries. Challenges in the Pacific are vast, with high prevalence of STIs, reproductive health supply shortages and weak, under-funded health systems.

Following a rich discussion, the session concluded with eight key recommendations:
1. Health systems must be strengthened, with the provision of comprehensive and free sexual and reproductive health services a priority.
2. Reproductive and sexual health services must be rights-based and gender-sensitive. Ad-hoc initiatives and coercive mass family planning campaigns that breach human rights must stop.
3. Recognising the power of parliamentarians to create policy, laws and make budgets, civil society must advocate forcefully to meet the demand for sexual and reproductive health and family planning.
4. Donors and governments must make long-term commitments to improving health outcomes, and ensure that spending on sexual and reproductive health demonstrates a strong commitment to women and development.
5. Donors, governments and civil society must work together and commit to a secure supply of reproductive health commodities.
6. Energetically and passionately promote a single global message that resonates through all possible channels. One example: ‘A woman dies every minute giving birth'.
7. The role of NGOs as reliable service-providers at the community-level must be affirmed.
8. Strengthen and amplify the independent advocacy voice of civil society. Create a coordinated mechanism for NGOs in both developed and developing countries to support mentoring, coaching and joint action on agreed goals. This needs to be a long-term, relationship-based initiative, with adequate funding.