On the 26 May 2018, the world witnessed something extraordinary. The air carried a feeling of victory and the women of Ireland rejoiced, as the country voted decisively in a referendum to repeal one of the world’s more restrictive abortion bans, sweeping aside generations of conservative patriarchy.
On the other side of the globe, just recently, the lower house of congress in Argentina voted to decriminalize abortion. The vote was close, 129-125, and the bill is unlikely to get through the Argentina Senate. Both these events are a major win for the sexual and reproductive health and rights (SRHR) of all women across the world.
SRHR are essential for protecting human dignity and development. In fact, sexual and reproductive health (SRH) is a fundamental human right and includes “the right of couples and individuals to decide freely and responsibly, the number, spacing and timing of their children; have the information, education and means to make the decisions; attain the highest standard of SRH and make decisions about reproduction free of discrimination, coercion and violence”. Access to essential SRH services, including family planning and safe abortion services, can help delay the first birth, space the subsequent births, prevent unintended pregnancies and reduce unsafe abortions. When a woman is denied these rights, she is robbed of her agency and her right over her own body.
There are several barriers that prevent women from accessing such SRH services. Key among them include infrastructural, legal and social barriers, but central to all these barriers are the inherent gender/power imbalances and patriarchy. For centuries, women across the world have struggled to exercise control over their bodies due to such norms and practices.
These are deeply entrenched in many cultures, and have allowed and continue to allow those in positions of power to make critical decisions for women, thereby reinforcing the belief that women do not have the right to their own bodily integrity or autonomy. Consequently, many women cannot refuse unwanted or unprotected sex. Important decisions such as which family planning and contraceptive method to use, whether to have or not to have an abortion, and how many children to have are often taken without their say.
Especially in South Africa, we are falling short of giving women this crucial right to choice and health. About one in every seven women in the country do not have access to family planning services. According to a 2017 study conducted by Amnesty International South Africa, of the 505 public health facilities designated to provide abortion services, only 264 were providing these services. It is also estimated that 23% of South Africa’s maternal deaths between 2008 and 2010 were a result of unsafe abortion procedures.
When women are unable to make their own reproductive health choices, the outcomes can be adverse. These can range from unintended pregnancies, health complications, sexually-transmitted diseases (STDs), infertility, maternal mortality and morbidity, and HIV/AIDS. The consequences are beyond just health risks. This also impacts their ability to participate in the labour market, pursue education, care for their families, and contribute economically, socially and politically to their communities.
In the last few years, there have been efforts by the South African government, civil society and other stakeholders to improve access to and availability of SRH information and services through targeted policies, legislation and programmatic interventions. However, we also need to adopt a rights-based approach that includes addressing gender inequalities in society. This is currently missing.
Tackling gender inequality and ensuring a woman’s ability to control her own fertility have been regarded as key to achieving a broad range of health and development goals. Many of the United Nations’ Sustainable Development Goals (SDGs) to be achieved by 2030 specifically recognise women’s equality and empowerment as both a target and part of the solution.
This month, South Africa will be chairing the BRICS Summit. A key new area of cooperation that has been proposed is the creation of the BRICS Gender and Women’s Forum. The timing could not be better. The need for greater respect and opportunities for women and promotion of gender equality must become an ever more prominent feature of the global and national conversations.
Longstanding advocates for women’s empowerment need to be energized, while countless others — women and men alike — need to be persuaded of the urgency of this task. We must ensure that BRICS discussions come out with real solutions and actions to challenge patriarchal norms and values and increase social and economic opportunities for women. This will help create an environment that supports the development and equality of women and, amongst other things, empower women to choose their own reproductive futures.
After the victory in Ireland and Argentina, it is heartening to see that gender equality is firmly on the agenda of the BRICS Summit. Giving women and girls the opportunity to thrive is not only the right thing to do but will also help transform our societies and economies.
Sikelelwa Geya Mdingi & Sushma Kapoor work at Global Health Strategies which is an international organisation that leverages policy analysis, advocacy and communications to advance health issues that include sexual, reproductive, maternal, newborn and child and adolescent health among others.