Transcript Sexual and Reproductive Rights and Women and Girls with Disabilities COMMITTEE ON THE RIGHTS OF PERSONS WITH DISABILITIES 17 April 2013 Insert file name.

Sexual and Reproductive Rights and Women and Girls with
Disabilities
COMMITTEE ON THE RIGHTS OF PERSONS WITH DISABILITIES
17 April 2013
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Suzanne Reier
Department of Reproductive Health and Research,
World Health Organization
Implementing Best Practices Initiative
Guiding Initiatives
ICPD- International Conference on Population and
Development – Basic right of all couples and individuals to decide
freely and responsibly the number, spacing and timing of their children and to
attain the highest quality of SRH….free of coercion and violence
Health for All by the Year 2000…now
Universal Health Coverage –
Alma Ata, 1978 WH Report: Primary Health Care, 2008
WH Report: Financing, 2010
MDG 5b: Universal Access to Reproductive Health
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Keeping the promise: Mainstreaming disability in the
Millennium Development Goals (MDGs) towards 2015
CRPD- Convention on the Rights of People
with Disabilities- Article 9,16,22,23,25
CURRENT SITUATION
UN, Bilateral, SRH NGOs are not systematically
implementing inclusive programmes
Some policies exist…ex. USAID, AUSAID but
not always implemented to the fullest extent
Strong need for awareness raising
– Universal Access, means full inclusion of PWD
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– Need champions, but not always experts
Window of opportunity- CRPD, Primary Health
Care, recognizing social determinants, human
rights approaches
Inclusive SRH programmes in the UN????
Reaching MDG 5…
Guidelines…how often do we see any mention of considerations for
people with disabilities?
Training….how often do training programmes or conferences bring
up issues related to people with disabilities?
Research….how often do we fund research that includes concerns
about people with disabilities
Evidence….do we count people with disabilities being served, dying
in child birth, using contraception?
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How many partner organizations are those run by people with
disabilities?
WHY NOT?
LACK OF AWARENESS, KNOWLEDGE AND
UNDERSTANDING
– PWD are invisible to policy-makers, providers, etc.
Underestimate numbers, needs…
PREJUDICE AND STIGMA
– Cultural bias and traditions…toward different types of disabilities,
not a priority…other issues are considered more important
PHYSICAL AND ATTITUDINAL BARRIERS
– Could be simple lack of awareness and forethought,
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misconception that physical barriers would cost a lot to remove,
– Attitudes based on ignorance, often harder to remove than
physical barriers
EXCLUSION OF PWD FROM DECISION-MAKING
– Unaware of how to include PWD in planning and decision-
making.
World report on disability
Joint publication of WHO and
World Bank, requested by
WHA, sets agenda for our
disability work after CRPD
First new prevalence figure
since 1970s: 15% or one
billion people, of whom 110190 million have very
significant disability
Headline recommendation:
remove barriers to
participation of PWD in
mainstream programmes
Healthcare: what's the problem?
– Poorer levels of health
– Same needs for general healthcare but
unequal access
– May require access to specialist healthcare
– Higher expenditure on health care and higher
risk of catastrophic health expenditure
– Health care is not affordable
Addressing healthcare barriers
– Reform policy and legislation
– Financing and affordability
– Service delivery
– Human resources
– Fill the gaps in data and research
Promoting Sexual and Reproductive Health of
Persons with DisabilitiesWHO/UNFPA Guidance Note
Why create a guidance note:
Consistent, systematic neglect of inclusion of people with disabilities in
SRH programmes, even though there is a great (perhaps greatest) need.
For whom:
WHO/UNFPA staff, international organizations, IBP partners, advocates,
anyone working the SRH area….where these needs have been so deeply
neglected.
Based on what:
Consultations face-to-face with key disability stakeholders,
discussion forum, UNFPA, WHO/RHR with the DAR team
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Approach:
Logical, easy to follow. Not technical guidelines. Offers review
of some of the evidence related to PWD and SRH.
Encourages partnering with disability organizations from
the beginning.
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Recommendations/Actions
Establish partnerships with organizations of PWD
"Nothing about us without us"
Raise awareness and increase accessibility in-house.
(IBP partners already doing that…WHO/RHR and
regions)
Ensure that all SRH work (programmes, activities,
guidelines, etc) reach and serve persons with
disabilities…most programmes designed for general
community can serve PWD with minor adaptations
Address disability in national SRH policy, laws and
budgets.
Promote research on SRH and persons with disabilities.
Stronger evidence base.
A Review of the Inclusion of People with Disabilities in Sexual and
Reproductive Health Programmes in Low- and Middle-Income Countries
Strategies of Disability Inclusion
NB: This model is non-hierarchical.
Inherent
Inclusive
Modified
Strategy of Inclusion
Description
Type I
SRH programme targeted to non-disabled people
is inherently accessible to one or more categories
of impairment.
Type II
SRH programme targeted to non-disabled people
is modified for accessibility for people with
disabilities.
Type IIIa
Organization which primarily delivers SRH
services to non-disabled people begins a new
initiative to target people with disabilities.
Type IIIb
Organization which was not designed primarily to
deliver SRH services begins a new SRH initiative
targeting people with disabilities.
Type IV
Organization founded to provide non-SRH
services to disabled people adopts into its
programming one or more SRH initiatives.
(1) 4%
(6) 22%
(1) 4%
Targeted
(4) 15%
(15) 56%
SRH Services
HIV/AIDS (20)
Sex Education (12)
Rights Advocacy (5)
Abuse Prevention (2)
Maternal Health (1)
This comic is featured in an issue of Straight
Talk (2008) focusing on PWD and provides
suggestions for how girls with disabilities may
resist sexual harassment. (Straight Talk
Foundation, Uganda)
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Statement on Involuntary/Coerced
Sterilization
Why do we need a statement?
Follows other statements- FGM, Sex selection
Focus on human rights approach for vulnerable
and excluded groups: women/girls with disabilities, HIV,
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indigenous or minority women and girls, transgender and intersex
people
Based on scientific evidence and lessons learnt.
Statement highlights relevant human rights considerations
Provides guiding principles for the provision of sterilization services
– Always obtain voluntary informed consent of the individual
– Delivery of sterilization services is free from discrimination,
coercion and violence
Development process:
–
Initial Draft Statement presented at Conference of States parties to the UNCRPD
September 2012
– 20 written submissions were received and considered as part of technical
meeting of 15 external experts – October 2012
– Now being revised/finalized- will be an interagency statement of OHCHR,
UNAIDS, UNDP, UNFPA, UN Women and WHO
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Funded by Open Society Institute
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We still have a lot of work to do
to ensure inclusion and achieve
universal access to reproductive
health.