Making the connections: the new SDGs and SRHR
The Sustainable Development Goals (SDGs) are a new set of global goals framing the development agenda for the coming decades; the UN member states will vote on them in September. The issue of primary importance to me from my perspective in South Africa is how the SDGs will address sexual and reproductive health and rights (SRHR).
The Secretary General’s new Zero draft of the goals addresses SRHR in a few areas but I am left with questions. The areas of SRHR are only covered in two of seventeen goals; and the detail is thin.
SRHR covers a vast range of needs and life experiences. For example, I am conscious of two current issues surfacing which concern SRHR. Caitlyn Jenner transitioned as a transwoman and braved the gaze of the world on the cover of Vanity Fair. In Nigeria, of 234 girls released after capture, 214 reveal pregnant bellies following rape in captivity. In looking towards the new SDGs what can we hope for?
The Zero Draft includes the following language:
Goal three: Ensure healthy lives and promote well-being includes:
- 3.1: By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
- 3.7: By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.
Goal Five: Achieve gender equality and empower all women and girls includes:
- 5.6: Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
The agenda section includes:
- 23: 'To extend life expectancy for all, we must achieve universal health coverage. No one must be left behind. We commit to accelerating the progress made to date in reducing infant, child and maternal mortality by ending all preventable deaths of infants, children and expectant mothers by 2030. We shall ensure universal access to sexual and reproductive health care services, including for family planning, information and education. We will equally accelerate the pace of progress made in fighting malaria, HIV/AIDS, tuberculosis and other communicable diseases and epidemics. At the same time we shall devote greater effort to tackling non-communicable diseases.’
In the Zero draft, there is no work at joining the dots of SRHR in relation to transport, education or environment or all the other goals. There is no language on sexual rights. While it is good to have reference to the ICPD and Beijing agreements of over 20 years ago, recent disagreements among UN member states have kept us from moving beyond these. The articulation of SRHR is weak and fragile. Some of this is due to strong sway of US politics in defunding international work on SRHR and the conservative agenda of many donors. It is all very well to have the language articulated in the Zero draft, but it is not reflected in the indicators and figures and linked to the social determinants of sexual and reproductive health and rights.
The term “family planning” is used, which is a deterrent to adolescents who are far from planning families and prefer the language of contraception. There is no clear mention of addressing abortion or transgender health, let alone adolescent SRHR, nor decriminalisation of sex work. These are all vital elements in the work of sexual and reproductive health and rights, but the ground work is not being laid.
The South African Minister of Social Development is on to something in her work both locally and internationally in relation to the concepts of sexual and reproductive justice. In speaking about abortion in South Africa, she links it to intersectional struggles facing women, noting the need to improve access to comprehensive sexuality education, contraception options and clearly linking to social and economic justice issues which enable choice. When women don’t have the money to travel to an abortion facility, or have no one to care for their children, or can’t afford to take a day off of work for the procedure, they essentially have no choice. This is the kind of lens we need in focusing on how the gaps persist and make the links and dots and join them up.
Within South Africa, health services are uneven in quality and health workers provide sub-standard care to transgender persons. Transactional sex, often used as part of transgender people’s ability to be resilient in the context of poverty, occurs quite frequently. Sex work remains criminalised. South Africa is lauded with having good abortion legislation, yet implementation is lacking with access to safe and legal abortion decreasing and maternal mortality increasing.
Caitlynn Jenner’s transition provided an opening for a broader conversation about transgender issues, but is a far distance from the experience of most transgender folks who battle to access health care. The Nigerian girls who survived rape as a weapon of war and captivity will likely not be provided with the option of a safe abortion. Similarly, in South Africa despite impressive laws, and status as a middle income country, abortion is not on the agenda for implementation locally as it is internationally. Women still die from unsafe abortions in South Africa.
If we are to improve the sexual and reproductive health of urban poor girls and women in South Africa, we will need to be specific and focused.
Additional Resources:Briefing cards: Sexual and reproductive health and rights (SRHR) and the post-2015 development agenda
UN High Level Panel Prioritizes Sexual and Reproductive Health and Rights in New Development Agenda