Operational SRH Indicators for Gender empowerment

1. Operational SRH Indicators for Gender empowerment

2. The ability of women to control their own fertility is absolutely fundamental to women�s empowerment and equality. When a woman can plan her family, she can plan the rest of her life. When she is healthy, she can be more productive. And when her reproductive rights � are promoted and protected, she has freedom to participate more fully and equally in society. Reproductive rights are essential to women�s advancement. Thoraya Ahmed Obaid, UNFPA Universal access to SRH is essential for gender equity

3. SRH and the MDGs Poverty � Without education the cycle of women�s poverty continues. Women cannot move out of poverty if they cannot control their own fertility. Women who are trapped in poverty with children to feed and absent husbands are often forced into prostitution. This happened in Australia. Girl�s education � Girls are frequently pulled out of school because they are needed at home as either child or granny carers. If they are pregnant it is almost universal in the Pacific region that they cannot return to school so whether the pregnancy was due to forced sex or unprotected sex they are penalized and forgo the opportunity of education. Frequently girls are forded to have unsafe abortion in order to hide the pregnancy and stay in school. � This happened in Australia. Gender equality � 50% of girls in some countries still marry before the age of 18 and many are also forced into shot gun marriages even when the family does not approve of the boyfriend. This happened in Australia. Gender violence � Gender violence and sexual violence go hand in hand. A recent study from Wewak showed that 50% of young men had participated in gender violence (line up) and as many as 50% of women reported having been raped. Poverty � Without education the cycle of women�s poverty continues. Women cannot move out of poverty if they cannot control their own fertility. Women who are trapped in poverty with children to feed and absent husbands are often forced into prostitution. This happened in Australia. Girl�s education � Girls are frequently pulled out of school because they are needed at home as either child or granny carers. If they are pregnant it is almost universal in the Pacific region that they cannot return to school so whether the pregnancy was due to forced sex or unprotected sex they are penalized and forgo the opportunity of education. Frequently girls are forded to have unsafe abortion in order to hide the pregnancy and stay in school. � This happened in Australia. Gender equality � 50% of girls in some countries still marry before the age of 18 and many are also forced into shot gun marriages even when the family does not approve of the boyfriend. This happened in Australia. Gender violence � Gender violence and sexual violence go hand in hand. A recent study from Wewak showed that 50% of young men had participated in gender violence (line up) and as many as 50% of women reported having been raped.

5. Using rates for country selection

7. CPR less than 10% Solomon Islands is a chain of islands that actually starts with Bougainville, the easternmost part of PNG. From Moli we could see the mountains of Bougainville. S.I. gained independence from the UK in 1978. Until the recent ethnic fighting the main income earners for the nation were Logging, fishing, gold mining, copra and tourism. Since the fighting started, the most of these have stopped and the country is technically bankrupt. Solomon Islands has a population of 400,00 and a growth rate of 3.5%, one of the highest in the Pacific.Solomon Islands is a chain of islands that actually starts with Bougainville, the easternmost part of PNG. From Moli we could see the mountains of Bougainville. S.I. gained independence from the UK in 1978. Until the recent ethnic fighting the main income earners for the nation were Logging, fishing, gold mining, copra and tourism. Since the fighting started, the most of these have stopped and the country is technically bankrupt. Solomon Islands has a population of 400,00 and a growth rate of 3.5%, one of the highest in the Pacific.

8. Home births greater than 40% Solomon Islands is a chain of islands that actually starts with Bougainville, the easternmost part of PNG. From Moli we could see the mountains of Bougainville. S.I. gained independence from the UK in 1978. Until the recent ethnic fighting the main income earners for the nation were Logging, fishing, gold mining, copra and tourism. Since the fighting started, the most of these have stopped and the country is technically bankrupt. Solomon Islands has a population of 400,00 and a growth rate of 3.5%, one of the highest in the Pacific.Solomon Islands is a chain of islands that actually starts with Bougainville, the easternmost part of PNG. From Moli we could see the mountains of Bougainville. S.I. gained independence from the UK in 1978. Until the recent ethnic fighting the main income earners for the nation were Logging, fishing, gold mining, copra and tourism. Since the fighting started, the most of these have stopped and the country is technically bankrupt. Solomon Islands has a population of 400,00 and a growth rate of 3.5%, one of the highest in the Pacific.

9. STI Rates � Solomon Islands

11. Prevalence of Chlamydia trachomatis in antenatal women Port Vila, Vanuatu, 1999

12. STI in ANC women in 2003

13. Quality of standard indicators Rising rates may not necessarily reflect an increase � only an increase in diagnosis Rates may be marked incorrectly � rising genital ulcers � Recurrent herpes or increasing syphilis Analysis of data needs to be accurate as data is biased or specific to geographic areas

14. CPR - Is it accurate and informative? Under-reporting Statistics not included from Hospitals, private pharmacies, and poorly collected data. Clinic reports not sent Over reporting TL and Vasectomy not withdrawn from numerators Natural family planning over-reported. (taught not practiced) Current users are calculated accumulatively and not concurrently. In Choiseul province we found the reported rate of CPR was 10%. Actual house to house surveys found a rate closer to 30%. It doesn�t really matter is the rate is wrong if it is consistently wrong and a trend can be determined.In Choiseul province we found the reported rate of CPR was 10%. Actual house to house surveys found a rate closer to 30%. It doesn�t really matter is the rate is wrong if it is consistently wrong and a trend can be determined.

15. Behavioural surveillance Adolescent Reproductive Survey � 2001 (SI) 4% used a condom for first sex 14% used a condom at last sex Wewak Behavioural Survey - PNG Forced Sexual Encounters Men � [forced others] 47% 37% Women [been forced] 50% 55%

16. Sexual and reproductive health and rights indicators Proportion of contraception demand satisfied Adolescent fertility rate Several indicators for goals 5 and 6 measure aspects of women�s reproductive health: maternal mortality ratio, the proportion of births attended by skilled health personnel, HIV prevalence among 15 � 24 year old pregnant women, and contraceptive prevalence rate. These are useful but do not assess women�s and adolescents ability to act on their reproductive preferences. The indicators here have been recommended With adolescent fertility rate I would also want to know condom use and two main statistics are collected. Use at first sexual contact Last use. Holly Buchanan�s work in Solomon Islands in 2003 collected the following information. Only 14% of girls used condoms at first sexual contact. Was this because it was forced or coercion used, or was it that girls still feel that carrying condoms, permits sexual promiscuity to occur and also labels the girls as �loose� if they have one with them. Another problem with the adolescent fertility rate is that it cuts across Several indicators for goals 5 and 6 measure aspects of women�s reproductive health: maternal mortality ratio, the proportion of births attended by skilled health personnel, HIV prevalence among 15 � 24 year old pregnant women, and contraceptive prevalence rate. These are useful but do not assess women�s and adolescents ability to act on their reproductive preferences. The indicators here have been recommended With adolescent fertility rate I would also want to know condom use and two main statistics are collected. Use at first sexual contact Last use. Holly Buchanan�s work in Solomon Islands in 2003 collected the following information. Only 14% of girls used condoms at first sexual contact. Was this because it was forced or coercion used, or was it that girls still feel that carrying condoms, permits sexual promiscuity to occur and also labels the girls as �loose� if they have one with them. Another problem with the adolescent fertility rate is that it cuts across

17. Universal Access A primary goal of the ICPD (1994) Programme of Action is to achieve universal access to Reproductive and Sexual Health Services, including Family Planning by the year 2015. There are an estimated 201 million women world wide who want to space or limit their childbearing or are using less effective traditional methods leading to 80 � 90 million unintended pregnancies each year. (UN Millennium Project 2005) Political, legal, socio-economic, cultural and religious barriers.

18. Basic � Intermediate - Tertiary Basic Level - Village Health Post Nurse Aid, Enrolled Nurse Intermediate - District Health Centre Registered Nurse and Midwife

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21. We have no indicators for Men�s Involvement! Involving men in reproductive health is crucial to promote gender equality and to improve men�s reproductive health. Are separate Men�s SRH services provided? Are men targeted for specific health promotion programmes Are male facilitators and trainers present?