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Guiding Initiatives

Sexual and Reproductive Rights and Women and Girls with Disabilities COMMITTEE ON THE RIGHTS OF PERSONS WITH DISABILITIES 17 April 2013 Suzanne Reier Department of Reproductive Health and Research, World Health Organization Implementing Best Practices Initiative. Guiding Initiatives.

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Guiding Initiatives

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  1. Sexual and Reproductive Rights and Women and Girls with Disabilities COMMITTEE ON THE RIGHTS OF PERSONS WITH DISABILITIES17 April 2013Suzanne ReierDepartment of Reproductive Health and Research, World Health OrganizationImplementing Best Practices Initiative Insert file name

  2. 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 HealthKeeping 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 Insert file name

  3. 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 • Need champions, but not always experts • Window of opportunity- CRPD, Primary Health Care, recognizing social determinants, human rights approaches Insert file name

  4. 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? • How many partner organizations are those run by people with disabilities? Insert file name

  5. 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, 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. Insert file name

  6. 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 110-190 million have very significant disability • Headline recommendation: remove barriers to participation of PWD in mainstream programmes

  7. 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

  8. Addressing healthcare barriers • Reform policy and legislation • Financing and affordability • Service delivery • Human resources • Fill the gaps in data and research

  9. Promoting Sexual and Reproductive Health ofPersons with Disabilities- WHO/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 • 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. Insert file name

  10. 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. Insert file name

  11. 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 Targeted

  12. 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) SRH Services • HIV/AIDS (20) • Sex Education (12) • Rights Advocacy (5) • Abuse Prevention (2) • Maternal Health (1)

  13. 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, indigenous or minority women and girls, transgender and intersex people • Based on scientific evidence and lessons learnt. Insert file name

  14. 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 • Funded by Open Society Institute Insert file name

  15. We still have a lot of work to do to ensure inclusion and achieve universal access to reproductive health. Insert file name

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