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Meeting Reproductive Health and Rights of indigenous people in Central African Republic

2011 Annual meeting of the UN interagency support group on indigenous Peoples Issues 21-23th Nov- 2011, New York. Meeting Reproductive Health and Rights of indigenous people in Central African Republic. Outline. Background information on CAR Geographic location

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Meeting Reproductive Health and Rights of indigenous people in Central African Republic

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  1. 2011 Annual meeting of the UN interagency support group on indigenous Peoples Issues 21-23th Nov- 2011, New York Meeting Reproductive Health and Rights of indigenous people in Central African Republic Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  2. Outline • Background information on CAR • Geographic location • Access to basic social and economic services :Challenges faced • UNFPA Responses : • Current and and perspective Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  3. CAR : Background information • Area (square km): 623,000 • Population size: 4,570,000 (est. 2011) • Density (Sq km): 7.3 • Total Adult Literacy rate: 55% • Total Fertility Rate (TFR)/ISF: 4.7 births per woman • Maternal Mortality Ratio: 850/100,000 live births (LB) • Infant Mortality Rate: 112 deaths per 1,000 LB • Under-5 mortality rate: 171 deaths per 1,000 LB • HIV&AIDS prevalence rate: 4,9% (MICS IV 2010) Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  4. Geographic Location and Population Size Tchad • Ombela-Mpoko: • 15,200 Soudan • MambereKadei: • 14,600 • SanghaMbaere: • 4,500 • Lobaye: • 10,700 Cameroun Bangui RDC Congo Total 45 000 people Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  5. Main characteristics: who they are and How they live • Account for 0.3% (minimum) of the whole Population (2003 Census) • Originally live in small communities from hunting and gathering with gender division of work (Men  hunting; Women  gathering and hut building) • Nowadays: “Pygmies” are the most vulnerable ethnic groups with the Mbororos • Changes in their lifestyle due to loss of land and natural resources as a consequence of deforestation  more involved in farming, agriculture (as “slaves” and underpaid) Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  6. Main challenges in a changing environment Limited (or no) access to basic social services, Poverty: almost 90%, 93% illiterate rate, high drop off from school. Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  7. Access to basic social and economic services : Challenges faced Legal Challenges : Considered as “second class” citizens: 60% of Aka people in Lobaye declared they had a Bantu “master” (Survey conducted by COOPI in 2004 (Italian Cooperation Agency) Discrimination/humiliation • Victims of SGBVs • No access to land • Underpaid and exploited • Not represented in decision-makingprocesses, Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  8. Access to basic social services :challenges • Reproductive Health of Aka Pygmies • Total Fertility Rate (TFR): 5.1- 6.2 children per woman (versus 4.7 for CAR as a whole) • High Infant Mortality rate:200 – 220 per 1,000 LB (versus 112 for CAR as a whole) • Maternal Mortality (and morbidity) higher than the country average • (very) early childbirth , no access to ANC; delivery in the bush or at home without skilled assistance), • Obstetrical Fistula as one of the consequences of early childbirth and delay to obtain care Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  9. Access to basic social and economic services : Challenges (cont’d) Infection after Abortion : Uncompleted delivery , 3 days with placenta retention before reaching a health center Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  10. Access to basic social and economic services : Challenges (cont’d) • Increasing of diseases and infections: Skin diseases: Pian (very easy to cure) Acute Respiratory Diseases (ARI) among children Intestine Parasitic diseases • Malaria • Tuberculosis • HIV & AIDS Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  11. Global Responses • Government , NGOs (national and international), faith based organizations, are providing a range of interventions in several areas for Pygmies and their communities, • mainly alphabetization, human rights, Education, health/ immunization, environment , Support to agriculture • High commissary for Human rights in CAR, • COPI (EU, UNICEF, BINUCA, OCHA, OHCDH) • BIT, UNFPA • National NGOs • “Maison de l’enfant et de la femme Pygmee” ( MEFP), ADIBAC, MBOSCUDA • AFJC (Women legal professional association) Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  12. Reproductive Health and Rights : UNFPA Responses • From 2007 to 2010, UNFPA has provided support for Integrated RHR activities including HIV prevention and Sexual and reproductive health for youth in regions, prefecture/district and heath centers including two out off the four provinces where indigenous people are living in CAR • Commodities and medical equipments for Health centers and hospital • Training of health providers in : • Basic obstetrical care, and emergency obstetrical care • Training in maternal death audit • Fistulae surgical repair • Modern contraceptives methods integration in health centers Minimum Package of Services • BCC and tests for free counseling and testing for HIV

  13. Reproductive Health and Rights : UNFPA Responses • 01 ambulance for reference • Clean delivery kits (25000) • Mattress for post delivery unit of health centers (100) • Delivery medical table (22) • Cesarean kits (1000) • 3000 unit of extencillin to control “Pian” infection Difficulties to reach “pygmies” • Distance to the health center • they dwell in remote areas. They have to go too far fir care, • Services cost too high • they cannot pay (monetary poverty very high), • Lack of information, inadequate strategies to reach Pygmies • Discrimination, humiliation • they are subject to humiliation by health centre staff and other population because they are Pygmies Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

  14. Reproductive Health and Rights : UNFPA Responses, current and perspectives • In 2011, UNFPA planned to improve impact of all its support to pygmies in the Lobaye on a pilot based, results to be strengthened in the next Country Programme 2012-2016 through : • Launch of the community based intervention : Community mobilization to save vulnerable people life, including women empowerment (selection and training of community services providers) • RHR need assessment in preparation • Advocacy and BCC interventions in collaboration with MEFP : Administrative leaders, Health authorities at central and operational level, Pygmies and Bantus community leaders : • Strengthen Partnership with BIT, UNICEF, OCHA, BINUCA for Joint project on RHR and women and youth empowerment.

  15. Thank you Therese ZEBA KOBEANE, UNFPA REPRESENTATIVE CAR

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