Bill & Melinda Gates Foundation

Full Access and Full Choice Can Only Result from Full Rights

November 14, 2013

Thousands of people have gathered to Addis Ababa, Ethiopia, for the third International Conference on Family Planning. The Conference, titled “Full Access, Full Choice” is the largest-ever meeting focused on expanding access to contraceptives and family planning for women and girls worldwide.

 

According to the World Health Organization, there are 222 million women who would like to delay or stop childbearing, but currently lack access to birth control. Not surprisingly, these women live in developing countries, and the majority of them are in extreme or severe poverty. For millions of women, lack of access starts with simply not having family planning services and information available. Rural areas may not have health clinics and skilled personnel, schools do not offer sexual and reproductive health education, and contraceptives are either not available or are too expensive. 

At the 2012 London Summit on Family Planning, leaders of 150 countries, along with representatives of international agencies, civil society groups and the private sector endorsed a goal to expand access to family planning services, information and supplies to 150 million women and girls living in developing countries by the year 2020. This is an ambitious goal, but given the severity of the current situation, the bar has rightly been set high.

 The final decision of when, with whom and how many children women have is still, too often, made by someone other than the woman herself.However, other barriers related to culture, social norms, women’s and girls’ status and gender inequality also remain as severe obstacles to full access and full choice. Building more health clinics, training more health professionals, making contraceptives available and affordable, bringing sexual and reproductive education to schools and providing women and girls with reliable information about family planning are all essential steps–but not enough. 

Deep-rooted socio-cultural barriers may still prevent women and girls from actually being able to utilize such services and information, even where they do exist. In many societies, using contraceptives may not be considered culturally acceptable, and may be seen as a sign of women being promiscuous. In some countries, there is deep-rooted mistrust towards initiatives that promote contraceptives, due to cases where women have been unknowingly subjected to sterilization as an attempt to control population growth. Around the world patriarchy and gender inequality still curb women’s ability to access and use birth control and make reproductive decisions, and harmful practices such as child marriage rob girls of their autonomy and agency. 

In such cases, building a health clinic or making contraceptives affordable simply will not suffice–the final decision of when, with whom and how many children women have is still, too often, made by someone other than the woman herself.

 The barriers to women’s control over their reproductive decisions often result from systematic and broad violations of their other rights. Access to contraceptives is about more than control over childbearing–it is fundamentally about women’s empowerment and independence.This is why efforts to improve access must be embedded in larger initiatives that not only look at the availability of family planning services, but also build and promote an enabling environment that allows women and girls to truly utilize those services and take control over their reproductive decisions. Men and boys must be seen as allies and actively engaged in these discussions, and religious and community leaders also have a role to play in ensuring that while access to family planning is expanded, traditions and norms that still hinder women’s empowerment and gender equality are also being transformed.

The barriers to women’s control over their reproductive decisions and bodies do not exist in a vacuum but often result from systematic and broad violations of their other rights. Access to contraceptives is about more than control over childbearing–it is fundamentally about women’s empowerment and independence. Expanding access must be accompanied with a holistic approach that truly recognizes women as full, rights-bearing citizens with voice, power and agency. Full access and full choice can only be realized in a world where women’s other rights are also respected, protected and fulfilled. To echo the words of Theo Sowa, CEO of the African Women's Development Fund who spoke at ICFP on Wednesday: “Family planning isn’t enough on its own; it needs to be a part of something bigger. It’s no good for a woman to have a choice of contraceptive methods if there is a strong threat of violence against her.”

Want to know how ICFP participants define “full access”? Visit Girls’ Globe to find out!

 
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