Reproductive Health and Rights in an Age of Inequality. Indeed, women and girls are living worlds apart from each other as well as from men and boys, in terms of access to healthcare and opportunities for education, employment, and political participation.
The gap between the rich and the poor is not only unfair, it is a risk to people, especially women and girls, the marginalized and the vulnerable, as it breeds other inequalities in health, education, employment and socio-political participation.
It is also a risk to economies, to nations and to communities. Unfortunately, these disparities are not closing fast enough. In recognition of this, countries affirmed to adopt the Agenda for Sustainable Development built on a foundation of equality, inclusiveness and universal enjoyment of rights.
This agenda identifies poverty as the primary global challenge and calls for freeing the world from this tyranny, leaving no one behind. In reality, economic disparities are only one part of the inequality story. Many other social, political and institutional dimensions feed on each other, and together block the hope for progress among people on the margins, especially women and girls. Inequalities in sexual and reproductive health and rights are intertwined with gender inequality.
Both deserve urgent attention and demand more action. Without such action, many women and girls will remain caught in a vicious cycle of poverty, diminished capabilities, unfulfilled human rights and unrealized potential — especially in developing countries and especially among girls.
In 68 countries across the world, gender gaps have widened between and Exclusion and inequalities in opportunities can have profound consequences on women and girls now and in the future. Take the case of a young girl as portrayed in the report. She was born to a poor family, in a rural community, in a poor country. As her life unfolds, she may go to school, but probably far fewer in years than boys her age. She may have to stop schooling because she gets married young or is expected to care for her younger siblings.
As she becomes an adolescent, she may know how to perform household tasks and cultivate the farm, but she will find it challenging to join the paid labor force. She is more likely to stay home and start bearing a child as a teenager. Giving birth at an early age is already risky and the dangers will be compounded because her community lacks quality maternal health services. Looking ahead, she can expect that some of the disparities she suffers will be transmitted to her children, particularly her daughters.
At some point, she may get a glimpse of a better world, and she will wonder why she has so little, and so little opportunity for gaining anything more. Teenage pregnancy is three times likelier to happen with Filipino girls who have no education than those who reached college.
Stopping the downward spiral of inequality will require a vision for inclusive societies and shared prosperity, guided in principles of human rights. Actions on multiple fronts must tackle all forms of inequality, social and economic, and both the consequences and root causes.
Some countries have shown the way forward — for example, by including sexual and reproductive health services in broader objectives to achieve universal access to health.
Inclusive societies are a conscious, achievable choice, built through supportive public policies and laws, services and social norms. We all gain when human rights and dignity are universally upheld, with no exception and with no one left behind.
One measure of access to sexual and reproductive health services is the extent to which a woman who wants to use a modern method of contraception has access to it.
In the Philippines, unmet need for family planning among the poorest quintile is 4 percentage points higher than the unmet need among the richest quintile. Access to family planning services is a foundational element not just of reproductive health, but of social and economic equality, since unintended pregnancy constrains opportunities that women would otherwise have for education and economic advancement. The report cites a strong positive relationship between household wealth and skilled birth attendance.
The poorest and least educated women have the least access to sexual and reproductive health, are least able to exercise their reproductive rights and are most likely to be unemployed or under-employed and earn less than men.
Gender-unequal norms not only influence whether a woman enters the labor forces but can also dictate which types of jobs she may pursue, determine how much she will be paid and hinder her advancement in the workplace. For women everywhere, pregnancy and child-rearing can mean exclusion from the labor force or lower earnings. The challenges are even greater for women who lack the means to decide whether, when or how often they become parents.
Majority of people agree that women and men should have equal access to a university education. But in the area of employment, most believe that when jobs are scarce men should have priority over women. More than inequalities in access to reproductive health services, discrimination against women and girls is entrenched in many social institutions. In countries with high levels of discrimination, one in three girls is married by age Under these situations, there is high prevalence of domestic violence.
And in many countries, laws — or the absence of them — reinforce these dire situations. In another review of countries, the World Bank reports that 46 of these countries had no laws on domestic violence, and 41 had no laws pertaining to sexual harassment.
Laws protecting women from economic violence are rare. Economic violence occurs when a woman is deprived of her economic means because her partner either controls the economic resources or prevents the woman from having or keeping a job. Once in the paid labor force, women find themselves earning less than men for the same types of work.
This phenomenon is called the gender wage gap, or the percentage shortfall in the average age of women relative to the average age of men. Progress in narrowing this gap is rather slow and ILO estimate that it will take more than 70 years before the gender wage gap is closed. Subtle or overt pressure from, or discrimination by teachers can lead girls to forego or be excluded from advanced science and mathematics courses, limiting their future occupational choices.
In low and lower-middle-income countries, agriculture remains the most important sources of employment — work that is poorly remunerated, seasonal and less secure. In addition, women do on average 2. We are also seeing women indirectly being penalized for having children. They experience the so-called motherhood penalty. Employers may justify paying women less because of a wrong perception that women lack commitment to their jobs at a time when they just got married or have children at home.
Some employers even pass potential mothers over for promotion because of the anticipation of a pregnancy-related leave. Workplace discrimination against pregnant women and workers with family responsibilities is a violation of labour rights. Maternity and paternity leaves are an important mandatory provision to address pregnancy risks and to give time for parents to take care of their children. Unfortunately, some countries and some companies do not provide the standard maternity and paternity leave periods — or do not provide them at all.
Again, this is a violation of labor rights. The effect of education in reducing adolescent pregnancy has been documented. The longer a girl stays in school, the less likely she is to be married as a child or to become pregnant. What then are the social costs of inequality? And this leads to millions of unintended pregnancies, abortions, miscarriages and still births.
They also increase the risk of maternal mortality. Despite reductions in maternal deaths worldwide, the maternal mortality ratio in the least developed countries remains at deaths per , livebirths, compared with 12 deaths per , births in developed countries. The risk of maternal deaths for mothers under age 15 in low- and middle-income countries is double that for older women.
One thing is clear: When nations of the world came together in to chart the course towards sustainable development in the next 15 years, they committed to ending poverty and hunger everywhere, to combatting inequalities within and among nations, and to building societies that leave no one behind. Child mortality is four times higher among poor Filipino children than those living in the wealthiest households.
Reducing inequality in health, particularly reproductive health, can have a potential impact on economies through a demographic dividend. The demographic dividend sets in motion a virtuous cycle in which enhancement of human capabilities — through interventions in health and nutrition, education and employment — accelerates economic growth which in turn increase the potential for families and governments to invest additional resources in building the capabilities of the next generations.
And this can only be possible if everyone — especially the youth, the vulnerable and marginalized — are reached out by these investments. But equality is multi-dimensional, and one path to equality is universal health care. Health care that is universal is care that is accessible without resulting in financial hardships. The benefits of improved sexual and reproductive health care for all extend beyond health. For societies, there will be increases in growth of GDP and GDP per capita, increases in number of working age adults relative to dependent children, and decreases in demand for public expenditure in education, housing and sanitation.
For families and household, improved sexual and reproductive health care results in increased savings and household assets, reduced number of children who become orphans and increased resources for children, especially for schooling.
For women, there will be an increase in the ability to continue education, in production and in earnings, and will promote autonomy, self-esteem and gender equity. In conclusion, the report emphasizes that the multidimensional and persistent nature of inequality means that there is no single or easy way to close gaps between women and men, rich and poor, rural and urban, and the healthy and those who have no access to care.
Still, progress is possible, without addressing every dimension of inequality at the same time. Progress in one dimension can enable progress in others. Even small steps can open the path to great strides. Based on evidence of what works around the world, these 10 actions can help realize the quest for a more equal world. It requires all countries and all citizens to come together and tear down the inequalities in the lives of girls and women so that, in the end, they will not live worlds apart, but are part of a world where they too enjoy a life of prosperity, progress, and equality.
A world, where no one is left behind.