Girls Access Their Reproductive Health Rights

Narrative for Reproductive Health
Reproductive health challenges facing young people in Zambia are early pregnancies, early marriages, rape, and Gender Based Violence. Sexual activity begins early and is often unprotected and is associated with risks such as HIV/AIDS, pregnancy and unsafe abortion, economic hardship and school drop-outs. Over 30 percent of 15-19 year old girls in Zambia have already been pregnant or have had a child according to a UN joint statement released in 2013. This rate of pregnancy is considered alarming among adolescents and attributed it to early marriage and adolescent pregnancy. Adolescents face higher reproductive risks than older women. Pregnancy is the leading cause of death for young women aged 15-19 worldwide with complications of childbirth and unsafe abortion being the major risk factors. Teenage girls are not physically mature and at greater risk of obstructed labour, pregnancy-induced hypertension and obstetric fistula (the creation of a hole between the birth canal and anal area during prolonged labour). Girls aged 15-19 are twice as likely to die in childbirth as those in their 20s. Death and injury rates are higher among infants born to young mothers who are less likely to get pre-natal care, and babies born to very young mothers are most likely to be premature or underweight. Four in ten children under five in Zambia are stunted or too short for their age. This indicates chronic malnutrition. Stunting is more common in Northern Province w here almost half of children are stunted and less common in Lusaka, Copperbelt, and Western provinces where 36% of children are stunted. Stunting is more common among children of less educated mothers (45%) and those from the poorest households (47%). Wasting (too thin for height), which is a sign of acute malnutrition, is far less common (6%) and 15% of Zambians are underweight, or too thin for their age. This is a manifestation of the poor nutritional status which too often is associated with extreme poverty at household levels.

Reproductive Health is often linked to pregnancy, women often unique challenges to achieving the highest attainable standard of health.

National access to SRH cannot be achieved without the realization of gender equality and women’s rights. Women are disproportionately affected by poverty, violence, a lack of access to decision-making and political processes, and low social status, all of which arise from gender-based discrimination and lead to disproportionate human rights abuses, including of the right to health.

Violence against women violates women’s bodily integrity. A woman’s right to control her body, including her Sexual Reproductive is a basic human right. Failure to recognize this right allows for practices that cause harm to women. Violations of women’s reproductive health rights are often deeply embedded in societal values pertaining to women’s sexuality. Patriarchal concepts of women’s roles within the family mean that women are often valued based on their ability to reproduce. Early marriages and pregnancies, repeated pregnancies spaced too closely together, often as the result of efforts to produce male offspring because of the preference for sons, has devastating impact on women’s health with sometimes fatal consequences. Women are often blamed for infertility, suffering exclusion/ shunning and being subjected to various human rights violations.The Beijing Platform for Action States that “the human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence.”

The overall impact of the Reproductive Health Project is: Productive Communities where members (RHs) are responsible and enjoy Quality Reproductive Healthcare, Water, Sanitation and Hygiene. 

Reproductive Health, Water and Sanitation Goal:  Sustainable & Integrated Reproductive Health Care Services accessible to Rights Holders in Project Areas.  
In order to achieve the Reproductive Health Project Goal, GYT Zambia will follow four (04) objectives:

Objective 1: Duty bearers have included men and women’s recommendations on WASH services in their work plan
If awareness on WASH and existing WASH policies is raised in targeted communities, these shall contribute to and strengthen the GYT partners’ advocacy work for the government’s development & implementation of appropriate WASH policies in an accountable and transparent manner which shall both influence and cause Health Facilities to implement integrated WASH policies through service provision and information sharing. Therefore, Rights Holders will have access to integrated: WASH services. The assumption is that the government as the key actor shall be willing to implement existing policies, change inappropriate policies and fund WASH programs, communities shall be willing to participate, and also that various partners/stakeholders shall be willing to network and advocate together.

Objective 2: Conventional Reproductive Health Services are preferred over harmful traditional practices
The establishment of safe delivery networks and maternal homes will lead to increase in the number of referrals to Rural Health Centres (RHCs) and accessibility to Reproductive Health services in areas that are within and outside the recommended 5km radius around each Rural Health Centre (RHC) but up to the Ministry of Health RHC designed radius of 29km for an RHC. This together with community awareness raised and  training of Traditional Birth Attendants (TBAs) & Community Health Workers (CHWs), will increase Rights Holders’ knowledge and skills, and practice positive cultural & traditional norms, and hence more preference to Conventional Reproductive Health Services by Rights Holders. The assumption is that communities shall be willing to participate & own the program, training materials approved by Ministry of Health shall be available and that funding shall be available to conduct a research.

Objective 3: Maternal and Child Mortality is Reduced
The trainings that shall be provided (to Community Health Volunteers, Community Village Committees & Community Health Workers), the promotion of improved staffing at RHCs & improved availability of RHCs and also the promotion of building & usage of WASH facilities in targeted communities/RHCs/schools shall lead to improved service delivery, women’s awareness and increased availability, access to, and utilization of reproductive health services. This shall ultimately lead to easy access due to availability of health services and information in targeted communities and improved service delivery which will further contribute to the progressive reduction of Maternal and Child Mortality.The assumption is that GYT partners shall work with RHCs, training materials shall be available & approved by Ministry of Health and that targeted communities shall actively participate and own the program.

Objective 4: Communities take responsibility to prevent communicable and non-communicable diseases
The training of Community Health Committees shall increase their knowledge in communicable and non-communicable diseases coupled with increased community participation shall lead to reduction in these diseases because communities shall take responsibility in the prevention.The assumption is that GYT partners shall work with RHCs, training materials shall be available & approved by Ministry of Health and that targeted communities shall actively participate and own the program.

The follow are the activities that need to be implemented and how funds shall be used:

  • - Improve girls’ health & development by reducing child marriages.
  • - Develop leadership of young people to access information & services (to be visible champions of policies & programs that serve a large number of their peers)
  • - Provide information & support that would enable young people to protect their SRH.
  • - Provide support to SRHR (Sexual Reproductive Health Rights) in form of education, information, and counseling for young people, SRHC (including counseling & medical care)
  • - Provide support through efforts within the framework of broad approaches that focus on information & preventive measures e.g. prevention of teenage marriages/ pregnancies, unsafe abortions, sexual violence, harmful customs like female genital mutilation (that endanger lives of women & girls)
  • - Challenge harmful traditional norms and modify social & cultural patterns that arise from and perpetuate the notion that women are inferior to men.
  • - Advocacy for Gender justice and SRHR
  • - Advocacy for allocation of appropriate resources for support of Gender justice and SRHR policies and programs
  • - Advocacy for provision of pre-natal care, safe motherhood services, assisted child birth from trained attendants and infant health care
  • - Provision of sexual health information, education & counselling to enhance personal relationships and quality of life
  • - Provision of voluntary, informed and affordable family planning information/ services
  • - Support education & policies to address gender & economic inequalities
  • - Prevention & treatment of violence against women and girls including torture & sexual violence
  • - Prevention & treatment of sexually transmitted infections (STIs), including HIV & AIDS, and Cervical Cancer.

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