Ellen Hagerman Project Manager SRHR, Hivos Southern Africa PRESENTATION TO SADC: Sexual and Reproductive Health and Rights And Sustainable Development Goals

BACKGROUND Finalization of SADC Integrated Strategy Request by Member States to incorporate the SDGs Regional SRHR Fund offered to prepare a document

Seek and receive information on SRH Receive education on SRH Choose their partner Decide to be sexually active or not Decide whether or not and when to have children Pursue a satisfying, safe and pleasurable sexual life SRHR includes the right of all persons to:

Contraceptive Info and Services Maternity care Safe abortion Info and counselling on Violence against women Actions to eliminate harmful practices e.g. child marriage Services and medicine to deal with HIV, STIs SRHR includes:

Lack of data on SRH in the SADC region HIV and SRH are linked and should be integrated A number of commitments to SRH/HIV have already been made Consultation and inclusion is critical Key Considerations:

Reduce maternal mortality ratio to less than 250 deaths per 100,000 live births by 2020, to less than 100 deaths per 100,000 live births by 2025 and reach the SDG target of less than 70 deaths per 100, 000 live births by Increase the number of skilled birth attendants in the region by 25% by Reduce the maternal deaths linked to HIV/AIDS by 50% by Increase the percentage allocation on maternal health as part of health systems strengthening by 15% by Increase number of clinics/hosptials that offer integrated SRHR/HIV services by 50% by By 2030, reduce the global maternal morality ratio to less than 70 per 100,000 live births: TARGETS

ESA region: 510 maternal deaths per 100,000 in 2013 AIDS-related maternal mortality: 50% in most SADC countries Africa: 40% of girls & women get help from a skilled birth attendants Contraception can avert 7000 newborn and child and 600 maternal deaths 3.1 By 2030, reduce the global maternal morality ratio to less than 70 per 100,000 live births: SITUATION

Encourage girls to stay in school Address barriers to access Increase # of skilled birth attendants Engage communities to promote delay and spacing of pregnancies Link fertility planning to HIV services Promote preventative measures e.g. EANC and HIV testing when pregnant Commit financial and human resources to health systems strengthening 3.1 By 2030, reduce the global maternal morality ratio to less than 70 per 100,000 live births: RECOMMENDATIONS

Increase the availability and diversity of contraceptive options for all citizens of reproductive age by 50% by 2030 Increase the availability of Adolescent and Youth-Friendly Services (AYFS) by 45% by 2030 Reduce the number of unwanted pregnancies by 40% by 2030 Reduce the rate of HIV/AIDS among young people by 45% by By 2030, ensure universal access to sexual and reproductive health care services: TARGET

Gender inequalities and discrimination: 1) increases the risk of HIV infection and impacts; 2) reduces their ability to negotiate the use of condoms; 3) is linked to poverty and exclusion Girls experience sexual violence and harassment at school which prevents gender equality Girls and women are subject to deep- rooted social norms and attitudes 5.1 End all forms of discrimination against all women and girls everywhere: SITUATION

Adopt and strengthen policies and legislation for the promotion of gender equality and the empowerment of all women and girls Collect sex disaggregated data to improve overall knowledge on gender-based discrimination Mobilize communities to promote egalitarian gender norms Engage men and boys to help end gender-based, sexual and intimate partner violence. Empower women, young women and girls, including by investing in women’s leadership 5.1 End all forms of discrimination against all women and girls everywhere: RECOMMENDATIONS

Reduce the number of women and girls who have experienced Gender- Based Violence by 50% by 2020, by 75% by 2025 and eliminate all forms of GBV by 2030 Reduce the number of girls whose first sexual experience is either coerced or involves rape by by 2020, by 75% by 2025 and eliminate all forms of Sexual- Based Violence by Eliminate all forms of violence against all women and girls including trafficking and sexual and other types of exploitation: TARGETS

Southern Africa: GBV is pervasive 1 in 3 girls has been forced to have sex by the age of 18 years 1 in 5 adolescents have been victims of sexual violence Global: Girls are vulnerable due to gender norms that encourage men to be aggressive Sexual violence exposes girls to HIV & STIs Women living with HIV face increased violence 5.2 Eliminate all forms of violence against all women and girls including trafficking and sexual and other types of exploitation: SITUATION

Develop policies and programs that respond to the SADC Gender Protocol Establish GBV baselines and indicators Scale up recourse to GBV in terms of legal provisions & implementation Make policing and justice departments accountable Allocate resources to train HCWs in forensic care to address GBV 5.2 Eliminate all forms of violence against all women and girls including trafficking and sexual and other types of exploitation: RECOMMENDATIONS

SADC Gender Protocol Enact and enforce legislation prohibiting all forms of gender-based violence; Ensure that the laws on gender based violence provide for the comprehensive testing, treatment and care of survivors of sexual assault; Review and reform their criminal laws and procedures applicable to cases of sexual offences and gender based violence; Enact and adopt specific legislative provisions to prevent human trafficking and provide holistic services to the victims, with the aim or re- integrating them into society; Enact legislative provisions, and adopt and implement policies, strategies and programmes which define and prohibit sexual harassment in all spheres, and provide deterrent sanctions for perpetrators of sexual harassment; and Adopt integrated approaches, including institutional cross sector structures, with the aim of reducing current levels of gender based violence by half by 2015.

Reduce the number of early forced marriages by 50% by 2020 and eliminate early and forced marriage by Increase services to married girls under the age of 18 by 50% by Eliminate all harmful practices such as child, early and forced marriage and female genital mutilation: TARGETS

Africa: 40% of girls are married before the age of 18 ESA: 34% of girls aged were married before the age of 18 Global: girls in rural areas are more likely to be child brides Forced marriage and virginity testing increase vulnerability to HIV Child marriage has a lower chance of using contraception 5.3 Eliminate all harmful practices such as child, early and forced marriage and female genital mutilation: SITUATION

Develop and implement laws that set a minimum age of marriage; Develop and implement programs to meet the needs of child brides Address the cultural drivers of child marriage and FGM Strengthen child protection systems Recognize children in the law 5.3 Eliminate all harmful practices such as child, early and forced marriage and female genital mutilation: RECOMMENDATIONS

Reduce the number of deaths related to unsafe abortions by 50% by 2030 Decriminalize abortion and ensure safe abortion services are universally available by 2030 Reduce adolescent fertility rates by 50% by Eliminate the number of deaths of adolescents due to HIV by 2030 Improve SRH of young people aged with a focus on HIV prevention by Increase the number of schools providing life skills-based HIV and sexuality education by 75% by 2030 Increase HIV awareness among adolescent and youth by 40% by Ensure universal access to SRHR as agreed in the POA of the ICPD and Beijing POA: TARGETS

Abortion: the cost of treating complications of unsafe abortion is $680 million globally and contributes to 30% of maternal deaths in SSA Adolescent fertility: live births per 1,000 girls in the ESA region CSE: Programs that address sexuality education decrease pregnancy and risk of HIV Child Trafficking: there is limited data. Girls are women are most vulnerable 5.6 Ensure universal access to SRHR as agreed in the POA of the ICPD and Beijing POA: SITUATION

Decriminalize abortion. Develop safe abortion laws. Ensure adolescents are aware of their rights to access SRH and HIV services. Address sexuality education at early adolescence to improve health and social outcomes. Increase the number of teachers who have received training on CSE. Ensure each country has a national CSE strategy. Undertake research to understand the reality and responses needed to address child trafficking. 5.6 Ensure universal access to SRHR as agreed in the POA of the ICPD and Beijing POA: RECOMMENDATIONS

HIV/AIDS services are available to all citizens including Key Populations by 2030 Decriminalize homosexuality in all SADC countries by Increase access to SRH and HIV services for the disabled by 50% by 2030 Increase access to SRH and HIV services for migrants and mobile populations by 50% by By 2030, empower and promote the social, economic and political inclusion of all irrespective of age, sex, disability, race, ethnicity, religion or economic or other status: TARGETS

HIV/AIDS services are available to all citizens including Key Populations by 2030 Decriminalize homosexuality in all SADC countries by Increase access to SRH and HIV services for the disabled by 50% by Increase access to SRH and HIV services for migrants and mobile populations by 50% by By 2030, empower and promote the social, economic and political inclusion of all irrespective of age, sex, disability, race, ethnicity, religion or economic or other status: TARGETS

Income inequality is linked to higher HIV prevalence MSM and People who inject drugs account for 33% and 26% of new HIV infections HIV prevalence of transgender is 19% HIV prevalence of sex workers is 12 times greater than the general population Decriminalization of sex work would have the greatest effect on the course of HIV Persons with disabilities are at high risk of exposure to HIV By 2030, empower and promote the social, economic and political inclusion of all irrespective of age, sex, disability, race, ethnicity, religion or economic or other status: SITUATION

Decriminalize sex work and ensure access to SRH services Ensure safe and equitable health services for marginalized groups Introduce and scale up access to PrEP Address disability in national SRH policy, laws and budgets Invest in programs to change people’s attitudes towards LGBTI and disabled 10.2 By 2030, empower and promote the social, economic and political inclusion of all irrespective of age, sex, disability, race, ethnicity, religion or economic or other status: RECOMMENDATIONS

Exclusion, stigma, discrimination and violence fuel the HIV epidemic among adults and children. People living with and affected by HIV often lack access to justice. There are insufficient people-centred accountability mechanisms that ensure the inclusion of vulnerable and marginalized people Ensure equal opportunity and reduce inequalities of outcome, including eliminating discriminatory laws and policies and practices: SITUATION

Set up accountability mechanisms with a range of stakeholders Decriminalize punitive laws against LGBTI and other Key Populations Take into account and adapt policies and programming to accommodate particular vulnerabilities 10.3 Ensure equal opportunity and reduce inequalities of outcome, including eliminating discriminatory laws and RECOMMENDATIONS

Does this meet your needs? Does this cover everything? Any recommendations or ideas? QUESTIONS

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