#ICPD25: Are we really Accelerating the Promise?

Sexual and Reproductive Health (SRH) has been in the air for a while with much attention being given to the discussion mostly in high level forums and at the lowest with young people either by Non-Governmental Organizations, Community Based Organizations or politicians when they want to appeal to the youth. This is a topic that is rarely covered especially in the African context where saying anything around sex is a taboo by itself. This is rather absurd considering the largest family sizes are in Africa and Africa boasts of the highest fertility rates globally. No pun intended, check the statistics.

The focus on SRH is normally fueled by a felt need for sexual health which according to the WHO definition is a state of complete physical, emotional, mental and social well-being in relation to sexuality; not merely the absence of disease, dysfunction or infirmity. The needs are normally in relation to the financial strain unplanned pregnancies put on families necessitating need for family planning; increased risk of sexually transmitted infections (STIs) including HIV/AIDs; gender based violence (GBV), female genital mutilation (FGM) among others.

Translating this need however is often times a challenge, this is because the findings that influence these decisions are made based on data which unless one can relate with will remain as mere numbers. There is an abstraction from these challenges and every individual who should champion SRH doesn’t get the push to do so as they don’t feel the seriousness of the matter and consider themselves distant from the matter. I am writing this piece in Juja, Kenya at a time that I've just received news about the killing of #UyineneMrwetyana in South Africa after being raped. This hurts yet its miles away. This is because for every lady who is raped, I change the lens and view her as my sister, aunt, niece, cousin or even my daughter. How does that feel to you? The basic idea that I am driving is that when we can relate with a problem facing our society, we are more inclined to act or at the very least influence the rate at which a solution is found.

The International Conference for Population and Development (ICPD) set the stage for adoption of adolescent sexual and reproductive health on the international agenda in 1994. As I write this piece we are barely two months to #ICPD25 which luckily or unluckily will be hosted in Kenya from 12th to 14th November 2019. My concern and worry is on what we have achieved in the last 25years in championing SRH. According to the theme: “Accelerating the Promise”, it’s my hope we’ll get a chance to review the promise, monitor what we’ve done so far and most importantly set course on what should be done moving forward. This is the basis as to why I am writing this piece.

The current advances to champion SRH have been focused on young people with priority being given to ensuring there are Youth Friendly Services (YFS) and Safe spaces for young people when it comes to SRH services they need. The WHO defines YFS as services that are accessible, acceptable, equitable and appropriate to meet the SRH needs of young people aged between 10-24years. This definition makes a lot of sense however there is a catch 22. This is because we are championing access to services that are not supported by the very communities that these young people live. Imagine leaving a safe space after receiving the most youth friendly services to be raped on your way home?

When we consider access, we need to ask ourselves which services the young people need spanning access to information about their sexuality, risks around sexual conduct and aspects on safe sex. Once this is guaranteed, then we should act on their environment. Promoting access to condoms for young people especially ladies when they depend on their male sexual partners for livelihood downplays the power they can exercise on use of the condom. This cuts across all other contraceptive methods as well. We therefore need to assess the factors that influence the use of SRH services that young people need. It’s the same as physical health where we’ll consider the social determinants of health and design interventions to tackle these barriers will we be able to authoritatively say we are accelerating the promise.

Another issue of interest is on access to abortions which is part of the discussion on SRH. This is one issue that have polarized the world extensively even in the United States of America (USA) that most countries look up to when it comes to liberties and all. It emerged with considerations on pro-choice and pro-life but these are not going to guide this part. I will focus entirely on choice when it comes to SRH.

What choices do we have as young people to have a healthy sexual life? The choices are limited already. Some ladies can’t choose whether to have sex or not because they are dependent on their partners; some are abused physically & emotionally by husbands but can’t leave their marriages because of the shame that comes with separation/divorce etc. Do we really advocate for choice when we can’t guarantee the very people we claim to serve a chance to exercise their choices because the society doesn’t allow? Who is the society here? I thought you’d ask. It’s me and you. And for your information we have double standards on everything; we favour what supports our ideals and benefits us and turn a blind eye on any other thing.

When we can’t guarantee any lady the chance to walk a street without fear of being raped, to question her husband without fear of being abused, to consider separation out of fear of being shamed by the society, then we need to reassess what we say we are doing.

The focus of SRH as ascribed to by WHO is to increase the possibility of having safe sexual experiences which are free from discrimination, coercion and violence. To allow for a sexual life that is safe and satisfying with the freedom to decide if, when and how often to reproduce. As we prepare for #ICPD25, my question to you is why this should be an aspiration and not a norm? Why should it not be possible for one to have safe sexual experiences? If you can get the answer to this then you are on track to changing the narrative and that’s what you should do.

Register here and make your voice count: https://www.nairobisummiticpd.org/