When policy isn’t enough: Examining accessibility of sexual and reproductive health rights for displaced populations in South AfricaPosted: 21 December, 2020
Author: Lidya Stamper
Research Fellow, Centre of Human Rights, University of Pretoria
The right to sexual and reproductive health services (SRHS) is a fundamental human right for all, guaranteed under international human rights law. Legal protections outlining these rights have been recognised in South Africa through international, regional and domestic instruments. More specifically, these protections are highlighted and specified in documents such as the ‘Convention on the Elimination of all Forms of Discrimination Against Women’ (CEDAW), the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women in Africa (Maputo Protocol), and the 1996 Constitution of the Republic of South Africa. Despite the presence of these legal frameworks, outlining equality and non-discrimination, persistent inequalities continue to act as barriers to exercising SRHS. Legislative and policy advances in SRH have been undermined by a lack of successful implementation and improvements in service delivery, service accessibility, and service availability. Implementation challenges combined with a fragmented health sector have resulted in various obstacles including a lack of standardised care, gaps in the dissemination of information, overburdened health facilities, and provider opposition. Social conditions such as gender inequality, poor access to health services, and provider attitudes continue to reinforce these barriers, undermining many of the intended outcomes of the existing legislative and policy advances in the SRH realm.
Author: Mary Izobo and Folasade Abiodun
(An earlier version of this article was published by Daily Maverick)
Since January 2020, COVID-19 pandemic, has held the world to ransom and has posed a threat to public health. It has put a lot of pressure on available medical facilities with a record of more than 9 million persons infected and more than 470 000 deaths globally with numbers set to increase. In order to stop the spread of the coronavirus, several countries are taking measures such as the closure of airports, seaports and land borders, isolation and quarantining of persons, banning of religious, sporting and social gatherings, closure of schools and universities, restaurants, public spaces and complete or partial ‘lockdown’ of some countries. The lockdown of countries entails complete restriction of movement as the virus is transmitted through direct contact with infected persons or surfaces. Some of these measures as well as their enforcement , have implications on the right to freedom of movement, the right to freedom of association and the right to freedom of assembly.
A case currently before the Constitutional Court of Uganda is providing an interesting test for how far courts can go in protecting basic human rights. Human rights are rights inherent to all human beings. Every person is equally entitled to them without discrimination. They are interrelated, interdependent and indivisible.
Universal human rights are often guaranteed by law through treaties and various sources of international law which generally oblige governments to respect, protect and fulfill human rights and fundamental freedoms of individuals or groups.
Apart from international obligations, countries have various ways of entrenching human rights. Most contemporary constitutions entrench basic human rights. Such constitutions include the 1996 Constitution of South Africa and the 2010 Kenyan Constitution. Likewise, the 1995 Constitution of Uganda contains the Bill of Rights that guarantees fundamental freedoms and basic rights including the rights to health and to life.
Realising the right to health for children with HIV/AIDS in Botswana: Policy based approach v rights based approachPosted: 13 August, 2013
Botswana faces significant challenges on the HIV/AIDS epidemic. According to the third Botswana AIDS Impact Survey (BAIS III) which took place in 2008, 17.6% of Batswana were living with HIV/AIDS. The survey revealed that about 18 000 children below the age of 19 were HIV positive.
Strong political commitment at national level has however resulted in impressive scale up in HIV treatment for children under the Prevention of Mother-to-child Transmission programme. Children are currently treated in about 33 centres issuing antiretroviral drugs. However, Baylor Children’s Clinical Centre of Excellence provides a more in-depth pediatric content. There are also community-based non-governmental organisations (NGOs) such as Child Line, Mpule Kwelagobe Centre, SOS Children’s Home and Paolo Zanichelli Children’s Centre that are currently providing specialised services to vulnerable children. It is however important to point out that, in Botswana, the needs of HIV/AIDS affected children are not provided for in a comprehensive National legal framework. Care and treatment for children with HIV is currently addressed in overall HIV policy guidelines.
It is a universal and timeless reality that women face the risk of death in the process of giving life. In recent years, this risk has been virtually eliminated for those who have access to the necessary prenatal care and emergency medical assistance. Contrary to the global trend, Zimbabwe has seen a stark increase in its number of maternal deaths and currently sits with a figure that is 50% higher than the sub-Saharan average.
This state of affairs is not surprising in light of the disintegrated nature of Zimbabwe’s public health system, which reached its lowest point in 2008. At that time, government policies led to the closure of public hospitals and a medical school in Harare. Basic resources and emergency care have not been consistently available and the government’s failure to remunerate healthcare professionals with set salaries left many of them with no choice but to leave the country. The continuing epidemic of deaths which could have been prevented indicates an alarming disregard for a variety of rights and obligations on the part of the Zimbabwean government. Questions arise as to whether the government is taking appropriate measures to address the plight of Zimbabwean women.
Sometime in May 2013, the Republic of Kenya, together with two of her counterparts, Zambia and The Gambia, received the prestigious Resolve Award from the Global Leaders Council for Reproductive Health. Briefly, the Resolve Award was launched in 2011 as an annual award issued by the Aspen Institute. The Award recognises countries that are surmounting various challenges to bring essential reproductive health services to their people and celebrates progress made by governments towards delivering on the promise of universal access to reproductive health. We must therefore begin by celebrating our nation’s achievement. Indeed, impressing a Council comprising of 18 sitting and former heads of states amongst others, the Honourable Mary Robinson, Her Excellency Joyce Banda, Honourable Gro Harlem, Vice Admiral Regina Benjamin and Honourable Tarja Haloren is by no means an easy step.
The Award comes at an opportune time when mothers all over Kenya are celebrating the reprieve granted by the Jubilee Coalition which on 1 June 2013 issued a directive waiving all fees payable by mothers for maternal services at public health facilities. In recent times, we have in addition seen other efforts by the Kenyan government aimed at transforming access to reproductive health services and lowering maternal mortality. First, there is the constitutional recognition of reproductive health as a fundamental human right under Article 43(1)(a). There is also the enactment of many visionary policies and guidelines, including the National Reproductive Health Policy and the comprehensive Population Policy for National Development which places family planning at the centre of Kenya’s development agenda. Additionally, there is also the Child Survival and Development Strategy and the National Road Map for accelerating the attainment of the Millennium Development Goals (MDGs) related to maternal and newborn health in Kenya.