#IWD2017: Be bold for change
Below is a statement from Dr Denise Chevannes, Executive Director, National Family Planning Board-Sexual & Reproductive Health Agency (NFPB-SRHA), on the occasion of International Women’s Day 2017.
IN commemoration of the 2017 International Women’s Day, the theme of which is ‘Be Bold for Change’, the National Family Planning Board-Sexual and Reproductive Health Agency pauses to more closely reflect on the pernicious challenge of violence against women, including sexual violence.
Violence against women including sexual violence remains one of the most serious threats to the health and safety of women and girls worldwide. In Jamaica, the problem has been increasingly reported in the media in recent times and, given that the issue is often veiled behind a cloak of silence, it would be instructive to know if the acts are becoming more severe and macabre and thereby come to public attention or whether the magnitude being reported really represents an actual increase in the incidence of the problem.
In any event, the United Nations defines violence against women as “any act of gender-based violence that results in, or is likely to result in, physical, sexual or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.” The World Health Organization (WHO) defines sexual violence as “any sexual act or an attempt to obtain a sexual act, unwanted sexual comments, or advances, acts to traffic or otherwise directed, against a person’s sexuality using coercion, by any person regardless of their relationship to the victim in any setting, including but not limited to home and work.”
Unfortunately, violence against women including sexual violence of which rape and incest are manifestations affect a significant proportion of the population. The majority of those directly experiencing such violence are women while the majority of perpetrators are men although the inverse also occurs. The harm that such violence causes can last a lifetime and span generations, with serious adverse effects on sexual and reproductive health as well as broader physical and psychosocial health issues, and negative socio-economic outcomes on education and employment.
The prevention of such violence will save lives and money. The investments made to stop violence against women including sexual violence before it occurs will protect the physical, mental and economic well-being and development of individuals, families, communities and whole societies.
Optimal sexual and reproductive health through universal access to sexual and reproductive health information and services is an imperative in its own right, and a key factor which affects population and development dynamics. Ensuring that everyone can enjoy the right to “decide freely and responsibly the number, spacing and timing of their children is vital for the well-being of women, and for overall sustainable development.”When women and couples have the means to determine the number of their children, families tend to be smaller, or the size that they can best provide for. This improves their chances of breaking the poverty cycle, and by helping people to manage their fertility, addresses population dynamics and offers opportunities to advance all three dimensions of sustainable development – social, economic and environmental.
At the genesis of violence against women including sexual violence lie gender inequalities among different categories of women and men – or those who assume feminine and masculine behaviours and roles. Gender inequalities are therefore an underlying determinant of adverse sexual and reproductive (SRH) and HIV risk as well as vulnerability in Jamaica. On the other hand, not providing opportunities for gender equality results in high social, medical and economic costs to individuals, families and public budgets. For sexual and reproductive health services to be effective they must cover all the related dimensions including preventative services to reduce gender based violence and sexual violence.
Social vulnerability for males is related to cultural norms of the dominant (heterosexual) masculine identity which is associated with aggression and risk taking behaviours, having multiple sex partners to prove their virility, having many children, having sex without using a condom and poor health seeking behaviour. The Bureau of Gender Affairs in Jamaica notes that male involvement in domestic violence as perpetrators is linked to “macho” definitions of men as unemotional beings who do not talk through issues but act out feelings of discontent and frustration in violent aggressive ways. To act otherwise is to be effeminate and not meet up to the heterosexual male norm.
In contrast, cultural myths suggest to women that being hit by a man is a sign of his love. Socialization ascribes gender roles to women that include motherhood, responsibility for the domestic front, and passivity about being sexually assertive in demanding condom use and refusing sex. Even our boys and girls are raised in this way – “tie the heifer and loose the bull”! And age is no respecter of persons as the evidence, albeit limited, indicates.
According to UNICEF, in 2006, children and adolescents made up an alarming 78% of all the sexual assault/rape cases admitted to public hospitals. In the same year, girls under 16 accounted for 32% of all sexual assaults in Jamaica. According to the 2012 Knowledge, Attitudes and Behaviours Survey, almost half of adolescent females (48.8%) said their first sexual encounter was forced or unwanted, compared to 4.4% of males.
The National Family Planning Board-Sexual & Reproductive Health Agency (NFPB-SRHA) fully understands that gender mainstreaming for gender equality, the empowerment of women and the greater involvement of men for their own sexual and productive health as well as in support of women is critical to optimizing sexual and reproductive health outcomes in Jamaica. Our comprehensive programme of work includes information, prevention measures and provision of services, using a gendered and human rights based approach that enables people to protect themselves from sexually transmitted infections, including HIV, and unwanted pregnancies. Our programmes address self-esteem, life skills as well as assertiveness training for the reduction of violence against women.
The NFPB-SRHA believes that the key to women’s empowerment is to strengthen not only their economic and social autonomy but also their ability to decide freely on the number and timing of children which expands their opportunities for work, to get educated, and for social participation which in turn enables them to contribute more effectively to the economic growth and social development of their country. The result is improved quality of life for all but particularly women and children. Families with fewer children and children spaced further apart can afford to invest more in each child’s education that in the end contributes to the development of the country.
Likewise, the healthier and better educated the mother, the healthier and better cared for her children are likely to be. The death of the mother increases the risk that her children will suffer adverse events or die. Therefore, a continuum of care before and through pregnancy and early childhood can reduce maternal mortality and infant and under five deaths.
The work of the NFPB-SRHA is critical to advancing sexual and reproductive health and rights, including increasing universal access to rights-based family planning services. Especially in the era of the Sustainable Development Goals, optimal sexual and reproductive health can positively influence population dynamics and advance a number of sustainable development priorities, including those related to health, gender equality, food, water and energy security and environmental sustainability.
Since the integration of the HIV prevention and enabling and human rights environment of the former National HIVSTI Programme of the Ministry of Health into the family and population planning programmes of the NFPB, creating the NFPB-SRHA in 2013, gender mainstreaming has been introduced in a cross-cutting way.
One of the strategies being pursued is a gender and rights based approach to programming to support the empowerment process by which communities – and youths, especially young women – increase their awareness about their sexual and reproductive health and rights, as guaranteed under local laws and adopted in international agreements to which Jamaica is signatory. At the policy level, and this is the focus of our Enabling Environment and Human Rights Unit, a gender and rights based emphasis may lead to advocacy and necessary reforms to support an enabling environment for addressing the special needs of youth, including ensuring confidentiality in service provision and protecting youth from sexual violence and exploitation.
Other notable examples at the NFPB-SRHA are our Health Promotion and Prevention Unit where our outreach officers provide not only HIV testing and family planning counselling island wide for free, but have also introduced risk assessment counselling that includes information on gender based violence (GBV). The Marge Roper Counselling Service provides private and confidential counselling on all matters relating to sexual and reproductive health, including gender based violence, to a wide variety of target audiences, including adolescents and women of reproductive age. Our Training Officer conducts integrated SRH/HIV Training programmes that have been designed to reach groups of men, women, parents and healthcare workers and are delivered using participatory learning approaches.
This comprehensive approach helps men, who might otherwise be reluctant to attend programmes solely concerned with violence against women, to participate and discuss a range of issues concerning violence. Furthermore, if the men have been involved in sexual coercion or violence, the programmes are careful to make referrals for conflict and dispute resolution. The NFPB-SRHA is of the view that the underlying starting point for this type of initiative is that men as individuals need to be better informed and more aware of the need for help-seeking behaviours including mental and psycho-social support, in order to take responsibility and adopt measures to reduce their use of violence.
Ultimately, we will really have to Be Bold for Change. Strong and robust commitment and involvement of government agencies and civil society, along with a coordinated response across a range of sectors, are required to end violence against women and sexual violence. We must be bold to end the culture of silence where the most abhorrent sexual violence acts of rape and incest are covered up by families and communities being excused as “jus a likkle sex”. Or the “droit de seigneur” – the right of the master – where fathers feel entitled to take the virginity of their daughters so that another man does not “pick their cherry”.
The NFPB-SRHA is committed to that task and invites all stakeholders to join us as we seek to advance sexual and reproductive health and rights in all three dimensions of sustainable development – social, economic and environmental. The resultant savings will surely redound to investment of financial resources into national growth activities including debt servicing, poverty reduction, education and environmentally sustainable practices in pursuit of the Vision 2030 Agenda as well as the Sustainable Development Goals.
