BY HAMZAH DZIKRI FADLIANSYAH
Photo by Tasaveeer Studio on Unsplash
All individuals have the right to govern their own bodies as well as receive access to maintain their sexual and reproductive health. This is the basic idea of Sexual and Reproductive Health and Rights (SRHR), which is essential to achieving gender equality. However, these rights are restricted in many parts of the world. Although the awareness of the importance of SRHR is widely spread in many places, it still only covers big cities rather than isolated and rural areas in certain regions. Dance4Life explained the different obstacles children and young people from rural areas face when it comes to getting access to their sexual and reproductive health and rights, ranging from poor infrastructures to violence, stigma, and discrimination. For instance, if children and young people do not have access to clean water and hygiene, it limits their access to menstrual hygiene and they become more vulnerable to sexually transmitted infections. Similarly, if stigma regarding the sexual and reproductive subjects still persists, children and young people will likely suffer from discrimination to get access to the SRHR materials such as sexual education, contraception, and SRH care and support. Moreover, this can also extend to sexual and gender-based violence (GBV) if the laws regarding the issues are not well-implemented or corrupt actions are taking place, which often happens in rural areas.
There are many factors influencing developing infrastructures in particular regions such as economic disparity, geographical boundaries, and so on. However, religious and cultural beliefs are also contributing factors. To illustrate, according to Guttmacher Institute, around 4.3 billion people of reproductive age do not receive essential sexual or reproductive health service throughout their reproductive life because of stigma and taboo surrounding the topic of sex and reproduction. Likewise, the Department for International Development in the United Kingdom reported that among those who do not get adequate access to SRHR are young people, women, and men living in poverty, where poor infrastructure is often found. However, cultural beliefs hindering the progression of SRHR do not only limit access to physical infrastructures but also influence the actors who are dealing with supporting SRHR such as health practitioners, doctors, and policymakers.
“Our culture does not allow us to discuss sexual and reproductive health and rights. We feel hesitant to talk about what is happening with our bodies with men, families, and male doctors. It is not allowed to discuss women’s problems with male doctors openly. We have to find female doctors to discuss this issue,” said a female psychologist who works at an orphan care organization in Pakistan.
More often than not, this hesitation prohibits adolescents, especially young women, from discussing topics related to sex and reproduction with people who are liable in the areas, such as doctors and practitioners. Instead, it is unsafe if they get the information from the wrong people who believe in misleading traditional values about sexual and reproductive health. For example, if a young woman is confused about her body changes due to puberty, she feels reluctant and uncomfortable talking about it to professional male doctors. Instead, she seeks answers from her parents who can oftentimes refer to misleading traditional values and practices, for example, “menstruation is dirty” which leads to girls being shunned from any human interaction for a while.
The results of this lack of access to sexual and reproductive health and rights are very detrimental to their physical and mental health. They will be vulnerable to sexually transmitted diseases, traditional harmful practices to their genitalia, unwanted pregnancy, and unsafe abortions. Moreover, it also heavily affects psychological health such as cases leading to depression, an increased risk of anxiety, and post-traumatic stress disorder to name a few.
The psychologist said, “if you have a good body, you have a good mind. If you have a problem with your body, you cannot think properly. Overall, everything [starting] from the biological and medical problem is connected to psychology, emotional, and social life.”
For instance, the psychologist also told us the story of a common incident that often happens in the region. “When it comes to sexual harassment, the survivors, mostly young women, usually do not get help from their families. The families tend to keep the story to themselves and do not let anyone else know about it because it will bring shame to them. Then, instead of prosecuting the abusers, the family marry their young girls to the abusers. This incident is clearly wrong in the eyes of human rights. Frequently, the survivors suffer from depression, which heavily affects their social life.”
Furthermore, different regions possess different laws regarding SRHR, including access to sexual and reproductive health education and sexual harassment policies. Plan International stated that some laws and policies may limit the access and services to SRHR and furthermore may hinder the access based on marital status or gender. As a result, it is even harder for young people to access their rights to that knowledge and services.
For example, in Pakistan, the psychologist told us that the topic of SRHR is exclusive to medical students only. Other people do not have the same access to knowledge about SRHR, so they do not know about their rights. Moreover, there are few to no books for children to learn about their body, sexual, and reproductive health written in Urdu, the language spoken in Pakistan. Again, the stigma around this topic is not discussed in public spaces. Thus, it is silenced. She added further that if the children or young people do not get the information about it, they will get stressed out and worry about their biological and physical changes.
Letting the stigma about sexual and reproductive health claim children’s rights to get access to SRHR costs them their physical and psychological well-being, making them suffer in the long term. Therefore, some actions need to be taken.
There are many ways to address this problem by offering information and advice to adolescents about their SRHR. One of which is what the psychologist shared with us during an interview and that is using individual sessions for talking openly with the children about their bodies, such as biological changes, hormonal issues, and psychical changes. She also lets them draw the structure of their bodies to understand their bodily changes. The method that was used by the psychologist and the organization for addressing the SRHR issues was focusing on the welfare of the children to get knowledge of sexual and reproductive health. However, a more holistic approach is also needed for addressing this issue from the structure of the society. Specifically, a human rights-based approach is needed to challenge a view where sexual and reproductive health issues are stigmatized, educating people about their rights to learn about and govern their bodies that are usually disrupted by religious beliefs and social systems. In order to make this work, an active joint effort by key influencers in the community such as leaders, governments, law officers, and health practitioners based on human rights principles is needed.
The holistic approach is the bigger step to achieving the SRHR for everyone, especially for children and young women. In our work over the past several years, Child Rights Eurasia has observed the necessity for capacity building, knowledge transfer, citizen engagement, and key influencers’ training in our target beneficiaries. In that regard, we partner with local organizations for change and together fight for equal rights to health and well-being for children and young women globally.
You can also help us in our mission. Become one of our volunteers, members, partners, or donors, and together we start making the world a better place for children. We really appreciate your aid in supporting us to challenge the traditional beliefs that claim the SRHR of children and young people.
Sexual and Reproductive Health and Rights for Young Rural Women and Girls
Sexual and Reproductive Health and Rights - A Position Paper
A Time to Lead: A Roadmap for Progress on Sexual and Reproductive Health and Rights Worldwide | Guttmacher Institute
Access to sexual and reproductive health services | Plan International (plan-international.org)