Supporting women's empowerment in Djibouti

This article reports on the work carried out by the UN Population Fund (UNFPA) in the small island of Djibouti, Africa. The republic's population has been plagued with problems of high levels of unemployment, poverty, malnutrition, an almost non-existent family reproductive health care service, 100% prevalence rate of female genital mutilation and low literacy rate, especially for women. In addition, refugees from Ethiopia and Eritrea have settled in the country increasing the risks of sexually transmitted diseases (STDs), HIV/AIDS, prostitution, and other social ills. In 1983, UNFPA started funding family planning and later reproductive health projects aimed at assuring access to services for a majority of Djiboutan women. The first country population program of assistance was started in 1992. This would help the government with health care for its population and to conduct a population census. In addition, the Fund has paid for training of doctors, midwives, and traditional birth assistants in the country and for rehabilitating maternity clinics and information centers. Moreover, it has supported agencies concerned with educating people on STDs, HIV/AIDS, safe motherhood and reproductive health for men and women, and other important issues.     

Reproductive rights and health discussed

The 29th session of the UN Commission on Population and Development (February 26 to March 1, 1996) focused on reproductive health and rights, including population IEC (information, education, and communication). Speakers relayed national responses to the Programme of Action of the 1994 International Conference on Population and Development, highlighted the critical role of nongovernmental organizations in meeting reproductive health needs through IEC and advocacy, and applauded the recent expansion of the Population Information Network. The Director of the UN's Population Division noted that in 1946, when the Commission was founded, the Division estimated that the world population would reach 6.3 billion in the year 2000. The latest estimate of 6.2 billion confirms this early estimate. Sensitive issues which the Commission expects to face in coming years are abortion, the aging of populations, HIV/AIDS, and international migration. The Executive Director of the UN Population Fund reported that guidelines are being developed on the quality of reproductive health care and that gender concerns are increasingly being included in program design and implementation. The Commission also considered the Secretary-General's January 15, 1996, report on world population monitoring, reproductive rights, and reproductive health. Finally, the Commission announced that Leticia Ramos-Shahani, an advocate from the Philippines, and Pathfinder International would share the 1996 Population Award.     

Population. The new challenge: translating Cairo success into meaningful activities

The newly named Commission on Population and Development, at its 1995 session in New York, stated it should have the primary responsibility for reviewing the implementation of the Program of Action of the International Conference on Population and Development, held in Cairo in September 1994. The Population Commission was renamed the Commission on Population and Development by the General Assembly. In debate, some countries reviewed their national experiences in population matters, stressing how the Program of Action would influence their policies. At mid-1994, world population stood at 5.63 billion persons, a report on world population trends and policies revealed. During the preceding 12 months, population had grown by 86 million and was expected to grow by an additional 87 million during the next 12 months. While China's representative described a near-crisis situation marked by a net increase in population of 14 million per year in her country, the representative of the Russian Federation expressed concern over the decrease in Russia's population. Between 1990 and 1994, world population had grown at 1.57% per annum. UN medium-fertility-variant projections indicated that the population growth rate would continue declining to 1.33% per annum between 2000 and 2010; 1.15% in 2010-2020; 0.95% in 2020-2030; 0.72% in 2030-2040; and 0.54% in 2040-2050. Consequently, the world population was projected to reach 7.5 billion by 2015 and 9.8 billion by 2050. Assistance for population programs had increased from $220 million in 1988 to $305 million in 1992, the bulk of which came from UNFPA. Family planning, integrated with reproductive health and carried out through a primary health care system, continued to receive the bulk of multilateral resources. Projects to improve the status of women, such as education for girls, leadership training, literacy programs, and projects designed to increase the income of women and their families were being supported by multilateral agencies. An update on global contraceptive requirements from 1994 to 2005 estimated that the total cost of contraceptive commodities would be $7.7 billion.     

Reproductive rights,family planning: a cornerstone of control

The main objective of the action plan for the International Conference on Population and Development is to assure access to high quality information and reproductive health care services in a manner that is affordable, acceptable, and convenient. Informed choice should be voluntary for childbearing and fertility control decisions. Services must be sensitive to the cultural, economic, and demographic diversity of local communities. The target date for countries to implement family planning (FP) and reproductive health programs that are available to all is 2015. Programs must involve women in all phases of planning, management, and delivery of services; outreach programs must be developed to involve men. Public and private FP programs should be directed to removing all obstacles to method use by the year 2005 by redesigning and expanding information and services. IEC (information, education, and communication) should also focus on sexually transmitted diseases, including AIDS. Programs should provide high quality condoms from stock on hand. About 55% of couples in developing countries use some form of contraception. The increase in contraceptive use has contributed to the decline in total fertility from 6.1 children per woman in the 1950s to 3.7 in the 1990s. At least 350 million couples still lack access to modern FP methods. The draft plan emphasizes that couples must be given the freedom and responsibility to decide on the number and spacing of their children.     

Choices and responsibilities: finding the balance

Rapid population growth means the addition of a billion more people in 11 years. The International Conference on Population and Development (ICPD), scheduled for September 5-13, 1994, will address the issue of population growth and design strategies for slower growth with economic development and environmental protection. This article summarizes Dr. Nafis Sadik's special preparatory message about the conference. The ICPD will address the issues of reproductive health, affordable family planning (FP), and informed choice. There will be an emphasis on better health care, housing, education, and other poverty alleviation measures. Empowerment of women through educational and economic opportunity and increased foreign aid are also themes. Improvements in the quality of life as well as demographic and social change are required. The key to slowing population growth is to meet the need for FP services to reduce fertility. Reexamination of the life-styles of the more affluent is also required. Needs and resources must be balanced. Sustainable development and resource use will depend upon slower population growth, more rational population distribution, alleviation of poverty, environmentally safer consumption patterns, and other measures. The 1994 draft plan of action has a broad mandate which recognizes the linkages between population and development. Target dates and reproductive rights language are bracketed and will be discussed during the conference. Quantitative goals are set for education, child and maternal mortality reduction, and universal access to FP and reproductive health services. The public should be made aware of the development and population links. Developing countries are asked to devote 20% of their government budget to social development. Countries by their action or inaction will choose a world population size in 2015 ranging from 7.27 to 7.92 billion. The difference of 660 million in 20 years is equal to the current population in Africa. The high projection for 2050 is 12.5 billion people. The ICPD will be the last global opportunity before the turn of the century to address the challenges of shared responsibility for the future of life on earth.     

‘It’s a very isolating world’: the journey to HIV care for women living with HIV in British Columbia,Canada

HIV health services research conventionally defines place in terms of proximity to care. However, understandings of place must also include the social spaces that women living with HIV (WLWH) occupy which shape their experience of health and access to care. Drawing on focus group data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study, we explored how 28 WLWH navigate geographic place and social space in attempting to access HIV-related healthcare within and across a range of urban to rural localities in British Columbia (BC), Canada. We describe how existing services, even if physically close, can be socially marginalizing as women confront HIV stigma, racism, and classism, which operate to exclude women from the places and spaces they must access for care. We also emphasize how women enact ‘geographies of resistance’ and succeed in carving out their own safe options for care and support. Finally, we share recommendations identified by women themselves towards developing local and community-driven ‘geographies of change’ that support the health and healing of diverse communities of WLWH. Our findings stress the urgent need to acknowledge and redress socio-spatial barriers to care and to work with WLWH to co-create a therapeutic landscape that reflects women’s diverse identities, localities, emotions, and experiences.     

Empowering women: an essential objective

The draft action plan of the International Conference on Population and Development (ICPD) calls for enhancing women's participation in all levels of the political process and public life, promoting women's education and employment with attention to alleviation of poverty and illiteracy, halting discriminatory practices against women, establishing women's rights, and improving women's ability to earn income and achieve economic self-reliance. The document specifically refers to the importance of girls beyond their traditional roles as potential childbearers and caretakers. The action plan requests actions to enforce minimum marriage age laws and to assure women's choice in spouse selection. Female genital mutilation is prohibited. Preventive efforts are to be directed to infanticide, prenatal sex selection, trafficking in girls, female prostitution, and pornography. The men who are in positions of power have a particular responsibility to bring about gender equality and to focus on men's responsibility in parenthood and child support. Fertility is related to women's paid employment and higher educational levels. The longterm success of population programs is dependent on women's ability to make informed decisions at all levels and in all spheres of life.     

Declines in fertility levels evident in Africa,notes UN Population Fund

This article reports on the UN Population Fund's (UNFPA) African regional meeting that was held in November 1997. The meeting was attended by an assortment of UNFPA representatives and program staff. This meeting followed up the 1994 Cairo International Conference on Population and Development (ICPD) and 1995 regional meetings on the 1994 Plan of Action. These prior meetings emphasized the link between population and development and the urgency of meeting the needs of individual women and men in a people-centered approach to development, rather than a target oriented one. The 1997 meeting reviewed the progress made toward achieving the goals of the 1994 plan of action by the UNFPA. UNFPA aims to decentralize operations, to play a role in emergency situations, to encourage South-to-South cooperation, to advocate for reproductive rights, and to promote gender equity and women's empowerment. The meeting discussed UNFPA's role in reproductive health, population and development strategies, and advocacy in detail. Participants agreed that there were signs of fertility decline in Africa. Countries are beginning to adopt a reproductive health and rights approach and to address female genital mutilation as a human and reproductive right's issue. Population policies are being changed to include ICPD goals. 32 countries adopted new programs in 1996 and 1997, that integrated the 1994 strategies and selectively focused on issues of concern. Partnerships confirm that population issues are becoming an agenda for all. The major challenge ahead is the mobilization of resources, while dealing with civil strife and political instability.     

‘You just have to be smart’: spatial practices and subjectivity among women in sex work in London,Ontario

Social science research on the relationship between space and sex work, specifically among women in street-based settings, demonstrates the spatialized nature of risk and how different forms of civic and legal governance contribute to their socio-economic marginalization. However, these studies rarely consider the women’s spatial practices and gendered subjectivities beyond the sex trade, which is problematic because sex work is not their singular life activity or the only impetus for their spatial movements through the urban landscape. Using social mapping and interview data from 33 women in sex work in London, Ontario, this article explores how our participants navigate the spaces where they work and live alongside those regarding health care, social services, violence and places they avoid. Findings reveal that the women traverse diverse spaces as they access health services, especially for crisis issues that necessitate travel to hospitals located beyond the inner city. The spaces used to access social services and those they avoid (i.e. to not be emotionally triggered or under police surveillance) overlap significantly, which presents unique challenges for our participants who depend upon these services for their socio-economic survival. The theoretical contributions these data make to the feminist geography literature on gender and space are discussed, particularly with respect to the issues of nomadic subjectivity and the relationality between city spaces and marginalized bodies.     

BIRTH CONTROL,PREGNANCY AND ABORTION AMONG ADOLESCENTS IN CHIANG MAI,THAILAND

The authors studied more than 1750 young urban Chiang Mai residents regarding pre-marital sex, contraception and reproductive health outcomes. Almost two-thirds of the males had had sexual intercourse, compared to one-third of the females. Withdrawal was the most popular method of birth control followed by condom use. There were more females (30.5 per cent) reporting that they had been pregnant than males (17.5 per cent) reporting that they had caused pregnancies. Two-thirds of the respondents who had experienced or caused pregnancy reported that it ended in abortion. Almost half of those who had experienced abortion had induced it themselves, usually using illegal abortifacients. One-third went to a private clinic or hospital illegally. Self-induced abortions were sometimes associated with complications that were treated with pharmacy medications or severe complications requiring hospital treatment. Adolescents in northern Thailand need improved sexual health services and programmes. To be effective though, attention should also be given to underlying cultural attitudes toward sexuality and young people, especially women.     

The Indonesian Family Planning Programme: A Success Story for Women?

The Family Planning Programme of Indonesia is constantly being hailed as a success story for its performance in reducing fertility rates in many parts of the country. This paper examines what this apparent success has meant for women, taking women's rights to the control of their fertility as the necessary aim for all family planning programmes, and the safeguarding of their reproductive health as an obligation. In the paper, the aims and methods of the Family Planning Programme are examined separately, in order to assess on the one hand the extent and the manner in which women's interests are acknowledged in its objectives, and, on the other, whether in its implementation the programme takes into account the needs of women, both as recipients and as family planning workers. The main conclusion of the paper is that the priorities, style of implementation and service delivery of the programme do not provide women with the means of regulating their fertility autonomously through access to freely chosen contraceptives and related services. In addition, the paper concludes that the safeguard and improvement of women's reproductive health is not among the concerns of the programme, in principle or in practice.     

Africa's population and family planning dynamics

The historical and current demography of Africa in this discussion focuses on the context of population policy, contraceptive use, reproductive behavior, polygamy, and economic impacts. Sub-Saharan Africa countries have the highest rate of population growth in the world. 50% are aged under 20 years, and 20% are aged under five years. Urban areas are growing at the fastest rates in the world (5-6% annually). Population density remains low, except for areas where there is high soil fertility. Many African countries recognize the need for population policies. The most important donor to Africa, the World Bank, has pressured African governments to adopt family planning (FP) programs. A major World Bank study has shown that more FP services are desired by African women. Family expenditures for the 1980s for FP were estimated at $100 million annually, of which $53 million was provided by donors. Further expansion in the program is needed. The World Bank targeted contraceptive use at 25% of African married couples. Except for Egypt and North African countries, contraceptive use is around 3-4%. Another perspective on population reduction is to expand programs for child spacing and postnatal nutrition of mothers and infants. There has been a failure to turn health systems around to low-cost preventive health, particularly in rural areas. Infant mortality must be reduced before fertility will decline. Population growth can be slowed by changing the status of African women (high social status and recognition are associated with high fertility), age of marriage, child spacing, agricultural productivity, and nutrition. Demographic data on Africa have only become available during the past 25 years. African demographers are in short supply and require training abroad. Demographic data gaps and reliability problems are offset by the recent availability and quantity of survey data. Historical demography has produced conflicting results. Although some investigators, such as Ester Boserup, argue that population pressure results in agricultural innovations, Africa has yet to experience this phenomena. The youthful composition of the population guarantees continued population momentum. Fertility is enhanced by the cultural emphasis on perpetuating lineage and high fertility. Changes in reproductive behavior will depend on major social changes for women.     

By the time you read this one million children infected with HIV will be living in the shadows

Every day, 1000 children become infected with HIV. UNAIDS therefore estimates that by the end of 1997, 1 million children under age 15 years will be living with HIV and experiencing the physical and psychological consequences of infection. Since the beginning of the pandemic, more than 2 million HIV-positive children have been born to HIV-positive mothers, and hundreds of thousands of children have acquired HIV from blood transfusions and through sex or drug use. More than 9 million children are estimated to have had a mother who died due to AIDS. Although AIDS is the most recognized disease in the world, insufficient attention has been given to the impact it is having upon children. Unless the spread of HIV is quickly checked, gains achieved in reducing infant and child death rates will be reversed in many countries. An UNAIDS report estimates that by 2010, AIDS may increase infant mortality by as much as 75% and under-5 child mortality by more than 100% in the worst affected countries in the world. It is clear that AIDS will soon be a major cause of death among children. Since about 90% of children under age 15 years acquire HIV from their mothers, either before or during birth or through breast feeding, reducing the vulnerability of infants to HIV infection means enabling women to prevent themselves from contracting HIV and to procure antiviral drugs which can reduce the risk of mother-to-child HIV transmission.     

Sexual citizenship, political obligation and disease ecology in gay Seattle

While rights and freedoms of sexual citizenship have been foregrounded in geography, vaguer attention has been given to questions of political obligation. Feminist work on political obligation, grounded with a framing in political ecology of disease, however, provides a means to correct this neglect. Empirically, I narrate a story of local public health politics in Seattle, WA. There, a cultural panic played out in the media over the alleged failure of political obligations by gay men around sexually transmitted infections. Political obligation and ecology usefully extend the concept sexual citizenship on its own terms by moving beyond a rights-versus-obligation polarity, highlighting the biophysical realities of sex, recognizing the spaces in which sex occurs, and noting the social relations inherent in sex and sexuality. Thus, this paper contributes to deeper thinking for activists involved in working through these questions as well as bolstering the notion of sexual citizenship in political geography.     

Winding Back Australian Women's Rights: Conventions,Contradictions and Conflicts

Since 1996, Australia's Coalition government has been involved in winding back women's rights. It has diluted the role of the Sex Discrimination Commissioner, attempted to weaken the Sex Discrimination Act to allow for discrimination on the basis of marital status, and has refused to provide Australian women protection through the international realm via the Optional Protocol to the Convention on the Elimination of All Forms of Discrimination Against Women. In taking these steps, the government has not only placed rights in conflict against each other but has also been contradictory in its approach. The attempts to wind back women's rights demonstrate the fragility of existing rights protection measures in Australia more generally and suggest the need to consider alternative rights protection mechanisms such as sex equality guarantees in a bill of rights.     

Fourth World Conference on Women. Seeking action for equality,development, peace

There is a strong international push to secure broader rights for women. In the 20 years since the first global conference on women's issues was held in Mexico City, governments have adopted legislation which promotes equal opportunity, treatment, and rights, and women are entering the labor market in unprecedented numbers. There is evidence that investments in women have had an enormous impact upon society overall, but millions of individual women continue to face discrimination in social, economic, political, and cultural spheres. They are disproportionately denied access to positions of leadership, undereducated, underpaid, die from complications related to childbirth and unsafe abortions, and are battered and killed by men. The Fourth World Conference on Women will be held September 4-15, 1995, in Beijing, to allow participants to assess the progress and shortfalls of the past two decades and identify action to be taken into the next century. The UN-sponsored global meeting will offer governments, nongovernmental organizations, the private sector, and individuals the opportunity to review their efforts and renew their commitment to improve the equality and conditions of women and defend their human rights. The main objectives are to adopt a plan of action against obstacles to the advancement of women worldwide, to determine priority actions to be taken by the international community over the period 1996-2001, and to mobilize men and women at the grassroots level to achieve those objectives. A parallel nongovernmental organization forum on women will be held August 30 - September 8, also in Beijing.     

Contesting ‘Global Sisterhood’: The Global Women's Health Movement,the United Nations and the Different Meanings of Reproductive Rights (1970s–80s)

The article contributes to a genealogy of the global articulation of reproductive rights principles, as established at the 1994 United Nations (UN) Conference on Population and Development held in Cairo and the UN Women's Conference held in Beijing the following year. It highlights the key role played by an emerging global women's health movement in the 1970s–80s, in shaping UN debates on family planning, women's rights in procreative choice and women's roles in socio-economic development. The article focuses on the International Campaign for Abortion, Sterilisation and Contraception (est. London 1978) and the Women's Global Network for Reproductive Rights (Amsterdam and Manila 1984; ECOSOC consultative status in 1992). Adopting an intersectional perspective, the paper highlights the local embeddedness of feminist positions, the shortcomings of Western feminism and the ways in which conflicts between women's organisations allowed for an original and evolving concept of reproductive rights to emerge. It is based on UN papers and the archives of the above organisations and family planning movements.     

Intersectionality and planning at the margins: LGBTQ youth of color in New York

Through an intersectional lens, this article reflects on the dialog between planning and gender, feminist, and queer studies to analyze the lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth of color (YOC) community in New York City (NYC). The community is subject to multiple disenfranchisements, given their ethno-racial status, class, age, gender, and sexual orientation. This community's limited access to safe public spaces and amenities, housing, health services, job training, and other opportunities is an urban planning challenge insufficiently understood or addressed. Our methodology includes participant observation and analysis of an LGBTQ YOC tour of West Village in NYC, interviews with LGBTQ individuals and NGO staff, life stories, observations in LGBTQ-friendly meetings and facilities, and content analysis of LGBTQ reports and media coverage. The research shows the agency of an LGBTQ youth group as a resilient community organization effectively participating in planning processes and exerting rights to public space and services. Finally, it offers recommendations to planners and policy-makers to facilitate the recognition and expansion of rights to the city for LGBTQ, particularly YOC, by committing to understanding their unique conditions and needs and expanding their access to safe housing and public spaces, poverty reduction programs and job opportunities, and health and social support services.     

Obstacles to women's progress to be addressed in Beijing

Speakers at the Third Social, Humanitarian, and Cultural Committee Assembly held in December 1994 maintained that power sharing between women and men is still intolerably low and that economic hardship, abuse, and discrimination remain. One speaker announced that society needs to do more to challenge obstacles to women's advancement: poverty, violence, access to resources, women's rights, education, and health. She asserted that, for this reason, the Fourth World Conference on Women scheduled for September 1995 in Beijing must succeed. Discussions and action at the December assembly will constitute a major part of the groundwork for the Beijing Conference. The Committee debate centered on the advancement of women as a cause and effect of development. The 1994 World Survey on the Role of Women in Development shows that economic development may be complexly connected with advancement of women. In societies where women have progressed, the economy tends to grow steadily, while, in societies where women cannot fully participate in development, the economy is stagnant. The Assembly called on the Commission on the Status of Women to ensure that the Platform for Action recognize and incorporate older women's concerns and contributions to development into its strategies, programs, and policies. It also called for countries to protect women migrant workers from violence and corrupt recruitment practices. It condemned the illegal trafficking of women and girls across borders for sexual or economic oppressive and exploitative purposes and for other illegal activities (forced domestic labor, false marriages, clandestine employment, and false adoption).