Six of the countries of the East African Community – Burundi, Kenya, Rwanda, South Sudan, Uganda and Tanzania – just lately concluded public hearings on a brand new sexual and reproductive well being invoice. Proponents of the invoice argue that it’ll enhance entry to sexual and reproductive well being which, in flip, will enhance different public well being and growth indicators corresponding to maternal mortality and HIV an infection charges. But the invoice has confronted fierce opposition because it was first tabled in 2017. The Conversation Africa’s Ina Skosana spoke to researchers Anthony Ajayi and Nicholas Etyang to unpack what the invoice covers and the place the sticking factors are.
Is a regional response sensible? Has it labored anyplace else?
Article 118 of the Treaty for the Establishment of East African Community mandates accomplice states to cooperate round well being points, and to develop insurance policies for the area.
Regional responses will help fast-track progress, harmonise laws and create a uniform entrance for addressing sexual and reproductive well being points. The growth of regional frameworks shouldn’t be new on the continent. Other examples embody the South Africa Development Community sexual and reproductive well being technique 2019-2030, South Africa Development Community mannequin regulation on gender-based violence, and the regional physique’s mannequin regulation on eradicating little one marriage and defending kids already in marriage.
Regional frameworks assist residents maintain their governments to account. The East Africa area is pushing for integration on many fronts. These embody immigration insurance policies, commerce, and safety. Remarkable progress has been made in the areas of trade and immigration. This might be repeated with well being cooperation.
But getting regional laws via is difficult. In the case of East Africa, seven countries are a part of the East Africa Community. Getting everybody on board is a tricky ask particularly in relation to contentious points like sexual and reproductive healthcare.
The first try to move an East African sexual and reproductive well being invoice was in 2017, with the third Legislative Assembly. But numerous concerns were raised by stakeholders. And restricted time for session earlier than the tip of their time period meant the invoice couldn’t transfer ahead.
The 4th Legislative Assembly started engaged on a revised invoice in January 2020 and has performed a collection of stakeholder consultations. But resistance continues.
Why does the invoice matter?
The 2021 model of the invoice is a progressive laws. It has enormous potential to deal with the sexual and reproductive well being challenges of East Africans. Adolescent ladies are disproportionately affected by sexual and reproductive well being points. The invoice addresses these disparities substantively.
In East Africa, problems arising from early being pregnant and little one delivery are among the many main causes of demise amongst ladies aged 15 to 19 years. Young ladies are additionally disproportionately uncovered to new HIV infections and sexual violence. If handed, the invoice will tackle adolescent being pregnant and shield the appropriate of younger moms to return to highschool.
Unsafe abortions are additionally among the many main causes of maternal demise. These account for about 10% of maternal mortality. By increasing entry to secure abortion, extra lives can be saved. If handed, the invoice can be an enormous win for ladies’s and ladies’ reproductive rights in the area.
What’s in the Bill?
The sexual and reproductive well being Bill lays out 5 formidable goals. These are:
- to guard and facilitate the fulfilment of all individuals’ sexual and reproductive well being and rights throughout the life course;
- to advertise and present age-appropriate sexual and reproductive well being info and providers for all individuals, together with adolescents and younger individuals
- to facilitate and promote the prevention of new child, little one mortality, maternal mortality, and morbidity from preventable causes;
- to facilitate and promote the discount and elimination of unsafe abortions, HIV and different sexually transmitted infections, early and unintended pregnancies; and
- to ban and facilitate the elimination of dangerous practices.
The Bill has 29 clauses overlaying a variety of points. These embody integration of sexual and reproductive well being providers into common well being protection, sexuality schooling, continuation of schooling after being pregnant, menstrual well being in addition to household planning.
In addition, the Bill makes provisions to safeguard the sexual and reproductive well being and rights of individuals with disabilities.
Section 16 supplies restricted entry to abortion on the grounds that, in the opinion of a well being employee, the being pregnant can endanger the psychological or bodily well being or lifetime of the girl. Additionally, in case of sexual assault, rape, and incest.
Section 17 protects the appropriate of ladies and ladies to post-abortion care regardless of the legality of the abortion. It additionally shields well being staff from prosecution for offering post-abortion care.
Section 21 recommends limiting using assisted reproductive know-how corresponding to surrogacy for under these medically recognized as unable to bear kids. In addition, it recommends that accomplice states give particular licenses to designated suppliers and shield surrogate moms from exploitation.
Section 22 prohibits dangerous cultural practices corresponding to little one marriage, pressured sterilisation, and feminine genital mutilation.
Lastly, the Bill mandates accomplice states to develop and implement frequent methods for detecting, stopping and reporting sexual and gender-based violence.
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What’s the hold-up in passing it?
The Bill confronted opposition on the public hearings held on June 27-30. Some oppose the Bill solely, whereas others need particular provisions eliminated.
Resistance is primarily from spiritual and conservative teams, who keep that some provisions of the Bill are a part of the Western agenda, and towards East African cultural values.
Three sections of the Bill stay contentious regardless of the revisions made after the primary studying and stakeholder consultations.
First is the supply for complete sexuality schooling for younger individuals, which they oppose as a result of they imagine it can expose kids to early intercourse. Some query why the federal government must be answerable for offering intercourse schooling to kids as a substitute of oldsters. They additionally oppose contraceptive entry for younger individuals and argue that abstinence-only messages must be supplied to younger individuals. This is regardless of scientific evidence on the contrary.
A consultant of the ministry of schooling in Uganda desires the phrase “comprehensive” eliminated as a result of it’s inconsistent with the language permitted nationally.
Advocates for the Bill keep that sexuality schooling shouldn’t be all about intercourse however encompasses info on menstrual well being, choice making, physique consciousness, social expertise (household, respect, and kindness), sexual consent, wholesome relationship, gender-based violence, HIV testing, and being pregnant.
The provision on abortion faces probably the most opposition. Opponents take problem with the definition of abortion in the Bill and argue that it doesn’t mirror African values. They declare that, if handed, the Bill would make abortion providers obtainable on-demand.
Partner states have ratified the Maputo protocol, which permits for the termination of being pregnant on the grounds supplied for in the proposed Bill. But opponents reject the supply that permits for being pregnant termination in circumstances of rape, incest and sexual assault. Stakeholders from the Burundi authorities declare the invoice promotes immorality and voluntary termination of being pregnant, opposite to divine ideas, the nationwide structure, and tradition.
Lastly, critics oppose the part on surrogacy, claiming it deviates from the order of creation and permits for LGBT people to have kids. Just a few Muslim leaders in Kenya and Tanzania reject the ban on little one marriage and argue that after menstruation begins, no matter age, a woman may be married.
Anthony Idowu Ajayi, Associate analysis scientist, African Population and Health Research Center and Nicholas Okapu Etyang, Policy officer, African Population and Health Research Center
This article is republished from The Conversation below a Creative Commons license. Read the original article.