Last Saturday I woke with my heart in my mouth wondering about the outcome of the Irish referendum. The night before, I’d had an inkling of the results from the exit polls reports appearing on Twitter, through which I was also aware of the huge number or women, girls, brothers and fathers returning Ireland to cast their votes; a movement in which Irish staff at ODI also took part. I was deeply moved, having never heard of a similar event at such a scale. It worked, thanks partly to social media and the unprecedented number of young people who voted.
This is a momentous occasion not only for girls and women in Ireland but also for girls and women globally. If such a conservative country can overturn an out-dated ruling and take it 'out of the hands of unrepresentative lobby groups and celibate clerics’, then there is hope for those facing similar legislative challenges elsewhere.
The impact of the Gag Rule
This pro-choice victory comes in the wake the Trump administration’s proposal to deny federal funding to organisations whose doctors refer women to abortion services. It follows Trump’s reinstatement of the Global Gag Rule which, as Engender Health note, ‘had terrible consequences for the health and lives of poor women and their families in ways that had nothing to do with abortion. From 2001 to 2009, 20 developing countries in Africa, Asia, and the Middle East lost U.S.-donated contraceptives, and many organizations and clinics were forced to reduce services, lay off staff, or shut down entirely.’
The recent Global Gag Rule has already seen organisations such as the International Planned Parenthood Foundation lose much of their funding base. In response and to help plug the funding gap, the SheDecides movement was established. It has benefited from the generous support of a range of international donors and individuals.
ODI had the honour of hosting a round table discussion with ODI Distinguished Fellow and SheDecides founder Lilianne Ploumen. Three broad themes were discussed: How can SheDecides continue to drive momentum on sexual and reproductive health and rights (SRHR) policy at the national and international level? How can it overcome discriminatory social, cultural and religious norms to protect and advance the rights of women and girls? What are the catalysts for change in progressing SRHR more broadly and how can they be operationalised by SheDecides? I was struck by the movement’s clarity of purpose (a focus on safe abortions), its flexibility and its willingness to explore its future, its structure and its desire for transparency and accountability.
Empowering women with choice
The issue of sustainability represents a challenge to those working in this area. How can national-level funding for safe abortions and SRHR-related services be sustained and institutionalised in developing countries? Among other things, we need appropriately resourced and operationalised policies; commitment and champions at the highest level; and resilient, responsive, integrated health systems. We also need to consider the problem at sub-national, provincial, district and community levels because it is at these levels that policies are implemented, services are provided and the users of these services are found. At these levels, however, an array of supply- and demand-side constraints exist including limited infrastructure, untrained, unincentivised and poorly supervised staff; lack of knowledge about SRHR-related services; and poverty that restricts access to and use of services.
The social and gendered norms influencing the behaviours, attitudes and practices of all members of society underlie these constraints. These informal, often unstated rules usually discriminate against women and girls leading to issues such as a lack of mobility, early marriage, early pregnancy, restricted access to education and a lack of career or other aspirations.
Perhaps most importantly, such norms mean girls and women do not have a choice; they are not empowered to make decisions about their own body, let alone their own future.
The Irish referendum result has empowered the women of Ireland with the right to choose. How do we do the same for girls and women in developing countries? We must empower them by giving them voice, agency, self-confidence and self-efficacy. There are successful programmes and approaches that have empowered women and girls. These are not necessarily health focused but have built skills and confidence and had an impact on sexual and reproductive health; for instance, by reducing early marriage and school drop-out rates, and addressing structural issues like social norms. Arguably, these programmes have also given back girls the choice; choice about when and whom they marry, when they leave school, when they have children, the number of children they have and what they want to do with their lives.
The proliferation of women’s movements and also (at last!) of sustained press coverage, demonstrates momentum in the right direction. There will inevitably be resistance and backlash, but these are critical and positive times for women’s rights.