Developing clear strategies can improve gender equality, human rights, and women-centred care in The Gambia.
Reproductive health rights are key human rights instruments. Since the 1990s, sexual and reproductive health and rights has been recognised as a major topic in the international health and development agenda, and they remain critical for the attainment of the Sustainable Development Goals (SDGs) and the 2063 ‘Africa We Want’ of the African Union (AU) agenda. In the past few years, we have come to recognise that gender equality is an important indicator of development.
The review of the ICPD + 25 (International Conference on Population and Development) highlights the progress made over the past two decades with respect to gender equality. In most African countries, laws to protect women and girls against violence have been enacted. We have also seen an increased number of female enrollments in primary schools and some advancements in political representations. There has also been some progress in access to contraception, but at an estimated 4.6 children per woman, Africa has the highest fertility rate in the world. This is largely because of inequitable sexual and reproductive health care information and services.
The Gambia, in particular, has one of the highest fertility rates (5.6 births per woman) in the world. It is home to the world’s youngest population, with more than 60% under the age of 25. It is estimated that about 31% of women give birth by the age of 18, and almost half (49%) by 20. According to a Demographic and Health Survey done in 2015, almost one in five (18%) female adolescents between 15 and 19 are already mothers, or pregnant with their first child. Pregnancies remain unplanned or unwanted. About 25% of married women in The Gambia have an unmet need for contraception (GBOS, 2014). This is probably higher in reality, as the figures do not include unmarried women. Women in The Gambia do not usually use modern contraceptive methods, including pills, IUDS, implants, female condoms and injections due to reasons ranging from access, religious objections, to lack of awareness and knowledge. In 2018, modern contraceptives prevalence rate was at a dismal eight percent, which is amongst the lowest in all of Africa (The Gambia National Family Policy, 2019-2026). These numbers illustrate the huge gaps in access to basic sexual and reproductive health services for women and girls. This is further exacerbated by the high cultural value placed on childbearing, which places an added (sometimes unfair) expectation and responsibility on the women to procreate and perpetuate the family line, which continues to be shaped by a dominant patriarchal ideology (Braam & Hessini, 2014).
Even though the ICPD has been established for more than two decades, women’s bodies continue to be the battlegrounds on which ideological battles are fought. Norms of masculinity and femininity that perpetuate gender inequality constrain the ability of women to live fulfilling, healthy, and safe lives. Harmful gender norms including child marriage, Female Genital Mutilation (FGM), inheritance laws, and the lack of rights, that women have in being able to make decisions about their own bodies remain continue to produce this catastrophic problem.
In order to improve access to sexual and reproductive health services including family planning, there is need for political will, support and financial resources, an integrated package of intervention and evidence-based comprehensive sexuality education. Mechanisms that promote gender equality must also be strengthened. As noted elsewhere, “investing in women and girls’ empowerment is pivotal for reaching the goals of sustainable development,” which can only be fulfilled when women and girls enjoy the full set of sexual and reproductive rights.
For all these reasons mentioned above, a dedicated group of activists have set up Sexual and Reproductive Rights Network (SRRNet), a feminist movement-building initiative committed to using human rights principles to realise sexual and reproductive health and rights for all; investing in and improving the quality of life for women and girls in The Gambia remains a core focus. On 4 May 2019, the first National Coalition Building Meeting on Sexual and Reproductive Health and Rights was held.
Building upon the knowledge and lived experiences of women and girls, it was determined that one of the key strategies to be undertaken by the initiative is health service delivery. We hope that developing clear strategies in this area can improve gender equality, human rights, and women-centred care in The Gambia.
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Satang Nabaneh is a doctoral candidate and works as a project officer of the Womens Rights Unit Centre for Human Rights University of Pretoria. Satang ...
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