by Bergen Cooper, Senior Policy Research Associate & Devan Shea, Policy and Outreach Associate
In a hotel conference room in Nairobi, Kenya, women advocates from across sub-Saharan Africa met to talk about a prevention agenda for women and girls – to ensure that women and girls are able to avoid unintended pregnancies and HIV infections. Having long listened to the voices of women and girls when it comes to prevention, CHANGE went into the meeting with two core beliefs: for a prevention agenda to thrive women need to be at its center, and services must be integrated. Not surprisingly, as the conversations began, one advocate began to discuss how reproductive health fits in the agenda. Another talked about abortion. And another talked about the role that gender based violence (GBV) plays in prevention. And just like that, we were engaged in a dynamic conversation about the integration of sexual and reproductive health and rights (SRHR) and what that means for a prevention agenda for women and girls.
When women’s rights and SRHR advocates whose work is rooted in the lived experiences of women and girls come together, the dreams and possibilities put forward have no bounds. So, at this meeting a vision was born. We envisioned a world in which a woman can walk into one health clinic and have all of her sexual and reproductive health needs met free from any form of discrimination, financial barriers, or bureaucratic inefficacies. She can visit respectful, trained providers who offer affordable contraceptive options, including emergency contraception; pre-natal care and referral to obstetric services; abortion services and counselling; gender-based violence screening; and prevention, treatment, and care for HIV.
These health needs are intimately connected in the lives of women and girls, but services, research, funding, organizations, conferences, and public policies tend to operate in silos that do not reflect lived experiences.
Back in that hotel conference room in Nairobi, twenty-four advocates from across sub-Saharan Africa and the U.S. united at a meeting convened by CHANGE and AVAC to identify the barriers and challenges to implementing a well-integrated prevention agenda that addresses the real needs of women and girls. The group, composed of advocates working at the intersections of SRHR and HIV, gender-based violence, sex worker rights, youth health and rights, maternal health, and abortion access, put our collective vision to paper as a concrete action plan. And, earlier this month, CHANGE and AVAC launched the outcome report from this meeting, “Prevention Now: An Integration Agenda for Women, by Women,” along with our collective vision statement, “Our Vision: Integrated Health Services for All Women and Girls, Everywhere.”
The report outlines a path forward for advocacy. Advocates committed to ensuring that when we participate in global conversations about research, policy, and advocacy on HIV, we also address the contraceptive, GBV, family planning, maternal health, and respectful maternity care needs of women and girls. We also pledged to aim our advocacy at funding silos so that researchers, implementers, and advocates are supported to work on integrated services. Together as advocates, we will demand meaningful engagement of civil society organizations that are human rights-based and woman- and girl-led with government and multilateral health initiatives.
Prioritizing integrated SRHR is important for a prevention agenda because it can improve the efficiency, efficacy, and overall health outcomes of HIV, reproductive health, sexual health, maternal health, and gender-based violence interventions. But, more critically, integration of SRH services reflects the realities and experiences of women and girls themselves – women and girls who may hope to get pregnant one day but not just yet, who are both nervous and excited to start having sex, who are just starting to fall in love, who are figuring out how to leave a violent relationship, who are worried about meeting their parents’ expectations, and women who with hope and fear and joy are expecting their first child.
At the end of our second day in Nairobi we each committed to enact our collective vision and move forward with our advocacy agenda for prevention and SRHR with renewed purpose and collaboration. We will insist that policies, funding priorities, and programs prioritize integration. And our own advocacy will now be linked in a new network of SRHR leadership committed to a holistic and comprehensive vision of health that reflects the lived experiences of all women and girls, everywhere.