Lakshmi Puri: “Gender inequalities affect health outcomes and must be addressed accordingly”
Remarks by UN Women Acting Head and Assistant Secretary-General Lakshmi Puri at a meeting hosted by H4+ and the Inter-agency Task Team on the Prevention and Treatment of HIV among Pregnant Women, Mothers and Children, during the Women Deliver Conference, 29 May 2013, Kuala Lumpur, Malaysia.
Good morning to all of you.
It is a pleasure for UN Women to join in the discussion this morning as the “newest girl on the block” when it comes to the field of health and HIV. We are the newest member of the H4+ partnership and the 11th cosponsor of UNAIDS and we are keen to support the implementation of commitments to women and children’s health. This is an important part of our coordination mandate according to which we promote the coherence and accountability of the UN System to gender equality commitments.
The role of gender equality and women’s empowerment in influencing health outcomes for women and children, and indeed, families and communities cannot be underestimated.
We know that there is a positive correlation because the more that women’s rights are respected, including the right to sexual and reproductive health, the lower the rates of teenage girls getting pregnant, the lower the rates of abortion, and the lower the rates of women dying from complications of pregnancy and childbirth, and from AIDS. This is particularly important for the 600 million adolescent girls in developing countries, a third of whom are married before they are 18.
It is critical to create an enabling environment for women to be made aware of their rights, to be demanding access to services or commodities for their sexual and reproductive health, such as female condoms for example for HIV prevention, and to have the knowledge and power to use them correctly and consistently.
Yesterday we heard a lot about the supply side and how we must deliver for women who deliver. At the same time, there is a need to raise awareness on the “demand-side” and tackle challenges such as lack of knowledge, financial constraints, lack of autonomy or lack of power of decision-making.
We must understand and address structural inequalities determined by factors such as social norms and discriminatory institutions. These factors affect women’s ability to act on their own behalf and protect their health, including having autonomy in decision-making, control over income and assets, and living free of gender-based violence and discrimination.
Addressing these issues is essential if we are going to transform demand, delivery and effective use of services for women’s health. This includes creating gender-responsive institutions and budgets.
We have seen that HIV prevention programmes that address gender norms, and unequal power dynamics between men and women, and the challenges brought on by violence against women, are showing great promise in successfully reducing STIs/HIV infection. These programmatic models are few but compelling and should be scaled up.
The Stepping Stones project on HIV and safer sex resulted in a 33 per cent reduction in the incidence of Herpes Simplex Virus -2 among participants, and reductions in the proportion of men reporting they committed intimate partner violence.
The Intervention and Microfinance for AIDS and Gender Equity (called IMAGE) reduced intimate partner violence by 55 per cent in women in the intervention group, relative to the comparison group. The programme combined a microfinance initiative that targeted the poorest women in communities, with a participatory curriculum of gender and HIV education. Improvements were also registered in household economic well-being, social capital, and empowerment.
And Program H, which focuses on helping young men question traditional norms related to manhood and was piloted in Latin America, found that positive changes in gender norms were associated with reductions in reported STI symptoms.
Whether it is in terms of prevention, or treatment, or care and support, gender inequalities affect health outcomes and must be addressed accordingly. The low status accorded to women and girls in society puts their health in jeopardy and violates their rights. This impacts directly on the effectiveness of the strategies we put in place.
In order to respond we must work within and beyond the health sector. We must engage, for example, the justice sectors to promote women’s legal rights. We need to advance women’s economic security and improve women’s livelihoods. And we need to promote women’s political empowerment to ensure engagement in decision-making and for this, we must support women’s leadership.
For UN Women, this means women must be able to participate as equal citizens in a country’s political and formal economic spheres. They must have a right to a life free from violence. They must have equal access to and control over productive resources. They must have greater access to information and prevention methods, and the power to use this knowledge. And their work in the care economy must be counted, valued, and supported.
To move forward, we need legal and policy reforms to protect women and girls from violence. We need to ensure their equal rights to education, social security, property, employment, political participation and an adequate standard of living. And we need to ensure that women and girls can exercise and enjoy the full range of human rights, including their right to sexual and reproductive health and reproductive rights, and access integrated health care and other services in stigma-free environments.
Together, we need to tackle the social, economic, and political inequalities that stand in the way of achieving goals and meeting the needs of all populations – particularly those most discriminated against and most excluded.
We know that important strides have been made in reducing maternal and infant mortality, but more needs to be done. Real and continued progress is possible and we have to work together to make this progress happen as we race to achieve the MDGs.
Finally, as we plan for the post-2015 agenda and the way forward for women’s health, for eliminating HIV, let us keep human rights, universal access to health and other social services, and gender equality as central guiding principles.
Lakshmi Puri visits Malaysia, Japan and the Republic of Korea