Reproductive Health in Humanitarian Crises

In my last post, I talked about one of the themes the Executive Director of UNFPA discussed in his statement to the UNFPA Executive Board. I’m going to discuss another one here that is incredibly relevant around the world: humanitarian crises. Whether because of natural disasters, pandemics, or conflict, women and girls are disproportionately vulnerable. More than 75% of the people affected by these crises are women and children, and the risks that women already face in their daily lives become heightened when resources are scarce and security breaks down.

Abuse, sexual exploitation, violence, and forced marriage all increase during crises, as well as illnesses and deaths related to reproductive health and pregnancy. Sexual and reproductive health services are difficult to access, if they exist at all, leaving women with few resources if they are victims of violence or are giving birth.

The experiences of women in Za’atari refugee camp in Jordan demonstrate how all these risks intersect. The camp is populated with Syrian refugees, who are already dealing with the psychological trauma of displacement. In such an insecure atmosphere, many families arrange marriages for their adolescent daughters, hoping it will keep them safe. However, child marriage exposes girls to many other dangers, especially pregnancy. In Za’atari, many of the pregnant women that health care workers attend are under 15. Many girls fear violence from their husband if they try to prevent or delay pregnancy. Once girls get married, it becomes difficult to continue their education and achieve their full potential.

UNFPA’s State of the World Population report from 2015 does a great job going into detail about the dynamics that threaten women and girls in humanitarian crises, and the steps that can be taken to address it.

• Include family planning in basic emergency supplies delivered to those affected by the crisis, rather than treating it as an additional, optional service.
• Couple family planning supplies with education targeted at women and men about how delaying first pregnancy and increasing the spacing between pregnancies is good for the health of the mother and the whole family.
• Connect women, who may be dispersed in rural, hard-to-reach areas, to maternal and newborn health services.
• Target assistance to HIV treatment and prevention.
• Give adolescents access to education and vocational training. This will mitigate the vulnerability they face due to poverty and separation from their families, and give them the tools to be active advocates for positive change.
• In all areas, work with local women to understand their unique challenges, as well as their input on solutions that make sense given their needs and context.

But most importantly, before a crisis hits, governments and civil society must work to address the underlying socioeconomic and structural issues that affect its severity and the possibility of full recovery. That includes investment in reproductive health infrastructure, education, and gender equality. The issue of reproductive health in humanitarian crises shows how gender, health, and economic development are intertwined. When women have the agency to contribute fully to their societies, then their societies will be that much more resilient and able to bounce back in the face of disasters.


By Morgan, MPP '17
WAPPP Summer Intern Blog
Originally posted on Wanted, Safe, Fulfilled: UNFPA Summer 2016

What Do Women Really Want? Equality, to Start

Claiming to know “What Women Want” can be a slippery slope, but fortunately, it was Professor Deborah Rhode of Yale Law School, and not Mel Gibson, making the claim at this week’s WAPPP seminar. Professor Rhode discussed the widespread and varied gender disparities featured in her 2014 book of the same title. She began by speaking about her time in law school and as a young law professor, remembering that gender was noticeably absent from the curriculum, and comments that would be considered sexual harassment today ran rampant and unchecked.

Rhode argued that changing gender disparities begins by recognizing them, though there is a gap between those who recognize such inequality and those who self-identify as feminists. When the definition of feminism is provided, between two-thirds and four-fifths of women identify as feminists, yet when the definition is not provided, only one quarter of women self-identify. This is important because identifying as a feminist is correlated with activism around gender equity issues.

Though we often discuss the harms of gender inequality anecdotally - our friend who struggles to balance her job and parenting duties, the story of a survivor of campus sexual assault in the news - Rhode made the case for just how widespread and systematic these disparities are. This unfortunate truth is exacerbated by the fact that many women who experience discrimination aren't likely to challenge it. Even individuals who have convincing evidence of bias are hesitant to challenge the institution responsible for it; many are deterred by the high psychological and financial cost of challenging their institutions, paired with the low probability of success. The recent gender discrimination law suit by Ellen Pao against a prominent venture capital firm is a prime example of this.

The statistics in many areas of professional and personal life are bleak. Women constitute over a third of MBA graduates but only 5% of Fortune 500 CEOs. Though much of the country's pay gap is driven by women being clustered in low pay industries, similarly situated women also earn less than men, even when controlling for many relevant factors.

Gender pay disparities are the most pronounced among those who opt out of the formal economy, which are disproportionately women. Less than 1% of men with kids under 15 are stay-at-home dads, and women are responsible for twice as much childcare and three times as much housework as men. The fact that the U.S. is one of three countries in the world without paid maternity leave speaks to how far our society has to go on the issue.

Rhode argued that a major way to remedy these disparities within household labor division is to protect women's reproductive rights, which include working towards making abortion safe and unnecessary. Despite the ideological divides over this issue, about two-thirds of women believe the Supreme Court should not overturn Roe v. Wade.

The intersection of economic opportunities and women's security was also highlighted. Rhode pointed out that inadequate safety nets keep women in violent relationships, and this is especially important when we consider that two-thirds of minimum wage workers are women. In addition, the United States has the highest rate of partner homicide in the developed world, and women in the United States Armed Forces are more likely to be raped by a fellow soldier than killed in action.

Rhode argued that to change the agenda and move the dial on all of these issues, we must get more women into leadership roles. It's well-documented that the statistics on women in political leadership in this country is dismal. The U.S. ranks 78th in the world in the percentage women in office, below Saudi Arabia. Indeed, only 10% of American governors and mayors of major cities are female.

Rhode was quick to point out that putting women in positions of power is not the same as empowering women, however, arguing that we also need a strong women’s movement to create political support for these issues. She suggested greater dialogue between generations on strategies for activism and applauded young women tackling campus sexual assault, whose activism led to a Presidential Task Force on the subject.

When asked about the potential use of quotas in American government or corporate boards, similar to those recently instituted by European countries, Rhode expressed concern. In addition to what she deemed America's negative knee-jerk reaction to affirmative action programs, she also questioned whether appointing more women would change corporate culture. However, Rhode argued that more disclosure on the gender breakdown within organizations could be used to embarrass institutions that have large gender disparities.

In closing, Rhode made sure to remind the audience that it is difficult to know what women really want because we don’t know what preferences would be in an equal world. There are currently far too many ways in which society constructs and constrains the choices of women, so our desires might be very different in a world in which women could really choose.