This paper reviews the legal and policy context of HIV disclosure in sub-Saharan Africa, as well as what is known about rates, consequences and social context of disclosure, with special attention to gender issues and the role of health services. Persistent rates of nondisclosure by those diagnosed with HIV raise difficult ethical, public health and human rights questions about how to protect the medical confidentiality, health and well-being of people living with HIV on the one hand, and how to protect partners and children from HIV transmission on the other. Both globally and within the sub-Saharan African region, a spate of recent laws, policies and programmes have tried to encourage or – in some cases – mandate HIV disclosure. These policies have generated ethical and policy debates. While there is consensus that the criminalization of transmission and nondisclosure undermines rights while serving little public health benefit, there is less clarity about the ethics of third party notification, especially in resource-constrained settings. Despite initiatives to encourage voluntary HIV disclosure and to increase partner testing in sub-Saharan Africa, health workers continue to grapple with difficult challenges in the face of nondisclosure, and often express a need for more guidance and support in this area. A large body of research indicates that gender issues are key to HIV disclosure in the region, and must be considered within policies and programmes. Taken as a whole, this evidence suggests a need for more attention to the challenges and dilemmas faced by both clients and providers in relation to HIV disclosure in this region and for continued efforts to consider the perspectives and rights of all those affected.
Values, Policies and Rights
The State of the World’s Children 2007 examines the discrimination and disempowerment women face throughout their lives – and outlines what must be done to eliminate gender discrimination and empower women and girls. It looks at the status of women today, discusses how gender equality will move all the Millennium Development Goals forward, and shows how investment in women’s rights will ultimately produce a double dividend: advancing the rights of both women and children.
Making voluntary family planning available to everyone in developing countries would reduce costs for maternal and newborn health care by $11.3 billion annually, according to this report by the United Nations Population Fund (UNFPA). UNFPA argues that increased access to family planning has proven to be more than just a sound economic investment, with knock-on gains in reducing poverty, exclusion, poor health and gender inequality. Nevertheless, the report finds that financial resources for family planning have declined and contraceptive use has remained mostly steady. The report also calls on governments and leaders to: take or reinforce a rights-based approach to family planning; secure an emphasis on family planning in the global sustainable development agenda that will follow the Millennium Development Goals in 2015; ensure equality by focusing on specific excluded groups; and raise the funds to invest fully in family planning.
This guide is intended to aid civil society actors in becoming more involved in the work of the UN Special Rapporteur on the right to health, with a specific focus on the valuable role that health workers can play. The appointment of the first Special Rapporteur on the right to health in 2002 and the resulting body of work on the right to health has proven to be a valuable catalyst for further action within the health and human rights movement. At the same time there remains much unawareness and misconception concerning the work of the Special Rapporteur and the ways in which civil society actors can be involved. The guide provides general information on the Special Rapporteur, and presents possibilities for contribution and follow-up to the three main areas of his work. It offers concrete assistance on how the annual reports, country missions, and the individual complaints mechanism of the Special Rapporteur can be used by civil society.
In the past six years the UN Special Rapporteur on Human Rights and the Human Rights Centre have prepared an impressive body of reports offering detailed analyses on elements of the right to health. They have developed a framework for analysis of health-related issues that had so far not been studied from a human rights perspective. A September 2008 symposium reviewed these themes and strategies and made suggestions for further research and implementation. The meeting covered health systems and the right to the highest attainable standard of health, mainstreaming a human rights-based approach to health and the Special Rapporteur’s missions and reports, such as those on community participation and HIV and AIDS.
This article reviews formal and informal mechanisms through which the World Health Organization (WHO) is promoting policies for the advancement of women's health, such as Countdown to 2015 and the Partnership for Maternal, Newborn, and Child Health. Specific attention is given to examples of innovative strategies WHO has adopted in recent years to increase political commitment to women's and children's health and influence the development of policies supportive of country efforts to achieve Millennium Development Goals 4 (MDG4) and MDG 5 (to reduce child mortality and improve maternal health, respectively). It is expected that WHO’s commitment to women’s health and efforts to translate its political agenda of improving the lives of women and girls through influencing policy development at the country level will progressively increase under the leadership of Dr Margaret Chan, the current WHO Director General. The Director-General has indicated that improvements in the health of the people of Africa and the health of women are considered the key indicators of WHO’s performance in the coming year.
The Global Call to Action against Poverty Africa (GCAP Africa) secretariat celebrated the 60th anniversary of the Universal Declaration of Human Rights on 10 December. In partnership with the Every Human Has Rights campaign (EHHR) – spearheaded by the Elders, like Nelson Mandela and Desmond Tutu – GCAP is calling for true reflection on the universality of these celebrated rights. It is calling on all humanity and even more so those in power to re-look their interactions and perceptions of those that are extremely marginalised and have absolutely no voice. Africans are well aware of the disparity in the application of all documents regarding human rights. The continued exodus of African people toward the West in search of ‘better lives’ is one clear manifestation of dissatisfaction in Africa.
In this paper, the authors evaluate the effectiveness of the World Starts With Me (WSWM), a comprehensive sex education programme in secondary schools in Uganda, focusing on socio-cognitive determinants of safe sex behaviour, namely delay, condom use and non-coercive sex. A survey of 1,864 students was conducted, which showed significant positive effects of WSMW on beliefs regarding what could or could not prevent pregnancy, the perceived social norm towards delaying sexual intercourse, and the intention to delay sexual intercourse. Furthermore, significant positive effects of WSWM were found on attitudes, self-efficacy and intention towards condom use and on self-efficacy in dealing with sexual violence (pressure and force for unwanted sex). However, all significant positive effects disappeared for those schools that only implemented up to 7 out of 14 lessons in the programme. The authors conclude that the effectiveness of WSWM could be improved by giving more systematic attention to the context in which such a programme is to be implemented.
Zimbabwe's 2007 National Maternal and Neonatal Health Road Map provided an over- arching strategy for scaling up the national response to reduce the current levels of maternal and neonatal mortality and morbidity in line with the MDG health related targets, bringing together all national stakeholders to support one national MNH programme, one national MNH coordination mechanism, and one national MNH Planning, Monitoring and Evaluation Framework. The concept of the Four Pillars of Safe Motherhood describes comprehensively all prerequisites to be met in order for a woman to safely live through her life cycle, from informed teen age through supervised, healthy pregnancy, through safe delivery and childbirth, the safe-guarding of her newborn’s health start of life, and through a continued, problem free reproductive life. The MNH Road Map sets two clearly defined phases, a first phase of prioritisation on the supply issues of the interventions to make services available first, before fully focusing on a further creation of demand in the second phase.
When Malala Yousafzai turned 18, she opened a school for Syrian refugee girls, calling on leaders from around the world to provide “books not bullets.” It was at 18 that Cleopatra became ruler of Egypt, in 51 B.C.E., and Victoria the queen of Great Britain, in 1837. By the time she was 18, Britney Spears had had two No. 1 albums on the Billboard chart, and Serena Williams had won the U.S. Open. Emma Gonzalez, 18 now, has become a global leader in the movement to end gun violence. No pressure, right? Eighteen is an age. But it’s also something more. It’s a moment, a rite of passage, a gateway to adulthood.In the United States, 18 means you can finally vote, sign a lease on an apartment, obtain a credit card and buy a Juul. In China and parts of Canada, 18 grants you entrance to a pub, while for most Israelis, it means a mandatory draft into the military. By 18, one in five women across the globe will be married. Millions will enter college or university. “This is 18” aims to capture what life is like for girls turning 18 in 2018 across oceans and cultures. The editors asked young women photographers to document girls in their communities — taking the photos and conducting the interviews themselves. Each photographer was paired with a professional mentor to guide them through the process. The result is a celebration of girlhood around the world — across 12 time zones and 15 languages, featuring 21 subjects and 22 photographers. #ThisIs18 — a look at girls’ lives, through girls’ eyes.