The number of abortions among women older than 18 has increased steadily over the past two years in the Western Cape Province, according to South African Health MEC Theuns Botha. Responding recently in the legislature on the impact that illegal abortions have on public health care facilities, Botha said such abortions continued to take place, despite the legal service that was offered at more than 30 health care centres in the province. While health care facilities had treated a number of women with complications arising from illegal abortions, Botha said it was difficult to say how many cases there had been as those known to the department were only of women who volunteered the information during treatment. According to the latest figures from the National Health Department, between 1997 – when legal termination of pregnancy was introduced – and last year, about 702,354 abortions were performed at public health care facilities nationwide. About 528,000 of these involved teenagers. Health Minister Aaron Motsoaledi expressed concern about the number of teenagers who were having abortions, arguing this was proof that young people were engaging in unprotected sex and risking HIV infection. A spokesperson from Marie Stopes – a non-profit organisation offering reproductive health services – called on parents and teachers to talk openly about contraception, saying that research showed that most pregnant teenagers are in poor communities where educational and financial opportunities are limited. Women need to be made aware that abortion is not a form of contraception, she said.
Values, Policies and Rights
A new national HIV and AIDS strategic plan for Uganda is due to be finalised before the year's end, and gay rights activists are reported in this article to be urging its authors to break with tradition and, for the first time, provide for programming for men who have sex with men (MSM). A draft version of the new strategic plan distributed to civil society organisations mentioned the MSM community by name under an introductory section outlining groups that have prevalence rates above the national average, but the strategy concluded that MSM did not play ‘a big role’ in the transmission of HIV in Uganda and did not warrant a high rank among prevention activities. The draft strategy did recommend that more research be done within communities of MSM and injecting drug users to determine whether the groups were at risk of an upsurge in new infections. However, James Kigozi, spokesman for the Uganda AIDS Commission, said that because homosexual activity was illegal in Uganda, programming for MSM was unlikely to make it into the final version on the plan.
According to this article, World Health Organization (WHO) member states are responsible for directing and enabling WHO to undertake its normative and standard-setting functions effectively in facing the increasingly transnational nature of health threats, to be a trusted repository for knowledge and information, and to act as an effective convener of multiple players and stakeholders that can drive appropriate convergence, innovation, and effective decision making for health in a diverse landscape. In support of effective health governance, it states that better evidence and best practices are needed on how foreign policy can improve policy coordination at all levels and create an improved global policy environment for health. Foreign policy practitioners need to become more aware of positive and negative impact of policy options and decisions on health outcomes. This is how foreign policy can make a difference to health.
This article systematically reviews a set of health policy papers on agenda setting and tests them against a specific priority-setting framework. The article applies the Shiffman and Smith framework in extracting and synthesizing data from an existing set of papers, purposively identified for their relevance and systematically reviewed. Its primary aim is to assess how far the component parts of the framework help to identify the factors that influence the agenda setting stage of the policy process at global and national levels. It seeks to advance the field and inform the development of theory in health policy by examining the extent to which the framework offers a useful approach for organizing and analysing data. Applying the framework retrospectively to the selected set of papers, it aims to explore influences on priority setting and to assess how far the framework might gain from further refinement or adaptation, if used prospectively. The article also demonstrates how framework synthesis can be used in health policy analysis research.
With adolescents and youth constituting a quarter of the global population – for a total of 1.8 billion people – it has never been more critical that their human rights be fully recognised and realised within global arenas and at the regional, national, and community level. This publication sets forth the barriers adolescents face in realising their sexual and reproductive health and rights, discusses recent critical developments in the human rights framework underpinning these rights, and proposes a way forward for guaranteeing all adolescents the full exercise of their sexual and reproductive health and rights.
On 11 July 2013, the Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Women (the Protocol) turns 10. The author of this article argues that there is much to celebrate, as the Protocol remains one of the worlds’ most progressive women’s human rights instruments. While ratifications are a welcome measure, the provisions enshrined in the Protocol only have real meaning if governments go further and show their commitment to the protection and advancement of African women’s human rights by domesticating and fully implementing the instrument, she argues. Challenges that require mitigation exist and include limited technical and financial support in many states particularly with regard to the efforts to sensitise and build the capacity of government officials as well as the general public on the provisions of the Protocol; lack of political goodwill and weak institutional mechanisms to support the domestication and implementation of the Protocol; and lastly religious and cultural conservativism.
The recent proliferation of non-governmental organisations (NGOs) and independent media across Africa is argued by the author to be an important positive development. They are said to play an essential role by investigating government policy, exposing corruption and human rights violations, advocating for the rights of minorities and vulner-able communities, and providing social services. However the continent’s leaders reject what they see as an imposition of ‘Western’ ideas of human rights. This policy briefing highlights the shift in human rights discourse among African leaders towards more anti-imperialist rhetoric and the placing of African traditions above human rights. It provides examples of how local civil society organisations (CSOs) are challenging this view in the face of increasing government attacks. CSOs are argued to be crucial to positive transformation and the universal protection and promotion of human rights, and the author proposes that more needs to be done to protect human rights and create an enabling environment for CSOs.
Gendered norms are embedded in social structures, operating to restrict the rights, opportunities, and capabilities, of women and girls, causing significant burdens, discrimination, subordination, and exploitation. This review, developed for the Women and Gender Equity Knowledge Network of the WHO Commission on the Social Determinants of Health, sought to identify the best available research evidence about programmatic interventions, at the level of household and community, that have been effective for changing gender norms to increase the status of women. The focus was on developing countries. Key themes were identified: education of women and girls; economic empowerment of women; violence against women, including female genital mutilation/cutting; and men and boys. A key finding is, that targeting women and girls is a sound investment, but outcomes are dependent on integrated approaches and the protective umbrella of policy and legislative actions.
Activists from organisations in North Africa met in Tunis in July 2017 to set up the North African Network for Food Sovereignty. The network’s charter states that food sovereignty is the human right of peoples as individuals and communities to define their own food systems. Food sovereignty is tied to the right of people to self-determination at the political, economic, social, cultural and environmental levels. It means, working with nature and protecting resources to produce sufficient, healthy and culturally appropriate food by giving priority to local production and staple food, putting in place popular agrarian reforms, guaranteeing free access to seeds, protecting national produce and by involving people in elaborating agricultural policies. The charter identifies that this is undermined by extractivist policies implemented in the name of development and by neoliberal adjustment policies. In order to address this the North African Food Sovereignty Network was formed to achieve food sovereignty, climate and environmental justice, through critical studies; campaigns, workshops, direct actions as well as networking, coordination and solidarity with movements that share objectives.
Children under 18 are legal minors who, in South African law, are not fully capable of acting independently without assistance from parents/legal guardians. However, in recognition of the evolving capacity of children, there are exceptional circumstances where the law has granted minors the capacity to act independently. This paper describes legal norms for child consent to health-related interventions in South Africa, and argues that the South African parliament has taken an inconsistent approach to: the capacity of children to consent; the persons able to consent when children do not have capacity; and restrictions on the autonomy of children or their proxies to consent. In addition, the rationale for the differing age limitations, capacity requirements and public policy restrictions has not been specified. The paper argues that these inconsistencies make it difficult for stakeholders interacting with children to ensure that they act lawfully.