State of World Population 2012 - Country Page List - UNFPA

Family planning in humanitarian
settings: Somalia
Women in Somalia have the highest fertility rates in the world, averaging
more than six children each (United Nations Population Fund, 2012b). In
spite of conflict, famine and high maternal, infant and child mortality rates,
the country’s population has nearly tripled in the past 50 years. In this
pastoralist society, where so many have been lost to war, children have
enormous value.
Throughout the past two decades of conflict in Somalia and the lack of
a functioning central government since 1991, international attention has
centred on resolving the political crisis and delivering emergency relief.
In this context, developing the programmes and healthcare infrastructure
necessary to generate and fulfil a demand for family planning has not been
a priority.
Some believe that the only way to effectively communicate about
family planning to Somalis, most of them devout sunni Muslims, is through
religion. Partnering with faith-based organizations can alleviate the religious
and social pressures on women who practice child spacing. Traditional
methods such as withdrawal and exclusive breastfeeding are most easily
accepted in Somali society. UNFPA is collaborating with non-governmental
and governmental organizations to deliver essential reproductive health
supplies and services. With the worst of the famine now over, Somalia
faces an opportunity to focus on family planning programmes as a way to
safeguard the well-being of future generations.
while also supporting community-based
interventions that mobilize communities to
save women’s lives. The “cultural brokerage”
roles that indigenous authorities and leaders,
including traditional birth attendants, play are
fundamental in this process.
UNFPA has also contributed to advancing
knowledge on indigenous peoples at the
regional and country level through qualitative
and quantitative studies, advocating for the
inclusion of indigenous peoples issues in population
and housing censuses, and assisting in
the improvement of health registries and other
administrative records.
Persons with disabilities. The Convention
on the Rights of Persons with Disabilities
recognizes their specific rights and outlines corresponding
State obligations. The Convention
specifies that persons with disabilities enjoy legal
capacity on an equal basis with others (Article
12), have the right to marry and found a family
and retain their fertility (Article 23), and have
access to sexual and reproductive health care
(Article 25).
Research finds that persons with disabilities
experience discrimination that violates
their rights and social biases that restrict their
abilities to academically, professionally, and
personally excel (World Health Organization,
2011). Furthermore, disabled persons experience
poorer socioeconomic outcomes
and poverty (Scheer et al., 2003; European
Commission, 2008).
Worldwide, the belief that disabled persons
are asexual or should have their sexuality and
fertility controlled is commonplace (World
Health Organization, 2009). But persons with
disabilities are sexually active, and studies have
documented significant other unmet needs
for family planning (Maart and Jelsma, 2010;
World Health Organization, 2009). Despite
legal prohibitions that grant disabled persons
the right to plan and time pregnancies, disabled
persons are more likely to be excluded from
sex education programmes (Rohleder et al.,
2009; Tanzanian Commission for AIDS, 2009).
Studies have also documented cases of involuntary
sterilizations of disabled women (Servais,
2006; Grover, 2002). Non-consensual sterilization
is against international human rights
standards.
People living with HIV. Research in both
developed and developing countries suggests
that HIV status does not repress the desire to
have children (Rutenberg et al., 2006). The
specific considerations of women and men
58 CHAPTER 3: CHALLENGES IN EXTENDING ACCESS TO EVERYONE