State of World Population 2012 - Country Page List - UNFPA

CASE STUDY
Expanding family planning in
humanitarian settings
As part of the emergency response in South
Sudan, UNFPA delivered supplies for oral
and injectable contraception and insertion of
intrauterine devices and other family planning
commodities (United Nations Population
Fund, 2011a). And in collaboration with
the American Refugee Committee, UNFPA
contributed to training health care workers,
community distribution workers and peer
educators on family planning.
Strategies and programmes often fail to fulfil
the family planning needs of refugees and internally
displaced populations who take refuge away
from home for varying lengths of time. A focus
on the emergency provision of shelter, food, and
basic health services has not always included
targeted programming to deliver essential reproductive
health information and services. In recent
years however, humanitarian inter-agency
working groups have developed resources and
tools to help humanitarian personnel generate
demand for family planning and ensure refugees’
right to family planning is met.
Sex workers. Sex workers not only have a right
to time and space their children, but also to rely
on condoms as a means of protecting themselves
from sexually transmitted infections including
HIV. However, sex workers often face social
stigma and discrimination, which subsequently
inhibit them from accessing family planning
information and services (Lin, 2007).
Social norms often classify sex work as being
immoral, and the institutions and individuals
responsible for law enforcement and health
may reinforce discriminatory attitudes and practices,
with harmful effects on sex workers. For
example, in some countries such as Lebanon
and the Philippines, stigma against sex work and
non-marital sex has been used to pass legislation
that prevents people from freely possessing
condoms (Human Rights Watch, 2004; World
Health Organization, 2005). As a result, sex
workers often perceive that health systems
are non-responsive to their needs, including
denying them access to the full range of
available contraceptives.
Studies affirm that when sex workers access
family planning services, they often do so reluctantly
and fall victim to the biases of health-care
workers who neglect their sexual and reproductive
health needs, focusing primarily on the risk
of HIV and sexually transmitted infections (Lin,
2007; Human Rights Watch, 2004). There are
documented cases of providers in South Asia and
South East Asia being accused of exposing HIV
statuses and threatening to report those with
HIV to the authorities (Mgbako et al., 2008).
The consequences of the stigmatization of
sex workers violate universal human rights.
According to the World Health Organization,
“interventions to promote safer sex among sex
workers must be part of an overall effort to
ensure their safety, promote their health and
well-being more broadly and protect their human
rights” (World Health Organization, 2005).
Lesbian, gay, bisexual and transgendered
people. State-run family planning programmes
largely neglect the needs of those who identify
themselves as lesbian, gay, bisexual and
transgendered. The United Nations High
Commissioner for Human Rights has affirmed
that, “discrimination on the basis of sexual
orientation is contrary to international human
rights law” (United Nations High Commissioner
for Human Rights, 2008). However, in most
places it is heterosexuals who are privileged in
64 CHAPTER 3: CHALLENGES IN EXTENDING ACCESS TO EVERYONE