Gender Responsive Budgeting and Women's Reproductive Rights ...

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Using the budget angle to advance other workThis section describes how the GRB approach can be used to strengthen advocacy and effectivenessin a wide range of different programs, campaigns and activities. Possible arenas for using the GRBapproach include national development agendas such as the poverty reduction strategy papers (PRSPs)which are found in many developing countries and the Millennium Development Goals (MDGs). Alsodiscussed is the use of the GRB approach for work on particular issues such as maternal mortality andgender-based violence. The last part of the section describes how GRB work can form part of an agendaof increasing public participation in policy making.Reproductive health, budget work and MDGsReproductive health in the MDGsThe MDGs are the world’s targets for addressing different dimensions of extreme poverty by 2015.Goal 5 focuses on maternal mortality and reproductive health. But there is no formal MDG with targets .for sexual and reproductive health beyond this. Adolescents are not mentioned at all in the UN MillenniumDeclaration.The UN Millennium Project (www.unmillenniumproject.org) serves as an advisory body to the UNSecretary-General. Its ten task forces bring together participants from academia, government, UNagencies, IFIs, NGOs, donor agencies, and the private sector. Several of these task forces, not onlythe one for Goal 5, have recognised that access to sexual and reproductive health (SRH) services andprotection of reproductive rights is important for the achievement of other MDGs, including povertyand hunger, gender equality and the empowerment of women, educational attainment, environmentalsustainability, and the improvement of the quality of life of slum dwellers.The outcome document from the 2005 World Summit raises RH issues under the HIV/AIDS heading andrefers to the need to achieve “universal access to reproductive health by 2015,” in line with the ICPD.When discussing the goal of gender equality and empowerment of women, the document refers to theneed to ensure “equal access to reproductive health.”Appendices 1 and 2 of the Millennium Project’s Investing in Development include a variety of SRHrelevantinterventions. Examples include universal access to sexual and reproductive health servicesand information (including family planning; safe motherhood as well as prevention, treatment and careof STIs including HIV/AIDS); age-appropriate education and services; attention to men’s involvement;adolescent reproductive health; parental education; ensuring contraceptive choice; improving counselling;combating gender violence; discouraging early marriage; eliminating female genital mutilation and otherharmful traditional practices; expanding access to safe abortion (where permitted by law), and reviewingsuch legislation to protect women’s health.38U s i n g t h e b u d g e t a n g l e t o a d v a n c e o t h e r w o r k
Task Force on Child Health and Maternal HealthThe Task Force on Child Health and Maternal Health emphasised the need for fundamental changesto systems, including budgets. It came up with the nine key recommendations, of which the secondfocused on financing. The Task Force stated that significant additional funds were needed. It said thatcountries should increase allocations to their health sectors. It also said that user fees for basic healthservices should be abolished. The fourth key recommendation dealt with sexual and reproductive rightsand stated firmly that these are “essential” in order to meet all the MDGs. In elaborating, the Task Forcerecommended that HIV/AIDS initiatives be integrated with SRH programs, that adolescents should receiveexplicit attention, and that in all countries women should have access to quality services for themanagement of complications arising from abortion. The sixth recommendation, on maternal mortality,advocated that efforts to establish a “functioning primary healthcare system” must include provision foremergency obstetric care. The final recommendation states that universal access to RH services shouldbe added as a target to MDG 5.The emphasis on “universal” is in line with the task force’s consistent emphasis on equity and on addressingthe needs of the poor. The task force notes that although poor people generally experiencegreater levels of ill-health than rich people, they generally have worse access to health services. Theyadd that the fact that a particular health intervention addresses a disease that is more prevalent amongpoor people does not necessarily mean that it will benefit poor people most. Specific strategies areneeded to ensure that this happens.Budget analysts often complain about the large proportion of budgets spent on salaries. They ignore thefact that without the workers paid by these salaries, no services will be available. In contrast to theseanalysts, the task force states that salaries, career paths and working conditions of health providersshould be “substantially” increased. They suggest that this can help, among others, to address the“brain drain” of nurses and doctors from poor to rich countries—a drain that transfers skills developedthrough third world budget allocations to the first world.The task force also questions some of the other common aspects of HSR and, in particular, the shifttowards privatisation. It notes that “even the most ardent health sector reformers … recognize thatmarket-based reforms based on the commodification of healthcare will end up failing to reach the poor,who simply do not have sufficient cash or other assets to purchase the care they need.”References: UN Millennium Project. Who’s Got the Power? Transforming Health Systems for Women andChildren. Summary version of the report of the Task Force on Child Health and Maternal Health. New York:UNDP, 2005.United Nations Development Program. Population, Reproductive Health and the MillenniumDevelopment Goals: Messages from the UN Millennium Project Reports. UNDP, 2005http://www.unmillenniumproject.orgDraft resolution referred to the High-level Plenary Meeting of the General Assembly by the GeneralAssembly at its fifty-ninth session 2005 World Summit Outcome. A/60/L.1*. September 2005 World SummitOutcome documentU s i n g t h e b u d g e t a n g l e t o a d v a n c e o t h e r w o r k39
Page 3: TABLE OF CONTENTSForeword..........
Page 6 and 7: BoxesBox 27 Evidence on the impact
Page 8 and 9: AcknowledgementsIwould like to than
Page 10 and 11: AcronymsIPPF International Planned
Page 12 and 13: The resource pack builds on, rather
Page 14 and 15: What is Gender responsive budgeting
Page 16 and 17: Box 1: Advocating for Afro-descenda
Page 18 and 19: Some key linkagesThe first part of
Page 20 and 21: Budget work and rightsBudgets refle
Page 22 and 23: GRB and CEDAWThe 1979 Convention on
Page 24 and 25: The ICPD’s Program of Action prov
Page 26 and 27: Reproductive health services can of
Page 28 and 29: • attention to the needs of HIV-p
Page 30 and 31: Primary health care and reproductiv
Page 32 and 33: Improvements in health can contribu
Page 34 and 35: What are the economic consideration
Page 36 and 37: Box 8: Money alone is sometimes not
Page 38 and 39: Box 9: The costs of home-based care
Page 42 and 43: Box 11: Maternal mortality and emer
Page 44 and 45: assessment to what is needed to mak
Page 46 and 47: Box 12: Civil society tracking educ
Page 48 and 49: Box 15: What is the cost of combati
Page 50 and 51: Participatory budgets and genderUNI
Page 52 and 53: What do budgets look like?This sect
Page 54 and 55: often use very different formats, w
Page 56 and 57: Ministry ofHealthGenderdimensionOut
Page 58 and 59: Frameworks and toolsThis section gi
Page 60 and 61: 1. An analysis of the situation of
Page 62 and 63: Mexican guide to formulating health
Page 64 and 65: Beneficiary assessment is a way of
Page 66 and 67: The community-based monitoring syst
Page 68 and 69: Actors, activities and focusThis se
Page 70 and 71: Box 25: Public representatives are
Page 72 and 73: • Estimation by the Ministry of F
Page 74 and 75: The revenue sideThis section looks
Page 76 and 77: User feesUser fees for government s
Page 78 and 79: might stipulate that a certain prop
Page 80 and 81: focusing on programs for their own
Page 82 and 83: PEPFAR will only provide funds for
Page 84 and 85: Box 29: Ensuring that women benefit
Page 86 and 87: Transfers consist of two main types
Page 88 and 89: Disaggregation of budget numbersFin
Page 90:
In conclusionAs emphasised at the o
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