State of World Population 2012 - UNFPA Haiti

Family planning in humanitariansettings: SomaliaWomen in Somalia have the highest fertility rates in the world, averagingmore than six children each (United Nations Population Fund, 2012b). Inspite of conflict, famine and high maternal, infant and child mortality rates,the country’s population has nearly tripled in the past 50 years. In thispastoralist society, where so many have been lost to war, children haveenormous value.Throughout the past two decades of conflict in Somalia and the lack ofa functioning central government since 1991, international attention hascentred on resolving the political crisis and delivering emergency relief.In this context, developing the programmes and healthcare infrastructurenecessary to generate and fulfil a demand for family planning has not beena priority.Some believe that the only way to effectively communicate aboutfamily planning to Somalis, most of them devout sunni Muslims, is throughreligion. Partnering with faith-based organizations can alleviate the religiousand social pressures on women who practice child spacing. Traditionalmethods such as withdrawal and exclusive breastfeeding are most easilyaccepted in Somali society. UNFPA is collaborating with non-governmentaland governmental organizations to deliver essential reproductive healthsupplies and services. With the worst of the famine now over, Somaliafaces an opportunity to focus on family planning programmes as a way tosafeguard the well-being of future generations.while also supporting community-basedinterventions that mobilize communities tosave women’s lives. The “cultural brokerage”roles that indigenous authorities and leaders,including traditional birth attendants, play arefundamental in this process.UNFPA has also contributed to advancingknowledge on indigenous peoples at theregional and country level through qualitativeand quantitative studies, advocating for theinclusion of indigenous peoples issues in populationand housing censuses, and assisting inthe improvement of health registries and otheradministrative records.Persons with disabilities. The Conventionon the Rights of Persons with Disabilitiesrecognizes their specific rights and outlines correspondingState obligations. The Conventionspecifies that persons with disabilities enjoy legalcapacity on an equal basis with others (Article12), have the right to marry and found a familyand retain their fertility (Article 23), and haveaccess to sexual and reproductive health care(Article 25).Research finds that persons with disabilitiesexperience discrimination that violatestheir rights and social biases that restrict theirabilities to academically, professionally, andpersonally excel (World Health Organization,2011). Furthermore, disabled persons experiencepoorer socioeconomic outcomesand poverty (Scheer et al., 2003; EuropeanCommission, 2008).Worldwide, the belief that disabled personsare asexual or should have their sexuality andfertility controlled is commonplace (WorldHealth Organization, 2009). But persons withdisabilities are sexually active, and studies havedocumented significant other unmet needsfor family planning (Maart and Jelsma, 2010;World Health Organization, 2009). Despitelegal prohibitions that grant disabled personsthe right to plan and time pregnancies, disabledpersons are more likely to be excluded fromsex education programmes (Rohleder et al.,2009; Tanzanian Commission for AIDS, 2009).Studies have also documented cases of involuntarysterilizations of disabled women (Servais,2006; Grover, 2002). Non-consensual sterilizationis against international human rightsstandards.People living with HIV. Research in bothdeveloped and developing countries suggeststhat HIV status does not repress the desire tohave children (Rutenberg et al., 2006). Thespecific considerations of women and men58 CHAPTER 3: CHALLENGES IN EXTENDING ACCESS TO EVERYONE