Family planning in humanitariansettings: SomaliaWomen in Somalia have the highest fertility rates in the world, averagingmore than six children each (United Nations <strong>Population</strong> Fund, <strong>2012</strong>b). Inspite <strong>of</strong> 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 <strong>of</strong> conflict in Somalia and the lack <strong>of</strong>a 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 <strong>of</strong> 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. <strong>UNFPA</strong> is collaborating with non-governmentaland governmental organizations to deliver essential reproductive healthsupplies and services. With the worst <strong>of</strong> the famine now over, Somaliafaces an opportunity to focus on family planning programmes as a way tosafeguard the well-being <strong>of</strong> 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.<strong>UNFPA</strong> has also contributed to advancingknowledge on indigenous peoples at theregional and country level through qualitativeand quantitative studies, advocating for theinclusion <strong>of</strong> indigenous peoples issues in populationand housing censuses, and assisting inthe improvement <strong>of</strong> health registries and otheradministrative records.Persons with disabilities. The Conventionon the Rights <strong>of</strong> Persons with Disabilitiesrecognizes their specific rights and outlines corresponding<strong>State</strong> 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, pr<strong>of</strong>essionally, andpersonally excel (<strong>World</strong> Health Organization,2011). Furthermore, disabled persons experiencepoorer socioeconomic outcomesand poverty (Scheer et al., 2003; EuropeanCommission, 2008).<strong>World</strong>wide, the belief that disabled personsare asexual or should have their sexuality andfertility controlled is commonplace (<strong>World</strong>Health Organization, 2009). But persons withdisabilities are sexually active, and studies havedocumented significant other unmet needsfor family planning (Maart and Jelsma, 2010;<strong>World</strong> 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 <strong>of</strong> involuntarysterilizations <strong>of</strong> 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 <strong>of</strong> women and men58 CHAPTER 3: CHALLENGES IN EXTENDING ACCESS TO EVERYONE
who are living with HIV and are consideringpregnancy remain linked to the stigma anddiscrimination they encounter from their families,community or health system (Oosterh<strong>of</strong>fet al., 2008).For women and men with access to antiretroviraltreatment, a diagnosis <strong>of</strong> HIV can nowbe managed largely as a chronic disease. Eventhough universal access to life-saving treatmentshas not been achieved in all parts <strong>of</strong> the world,the international community has made considerableprogress towards expanding access. Inlow- and middle-income countries, the number<strong>of</strong> people receiving treatment has reached 6.65million, representing a 16-fold increase withinseven years (<strong>World</strong> Health Organization, 2011).As progress towards universal access to antiretroviraltreatment continues, more people who liveYoung men are more likely than young women to have high-risk sexwith a non-marital, non-cohabiting partner in the last 12 months(PER CENT <strong>of</strong> young people 15-24)Implications for family planning: married and unmarried people need access to contraceptionto prevent unintended pregnanciesYoung womenYoung menViet NamIndiaCambodiaMalawiUgandaCentral African RepublicZambiaZimbabweUnited Rep. <strong>of</strong> TanzaniaGuyanaRepublic <strong>of</strong> MoldovaKenyaUkraineDominican RepublicNamibia<strong>Haiti</strong>11114162126272428363240363338465557656972788081838376878790950 20 40 60 80100Source: AIS, DHS, MICS and other national household surveys, 2005-2009. For each country, data refer to the most recent yearavailable in the specified period. THE STATE OF WORLD POPULATION <strong>2012</strong>59
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OverviewOne hundred seventy-nine go
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The report is structured to answer
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viiiCHAPTER 1: THE RIGHT TO FAMILY
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“All human beings are born free a
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Treaties, conventions and agreement
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Health: a social and economic right
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Monitoring Monitoring ICPD ICPD Goa
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Monitoring Monitoring ICPD ICPD Goa
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Monitoring ICPD Goals Demographic -
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Monitoring ICPD Goals - Selected In
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BibliographyAbbasi-Shavazi, Mohamma
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Monitoring ICPD Goals - Selected In
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Delivering a world where every preg