CASE STUDYExpanding family planning inhumanitarian settingsAs part <strong>of</strong> the emergency response in SouthSudan, <strong>UNFPA</strong> delivered supplies for oraland injectable contraception and insertion <strong>of</strong>intrauterine devices and other family planningcommodities (United Nations <strong>Population</strong>Fund, 2011a). And in collaboration withthe American Refugee Committee, <strong>UNFPA</strong>contributed to training health care workers,community distribution workers and peereducators on family planning.Strategies and programmes <strong>of</strong>ten fail to fulfilthe family planning needs <strong>of</strong> refugees and internallydisplaced populations who take refuge awayfrom home for varying lengths <strong>of</strong> time. A focuson the emergency provision <strong>of</strong> shelter, food, andbasic health services has not always includedtargeted programming to deliver essential reproductivehealth information and services. In recentyears however, humanitarian inter-agencyworking groups have developed resources andtools to help humanitarian personnel generatedemand for family planning and ensure refugees’right to family planning is met.Sex workers. Sex workers not only have a rightto time and space their children, but also to relyon condoms as a means <strong>of</strong> protecting themselvesfrom sexually transmitted infections includingHIV. However, sex workers <strong>of</strong>ten face socialstigma and discrimination, which subsequentlyinhibit them from accessing family planninginformation and services (Lin, 2007).Social norms <strong>of</strong>ten classify sex work as beingimmoral, and the institutions and individualsresponsible for law enforcement and healthmay reinforce discriminatory attitudes and practices,with harmful effects on sex workers. Forexample, in some countries such as Lebanonand the Philippines, stigma against sex work andnon-marital sex has been used to pass legislationthat prevents people from freely possessingcondoms (Human Rights Watch, 2004; <strong>World</strong>Health Organization, 2005). As a result, sexworkers <strong>of</strong>ten perceive that health systemsare non-responsive to their needs, includingdenying them access to the full range <strong>of</strong>available contraceptives.Studies affirm that when sex workers accessfamily planning services, they <strong>of</strong>ten do so reluctantlyand fall victim to the biases <strong>of</strong> health-careworkers who neglect their sexual and reproductivehealth needs, focusing primarily on the risk<strong>of</strong> HIV and sexually transmitted infections (Lin,2007; Human Rights Watch, 2004). There aredocumented cases <strong>of</strong> providers in South Asia andSouth East Asia being accused <strong>of</strong> exposing HIVstatuses and threatening to report those withHIV to the authorities (Mgbako et al., 2008).The consequences <strong>of</strong> the stigmatization <strong>of</strong>sex workers violate universal human rights.According to the <strong>World</strong> Health Organization,“interventions to promote safer sex among sexworkers must be part <strong>of</strong> an overall effort toensure their safety, promote their health andwell-being more broadly and protect their humanrights” (<strong>World</strong> Health Organization, 2005).Lesbian, gay, bisexual and transgenderedpeople. <strong>State</strong>-run family planning programmeslargely neglect the needs <strong>of</strong> those who identifythemselves as lesbian, gay, bisexual andtransgendered. The United Nations HighCommissioner for Human Rights has affirmedthat, “discrimination on the basis <strong>of</strong> sexualorientation is contrary to international humanrights law” (United Nations High Commissionerfor Human Rights, 2008). However, in mostplaces it is heterosexuals who are privileged in64 CHAPTER 3: CHALLENGES IN EXTENDING ACCESS TO EVERYONE
<strong>State</strong>-run family planning programmes. Some <strong>of</strong>these individuals may seek to prevent unintendedpregnancies. For example, men who have sexwith men and bisexuals may choose to engagein heterosexual sex without wishing to havechildren. In other situations, lesbians and gaymen may wish to plan families. Sexual violenceagainst people based on their perceived or actualsexual orientation makes women vulnerable tounintended pregnancy as a result <strong>of</strong> rape, requiringaccess to emergency contraception.Child brides. Despite declines in rates <strong>of</strong> earlymarriage, the practice <strong>of</strong> marrying girls beforethe age <strong>of</strong> 18—the internationally agreed age <strong>of</strong>adulthood—remains widespread sub-SaharanAfrica and South Asia. It remains relativelyuncommon for young men. Estimates suggestthat 34 per cent <strong>of</strong> women between the ages <strong>of</strong>20 and 24 in developing countries were marriedor in a union before their eighteenth birthday.In 2010, this was equivalent to almost 67 millionwomen. Social expectations, including theexpectation that girls will marry early, shape girls’sexual behaviour, compromising their schoolperformance, and making them vulnerable toearly marriage.Child marriage leads to the initiation <strong>of</strong> sexualactivity during a period when girls know littleabout their bodies, their sexual and reproductivehealth, and their right to family planning. Childwives are also under intense social pressure toprove their fertility, which makes them more likelyto have early and closely-spaced pregnancies.Even when child wives have accurate, comprehensiveknowledge about how to prevent earlytNujoud, Sana'a,Yemen, was marriedto her husband, morethan 20 years hersenior, when she wasonly 10 years old. Theyare now divorced.©VII/Stephanie SinclairTHE STATE OF WORLD POPULATION <strong>2012</strong>65
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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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“Everyone has the right to educat
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designing and delivering accessible
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Monitoring ICPD Goals - Selected In
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BibliographyAbbasi-Shavazi, Mohamma
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Delivering a world where every preg