UNFPA at Work: Six Human Rights Case Studies

An underlying dynamic that helped account for communitymembers’ attitudes was their perception of reproductivehealth not in terms of rights, but rather as services theGovernment was encouraging them to use. Thus, the emphasisseemed to be on the supply rather than demand side, withpeople understanding information about services as arequest for them to use these services. In contrast, a humanrights-based approach suggests the opposite: that peoplehave the natural authority to evaluate available resources inview of their needs, and to communicate to duty-bearers howto modify the resources to better meet those needs, thus contextualizingthe response to their needs.Another challenge was related to informed consent for familyplanning purposes. Many residents viewed the process ofchoosing a family planning method as too complicated,because they did not understand the associated biologicalissues, and those few who did seek family planning resourceswere inclined to ask providers to choose a method for them.Many people in Geita District appeared to be unaware ofthe danger signs of pregnancy, which contributed to thehigh rate of maternal mortality. Stronger Voices identifiedthe lack of community awareness of sexual andreproductive health and reproductive rights as a rootcause of these unnecessary deaths. Another factor wasthe inability of community members, particularly women,to articulate concerns about their health and well-beingto service providers. Stronger Voices sought to empowerthem with knowledge to demand high-quality servicesnot as a favour but as a right to which they are entitledas human beings.Implementation of training activities forrights-holdersImplementation of Stronger Voices began with projectmanagers and village leaders meeting to suggest criteriafor choosing workshop participants. Village leaders wereasked to encourage the participation of people living underparticularly vulnerable conditions, including both marriedand unmarried pregnant women, people living with HIVand AIDS, people with mental health issues, widows, andresidents of hard-to-reach areas with poor infrastructure.In each participating ward, village leaders drew up plans forreaching vulnerable people. When they recruited workshopparticipants, they sought to maintain a gender balance aswell as a diversity of ages. They also sought to reach out tothose with poor attendance at health facilities.There were several villages in each of the wards participatingin the intervention. Each village fielded four communitygroups of 20 people each. The groups had balanced numbersof female and male participants, with ages rangingfrom the teens to the elderly.The workshop sessions were led by trained facilitators, whoguided the groups through the seven modules making upthe Stronger Voices community manual. The manual wascrucial to the success of the workshops. It was designed toenable people to understand seemingly complicated andabstract human rights principles, so that they could seehow the principles related to their day-to-day lives.The curriculum was organized so that each moduleaddressed the root causes of a different sexual and reproductivehealth issue, and did so by framing responses interms of the relevant human rights. Thus, participants wereable to see that health-related human rights principles canserve as the foundation for very practical strategies forimproving health outcomes. This point can best be illustratedthrough a summary of the curriculum.Module 1: Our bodies. A lack of information was identified asone of the root causes of a number of sexual and reproductivehealth problems that were prevalent in the community.This lack related to a fundamental human rights principle: theright to information. Looking at access to health informationas a right, Module 1 sought to provide information about theanatomy of male and female bodies, and how this relates tosexual and reproductive health and reproductive rights.Module 2: Pregnancy. The impact of lack of awarenessabout pregnancy and motherhood was also identified as anissue that required attention. This included issues such asthe social function of pregnancy, women’s rights duringpregnancy, irrespective of marital status, and the role ofspouses/partners in promoting safe motherhood. There aremultiple rights that can help guide responses. One is accessto information to help ensure the health and well-being offamilies. Another is the right to non-discrimination asapplied to the marital status of pregnant women – i.e.,unmarried pregnant women have the right to the same benefitsand services as their married counterparts. A third isthe right to live free from the prejudices associated withgender-role stereotypes. Module 2, which provided informationabout pregnancy as well as about the aforementionedrights, was structured to encourage a dialogue about what itmight mean to realize those rights within the specific socialand cultural context of Geita District.22SIX HUMAN RIGHTS CASE STUDIES