Talk about the importance of gender equality and women’s empowerment in all the MGDs abounds. It is a highly recommended principle, although very few arrive at the specifics of programming and implementation. Beyond the talk there is frenzy over what to do about reducing maternal mortality rates. UN Secretary-General Ban Ki-moon has announced a ‘Global strategy for women and children’s health’. The Clinton Global Initiative annual meeting is dedicating an entire track to women’s and girls’ empowerment. There is also the G8’s Muskoka Initiative for the reduction of maternal mortality rates and the improvement of maternal and child healthcare. This is just to name a few.
Our attention has been diverted away from the Programmes of Action (POAs) from the International Conference on Population and Development (ICPD), and the Fourth World Conference on Women. This is despite government officials and leaders meeting in 2004 pledging to achieve universal access to reproductive health (MDG target 5B). In Nigeria, for example, the comprehensive and integrated sexual rights and reproductive health and rights (SRHR) agenda found in the Maputo Plan of Action has been side-tracked.
The MDGs have created silos of intervention in development strategies and plans. Government programmes and official projects are focused on targets and indicators, and less concerned about inter-sectoral approaches and complementarities. In their worst incarnation, the MDGs are a dangerous demographic numbers game.
Maternal mortality rate narrowly channels concern about deaths, instead of also calling attention to the serious range of morbidities and injuries women face in pregnancy and in the course of their sexually active and reproductive years.
There is the creeping return of family planning and population control discourse. While some NGOs engage with the MDGs to direct discussion to SRHR issues, a growing number of funders and other stakeholders follow the MDG5 bandwagon taking along a revival of pre-ICPD population control and population-management language that is often directed at the poor.
The maternal health focus of local-level SRHR programmes has also subtly ignored and excluded the unmarried and younger population groups, without recognizing their rights to access contraception. In Mexico, the Federal Health Ministry issued a specific action plan ordering the public health system to address the reproductive health of teenagers, but few steps have been taken to enforce it. The youth also tend to be neglected when links between the MDG on reducing HIV/AIDs and the MDG on gender equality are weak. The link to safe abortion, which is of particular importance to young women, is perhaps one of the weakest within the silos of the MDGs.
Donor influence also facilitates fragmentation into policy and programmatic silos. In contexts where aid is the main (if not exclusive) source for funding for specific MDG-related programmes and projects, as in the case of Nigeria, governments take on a donor’s preferred focus instead of being in a position to make lasting investments in health infrastructure and quality of care.
In 2015, both the MDGs and the ICPD POA will end. Even now, decisive steps need to be taken to rescue maternal mortality from the MDG 5 silo. DAWN calls on world leaders to resurrect, reconfirm and return to centre-stage the more holistic and integrative rights-based SRHR agenda of the ICPD.