+Forced And/Or Coerced Sterilisation
of Women Living with HIV in Public
Health Facilities
ARASA PARTNERSHIP FORUM 2015
MARIDADI .K. Bernard Gift
PROGRAMS ASSISTANT
ICWEA
www.icwea.org
Presentation at the ARASA Partnership
Forum 2015
15th – 16th April 2015
The International
Community of
Women Living
With HIV&AIDS
Eastern Africa
+
The International Community of Women living with HIV Eastern
Africa (ICWEA) is a registered regional advocacy network and
membership based organisation”
Founded in 2005 to give visibility to women living with HIV.
ICWEA believes that gender inequalities and the limited access to
sexual & reproductive health & rights for women are at the heart of
the HIV epidemic.
Our advocacy is based on evidence of our daily lived experiences
and we use participatory processes to addresses the priorities of
women living with HIV, including young women.
Background
+
A world where all HIV positive women:
Have a respected and meaningful involvement at allpolitical levels, local, national, regional, andinternational, where decisions that affect our lives arebeing made;
Have full access to care and treatment; and
Enjoy full rights, particularly sexual, reproductive, legal,financial and general health rights;
irrespective of our culture, age, religion, sexuality,social or economic status/class and race.
Vision
+Where We Work in Africa
+
Creating safe spaces for women living with HIV to share their experiences;
What We Do
a young woman
making a presentation
during a meeting of
young women living with HIV
+
What We Do Cont’d... Giving
visibility to
WLHIV and
advocate for
comprehensive
quality
Prevention,
Treatment,
Care & Support
Services
ICWEA at ICASA and
facilitating a SRHR session at WNZ
+
What We Do Cont’d…Addressing
Gender and
SRHR at the
heart of
HIV&AIDS
pandemic
+What We Do Cont’d……
Advocating for the
protection of the
Human Rights of
Women living with
HIV including young
women
+What We Do Cont’d…
Challenging
unfavourable
policies, laws and
legal environments
+
What We Do Cont’d…
Representing
Women living
with HIV and
our issues
ICW at a Meeting with Obama Administration Staff
+What We Do Cont’d...
Building
capacity of
WLHIV
including
young
women
ICWEA hosting a meeting of key African Advocates
+
What we do Cont’d….Challenging
policy,
programmes
and funding
decisions,
actions and
mis-actions
+What We Do Cont’d…
Advocating for
increased
financing/fundi
ng particularly
by our
governments &
country funding
mechanisms
+Forced and/or Coerced
Sterilisation: Key Definitions
Sterilisation: may be defined as the performance of a
medical procedure which permanently removes an
individual’s ability to reproduce, and/or the administration of
medication to suppress menstruation.
“Forced sterilization” is a situation where a woman is
operated on without her knowledge or by force
“Coerced sterilization”: is a situation where a woman is
pushed or persuaded to sign a consent form
during distressing circumstances—such as during labor or
without being properly informed.
+Is Coerced and/or forced
Sterilisation happening?
From 2005 onwards, several cases of forced
sterilization of women living with HIV have been
reported for example in Kenya, Uganda and
Namibia among others.
In 2007, for instance, NACWOLA reported a case
involving sterilization of HIV positive women; one
of these women was a Sudanese Refugee and the
other two IDPs affected by the war in Northern
Uganda.
+Coerced &/or forced sterilisation real
Testimonies from participants during the SRHR trainings
under the ICWEA/ICWSA NORAD funded project-2010-2012.
(Political Voice for women living with HIV 2010)
In the PLHIV stigma index study (NAFOPHANU, 2013-
Uganda), 34% of PLHIV involved in the study reported
having been advised by health professionals not to have
children after being diagnosed HIV positive.
11% of the respondents reported to have been forced by
health workers to undergo sterilization because of their HIV
positive status
Note!! 1110 respondents were determined to represent
approximately 1.2m PLHIV in Uganda at the time.
+Coerced &/or forced sterilisation real
According to the PLHIV Stigma index assessment by
NEPHAK -Kenya 2011;
28.1% of 1086 respondents reported being
advised by a health care professional not to have
child
8.6% reported having been coerced In to
considering sterilisation
16 women (2.34% ) had felt /been coerced by A
health professional Into termination of A
pregnancy within the past 12 months.
+ICWEA unveils first cases of coerced &
forced sterilisation in Kenya & East Africa
Through our SRHR programme (2010 – 2012 in East
Africa, WLHIV unveiled that they were being forced
and coerced into sterilisation and this was being
heard for the first time.
In Kenya ICWEA hosted a Policy dialogue followed
by a media briefing & during the dialogue meeting
with several partners including funders one partner
Open Society Institute Eastern Africa (OSIEA
committed to supporting ICWEA get to the bottom
of this but later on worked with Africa Gender &
Media Initiative & over 50 cases of WLHIV who were
sterilized were revealed.“Robbed Of Choice”
+How does it happen?During an emergency cesarean section
Some HCW’s belief that WLHIV should not have
children or that they had too many children
already.
Spouse and/or parents gave consent for
sterilization on behalf of the women.
Misinformation by some HCW’s about their FP
choices or the risks of future pregnancies to their
health and that of their baby.
+ImpactAt ICWEA, we recognise that the practice constitutes
one of the worst form of violence for Women and
violates multiple human rights,
This action undermines the self-worth of WLHIV
and sense of identity as women and mothers.
Increasing women’s vulnerability to intimate
partner violence
Long term negative impact on mental health,
wellbeing, access to land and social economic
opportunities.
+What is being doneStrengthening institutional capacity of HIV-positive
women’s networks to document, monitor and
publicize HR violations Capacity building trainings
Dialogue meetings with Health workers
In Kenya Litigation has been opted and Kenya
Legal Netwok on AIDS working hand in hand with
WLHIV, ICW Kenya Chapter and ICWEA
In Uganda, ICWEA has undertaken a national
research and data is currently being analyzed
+Underlying challenges Its difficult to find women willing to endure the difficult process
of litigation
Lack of recognition amongst WLHIV & HCW of what constitutes
SRHR violations
Unfavorable legal environments
Denial from authorities that this is a systemic pattern, focus on
individual instances
Ignorance of the women’s SRH and rights makes them more
vulnerable to this violation!
Many women who are vulnerable due to HIV infection, are not
aware of the various laws and policies that protect them from
violence.
+Recommendations Empower women living with HIV to understand
their rights, fend .and demand for them
Family planning options must be available for all
including WLHIV and they should make their
informed choices
Deal with the negative attitudes of some Health
workers towards WLHIV reproductive choices
Support WLHIV to access redress, support and care
for those who have undergone C/F S
Governments should put in place SRH policies ,
disseminate to them and human rights charters, etc
+
Conclusions
Sterilization without informed consent is part of a
pattern of discriminatory violations of SRHR
experienced by women living with HIV. This has
been documented by ICW networks in at least 30
countries. Despite differences of geography, the
stories of women living with HIV who have
experienced coercive and/or forced sterilization
are very similar and are frequently reported in the
context of prevention of vertical transmission.
+
ICWEA@10: “Celebrating
Women living with HIV”
10 Years of Excellence in International,
Regional and National Advocacy!!!!
+ICWEA’s New Home
+Lillian with Stephen Lewis
+HE Festus Mogae-Botswana
+Other Guest in attendance
+UNAIDS Country Director, Board
Member & HE Festus Mogae
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