Improving Maternal Health and Sexual and Reproductive Health - Australia's Responsibility -
In: http://hdl.handle.net/1885/14005
The Millennium Development Goals, particularly the eradication of extreme poverty and hunger, cannot be achieved if questions of population and reproductive health are not squarely addressed. And that means stronger efforts to promote women's rights, and greater investment in education and health, including reproductive health and family planning. United Nations Secretary-General, Kofi Annan (United Nations Economic and Social Commission for Asia and the Pacific 2002) Poor sexual and reproductive health contributes significantly to poverty and the ability to participate in socio-economic development. It is the major cause of death, disability and suffering among women globally (World Health Organisation 2009). It is the poorest and least educated women who have the highest risk of death during pregnancy or childbirth (WHO 201 0). Targeted investments in reproductive health can have dramatic benefits for the economic and social health of communities. Recognition of the importance of maternal health has gained international momentum, particularly following the International Conference on Population and Development (ICPD) and the inclusion of Maternal Health and Sexual Reproductive Health (MH&SRH) in the Millennium Development Goals (MDGs), to which Australia is a signatory. There are eight goals, and MGD5 relates to reducing maternal mortality and achieving universal access to reproductive health. This target is central to achieving the other development goals. However, MGD5 is the goal that has shown the least improvement (WHO 2010). Funding for health initiatives mostly comes from government donors , and so monitoring funding levels of aid programs from donor governments verifies if governments are fulfilling their international obligations and treaties. It is within this context, as the 2015 MGD deadline draws closer, that this report has been written. The funding by the Australian Agency for International Development (AusAID) to MH&SRH is examined. This report was initiated with the premise that various donor agency health budgets would be comparable. However, the flow of international aid funds is complex. The recent implementation of the Paris Declaration on Aid Effectiveness has had an impact on the dispersion of aid, with the effect that it is now becoming more difficult to trace bilateral aid flows. Partly as a repercussion of this new form of aid dispersion, donor agencies have a regrettable lack of specific expenditure allocation because the recipient country now determines how the money is spent in line with their development priorities. There is the concern that core aspects of family planning such as contraceptive dispersion, counselling and comprehensive reproductive health information is not being provided. A comprehensive approach to MH&SRH maintains a degree of controversy within Australia and the United States (US). Access and provision for sexual education for young people, the availability of contraception, counselling, and safe and legal abortion services is met with some consistent opposition, despite the policy reforms by the US in 2008 and Australia in 2009. Therefore, the MDG and ICPD goal of 'universal access to reproductive health' is fronted with resistance. In terms of general aid, the gross level of Official Development Assistance (ODA) that Australia provides has been consistently below the average of other countries. Also, of the four national agencies examined, Australia contributes the least proportion of ODA to 'population activities', of which MH&SRH is a component. Australian contributions to family planning have declined significantly and consistently over the last ten years (Smith 2009). There is disproportionate funding support for Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) in relation to other reproductive health and family planning support. AusAID does not have a clear strategy or timetable for fulfilling their commitment to MH&SRH. The ICPD goals and MDGs cannot be achieved without the financial means to do so. Current funding levels are far below the targets needed to facilitate the achievement of these goals, especially for family planning and reproductive health. This report monitors Australia's contribution to achieving the financial resource targets agreed to at ICPD . It urges AusAID to consider their current spending priorities within the health budget, to ensure delivery of a comprehensive package of sexual and reproductive health information, supplies and services. We must place MH&SRH at the centre of health initiatives and harness the reinvigorated interest in MGD5 with more comprehensive funding.