Washington D.C., 5 June 2019 (PAHO/WHO) - Teenage pregnancy, domestic violence and intercultural dialogues were some of the main focuses of a discussion hosted by the Pan American Health Organization (PAHO) at the 2019 Women Deliver Conference in Vancouver, Canada, on 4 June.
The panel, which featured Dr. Isabella Danel, the Deputy Director of PAHO and Dr. Gabriela Montaño, Minister of Health of Bolivia, discussed some of the primary issues addressed by the “Integrated Health Systems in Latin America and the Caribbean Project” (IHSLAC), a joint initiative of PAHO and the government of Canada.
“If we really want to improve the health and well-being of women and girls, we must look at the fundamental issues affecting their health, including gender equality,” said Danel. “It is fundamental that women have a voice, become more involved and can represent themselves,” she added.
During the panel, participants heard testimonies from three adolescent mothers from Guyana, a country where 22.4% of pregnancies occur in women under the age of 18.
Through the IHSLAC Project, PAHO is supporting the Guyanese Ministry of Health to create the conditions for adolescent mothers to empower themselves and have access to available family planning services in order to prevent second pregnancies. The project has already provided more than 1100 family planning methods to women in Guyana since 2016, which has had a huge impact on adolescent health.
For Selina, an empowered adolescent mother who accessed contraception from an adolescent-friendly unit run by the Ministry of Health, “I am not ready for a second child and will try as much as I can to prevent it. I want my own business. I know it is hard work but, I am willing to do whatever it takes to make sure I have my own business in the future.”
The panel also highlighted the project’s work to address domestic violence, which can lead to long-term health complications for women, including physical injury, mental health disorders, reproductive health problems, sexually transmitted infections and unwanted pregnancy.
Jose Bejarano, Municipal Mayor in Yamaranguila, Honduras, referred to women empowerment and economic independence as key to eliminating domestic violence: “For us it is very clear that the issue of domestic violence will be reduced as women gain economic independence…this is how we approach this issue,” he stated.
In Honduras, the IHSLAC Project supports several self-help groups that are run by local authorities and organizations to empower women in the community. According to Patricia Perez, a domestic abuse survivor and women’s advocate in Yamaranguila, the groups have been “one of the strongest tools through which we have recognized the way we were living before and how we have come out of it (domestic violence), as we have taken a step to success (economic independence)."
Domestic violence is not only an issue exclusively concerning women. Min. Montaño affirms that “if women and men, alike, are not involved in decision making processes around issues of domestic violence, we would only be giving partial solutions to the problem.”
“Health services are the first point of contact to identify domestic violence,” said Dr. Danel. “The health sector can also play a key role in prevention by involving men in health services, particularly reproductive, prenatal and maternal health, and using this as a means of promoting other forms of masculinity, gender equality and more respectful relationships between men and women.”
The final topic discussed during the panel, was the IHSLAC Project’s work on intercultural approaches to women’s health care in indigenous communities. Although health outcomes have importantly improved in the region, Dr. Danel emphasized that this region has some of the greatest health inequities in the world, indigenous populations particularly affected. “That is why the idea of leaving no-one behind is so critical for this region,” she stated.
Maternal mortality is higher in indigenous peoples due, importantly, to discrimination and a lack of access to culturally appropriate services. Minister Montaño made a call to action that states, “need to have the capacity to integrate all these different ways of life within our health system so that we may reach universal health.”
The IHSLAC Project has supported inter-cultural dialogues whereby indigenous communities and services providers understand and respect different cultural perspectives and knowledge about health and health services. As a result, these have been strengthened by culturally adapting them.
A woman from an indigenous community in Bagua, Peru, was satisfied with the services she accessed. “When I came to this health center in Chiriaco for my two births, the care was the best. I am very happy with the care I have been given,” she said.
The IHSLAC Project
This project is the latest in a series of collaborations between PAHO and Global Affairs Canada (GAC), which focuses on the health of women, children and adolescents, thus serving as a vehicle to advance PAHO’s mandate for health equity, as well as gender and ethnic equality in health.
"Since the implementation of Canada’s Feminist International Assistance Policy (FIAP), there has been a much stronger focus on gender equality and human rights. Thanks to the IHSLAC Project, we have really learned a lot about how to ensure that gender equality and human rights are a cross-cutting element in the work we do,” said Dr. Danel.
For Minister Montaño, there is no magic wand that will solve everything in one go, but “progress towards universal health fundamentally transforms the lives of women in our countries. We cannot advance the sustainable development agenda if fundamental steps are not taken to ensure equality towards women. If there is no equality for women, there can be no development, let alone sustainable development.” This is the main issue addressed by the IHSLAC Project.
