Friday, 6 June 2014

Inclusion or Exclusion of CEDAW's Concluding Observations on Health in Government Plans? The Case of South Asia

The booklet I have just published is a result of my experiment with researching and writing topics that I want to, rather than focusing on topics that I am commissioned to write by development agencies. At times they match, but other times it is just an “assignment”.

I have always been curious as to the extent to which the Concluding Observations of the Committee on Elimination of Discrimination against Women (CEDAW) (after reviewing reports of State Parties and civil society groups) is followed up by governments, and more so gets reflected in their development plans of government. I took the example of the health sector in South Asia and examined this aspect. 

I was also inquisitive as to whether global statistics - in particular sex disaggregated ones - are examined and implications analysed in national planning process. Again I took the example of health, examining the links between World Health Statistics (sex-disaggregated data in particular) on South Asia and the analysis within the health section of national development plans. The health plans of the following South Asian countries were examined: Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri-Lanka.

What were the findings? 

The health sections of most national development plans only partially take into account the Concluding Observations of CEDAW. The gaps were larger in countries recovering from conflict and where democratic spaces were lesser. The gaps between Concluding Observations and national development plans were largest with regard to ‘controversial’ issues like providing treatment to survivors of violence against women and providing abortion services. As well as for low priority issues like women's mental health or reproductive cancers. Further, the gaps were wider with regard to health/sexual and reproductive health of ‘controversial groups’ like unwed adolescent girls and women or women who were married but in other relationships. Gender-intensified aspects of quality of care were other issues, like access to confidentiality and privacy. To address this gap it is suggested that the CEDAW insists that governments incorporate comments on each sector into their national planning process, and report back to the CEDAW on how this had been done. 

It is also suggested that the CEDAW and the national governments together identity gender and health experts (well versed with the Convention), public health financing experts, women’ federations and women’s health rights groups who could be part of the planning process of the health section of the national development plan. 

Lastly, the national governments and other stakeholders, while planning the health section, must identify and analyse sex-­disaggregated data on health financing, health risks, health systems, health laws, health services and health outcomes.  In particular, barring two South Asian countries, per-capita private health expenditure (over 80% out-of-pocket expenditure) exceeds public health expenditure; and the trend of privatisation has been increasing in most South Asian countries.  Concluding Observations on health, critical analysis of gender and health statistics and national development plans must go hand in hand to combat gender inequalities in health in South Asia.

I decided to publish my booklet as an e-book (Kindle Direct Publishing on the Amazon Kindle Store) as I want to see if it can also fetch me an income, and I can pursue full time researching and writing what I please, but related to development, as a profession! I am also planning to publish the same through Amazon CreateSpace at the suggestion of Kindle Direct Publishing. 

By Ranjani.K.Murthy, IDS Alumni Ambassador for India

[1] Other than for sex selection.

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