Unplanned pregnancies: One of the biggest issues to tackle is unplanned and unintended pregnancies, especially in young people. This has resulted in what we call baby dumping in countries like Malaysia and Japan where unwanted infants are born to adolescent school-going girls and then thrown away. We have to ensure that girls and women have access to contraceptives and they are able to make informed choices about their bodily autonomy. There is need for comprehensive sexuality education for young people so that they get correct information on reproductive health early on, and are able to access services that will prevent them from having unintended pregnancies.
Gender and social inequity: It persists even in the rich nations of the region, like Japan. It is not just about inequities between urban and rural areas, or between the rich and the poor, but also inequitable access to SRHR services. Rich people may still have no knowledge about SRHR or they may belong to very traditional communities where they are not able to come out openly with regards to their sexual identity and their sexual and reproductive health needs. On other hand, people living in slums or unauthorised settlements in urban areas may not have access to government health services that are there for other communities.
Child rape: It is appalling to see that incidences of childhood rape cases are increasing in some of the region's countries. We have to raise more awareness on this issue and also collect data. People often try to hide such incidents and when we try to hide them, there is no way to tackle them openly. Very often governments also do not want to raise this issue. If we have stories and data to support it, that will make our cause even stronger. Perhaps the APCRSHR10 (10th Asia Pacific Conference on Reproductive and Sexual Health and Rights) platform can give us an opportunity to develop an initiative, similar to the #MeToo movement, and use social media to become the voice of these innocent and voiceless child victims.
Humanitarian /natural crises: Natural disasters and post conflict situations impact sexual and reproductive health services, and women are the worst sufferers. And yet more often than not they are neglected. Many member associations of International Planned Parenthood Federation (IPPF) are now working with governments, especially in countries like Myanmar, Philippines, Indonesia, and Pacific islands, so that in times of humanitarian crises they are part of the local networking and a part of the conversation to ensure that sexual and reproductive health services are accessible.
Vulnerable communities: We also have to look into the SRH needs of people with diverse sexual orientation and gender identities; people with disabilities-both physical and psychological and also the ageing populations, as many countries of the region, like South Korea, Japan, China, Thailand and Vietnam are ageing very fast.
What are the challenges in advancing SRHR in the region?
Tomoko Fukuda: People (including donors) assume that once countries develop economically, SRHR issues will also be solved. But this is not true of most countries of the region, including Japan. Donor interest has shifted from the region on the false assumption that since these countries have developed economically, SRHR issues too have been taken care of. This is a challenge for us. We have to raise our voices to say that SRHR is still very much an issue in various forms in all the countries of this region and that we need continued donor commitment to tackle it.
Then again, it is a challenge to ensure that governments really move towards delivering the promises made by them. A survey done by IPPF reveals that governments of 25 countries in east and south-east Asia and Oceania region, have committed to achieve SRHR partially: 12 countries have committed to comprehensive sexuality education, 5 have committed for gender equality, 14 have committed to sexual and gender based violence, and 12 have committed to universal health coverage. Also, some of the promises are either unclear or they are too aspirational in terms of promised deliverables. Pushing governments to make commitments that are clear on their outcomes and more tied to deliverables is a daunting task.
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