+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