Population Action International

International Advocacy & Partnerships

Sharing PAI’s Voices: Shining a Light on the Future of Women’s Sexual and Reproductive Health in the Pacific

Located in New Zealand with a focus on the Pacific Island region, Family Planning International (FPI) has become one of the lead advocacy voices in the region, instrumental in improving access to family planning services and supplies and has developed research tools and advocacy skills that are invaluable to building capacity on sexual and reproductive health issues.

In 2007, PAI launched A Measure of Survival: Calculating Women’s Sexual and Reproductive Risk which assessed reproductive risk globally.  In 2009, partners in Kenya and in the Pacific Islands developed complementary regional reports that enabled them to use their own research and highlight specific regional needs.

Joanna Spratt
Family Planning International
Wellington, New Zealand
January 2010

Home to approximately 10 million people, over 20,000 islands make up the 22 countries and territories of the Pacific (excluding Aotearoa New Zealand and Australia). The islands are hugely diverse both culturally and geographically. Yet, when it comes to sexual and reproductive health, the Pacific faces similar challenges to much of the world. For the first time ever, the measures used to assess these challenges have been brought together into a sexual and reproductive risk index for Pacific women. Called A Measure of the Future, this resource is a catalyst for action.

measure of the futureA Measure of the Future is the result of a collaborative effort between Family Planning International, the Secretariat of the Pacific Community and Population Action International. It provides an excellent tool to gauge efforts to achieve the landmark International Conference on Population and Development Programme of Action (ICPD PoA).   A Measure of the Future builds on the work of Population Action International, by using their reproductive risk index methodology and adjusting it for the Pacific context. The resulting index provides a tool to assess which Pacific Island countries and territories, and which sexual and reproductive health issues require greatest attention to achieve sexual and reproductive rights for all.

The report explores the challenges preventing people from enjoying their full rights, choices and opportunities. It begins by highlighting the cross-cutting social determinants of health—poverty, urbanization, gender discrimination, geography and education, to name but a few. These determinants establish the context within which women exist, and contribute to whether they enjoy safe and healthy sexual and reproductive lives. The region’s predominantly under-resourced but over-burdened health systems are also discussed, including what needs to be done to build their responsiveness and accessibility.

Many Pacific Island Countries and Territories (PICTs) have alarmingly high sexually transmissible infection (STI) rates, some amongst the highest in the world. One study showed a prevalence of Chlamydia of 40.7 percent in under 25-year-old antenatal woman in Samoa. This situation is not only of great concern in itself but also increases the possibility of more HIV infections in the region. Unintended teenage pregnancies are also high, further highlighting the lack of access to quality sexual and reproductive health information and services. In the Marshall Islands the adolescent fertility rate is an astounding 138 births, while in several other countries it is in the high sixties.

With 56 percent of the population under the age of 25 years, these statistics highlight the discrimination against and neglect of young people who are the future of the Pacific. For teenage mothers in particular social and cultural taboos can lead to further discrimination and stigmatization, which in turn impacts young women’s willingness to seek necessary antenatal care assistance. This is especially so for women in outlying rural communities who have little or no access to health services.

Despite international research showing that as many as 13 percent of all maternal deaths are attributable to unsafe abortion, there is an almost no research exploring the relationship between unsafe abortion and Pacific maternal deaths. This continues in the face of ever-growing anecdotal evidence that unsafe abortions often occur in the region.

Every day across the Pacific, five women die because of predominantly preventable problems before, during and after pregnancy. A Measure of the Future is a resource that catalogues the long causative chain of these deaths, across a woman’s life-cycle. After fifteen years of action to achieve the ICPD PoA there is still so far to go.

Yet, A Measure of the Future is not all bad news. Several countries have made progress in improving women’s sexual and reproductive health. More good news is that we know what to do and A Measure of the Future holds many solutions, with recommendations throughout. The overarching message of the report is that PICT governments have made commitments to sexual and reproductive health and rights time and time again. Now it is time to honor them.