PROFILE
AMANITARE and African Women's Sexual and Reproductive Health and Rights
Jessica Horn
Introduction
AMANITARE, [1] the African Partnership for the Sexual and Reproductive Health and Rights of Women and Girls, is a pan-African network that brings together the voices and expertise of organisations and individuals across Africa working on women's sexual and reproductive health and rights (SRHR). The launch of the Partnership in 2000 was compelled by the need to confront the devastation of HIV/AIDS, the disturbing prevalence of sexual violence, persistent lack of access to health services and the ongoing tragedy of high maternal mortality rates, among other gendered thorns in the side of Africa's development. The Partnership seeks to support legislative and policy reform, while popularising awareness and activism on sexual and reproductive health and rights, particularly among Africa's young people (AMANITARE, 2000). Motivated by a concern with strengthening regional commitment to women's rights, AMANITARE seeks to transcend the linguistic and geo-political boundaries that divide the continent, and welcomes participation and activism across North and sub-Saharan Africa. The Partnership is ever-growing, with a current membership of 51 organisations and individuals from 18 African countries.
The idea of AMANITARE came from a realisation of the need to consolidate and develop the work being done on various aspects of women's health, gender equality and the prevention of violence in the African region. The conceptual foundations and programmatic scope of the initiative were developed among organisations across Africa through a process of research and dialogue aimed at creating an inclusive, dynamic and effective partnership. This preparatory process laid the foundation for an initial consultation meeting, attended by 39 members, which took place in Kampala in February 2000. Participants were committed to addressing the violence and compromises that frame many African women's lives, and to strengthening expertise and sharing information about solutions. Focusing on the future, participants affirmed the need to support a deeper engagement with Africa's young people on issues of sexuality, gender and health at both policy and programmatic levels.
The group agreed on a mandate drawn from the outcome documents of the World Conference on Human Rights (Vienna, 1993), the International Conference on Population and Development (Cairo, 1994), and the Fifth World Conference on Women (Beijing, 1995). All of these documents established sexual and reproductive health, freedom from gender-based violence, and women's rights to control their sexuality and reproduction as fundamental human rights. While these documents have been signed by many African states, many AMANITARE Partners and other African activists have been lobbying for their translation into practice.
In its core principles and values, the AMANITARE Partnership affirms the rights of all women, regardless of citizenship, class, age, culture, religion, marital status, ethnic identity, sexual orientation and physical and mental ability to:
· bodily integrity and sexual autonomy
· sexual enjoyment and healthy reproduction
· protection from the threat of death or disease as a result of their reproductive functions
· freedom from coercion, violence or punishment as a means of controlling their sexuality and fertility.
Sexual and Reproductive Health and Rights (SRHR) in the African Context
Reproductive health, and to a lesser extent, sexual health, have been on the African policy radar for decades. But the issues have been dominated by campaigns for safe motherhood and family planning, with public debate and policymaking focusing mainly on women's prescribed roles, and ignoring many of their rights to choice and individual freedoms. Furthermore, the single-issue policies resulting from many earlier campaigns have failed to tackle the complicated nexus of gender inequality, cultural norms and poverty in which sexual and reproductive health concerns are rooted [2] . The effectiveness of such policies has also been undermined by the introduction of health sector reforms led by the World Bank. These have promoted privatisation and user fees, and have created further barriers of access to health services for the economically impoverished, in particular women (see Ravindran et al, 2003).
In the face of these reductionist trends in health policy, African women's health advocates, activist lawyers and feminist scholars in many parts of the continent have sought to broaden the sexual and reproductive health agenda and to develop more holistic policy frameworks. The localised analysis and activism of the 1980s gained momentum and cohesion in preparation for the historic trilogy of the Vienna, Cairo and Beijing conferences. Through workshops, conferences, information campaigns and demonstrations, women's groups across Africa began to mobilise around violence against women, HIV/AIDS, female genital mutilation and reproductive choice, positioning these as part of a broader women's rights and development agenda for the region. Alliances with the international women's health and women's rights movements strengthened this work, and helped to craft SRHR as a global policy agenda.
The growth of debate on SRHR in Africa has unfolded against a backdrop of regional rejuvenation, with the launch of the African Union and a new discourse of "African Renaissance" promising greater progress towards democratisation and social justice. For African women's rights activists, these promises have raised questions around whether the continental "rebirth" will support the recognition and fulfilment of women's rights, or simply the "rebirth" of African patriarchies, amplified by an equally patriarchal global world order. There are clearly grounds for this scepticism, given the relative absence of women's rights from documents such as the New Partnership for Africa's Development (NEPAD), the continued presence of discriminatory customary laws, and an overall dearth in women's representation in national governments and legislatures. The Protocol on Women's Rights in Africa adopted by the African Union this July presents a hopeful advance in regional policy. It affirms state responsibility to protect sexual and reproductive health and reproductive choice, and to combat violence against women and discriminatory cultural norms.
The entry of "rights" into the often technocratic domain of reproductive health has meant a re-politicisation of health, reproduction and sexuality. Indeed, the conceptual and practical contributions of women's rights activists have positioned these concerns firmly in the realm of social and economic justice, and, ultimately, at the centre of the achievement of democracy (McFadden, 2002). Advocacy on sexual and reproductive rights has also prompted an interrogation of women's rights in the private realm of the home and family relations, a realm that is often sealed off by naturalised cultural dictates about women's bodies, sexuality and life choices. At a micro-political level, the concept of "rights" is transforming self-perceptions and organising strategies by supporting women's rights to choice and their own sense of entitlement to bodily integrity and social autonomy (Butegwa, 1997). The sexual and reproductive rights framework has also underscored the need for a gendered redistribution of resources, responsibilities and possibilities (Klugman, 2000). The process of redistribution includes the need for men to take greater responsibility for care work, as well as the strengthening of women's participation in the formal economy and in policymaking processes. Strategies of engaging the private and personal as well as the public and collective are key strengths of SRHR activism. These multiple levels of engagement provide a progressive framework for developing holistic policies that focus explicitly on women's freedoms and choices.
Supporting a Culture of Rights
The AMANITARE Partnership is named after Queen Amanitare, a queen of ancient Nubia, and invokes a legacy of African women's leadership and agency. Queen Amanitare is symbolic of an alternative genealogy of rights that stretches beyond the acknowledged Euro-American history to recognise the contributions of African women to the theory and practice of human rights. Through its advocacy, training and publications, AMANITARE seeks to challenge conservative defences of "culture", "religion" and "community" as the basis for denying women's rights, while developing alternative definitions of African womanhood premised on principles of autonomy, bodily integrity and gender equality.
The vision of the Partnership is to open greater space for discussion of often-silenced issues of sexuality and reproduction. The emphasis is on empowering women and girls by providing information about their bodies and tools for analysing the laws, policies and social practices that affect their well-being. Convinced of the need for integrated measures to address SRHR, AMANITARE promotes activism and reform on all issues affecting African women's economic, social and political rights. The Partnership challenges existing policy frameworks that support vertical interventions and restrictive economistic approaches to development. In so doing, it acts on the conviction that economic development, poverty eradication and democratisation on the African continent cannot be achieved without the realisation of women's rights to be free from violence; to have access to appropriate health services and information; and to make informed choices regarding their sexuality and reproduction.
The struggle for African women's rights to autonomous decision-making regarding their bodies has not gone unchallenged. The agenda of SRHR has generated conflict between African women's rights advocates, who situate their work within histories of women's resistance, and conservative commentators, who define the agenda of SRHR in Africa as an index of misguided "Westernisation". As Nahid Toubia observes "[t]he notion that a woman is the sole owner of her body and all the decisions that concerns it … is often attacked as too 'individualistic' and against 'African communal sensibility'" (2002: 10). In confronting the use of "tradition" to deny the rights of African women, the programmatic activities of AMANITARE promote critical reflection on cultural discourses and gender norms that affect SRHR in different local and national contexts.
Despite conservative opposition, AMANITARE continues to affirm the relevance of women's sexual and reproductive health and rights in the African context, and to work towards the protection of these rights in national, regional and international policy and legislation. The Partnership's activities are guided by a twelve-member Technical Advisory Committee (TAC), elected by the Partnership, and are developed and managed by programme staff at Research, Action and Information Network for the Bodily Integrity of Women (RAINBO). AMANITARE partners contribute through involvement in three action groups: advocating for freedom from gender-based violence; integrating rights into health services; and reaching out to new generations by engaging Africa's young people on SRHR. AMANITARE's current work is organised around three objectives. The first involves building and maintaining the partnership, and giving support to partners through exchange and advancement of ideas, information and practical skills concerning issues of SRHR. Regular skills development workshops present an important opportunity to deepen analysis, exchange information and develop skills to advance the SRHR agenda, while promoting intra-African technical assistance and exchange. The workshops draw on expertise from within the Partnership and provide training on a range of topics, including the use of litigation in SRHR advocacy, the design of anti-violence programming and strategies for working with young women. Training contains discussion of international and regional human rights provisions, and an analysis of gendered power relations. It also encourages critical reflection on social norms and cultural beliefs regarding women's bodies, sexuality, reproduction and health.
A second set of goals centres around AMANITARE's role as a regional network. Here the Partnership advocates for regional SRHR policy reform and the implementation of progressive SRHR provisions established in international and regional agreements. AMANITARE supports the positive trends in regional policy on women's rights and gender equality. These are evidenced in policies on gender parity and mainstreaming in the African Union, and the election of a Special Rapporteur on women's rights by the African Commission on Human and People's Rights. AMANITARE has contributed language on SRHR for the Protocol on the Rights of Women in Africa, and is developing a body of work that engages NEPAD and ways of integrating SRHR into this "blueprint" for Africa's development.
A third aim involves impacting on international policy by facilitating African women's contributions to the UN and other global policy negotiations. At this level, AMANITARE highlights African perspectives in international dialogues around women's rights and gender equity. AMANITARE is currently co-ordinating African regional participation in the NGO Roundtable for the tenth anniversary of the International Conference on Population and Development, and an inter-regional project assessing "The Effects of Health Sector Reforms on Sexual and Reproductive Health and Rights", co-ordinated by the Women's Health Project in South Africa. In addition, focused research and writing, both in the AMANITARE newsletter and other publications, provide a forum for communicating African women's perspectives on international debate and policy change.
The concept of "celebration", as the assertion of positive rights to choice, autonomy and integrity regarding women's sexuality and reproduction, is central to AMANITARE's work. An emphasis on celebration is extremely important when we consider how colonial and post-colonial patriarchal discourses - ranging from mythology to policy - have worked to define and control African women's bodies and to undermine women's rights to enjoy their bodies. In the spirit of celebration, AMANITARE established African Women's Health and Rights Day, to be commemorated annually across the continent on the 4th of February. This day is an opportunity for NGOs, women's groups, youth organisations, activists, artists and government representatives to come together and highlight positive advances in SRHR, educate the community on new laws and policies, engage the media on SRHR issues and debate issues of current concern. Each year AMANITARE also presents an award to honour the work of an individual or organisation who has made a notable contribution to the SRHR of African women and girls. In all its activities and publications, AMANITARE encourages creative expression as a crucial medium for communicating the meaning, significance and positive potential of SRHR for African women.
There are many ways to be involved in AMANITARE's work. Membership is open to individuals and Non-Governmental Organisations (NGO's) who are committed to AMANITARE's principles and core values, and who seek to advance SRHR in their own area of work. For information on applying for membership, a list of AMANITARE partners and countries, as well as the newsletter, AMANITARE Voices, visit the website http://www.amanitare.org.
References
AMANITARE 2000. "Closing Statement from the First Consultative Meeting, 31 January - 4 February, 2000, Kampala, Uganda". See http://www.amanitare.org.
Butegwa, F. 1997. "Women Taking Action to Advance their Human Rights: The Case of Africa", Paper presented at conference "Strategies and Analyses from the ICCL Working Conference on Women's Rights as Human Rights", Dublin.
Hall-Martinez, K. 2003. "Maternal Mortality: A Violation of the Right to Life", AMANITARE Voices, 3. London: RAINBO.
Klugman, B. 2000. "Sexual Rights in Southern Africa: A Beijing Discourse or a Strategic Necessity?" Health and Human Rights: An International Journal, 4: 2.
McFadden, P. 2002. "Reproductive Rights and Sexual Freedoms: We Must defend Them at All Costs", AMANITARE Voices. London: RAINBO.
Ravindran, S. Kikomba, D. and Maceira, D. 2003. "The Impact of Health Sector Reforms in Developing Countries on Reproductive and Sexual Health Services: A Review", Initiative for Sexual and Reproductive Rights in Health Sector Reforms, Women's Health Project, University of Witswatersrand, South Africa. Draft Global Papers.
Toubia, N. 2002. "Editorial", AMANITARE Voices, 1. London: RAINBO.
Footnotes
[1] AMANITARE is a ten-year initiative of RAINBO, an African-led NGO that promotes and protects women's and girl's rights to sexual and reproductive health. For information on RAINBO, please visit http://www.rainbo.org.
[2] After decades of policy interventions, pregnancy-related deaths in Africa currently account for a disturbing half of the global total. Early marriage, the prevalence of violence against women (including practices such as female genital mutilation) and lack of access to safe abortion and pre- and postnatal care are factors contributing to the persistence of maternal mortality in Africa (Hall-Martinez, 2003).
Jessica Horn is a Ugandan/American living and working in London. She is AMANITARE Programme Officer at RAINBO, an African led NGO working to promote and protect African women's and girl's sexual and reproductive health and rights.