Women’s empowerment in reproductive decision-making, the need of the hour | Sunday Observer
Medi Snips

Women’s empowerment in reproductive decision-making, the need of the hour

3 April, 2022

Q: Women’s International Year was celebrated last week, with the focus on empowering women in all aspects of life, to achieve gender equality and empower all women and girls.

The Sunday Observer spoke to Senior Lecturer in Paediatrics and Honorary Consultant Paediatric Neurologist, University of Sri Jayewardenepura/Teaching Hospital Colombo South, and former President of the Sri Lanka Association for Child Development ( SLACD) Dr, Saraji Wijesekara to get more insights into the whole issue of empowering women, why it is important and how we should set about it.

Since an important aspect of empowering women was related to Reproductive Health ( RH) our first question was to define Reproductive Health and what it involved.

Her reply was, “Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or weakness in physical or mental aspect, in all matters relating to the reproductive system and its functions and processes.

To our query as to why Reproductive Heath was important to empowering women and how educating women in this particular area could help her, she said, “Educating women in Reproductive health offers her the opportunity to make her own choices, whether in decisions over vital sexual and reproductive health matters, in nutrition, spacing one’s family – all of which would eventually lead to her overall well being”.

She said, “Reproductive health provides complete knowledge about the importance of nutrition in the girl child, early pregnancy, infertility, birth control methods, pregnancy, post-childbirth care of the baby and mother. This covers almost the entire lifespan of a woman making the empowerment of women in decision making all the more important.”

We next asked her what the common health issues associated with RH were. She said, “Any disease or issue that impact on her Reproductive health in general such as sexually transmitted diseases( STI’s) like syphilis, lack of proper birth control resulting in less spacing between pregnancies and compromising both mother and child, low birth weight of babies, physical abuse and rape.

Asked if there have been any studies on this aspect anywhere including Sri Lanka she said, “The World Health Organization has taken an initiative on this topic and many experts have highlighted the need for data on this subject. In Sri Lanka, some organisations have shown an interest to take up the task. Hopefully, in the near future, we might be able to see the results of much-needed research on reproductive health.

To a further question by Medi Snip that studies had proved that intimate relationships frequently occur between persons with vastly unequal power, while traditional expectations and norms toward women had negatively influenced women’s sexual power, restricting their choices on sexual matters with male partners, she said, “The unbalanced power dynamics in a relationship can affect the intimacy in a relationship with demand-withdraw,distance-pursue, and fear-shame dynamics. If the power dynamics do not balance out the relationship will break and as a result, we see many divorces.”

Was this a reason why many women especially in Asia lead less meaningful productive lives that are constantly exposed to fear of violence and intimidation? we asked.

“Yes of course.”, she replied, adding that recent data had shown that the underlying reason why most women in our region were affected was due largely to social and cultural issues.

Asked to comment on new facts from recent literature which revealed that there is a considerable dearth of official metrics for women empowerment, which is pivotal to observe universal progress towards Sustainable Development Goals 5, targeting “achieve gender equality and empower all women and girls, ‘’ her response was, “. I agree with this. However, the key stakeholders have initiated pathways to achieve this goal and research has been implemented.

Going on the World Health Organization definition that reproductive health and Reproductive health care aims to ensure that people have responsible, safe, and satisfying sex lives, and can decide if, when, and how often to reproduce, we asked if family planning was part of this?

In reply she said, Yes , family planning is definitely part of this. To give you an example, if a teenage girl decides to get married, it is always best to postpone pregnancy until she is physically and mentally fit enough to have her first baby. As she is still young and her body is growing, spacing between pregnancies is also important to enhance the health of the mother and the baby.”

Drawing her attention to what the WHO has described as the unmet needs for family planning and to elaborate more on this aspect, she said, “WHO has taken an initiative with this regard where they published a book in 1996 on available methods and how to use them. In 2016 the coverage is on the medical eligibility for contraception and implementing national programs

What age groups and categories of women are at the highest risk of facing such unmet needs? Teenagers? Adolescents? Middle-aged women? Married women? Migrant women?

Her reply was, “ I feel it’s mostly teenagers, adolescents, and migrant workers.

Asked if there was evidence to prove this with studies done she said,

Her reply was “There have been ad hoc studies done in different parts of the world. Accordingly, adolescent health has become a prime topic in the reproductive health

What about sexually active women who are at risk of developing Sexually transmitted diseases ( STI) like Gonorrohoea and syphyliis? What are the safeguards provided for them in our own country?

In reply she said, “Awareness programs on symptoms and signs of STI, availability of treatment and the ways of prevention are already in place for the public. STI screening is carried out at the booking visit of pregnancy clinics and treatment is offered. Anybody who wishes to walk into a STI clinic is welcome at all government hospitals.

So do men have a role to play here in helping women in decision-making capabilities ? If so, how? We asked.

Her reply was, “ Yes. They could be supportive of their partners allowing them to discuss their wishes on reproductive issues. Also to protect them from sexual abuse and promote the health of girls and women.

To our final question on a message to all women out there looking for ways and means to empower themselves whether by improving their life skills or by improving their Reproductive choices, she said, “ As women are literate compared to previous times they should seek for knowledge on reproductive health and look after their well being which in turn would be transmitted to the offspring. Also, they should empower themselves to improve their reproductive choices. The opportunities to improve their life skills are being communicated to the public via mass media, through clinics, and health care workers.