An Op-Ed by Ms. Bidisha Pillai, Country Representative, UNFPA Liberia
From 6 – 10 November 2023 Ministers, Government officials, parliamentarians, population experts, civil society representatives, and young people from 55 countries in the African Continent will meet to review and endorse the continental report on progress made 10 years since the Addis Ababa Declaration on Population and Development (AADPD + 10), tied to 30 years of the International Conference of Population and Development coming up in April 2024 (ICPD@30).
Liberia will also be present and will discuss progress made in key areas of the six pillars of the review: (1) Dignity and Equality; (2) Health;
(3) Place and Mobility; (4) Governance; (5) Data and Statistics; and (6) International Cooperation and Partnership. Collectively, the Continental review will track the progress individual member states of the African Union have made on the 81 commitments Governments signed up to earlier as part of International and Regional processes. The review, commissioned by the African Union Commission, is supported by the United Nations Population Fund (UNFPA) and the United Nations Economic Commission for Africa (UNECA).
The progress is benchmarked to the landmark International Conference on Population and Development held in Cairo, Egypt, nearly three decades ago, which put people’s rights at the heart of development. It affirmed sexual and reproductive health and rights as a fundamental human right, emphasizing that empowering women and girls is crucial in ensuring the well-being of individuals, families, nations, and our world. At the heart of the promise of the ICPD Agenda is the conviction that population is not about numbers, but people, and that women and girls must be placed squarely at the center of sustainable development. It adds that rights and choices are essential for everyone to live and thrive.
Since adopting the ICPD Agenda and its Programmes of Action, as well as the AADPD commitments, Liberia has undergone far-reaching changes to ensure access to quality sexual reproductive health and rights information and services in many areas. Among the most significant are the major shifts regarding reproductive health, family planning, and population growth. This has resulted in, among other things, a comprehensive concept of reproductive health, including family planning and sexual health, as defined in the ICPD Programme of Action.
A particularly encouraging phenomenon is the strengthening of political commitment to population-related policies, family-planning programmes, and investments to tackle gender-based violence and harmful practices in Liberia. This includes providing matching funds to UNFPA’s annual contribution for procuring reproductive health commodities; the availability of a costed family planning implementation plan; the development of evidence-based National School Health Policy; the development and integration of age-appropriate Comprehensive Sexuality Education (CSE) into the national curriculum for primary and secondary schools and in non-formal education and the recent ban on FGM.
The emphasis on data and statistics for development is encouraging, as seen with the completion of recent surveys such as the Demographic Health Survey (DHS), Census, and upcoming Information Management System for Gender-Based Violence (GBVIMS).
However, enormous inequalities and challenges persist. Almost a quarter (24 percent) of Liberia’s population comprises women of reproductive age (15-49 years). But many women and their families are robbed of the joy of motherhood as the death of women in childbirth and their newly born babies remains one of the highest in the sub-region: 742 per 100,000 live births and 63 per 1000 live births, respectively. Many women who survive difficult and prolonged labor often suffer debilitating childbearing injuries, including obstetric fistula, as only 31 percent of women who attend labour and delivery services receive quality care per WHO standards. Additionally, an estimated 33 percent of women who want to avoid pregnancy are not using safe and effective family planning methods for reasons ranging from lack of access to information or services to the lack of support from their partners or communities.
Adolescent girls continue to be disproportionally affected by harmful traditional practices. Approximately 85 percent of rape survivors are adolescents and very young children. Child marriage, Female Genital Mutilation/Cutting, and the pressure from parents for girl children to become breadwinners at an early age continue to affect adolescent girls’ development. In addition, the restrictive legal and policy environment has led to limited access to sexual and reproductive health and rights (SRHR) services by adolescents, in particular, the use of contraception. This is reflected by the low contraceptive prevalence rate among adolescents at 16.4 percent and a very high unmet need for family planning at 47 percent. The impact of this is reflected in the high teenage pregnancy rate at 33 percent and adolescent (15-19 years) maternal mortality at 32 percent of all maternal deaths.
Yet, change is possible, as we have seen with the programme on Empowered and Fulfilled for adolescents in 4 South Eastern counties in Liberia; modern contraceptive utilization among adolescents in the four counties increased from a baseline of 24.7 percent in 2017 to 66 percent in 2020. Overall, the incidence of teenage pregnancy (among 15-19-year-olds) reduced by nearly 50 percent in those counties during the same period. The program uses a three-access point model: health facility, community, and school to reach adolescents with a package of SRHR information and services through a multi-sectorial platform.
Achieving the ICPD agenda and commitments, therefore, is possible. In a young country like Liberia, where 75 percent of the population is under the age of 35, it is possible with the political will and investments in critical areas of adolescent and youth health and well-being; future-oriented education and skills development; employment and entrepreneurship opportunities; freedom from violence and harmful practices and the agency and empowerment to stand up for themselves and claim their rights. However, this must be backed by robust data and statistics to help plan and track progress.
It is possible with the right kind of partnerships between the government, multilateral and bilateral agencies, development partners, academic institutions, the media, and people themselves. Partnerships based on a shared vision for the country, trust, accountability, and leveraging complementing strengths, technical expertise, and resources.
From Cairo to Lusaka and beyond, Liberia is assured of appreciable success if it makes smart investments in empowering its adolescents and young people between now and 2030.