JRD Tata Memorial Oration Statement by
Dr. Babatunde Osotimehin
United Nations Under-Secretary-General
UNFPA Executive Director
“Dignity and Choice for girls and women in the post-2015 framework”
4:00 – 6:00 p.m.,24 April 2015
India Habitat Centre
Distinguished guests, dear friends, ladies and gentlemen, Good afternoon! It is a pleasure to be back in the beautiful city of New Delhi and an honour to deliver the JRD Tata Memorial Oration.
JRD Tata was a man of great vision, diverse interests and extraordinary achievements — India’s first licensed pilot, a successful businessman, and committed philanthropist.
He dreamed of an India where every family is planned and every child is healthy and wanted. This vision aligns perfectly with our mission at the United Nations Population Fund, UNFPA, to deliver a world where every pregnancy is wanted, every child birth is safe and every young person’s potential is fulfilled.
So let me begin by thanking the Population Foundation of India and its Executive Director, Ms Poonam Muttreja, for organising this important event and inviting me to be with you, butmost importantly, for the work that they do every day to help realize JRD Tata’s vision, which, at its heart, is about ensuring dignity and choice for women and girls, the subject they have asked me to speak about today.
Last year, the world marked 20 years since the historic Cairo International Conference on Population and Development — historic because it was at this time that the world endorsed a human rights-based approach to population and development, an approach based on the realization of dignity and choice for everyone, and particularly for women and girls.
The ICPD Programme of Action marked a shift in focus from human numbers to the quality of human lives, and particularly, to ensuring universal access to sexual and reproductive health and the realisation of reproductive rights.
In Cairo, delegates from all regions and cultures recognised that empowering women and girls and enabling them to make informed choices about their bodies and their lives is both the “rights” thing to do and the basis for individual well-being and sustainable development. The delegation from India, with members from both civil society and government, was an important player in achieving this forward-looking consensus.
A year later in Beijing, world leaders reaffirmed that women’s rights are human rights and committed themselves to developing the fullest potential of girls and women, and ensuring their full and equal participation in decision-making and in the development process.
The 20-year reviews of the Cairo and Beijing agendas show that we have made considerable progress over the past two decades. They also show that we still have a long way to go to ensure dignity and choice for all, to achieve gender equality and to realise Mr. Tata’s dream and the vision of Cairo and Beijing.
Today, I would like to talk about some of the findings of the ICPD beyond 2014 review that illustrate our progress, but also point to some of the challenges and opportunities both in India and globally for the realisation of dignity and human rights, which are the foundation for a resilient, sustainable future.
The results of the ICPD review reveal substantial gains over the two decades since Cairo:
Adolescent girls are particularly at risk in the poorest communities. More girls are finishing primary school, but they are facing challenges in accessing and completing secondary education. Supporting their aspirations – and the aspirations of all young people – is key. We need to ensure that the most marginalized women and adolescent girls are afforded choices that enable them to lead dignified, productive lives – not least the choice to plan the number, timing and spacing of their children.
We know that access to comprehensive reproductive health services, including voluntary family planning, saves lives, protects women’s health and helps unleash the power of women to contribute to their societies and drive sustainable economic growth.
But 225 million women living in developing countries want to avoid pregnancy and are not using modern contraception. That is equivalent to the entire population of Brazil.In India, over 13% of married women have an unmet need for contraception. We need more progress. India has made tremendous progress in reducing maternal mortality. Maternal deaths in India fell 65% between 1990 and 2013 — well above the global average of 45% for the same period.
But as with the global picture, this positive overall trend masks significant inequalities when one looks at the data by wealth quintile. Let’s look at two critical reproductive health indicators closely related to women’s dignity and choice: skilled attendance at birth and contraceptive prevalence. Most obstetric complications could be prevented or managed if women had access to a skilled birth attendant – doctor, nurse, midwife – during child birth.
The proportion of deliveries attended by skilled health personnel rose in developing countries from 56 per cent in 1990 to 67 percent in 2011. India has also seen steady upward progress, but if we look at skilled attendance by household wealth quintiles, we see tremendous inequality. In the wealthiest quintile, skilled attendance at birth was around 85% in 2005. For the poorest quintile, the figure was around 13%.
These disparities in India and elsewhere illustrate the limited capacity of many health systems to meet the sexual and reproductive health needs of poor women, particularly those living in rural areas or dense urban slums. If we look at trends in contraceptive prevalence, we see a similar picture. Globally contraceptive prevalence among women aged 15 to 49 who are married or in union rose by around 10 percent between 1994 and 2012 — from around 58 percent to around 64 percent. India’s overall contraceptive prevalence has seen a slow but steady upward trend over the same period. But again, when CPR is disaggregated by wealth quintile, disparities emerge. In 2005, 35% of the poorest Indian women of reproductive age were using contraception, while nearly 60% of women in the richest quintile were. In most countries the distribution of contraceptive prevalence by household wealth quintiles is more equitable than the distribution of skilled birth attendance, with greater outreach to the poor.
This is most likely because contraception is easier for weak health systems to offer than skilled birth attendance, as it does not necessarily depend on the availability of skilled health workers. Let’s turn now to contraceptive method mix. Twenty years ago, the global contraceptive method mix was dominated by female sterilization and the intrauterine device, at 31 and 24 percent respectively, followed by pills at 14 percent. Today, these three methods continue to dominate, but they are accompanied by greater diversification of female methods, including increased use of injectables and implants, and rise in the use of male condoms. Because clients differ in their method preferences and clinical needs, for health or other reasons, which may vary over their life course, a range of distinct contraceptive methods is a hallmark of safety and quality in human rights-based family planning services. Typically, the greater the range of choices, the greater the overall use. Choice means ensuring the quality of service for all contraceptive methods.
Choice means the ability of fully informed men and women to choose freely from among a full range of modern contraceptives, without incentives or coercion of any kind. Choice means surgical contraception is always administered in safe and sanitary conditions. Female sterilization still accounts for 76% of all contraceptive use in India. Greater efforts to expand contraceptive choice and ensure quality of service and accountability must be part of broader efforts to provide rights-based quality health services. UNFPA stands ready to assist, in partnership with the Government and other stakeholders,in bringing about any policy, procedural or legal reforms necessary to ensure quality of service and expand women’s choices.
We have seen enormous progress since Cairo, and under the framework of the Millennium Development Goals,but as we embark on a new era for development, there is no room for complacency.
Human rights, dignity and choice must remain at the centre of our efforts. Sexual and reproductive health and reproductive rights are the foundation on which women and girls build a life of choices, empowerment and equality. And they are the cornerstone of sustainable development.
These rights must be protected even in the most difficult circumstances. UNFPA and our development partners face an unprecedented number of complex challenges – from the protracted conflict in Syria to the eruption of conflict in South Sudan…from the Ebola outbreak in West Africa to the epidemic of gender-based violence facing women and girls worldwide. From the brutality of Boko Haram in Nigeria to the viciousness of ISIS in Syria and Iraq… the human rights and dignity of women and girls are increasingly under threat. Women are the backbone of their communities’ resilience.
Time and time again, they sustain their households during difficult times. Of the women and girls caught in the Syrian crisis, more than half a million are pregnant and in desperate need of reproductive health and protection services. When a crisis strikes, skilled birth attendance, emergency obstetric care and access to family planning services often become scarce or unavailable and violence against women and girls increases. UNFPA is committed to delivering effectively in a range of emergency settings and to preventing and addressing the impacts of gender-based violence.
Our frontline staff and partners provide life-saving maternal health care, family planning, protection and counseling to ensure that the dignity and choice of women and girls are assured even in the most difficult settings. To take just one example, in the Zaatari refugee camp in Jordan more than 120,000 women have received reproductive health services from UNFPA-supported clinics. UNFPA has assisted 3000 births in Zaatari to date and none has ended in the death of a mother or child. And we will continue to strengthen our humanitarian work because we know that protecting the sexual and reproductive health of women and girls not only protects the human rights and dignity of individuals; it also reduces risks and builds countries’ resilience. Let me turn now to another priority area for UNFPA – young people, particularly adolescent girls.
One of the fundamental questions facing many countries, including India, and indeed the world, is how to ensure that today’s largest-ever generation of young people have what they need to fulfil their potential and contribute to the growth and development of their countries. Many countries have a window of opportunity to reap a demographic dividend of rapid economic growth, as their working age population grows relative to younger and older dependent populations. East Asia’s investment in the human capital of its young people starting in the 1960s enabled the region to realize its demographic dividend, contributing to a six percentage point surge in GDP and a quadrupling of per capita incomes in some countries.
A demographic dividend is not automatic, however. It only occurs if countries make time-bound investments to empower, educate and employ their young people before they enter the workforce, and ensure an investment climate and labour policies to expand and sustain safe and secure employment. The window of opportunity is time-limited, but it is now open for many young economies in Africa and Asia. With the world’s largest youth population, the opportunity for India is enormous. The cohort of young people currently moving into the 15-64 age bracket will increase India’s working age population to a staggering 908 million by 2020 And the demographic window is expected to last until 2040.
Investments in young women and adolescent girls are particularly critical as they face more obstacles than young men and boys in building their capabilities, seizing opportunities and enjoying their rights. Right now, in Niger or Nepal, Mali or Mozambique, Bangladesh or Uttar pradesh, there is a young girl at a critical turning point. She is 10 years old, with her entire life in front of her. Yet in a year or two, she might be married and out of school, another year after that pregnant, and this could start her on a path that we have seen all too often – to early child bearing, ill-health, lack of control over her life or protection from violence, lack of choices, with few prospects of achieving her full potential or developing her capabilities for herself, her family and her society. Empowering that 10-year-old girl to delay childbearing, prevent adolescent pregnancy, and avoid early marriage, and enabling her to stay in school and gain the skills she needs to transition into gainful employment is vital.
Public support for the empowerment of women is changing in much of the world, but perhaps not quickly enough. In India, as in most countries, there is more public support for the equal rights of boys and girls to education, than for their equal rights to employment. And overall, the proportion of those who support equal rights for girls in India — whether in education, jobs or politics — is lower than in most countries. Data from the World Values Survey collected in 2004-09, from a random sample of 2000 adults across 18 states accounting for 97% of the population, found that around 55% of adults in India believe that a university education is as important for girls as for boys.
Positive as that is, this value is lower than that recorded in 43 of the 47 countries sampled, meaning that public opinion in India is less convinced of the equal value of education for girls and boys than elsewhere in Asia, in most African countries, and in all the countries of Latin America and Eastern Europe. When asked if jobs are scarce, should men have greater rights to a job than women? 80% of those sampled in India agree.
There is greater support for gender equality among women than men, but the difference is small. And yet, women are a crucial part of the workforce in India, representing close to a third of the active labor force. This is lower than in China (82%) and Brazil (72%), but still significant, and crucial to the fiscal security of millions of families. Yet, there are challenges for the dignity and safety of women within the labour force as well.
The majority of women work in the informal sector, with low wages, limited security, and no benefits – what is called vulnerable employment. Most are unskilled – reflecting low levels of education; in 2010, an estimated 65% of working age women in rural areas lacked primary school education.
India is on the cusp of having a large working-age population with fewer dependents, providing a time-bound opportunity to reap a “demographic dividend” from their age structure. But such a dividend will only be possible if the working age population – both men and women – have the good health, the training and the opportunities for secure employment. I know that India has outlined a strong commitment to capitalizing on the potential dividend through skills development, and partnerships across the private sector. These are exciting developments, and they hold promise for millions of young workers.
But the rights and freedoms of women, their dignity and choice, must be part of this formula for India to succeed. We at UNFPA are encouraged by the prominent attention the government has given to ending the gender-discriminatory practice of sex-selection and to providing economic incentives to save India’s girls, through the government’s Beti Bachao Beti Padhao programme and other initiatives. Prime Minister Modi has spoken passionately and publicly about the scourge of violence against women and the discriminatory attitudes that encourage it.
It is notable that the Government of India has mandated a health sector response to sexual assault and violence. It is equally important that the health sector and health personnel be sensitive to the causes and consequences of gender based violence and tackle this as a health issue.
This would make for a powerful addition to India’s Reproductive Maternal Newborn Child and Adolescent Health programme, because domestic and other forms of violence against women greatly affect reproductive health outcomes. Such initiatives are critical if we are to change the harmful practices and social norms that jeopardize the health and well-being of women and girls, keep them from reaching their full potential, and serve as a drag on development. No country can advance while leaving half its population behind. UNFPA looks forward to exploring new opportunities to expand and deepen our collaboration with the government and other partners in India, including the private sector.
This evening, in partnership with the Tata Institute of Social Sciences, we will be launching a Centre of Excellence on Youth and Adolescents to improve the availability of relevant knowledge, services and data, enable informed policies and investments, and informed choices by young people.
This includes a Research and Development Centre that will serve as a critical knowledge hub on adolescents and youth and online platforms to provide cutting-edge data, information and services on and for young people. The Centre will engage actively with South Asian and other international centres and universities, fostering regional and South-South cooperation. We know that by unleashing the power of people, particularly young people, enabling them to exercise their rights and contribute to and share equally in the benefits of development, we can advance dramatically towards realizing the dignity and human rights of all.
This year, around the world, over 59 million girls will turn 10 years of age. So, as we embark on an ambitious, universal post-2015 development agenda to follow the Millennium Development Goals, we have 59 million chances to do it right, to catalyze the dramatic transformations they – and we – so desperately need. We know what we can achieve with the right investments in our young people. JRD Tata did as well, funding post-graduatescholarships for promising Indian students, investing in the health and education of women and children, empowering the poor and vulnerable. “Money is like manure,” Mr Tata said. “It stinks when you pile it; it grows when you spread it.” Words to live by in our increasingly unequal world… Sexual and reproductive health is one of the most cost-effective yet neglected investments in international development. Education, including comprehensive sexuality education, is one of the best investments countries can make.
If we enable a girl’s birth to be welcomed in the same way as her brothers’, If we keep girls in school and out of marriage, If we give them access to the information and services they need to avoid motherhood in childhood, If we protect them from violence and harmful practices, If we equip them – and their brothers – with skills and opportunities to participate in the workforce and in decision making, they will transform their communities, India and the world. The formula is simple: Empower, Educate, Employ! The time is now. Thank you.