Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694818543900.pdf (Australia)
Inquiry into the human rights issues confronting women and girls in the Indian Ocean – Asia Pacific region Submission by the members of the International Sexual and Reproductive Health and Rights Consortium 22nd May 2014 0 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 Inquiry into the human rights issues confronting women and girls in the Indian Ocean – Asia Pacific region Executive summary  The right to sexual and reproductive health is a fundamental human right, which includes: the right to liberty, autonomy, privacy and security of person; the right to access healthcare; and the right to non-discrimination in the allocation of healthcare resources and services1.
 Sexual and reproductive health and rights saves lives, empowers women, and lifts women and their families out of poverty.

Family planning is one of the most cost-effective investments in global health and development2.

 Despite numerous international and national commitments to sexual and reproductive health and rights, 800 women die every day due to pregnancy-related complications, and most of these deaths are preventable3.
Approximately 50,000 women and girls die annually as a result of unsafe abortions4.

Globally, over one in three women has experienced sexual and/or physical violence5.

 There are significant barriers to achieving sexual and reproductive health and rights for all, which range across cultural, legislative, social, financial and geographical factors.

Young people face multiple barriers to accessing high quality, youth-friendly sexual and reproductive health information, counselling and services.
 There have been great achievements in advancing women and girls’ sexual and reproductive health and rights in the Indian Ocean – Asia Pacific region, with a number of countries on track to reduce their maternal mortality ratio by three quarters in line with Millennium Development Goal Five.

Even so, large inequities are evident at both inter- and intra-national levels.
 Recognising that effective aid programming brings the best health and development outcomes, the International Sexual and Reproductive Health and Rights Consortium welcomes the Australian government’s commitment to delivering an effective Australian aid program.
 The International Sexual and Reproductive Health and Rights Consortium recommends that the Australian government considers: recognising sexual and reproductive health and rights as an integral component of any women’s empowerment initiatives; and increasing its foreign aid funding commitments for sexual and reproductive health and rights, with a focus on effective and efficient programming, accompanied by transparent monitoring.
1 http://www.unfpa.org/rights/rh.htm 2 http://www.guttmacher.org/pubs/gpr/13/2/gpr130212.html 3 http://www.who.int/mediacentre/factsheets/fs348/en/ 4 http://www.guttmacher.org/pubs/fb_IAW.html 5 WHO, (2013), Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non‐partner sexual violence.
1 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 The International Sexual and Reproductive Health and Rights Consortium The International Sexual and Reproductive Health and Rights Consortium is a partnership of non- government organisations, who have come together to advance universal access to sexual and reproductive health and rights6.
This submission is submitted on behalf of the following Consortium members: Asian Forum of Parliamentarians on Population and Development, the Burnet Institute, CARE Australia, Family Planning New South Wales, International Women’s Development Agency, Marie Stopes International Australia, Medecins Sans Frontieres Australia, Plan International Australia, and Save the Children Australia.

We welcome the opportunity to comment on human rights in the Indian Ocean – Asia Pacific region.
The right to sexual and reproductive health Sexual and reproductive health and rights is a broad concept that encompasses all matters related to sexuality and relationships, fertility and birth7.
Where sexual and reproductive health rights are fulfilled, all people - regardless of age, gender, marital status, sexual orientation or disability - are able to make choices which support a satisfying and safe sex life free from discrimination, coercion and violence, with the capacity and freedom to decide if, when and how often to have children.
The right to sexual and reproductive health includes: the right to liberty, autonomy, privacy and security of person; the right to access healthcare; and the right to non-discrimination in the allocation of healthcare resources and services.

As such, sexual and reproductive rights represent fundamental human rights8.
The right to decide freely the number, spacing and timing of children and have access to information and services needed to achieve this was adopted by 179 countries, including Australia, through the International Conference on Population and Development (ICPD) Programme of Action, and reaffirmed in the Millennium Development Goals, particularly as MDG5b.
In recent decades, sexual and reproductive rights have also been adopted and endorsed as fundamental human rights at: the 1981 Convention on the Elimination of all forms of Discrimination against Women (CEDAW); the 2012 London Summit on Family Planning; and, most recently, the 47th Commission on Population and Development.
6 The International Sexual and Reproductive Health and Rights Consortium comprises the Asian Forum of Parliamentarians on Population and Development, the Burnet Institute, CARE Australia, Family Planning New South Wales, International Women’s Development Agency, Marie Stopes International Australia, Medecins Sans Frontieres Australia, Plan International Australia, and Save the Children Australia.
For more information, please refer to http://isrhrconsortium.org 7 This includes, but is not limited to, family planning, safe abortion and post-abortion care, sexual and gender-based violence (including female genital mutilation), sexually transmissible infections (including HIV), cancers related to sexual and reproductive health, and maternal and perinatal health.
8 http://www.unfpa.org/rights/rh.htm 2 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 Responses to the terms of reference 1.
Barriers and impediments to enhancing the human rights of women and girls, especially regarding the high burden of sexual and reproductive rights violation in the Indian Ocean – Asia Pacific region Despite international commitments to sexual and reproductive health and rights as fundamental human rights, 800 women die every day due to pregnancy-related complications, most of which are preventable9.
In the developing world, the two leading causes of death for girls and women of reproductive age both relate to sexual and reproductive health: HIV/AIDS and problems that arise as a result of pregnancy and childbirth10.

Unmet need for family planning and safe abortion There are 222 million women in the developing world, including 140 million in the Asia Pacific region11, who would like to delay or stop childbearing but are not able to use an effective method of contraception12.
Unmet need for family planning and safe abortion services is particularly high among adolescent girls and young women, poor women (including the urban poor), and migrants and refugees13.

Of the 287,000 maternal deaths which happen annually due to pregnancy-related complications, almost 50,000 are a result of unsafe abortion14.
When women and girls cannot access high quality, comprehensive reproductive healthcare, there are substantial negative implications for: their own health and the health of their children; gender equality and women’s educational, economic and political participation; and poverty reduction15.

There are significant barriers to universal access to family planning and safe abortion.
In many countries, discriminatory legislation and policies limit access to essential, comprehensive sexual and reproductive health information and services, including family planning.

As a result, unmarried young women, adolescents, sex workers, sexual minorities, migrants and refugees are increasingly vulnerable to poor sexual and reproductive health outcomes.

Restrictive abortion laws are in place in 85 per cent of countries in the Indian Ocean – Asia Pacific region16.
In combination with limited access to reproductive healthcare, these restrictive and discriminatory laws result in over 13 million unsafe abortions in the region every year, violating women’s human rights and contributing to preventable death and disability17.

Weak health systems, financial barriers and lack of political investment also hamper access to high quality, non-discriminatory sexual and reproductive health services, particularly for poor and marginalised women.
Even where services are available, socio- cultural factors that support harmful gender norms continue to limit the ability of women and girls to make informed choices about their own health and wellbeing, including the prevention of unwanted pregnancy.
9 http://www.who.int/mediacentre/factsheets/fs348/en/ 10 http://www.who.int/mediacentre/factsheets/fs334/en/ 11 http://asiapacific.unfpa.org/public/pid/13199 12 http://www.who.int/mediacentre/factsheets/fs351/en/ 13 http://www.who.int/reproductivehealth/topics/family_planning/unmet_need_fp/en/ 14 http://www.guttmacher.org/pubs/fb_IAW.html 15 Cates W, (2010), Family planning: the essential link to all eight millennium development goals, Contraception.
16 http://worldabortionlaws.com/index.html 17 Sedgh G et al., (2010), Induced abortion worldwide in 2008: levels and trends, The Lancet.

3 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 A rights-based approach challenges these barriers, empowering women and girls to make informed choices about their own sexual and reproductive health and act as agents of change, rather than simply recipients of commodities and services.
Violence against women and girls Globally, more than a third of women have experienced sexual and/or physical violence, with some of the highest rates of violence experienced in the Pacific18.

Intimate partners are the main perpetrators of violence, with many women experiencing sexual and gender-based violence for the first time during adolescence19.
Sexual and gender-based violence has significant, negative physical consequences, and it can also result in unintended pregnancy, infertility, poor health outcomes for children, sexually transmitted infections (including HIV) and implications for mental health.

Violence perpetuates gender inequality and disadvantage, preventing women and girls from participating fully in education, economic and political life.
In addition, sexual and gender-based violence acts as a barrier to accessing sexual and reproductive health services, which are essential for the prevention and treatment of sexually transmitted infections and for women to space and limit their pregnancies.

The determinants of violence are complex, pervasive and inextricably linked with gender inequality.
Important risk factors for both violence perpetration and victimisation include: low levels of education; exposure to family violence as a child; harmful alcohol and drug use; and permissive attitudes towards violence and gender inequality20.

Additionally, a lack of political will, inadequate legislation and weak law enforcement hinder efforts to eliminate violence.
Women and girls who have been displaced by natural disasters and those living in conflict and post-conflict settings are particularly at risk for sexual and gender-based violence21.

Sexual and reproductive health and rights for young women and girls Adolescents and young people aged 10-24 years account for over a quarter of the population in the Indian Ocean - Asia Pacific region22.

For the majority of these young people, the transition into adulthood marks the onset of sexual activity.
However, many lack access to high quality, youth-friendly sexual and reproductive health information and services, which are essential in safeguarding their health and wellbeing.
Limited access to school-based comprehensive sexuality education, discriminatory health services and policies, and harmful socio-cultural norms mean that many young people in this region are denied sexual and reproductive health and rights.23 This is particularly true for adolescent girls who experience high rates of forced and coerced sex and poor access to family planning and safe abortion services.
Subsequently, young people are vulnerable to poor sexual and reproductive health outcomes; in 18 WHO, (2013), Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non‐partner sexual violence.

19 WHO, (2013), Global and regional estimates of violence against women: prevalence and health effects of intimate partner violence and non‐partner sexual violence.
20 WHO, (2013), Violence against women: Intimate partner and sexual violence against women.

21 http://www.who.int/mediacentre/factsheets/fs239/en/ 22 UN, (2012), World Population Prospects: 2012 Revision.

23 Bearinger L et al., (2007), Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential, The Lancet.
4 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 comparison with other age groups, young people experience the highest rates of sexually transmitted infections and unmet need for family planning24.

Despite commitments to end child marriage25, around 15 per cent of girls aged 15-19 years in the region are married26.
In South Asia, almost half of all young women are married before the age of 18 and 20 per cent are married by the age of 15, which increases their risk of sexually transmitted infection, violence and early pregnancy27.

Almost one in 10 girls in the East Asia and Pacific region and more than a quarter in South Asia give birth before the age of 18 years28.

Early pregnancy remains one of the leading causes of death of girls aged 15- 19 years29 and also has substantial socio-economic implications.
Early pregnancy, whether or not in the context of child marriage, often leads to the premature end of schooling, which denies girls’ right to education.

In turn, this limits their future participation in economic and political life, and contributes to an inter-generational cycle of poverty, gender inequality and disadvantage.

2.
2.

Achievements to date in advancing women and girls’ sexual and reproductive health and rights There has been some progress in advancing women and girls’ sexual and reproductive health and rights in the Indian Ocean – Asia Pacific region, with a number of countries on track to reduce their maternal mortality ratio by three quarters in line with MDG targets.
Nonetheless, violation against women and girls’ sexual and reproductive rights remains a significant issue, and health indicators reveal widespread inequities at both the inter- and intra-national level.

Increased access to family planning services has come as a result of increased political and financial commitments.

Amongst others, Nepal, Cambodia and South Africa have increased access to safe abortion services, through liberalised abortion legislation30.
In South Africa for example, the annual number of abortion-related deaths fell by 91 per cent after the abortion law was liberalised31.

A number of initiatives, such as micro-financing schemes in combination with gender equality training and community- based interventions, have shown promise in eliminating sexual and gender-based violence by addressing gender inequality and building communication and relationship skills.
Furthermore, governments in the region are increasingly recognising the sexual and reproductive rights of adolescents, and are investing in programs that build life skills, address barriers to accessing services and prevent child marriage.

The following case studies document three examples of achievements to date in progressing sexual and reproductive health and rights in the Indian Ocean - Asia Pacific region.
24 Bearinger L et al., (2007), Global perspectives on the sexual and reproductive health of adolescents: patterns, prevention, and potential, The Lancet.

25 These commitments include those made at the Convention on the Rights of the Child as well as legislation in some countries prohibiting marriage before the age of 18.

However, many countries in the Indian Ocean – Asia Pacific region still have laws that allow marriage of girls younger than this (often with parental consent).
26 UNFPA, (2012), Marrying too Young.

27 UNFPA, (2012), Marrying too Young.

28 UNFPA, (2013), Motherhood in childhood: Facing the challenge of adolescent pregnancy.

29 http://www.who.int/mediacentre/factsheets/fs334/en/ 30 Cohen, S, (2009), Facts and Consequences: Legality, Incidence and Safety of Abortion Worldwide, Guttmacher Policy Review.

31 Jewkes R and Rees H, (2005), Dramatic decline in abortion mortality due to the Choice on Termination of Pregnancy Act, South African Medical Journal.
5 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 Case study 1: Engaging and educating men and boys to progress the sexual and reproductive health and rights of women and girls in Timor-Leste The involvement of men in programs about sexual and reproductive health and rights has been largely ignored.
This issue is particularly pertinent in Timor-Leste, where men hold most of the power and are responsible for decision making, including in regards to health and healthcare.

Such inequality has a negative impact on the rights of women and girls.

By focusing on the needs, responsibilities and roles of men within families and communities, Family Planning NSW aims to create positive change for women and girls in Timor-Leste.
Peer education is an approach to promoting good health, where community members are supported to encourage improved health among their peers.

Peers are people of a similar age or gender and role modelling for men as fathers and partners is an important part of the process.
The aim is to provide information to support men, young and old, to make wise and informed decisions about their health and the health of their families leading them to understand and accept the benefits of using maternal health and family planning services.

The Men and Boys Peer Education Program has been supported by the Australian Government since 2010 and is implemented as a partnership between Family Planning NSW and the Cooperative Café Timor (CCT).
As a community-based men’s health program, it has introduced concepts of health, wellbeing and consent to rural men within their village environment.

The men discuss issues such as respectful relationships, sexual health, and sexually transmitted infection (STI) testing and treatment.

Issues such as dealing with stress, emotion and anger and violence in relationships and the community, and prevention of gender-based violence are all part of program.
Family Planning NSW has provided the technical expertise to design and test the education program and CCT has reviewed and delivered the program.

From January to April 2014, 19 of 22 volunteer peer educators are actively working.

They have established 92 individual men’s health groups in all but one of the 93 Aldeia of the 14 target Sucu, covering a population of close to 30,000.

There have been 206 men’s health community meetings during the second quarter, with approximately 3,300 persons in attendance.
In addition, CCT community health workers have been trained in the practical application of men’s health concepts to integrate into their maternal and child health and family planning community extension duties in Ermera and Ainaro Districts.
Case study 2: Addressing inequity and unmet need through advocacy in the Asia Pacific region The Asian Forum of Parliamentarians on Population and Development (AFPPD), with support from the Government of Japan and United Nations Population Fund (UNFPA), convenes an Asia Pacific Women Parliamentarians’ and Ministers’ Conference annually to address gender-related issues including sexual and reproductive health and rights, and serve as a platform for women parliamentarians to exchange information, expertise and best practices.
This year, the 10th Women Parliamentarians and Ministers Conference is a very timely opportunity for women parliamentarians to discuss and draft recommendations on gender equality and equity that will feed into the Asian and Pacific Conference on Gender Equality and Women's Empowerment: Beijing+20 Review in Bangkok in November.
6 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 Building on the achievements of the ICPD implementation and taking into account the urgency of addressing issues that are lagging behind, particularly those concerning women, this conference will discuss how women parliamentarians can champion and progress the ICPD agenda beyond 2014 where the issues such as gender and SRHR still remain as priority issues.
Fifty champion MPs and emerging champions on sexual and reproductive health and rights and Beijing +20 will be brought to Bali for this conference.
The goals of this conference are to identify champion women MPs who can enhance their role in establishing policies and legislation related to gender issues and sexual and reproductive health and rights; and to have them to be embedded in the national delegations attending Commission on Population and Development (CPD) and Beijing +20, aware of ensuring linkages between violence against women and other proposed post-2015 development goals.
Case study 3: Addressing the sexual and reproductive health and rights of adolescent girls and women in the Pacific Women in the Pacific have among the highest unmet need for family planning in the Indian Ocean – Asia Pacific region, and up to one in four girls have commenced childbearing before the age of 1932, with significant implications for their health, education and empowerment.
Funded by the Australian Government through the Women’s and Children’s Health Knowledge Hub, Burnet Institute has worked collaboratively with communities, civil society organisations, international non-government organisations, Ministries of Health and UN agencies to better understand the determinants of poor sexual and reproductive health in the Pacific, and work with key stakeholders to strengthen programs and policy in this region.
This work has included public health research to understand the determinants and consequences of adolescent pregnancy in Vanuatu, which has led to the development of new public health interventions delivered at community level to improve adolescent girls’ ability to prevent unwanted pregnancy and avoid negative consequences such as school expulsion.
It has also informed efforts to improve the delivery of youth-friendly health services and ensure adolescent girls’ right to health information and care is realised.

Burnet has also worked in partnership with Family Planning International to estimate the resources required to meet women’s demand for contraception in Vanuatu, the Solomon Islands and Kiribati and identify the health and socio-economic benefits of eliminating unmet need for family planning.
These findings have contributed to governments identifying addressing unmet need and adolescent pregnancy as key health and development priorities, and supported efforts towards universal access to reproductive health for girls and women in the Pacific.

32 Kennedy E et al., (2013), The case for investing in family planning in the Pacific: costs and benefits of reducing unmet need for contraception in Vanuatu and the Solomon Islands.
Reproductive Health; and Kennedy E et al., (2011), Adolescent fertility and family planning in East Asia and the Pacific: a review of DHS reports.

Reproductive Health.

7 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 3.
Implications for economic and social development in the region of promoting women and girls’ sexual and reproductive health and rights Ensuring universal access to sexual and reproductive health and rights is central to women’s empowerment, health and wellbeing and to breaking the cycle of poverty.

Sexual and reproductive health and rights are critical for improving maternal and child health, and ensuring the wellbeing of individuals, families and communities.
Annually, an estimated 287,000 women die from complications relating to pregnancy and childbirth33.

Children who have lost their mothers are up to ten times more likely to die prematurely than those who have not34.

Approximately 30 per cent of maternal deaths occurred among women who did not want to become pregnant35.

Increasing access to effective methods of contraception enables women to avoid unintended pregnancy, which alone would prevent a third of all maternal deaths36.
In addition to improved maternal and child health outcomes, sexual and reproductive rights enable the achievement of many other development and population health goals, including women’s empowerment and gender equality, poverty reduction, and environmental sustainability37.

Supporting the right of women and girls to plan their pregnancies and to experience their lives free from violence has considerable social and economic benefits at household, community and national levels.
Women and girls who are empowered to make choices about their own sexual and reproductive health have higher rates of educational attainment and labour force participation, supporting progress towards poverty reduction and gender equality38 , 39.

This is especially important for adolescent girls because early pregnancy is associated with less schooling and lower earning potential.
Improving access to voluntary family planning also leads to increased household resources and investment in children’s education, including that of girl children40.

Preventing unwanted pregnancies also saves families and health systems the financial costs associated with unsafe abortion, and maternal and newborn care.

Such expenses can have a devastating impact on household economies, particularly among poor families41.
At a national level, investing in family planning can result in substantial savings in public spending and support economic growth.

Emerging evidence indicates an economic return of US$20 for every US$1 invested in sexual and reproductive health, in large part due to increased productivity, making it one of the most cost-effective investments in global health and development42.
33 http://www.who.int/mediacentre/factsheets/fs348/en/ 34 http://web.unfpa.org/mothers/facts.htm 35 http://www.who.int/reproductivehealth/topics/unsafe_abortion/magnitude/en/ 36 https://www.unfpa.org/swp/2005/presskit/factsheets/facts_rh.htm 37http://populationmatters.org/documents/countdown_2015.pdf?phpMyAdmin=e11b8b687c20198d9ad050fbb1aa7f2f 38 Canning D and Schultz TP, (2012), The economic consequences of reproductive health and family planning.

The Lancet.
The Lancet.

39 Sonfield A et al., (2013), The social and economic benefits of women's ability to determine whether and when to have children.

40 The Partnership for Maternal, Newborn and Child Health, (2013), The economic benefits of investing in women's and children's health; and Canning D and Schultz T, (2012), The economic consequences of reproductive health and family planning, The Lancet.
41 Russell S, (2005), Illuminating cases: understanding the economic burden of illness through case study household research.

Health Policy and Planning.

42 The Partnership for Maternal, Newborn and Child Health, (2013), The economic benefits of investing in women's and children's health.

8 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 4.
The effectiveness of Australian programs to support efforts to improve the sexual and reproductive rights of women and girls in the Indian Ocean – Asia Pacific region The Australian Government is committed to delivering an effective Australian aid program.

Minister for Foreign Affairs, Julie Bishop, states: “We want to find ways to make Australia’s aid program work more effectively, to help improve people’s lives.
We want to find the very best ways to alleviate poverty and improve economic outcomes and build stability and prosperity”43.

Recognising that effective aid programming brings the best health and development outcomes, we welcome the Australian government’s focus on effective aid.

The following case studies are examples of effective sexual and reproductive health and rights initiatives, undertaken by Consortium members with support from the Australian Government.
Case study 4: Empowering women in Laos by informing them of their rights and opportunities Through the ANCP-funded Legal Awareness and Life Skills (LALS) project, CARE has been supporting the empowerment of marginalised urban women in Laos.

This project first focused on ‘entertainment workers’, women who may not identify as sex workers but who may engage in commercial sex as a primary or secondary source of income, often working in the entertainment industry, hotels and bars.
The project later expanded to include garment factory workers.

By establishing peer networks and self-help groups, CARE was able to promote opportunities for women to share knowledge, skills and tools on a range of issues, including laws, women’s rights, preventing violence and self-defence, and sexual and reproductive health issues.
CARE and the networks they helped establish could then advocate for better treatment and conditions from public officials and other people in positions of power, such as beer garden owners and hotel managers.

From initially denying or dismissing the problem, they can now formally discuss sensitive issues regarding sex workers and violence against women.
Evaluations revealed that since the start of the project five years ago, entertainment workers, who were typically considered ‘bad and dirty’ women with no position in society, now have better self-esteem, no longer feel they deserve to be treated violently and feel they have more influence over what happens to them, such as preventing or escaping violence and negotiating safe sex.

They have learnt new skills and knowledge and are using this to help their peers.
The women have increased access to friendly and confidential health services, and the Lao Women Union has now embraced them as part of their constituency for protection.

Bringing this advocacy to a higher level, these women are working to break the taboo against sex work and build national debate about violence against women, with coverage in the media, and discussions among the police force and politicians.
Recognising the need among female garment workers, who also experience social exclusion, the project’s activities are now being scaled-up.

This follows the success of a similar initiative in Cambodia, where CARE works with garment factory workers and the private sector to provide peer education.

This includes basic literacy, legal awareness, financial management, family planning and reproductive health.
Factory managers are now looking to expand these training programs as they recognise the business benefit of having a better educated and more productive workforce.

43 Bishop J, (2014), Opening address – 2014 Australasian Aid and International Development Policy Workshop.

Speech.

April 14, 2014.


9 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 Case study 5: Effective community-based interventions through the Australian Africa Community Engagement Scheme The Australia Africa Community Engagement Scheme (AACES) is one of the largest Australian Government programs of funding for Australian NGOs in Africa44.
The program focuses on community- based interventions across the sectors of water and sanitation, food security, and maternal and child health, with a key objective of improving access to essential services by marginalised communities.

This focus ensures that the outcomes of AACES are embedded in the framework of improving the rights of the poorest communities.
As AACES focuses on partnership, community empowerment, learning, innovation and value for money, it has been able to document and demonstrate effectiveness in multiple areas, as well as at both the NGO and the program level.

Under AACES, Marie Stopes International provides reproductive healthcare to marginalised communities in Kenya and Tanzania.

Over 100,000 marginalised people have accessed sexual and reproductive health services through the Marie Stopes International AACES project45.
As a result of the Marie Stopes International AACES project so far, services provided are estimated to prevent approximately 127,500 unintended pregnancies, 17,400 unsafe abortions and 303 maternal deaths over the life of services provided in rural areas of Kenya and Tanzania46.

Marie Stopes International’s AACES program also demonstrates very good value for money in itself, and in comparison to both other health services and other modern family planning services47.
Conclusion As recently cited by Minister for Foreign Affairs, Julie Bishop, the Asia Pacific region alone loses an estimated US$50 billion a year because of limited female access to jobs and an estimated US$30 billion a year is lost to poor female education.48 Investing in the right to sexual and reproductive health is critical to addressing this; sexual and reproductive health and rights saves lives, empowers women, lifts women and their families out of poverty, and is one of the most cost-effective interventions in global health and development.
Investing in family planning in addition to maternal and newborn care saves more lives, and costs less, than investing in maternal and newborn care alone49.

44 AACES is being implemented across 11 African countries over five years (2011-2016), through 10 Australian NGOs and their local partners.

The AACES program includes three members of the Consortium members - CARE, Marie Stopes International and Plan 45 MSI, (2014), AACES Mid-Term Review Report.

46 MSI, (2014), AACES Mid-Term Review Report.


47 MSI, (2014), AACES Mid-Term Review Report.

48 Bishop J, (2014), A new paradigm in development assistance – harnessing the private sector.

Speech.

April 29, 2014.

49 UNFPA and Guttmacher, (2012), Costs and Benefits of Investing in Contraceptive Services in the Developing World.
10 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52 Recommendations We recommend that:  The Australian government considers recognising sexual and reproductive health and rights as an integral component of any women’s empowerment initiatives;  In the discussions to establish the post-2015 development agenda, the Australian Government considers endorsing a stand-alone gender equality goal – that includes a target relating to sexual and reproductive health and rights – and encourages mainstreaming of women’s empowerment and gender equality across all development objectives and initiatives;  The Australian Government considers increasing its foreign aid funding commitments for sexual and reproductive health and rights – including increasing access to family planning, safe abortion and youth-friendly reproductive information and healthcare, and the elimination of gender-based violence – with a focus on effective and efficient programming, accompanied by transparent monitoring.
11 Human rights issues confronting women and girls in the Indian Ocean – Asia Pacific regionSubmission 52