International Day of Action for Women’s Health: An Interview with UN Women

Thought LeadersNazneen DamjiSenior Policy Advisor for Gender Equality, HIV, and HealthUN Women

In commemoration of the International Day of Action for Women's Health, we interviewed Nazneen Damji, from UN Women, about the health challenges women face in 2021.

Please could you introduce yourself and tell us about your role within UN Women?

I am the Senior Global Policy Advisor for Gender Equality, HIV, and Health at UN Women.  With over 20 years of professional experience promoting women’s rights and gender equality, I oversee UN Women’s policy and programming efforts on gender equality dimensions of HIV and AIDS, as well as, women’s health, including sexual and reproductive rights.

I have specific expertise on the socio-economic impact of HIV and AIDS on households and hold an MSc. in Economics (Gender and Development) from the London School of Economics.

The last year has impacted healthcare and the world in a way that no one was prepared for. What do you believe are some of the greatest challenges women face in 2021?

COVID-19 has exacerbated existing inequalities across all aspects of life for women and girls. Progress towards gender equality on most of the Sustainable Development Goals has been interrupted or is being reversed as a result of COVID-19: women and girls are facing acute hardships, including higher rates of poverty, increased care burdens, greater exposure to violence, and obstructed access to sexual and reproductive health services.

Discriminatory laws and social norms also persist. And with few women directing policy responses at the national and local levels, such issues are not being sufficiently prioritized and resourced. Immediate and sustained action is needed to stop the derailing of hard-won gains in gender equality and women’s empowerment.

The COVID-19 pandemic has put almost universal pressure on the gains in gender equality made since the adoption of the Beijing Declaration and Platform for Action, the most progressive blueprint for advancing women’s rights.  Gender equality and women’s empowerment are essential for health and well-being.

Gender, independently and intersecting with other determinants of health, including socioeconomic status, disability, ethnicity, geography, age, legal identity and migration status, sexual orientation, and gender identity, can influence access and coverage of essential health interventions, thereby directly affecting health outcomes.  Gender relations are about social relations.  They can determine hierarchies between groups based on norms and can contribute to unequal power relations. They operate across many dimensions of life and determine whether people’s needs are acknowledged, whether they have voice or control over their lives and health, and whether they can realize their rights.

As a power relation, gender influences: vulnerability to ill health, household decision-making and health-seeking behavior, access to and utilization of health services, the design and use of health products, commodities, and technology, the nature of the health labor force, the implications of health financing, what data is collected and how it is managed, and how health policies and programs are developed and implemented.

Conversely, there are numerous pathways by which greater gender equality and women’s empowerment can lead to improvements in health and quality of life for women and their families. Women with greater agency are more likely to have fewer children, more likely to access health services and have control over health resources, and less likely to suffer domestic violence.  Their children are more likely to survive, receive better childcare at home and receive health care when they need it.

Improved health for women can also help to strengthen their own agency and empowerment. Healthy women and girls are more able to actively participate in society and take collective action to advance their own interests, such as demanding rights-based, gender-responsive health services. Enabling environments for gender equality are also linked to positive health and broader societal outcomes.

It is clear that gender equality and women’s empowerment are inextricably linked to positive health outcomes, thus it is necessary that existing gender biases in the social, cultural, institutional, legal, and economic structures are addressed.  It is critical that women and girls are involved in the design and delivery of health services and are empowered to claim their rights to these services.

Gender Equality

Gender Equality. Image Credit: Overearth/Shutterstock.com

The International Day of Action for Women’s Health is celebrated every year and a large part of their message is surrounding women’s sexual and reproductive rights, described as ‘an indivisible and inalienable part of our human rights’. With women all over the world being systematically violated, why is important to celebrate women’s sexual and reproductive rights and their human right to make their own decision with their body?

Women’s and girls’ bodily autonomy and decision-making around their health is central to achieving gender equality. The ability of women to control what happens to their own bodies is associated with the roles they are able to play in society, whether as a member of the family, the workforce, or the government.

Women’s health is a fundamental right within which reproductive rights cannot be compartmentalized. The human rights of women include their right to have control over and decide freely and responsibly on matters related to their sexuality and individual agency, including sexual and reproductive health, free of coercion, discrimination, and violence.  

Only 55% of women aged 15 to 49 who are married or in a union make their own decisions about sexual relations and the use of contraceptives and reproductive health services.  This means almost half (45%) of women in that age group are not permitted to make their own SRHR decisions7.

Supporting women and girls’ bodily integrity includes addressing various points when they need information, services, skills, and opportunities to make choices about their own health. Empowering women and girls’ right to make informed choices is one of the most effective pathways to improve health outcomes as well as fulfill women’s potential as agents of change.

UN Women is an energetic advocate of ‘universal access to sexual and reproductive health and rights’ and recognizes that women have the right to control and decide freely on matters concerning their sexuality.

Through the efforts of the Generation Equality Forum, UN Women, with the Governments of France and Mexico, and in partnership with civil society, and youth, has launched a Global Acceleration Plan for an Action Coalition on Bodily Autonomy and Sexual and Reproductive Rights, co-created by a multi-stakeholder partnership with governments, civil society, youth-led organizations, international organizations, philanthropies and the private sector to deliver transformational progress through four concrete actions: 1) Expand Comprehensive Sexuality Education; 2) Increase the availability, accessibility, acceptability, and quality of comprehensive abortion and contraception services; 3) Increase SRHR Decision-Making & Bodily Autonomy; and 4) strengthen girls, women’s and feminist organizations and networks to promote and protect bodily autonomy and SRHR.

These actions are critical as the world rebuilds after COVID19 and is a call for others to join in accelerating investments and implementation to support women’s and girls’ rights.

HIV is a global health problem faced by women and it is most prevalent in young girls and adolescents aged 15-24. What are some of the factors that fuel this statistic and what resources and preventative measures can be carried out to help these women?

Women continue to bear the brunt of the HIV/AIDS epidemic. Globally, there were more women living with HIV and they constituted nearly half of the new HIV infections in 2019.[1] Overall, new HIV infections among women continue to decline. Yet, the pace of the progress is slow and uneven – new HIV infections among women in Eastern Europe and Central Asia, Middle East, and Latin America continue to climb. Adolescent girls and young women in sub-Saharan Africa are particularly affected: around 4,500 adolescent girls and young women became infected with HIV every week in 2019.[2]

Unequal power dynamics and gender norms continue to put adolescent girls and young women at a greater risk of HIV and hamper their ability to mitigate the impact of the epidemic. 1 in 3 women, including young women, experienced physical and/or sexual violence in their lifetime,[3] increasing their risk of acquiring HIV by 50%.[4] AIDS remains one of the leading causes of death among women of reproductive age.[5] Discriminatory laws and practices, such as the age of consent laws, restrict young women’s ability to access sexual and reproductive health and services. Only one-third of young women and girls have comprehensive HIV knowledge.[6]

Empowering young women and adolescent girls and guaranteeing their rights is imperative for their bodily autonomy, their ability to use the knowledge and skills to negotiate safer sex in order to protect themselves from HIV infection and mitigate its impact. We need to scale up effective interventions to increase HIV knowledge and transform gender norms and enhance girls’ access to services.

Removing discriminatory laws and practices that put adolescent girls and young women under heightened risk to HIV is key. Resolving the digital gender gap, especially in times of COVID-19, is a critical approach and essential to equalize access so that young women and girls can capitalize on all the benefits of the digital world and its innovations and access decent employment opportunities and professional growth.

Therefore, we are pleased to be working with our sister organizations – UNICEF, UNESCO, UNFPA, and UNAIDS – on the joint initiative Education Plus to ensure we can alter the course, and transform societies to enable the path for young women and girls to be free of HIV, empowered, educated, and economically secure.  

Woman supporting HIV

HIV. Image Credit: AS photostudio/Shutterstock.com

Inspiring young women to become leaders is crucial to accelerating progress towards gender equality. How does UN Women work to inspire young leaders and what message would you give to young people and adults wanting to become leaders within their field?

Today's youth should not be dismissed as the leaders of tomorrow because many young women are already leading today.  UN Women calls upon all partners to ensure that young women, particularly those living and affected by HIV, have a formal seat at the table and a safe space to raise their needs and priorities at all levels of where the decisions are made.  UN Women also creates new and sustains existing informal and formal platforms for young women’s meaningful engagement and we call upon tracking this engagement more consistently.

For example, in South Africa, young women living with HIV participated in and inputted the review of the existing legislation on violence against women and prepared policy recommendations to address the needs and priorities of women living with HIV and to include measures to prevent HIV for the survivors of sexual violence.

With UN Women support, young advocates engaged with the Minister of Justice and shared their proposals to the three bills: the Criminal Law and related crimes bill; the Domestic Violence amendment bill and the Victims Support Services bill. (see the related story 'In South Africa, young women leading HIV and violence prevention say men’s involvement is key').

We also are mobilizing gender advocates across the movements of women’s organizations, traditional and faith-based leaders, men and boys, youth organizations, change-makers, and others to amplify our collective strengths and build a stronger movement of young women leaders. And we are using innovative ways to mentor future leaders and mobilize them for change.

For example, UN Women’s “Engagement + Empowerment = Equality” program in Malawi, Uganda, and Kenya, in just 9 months, mobilized over 1,000 young women champions, including 250 girls living with HIV. Young women were involved in the design and validation of national assessments on the status of HIV amongst adolescents and youth. They were reached through mentoring, capacity building, peer support, and outreach activities including using social media. (see 'End gender based violence and HIV to ensure equity').

The ongoing COVID-19 pandemic has taken up much of the world’s resources and attention over the last year and a half, making it incredibly important to recognize and raise awareness for other global issues and push society to pay attention to them. How has the ongoing COVID-19 pandemic impacted the work of UN Women?

At the outset of the pandemic, UN Women’s Executive Director,  Phumzile Mlambo-Ngcuka issued a call to action to ensure gender dimensions were considered in responses – including through sex-disaggregated data, social protection for women, addressing the ‘shadow pandemic’ of violence against women, and girls, and ensuring national coordination mechanisms for health were considering gender equality dimensions.

UN Women issued a series of policy briefs on areas affected by the COVID-19 pandemic: economic fallout, the care economy, violence against women and girls, women’s leadership, and humanitarian response.

Rapid gender assessment surveys with national and United Nations partners were undertaken by UN Women focused on the impacts of COVID-19 in several countries across the world. The results confirmed that the COVID-19 pandemic was exacerbating pre-existing gender inequalities and deepening gender-based discrimination and vulnerability.  A COVID-19 and gender monitor on the UN Women data hub was created as well as a COVID-19 Global Gender Response Tracker with the United Nations Development Programme, and fact sheets with country examples, best practices, and gaps in the COVID-19 policy response were produced.

A global program was developed that framed UN Women pandemic response from the global to local levels: Gender-Responsive Prevention and Management of the COVID-19 Pandemic: from Emergency Response to Recovery and Resilience.  This framework focuses on five key priorities: a) mitigate and reduce incidence and impact of gender-based violence, including domestic violence, to also prevent HIV and end violence against women living with HIV; b) ensure social protection and economic stimulus packages serve women and girls, including those affected by and living with HIV; c) support and practice the equal sharing of the burden of care among men and women, particularly in the context of HIV where women and girls bear the brunt of unpaid care work for family and community members living with HIV; d) support women and girls, particularly those living with HIV, to lead and participate in COVID-19 response planning and decision-making; and e) mainstream gender into national, regional and global efforts including through gender data and coordination mechanisms.

The COVID-19 pandemic has shown us the dire need for a gender-responsive health ecosystem and the urgency to build back ‘better and fairer’, with women’s needs, voices, and leadership at the heart of the recovery.

What do you believe a ‘gender equal’ world would look like and are you hopeful that this will one day be achieved?

A gender-equal world is not possible without addressing inequalities which already exist. COVID-19 has exposed and accelerated existing gender inequalities and left millions of women and girls, particularly those who are most marginalized, behind.

The impact on women and girls has been severe and disproportionate – violence against women has increased significantly, and women and girls have experienced increasing rates of unpaid care work – women and girls have experienced on average three times as much of an increase in unpaid care work duties as men. Furthermore, women constitute a majority of the health and care workforce globally. As the world begins to recover from the COVID-19 pandemic, we must put gender equality at the heart of this process.

UN Women’s Generation Equality Forum is a ‘once in a generation’ opportunity to put gender equality at the forefront of our efforts to build back better and more equal, inviting interested partners to engage in multi-stakeholder coalitions focused on the areas of gender-based violence, economic justice and rights, bodily autonomy and sexual and reproductive health and rights (SRHR), feminist action for climate justice, technology and innovation for gender equality, and feminist movements and leadership.

#ActForEqual - Join Generation Equality

How can people get involved and support the work of UN Women?

UN Women values its multi-stakeholder partnerships and initiatives and works with governments, multilateral organizations, civil society organizations, and other UN partner agencies to achieve the goal of achieving gender equality and empowerment of all women and girls by 2030, in line with the United Nations Sustainable Development Goals.

The Generation Equality Forum is a global movement for gender equality, convened by UN Women and co-hosted by the governments of Mexico and France. The Forum brings together governments, corporations, NGOs, youth-led groups, and Foundations to secure concrete, ambitious, and transformative commitments for gender equality. These are shaped by the Action Coalitions – global, innovative, multi-stakeholder partnerships across 6 thematic areas to accelerate a transformative agenda of generational change.

We invite all interested stakeholders – Governments, private sector entities, youth-led organizations – to join this critical moment for gender equality and pledge their engagement as an Action Coalition Commitment Maker.

The Generation Equality Forum Paris, taking place from 30 June - 2 July 2021, will be a major global inflection point for gender equality, where commitments, actions, and partnerships will drive lasting and transformative progress for women and girls. We invite you to spread the message across your networks and encourage partners to join us virtually at this landmark event in Paris.

Where can readers find more information?

UN Women: https://www.unwomen.org/en

UN Women Gender Equality and HIV/AIDS web-portal: http://genderandaids.unwomen.org

Generation Equality Campaign: https://forum.generationequality.org/

#ActForEqual (UN Women campaign): https://forum.generationequality.org/actforequal

Gender & Health Hub, of which UN Women is a partner: https://www.genderhealthhub.org/

COVID19 and Gender Monitor: https://data.unwomen.org/resources/covid-19-and-gender-monitor

Global Gender Policy Tracker: https://data.undp.org/gendertracker/

About UN Women

UN Women is the global champion for gender equality, working to develop and uphold standards and create an environment in which every woman and girl can exercise her human rights and live up to her full potential.

We are trusted partners for advocates and decision-makers from all walks of life, and a leader in the effort to achieve gender equality.

[6] UNAIDS 2020, Global AIDS Up-date.

[7] UNFPA 2020

Emily Henderson

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Emily Henderson

During her time at AZoNetwork, Emily has interviewed over 300 leading experts in all areas of science and healthcare including the World Health Organization and the United Nations. She loves being at the forefront of exciting new research and sharing science stories with thought leaders all over the world.

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