EAC: Integration of sexual, reproductive health is key

Author: Peter Eceru. PHOTO/FILE/COURTESY

What you need to know:

  • To strengthen regional Health Information Management Systems, it is critical to have a regional framework to guide this. 

Currently, the East African Legislative Assembly is undertaking regional consultations on the Sexual and Reproductive Health Bill, 2021 in members states.

The Bill is premised on Article 118 of the treaty for the establishment of the East African Community (EAC) which provides for cooperation in health, promotes management of health delivery systems and better planning mechanisms to enhance the efficiency of healthcare services.

The EAC treaty also seeks to harmonise national health policies and regulations in order to achieve quality health care in partner states. It also looks at cooperation in the development of specialised health training, health research, reproductive health, pharmaceutical products and preventive medicines.

The Bill further seeks to strengthen the mechanism that facilitates attainment by the Community of the goal to ensure universal access to sexual and reproductive health care services by 2030. These include family planning, information and education, and the integration of reproductive health into national strategies and programmes.

This goal is enshrined in the EAC Integrated Reproductive Maternal, New-born Child and Adolescent Health Policy Guidelines 2016-2030, and the EAC Sexual and Reproductive Health Rights Strategic Plan.

The Bill recognises the obligation of Partner States under several international, continental and Community frameworks, to respect, protect and fulfil the right to health. They do this by facilitating, providing, and promoting the highest attainable standard of health and providing measures toward the full realisation of the right to health.

The Bill will strengthen the mechanism to facilitate the attainment of the Community goal of ensuring universal access to sexual and reproductive health care services, including family planning, information and education.

Reproductive, maternal, newborn, child and adolescent health indicators in the EAC member states are worse than the average in the rest of Africa. High maternal and mortality rates for children under five, high unmet need for contraceptives and adolescent fertility rates demonstrate a need for collective action across  EAC.

 In 2020, 39,000 children in East Africa were born with HIV infections that could have been easily prevented. During the same period, 62,000 mothers died from childbirth complications.
Two hundred million girls and women are estimated to have undergone genital mutilation worldwide. Additionally, cervical cancer remains a leading cause of cancer-related deaths among African women.

Currently, 19 million women in East Africa cannot access modern contraception and a further 2.5 million are at risk of death due to complications from unsafe abortions. The Covid pandemic led to a very big increase in violence against women and girls putting the future of millions of women and children in jeopardy.

Indicators across the different countries in the region vary in terms of severity. For instance, South Sudan has the highest maternal mortality rate with 1,150 deaths per 100,000 women who give birth, while Rwanda has the lowest at 248 deaths per 100,000 women giving birth.

These variations demonstrate the need for collaborative health systems planning. Various countries have over time developed best practices that can be shared across the EAC.  In Uganda, a weekly maternal death surveillance enables the ministry to follow up on deaths.

To strengthen regional Health Information Management Systems, it is critical to have a regional framework to guide this. The collection of data on contraceptive use, sexual and reproductive health and the wider reproductive, adolescent maternal newborn remains uncoordinated across the EAC. In Uganda, this information is collected through the Uganda Demographic Health Survey and the Health Information Management Systems.

In the partner states, different information is collected among partner states and this information is collected along different time periods.  Thus, it is difficult to utilise the information for regional planning and collective decision-making.

Sound and reliable data is the foundation for decision-making across all health systems. The consultations on this Bill are a very important process in strengthening regional integration and specific emphasis on the promotion of sexual and reproductive health.

Mr Eceru is the Programme Coordinator - Advocacy at the Center for Health, Human Rights and Development