Wanted: Comprehensive Solutions for All Women

Run by a powerful panel of speakers, the session looked at linkages between SRHR, HIV and VAW, defined the meaning of safe spaces for women and girls, looked at approaches and models of comprehensive prevention at the community level and ended with a discussion on funding approaches for comprehensive prevention.

The session started with the voice of a young World YWCA delegate from Ethiopia, Fasika Waltengus. Fasika has been working on HIV and AIDS for four years and is currently running an HIV prevention programme for young women. Her presentation explored the meaning of safe space for women and girls. She then demonstrated how it can serve as a fundamental building block for women and girls empowerment activities. Describing the situation of women in her country, Fasika reported that most women in Ethiopia are oppressed and denied a range of rights such as the rights to education and employment opportunities, gender equality, economic security, self expression and social connection. “All of this has caused vulnerability to HIV and other sexually transmitted infections”. In the same way, girls suffer both physically and socio-economically from lack of safety, privacy, and self-expression. “We have noticed that young women and girls lack private spaces even in their homes as they try to deal with menstruation and sanitation secretly.” The YWCA in Ethiopia has engaged itself in creating safe spaces, notably for young women, through female football teams, university gender clubs, or summer youth groups among others. All these activities address reproductive choices and negotiation skills and aim to develop the leadership of the young women. "The creation of safe spaces for women and girls is the least expensive intervention technique that can be used,” said Fasika, “but it is the most significant way to make positive contributions in the lives of everyone, especially the disadvantaged and underserved women and girls.

Linking SRHR, HIV and AIDS and VAW was the core of Naina Khanna’s presentation. “We cannot really separate these issues,” said Naina, who is Director of Policy and Community organising at Women Organised to Respond to Life-threatening Disease (WORLD) in USA. In her country and in many parts of the world, violence remains a barrier for women in accessing HIV prevention, care and treatment services. “Women living with HIV are more likely to experience violence and stay in violent situations.” Naina explained that AIDS-related illnesses continue to be the leading cause of death among African-American women aged 25 to 34 years old and that violations of the SRHR of women still persist for many women living with and vulnerable to HIV and AIDS. Health systems remain places of stigma and discrimination and they are dramatically unequipped to respond to their needs. “Access to comprehensive reproductive health services, which is the core of HIV prevention for women and girls, remains sadly lacking”. She stressed the need to implement holistic and comprehensive programmes. She also brought up the challenge to get funds for projects related to sexual and reproductive health services.

Priya Nanda, from the International Centre for Research on Women (ICRW), India, gave a more conceptual presentation, explaining what comprehensive prevention is and why it is important for women and young women. She defines comprehensive prevention as a combination of behavioural strategies (risk modification, i.e. condom), structural strategies (changing the context and the situation) and biomedical interventions (blocking the infection, i.e. treatment). Priya stressed the need to address the structural factors, with traditional behavioural knowledge and attitudinal approaches. Increasing acknowledgment that social, economic, political and environmental factors directly affect HIV risk infection and vulnerability is key. “The prevention is ailing and one of the reason is that we see repeated failures to achieve the right balance between prevention and treatment efforts. The prevention of HIV seems to be more controversial than treatment for HIV and AIDS. It should not be treatment versus prevention,” said Priya Nanda.

Krista Newhouse, Research Associate and Public Health Institute Advisor to the Population Programme at The David and Lucile Packard Foundation, offered a donor’s perspective. As many ask why donors cannot fund across the spectrum of SRHR, HIV and AIDS and VAW, Krista Newhouse raised several challenges that donors face, among others, the risk to compromise their mission by working outside of their core strategies, but most importantly some donors simply do not have the resources to fund everything. “We must prioritise. Donors can choose to have a more focused approach and use limited resources to focus on 3-4 areas rather than a shallow focus in 10 areas.” Krista added that a more focused approach allows for longer-term partnerships rather than shorter, more inconsistent ones. While they do not fund everything, donors do have a strong value and commitment to collaborating with groups and other donors working on adjacent issues to ensure that a comprehensive approach is achieved.

“Donors are in communication with each other about themes, programme areas, responses to specific needs, and grantees. Sometimes it is perceived that donors are siloed or work alone. For most donors, this is not true,” said Krista. The David and Lucile Packard Foundation believes that they have a responsibility to highlight their grantee’s work or the work of potential grantees, as well as mobilising funds for these organisations. They do this by philanthropic gatherings or other types of donor meetings. Because their grantees do not solely focus on reproductive health, they may receive funding for other programmes such as HIV. Like many donors, The David and Lucile Packard Foundation strives to be on the cutting edge of the issues and is always looking for ways to learn and then share and present innovative ideas and actions with their donors network.

The satellite session ended with a clear agreement: investing in comprehensive prevention strategies that are grounded in SRHR and that address VAW is crucial for an effective AIDS response that works for women, especially young women.

• Visit the World YWCA Blog Women Leading Change