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Memo: Echoing Colombian Sexual Healthy Policy in the Rest of Latin America » Women's Courage

Memo: Echoing Colombian Sexual Healthy Policy in the Rest of Latin America

March 8th, 2011 by kheflin Leave a reply »

(MOCK) MEMORANDUM, March 2011

To: Hilary Clinton, Secretary of State

From: Director of the WHA/PPC (Western Hemisphere Affairs Office of Policy Planning and Coordination)

Subject: Birth control dissemination/Family Planning in Latin America—Colombia’s New Policies as Example

Background: Contraception Policy in Latin America

Family Planning is essential to women’s health, and it has been shown to lead to reduction of poverty and more desirable family situations for women. Thus, both children and women  have more control over their future and livelihoods. Family an rights and economic factors, it is within U.S. interest to further these rights.

Women with pre-child-bearing opportunities and ultimately fewer children sizes can contribute to the Latin American economies and thus assist stability. This is most apparent in their control over timing of childbirths: with access to contraception, they can better decide time in their life they are willing to rear children, how many they can afford, and how far apart between ages they can logically handle. Studies also show that smaller families allow people to attend school longer (see figure 1) and both mothers and children can eventually achieve better economic stability.

But as part of the goal to increase funding for preventative contraceptive needs of Latin American women, it will be necessary to exclude important messages on other related topics—such as address abortion debate, competing needs such as maternal care and HIV treatment, and goals of gender equality/women empowerment (Wilson).

Why Latin America?

The Millennium Development goals and UNFPA are both doing great work in family planning right now; however, they are focusing on selected countries in sub-Saharan Africa and South Asia (USAID, International). The world is turning away from Latin America for family planning because it has a smaller population and thus a less total need than Asia and Africa (see figure 2). Also, many assume that as our neighbors and our backyard, Latin America will receive the U.S. government’s focus when we pass our individual appropriation bills for Family Planning.  It is time to take on that expectation and help the women of Latin America, spread prosperity across the Americas—furthering human rights and improving Western Hemisphere economic stability.

Current Funding Situation:

Most U.S. funding for family planning is procured through two main sources: Congress’s annual appropriations bills, and money funneled through USAID (Kaiser). U.S. funding for international family planning has fluctuated and decreased as a share of the U.S. global health budget. After reaching approximately $575 million in 1995, it dropped or remained relatively flat for more than a decade, until this year when it reached $648.5 million, including $525 million in the USAID account. The request next year, the 2011 fiscal year budget, is $715.7 million for family planning (see figure 3).

Two years ago, on January 23, 2009, just after President Obama had repealed the Mexico City Policy—which had gagged vital birth control organizations from receiving government funding, you, Madam Secretary, said that you were looking forward “to promote programs and policies that ensure women and girls have full access to health information and services” (CRS). I wholeheartedly support your commitment, and I hope that over the next few years this can include our Latin American neighbors. Now that the President has proposed to increase the funding to $715 million for 2011—which is the highest funding for this issue in US history (USAID, Obama)—it needs to be followed through on with a newfound focus on our nearest neighbors. The budget cuts have been necessarily harsh across the board, but this is one are worth investment: never before has birth control been so affordable and effective.

There so much to be gained without a relatively small actual monetary investment. The costs include the contraceptive commodities themselves (condoms, IUDs, pills), personnel, and management/shipping. And given the proximity of Latin America, the shipping costs are minimal. But these costs are not to be borne by the U.S. alone; the most efficient and culturally sensitive distribution would be through lobbying the NGOs and governments of the nations themselves to follow the Colombian method.

The Colombian Method:

Historical Background: Sexuality and Contraception in Colombia

From the introduction of contraceptives in Colombia during the 1960s up until present, the nation’s population growth rate has “decreased steadily.” And during an especially key period between 1980 and 1995, the population growth rate decreased by an estimated 23% (IES). For example, the average children born per family moved from seven during the 1960s to just under three in 2001. Yet, there are wide variances between regions; for example, the average in 4.3 in the mountainous regions. Similarly, education levels play an important role–such as the average of five children per woman among those lacking any formal education, compared to 1.8 for women with higher education (IES).

Another important factor is culture. Colombia has an interesting mix of cultures which contribute to its sense of sexuality in society: “The Spanish cultural influence, which is a mix between the Arab-Andaluzian influences, mixes the glorification of sensuality and eroticism in its most beautiful form with the Spanish Catholic Inquisition’s very strong repressive ideas.” To confuse matters worse, the African culture adds a view of “sexuality, eroticism, and sexual vigor as natural phenomena” (IES).

Then, one other incredibly important aspect of cultural norms is religion. Studies in Colombia have shown “the presence of important religious beliefs related to sexuality”: the ingrained Catholic ideas around birth control and pleasure, including “religious concepts that emphasize feminine resignation” contribute significantly to sexuality in Colombia (IES). Luckily, despite the fact that a majority of Colombians are Catholic, social and economic issues as well as marital instability “have led to the acknowledgment of the civil rights of all couples and their children.” According to studies and censuses, more than half of Columbians continue to practice Catholicism, but also engage in birth control without experiencing guilt: 72.2 percent of women in a relationship use birth control of some form. Yet, the issue is still not equitable among the genders: for every six women using contraception in the late 1990s, only one man did so (IES).

On the other hand, Colombia has for over a decade had several laws which seek to protect the rights of women: “Family Planning is viewed as an individual’s right and an obligation of the state.” In the 1991 Constitution, all discrimination against women in condemned in Articles 17 through 30. The Constitution states: “Women have civil rights as they pertain to reproduction and the judicial system equal to men in education, nationality, employment, health, matrimony and family.” While such legislation was a good step forward, however, implementation has often occurred rarely if at all (IES).

As with much of the world, premarital sex is common throughout Colombia. Studies have shown 90.4 percent of males and 62.8 percent of females have engaged in premarital sex before college life (IES). And in the realm of adolescents, ten percent of 13-14 year olds has had sexual relations, and in increases to forty percent for 15-17 year olds (IES).

Colombia’s 2010 Policy:

The nation’s policy is such a fundamental success that even this early on, I think it is clear already that we should encourage other Latin American countries to emulate.”Since a law was passed guaranteeing all citizens access to free birth control drugs and procedures, clinics have opened, especially in impoverished areas where teen pregnancy rates are high” (Kraul).

Free contraceptive implants were given out in December 2010 as part of “one of Latin America’s most liberal reproductive rights laws,” passed by Colombia’s Congress which guarantees citizens access to free contraception in the form of medicinal or surgical methods. Psychologist Maribel Murillo of the Diamante health clinic in Colombia notes that “it will advance the sexual rights of women of little means, many of whom already have several children” (Kraul).

One factor that applies to the rest of Latin America is the concept of Colombia as a mostly- Catholic nation (estimates are around 90%). And yet, legislation as progressive as this was able to advance reproductive rights “in this largely Roman Catholic nation.” Colombia has been slowly liberalizing, evidenced by the constitutional court rulings just before this policy on removing abortion penalties for medical providers (Kraul).

Enabling women to access reproductive health care for free, the Colombian policies are making women’s control over their futures and bodies a priority. Beyond social justice, this legislation also certainly presents economic benefits for the nation: “because maternity and neonatal care are among the healthcare system’s fastest-growing costs, free contraceptive medicine and surgeries could end up saving the government money” (Kraul).

As observed in various studies, teen pregnancies cause a vicious poverty cycle. And given Colombia’s worsening situation in this area (2010 figures show that 21% of teen Colombian girls bear children—compared to 13% in 1990).  In the rest of Latin America, this 2010 teen pregnancy rate in Colombia was surpassed only by Nicaragua (which was up to 25%), and Venezuela, El Salvador, and Honduras (all at around  21.5%). If we compare them to ourselves, the U.S. is estimated by Guttmacher to have around  a 7% of teen pregnancy rate. As a response to the Colombia’s teen pregnancy issues, another result of the policy was the creation of over 600 offices have been opened across Colombia to increased access to contraception and advice for adolescents, called Friendly Health Services for Youths (Kraul).

Applying the Lessons to the Rest of Latin America:

If these liberal social service policies can radiate across the region, the issues of teen/unplanned pregnancy, HIV/AIDS, and STI infections could be easily controlled. Of course, the exact plan cannot apply universally. As we know from even the variance among U.S. states and reproductive health policy, small demographic and social/political changes can have a large impact on the logistics of family planning policies. Each country had its own background, political climate, and specific needs.

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Works Cited:

CRS. <http://pdf.usaid.gov/pdf_docs/PCAAB323.pdf>

IES. José Manuel González, M.A.; Rubén Ardila, Ph.D.; Pedro Guerrero, M.D.; Gloria Penagos, M.D.; and Bernardo Useche, Ph.D. “Colombia,” from International Encyclopedia of Sexuality, Volume I-IV 1997-2001, Edited by Robert T. Francoeur. <http://www2.hu-berlin.de/sexology/IES/colombia.html#2>

Kaiser Family Foundation. “US Government and International Family Planning & Reproductive Health.” US Global Health Policy Fact Sheet.

Kraul, Chris. “Colombia launches large-scale birth control effort,” 12 December 2010, Los Angeles Times. <http://articles.latimes.com/2010/dec/12/world/la-fg-colombia-birth-control-20101212>

USAID, “International Alliance For Reproductive, Maternal, and Newborn Health.” <http://www.usaid.gov/our_work/global_health/pop/alliance.html>

USAID, “Obama Administration Statements on Family Planning.”  <http://www.usaid.gov/our_work/global_health/pop/news/obama_fp.html >

Wilson Center < http://www.wilsoncenter.org/events/docs/Gillespie.pdf>

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