KUALA LUMPUR, Oct 28 – Advocates have told political parties and politicians not to ignore sexual and reproductive health (SRH) issues that affect women, community, and even the economy at large.
SRH issues seldom receive the attention it deserves from political parties despite its critical impact on various aspects of women’s lives, including health, safety, education, economic and social prospects, said obstetrician and gynaecologist Dr John Teo.
“The sexual and reproductive health framework includes access to accurate information, affordable and highly effective contraceptive methods, protection from STDs (sexually transmitted disease) and access to skilled health care.”
According to the Families on the Edge report by Unicef, which explores the immediate socio-economic impact of the Covid-19 pandemic on women and children in low-income urban families in Malaysia, women and children are rendered most vulnerable and suffer the most in a crisis, particularly those from the B40 income group as well as undocumented and marginalised communities, said Dr Teo.
He added that investing in sexual and reproductive health is a way to ensure that family sizes and spacing remain optimal to a couple’s desire, while taking into account their financial ability to provide for their family including ensuring health care and education.
“If we can ensure that women and children are healthy–the compulsory precursor to a healthy family, community and nation–then we can solve a large proportion of all the ensuing problems and issues that the nation faces,” Dr Teo said.
Unintended Pregnancies And Baby Dumping Are Major SRH Issues
Unintended pregnancies is a major sexual and reproductive health issue in Malaysia, said Dr Teo, who added that 40 per cent of pregnancies in Malaysia are estimated to be unplanned.
To address this, he suggested that one per cent of the health care budget be allocated for family planning.
This allocation can go towards increasing the availability of highly effective contraception such as hormonal implants or intrauterine devices, training on SRH for health care providers, and disseminating accurate information to the public.
Another SRH issue that remains a serious problem in the country is baby dumping, said Dr Teo, adding that one baby is dumped every three days.
He said this issue should be tackled by implementing comprehensive sexuality education (CSE) in all school systems and amending laws to ensure access to SRH services for all adolescents in need.
Improve CSE In Schools
The Reproductive Rights Advocacy Alliance Malaysia (RRAAM) said that although sex education is provided in government schools as per the Ministry of Education, it is mostly abstinence-based.
“The main feature of this type of education is that it promotes abstinence from sexual activities,” RRAAM told Ova in a statement.
“Our syllabus is not comprehensive by the standard of the International Technical Guidance on Sexuality Education (ITGSE).
“CSE provides medically accurate age-appropriate information about abstinence, as well as safer sex practices including contraception and condoms as effective ways to reduce unintended pregnancy and STIs (sexually transmitted infections).
“It also includes information about healthy relationships, communication skills, and human development, among other topics.”
The content can be improved by including age-appropriate and non-judgemental scientifically and medically accurate information on sexual and reproductive health, while promoting positive values, said RRAAM, adding that public education and awareness is also important.
“Educating boys on gender equality is a strategy to prevent sexual abuse and gender based violence,” said the reproductive rights group, adding that youth-friendly sexual and reproductive health care services should also be made available.
Another critical SRH issue is STDs and cervical cancer, which continue to pose very significant risks to all women, said Dr Teo.
He recommended making STDs clinics available nationwide and increasing the budget allocation for STD detection tests and treatments.
Dr Teo said a national cervical cancer call and recall screening system for all women should also be implemented.
Discriminatory Policies Hinder Access To Health Care
The underlying problem when it comes to addressing health care for women in Malaysia are discriminatory policies, according to RRAAM president Dr Subatra Jayaraj.
She proposed removing all barriers to health care access, especially for sexual and reproductive health, as well as mental health services, and institutionalising non-discriminatory policies and data driven guidelines in health care.
Dr Subatra, who runs her own primary care clinic in Petaling Jaya, also proposed that the government commit to gender-responsive budgeting in health care.
“The Malaysian government is shameless in ignoring international covenants while claiming to be a progressive first world nation,” RRAAM founding member Dr SP Choong told Ova.
“On women’s rights, all they need to do is to study the clauses of Cedaw (convention on the elimination of discrimination against all women) and implement them through formal legislation without exception.
“In particular, it is essential that religious beliefs are not allowed to impinge on any woman’s civil rights under such laws.”
Ova previously reported on how cultural and religious beliefs affect access to contraception and abortion in Malaysia.
Women and children’s health currently fall under the purview of both the Ministry of Health and the Ministry of Women, Family and Community Development, said Dr Teo. “Due to the intermixing of responsibilities between ministries, the focus often gets lost in translation.”
Dr Teo proposed the establishment of a Women’s Health Commission that is headed by a commissioner who reports only to the Parliamentary Select Committee on Women and Children Affairs and Social Development or to Parliament directly.
“But not to the government of the day as this is critical in advocating for this crucial agenda,” he said, referring to SRH.