AFD co-funded project on improving access to sexual and reproductive health and rights in Sri Lanka
In 2015 co-funded by Agence Française de Development (French Agency for Development, AFD) and Médecins du Monde (MDM), or Doctors of the World, started a 1 M€ project to improve access to sexual and reproductive health (SRH) and Gender Based Violence (GBV) related services and reduce maternal mortality and morbidity in Sri Lanka. The AFD/MDM co-sponsored intervention is implemented by Human Development Organization (HDO), a local organization working in the plantation sector in the Central province of Sri Lanka, and several other local organization working in the Northern and Eastern provinces.
Sri Lanka maintains its high standards of health services and education with remarkable health and education indicators, and is identified as a country comparable with the developed world. A low maternal mortality ratio, low infant mortality rate, high literacy rate, and high life expectancy are some of the key achievements. While this is well recognized and appreciated, still, women and young people in Sri Lanka face significant barriers in accessing Sexual and Reproductive Health and Rights information and services, which create adverse effects on health and wellbeing of women and youth violating some of their basic human rights.
Inadequate knowledge on sexual and reproductive health and cultural barriers that create stigma and discrimination around accessing sexual and reproductive health services are key deterrents that create challenges for women and young people to access information and services particularly in the plantation areas in Sri Lanka. Adolescents and young people do not have access to proper information and teachers or sometimes health service providers are reluctant to discuss and provide accurate information these topics as a result of cultural barriers. Some of the key issues and challenges therefore need to be addressed in the implementation areas are unprotected sex, teenage pregnancies, unsafe abortions, sexually transmitted infections, HIV and AIDS, and Gender Based Violence.
In order to attempt to bridge some of these gaps AFD and MDM along with its partners are working with the Ministry of Health, National STI and AIDS control programme and National Youth Corps; the largest government youth training institute closely building capacities of health service providers such as public health midwives, nurses, teachers, principals, trainers, and community leaders to address SRH related issues more comprehensively in a culturally sensitive manner.
Awareness sessions on SRH are conducted to community members and also further training on sexual and reproductive health aspect and ethical non-judgemental service provision to in service and student Public health midwives. Teacher counsellors, principals and trainers of National Youth Corps are also being trained and sensitised about the importance of providing sexuality and relationship education in schools and about the importance of counselling and psychosocial support to young people in the North.
In the plantations, community based groups get together every month to discuss women and young people’s health issues and the trained health volunteers of MDM’s partner organisation refer them to access relevant services. In the plantation they are also lobbying and advocating for legal and policy changes to integrate the plantation health system to the national health system to ensure free, quality and standard service provision to people living in the plantations, since some areas in the plantations are not under the national health system yet. In our work we generally finding it difficult to engage men and boys in the conversation but our partner organisations are using various youth friendly techniques such as sports festivals and theatre to engage them in the conversation and create a dialogue around preventing violence against women and girls.
It is incredible to see the improved access to health services and increased dialogue around SRH GBV related issues in the community as a result of project’s intervention and moreover all the life changing stories of empowerment shared by community members.