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Knowledge Gaps Keep Many Women From Exercising Their Reproductive Rights
March 8 marked International Women’s Day, which celebrates the economic, political, and social achievements of women in the past and present, while simultaneously calling for greater equality in the future. While many of the day’s discussions focused on economic and social issues, the right to reproductive health is also a crucial element in realizing full equality.
To ensure reproductive health rights, women must be able to decide whether or when to have children; have access to the best reproductive health care that is available; and have the ability to make choices regarding their reproductive health without force or discrimination. These rights are not only a moral obligation, but ensuring them is one of the most cost effective development interventions available, according to research by the Copenhagen Consensus Center.
For many women around the world, however, they are far from a reality. The common denominator in ensuring reproductive health rights is knowledge. Even where there is access to services, women need to have the necessary knowledge and skills to make decisions about their fertility within a context of high-quality health care and free from stigma. And the medical professionals they work with need to be reliable partners. Unfortunately, many women in less developed countries do not possess the relevant knowledge to make voluntary, informed decisions about their reproductive health.
Better Quality of Care
Several treaties, national constitutions, and laws provide guarantees related to access to contraceptive information and services, and numerous legislative bodies have explicitly made the link between human rights and contraceptive information and services. Simply put, access to reproductive health is a woman’s right. Women must also have a choice in their contraceptive methods – which can only be achieved if countries have the appropriate mix of quality reproductive health supplies. Within the context of reproductive health services, this includes, at a minimum, informed and voluntary decision-making, counseling, client safety, and service quality.
Not only a moral obligation, but one of the most cost effective interventions availableA critical factor in realizing this right is the role of health professionals. Despite recent improvements in technology – mobile phone coverage and online communication is on the rise in low- and middle-income countries – health professionals often lack the knowledge they need to make evidence-based decisions and provide their clients with the best possible care. Quality of care for women is a major problem in some countries, and the need for knowledge persists at all levels, from the global policy level to the national, regional, and community.
Knowledge management, the systematic process of collecting and curating knowledge and connecting people to it so they can act effectively, can help fill this gap by ensuring that treatments are disbursed correctly and women understand the decisions they’re making. By assessing specific needs and responding to them, knowledge management helps strengthen both individual and organizational capacity, which in turn can improve reproductive health outcomes.
Provider Guidance
Helping doctors, midwives, and other health care providers offer women a full range of contraceptive options is a key step toward attaining reproductive health rights. Making this a reality, however, involves addressing more than operational and supply issues, which sometimes dominate the discussion, but knowledge gaps as well. For example, a clinic may have a full stock of IUDs, but if clinicians do not have the proper knowledge to determine eligibility and properly counsel their clients, women’s choices are limited.
A range of materials have been designed and distributed to help providers in these situations. For example, Family Planning: A Global Handbook for Service Providers, developed by experts from the Johns Hopkins Bloomberg School of Health, World Health Organization, USAID, and more than 30 other organizations, provides a synthesis of the latest contraceptive research in a user-friendly guide and wall chart. Efforts like these are a step in the right direction, but more understanding is needed in order to address barriers to providers’ access to the specific, up-to-date, and contextualized knowledge they need to do their jobs.
Building a Global Community
While community-level knowledge is crucial for guaranteeing reproductive health and rights at the point of contact with patients, knowledge management’s role in ensuring a supportive policy environment shouldn’t be overlooked. There is no shortage of advice for decision-makers on country-level health policy, but they often need to know how to implement these strategies. This is where knowledge management can help.
Decision-makers often need to know how to implement strategiesThe Family Planning 2020 (FP2020) initiative, for example, has developed an online package to help country leaders develop and implement “Costed Implementation Plans,” or CIPs. CIPs are multi-year strategies that help governments efficiently and effectively achieve their national family planning goals. The resource guide, which will soon be available on the FP2020 website, uses a variety of knowledge management techniques – including synthesis, generation, capture, and sharing – to provide relevant tools to decision-makers. Countries that have already implemented CIPs can share their stories and experiences to help other countries overcome similar barriers. This sort of knowledge sharing can foster a community of reproductive health professionals and strengthen health systems to improve outcomes for women and their families.
As the appalling knowledge gaps in some health systems around the world demonstrate, there is still work to be done in advancing women’s health and rights. By ensuring that the right information is available at the right time, knowledge management can help health professionals at all levels counsel their clients on a range of reproductive health options. This, in turn, allows women to have more control over their bodies, health, and (re)productive lives.
Rupali J. Limaye is the research director for the Knowledge for Health (K4Health) Project, which is housed at the Johns Hopkins Center for Communication Programs, and serves as associate faculty at the Johns Hopkins Bloomberg School of Public Health. Sarah V. Harlan is the learning director for the K4Health Project.
Sources: Copenhagen Consensus Center, The Economist, Family Planning 2020, Human Resources for Health, Journal of Health communication, K4Health, UN Office of the High Commissioner for Human Rights, UNFPA, World Health Organization.
Photo Credit: A health clinic in Nepal, courtesy of Aisha Faquir/World Bank.