Middle East and Northern Africa

The Middle East & North Africa (MENA) Regional Consultation on Women’s Health & Rights took place on Sunday, May 26, 2013 in Kuala Lumpur, Malaysia with coordinating partners the Women’s Learning Partnership (WLP) and the Choices and Challenges in Changing Childbirth (CCCC) Regional Network.

The consultation, held as a pre-meeting to Women Deliver’s third global conference, convened approximately 60 experts and advocates from more than 20 different countries. Participants came from a wide range of backgrounds, representing regional governments, professional and academic networks, multilaterals, United Nations agencies, donor countries, and civil society groups. View the full report for a comprehensive description of the meeting.

Conversations at the MENA Regional Consultation laid out a number of recommendations and goals for a potential development framework for the region. The following are the top ten key recommendations highlighted by participants and experts:

1. ENSURE A SAFE AND HEALTHY ENVIRONMENT FOR GIRLS AND WOMEN: The ongoing, volatile political situation in many MENA countries has led to challenges on the health, rights and safety of girls and women in the region. Female genital mutilation, polygamy, maternal mortality and morbidity, and unemployment are all on the rise among women in the region. Women’s political participation, education enrollment, and general independence have been threatened as well. Healthcare systems in conflict zones have been negatively impacted, and in some cases, destroyed.  Displaced populations are straining social and political systems in neighboring countries, and many refugees are unable to access safe and effective healthcare services. Moreover, violence against women has become more prominent in refugee camps and broader societies.

Policymakers in the MENA region must be held accountable for ensuring the safety and wellbeing of girls and women. MENA societies must make a commitment to creating, cultivating and ensuring a healthy working environment for women and girls. Girls and women must be granted the same opportunities as men, including access to education, healthcare services, employment, and political positions.

Laws must eliminate rape, female genital mutilation, public beatings, and other forms of gender-based violence against women in the region. Social policies must be implemented to guarantee all women and girls safe maternal and reproductive healthcare services, even in conflict zones and refugee camps.

In addition to the ongoing struggles women in the MENA region face on their health, rights and general wellbeing, sudden relief in conflict zones must be prioritized. There needs to be a more reliable system to monitor the health and safety of displaced women. Health professionals must be trained to provide care in emergency situations, especially considering that they are also members of the displaced populations. 

2) STAND ALONE GOAL FOR GENDER EQUALITY: Future development goals, written regionally and internationally, must take into account the role of girls and women at every level. Gender rights and equality should be integrated into every development initiative, from the grassroots efforts to policy changes, in order to ensure that voices advocating for girls and women of the MENA region are heard at every level.

Sexual and reproductive health and rights (SRHR), while incorporated into the MDGs and post-2015 development framework, deserve special attention and action in order to ensure that they are achieved for every girl and woman, both in the MENA region and globally. Guaranteeing SRHR in the MENA region should be a standalone goal and will require additional financial resources and political commitments from regional and international policymakers, donors and advocates.

Additionally, there a system should be implemented to closely monitor progress (or lack thereof) in accomplishing SRHR goals, including but not limited to: meeting the need for contraceptives and other family planning methods, eliminating gender-based violence, ending child marriage, halting the spread of STIs, providing quality maternal and reproductive healthcare, ensuring access to safe abortion, and other human rights services.

3) IMPROVE COMMUNICATION AROUND WOMEN’S HEALTH AND RIGHTS: Language used to advocate for girls’ and women’s health, rights and wellbeing is often complex and cannot be universally applied, even within MENA. Advocates should begin to use language that is more accessible to help their audience identify with their messages, framing women’s issues in a way that allows the general public to contextualize the situation and empathize with the cause.

New communications tactics should lead to renewed thinking of women’s role in promoting regional health, development, stability and democracy. Messages should emphasize that although political diversity exists within the region, women’s social and economic rights are equal to those of men. They should also position women as regional and global priorities, ensuring that their health and wellbeing are at the top of development agendas as the region undergoes this volatile transition.

Experts and advocates for MENA women should also make an effort to engage more closely with local and global media. Media outlets and reporters should be viewed as partners in the women’s movement as they can relay messages to broader audiences efficiently and effectively. Similarly, journalists interested in publishing stories about women’s health and rights should seek out individuals and organizations working on relevant issues.

4) TAKE A MORE YOUTH-INCLUSIVE APPROACH TO DEVELOPMENT: Between 1950 and 1980, MENA countries experienced large declines in infant mortality rates and high increases in fertility rates, leading to the region’s current demographic “youth bulge.” About one out of three people in the region is between the ages of 10 and 24, and youth make up the largest cohort in the region’s history. Yet despite comprising a significant portion of the MENA population, youth are often excluded from development conversations and agendas and are not seen as catalysts for change.

Development agendas in the MENA region should prioritize youth involvement moving forward. Youth should be given a voice in writing and executing agendas as well. The young people of the region should be viewed as allies, which will pay dividends at every level at society. Engaging youth will help spur development agendas, reduce the high unemployment rates, contribute to regional stability, and eventually promote economic growth.

Youth should be included and engaged in sexual and reproductive health education and service programs to ensure that the population as a whole is as healthy and productive as possible. Including youth will help slow the spread of sexually transmitted infections, prevent unwanted pregnancies, promote education enrollment, reduce maternal mortality and morbidity, and provide additional social, economic and political benefits to the broader society.

5) CREATE A REGIONAL NETWORK FOR WOMEN’S HEALTH AND RIGHTS: Experts and advocates of different backgrounds should work together more closely to promote the health and wellbeing of women and girls. In the MENA region, there should be a more concerted effort to bridge groups that focus on promoting democracy, peace and/or women’s rights with those that work on maternal and reproductive health and rights more specifically. Additionally, women’s health advocates should engage and work with politicians and parliamentarians that are already advocating for women’s rights.

A regional network connecting women’s health groups, rights activists, and policymakers would widen impact, improve effectiveness, and avoid duplicated efforts. It would also ensure that communications is synchronized and amplify voices advocating for the same development goals for girls and women. This network should aim to horizontally integrate women’s health and rights groups working at the grassroots level. Such groups can exchange lessons learned and strategize ways to overcome similar challenges they face when advocating for girls and women in the MENA region. The regional network should also strive to have a stronger presence on the global level, ensuring recognition for the MENA region during international development conversations and events in the lead up to the 2015 MDGs deadline, through the post-2015 development framework, and beyond.

6) CHANGE REGIONAL CONVERSATIONS AROUND ABORTION: Abortion has become a larger part of global conversations on family planning and reproductive health, but remains a “taboo” topic in most of the MENA region. In many MENA countries, abortion is illegal and can only be performed if the procedure will save the life of the mother. But despite legal constraints, it is estimated that more than three million unsafe abortions are performed in the region each year and contribute to almost 15% of maternal deaths. Additionally, laws forbidding abortion lead women to be financially exploited as providers unnecessarily raise the cost of the procedure.

Conversations in the MENA region tend to position abortion as a contraceptive method, when it should be viewed as a failure of contraception that contributes to high rates of maternal mortality and morbidity. Experts and advocates should overcome their fears of addressing abortion – safe and unsafe – in public spaces by moving conversations away from religion and politics to discussions about improving access to contraception, reducing maternal mortality and morbidity, and empowering women. Additionally, language around abortion should be rephrased to approach the issue as “prevention of unwanted pregnancy.”

Policymakers should begin by legalizing abortion services for specific situations, including rape and incest, and expanding sexual and reproductive health education programs. Eventually, laws should allow safe abortion services to all women, married and unmarried, at affordable prices.

7) EMPOWER MIDWIVES IN HEALTHCARE MODELS: Midwives usually provide more women-centric care and are better able to understand a pregnant woman’s needs and challenges.  Systems in the region should promote models that put midwives at the center of maternal and reproductive healthcare services and education programs. Empowering midwives will help provide a more comprehensive understanding of women and pregnancy, normalize birthing practices, and reduce the increasing number of C-sections in the MENA region.

Experts, advocates and policymakers should create a regional working group that will aim to develop strategies that strengthen midwifery practices. Based in the region, the group should mobilize midwifery associations and individual midwives; identify and support young champions; and attend regional and global meetings on maternal and reproductive health. The group could be supported by organizations such as the International Confederation of Midwives (ICM), UNFPA, International Federation of Gynecology and Obstetrics (FIGO), Women Deliver and other regional and international organizations.

8) ENCOURAGE INTER-PROFESSIONAL COLLABORATION: Evidence shows that healthcare providers who work together to manage the complex health issues of the entire birthing family play a key role in reducing maternal mortality and morbidity. There is a need for increased collaboration between physicians, nurses, midwives and other providers in the MENA region. Such collaboration between healthcare professionals will ensure that women and children are provided with the most holistic and effective care during pregnancy, childbirth and postnatal. Strategic interventions aiming to enhance inter-professional collaboration should promote open dialogue and create partnerships between individuals and/or organizations in the region, while allowing each respective profession to focus on the care they are most knowledgeable and experienced in providing.

9) DIFFERENTIATE THE MIDDLE EAST AND NORTH AFRICA: Too often, the MENA region is grouped in or even left out of global development progress reports. It is essential to track development progress in the MENA region so that trends can be compared on a global scale and so that region-specific needs can be highlighted and prioritized. Differentiating the region from other parts of Asia and/or Africa is vital to ensuring that girls’ and women’s needs are met in current and future development frameworks. Additionally, analysts would be better able to assess how well development programs impacting girls and women are being implemented and executed in the region and conduct intra- and inter-regional comparisons. Researchers, experts, advocates and policymakers in the MENA region should call on regional organizations, multilaterals and other international organizations to be more consistent in their definition of the “MENA region,” “Arab World,” “Eastern Mediterranean,” or other geographic descriptions. 

10) ACTIVATE THE DIASPORA: As the world because increasingly globalized, regional issues can no longer be addressed in isolation as they inevitably impact those beyond designated geographic borders.  The Diaspora community living outside of MENA countries has a large role to play in guaranteeing the safety, health, rights and prosperity of girls and women in the region. Outside voices that are more removed from economic and political confounding factors can amplify those advocating for girls and women in the region. The Diaspora can apply increased pressure to international communities to commit to guaranteeing the sexual and reproductive health and rights and other human rights for the girls and women in the MENA region.





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