Choices and bodily autonomy are key to development

Felicita Hikuam

On 11 July, the world marked World Population Day, with the light shining brightly on the rights to bodily autonomy and integrity, which are prerequisites not only for realization of Sexual and Reproductive Health and Rights (SRHR), but also for overall socio-economic development in our countries and the entire world.

The day is observed annually to raise awareness about global population issues such as family planning, sexual and reproductive health and rights, poverty, gender equality and human rights. This year’s theme was: “Rights and Choices are the Answer: Whether baby boom or bust, the solution to shifting fertility rates lies in prioritising all people’s reproductive health and rights.”

The theme highlighted the critical role of choice and bodily autonomy during the COVID-19 crisis as alarmism over fertility rates has taken hold considering that the COVID pandemic persuaded some people to postpone child bearing while it has taken the option of choice of childbearing from others who have had to deal with unwanted pregnancies due to disruptions in healthcare. As the UNFPA Executive Director states: “The pandemic may influence choices, but the right to decide when and if to have a family does not change. Nor does the responsibility of the heath system to uphold that right.”

According to the United Nations Population Fund (UNFPA), when people, particularly women and girls, can make the most fundamental choices about their bodies, they not only gain in terms of autonomy, but also through advances in health and education, income and safety. They state that communities and countries can flourish only when every individual has the power to make decisions about their bodies and to chart their own futures.

As an integral part of a multi-country partnership and effort to promote respect for and the protection of the rights to bodily autonomy and integrity for all in order to reduce inequality, especially gender inequality and promote health, dignity and wellbeing in southern and east Africa since 2019, we at the AIDS and Rights Alliance for Southern Africa fully associate ourselves with the theme.

We understand the principle of the rights to bodily autonomy and integrity to mean that everyone has inherent dignity and should have the ability to exercise complete agency over their own bodies free from external interference, social or legal sanctions, coercion, violence, discrimination or other forms of interference.

For us, the achievement of sexual and reproductive health and rights depends on the realization of people’s bodily integrity, privacy, and personal autonomy being respected. We also believe that the rights to bodily autonomy and integrity are critical for the creation of just, equal, productive and resilient societies, in which social justice and human dignity are at the center of all development, policy and organising; and health and wellbeing are promoted for all.

Most importantly, we believe that the rights to bodily autonomy and integrity are core principles that can mobilise and unite diverse efforts to address the social and structural determinants of health, addressing gender inequality, and in advancing sexual and reproductive rights.

The rights to bodily autonomy and integrity are very important for everyone especially women, young women, adolescents and people who are marginalized and criminalised. It speaks to the wholeness of a human being – encompassing body and mind. A person’s ability to choose what they do with their body is critical to their ability to live a fulfilling life with dignity; to be a productive member of their society and to contribute to the socioeconomic development of their country.

Although many people use the terms bodily autonomy and bodily integrity interchangeably, they are not synonymous. Bodily autonomy refers to the freedom to make one’s own decisions in relation to one’s body. It puts a premium on agency in the face of social or legal sanctions, coercion, violence and discrimination. Bodily autonomy presupposes choice, itself an offshoot of an informed decision backed by the wherewithal to activate one’s choice. For example, deciding what type of contraceptive, when or if to use it is an example of bodily autonomy, as is choosing when or how often to become pregnant.

Bodily integrity is the right not to have one’s body touched or physically interfered with without one’s consent. Bodily integrity thus protects people from physical assaults such as rape, violence or torture, medical experimentation as well as cruel and inhumane treatment such as female genital mutilation, forced HIV testing, sterilization or sex-assigning surgery for intersex children.

Bodily integrity is a precursor to the attainment of the highest standard of health. Child marriage, which remains rife in many countries but is especially endemic in some parts of east and southern Africa, is a gross violation of bodily autonomy that is often accompanied by forced sex, forced child bearing and other vices.

Ahead of World Population Day, UNFPA released the State of the World Population Report titled: My Body is My Own: Claiming the Right to Autonomy and Self-determination, which states: “For many people, but especially women and girls, life is fraught with losses to bodily integrity and autonomy linked to a lack of agency in making their own decisions. There are many dimensions to the forces that prevent women and adolescent girls from enjoying bodily autonomy and integrity. But a root cause is gender discrimination, which reflects and sustains patriarchal systems of power and spawns gender inequality and disempowerment. Where there are gender-discriminatory social norms, women’s and girls’ bodies can be subject to choices made not by them, but by others, from intimate partners to legislatures. When control rests elsewhere, autonomy remains perpetually out of reach.”

While it should be obvious that the enjoyment of bodily autonomy and bodily integrity is critical to the realization of the full range of human rights and should thus be guaranteed for everybody, the sad reality is that for a disturbingly high number of the world’s women, girls, adolescents and members of the key population, bodily autonomy and bodily integrity remains elusive.

In some of our countries, harmful cultural practices such as sexual initiation, especially for young girls, remains a reality. In addition to this, young people’s sexual and reproductive health and rights are challenged by the fact that they still need permission from their parents or guardians to get tested for HIV or to access contraceptives. As if this is not bad enough, child marriage remains a big challenge, even though it is now common knowledge that it commodifies girls, who lose control over their own bodies and struggle to access health services once married off.

Since the beginning of 2020, COVID-19 has disrupted family planning and access to contraceptives which has fueled early and unwanted pregnancies. We need to face up to this reality. In about six months of lockdown, thousands of school girls all over east and southern Africa fell pregnant and many did not return to school when restrictions were relaxed. What is the implication of that to our vision of sustainable development? A huge chunk of these girls have no remote chance of growing into skilled or knowledgeable human resources for development.

In addition to thousands of girls that fell pregnant and did not return to school, thousands more children have dropped out of school for a plethora of reasons. This will have staggering implications for the future.

It is terribly important that our duty bearers – including but not limited to politicians, religious and traditional leaders – are presented with these harrowing facts. This is where the active involvement of an enlightened and proactive media becomes critical.

The capacity of duty bearers to take necessary action needs to be built. The media must also bridge the gap between the young and the old. Now is the time for the media to stand with everyone in questioning, probing, poring over and challenging duty bearers with respect to retrogressive or harmful public policy. There must be a space or platform for policy makers who are sometimes old and out of touch with BAI violations, and young people who bear the brunt, to exchange ideas.

Now is the time for all hands on board to tackle and bring down barriers to bodily autonomy and bodily integrity. Now is the time for parliamentary assertiveness in the face of the burgeoning phenomena of child marriage, early and unintended pregnancy, and gender-based violence.

Choice and the rights to bodily autonomy and bodily integrity are the cornerstones of sexual and reproductive health and rights. The rights to bodily autonomy and bodily integrity are key for development. To protect and promote the rights to bodily autonomy and bodily integrity, all duty bearers must come to the table.

*Felicita Hikuam is the Director for AIDS and Rights Alliance for southern Africa (ARASA), a regional partnership of civil society organizations working in 18 countries in Southern and East Africa.

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