Reflections on our Countries – July 2019

July 31, 2019


Every month RESURJ members collectively share their feminist analysis and reflect on news, events and personal experiences related to sexual and reproductive justice, as well as environmental and economic justice from the different regions and countries we work in. 

For the July 2019 edition of Reflections on Our Countries, RESURJ members share feminist analysis and opinions from Egypt,  Rwanda and Sri Lanka. We learn more about how the new egyptian Social Health Insurance defines “family” and how that limits access for certain segments of the population. We also dive into important observations on the recent VNR presented by Rwanda at the HLPF, comments related to the importance of making the interlinkages between the different SDGs and not approaching education as a siloed issue. In this issue we will also learn a bit more about the nature of our #365daysofpleasure campaign and the importance of incorporating a pleasure focus into all of our advocacy work, no matter the space. 

We hope you enjoy this month’s Reflections and join us on Twitter and Facebook to continue the conversation. Please also subscribe and share with your networks and allies as we are planning exciting new things for this space!

The “Family”

Nana Abuelsoud, RESURJ member from Egypt.  

On July 1st of 2019, Egypt launched the first pilot steps within the new social health insurance (SHI) in Port Said governorate, as part of a 15-year plan towards a universal health coverage. Over the past years, policy briefs, consultative meetings, and eventually a constitutional acknowledgment of the ‘right to health’ articulated a political will to secure the right to health for everyone. Yet, securing a right does not necessarily mean fulfillment. 

ٍIn the 60s, the Health Insurance Organization (HIO) came to life, with remarkable advancements over time for some groups, including; school students, female heads of households, pensioners and female widowers , but still implicitly excluding others. As of January 2018, the new Social health insurance law marks the frutiation  of decades of conceptualizing without citizen participation, authenticating a single voice and further marginalizing others.  

Article 1 of SHI lists Family Planning services as services aiming to plan childbirths, using birth control technologies, inter alia reproductive education, protection from sexually transmitted infections, prenatal consultation, infertility treatment. 

By now, we have had access to a handful of conceptual glimpses of how the new healthcare system is going to function: 

1) Linking payments and benefits to a national identity card, 

2) Setting ‘Family’ as a distribution unit (previously it was on individual basis), 

3)Establishing the Universal Healthcare Authority: a separate entity to oversee the implementation of SHI, and 

4) A separate funding pool. While SHI claims universality, it leaves us decoding accountability and responsibility towards that system, especially with an unmapped informal sector, made up mostly  by women. 

Over the past months, media coverage released a series of photographs of officials in press conferences, high level events and roundtables delivering the greatest news of #Healthforall. In reality, an added SHI tax has made it to major economic sectors, with an incomplete analysis of how those of us who fall out of the clean-cut categories are going to either benefit and/or contribute to this new healthcare system. 

What is different about these almost-transformative health commitments from past initiatives is; previous health insurance schemes were and are catering for certain groups; through a dispersed system of formalities and bureaucracy. The new move through SHI is a coverage per ‘Family’,rather than ‘household’ which could have been a more inclusive concept. This is not the first time (and sadly, probably not the last) we face the concept of “Family” as an institution that seems too rigid (nuclear heteronormative family) and at the same time, too broad to operationalize and generalize (Which family structure? extended, single parenting, grandfamilies or else?)

In addition to this, access to SHI healthcare services is only granted to those with identification documents. Therefore, leaving unregistered women or girls on the geographical, social and political peripheries for not owning a birth certificate nor a national identity card.

Why don’t we need Family? 

SHI defines Family to be a group of individuals made up of a husband and a wife or more and dependents. This definition is not even attempting universality. There is a teen mother, who is also a widow or single parenting. Another is a woman heading her household in an extended family, and she is divorced. Or a grand aunt raising a child. In reality there are countless structures of families, all of which are legitimate and valid -they have always been, but not institutionalized similarly to a heteronormative nuclear utopian form of what a family is, to be constitutional. 

 The interlinkages missing: Ensuring inclusive, equitable and public quality education in Rwanda by addressing structural inequalities

Chantal Umuhoza, Rwanda, RESURJ member, SPECTRA 

recent story published in the local media of a young girl who was found on the streets in Kigali late at night selling fruits while doing school homework has much to say on investment and interlinkage needed in Rwanda’s education sector.

Quality education and lifelong learning opportunities have the potential to transform societies but this needs strategic, adequate and domestically sourced funding. In addition, education investment has to go hand in hand with addressing other structural and systemic factors that hinder those most left behind to fully access their right to education.  

Rwanda’s VNR reports that enrollment in free primary basic education is over 98%, however, the rate of enrollment doesn’t tell the full story.The report falls short  on addressing the impact that the indirect costs of education have on families which may include school materials and uniforms, transport, food, water among others. These additional costs keep families in vicious  cycles of poverty and deprivation, and keep children from attending school. Indirect costs drive families and school going children to struggle for survival means, like in the case of the girl in the story mentioned above.

Education therefore is  intrinsically linked to other sectors and aspects including poverty eradication, gender responsive social protection and public services, universal health care, food security, decent housing, sanitation, violence free and peaceful environment.

Rwanda’s VNR reports on gender parity in education only in case of enrollment but doesn’t highlight progress in addressing other gender based barriers including the burden of care and domestic work on women and girls, household and school based gender based violence, access to comprehensive seuality education and sexual and reproductive health services especially to ensure prevention of unwanted pregnancies that contribute to school drop-out, poverty and vulnerability among others.

 We welcome the link that the Rwanda’s VNR makes between education and public infrastructure and services including access to electricity, water, toilets and internet within the school environment.   But we need to go further to also address the lack of public infrastructure and services at community levels that have an impact on the full realisation of the right to education, among the poorest. 

 More than 60% of Rwanda’s population is below 25 years. If realisation of a demographic dividend can be achieved for a sustainable, equitable and transformative society, adequate and strategic investment is crucial, targeting the out of school and unemployed youth in all aspects. Currently, there is a large  population of young people that have dropped out of school, some that have completed secondary school but can’t afford the high costs in higher learning institutions and those that have finished higher learning but have failed to get employment or start up capital for businesses. This poses a risk of having future generations engraved in extreme poverty and related cycles. There is therefore a need to ensure that investment in education, training and skills development reflect the realities and needs of young people and that career development, social protection, and unemployment welfare systems are strengthened  today.

 Last but not least, the unskilled, gender perspective indifferent and underpaid teachers in public pre-school, primary and secondary schools pose a challenge to the realisation of quality and transformative education that teaches children, adolescents and youth critical thinking. Ensuring well trained professionals, decent work conditions and a satisfactory living wage of teachers is equally important

Finding the Pleasure Point in Internet Policy Spaces

Sachini Perera RESURJ member from Sri Lanka and founder of GHOSHA 

The following is an excerpt from a published article, you can find the full paper here:

Someone called me a policy animal a few years back and I grudgingly agreed that indeed I’m one of those people who does get excited by the idea of influencing policy negotiations and policymaking. Grudgingly – because policy spaces, especially the grey corridors of the United Nations that I frequent for advocacy, are not fun places to be in. They are so far removed from ground realities, both geographically and empathetically. They are stiff, formal and hierarchical. Let alone getting our language and politics into policy documents, even getting our foot in the door as civil society is often considered a victory. They are tedious and often disempowering; the changes we manage to make are incremental and often invisible and human rights are traded away by states for overriding geopolitical interests with incredible ease. Especially the human rights of people who are already marginalised and disempowered. In spite of all of this, there is a thrill and geekery in trying to understand the dynamics between countries and country blocks, identifying allies and accomplices within state delegations and civil society, working with other feminists to raise our priority issues and find strategic ways to introduce progressive language to policy negotiations and outcomes.

There is also an imperative to be present in policy spaces to hold the line on the gains we have made over the years, especially as rising conservatism and populism from states and certain groups within civil society threatens those gains more than ever. There is a lot of heartbreak in watching the issues closest to our hearts being excluded or watered down but the payoff can be equally satisfying and pleasurable, such as finally ensuring that gender equality is a standalone goal in the 2030 Agenda on Sustainable Development or watching the efforts of activists to secure a main session on gender at the global Internet Governance Forum.

The achievement and advancement of our human rights is a dynamic process that involves;

  • us having the agency to name our rights and their violations
  • the recognition of our rights both socially and legally, and
  • the freedom to claim and assert our rights through state and non-state mechanisms.

…and the policy space, whether at local, national, regional or global levels, is a key space in which this process unfolds.

There is pleasure in doing policy advocacy as a direct constituency or facilitating the advocacy of others (and I would not disagree if I’m called a masochist for finding this grueling process pleasurable), but pleasure seems to be largely missing from the substantive discussions and negotiations that happening in policy spaces and this is an attempt to explore why.