Key Issues for Political Advocacy in Sexual and reproductive Rights in Africa.

1| MAP OF SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS IN AFRICA AND SPAIN
KEY ISSUES FOR POLITICAL
ADVOCACY IN SEXUAL
AND REPRODUCTIVE
RIGHTS IN AFRICA
African-Spanish Women’s Network for a Better World
December, 2011
Ana Lydia Fernandez Layos & Maria Elena Ruiz Abril

KEY ISSUES FOR POLITICAL ADVOCACY IN SEXUAL AND
REPRODUCTIVE RIGHTS IN AFRICAi
INTRODUCTION
This document is intended as an example of how to use data in the fight for women’s
sexual and reproductive rights. Information is power and when deployed strategically,
data can become the best ally in advancing the agenda of women’s rights. The data
upon which this publication is based derive from the Database of the Map of Sexual and
Reproductive Health in Africa and Spain, produced by the African Spanish Women’s
Network for a Better World.
The information in this document and the indicators in the Database in general are
probably not new. However, what is new is how they have been brought together in these
fact sheets to create messages for advocacy and for political action. The value added of
the database in this publication is not that it offers the latest figures with respect to the
maternal mortality or gender violence in 11 African countries. This can be found in other
reports. The value added is that right besides the information on maternal mortality in one
country the reader/user can find information on public expenditure on health in the same
country, and right besides information on whether abortion is legal or not in the country in
question. This will allow each and every interested activist to combine indicators and use
the information to create clear political claims and political advocacy messages to
influence governments and advance women’s sexual and reproductive rights.
CONTENTS AND METHODOLOGY
The Database. The Database of the Map of Sexual and Reproductive Health and Rights in
Africa and Spain, available at www.map-srhr.org, offers key information for sexual and
reproductive health and rights for 11 African countries. The information was collected via
various statistical sources and completed through interviews with civil society organisations
who lobby for Sexual and Reproductive Health and Rights in Africa. The 11 countries
included in the database are Cape Verde, Niger, Senegal, Mali and Gambia (in West
Africa), Namibia, Angola and Mozambique (in South Africa), Ethiopia and Kenya in the
Horn of Africa and the Democratic Republic of the Congo in Central Africa. In Appendix 1
of the present publication, there is a detailed list of indicators of the Database, divided
over the following blocks:
• Indicators of Human Development;
• Indicators of Gender;
• Indicators of Safe Maternity;
• Other indicators of Sexual and Reproductive Health;
• Indicators of Sexual and Reproductive Health among the Youth;
• Indicators of Gender Based Violence;
• Indicators of Access to Sexual and Reproductive Health Services;
2| KEY ISSUES FOR POLITICAL ADVOCACY IN SEXUAL AND REPRODUCTIVE RIGHTS IN AFRICA

• Legal and Policy Instruments in the fields of Human Rights at the Regional, National
and International levels;
• Public Expenditure on Health;
• National Policies and Strategies on Gender and on Sexual and Reproductive Health;
• State and Civil Society Agents working in the field of Sexual and Reproductive Health
and Rights.
Thematic fact sheets. The following 8 fact sheets offer examples of types of analysis that
can be made using the data collected in the Database of the Map of Sexual and
reproductive Health and Rights in Africa and Spain. The criteria used in the choice of the
subjects for these thematic fact sheets were its relevance in the analysis of Sexual and
Reproductive Rights in Africa, together with their potential to motivate political action. In a
user friendly and didactic manner, each fact sheet shows what is the issue in question and
what is happening regarding that issue in the 11 countries, what governments are doing
about it, and what civil society can do through political advocacy in that area. When
recourse has been made to information from other sources outside the database to
contextualise and support various elements of analysis, this has been duly referenced. The
themes chosen for this publication are presented next. It goes without saying that the
database allows for different themes and indicators to be analysed depending on the
interests and needs of the user and activist.
File 1: Abortion
File 2: Maternal Mortality
File 3: Early Motherhood
File 4: Family Planning
File 5: Gender Based Violence
File 6: HIV/AIDS
File 7: Sexual Discrimination
File 8: Legal and political Instruments in Health and SRR
The country profiles. Another way of using the information in the Database is by country
profile or overview. To this effect country profiles have been developed for each of the 11
countries. Each profile includes a narrative of the indicators included in the Database,
together with a table that offers all the information at a ready glance. The country profiles
are available on the online version of the Map, to be accessed on www.map-srhr.org
CONCLUSIONS
The fact sheets offer an overview of the situation of sexual and reproductive rights in
Africa through the analysis of 11 countries. The situation of Sexual and Reproductive
Health and Rights in Africa, as culled from the selected files, can be summed up in
the following manner:
KEY ISSUES FOR POLITICAL ADVOCACY IN SEXUAL AND REPRODUCTIVE RIGHTS IN AFRICA | 3

• Maternal mortality is still high, limiting the basic rights of many women in Africa. The
good news is that a large number of countries have taken measures to bring down
the maternal mortality, beginning with the launching of the CARMMA campaign.
However, there is still much to be done. In spite of being responsible for half of the
maternal deaths in the Region, abortion is still illegal in most countries in Africa.
• Activists and governments need to give more attention to the sexual and
reproductive health and rights of young men and women. Some problems such as
teenage pregnancy have taken on alarming dimensions in many countries, with
serious repercussions on the possibility of the development of future generations. Early
marriages, a practice closely related to teenage pregnancy require forthright
solutions and responses on the part of the institutions and communities in the Region.
• Access to family planning is still a challenge in Africa. Africa is the region with least
use of contraception in the world, with less than 3 out of every 10 women using
modern methods of birth control. Without a doubt, this lack of access to
contraception has serious repercussions on the life of the women in Africa and on
their possibilities to fully exert their rights. It also has an adverse influence on other key
indicators for the development of the Region.
• Gender-based violence is probably one of the most serious problems that women
suffer, taking on terrifying dimensions. For example, 85% of the women in Mali have
undergone Ablation; in South Africa, a woman dies every six hours at the hands of her
partner and in the DRC there are over 1,100 cases of rape per month. In spite of
advances in legislation designed to combat violence against women, there is still
much to do regarding the implementation of specific measures.
• HIV/AIDS, a serious problem in Africa, hits women in the Region harder. Inequality and
discrimination increase the negative impact of HIV/AIDS on women the continent
over. A greater investment in information and awareness together with sexual-
emotional education for women and men is vital to stave the advance of HIV/AIDS in
Africa.
• Unfortunately, the LGTB population still suffers serious breaches of their rights in many
parts of Africa. What is even cause of more concern is that discrimination against
LGTB is sometimes legitimised from state institutions in some countries.
• African countries have sufficient instruments at a regional and international level to
defend sexual and reproductive health rights. The rhythm of ratification is fine but the
implementation is still lagging far behind desirable levels.
At the level of political advocacy, some of the conclusions that can be reached are the
following:
• Civil society and the women’s movement in Africa, and beyond the frontiers of Africa
through inter-regional and international treaties have a role to play in making
governments take action in all of the areas analysed in this document. This may take
the shape of lobbying for the ratification of the treaties, or the launching of
CARMMA, through to the application of the present legislation in the field of gender-

based violence or the promotion of new legislation to make abortion legal or to give
the LGTB community full rights.
• When undertaking advocacy work, having data and knowing how to use them is
essential. Therefore, all of an effort must be made to press governments to integrate a
gender perspective in national information and statistic systems. Here, the role of the
women’s movement may be to foster cross-learning by presenting best practice of how
this has been done in other places.
• There is also, in a second instance, a lot of work to do to use such data strategically in the
fight for women’s rights. The factsheets in this publication use the strategy of name and
shame. However, there are many other ways in which to use data and the potential of
statistics in advocacy can go much further. To this effect, we may need to invest in
strengthening the capacity of activists in Africa (and elsewhere) to analyse and use
strategically in advocacy work.
• There are a series of tools that can be used in advocacy. We should not keep
reinventing the wheel but rather accessing and using existing resources, treaties and
databases for advocacy work. The fact sheets have mentioned some of them.
In the long run, what is most important is how each and every one of us uses this resource.
What is most important is how the data relate to what you are doing, as an activist or
researcher. This document is an invitation for you to put together your own fact-sheets,
leaflets, messages, advocacy tools or strategies for political action in favour of women’s
sexual and reproductive rights.

Despite the fact that it is responsible for over half the maternal deaths in Africa, abortion is
still illegal in most African countries. The WHO (2004) calculated that one out of every four
deaths related to pregnancy in the world was the result of unsafe practices in abortion.
Besides, it claimed that in Sub-Saharan Africa, 50% of the maternal deaths were due to
unsafe abortions. Of the 11 countries analysed, Angola, Mozambique, Ethiopia, Kenya
and the DRC have the highest unsafe abortion rates with 36 per 1,000 women between16
and 44, whereas Namibia has the lowest with 9 per 1,000 women between16 and 44. Of
the countries analysed, only in Cape Verde is abortion legal in the first 12 weeks of
pregnancy. In all the rest, abortion is illegal. In these countries, abortions may be carried
out only in exceptional circumstances that vary according to the country.
DESPITE BEING RESPONSIBLE FOR MORE THAN
ABORTION IS STILL ILLEGAL IN MOST COUNTRIES
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Figure 1. Abortion is illegal despite being a major cause of maternal mortality
Number of maternal deaths due to abortion per 100,000 live births
Illegal abortion
Legal abortion
Source: unsafe abortion data, regional estimations of the WHO 2011; data on legislation (Database of the Map of
Sexual and Reproductive Health in Africa and Spain, 2011)

POLITICAL ADVOCACY TIPS
You can tell your government that:
- Being able to choose how many children you want to have and when, is one of the
rights that it has committed to uphold (CEDAW, the Cairo Action Plan).
- Abortion is responsible for half the maternal deaths in Africa.
You can call upon your government:
- To be courageous and to initiate a process of social dialogue to legalise abortion.
- To increase the % of public expenditure on Sexual and Reproductive Health to
guarantee access to efficient methods of family planning.
Data are essential to do advocacy work. Without data, we cannot measure our progress.
Therefore, check up whether your country holds date with respect to the number of abortions
practised, the number of deaths as the result of abortions, etc.:
- If not, lobby for them to collect the data.
- If they do, compare the situation with other countries in the region to see whether your
country profiles well or badly in the family “photo”. Journalists love photos, so spread
the news around with an explanation of the causes and consequences of unsafe
practices in abortion for women and girls, and for the society in general.
MAP OF SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS IN AFRICA AND SPAIN | 7
HALF OF THE MATERNAL DEATHS IN AFRICA,
IN THE REGION.

As has been acknowledged in various international agreements, maternal mortality is a clear
indicator of inequality, poverty, lack of adequate medical care and a serious violation of the
basic rights of women. For this reason, improvements in the field of maternal health constitute
one of the eight Millennium Development Goals adopted by the international community in
2000. MDG 5 consists in reducing the maternal death rate by 75% between 1990 and 2015.
Maternal death rates are a clear violation of human rights and the right to health of all women
acknowledged under the Universal Declaration of Human Rights and the International Pact for
Economic, Social and Cultural Rights.
In Sub-Saharan Africa, maternal mortality remains high, with the consequent threat to the most
basic rights of the women in the Region. According to the Commission of the Legal and Social
Condition of Women in the UN (2011), in spite of the progress made since the declarations of the
MDGs, one in every 31 women in Sub-Saharan Africa still runs the risk of dying due to foreseeable
and avoidable complications during the term of pregnancy or in childbirth, as opposed to one
in every 4,300 in developed regions. In East and West Africa, the figures of maternal death rates
are among the highest in the world, between 500 to 1,000 deaths for every 100,000 live births in
2005 (WHO, UNICEF, UNFPA and the World Bank, 2007). Of the 11 countries analysed, Ethiopia is
the country with the highest maternal death rate, with 673 deaths for every 100,000 live births,
followed by Niger, Angola and the Democratic Republic of the Congo. The rest of the countries
have similar rates, between 400 and 500 deaths for every 100,000 live births, very close to the
average rate for Africa, except for Cape Verde where the rate is exceedingly low, with only 94
deaths for every 100,000 live births, closer to what is general for the industrialised countries
(average rate: 20) than to the rest of its geographical context.
Source: for CV, AN and GB: WHO et al. (2007), for the rest Demographic and Health Surveys: NB and KN 2008,
DRC 2007, NI and ML, 2006, SN and ET, 2005, MZ 2003
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Figure 2. Maternal mortality is still high in Africa
Deaths per 100,000 live births
MATERNAL MORTALITY IS STILL HIGH IN AFRICA
THE GOOD NEWS IS THAT A LARGE NUMBER OF
CHANGE THE SITUATION.

The campaign to bring down
maternal mortality is a priority in
many African countries that have
taken measures to combat IT. Many
African countries (see the map)
and, among these, the majority of
the 11 countries analysed in the
present document, have launched,
for example, the CARMMA, the
Campaign towards the Accelerated
Reduction of Maternal Mortality in
Africa (see box 1).
Source: UNFPA, 2010
Box 1. CARMMA
The Campaign for the Accelerated Reduction of Maternal
Mortality in Africa (CARMMA) was launched by the Ministers for
Health of the African Union together with the UNFPA and other
international organisations in 2009. The main goal is to save the
lives of the mothers and newborns that die in childbirth in Africa.
By launching CARMMA, the countries commit to:
• Building up the health system by consolidating integrated
services of maternal and child healthcare, together with
giving greater coherence to health and development
policies;
• Reach the Abuja commitment of 15% of the national
budget for health;
• To exert pressure on the Global Fund for HIV/AIDS, Malaria
and Tuberculosis to include financing to fight maternal
and child mortality.
• To establish monitoring mechanisms and evaluation tools
(for example, an annual progress report coordinated by
the African Union);
• To institutionalise an annual week for events organised
around CARMMA over 4 years.
The women’s movement has been key in promoting CARMMA. In
2010, for example, women’s organisations from all over Africa
organised a caravan for Maternal Health that crossed the whole
of East Africa to raise awareness to the problems involved and to
engage the main actors in applying solutions towards the
reduction of maternal mortality.
Source: authors’ own elaboration
- Maternal mortality violates women’s human rights: the right to life and the right to health (as in the
Universal Declaration of Human Rights).
- The fight against Maternal Mortality is one of the Millennium Development Goals that your
government has committed to achieve.
- Begin by launching CARMMA if it has not already done so (e.g. Niger and Mali)
- Increase the % of public spending on health and sexual and reproductive health in particular in line
with the Abuja commitments.
- Increase the number of midwives and medical staff in the health system
Data are essential to do advocacy work. Without data, we cannot measure our progress. Therefore
check and see if your country collects data related to maternal mortality and:
- If not, lobby for them to do so.
- If there is data, compare the data with that of other countries in your region and see if it profiles well
or badly in the family “photo”. Reporters love photos. Spread the news around with an explanation
of what the data with respect to maternal mortality means in terms of consequences on women
and on society in general.
- Other useful photos in your advocacy work may be: % of births attended by qualified health
personnel, % of women between 15-19 that have been pregnant, etc.
VULNERATING THE BASIC RIGHTS OF WOMEN.
AFRICAN COUNTRIES ARE TAKING MEASURES TO

Teenage sexual and reproductive health
requires attention from policy makers and
activists in Africa as over half the teenage
pregnancies in the world occur in the Region.
According to the WHO (2008), three of the
seven countries with the highest teenage
pregnancy rates in the world are in Africa
(Nigeria, Ethiopia and the DRC). Besides, more
than half of the women aged 15 to 19 that
give birth each year in the world are in Sub-
Saharan Africa. The proportion of women
who become pregnant before age 15 largely
varies across countries with, for example,
Rwanda’s rate standing at under one percent
and Mozambique at over 12% (WHO, 2008).
Out of the 11 countries analysed, Mozambique, Mali and Niger present the highest rates of
teenage pregnancy, in the order of 40% of girls 15 to 19 years old. Teenage pregnancy requires
urgent attention from policy makers and activists in Africa, not only because of its extent, but also
because of the dramatic consequences that it has on girls, and society at large (see box 2).
Source: Demographic and Health Surveys: NB and KN 2008, DRC 2007, NI and ML, 2006, SN and ET, 2005, MZ
2003
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Figure 3. Teenage pregnancy is still high
% of girls 15-19 who have been pregnant
Early marriage, one of the leading causes of teenage pregnancy in Africa, is highly prevalent in
many African countries. Governments are, however, taking measures to reduce it, mainly through
legislation. As figure 4 shows, many more girls than boys marry early in the countries analysed.
Overall, marriage before the age of 18 still persists especially for girls. Niger, Mozambique and
Ethiopia present strikingly high percentages of girls marrying before 18 (with 74.5%, 56% and 49%
respectively). The lowest proportion of early marriages is found in Mali and Senegal. With the
Box 2. CONSEQUENCES OF EARLY PREGNANCY
Early pregnancies have serious consequences on
girls, their families and society at large. Examples
include:
- The increased risk of maternal and infant
mortality;
- The increased vulnerability to HIV and other
STDs;
- Limited educational attainment as a result of
school drop-out;
- A lack of labour market skills to allow for
economic opportunities to be seized in the
future.
THE SEXUAL AND REPRODUCTIVE HEALTH OF
ATTENTION IN AFRICA. HALF OF THE TEENAGE
SAHARAN AFRICA.

exception of Mali and Gambia, and Niger for which there are no data available, all the countries
analysed have passed legislation to protect women against early marriage.
- That boys and girls have a right to be young, and that, for example, under-age marriage is a
violation of basic human rights.
- That investing in young women is investing in the future. By reducing teenage pregnancy your
government will be contributing to a healthy and able work force in the future, by reducing the
spread of HIV/AIDS among other things.
- To include protection for women from early marriages in the constitution and the national legislation
if it is not already there.
- To design, budget, and implement a strategy or plan on teenage sexual and reproductive health and rights.
- To invest in extracurricular activities that will help the youth and their parents understand the
practicalities of having greater ambitions in life than early parenthood, the disadvantages of early
parenthood and the importance of developing life and career abilities before parenthood.
- To include sexual education on the school curriculum.
- To pass legislation to punish sexual harassment in schools and to monitor the implementation of said
legislation.
Data are essential to do advocacy work. Without data we cannot identify the challenges or measure
our progress. Neither can we correctly frame our petitions and messages to policy makers
- Check if there is data on the extent of early pregnancy and early marriage in your country and use
it to make comparisons across the countries in your region or the world. See how your country
profiles in the family “photo” and get the word out to the general public and media.
- If there is no data available, tell your government to start collecting.
- Other indicators that can help you in your advocacy work are age of first sexual intercourse, access
to sexual and reproductive health and rights ‘information and services, including contraception and
abortion, rate of sexual violence rates among teenagers, etc.
YOUNG MEN AND WOMEN REQUIRES URGENT
PREGNANCIES IN THE WORLD OCCUR IN SUB-
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Figure 4. Many more girls than boys marry early
% women who are married at 18 years
% men who are married at 18 years
Source: Demographic and Health Surveys: NB and KN 2008, NI and ML, 2006, SN and ET, 2005, MZ 2003

High rates of fertility together with the expressed
desire on the part of women to have less children
indicate a problem of access to family planning
services in Africa. Of the countries analysed, Niger
with an average of 7.1 children and Mali with 6.6
have the highest fertility rates followed by the DRC
with an average 6.3. Moreover, these high rates
mask important differences between rural and urban
areas, with a marked increase in the average
number of children per woman being seen in rural
areas. The country with the least number of children
per woman is Cape Verde with an average 3.1. In all
the countries analysed, except Niger and Senegal,
women wanted to have less children.
The use of contraception is scarce and the type of methods used indicates scant implication of
men in family planning. Although the use of contraception has risen from 17 to 28% over the last
two decades in Africa, it is still limited to less than 30% of the population as opposed to 70% in Latin
America and Asia (WHO, 2011). Of the countries analysed, the pill is the modern method of
contraception most used, followed by injections. The male condom is the modern method most
used in only one of the 11 countries analysed, the DRC. Problems of access aside, these data
Box 3. FERTILITY AND DEVELOPMENT
Besides limiting women’s rights (the right to
sexual and reproductive health and
therefore to free and responsible
reproductive options and, in some cases,
the right to life) high fertility rates can limit a
country’s ability to achieve other
development goals. Poor countries have
higher fertility rates. Early pregnancy limits
the accumulation of human capital
(education) and the future capacity of
women to generate income, as a result. It
also affects the spread of HIV/AIDS and
maternal death rates, thereby affecting the
country’s capacity to achieve the MDGs.
AFRICA IS THE WORLD’S REGION WITH THE LOWEST
WOMEN USE MODERN CONTRACEPTIVE METHODS.
HELP TO ENHANCE THE QUALITY OF LIFE OF WOMEN
CAPE VERDE
NAMIBIA
KENYA
ETHIOPIA
MOZAMBIQUE
DR CONGO
SENEGAL
MALI
NIGER
0 2 4 6 8 10 12
Figure 5. Low access to family planning in Africa
Ideal number of children according to men
Ideal number of children according to women
Number of children per woman
Source: Demographic and Health Surveys: NB and KN 2008, DRC 2007, NI and ML, 2006, SN, CV and ET,
2005, MZ 2003

indicate the passive role of men in family planning in most countries. Therefore, there is broad
scope for action in public policies designed to improve access and to engage men in family
planning in many countries in Africa.
- The choice of how many children to have, and when, is one of the Sexual and Reproductive Right
that they have committed to guarantee (by signing CEDAW, or The Cairo Action Plan).
- Higher access to contraception reduces maternal mortality, child mortality, HIV/AIDS, the number of
abortions and unsafe abortions while increasing the social and economic opportunities of women,
girls and the society in general.
- Increase the % of public spending on sexual and reproductive health to guarantee access to efficient
methods of family planning and to comply with the Abuja commitment to allocate 15% of public
spending to Health.
- Facilitate free or subsidised contraceptives in health centres and public hospitals, above all in rural areas.
- Include modules of sexual and reproductive health in community health campaigns.
- Or you can call upon your President, if he is a man, or outstanding male figures such as sportsmen and
artists to lead an awareness raising campaign on the importance of the use of contraceptives,
specifically targeted at men.
Data are essential to do advocacy work. Without data, we cannot measure our progress. Therefore,
check to see if your country has data and:
- If not, lobby for them to collect data.
- If they do, compare the situation with that of other countries in the region to see if your country
profiles well or badly in the family “photo”. Journalists love photos, so get the news out with an
explanation of the causes and consequences of the lack of family planning for the welfare of women
and girls, together with the society in general.
- Other useful photos in your advocacy work could be: the link between use of efficient methods of family
planning and the reduction of maternal and child mortality, HIV/AIDS and unsafe abortions, etc.
Source: World Use of Contraceptives, WHO, 2011
0
5
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25
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GAMBIA
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KENYA
ETHIOPIA
MOZAMBIQUE
DR CONGO
3
4,9
9,9
21,621,8
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6,5
21,4
Figure 6. Family planning is a woman's job
% of the population who uses the pill (most used contraceptive)
% of population who uses injections (most used contraceptive)
% of population who uses male condom (most used contraceptive)
USE OF CONTRACEPTION. LESS THAN 3 IN 10
GREATER ACCESS TO CONTRACEPTION WOULD
AND OTHER KEY DEVELOPMENT INDICATORS.

Gender-based violence in its various manifestations is still one of
the most serious problems faced by women in Africa, both from
the point of view of incidence as for the direct repercussions on
the life and basic rights of women. In spite of the difficulties
encountered when attempting to measure the prevalence of
gender-based violence (GBV) as the result of lack of data,
various studies indicate a high prevalence of physical, sexual
and psychological violence against women and girls
associated with practices such as violence in the home, sexual
abuse, sexual trafficking, harassment, early and/or forced
marriages, revenge of honour crimes and female ablation,
among others. In South Africa, a woman dies every six hours,
killed by her partner (Mathews et. al., 2004); whereas in the DRC,
there are around 1,100 cases of rape per month, according to
the United Nations statistics for 2010.
Data on Female Genital Mutilation are deeply disturbing in some African countries. 85% of the women in
Mali and 74% in Ethiopia have suffered Female Genital Mutilation. In other countries such as Kenya and
Senegal, this practice is also common although to a lesser extent and, according to the data available,
the proportion of women undergoing FGM is much less in Niger. Complex socio-cultural factors lie at the
heart of such practices and their high rate of incidence in some countries in Africa. The gradual access of
women and girls to higher levels of education has proven effective in reducing this serious problem.
Most of the countries analysed have legislation to protect women against gender-based violence
but less than half implement specific plans to combat this form of violence. In all the countries
analysed, except in Angola and Gambia (and in Niger where there is no information), the
constitution protects women against gender-based violence. In 8 of the 11 countries analysed,
(there are no data available for Niger, Gambia or Angola), the constitution or the national
legislation specifically punishes sexual violence with sentences for rape. In addition to this, 5
countries have a specific gender-based violence law (Cape Verde, Namibia, Angola,
Mozambique and Kenya, with no data for the DR Congo) and 5 of the 11 countries analysed have
forbidden female genital mutilation by law. Moreover, some countries such as Cape Verde,
Gambia, Mozambique, Ethiopia, Kenya and DRC have even passed legislation in areas such as
Box 4. GENDER-BASED VIOLENCE
“…by violence against women, we
understand all types of violence
based on the fact of belonging to
the female sex that may or may
not result in harm or suffering of a
physical, sexual or psychological
nature for the woman, together
with any threat of such act,
coercion or arbitrary privation of
the woman’s freedom, whether
said act is produced in the public
or the private sphere”. Article 1,
Declaration on the Elimination of
Violence Against Women, 1993.
GENDER-BASED VIOLENCE IS ONE OF THE MOST
AFRICA. IN SPITE OF PROGRESS PASSING
WORK TO DO ON THE GROUND.
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Figure 7. Female Genital Mutilation is still a generalised practice in some countries
% of women between 15 and 49 who have suffered FGM
Source: Demographic and Health Surveys: KN 2008, NI and ML, 2006, SN and ET, 2005

trafficking of women for sexual exploitation. However, implementation of existing legislation against
gender-based violence through national strategies or plans has been slow. Less than half of the
countries analysed (Cape Verde, Namibia, Angola and Mozambique) have this type of instrument,
pointing to the gap between legislation and implementation on the ground.
- Several international treaties that they have subscribed (e.g. The Beijing Platform for Action) establish
that GBV violates in many different ways the human rights of women and girls.
- Besides violating human rights, GBV has high economic costs. According to the Inter-American bank of
Development, the total cost of domestic violence represent between 1.6% and 2% of the GDP of a country.
- Subscribe to the international agreements that they have not signed yet (e-g. Niger and Ethiopia, the
Maputo Protocol).
- Increase funds for prevention and assistance for the survivors of violence.
- Replicate the best practice of integrated responses to GBV that coordinate the work of the legal
system, the police and the community to combat violence.
Data are essential to do advocacy work. Without data, we cannot measure our progress. Getting data to
measure GBV is particularly difficult. Therefore, check whether your country has the data and:
- If not, lobby for them to be collected, giving examples of how other countries have incorporated
gender-based violence into their information systems (for example South Africa, Kenya, Cameroon,
Malawi, Rwanda, Liberia, the Ivory Coast, Zimbabwe, Uganda, and Mali, DRC, or Zambia).
- If the data exist, compare it with other countries in your region to see how your country profiles,
well or badly, in the family “photo”. Journalists love photos so spread the word around with an
explanation of the causes and consequences of GBV for the welfare and health of women and
girls, together with the society, in general.
- Other useful photos in your advocacy work may be: the cost of GBV in % of the GDP in your country and
neighbouring countries if in yours no data exist as yet.
Legislation against gender-based violence exists
A specific law on gender-based violence exists
The law specifically protects women against FGM
There is a national plan or strategy against gender-based violence
CAPE VERDE
NIGER
SENEGAL
MALI
GAMBIA
NAMIBIA
ANGOLA
MOZAMBIQUE
ETHIOPIA
KENYA RDC
Figure 8. Most countries have sufficient instruments to combat GBV
Source: Database of the Map of SRHR in Africa and Spain, 2011
SERIOUS PROBLEMS FACED BY WOMEN IN
LEGISLATION TO COMBAT IT, THERE IS STILL A LONG

The prevalence of HIV/AIDS is still high in Africa, particularly in the Southern part of the Region.
Besides, in Africa, HIV/AIDS affects adult and young women more than men. According to
UNAIDS, Sub-Saharan Africa houses 22 million people who live with HIV/AIDS, which is two-thirds
of the world total population living with HIV/AIDS (UNAIDS, 2008a). The virus is the main cause
of death in the Region, with devastating effects on individuals, families and communities
(UNAIDS, 2008b). According to data of UNAIDS for 2011, East and South Africa continue to be
the areas most affected by the virus. According to UNFPA (2009), almost 60% of people living
with HIV in Africa are women. Of the 11 countries analysed, in all except Cape Verde and
Niger, the prevalence is higher among women than men. Mozambique has the greatest
gender gap with 13.1% women compared to 9.2% of men infected, followed by DRC with 1.6%
of women as opposed to 0.9% men. This trend is repeated among the younger generations
with most of the countries with a higher rate of prevalence among the young women than
young men (see figure 9). The cases of Namibia and Mozambique are particularly alarming
with one in every 10 young women infected.
The inequality and discrimination suffered by women are, in part, responsible for the higher
rate of prevalence of HIV/AIDS among women. Lack of information about preventive
strategies, the position of subordination of women with respect to men in family planning
decisions, the abuses and the lack of sexual freedom that women undergo are key factors
HIV/AIDS IS A SERIOUS PROBLEM IN AFRICA THAT
TO THEIR SITUATION OF DISCRIMINATION AND
0
7,5
15,0
22,5
30,0
CAPE VERDE SENEGAL DR CONGO KENYA NAMIBIA
Figure 9. HIV/AIDS affects women more than men
Prevalence of HIV/AIDS among women
Prevalence of HIV/AIDS among men
Prevalence of HIV/AIDS among young women
Prevalence of HIV/AIDS among young men
Source: Demographic and Health Surveys: NB and KN 2008, DRC 2007, NI and ML, 2006, SN, CV and ET, 2005, MZ
2003.

contributing to the spread of HIV/AIDS among women in Africa. For example, the scarce use
of male condoms, the only modern contraceptive method that prevents the illness, is an
indication of this. In the 11 countries analysed, when modern contraceptive methods are
used, it is mainly women who use them, and they mostly use the pill (in Cape Verde, Niger,
Senegal, Gambia, Angola and Mozambique) or injections (in Namibia, Ethiopia and Kenya). In
the DRC, the only country where male condom is the most frequently used method, it is used
by barely 3% of the population. These data indicate the need to advocate for greater access
to information together with more work to improve women’s power to make decisions with
respect to their sexuality. Sexual education, both for men and women, is another of the
recommendations made by the World Health Organisation in this field.
The good news is that many countries are doing something about it and that the fight against
HIV/AIDS finds gradually its way onto the political agendas and public policies in Africa. In
spite of the episodes of institutional denial of the epidemic in countries such as South Africa,
more and more countries have public policies and health plans to tackle HIV/AIDS. Seven of
the 11 countries analysed, Cape Verde, Niger, Senegal, Ethiopia, Kenya and the DRC have
specific sections on HIV/AIDS in their health plans, whereas Gambia has none, and there are
no data for the rest. In general, it has been demonstrated that the countries that
acknowledge the presence of the epidemic and try to combat it using public policies from
the very beginning are the countries that have been most successful in reducing it.
- HIV/AIDS is endangering the future of the country. Besides implying a violation of human rights, HIV/AIDS
undermines growth and future development by decreasing the productive capacity of the affected men
and women, reducing the returns of public investment in education and increasing public expenditure on
health.
- Comply with the Abuja Declaration (2001) on HIV/AIDS, Tuberculosis and other related infectious
illnesses that calls for a 15% allocation of the national budget to health.
- Increase public expenditure aimed at combating HIV/AIDS: through prevention (sexual education),
awareness raising to reduce discrimination of people living with HIV/AIDS and the treatment of the
people affected.
- Adopt legislation against discrimination of people with HIV/AIDS at the labour place.
check if your country has data and:
- If not, lobby for them to collect data.
- If they do, compare the data with other countries in the region to see how your country profiles, well or
badly, in the family ”photo”. Journalists love photos so get the word out with an explanation of the
causes and consequences of HIV/AIDS for the welfare and health of women and girls, together with the
society, in general.
- Other useful photos in your work of advocacy may be: the impact of HIV/AIDS over time on key
socioeconomic indicators disaggregated by sex; a comparison between the figures on gender-based
violence, the use of contraceptives and the prevalence of HIV/AIDS.
AFFECTS WOMEN IN PARTICULAR, IN PART DUE TO
INEQUALITY.

The penalisation of homosexuality is still
entrenched in many of Africa’s legal
systems and homosexuals are victims of
persecution and violence from members
of the police force, hospitals and
community organisations. In spite of the
African Charter of Human Rights and the
Rights of People (1981) that was ratified
by 50 countries within the framework of
the African Union, where discrimination is
condemned and certain rights of the
LGTBs are acknowledged, the real
situation in Africa is still precarious
regarding the respect for the rights of this
group. Discrimination against the LGTB
population is to be found in many shapes
and sizes in many countries (see box 5).
Box 5. EXAMPLES OF VIOLATIONS OF THE RIGHTS OF
THE LGTB POPULATION IN AFRICA.
- In Cameroon, Kenya, Nigeria and Uganda,
administrators of schools, teachers and fellow
students have spelled gays and lesbians from
secondary and higher education.
- In Botswana and Sierra Leone, the LGTB community
has been denied the right to register as a NGO.
- In Uganda, the government has imposed fines and
censored journalists, media and theatre groups who
have dared to present a neutral or positive
perspective on homosexuality.
- In almost all the African countries, extortion and
blackmail of the LGTB community is known to exist,
often with the connivance of the forces of law and
order.
- In Senegal, different people presumed to be
homosexual were attacked between 2008 and
2010. Besides, ten men and one woman were
arrested after being photographed in a private gay
wedding later published in a magazine.
- Sudan, Nigeria, and Mauritania have defended the
death penalty for consented acts of homosexuality.
Source: Pan-African Voices for Freedom and
Justice, www.pambazuka.org
THE LGTB POPULATION SUFFERS SERIOUS
AFRICA. WHAT IS EVEN MORE WORRYING IS THAT
LEGITIMASED BY THE STATE.
NIGER
SENEGAL
MALI
GAMBIA
NAMIBIA
ANGOLA
MOZAMBIQUE
ETHIOPIA
KENYA DRC
Figure 10. Homosexuality is illegal in many countries in Africa
Relations between men are legal
Relations between men are illegal
Relations between women are legal
Relations between women are illegal

Besides, in many African countries, these violations are condoned or in some countries,
discrimination is even institutionalised. Of the 11 countries analysed only in Niger, Mali and
the DRC it is considered legal for men to have relations with other men and only in Niger,
Mali, Namibia, Kenya and DRC it is considered legal for women to have same sex relations.
Moreover, there is none of the 11 countries whose legislation prohibits discrimination on the
basis of sexual orientation or identity.
Apart from the 11 countries analysed, an example to be highlighted is the legislation passed
in Burundi in 2009 that criminalised same sex relations for the first time in the history of the
country. In other places, however, political advances have been noted and, in South Africa,
the law has been modified to enhance the rights of gays and lesbians.
MAP OF SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS IN AFRICA AND SPAIN | 19
- It has subscribed various international treaties (CEDAW, the Beijing Platform for Action, etc) that protect the
human rights of the LGTB population.
- By denying the fact that there are homosexual relations in a country, all messages and campaigns for the
prevention of HIV/AIDS are less effective in that they are only targeted at heterosexuals.
- Include legislation that condemns all discrimination against LGTB communities.
- Eliminate all discriminatory legislation against the LGTB population and to legalise unions between
people of the same sex, thereby guaranteeing human rights.
- Propose a specific mention in the African Charter of Human Rights and the Rights of the Individual
where the rights of the LGTB community are defended.
check to see if your country has data with respect to the different forms of discrimination against the
LGBT population and:
- If not, lobby for the data to be collected.
- If the data exist, compare them with other countries in your region to see how your country profiles
(well or badly) in the family “photo”. Journalists love photos so get the word out with an explanation of
the causes and consequences of discrimination on account of sexual orientation and the key
proposals to eradicate it.
- Other useful photos in your advocacy work may be to compare the international and regional
agreements that have been subscribed to and their coherence with the national legislation in the field
of LGBT rights.
VIOLATIONS OF THEIR RIGHTS IN MANY PARTS OF
IN SOME COUNTRIES, DISCRIMINATION IS

African countries have subscribed to multiple international and regional mechanisms in defence
of sexual and reproductive rights. The level of ratification of the treaties, although different from
country to country, in general is fairly high. The 11 countries analysed have aligned with or
ratified the Political and Civil Rights Convention (CCPR) together with the Convention for the
Elimination of All Forms of Discrimination against Women (CEDAW) and the Convention for the
Rights of Children (CRC). All the countries except Mauritania have aligned with or ratified the
Convention of Economic, Social and Cultural Rights (CESCR). The two countries that have
presented reservations with respect to the international treaties in sexual and reproductive
health and rights are Kenya (with respect to the CESCR, Article 10.2 pertaining to protection of
women during and after childbirth) and Niger (with respect to various sections of the CEDAW
that questions the commitment of the government to the Convention).
At the regional level, the African Union has two main mechanisms whereby to defend the
rights of Women: the Maputo Protocol and the Solemn Declaration of gender equality in Africa,
ratified by most countries. Of the 11 countries analysed, all have adopted the Solemn
Declaration of Gender Equality in Africa. All the countries compared have also ratified the
African Charter of Human Rights and of the People, and all except Ethiopia, which has only
signed it, have ratified the Protocol to the Charter on Gender Equality, known as the Maputo
Protocol. Kenya has expressed reservations, however, with respect to article 10.3 relating to
military expenditure and promotion of spending on social development and promotion of
women and article 14.2c relating to the authorisation of abortion under certain circumstances.
AFRICAN COUNTRIES HAVE SUFFICIENT
INTERNATIONAL LEVEL TO DEFEND SEXUAL AND
R A T I F I C A T I O N I S P O S I T I V E B U T T H E
0
20
40
60
80
CAPE VERDE
NIGER
SENEGAL
MALI
GAMBIA
NAMIBIA
ANGOLA
MOZAM
ETHIOPIA
KENYA
DRCONGO
Figure 11. At the national level there are also institutional mechanisms to work on SRHR
SRH National Strategy or Plan
Gender watchdog
Mechanisms for civil society participation

It is easier to ratify a treaty and not comply with it than not to ratify it. The previous sentence
sums up the present situation with respect to the compliance with the treaties on sexual and
reproductive rights and women’s rights in Africa. Although most countries have ratified the
treaties, later steps to implement them, whether ratification of the protocol or domestication
through national legislation have not taken place systematically. For example, Mozambique,
Ethiopia and Kenya have not ratified the optional protocol to the CCPR; Ethiopia and Kenya
have not signed the optional protocol to the CRC either, and Gambia, Ethiopia, Kenya and
the DRC have not ratified the Optional Protocol to the CEDAW. No country has signed the
Optional Protocol to the CESCR.
At the national level, there are also institutional instruments and mechanisms for the defence of
sexual and reproductive health and rights although there is still room for improvement in the
implementation through the pertinent structures. The 11 countries analysed have specific laws,
policies or strategies in the field of sexual and reproductive health and rights. However, only
Niger, Senegal and Kenya have a Watchdog Committee for Gender Equality and Watchdog
Committees or Observatories for Sexual and Reproductive Health and Rights do not exist
specifically as such in any of the countries. Niger, Senegal, Namibia, Mozambique, Ethiopia
and Kenya have institutional mechanisms such as the National Committee for Gender-Based
Violence (Namibia), the National Commission for Equality and Human Rights (Kenya), the
National Committee of Traditional Practices (Ethiopia) and the National Women’s Watchdog
Committees (in Niger and Senegal) that allow for civil society participation in the discussion of
different aspects of public policies in the field of equality, including those related to sexual and
reproductive health and rights.
To promote Sexual and Reproductive Health and Rights, you can:
- Ask your government to sign and/or ratify the relevant international and regional treaties designed
to guarantee human rights, Health and the Sexual and Reproductive Rights, if they have not done
so already.
- Create your own Map with information about what country has ratified which treaty and use it to
exert pressure on your government to ratify the treaty that is in the interests of the women in your
country. Tell them that their neighbours have already signed and that they are going to be the
pariah in the African and international arenas.
- Create and disseminate a map that compares the commitments signed with the indicators of
Sexual and Reproductive Health and Rights as they truly stand in your country. Make the gaps
visible and ask what is being done in the way of legislation, implementation mechanisms, or
financial allocations to comply with the treaties and agreements already signed.
- Other useful photos in your advocacy work may be to compare the international and regional
agreements that have been subscribed to and their coherence with the national legislation in the
field of LGBT rights.
I N S T R U M E N T S AT T H E R E G I O N A L A N D
REPRODUCTIVE RIGHTS. THE RHYTHM OF
IMPLEMENTATION IS STILL EXTREMELY SLOW.

BIBLIOGRAPHY
• Commission on the Legal and Social Condition of Women, 2011. 55th period of sessions, 22nd
February to 4th March 2011. http://www.un.org/womenwatch/daw/csw/csw55/panels/
Panel5-Spanish.pdf
• Mathews Shanaaz, N. Abrahams, L. Martin, L. Vetten, L. van der Merwe y R. Jewkes. 2004.
“Every Six Hours a Woman is Killed by her Intimate Partner.” A National Study of Female
Homicide in South Africa. Gender and Health Research Group, Medical Research Council.
• http://www.saynotoviolence.org/sites/default/files/SP_Say%20NO%20VAW%20Factsheet
%20Final.pdf
• UNFPA, 2009, Report on the application of decisions and recommendations of the Board of
Coordination of the Joint Programme of the United nations on HIV/AIDS, Executive Board of
the Programme of the United Nations for Development and the UNFPA.
• www.unfpa.org/webdav/site/global/.../2009/.../pcb_unaids_sp.doc
• UNFPA, 2010, CARMMA: Africa Cares: No Woman Should Die while Giving Birth. UNFPA African
Regional Office. Johannesburg. http://countryoffice.unfpa.org/uganda/drive/
CARMMABooklet.pdf
• WHO, 2004, Unsafe Abortion. Global and Regional Estimates of the Incidence of Unsafe
Abortion and Associated Mortality in 2000. www.who.int/reproductivehealth
• WHO, 2008, Making Pregnancy Safer Notes, Volume 1, Number 1, Adolescent Pregnancy.
http://www.who.int/making_pregnancy_safer/documents/mpsnnotes_2_lr.pdf
• WHO, 2011, Family Planning, Descriptive Notes N°351, April 2011.
• http://www.who.int/mediacentre/factsheets/fs351/es/index.html
• WHO, UNICEF, UNFPA and World Bank, 2007. Maternal Mortality in 2005. http://www.who.int/
making_pregnancy_safer/topics/mdg/es/index.html
• UN, 2010.
• http://www.un.org/es/women/endviolence/situation.shtml
• UNAIDS, 2008a, World HIV Epidemic Report.
• http://www.dvvimss.org.mx/pdf/informesida.pdf
• UNAIDS, 2008b.
• http://www.unaids.org/es/resources/presscentre/featurestories/2008/december/
20081203icasada1story
• UNAIDS, 2011. http://www.unaids.org/es/regionscountries/regions/easternandsouthernafrica/

ANNEX I. LIST OF INDICATORS IN THE
DATABASE OF THE MAP OF SEXUAL AND
REPRODUCTIVE HEALTH AND RIGHTS IN
AFRICA AND SPAIN
INDICATORSINDICATORS SOURCES
S-1 Human Development indicators PNUD, Human Development Report, 2010
S-1 Population below national poverty line UNSTATS, MDGs Follow up indicators, 2008
S-2 Gender Inequality Index - Value - 2008 PNUD, Human Development Report, 2010
S-2 Gender parity Index UNSTATS, MDGs Follow up indicators, 2011
S-3 Reproductive Risk Index Population Action International Report Card, 2007
S-3 Maternal Mortality Ratio (MMR)
Demographic and Health Survey (DHS) for all
countries except for Cape Verde, Gambia, and
Angola. For these countries: WHO, UNFPA, UNICEF and
the World Bank (2010) Trends in maternal mortality.
S-3 Main causes of maternal mortality Demographic and Health Survey
S-3 Use of maternal health services Demographic and Health Survey
S-4 Total Fertility Rate Demographic and Health Survey
S-4 Ideal number of children Demographic and Health Survey
S-4 Median birth interval Demographic and Health Survey
S-4 Contraceptive prevalence rate
Demographic and Health Survey, and WHO World
Contraceptive Use 2010
S-4 Most used method WHO - World Contraceptive Use 2011
S-4 Unmet need for family planning WHO - World Contraceptive Use 2011
S-4 Unsafe abortion WHO - Unsafe abortion regional estimation rates 2008
S-4 Primary infertility Demographic and Health Survey
S-4 HIV/AIDS prevalence
Demographic and Health Survey, except for Angola:
WHO World Health Statistics 2010
S-5
Youth who had sexual intercourse before
18
Demographic and Health Survey
S-5 Youth married by age 18 Demographic and Health Survey
S-5
Youth age 15-19 who have ever been
pregnant
S-5 Youth HIV positive age 15-24 Demographic and Health Survey
S-6 Experience of Gender Based Violence Demographic and Health Survey
S-6
Attitudes towards Gender Based
Violence

INDICATORSINDICATORS SOURCES
S-6 Prevalence of Female Genital Mutilation Demographic and Health Survey
S-6 Attitudes towards FGM Demographic and Health Survey
S-6 Trafficking for sexual exploitation Global Report in Trafficking in Persons, UNODC, 2009
S-7
Physicians, nurses and midwives
availability
Africa Health Workforce Observatory, 2011
S-7 Problems in access to health services Demographic and Health Survey
I - 1 Status of international treaties
Office of the UN High Commissioner on Human Rights
(2011)
I - 1 International HR Treaties
Office of the UN High Commissioner on Human Rights
(2011)
I - 2 Regional HR Treaties African Union, 2011
I - 3 National law
National Constitutions, Penal Codes, Family Codes,
laws
I - 4 Health budget WHO World Health Statistics 2010
I - 5 National policies and plans Policy documents, reports
I - 6 National policies and plans Policy documents, reports
A-1 State agents Reports, interviews
A-2 Civil Society Agents Reports, interviews
iThis publication has been produced by Ana Lydia Fernández Layos and Maria Elena Ruiz Abril. The authors are
grateful to Khanysa Eunice Mabyeka for comments to an earlier version of the paper. The information in this
publication comes from the Database of the Map of Sexual and Reproductive Health and Rights in Africa and Spain
compiled by Adriana Zumaran and Winifred Lichuma within the framework of the elaboration of the Map of Sexual
and Reproductive Health and Rights in the African and Spanish of the Women’s Network for a Better World. The
complete Map offers an overview of sexual and reproductive health and rights together with the political and legal
instruments, agents and mechanisms for dialogue in this area in Africa and Spain. The information in the Map is
divided in four chapters: the situation in Spain; Spanish cooperation in Africa; case studies of 11 African countries and
regional analysis in Africa. The document Key Issues for Political Advocacy in Sexual and Reproductive Rights in
Africa presents a comparative analysis of the 11 African country case studies. The complete Map can be accessed
in its online version on www.map-srhr.org

KEY ISSUES FOR POLITICAL ADVOCACY IN SEXUAL AND REPRODUCTIVE RIGHTS IN AFRICA | 25Pictures: Javier Martínez de la Varga
Graphic design: Marta del Castillo-Olivares

Key Issues for Political Advocacy in Sexual and reproductive Rights in Africa.

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