Statement by Dr. Julitta Onabanjo, Regional Director for UNFPA East and Southern Africa, at the Executive Board of UNDP, UNFPA and UNOPS Informal Session on 27 August 2018 in New York.
Mr. President,
Distinguished Members of the Executive Board,
Distinguished Delegates from the Permanent Missions of Burundi, Lesotho, Malawi, Namibia and South Sudan;
Ladies and Gentlemen;
Good morning.
The five country programmes that I have the privilege of presenting to you today, reflect the diversity of the East and Southern Africa region. A region that is home to some of the world’s fastest-growing economies - but also some of the poorest countries; and a region in which population dynamics, such as fertility, mortality, and migration, have played a decisive role in shaping the social, economic and political landscape.
South Sudan is a country that faces a protracted humanitarian crisis with four million people displaced, including 1.9 million internally and 2.1 million as refugees- people on the move.
Burundi has a high population density with over 400 persons per square kilometres, while Namibia in contrast, has a low population density with 2 people per square kilometres.
Lesotho’s life expectancy rates have stagnated in part due to HIV; and Malawi, Lesotho and South Sudan have high mortality rates, linked to maternal deaths.
These population dynamics pose important challenges, but also present opportunities for sustainable development, if the right policy and programmatic investments are made.
The programmes that I will present today, represent the new way of working as defined by the UNFPA Strategic Plan and Business Model (2018-2021). With a focus on the humanitarian-development nexus, resilience-building, the rights-based approach, leaving no one behind and placing young people at the centre, these country programmes are well positioned to deliver on the transformational results articulated in UNFPA’s Strategic Plan and the Sustainable Development Goals.
Mr. President, distinguished delegates,
Let me highlight the key components of individual country programmes that are being presented for your approval. I begin with the country programme for Burundi.
With a population of 11.8 million, mainly rural, and a youth population of 34%, ages 10-24 years, Burundi ranks 184th out of 188 countries according to the Human Development Index.
The country has a high maternal mortality ratio of 334 deaths per 100,000 live births; low contraceptive prevalence rate at 23% in rural areas, where 90% of the population live, and an adolescent birth rate of 58 per 1000. Sexual and gender-based violence also remains a concern with over one third of women of reproductive age experiencing physical violence.
Within this context, the new country programme seeks to improve access to integrated sexual and reproductive health services for adolescents and women. Building on the key achievements in the previous country programme, which led to 580,181 additional users of modern contraceptive methods, and successful fistula surgery for 1,658 women, the programme will consolidate the gains in relation to family planning and maternal health.
The eighth country programme for Burundi (2019-2023) will work to ensure that 152 health facilities offer emergency obstetric care; 80% of service delivery points experience no stock -out of contraceptives, and that 90% of births are attended by skilled health personnel.
The programme will ensure that comprehensive sexuality education is integrated into six formal school curricula, and that 150,000 adolescent and youth are reached by sexual and reproductive health information.
National institutions will be strengthened to promote gender equality and respond to gender-based violence, and the programme will ensure that all public hospitals and specialized centers provide comprehensive gender-based violence services, and 80% of identified most-at-risk women and girls actually receive these services.
Through collective efforts and partnerships with key stakeholders, it is expected that by 2023, the country programme would have contributed to 200,000 additional users of modern family planning methods including 50,000 adolescents & youth (15-24), thereby contributing to the reduction of unintended pregnancies and maternal mortality.
The overall programme budget stands at twenty-eight million dollars ($28) with $8.5 million from regular resources and $19.5 million to be mobilized.
Lesotho
Mr. President, let us now turn our attention to Lesotho. Lesotho has a population of just over 2 million people, with 58% of the population living in rural areas. The country has a high maternal mortality rate, and a high HIV prevalence rate which stands at 25% among adults aged 15-49 years, with young women four times more likely to be affected. Unmet need for family planning is approximately 18% and adolescent pregnancy stands at 19%.
Gender-based violence is a major concern, with a prevalence rate of 86% and child marriage standing at 24%.
In this regard, the seventh Lesotho country programme (2019-2023) aims to increase access to quality integrated, and youth friendly sexual and reproductive health and HIV prevention services by ensuring that 100% of health facilities are providing at least 5 modern methods; contributing to a 17% increase of women aged 15-24 with comprehensive knowledge of HIV, and a 20% increase in the contraceptive prevalence rate.
The programme will also place emphasis on eliminating gender-based violence and harmful practices, by strengthening the policy framework, and protection and response interventions, and by ensuring that essential services packages for gender-based violence (GBV) are adopted and implemented in priority districts.
By 2023, the country programme will contribute to decreasing unmet need for family planning by 5%, and ensuring that an additional 61,776 women are using family planning.
The programme is aligned to the new National Strategic Development Plan II (2019-2023) and the United Nations Development Assistance Framework which will be officially launched this week.
The budget for the country programme is $7.4 million, with an allocation of $3.6 million on regular resources and $3.8 million on other resources.
Malawi
Mr. President, distinguished delegates, I invite us now to turn our attention to the eighth country programme for Malawi (2019-2023).
Malawi has a population of approximately 17.4 million, and young people between the ages of 10-24 constitute 37% of the population. The contraceptive prevalence rate among adolescents is low at 37.5%, the adolescent birth rate of 136 per 1000, is one of the highest in Africa, and adolescent pregnancies account for 30% of all maternal deaths in Malawi.
While the maternal mortality rate has declined over the years, it currently stands at 439 per 100,000 live births. 48% of girls are married before they become eighteen years old.
Gender-based violence in Malawi is also a concern, since just over one third of women in the population have experienced physical violence. Deep rooted harmful cultural practices, high gender inequality and weak accountability systems continue to affect access to justice and the realization of sexual and reproductive health and rights in the country. However, since Malawi is one of the countries participating in the UN- EU Global Spotlight Initiative, which is geared towards eliminating all forms of violence against women, there will be a re-doubling of efforts to prevent gender-based violence.
Malawi has also begun to take steps towards harnessing the potential of its young people through the demographic dividend. His Excellency Professor Peter Mutharika, President of Malawi, is the UN Champion for Youth and Demographic Dividend, who has mobilized other African leaders and the African Union to prioritize investments that will help African countries harness the demographic dividend.
The country programme responds to the national priorities as outlined in the Malawi Growth and Development Strategy III (2017-2022), and the United Nations Development Assistance Framework for Malawi.
The programme aims to strengthen the national health system to ensure universal access to quality sexual and reproductive health services and information, empower women, adolescents and youth to be able to exercise their sexual and reproductive health and rights.
The programme aims to increase the additional users of family planning from the current 141,000 to 794,250, and to provide integrated sexual and reproductive health services to more than 1.2 million adolescents ages 15-19.
It is also important to note that Malawi will conduct its Population and Housing Census, with the data collection phase scheduled for September 2018. The results of the census will provide important population data to strengthen national planning processes and monitoring of SDG’s.
The budget of the country programme is $45.5 million, with regular resources contributing $10.5 million and other resources amounting to $35 million.
Namibia
Mr. President, I now bring your attention to the Namibia country programme.
Namibia is an upper middle-income country with a population of 2.3 million, a youth population of approximately 33%, and is a country with one of the most unequal distributions of wealth.
76% of sexually active adolescent girls do not use modern methods of contraception, particularly rural adolescents, and therefore adolescent pregnancy rates at national level stand at 19%, and is higher in rural areas.
At least one third of women ages 15-24 have ever experienced gender-based violence, in a context where there is limited implementation of the legal and policy framework, and limited access to quality integrated services for survivors of gender-based violence.
Within this context, the 6th country programme (2019-2023), which is aligned to the United Nations Partnership Framework, Harambee Prosperity Plan and the National Development Plan 5 will focus on interventions geared towards empowering young people, particularly adolescent girls on sexual and reproductive health issues. This includes advocacy for the implementation of laws and policies that promote adolescent sexual and reproductive health, strengthening institutional capacities to deliver comprehensive sexuality education in higher learning institutions, and training of health care workers to deliver quality adolescent friendly sexual and reproductive health and HIV prevention services.
The country programme will enable 60,000 sexually active adolescents (15-19), to use modern contraception to prevent unwanted pregnancies by 2023.
It will also seek to ensure a 28% increase in adolescent youth friendly health services, and will focus on ensuring that community norms that perpetuate adolescent pregnancy and gender-based violence are changed.
The total programme budget amounts to $7.5 million, with $3.2 million from regular resources and $4.3 million from other resources.
South Sudan
I now invite us to turn our attention to South Sudan, which is presenting its third country programme for the period 2019-2021.
South Sudan has a population of 12.3 million with approximately 80% of South Sudanese living below the poverty line. The reproductive health indicators reflect the significant challenges faced in the country, with a high maternal mortality ratio of 789 per 100,000 live births; total fertility rate of 7.5, and adolescent pregnancy at 300 per 1,000 adolescent girls.
While the country has been challenged by difficulties in coverage of reproductive health services with low skilled birth attendance and institutional deliveries, the previous programme contributed to zero maternal deaths and 100% skilled birth attendance in the Protection of civilian sites in Juba in 2017. With UNFPA’s support, the country also trained more than 25 obstetricians and 600 midwives by 2016, moving from 6 obstetricians and 8 midwives in 2011.
Despite this progress, South Sudan remains challenged with a low modern contraceptive prevalence rate at 1.7%, high prevalence of gender-based violence in three states standing at 65%, and early child marriage at 45% for those aged 20 – 24 years.
Mr. President,
I recently had the privilege of joining the UNFPA Executive Director, Dr. Natalia Kanem, who accompanied the Deputy Secretary General, Ms. Amina Mohamed on a mission to South Sudan at the beginning of July. This was preceded by a visit of UNFPA’s Goodwill Ambassador Ashley Judd.
While we were able to see firsthand, the challenges confronting the country, we also saw the incremental improvement in the reproductive health situation.
The new South Sudan programme will focus on delivering services and building resilient systems; abandoning child marriage, and empowering adolescents and youth to have a voice in decision making in peace, recovery and humanitarian programming. The programme will also support data for evidence-based decision making through the conduct of a hybrid census based on satellite imagery and remote sensing technology , thanks to the support of a DFID and Bill and Melinda Gates funded Geo-Referenced Infrastructure and Demographic Data for Development project (GRID3).
The country programme will also seek to increase institutional deliveries by 26%, increase skilled birth attendance by 39.7%, and train an additional 323 midwives-under the slogan ‘a midwife at every birth.’ The programme will also work with service delivery points to ensure that at least 40% have no stock-out of at least three contraceptive methods.
The country programme will seek to establish ten (10) one stop centres for gender-based violence case management and will seek to reduce child marriage from 45% to 40%.
The programme will also ensure that 50 secondary schools have integrated comprehensive sexuality education in the school curriculum, and that at least 15 national/state institutions engage youth in decision-making.
Overall, the programme will contribute to the attainment of ending zero preventable maternal deaths.
The total budget is US $55 million, with $7.8 million from regular resources and $47.2 million from other resources.
Mr. President,
These five country programmes through their focus on individual human rights, results and resources, will go a long way in improving the health and wellbeing of women, adolescents and young people that they serve.
Additionally, through the Common Chapter framework, UNFPA will continue to collaborate and strengthen partnerships with sister agencies such as UNDP, UNICEF and UNWOMEN on joint initiatives, in supporting countries to achieve their national development priorities and Sustainable Development Goals.
The Regional Office for its part will continue to provide technical guidance and support, quality assurance and oversight in the implementation of the programmes and facilitate good practices and exchange of experiences within and outside of the region.
We will continue to leverage flagship programmes such as the Safeguarding Young People programme- which is implemented in 8 countries in the Southern Africa region including Lesotho, Malawi and Namibia with support from SDC (Swiss Agency for Development Cooperation); the Joint UN Programme to Strengthen Quality Integrated Services for Sexual and Reproductive Health and Rights, HIV and Sexual and Gender-Based Violence in East and Southern Africa, in collaboration with WHO, UNICEF and UNAIDS ,supported by SIDA, Swedish International Development Agency, and which is implemented in five countries including Lesotho and Malawi; the Spotlight Initiative, which will be implemented in Malawi, alongside other countries in the region, and the Global Coalition on HIV Prevention which is co-chaired by UNFPA and UNAIDS, and seeks to strengthen political commitment to primary prevention. Lesotho, Malawi and Namibia are members of the Coalition.
Through the Middle Income Countries Expert Hub and Regional Operations Shared Services Centre (ROSSC), the Regional office will provide tailored technical and operational support to increase efficiency and effectiveness of programming and operations in middle income countries including Namibia and Lesotho.
This approach is guided by the recommendations in the Quadrennial Comprehensive Policy Review of operational activities for the development of the United Nations System, which calls on the UN system to address the specific challenges facing middle income countries, as a key aspect of UN reform.
The Middle Income Country Expert Hub and the ROSSC, further complement the Middle Income Country Strategy developed in collaboration with UN agencies across East and Southern Africa, at the level of the Regional United Nations Sustainable Development Group.
Mr. President and distinguished delegates,
I thank you for your attention, and for the opportunity to share the region’s country programmes with you. We look forward to your continued support.
I thank you.
