Transparent, Accommodative, and Collaborative Leadership is Essential for Sexual Reproductive Health Rights Programs
MA Global Leadership student, Mary Mandy, shares highlights from her Capstone project
Deep in the quiet night, my thoughts raced back and forth to the baby who became an orphan upon his arrival in this world. The mother had carried out a self-delivery. Why? She had no money to pay bills for professional services in a health facility. Then I hear the women's rusty voices telling me their struggles when trying to enjoy their sexual and reproductive rights (SRHRs) in Cross River State, Nigeria.
The women casually explain their struggles against dangerous cultural practices such as female genital mutilation (FGM), and money wife (a parent will offer a female child to his creditor as bride). I hear them say, "When it comes to the battle for women's bodies, both Muslims and the Christians come together to assert that women's bodies belong to men". Apart from the prevailing cultural norms and religious beliefs, inadequate or lack of access to sexual and reproductive health services has contributed to high maternal and neo-natal mortality rates; maternal mortality rate of 512/100, 000 live births, neonatal mortality of 39 /1000 live births (Igho, 2020). The crisis is compounded further by the ineptness and negative attitudes among what passes for skilled health workers. The restrictive abortion law has forced women to resort to illegal, unsafe abortion practices to eliminate unwanted pregnancies.
Nigeria has signed various international and domestic documents aimed at promoting SRHRs (Aghoja, 2013; Laukkanen and Garba, 2017; Afulukwe-Eruchalu, 2017). The government, however seemed not committed to the promotion of SRHRs (The Nigerian Voice, 2019). In line with the findings of UN spotlight initiative Nigeria (2018), civil society organizations addressing SRHRs issues in Cross River State, have operated in isolation without networking and their initiatives have been mostly politicized and commercialized. The lack of linkages and synergies has limited their ability to deliver SRHRs services. SRHRs are central to delivering the 2030 Agenda for Sustainable Development Goals, in particular SDGs 3,4 and 5.
To embark on the capstone project to study this issue that impacts women in Nigeria and around the globe in the Global Leadership Program, I chose a participatory methodology to deepen the understanding of SRHRs and the challenges in Cross River State in local, social, institutional, and political contexts. Respect for local knowledge and experience is key in the efforts to design effective interventions to promote SRHRs and spur knowledge production.
Key lessons from the findings:
- Adopting a systems’ thinking approach when promoting SRHRs to eliminate the socio-economic and legal barriers to accessing SRHRs is needed. Recognizing Indigenous people such as the traditional birth attendants as leaders, change-makers and Indigenous knowledge and practices is critical (Savingy & Taghreed, 2009).
- There is a need for universal health insurance funded with domestically mobilized resources i.e. through mandatory taxation contributions. The delivery of SRHRs services in the CRS lacks universality and permanence because the development partners have limited capability. Inadequate attention to intersectionality while addressing SRHRs in CRS will lead to higher program and policy costs, ineffective social and health policies, high mortality rates and low SRHRs indicators (Gopaldas, 2013).
- Transparent, accommodative, and collaborative leadership is essential today for the success of SRHRs programs. Adopting electronic applications could serve to improve accountability, client monitoring and support, and increase client referrals. In addition, the application could increase access to SRHRs information, improve data collection, and storage, and stakeholder’s coordination in CRS.
The findings of this project have emphasized the inadequacies experienced in the enjoyment of SRHRs in many parts of the globe. I suggest that subsequent research explores transparent, accommodative, and collaborative leadership as a strategy to address our SRHRs global challenge.
- Afulukwe-Eruchalu, O. (2017). Accountability for maternal healthcare services in nigeria. International Journal of Gynecology & Obstetrics, 137(2), 220–226. https://doi.org/10.1002/ijgo.12108
- Aghoja, L. (2014). Sexual and reproductive health: Concepts and current status among Nigerians. African Journal of Medical and Health Sciences 12 (2) :101. file:///C:/Users/hmans/Downloads/Article42_SRH_AfrJMedHealthSci_2013_12_2_101_1349061%20(1).pdf
- Aniekwu, N.I. (2006). Gendering sexuality: Human rights issues in reproductive and sexual health. African Regional Sexuality Resource Centre. http://arsrc.org/downloads/features/aniekwu.pdf
- De Savigny, D., Adam, T., Alliance for Health Policy and Systems Research, & World Health Organization. (2009). Systems thinking for health systems strengthening (Ser. Alliance flagship report series). Alliance for Health Policy and Systems Research. https://royalroads.on.worldcat.org/oclc/632338800
- Gopaldas, A. (2013). Intersectionality 101. Journal of Public Policy & Marketing, 32. https://royalroads.on.worldcat.org/oclc/5750974805
- Hathcoat J.D., Meixner C., Nicholas M.C. (2018). Ontology and Epistemology. In: Liamputtong P. (eds) Handbook of Research Methods in Health Social Sciences. Springer, Singapore. https://doi.org/10.1007/978-981-10-2779-6_56-1
- Igho, O. (2020). SDGs: Tackling Infant and Maternal Deaths in Nigeria. https://leadership.ng/sdgs-tackling-infant-and-maternal-deaths-in-nigeria
- Laukkanen, S., & Garba, A.M. (2017). Sexual and Reproductive Rights, Nigeria. Geneva Foundation for Medical Education and Research. https://www.gfmer.ch/srr/Nigeria.htm
- The Nigerian Voice. (2019). Nigeria’s restrictive laws and women’s sexual reproductive rights. https://www.thenigerianvoice.com/news/274942/nigerias-restrictive-laws-and-womens-sexual-reproductive-r.html