In honor of United Nations (UN) World Population Day, ACP is taking a moment to reflect on this year’s theme: UN Millennium Development Goal 5, which aims to achieve universal access to reproductive health care by 2015.

As a previous ACP blog post explained, Palestinian women face a relatively high rate of maternal mortality in the West Bank and Gaza Strip, where they have a 1 in 430 risk of death during pregnancy and childbirth (women in Israel, meanwhile, face a dramatically lower 1 in 3800 chance of maternal death). While our previous post provided an overview of the many factors that contribute to Palestine’s relatively high rate of maternal mortality, we now examine reproductive health care access more in-depth.

Reproductive health is a state of complete physical, mental and social well-being, and not merely the absence of reproductive disease or infirmity.  Reproductive health deals with the reproductive processes, functions and system at all stages of life.” –United Nations Population Fund

One organization that currently works to increase reproductive health care access is the Palestinian Family Planning and Protection Association (PFPPA). Based in Jerusalem with six branches and youth centers dispersed throughout the West Bank and the Gaza Strip, PFPPA is a member of International Planned Parenthood Federation. Since its inception in 1963, PFPPA has created programs to increase reproductive health care access and HIV testing, raise awareness of unsafe abortion, conduct cervical and breast cancer screening, and provide family planning—particularly in remote and underserved areas of the West Bank.

Dr. Hala Nassar with a client at PFPPA’s Bethlehem clinic.

While Palestinians’ restricted movement under occupation significantly impacts women’s ability to access reproductive health care, Faten Bakri, PFPPA’s Resource Development and Mobilization Officer, argues that Palestinian men’s decision-making power over women presents an even greater obstacle. “Regarding family planning,” Ms. Bakri told ACP, “most men do not permit women to partake in the decision making.” If a  married couple decides to use contraception, Ms. Bakri explained, “the man will select which family planning method is to be applied to the woman.” Furthermore, she added, “men refuse to cooperate and utilize condom contraceptive. As a result, unsafe abortion occurs owing to the overloaded responsibility bestowed on the woman herself.”

Men’s decision-making about their wives’ reproductive health is just one component of gender-based violence (GBV) in Palestine.  Although GBV is a global phenomenon, Palestinian women face a particularly high risk of physical, sexual and psychological abuse due to patriarchal social norms, ongoing political violence and poor economic conditions. According to a 2005 UNFPA study, Palestinian “women find themselves the targets of angry male relatives, frustrated at the erosion of their ability to be traditional providers for their families.”  Poverty and widespread unemployment in Palestine have also undermined efforts to empower women and girls to make decisions about their own health and reduce rates of early marriage.

Such acts of violence have a direct impact on women’s reproductive health, as it increases their risk of unwanted pregnancy, miscarriage, sexually transmitted disease, pregnancy complications and other reproductive health issues.  Women who experience violence from their husbands are also less likely to seek and have financial access to adequate reproductive health care.

Tulkarem, 2007. Graduation party for PFPPA training participants who completed a course to raise awareness about reproductive health rights in refugee camps.

In order to address these many challenges, PFPPA therefore reaches out to both women and men in order to improve reproductive health care access. For example, PFPPA implemented a “Reducing Gender-Based Violence and Encroachment of the Reproductive Health Rights of Youth and Women” program to raise awareness of the importance of reproductive health care in Abu Dis, Al-Eizarieh, Al-Sawahreh Al-Sharqieh, Arab Al-Jahaleen, Al-Tur, Shu’fat, Al-Thouri, and East Jerusalem from 2008-2011. PFPPA also runs “Centers of Excellence,” which integrate clinical health services and education on the body’s reproductive functions and family planning, as well as women’s and men’s sexual and reproductive health rights.

To mark World Population Day, we welcome your comments and questions on reproductive health access in Palestine.

–Jamie Leadens Johnson & Elizabeth Arend

(Photo courtesy of PFPPA)