Thank you so much for the opportunity to meet with you today.
I'm speaking to you on behalf of CECI, the Centre for International Studies and Cooperation, a Canadian organization founded in 1958 and headquartered in Montreal. CECI is active in over 15 countries, in Africa, Latin America, the Caribbean—mainly in Haiti—and Asia.
CECI's mission is to fight poverty, exclusion and inequality, through such means as women's rights programs, economic empowerment and adaptation to climate change, and work in communities living in fragile environments.
CECI has been carrying out sexual and reproductive health projects for over 35 years, advocating for equal access to health care and quality health services for mothers and children, and reducing violence against women and girls. In the past decade or so, it has completed projects of this kind in Haiti, Mali, Rwanda, the Democratic Republic of Congo and Burundi, among other countries.
We're currently seeing a decline in sexual and reproductive health rights. Various factors are to blame, but some appear to us to be predominant and recurring in a number of countries around the globe. I will address just four of them for now.
The first factor is the decline in public and international funding for sexual and reproductive health care, comprehensive sexuality education and outreach. This has led to a reduction in counselling services, outreach to rural areas and decentralized services. It's also had an impact on conflict-affected areas. Systems are becoming less efficient, and the use of technology for things like teleconsultations is relatively rare.
The second factor is the rise of a global narrative that is resistant and sometimes hostile to women's and girls' rights, gender equality, family planning, methods of contraception and comprehensive sexuality education, and this has set back sexual and reproductive health rights, especially for the most marginalized people.
The third factor is the disparity between women's and girls' needs and clinical training or training that promotes more egalitarian approaches. For example, in countries where abortion is illegal, medical staff lack knowledge about postabortion care, even in cases of involuntary termination. This staff also lacks the counselling skills to address women's needs or the difficulties women may face.
The final factor is the fact that sexual and gender-based violence continues to happen. The lack of skilled attendance among health care providers to assist victims and survivors of sexual and gender-based violence leads to fewer women seeking help, which may cause them to take health risks like unsafe pregnancy termination.
A few of the witnesses before me have said it, and I would also like to point out that, according to the World Health Organization, 13.2% of maternal deaths each year can be attributed to unsafe abortion. The WHO also says that restricting access to abortion does nothing to reduce the number of abortions, but it does affect their safety and the mothers' dignity.
Based on this experience and best practices from our various projects, CECI recommends that Canada take several steps.
First, it should increase funding for sexual and reproductive health, with a special focus on recognizing and building the capacity of Canadian expertise, including that of non-governmental organizations and universities that work internationally to support people around the world. In particular, these institutions help support collaborative initiatives to harmonize the work of health care services stakeholders with that of civil society organizations, particularly women's groups and decentralized communities.
Next, it should urge local civil society organizations to get involved. I'm making a connection with the localization of assistance in particular. This work needs to be done specifically with women's organizations that can connect with official health services. This has proven to be particularly effective in encouraging victims of gender-based violence to seek help, and in ensuring adequate follow‑up.
Support should also be provided for the use of new technologies and approaches that enable health care coverage in remote, underserved or prolonged crisis areas.
Lastly, formal medical education should be provided, with university curricula that are egalitarian and address sexual and reproductive health issues, including abortion, as public health rather than cultural issues. In addition, clinical knowledge would be paired with gender-sensitive coaching skills.
In closing, I'd like to make a recommendation regarding the political and legislative impact Canada can have legislatively. Either directly or through multilateral institutions, Canada can encourage amendments to discriminatory legislation in some countries or advocate for stronger legal mechanisms through new legislation or implementation laws.
For example, Mali passed sexual and reproductive health legislation 20 years ago—