Creative Commons November 2019: Development Alternatives with Women for a New Era (DAWN). Any part of this collection of essays may be reproduced or utilized provided that Development Alternatives with Women for a New Era (DAWN) is cited. DAWN would appreciate receiving a copy of any material in which information from this collection of essays is used. Title: Equality, Quality and Accountability in Advancing SRHR in China, India and Indonesia Authors: Riznawaty Imma Aryanty, Sapna Desai, Hu Yukun, Mridula Shankar, Ninuk Widyantoro, Cai Yiping Introduction: Vanita Mukherjee, Cai Yiping Copy editing: Seona Smiles, Damien Gock Editorial team: María Graciela Cuervo, Vanita Mukherjee, Gita Sen, Sharan Sindhu, Cai Yiping Published by: Development Alternatives with Women for a New Era (DAWN). Design and cover: Tasmy Gómez Development Alternatives with Women for a New Era (DAWN) Level 2 JP Bayly Trust Building, 193 Rodwell Road, Suva, FIJI. [email protected] | www.dawnnet.org Table of Contents Foreword ............................................................................................................................................... III Introduction by Cai Yiping and Vanita Mukherjee ........................................................................... 1 Background and Objective .................................................................................................................. 2 Methodology and Framework .............................................................................................................. 2 Main findings and Recommendations ................................................................................................. 5 China by Hu Yukun and Cai Yiping..................................................................................................10 Equality, Quality and Accountability in Sexual and Reproductive Health and Rights: China Case Study ............................................................................................................................................11 1. Introduction ............................................................................................................................11 2. The Key Trend of Law and Policy Development – Benchmark Status ..................................13 2.1. Legislative Frameworks ...................................................................................................13 2.2. Policy Trajectories ...........................................................................................................14 3. EQA in SRHR: Progress and Challenges .............................................................................15 3.1. Equality Profile ................................................................................................................15 3.2. Quality Profile ..................................................................................................................19 3.3. Accountability ..................................................................................................................25 4. Conclusion and Recommendations .......................................................................................28 4.1. The Remaining Gaps........................................................................................................28 4.2. Recommendations ............................................................................................................30 India By Sapna Desai and Mridula Shankar ....................................................................................35 An Analysis of the Current Status of Contraceptive Services and the Treatment of Gynaecological Morbidities in India Through the Lens of Equality, Quality and Accountability. ...............................................................................................................................................................36 1. Introduction ............................................................................................................................36 1.1. Approach ..........................................................................................................................37 2. Benchmark Status ...................................................................................................................37 2.1. Laws, Policies and Programs ...........................................................................................37 2.2. The Sustainable Development Goals ...............................................................................40 2.3. India and the SDGs ..........................................................................................................40 3. Analysis of the Provision of Contraception and Gynaecological Morbidities using a framework of Equality, Quality and Accountability ....................................................................42 3.1. Contraception Equality ....................................................................................................42 3.2. Gynaecological morbidities .............................................................................................49 4. Advances, Challenges and Opportunities .............................................................................53 Indonesia By Riznawaty Imma Aryanty and Ninuk Widyantoro ...................................................61 Sexual and Reproductive Health Services in Indonesia: An Analysis of Equality, Quality and Accountability ......................................................................................................................................62 1. Introduction ............................................................................................................................62 2. Laws and Policies on Maternal Health and Family Planning ............................................63 3. Equality, Quality & Accountability for Maternal Health and Family Planning ..............65 3.1. Maternal Health Program .......................................................................................................65 3.2. Family Planning Program .......................................................................................................70 4. Conclusions and Recommendations ......................................................................................75 About the authors ................................................................................................................................79 Foreword Ever since the United Nations International Conference on Population and Development (ICPD) was held in Cairo in 1994, governments, agencies, and civil society have been addressing the challenge of implementing the sweeping changes to population-related policies and programmes it had envisioned. The situation of sexual and reproductive health and rights (SRHR) varied greatly within and between countries then and has continued to do so in the following years. Some countries and regions faced shortages in supplies of contraceptives and programme capacity; others had to address and redress the consequences of coercive practices; while yet others have had to face the onslaught of conservative forces opposed to gender equality and women’s human rights, especially sexual and reproductive rights. In the lead-up to the twentieth-year review of ICPD, there was growing evidence that challenges in implementing SRHR through policies and programmes could be crystallized as three interlinked issues – inequality, poor quality services, and absence of transparency or accountability. The DAWN project on Equality, Quality and Accountability (EQA) grew out of these debates, and it was decided to focus on a few countries in one region for more in-depth analysis. The choice of Asia’s largest countries was challenging but also exciting because of their scope and diversity of concerns. The EQA case studies on China, India and Indonesia in this collection are a complement to previous DAWN work that produced Regional Advocacy Tools on SRHR. But EQA are also the most pressing concerns today and for the foreseeable future of SRHR policies and programmes, including in the context of universal health care. DAWN is happy to bring these case studies together as a contribution to the public discourse on the implementation of ICPD and the fulfilment of the SRHR agenda. DAWN wishes to thank many people who have contributed to this project – the authors of the case studies and the introduction, Seona Smiles – our smiling editor, the SRHR team, and all the secretariat staff who supported the project. Without you, this could not have been completed. Gita Sen & Maria Graciela Cuervo General Co-coordinators DAWN III Introduction by Cai Yiping and Vanita Mukherjee [insert graphic here: Over the above, do not delete the above] 1 Background and Objective “Equality, Quality and Accountability in Advancing SRHR in China, India and Indonesia” is a research project coordinated by DAWN as a contribution to advancing the sexual and reproductive health and rights (SRHR) agenda. Through concrete case studies for the three most populous countries of Asia, we examine what policies and programs have worked, what have not, and what are the continuing challenges that need to be addressed in order to move the SRHR agenda forward, 25 years after the International Conference on Population and Development (ICPD) conference in Cairo. The project originated from an intense phase of analysis, advocacy