POPULATION REFERENCE BUREAU Sexual & Reproductive Health in the Middle East and North Africa A GUIDE FOR REPORTERS Farzaneh Roudi-Fahimi and Lori Ashford 1 1 This guide provides a variety of regional and national data, trends, and other informa- tion on sexual and reproductive health in the Middle East and North Africa. It is avail- able online at: www.prb.org/reports/2008/mediaguide.aspx. Sexual & Reproductive Health 2 in the About the Population Reference Bureau Middle East and North Africa The Population Reference Bureau (PRB) informs people around the world about A GUIDE FOR REPORTERS population, health, and the environment, and empowers them to use that information 3 to advance the well-being of current and future generations. For nearly two decades, PRB has worked with print and broadcast journalists in the TABLE OF developing world to strengthen and expand media coverage of reproductive health, 4 development, and population issues. Accurate and timely reporting of these issues helps shape public discussion and inform policymakers. Contents PRB’s Middle East and North Africa (MENA) program, initiated in 2001 with funding 1 | Why Should Sexual and Reproductive Health 5 from the Ford Foundation office in Cairo, responds to the region’s need for timely and Issues Concern the Media? .............................................................................3 objective information on population, socioeconomic, and reproductive health issues. The project explores the links among these issues and provides evidence-based policy 2 | Marriage ...........................................................................................................7 and program recommendations. 3 | Childbearing ...................................................................................................11 6 Acknowledgments Farzaneh Roudi-Fahimi is program director of the Middle East and North Africa pro- 4 | Family Planning .............................................................................................15 gram at PRB. Lori Ashford is program director, policy communications, PRB. Thanks 5 | Maternal Health .............................................................................................23 are due to several people who reviewed and contributed to the guide: Montasser 7 Kamal of the Ford Foundation office in Cairo; Karima Khalil, public health consultant; 6 | Abortion .........................................................................................................31 Deborah Mesce, program director, international media training, PRB; and Richard Skolnik, vice president, International Programs, PRB. 7 | Sexually Transmitted Infections and HIV/AIDS ...........................................37 Design and Production: Michelle Corbett, Black Mountain Creative 8 | Adolescents and Young Adults .....................................................................43 8 This work has been funded by the Ford Foundation office in Cairo. 9 | Female Genital Cutting ..................................................................................49 © May 2008. Population Reference Bureau. All rights reserved. 10 | Cervical Cancer ............................................................................................55 9 Population Reference Bureau 11 | Sexual and Reproductive Health and Development Goals ........................59 1875 Connecticut Ave., N.W. Suite 520 | Washington, DC 20009-5728 | USA Appendix 1 | Population and Reproductive Health Indicators by Country .......63 Phone: 202-483-1100 | Fax: 202-328-3937 10 E-mail: [email protected] | Website: www.prb.org Appendix 2 | Sexual and Reproductive Health Glossary ...................................69 Appendix 3 | Sources of Information .................................................................81 11 Appx. FINLAND NORWAY ESTONIA DENMARK LATVIA LITHUANIA IRELAND NETH. POLAND BELARUS U. K. GERMANY BELGIUM LUX. CZECH SLOVAKIA UKRAINE AUSTRIA MOLDOVA SWITZ. HUNGARY SLOVENIA ROMANIA ITALY Population DistributionintheMiddleEastandNorthAfrica,2008 TURKEY TUNISIA LEBANON SYRIA PALESTINIAN TERRITORY ISRAEL MOROCCO IRAQ IRAN JORDAN ALGERIA KUWAIT LIBYA EGYPT BAHRAIN QATAR U.A.E. Western Asia North Africa SAUDI ARABIA 212 million 160 million 49% 37% OMAN YEMEN Arabian Peninsula 60 million NOTES: The Middle East and North Africa (MENA) region as defined in this report includes 14% CENTRAL AFRICAN SIERRA LEONE Algeria, Bahrain, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, ETHIOPIALibya, Morocco, Oman, Palestinian CAMEROON REPUBLIC LIBERIA Territory, Qatar, Saudi Arabia, Syria, Tunisia, Turkey, the United Arab Emirates, and Yemen. UGANDA EQUATORIALSome GUINEA of the country boundaries shown are undetermined or in dispute. REPUBLIC KENYA SAO TOME & PRINCIPE OF CONGO GABON CONGO RWANDA SOURCE: UN Population Division, WorldBURUNDI Population Prospects: The 2006 Revision (2007). http://esa.un.org TANZANIA ANGOLA COMOROS ZAMBIA MALAWI NAMIBIA ZIMBABWE Sexual andReproductive Health in MENA: AGuide for Reporters economic development. reproductive healthcontributes tosocialinequalitiesandhinders educate thepublicandmakecaseforpolicymakersthat poorsexualand reproductive healthforcountriesintheMENAregion,to helpjournalists from puttingtheissuesontheirdevelopment vents peoplefromseekinginformationandcareprevents governments that surroundssexualandreproductivehealth,asilence that alltoooftenpre (see Box1,page5).Themediahasthepowertobreak cultureofsilence providing objectiveinformationaboutsexualandreproductive healthmatters pronounced intheMENAregion,andmakeroleof mediavitalin and NorthAfrica(MENA)region. particularlyintheMiddle East be difficulttowriteaboutordiscusspublicly, deals withthemostintimateandprivateaspectsofpeople’slives,whichcan well-being inmattersrelatedtosexualrelations,pregnancies,andbirths.It Sexual andreproductivehealthisabroadconceptencompassing MADAGASCAR1 1 BOTSWANA MOZAMBIQUE KEY POINTS This guideaimstobringtogetherthelatestavailabledata onsexualand Cultural sensitivitiesandtaboossurroundingsexualityare particularly ✦ ✦ ✦ I Reproductive Health R Why ShouldSexualand Why issues topolicymakers’attention. issues tobreaktaboos,educatethepublic,andbring Journalists canreportresponsiblyandobjectivelyonthese cultural aspects Sexual andreproductivehealthissuestouchonsensitive and Sexual andreproductivehealthrelatestobothhumanrights theMedia? Issues Concern SWAZILAND ssues eproductive Health development. LESOTHO of SOUTH AFRICA taboos. people’s livesandtendtobesurroundedby S hould C oncern theMedia? S exual and agendas. www.prb.org - 3 1 1 1 1 1 1 | Why Should Sexual and Reproductive Health Issues Concern the Media? 1 | Why Should Sexual and Reproductive Health Issues Concern the Media? 1 1 1 Sexual and Reproductive Health for All The Cairo agreement recognizes that sexual and reproductive health affects and is affected by people’s relationships and by the broader context The right to health is acknowledged internationally as a universal human of their lives, including their economic circumstances; education; employ- right. Sexual and reproductive health relates to the health and well-being ment opportunities; family structures; and political, religious, and legal of individuals, families, and society, and is increasingly part of international environment. The interconnections have also been recognized in other and national development discourse. UN agreements, most notably the Platform of Action of the Fourth World Reproductive health and sexual health were first defined in the Programme Conference on Women held in Beijing in 1995, the Millennium Development of Action of the 1994 United Nations International Conference on Population and Development: Box 1 Reproductive health is a state of complete physical, mental and social Reporting Responsibly on Sensitive Issues well-being and not merely the absence of disease or infirmity, in all mat- Most people’s experience of sexual and reproductive health is very personal and ters relating to the reproductive system and to its functions and process. private. In producing stories on this topic, journalists need to consider certain Reproductive health therefore implies that people are able to have a ethical issues: satisfying and safe sex life and that they have the capability to reproduce ✦ Confidentiality. People may be abandoned by their community or suffer vio- and the freedom to decide if, when and how often to do so. lence from their spouses or family members if their identity is revealed in a story. If people are ostracized as a result of talking to a journalist, their ability Rooted in the principles of human rights, sexual and reproductive health to earn a living can be affected. implies that: ✦ Stigma. People may feel guilty or ashamed about their past actions or experi- ✦ Men and women have the right to be informed and have access to ences (for example, contracting a sexually transmitted infection). Journalists safe, effective, affordable, and acceptable methods of family planning should be sensitive to this and always treat the people they talk to with dignity. ✦ of their choice. Legality. Journalists need to make sure they aren’t putting people at risk of arrest or imprisonment by asking them to talk about their sexual behavior. ✦ The right to have access to health care services that will enable women ✦ Checking facts. All the facts in a story should be double-checked to avoid to go safely through pregnancy and childbirth and provide couples with misleading readers or unnecessarily increasing their health risks.