Expanding Reproductive Rights Knowledge and Advocacy with HIV-positive Women and their Allies in Namibia - An Action-Oriented Initiative

This 28-page report, published by Ipas, looks at a Namibian project that was designed to increase awareness about gender and reproductive rights among members of the International Community of Women Living with HIV (ICW) and youth in order for them to advocate on these issues, particularly with regard to unwanted pregnancies, emergency contraception and access to legalised abortion, within communities and nationally. The report outlines Namibia's sexual and reproductive health context and then details the impact of trainings on youth and women living with HIV before describing lessons learned. The report concludes with final observations that seek to support the use of varied communication tools in capacitating women and youth to advocate on gender and reproductive health.

As part of the project, skills-building youth workshops led by ICW facilitators employed a variety of communication strategies, including brainstorming, drawing, role play, and group readings, in order to capacitate youth as gender and reproductive rights advocates. Following the workshops, some youth conducted their own community outreach. Additional youth outreach was combined with vocational and entrepreneurial training. Youth were also part of broader media advocacy alongside ICW facilitators that utilised community radio call-in shows in Windhoek to raise awareness and debate the need for broader access to contraception and legal abortion.

Youth were also part of broader media advocacy alongside ICW facilitators that utilised community radio call-in shows and local newspapers in Windhoek to raise awareness and debate the need for broader access to legalised abortion. Like youth, ICW members had also previously undergone at least one training-of-the-trainers course on gender and reproductive rights with additional focuses on facilitation and campaign planning. Women used these skills to educate patients on their rights and establish clinic health ethics committees in two Windhoek area clinics after receiving reports of health workers poor treatment of HIV-positive women.

In the initial follow-up to a training-of-trainers held in 2007, young people aged 16-23 years formed a youth group in Dordabis, a rural community 80 km from Windhoek, which they called Youth Against Crime (YAC). Under the leadership of a primary schoolteacher, some parents formed a complementary group called Parents Influencing Community Change (PICC). The YAC had begun writing and performing skits about the issue of violence and received drama training to facilitate their use of drama to communicate with rural communities about issues such as abortion, domestic violence, and HIV. The local police credited them with making the "hidden" issue of violence visible and encouraging community members to report incidents; eventually, the number of incidents decreased and the success of these dramas mobilised other communities to request performances.

ICW members had previously undergone at least one training-of-trainers course on gender and reproductive rights with additional focuses on facilitation and campaign planning. Women used these skills to educate patients on their rights and establish health ethics committees in two Windhoek area clinics after receiving reports of health workers’ poor treatment of HIV-positive women. Staff of the clinics participated in the committees and treatment of patients improved. Other local communities asked for the committees to be established at their clinics as well.

Implementers note several lessons learned, including the need to balance project control between the technical assistance partner and the local implementing body. Ipas noted that long distance support to their Namibian partners was difficult and compromised its ability to provide timely feedback. It is recommended that similar projects include more field visits. Additional challenges emerged regarding ICW's capacity as a new organisation and high staff turnover. To remedy this, the report suggests including more funding for supervision, which could help retain skilled, mid-level staff. Finally, the report notes that establishing an advocacy coalition was time-consuming, and related goals should be planned accordingly.

While the report notes that the programme was poorly evaluated due to monitoring and evaluation mistakes, it concludes that the project enabled youth and ICW members to discuss gender and reproductive rights, especially abortion, in a variety of venues, and in addition contributed to making abortion a publicly "discussable" issue in Namibia. The report maintains that this advocacy work has had long-lasting impacts as evidenced by decision-makers' increased willingness to publicly discuss abortion and an increased interest in the issue by civil society groups. In 2011, the Namibian Women’s Health Network, together with other civil society partners, launched a booklet with testimonies about young and adult women’s experiences with unsafe abortions and asked the Ministry of Health to request assistance from the World Health Organization in conducting a strategic assessment of unwanted pregnancies, unsafe abortions and baby dumping in the country. They also asked the government to educate the public on the five indications for which abortion is legally allowed in the country as most people still think it is always illegal.