UNFPA BACKGROUND GUIDE - IMUNA
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Email: info@imuna.org Phone: +1 (212) 652-9992 Web: www.nhsmun.nyc Secretary-General Dear Delegates, Ankita Bhat I am beyond thrilled to welcome you to NHSMUN 2022 and the United Nations Population Fund Director-General (UNFPA)! My name is Sachee Vora, and I am so excited and grateful to be serving as your Session Kathy Li I Director. This is my second year on staff. I was an Assistant Director for UNICEF at NHSMUN- Chiefs of Staff NY 2021 and am currently working as the Director for the UNWTO for NHSMUN-MX 2021. My Jon Basile love for Model UN began in grade nine, and I continued participating in conferences throughout Abolee Raut high school, and I have since continued my involvement with Model UN at my university. Model Conference Services UN has provided me with many great opportunities for self-improvement and has truly shaped me Hugo Bordas into the person I am today (what a cliché, right?). I hope that your time at NHSMUN will foster a Sofía Fuentes great passion for debate and world issues in all of you as it has for me. Delegate Experience I am currently in my third year at the University of Western Ontario in London, Ontario, Canada, Akanksha Sancheti Beatriz Circelli pursuing an Honours Specialization in One Health and considering the pre-med route. Alongside my love for health and biology, I am super passionate about issues surrounding access to healthcare Global Partnerships worldwide and hope to pursue a career involving global health. On campus, I am a graphic designer Katherine Alcantara for the Science Student Council. In addition, I work as a Research Assistant developing and Clare Steiner reviewing types of educational strategies for Equity, Diversity, and Inclusion training in medicine. Under-Secretaries- Alongside this, I can usually be found binging Netflix shows/movies, drinking an oat milk chai latte, General watching Tik Toks, crocheting, and have recently started kickboxing! James Caracciolo Ana Margarita Gil After much deliberation and research, Therese and I decided on two topics that we felt would foster Ming-May Hu meaningful and important debate and research. This being said, our two topics for NHSMUN Brandon Huetter 2022 are “Poverty’s Impact on Women’s Health” and “Combating Gender-Based Violence.” Both Juliette Kimmins Caleb Kuberiet of these issues hold high importance and urgency, especially in today’s climate. Intersectionality Victor Miranda and the recognition of gender disparities worldwide will be imperative to understanding and Anikait Panikker communicating these topics. Both of these issues require in-depth research and knowledge to Frances Seabrook form comprehensive, sustainable solutions that will help elevate the voices of women and girls Sharon Tang worldwide, ultimately creating a better future for them around the world. I hope you enjoy reading Kylie Watanabe this background guide; Therese and I have spent a lot of time putting together this research paper Sophia Zhukovsky to aid in your preparation for the conference. I am so excited to see you and hear the debate and amazing solutions discussed in March! I hope that you are all looking forward to debating these interesting and important topics. I encourage you to reach out to me or Therese if you have any questions about the topics, the conference, or just want to introduce yourself! Good luck with the rest of your preparations, and I cannot wait to meet you all in March! Best wishes, Sachee Vora sachee.vora@imuna.com United Nations Population Fund Session I
Email: info@imuna.org Phone: +1 (212) 652-9992 Web: www.nhsmun.nyc Secretary-General Dear Delegates, Ankita Bhat Welcome to the 2022 National High School Model United Nations Conference! My name is Therese Director-General Salomone, and I am your Session II Director for the United Nations Population Fund (UNFPA). Kathy Li My co-Director, Sachee Vora, and I have worked incredibly hard to put together a comprehensive Chiefs of Staff and engaging background guide that will help you begin your research on the two topics for our Jon Basile committee. Abolee Raut This will be my fourth year attending NHSMUN and my second year on staff. One of the first Conference Services Hugo Bordas Model UN conferences I ever attended was NHSMUN 2019, my junior year of high school, and I Sofía Fuentes completely fell in love with MUN there! I learned so much about global issues I knew nothing about before, met people from all over the world, and had so much fun exploring New York City with Delegate Experience my friends. I participated in NHSMUN 2020 my senior year of high school and decided to apply Akanksha Sancheti Beatriz Circelli to be part of the NHSMUN staff after another amazing experience. Last year I was the Assistant Director for the United Nations Children’s Fund (UNICEF) Session II, and I loved being on staff Global Partnerships just as much if not more than being a delegate at NHSMUN. It was wonderful that we could still Katherine Alcantara interact with delegates virtually at last year’s conference. Still, I am very much looking forward to Clare Steiner being back in New York City with all of you in person this year! Under-Secretaries- General I am currently a sophomore at the Ohio State University in Columbus, Ohio. I am pursuing a James Caracciolo double major in public policy analysis and romance studies and a minor in business analytics. At Ana Margarita Gil Ohio State, I am involved in the Spanish and Portuguese Club, the John Glenn Civic Leadership Ming-May Hu Community, and a health and fitness organization for girls called CHAARG. I am also a member Brandon Huetter of the Irish Dance Team at Ohio State after having Irish danced competitively for ten years. I enjoy Juliette Kimmins Caleb Kuberiet traveling, learning new languages (I am currently studying Spanish and French!), baking, relaxing Victor Miranda with my family and friends, and watching television (especially sitcoms and reality TV!). Anikait Panikker Sachee and I have selected two topics we found to be very urgent and relevant to the UNFPA. Frances Seabrook This year, our two topics are “Poverty’s Effect on Women’s Health” and “Combating Gender- Sharon Tang Kylie Watanabe Based Violence.” The first topic explores the intersections of poverty and health, focusing on how Sophia Zhukovsky gender affects these issues and their connections. The second topic looks at how gender-based violence harms the health and well-being of women and girls worldwide and the implications it has for the international community. We hope that this background guide breaks down some of the complexities of these topics so that they are easier to understand and ultimately helps guide you as you conduct your own research. I hope you all have a fun and educational experience at NHSMUN and enjoy it as much as I have! If you have any questions, please do not hesitate to email Sachee or me. I look forward to meeting all of you in March and seeing all your hard work and preparation come together! Therese Salomone therese.salomone@imuna.org United Nations Population Fund Session II
UNFPA 4| Table of Contents Table of Contents A Note on the NHSMUN Difference 5 A Note on Research and Preparation 7 Committee History 8 Poverty’s Effect on Women’s Health 9 Introduction10 History and Description of the Issue 11 Current Status 27 Bloc Analysis 33 Committee Mission 36 Combating Gender-Based Violence 37 Introduction38 History and Description of the Issue 39 Current Status 53 Bloc Analysis 60 Committee Mission 63 Research and Preparation Questions 65 Important Documents 66 Works Cited 68
UNFPA A Note on the NHSMUN Difference |5 A Note on the NHSMUN Difference Esteemed Faculty and Delegates, Welcome to NHSMUN 2022! My name is Kathy Li, and I am this year’s Director-General. Thank you for choosing to attend NHSMUN, the world’s largest and most diverse Model United Nations conference for secondary school students. We are thrilled to welcome you to New York City in March! As a space for collaboration, consensus, and compromise, NHSMUN strives to transform today’s brightest thinkers into tomorrow’s leaders. Our organization provides a uniquely tailored experience for all in attendance through innovative and accessible programming. We believe that an emphasis on education through simulation is paramount to the Model UN experience, and this idea permeates throughout NHSMUN. Realism and accuracy: Although a perfect simulation of the UN is never possible, we believe that one of the core educational responsibilities of MUN conferences is to educate students about how the UN System works. Each NHSMUN committee is a simulation of a real deliberative body so that delegates can research what their country has said in the committee. Our topics are chosen from the issues currently on the agenda of each committee (except historical committees, which take topics from the appropriate time period). This creates incredible opportunities for our delegates to conduct first-hand research by reading the actual statements their country has made and the resolutions they have supported. We also strive to invite real UN, NGO, and field experts into each committee through our committee speakers program. Furthermore, our staff arranges meetings between students and the actual UN Permanent Mission of the country they represent. No other conference goes so far to immerse students into the UN System so deeply. Educational emphasis, even for awards: At the heart of NHSMUN lie education and compromise. As such, when NHSMUN does distribute awards, we de-emphasize their importance compared to the educational value of Model UN as an activity. NHSMUN seeks to reward students who excel in the arts of compromise and diplomacy. More importantly, we seek to develop an environment where delegates can employ their critical thought processes and share ideas with their counterparts from around the world. Part of what makes NHSMUN so special is its diverse delegate base. Given our delegates’ plurality of perspectives and experiences, we center our programming around the values of diplomacy and teamwork. In particular, our daises look for and promote constructive leadership that strives towards consensus, as real delegates do in the United Nations. Debate founded on knowledge: With knowledgeable staff members and delegates from over 70 countries, NHSMUN can facilitate an enriching experience reliant on substantively rigorous debate. To ensure this high quality of debate, our staff members produce extremely detailed and comprehensive topic guides (like the one below) to prepare delegates for the complexities and nuances inherent in each global issue. This process takes over six months, during which the Directors who lead our committees develop their topics with the valuable input of expert contributors. Because these topics are always changing and evolving, NHSMUN also produces update papers intended to bridge the gap of time between when the background guides are published and when committee starts in March. As such, this guide is designed to be a launching point from which delegates should delve further into their topics. The detailed knowledge that our Directors provide in this background guide through diligent research aims to spur critical thought within delegates at NHSMUN. Extremely engaged staff: At NHSMUN, our staffers care deeply about delegates’ experiences and what they take away from their time at NHSMUN. Before the conference, our Directors and Assistant Directors are trained rigorously through copious hours of workshops and exercises to provide the best conference experience possible. At the conference, delegates will have the opportunity to meet their dais members before the first committee session, where they may engage one-on-one to discuss their
UNFPA 6| A Note on the NHSMUN Difference committees and topics. Our Directors and Assistant Directors are trained and empowered to be experts on their topics, and they are eager to share their knowledge with delegates. Our Directors and Assistant Directors read every position paper submitted to NHSMUN and provide thoughtful insight on those submitted by the feedback deadline. Our staff aims not only to tailor the committee experience to delegates’ reflections and research but also to facilitate an environment where all delegates’ thoughts can be heard. Empowering participation: The UN relies on the voices of all of its Member States to create resolutions most likely to make a meaningful impact on the world. That is our philosophy at NHSMUN as well. We believe that to properly delve into an issue and produce fruitful debate, it is crucial to focus the entire energy and attention of the room on the topic at hand. Our Rules of Procedure and our staff focus on empowering every voice in the committee, regardless of each delegate’s country assignment or skill level. Additionally, unlike many other conferences, we also emphasize delegate participation after the conference. MUN delegates are well-researched and aware of the UN’s priorities, and they can serve as the vanguard for action on the Sustainable Development Goals (SDGs). Therefore, we are proud to connect students with other action-oriented organizations to encourage further work on the topics. Focused committee time: We feel strongly that interpersonal connections during debate are critical to producing superior committee experiences and allow for the free flow of ideas. Ensuring policies based on equality and inclusion is one way in which NHSMUN guarantees that every delegate has an equal opportunity to succeed in committee. In order to allow communication and collaboration to be maximized during committee, we have a very dedicated team who work throughout the conference to type, format, and print draft resolutions and working papers. As always, we welcome any questions or concerns about the substantive program at NHSMUN 2022 and would be happy to discuss NHSMUN pedagogy with faculty or delegates. Delegates, it is our sincerest hope that your time at NHSMUN will be thought-provoking and stimulating. NHSMUN is an incredible time to learn, grow, and embrace new opportunities. We look forward to seeing you work both as students and global citizens at the conference. Best, Kathy Li Director-General
UNFPA A Note on Research and Preparation |7 A Note on Research and Preparation Delegate research and preparation is a critical element of attending NHSMUN and enjoying the debate experience. We have provided this Background Guide to introduce the topics that will be discussed in your committee. We encourage and expect each of you to critically explore the selected topics and be able to identify and analyze their intricacies upon arrival to NHSMUN in March. The task of preparing for the conference can be challenging, but to assist delegates, we have updated our Beginner Delegate Guide and Advanced Delegate Guide. In particular, these guides contain more detailed instructions on how to prepare a position paper and excellent sources that delegates can use for research. Use these resources to your advantage. They can help transform a sometimes overwhelming task into what it should be: an engaging, interesting, and rewarding experience. To accurately represent a country, delegates must be able to articulate its policies. Accordingly, NHSMUN requires each delegation (the one or two delegates representing a country in a committee) to write a position paper for each topic on the committee’s agenda. In delegations with two students, we strongly encourage each student to research each topic to ensure that they are prepared to debate no matter which topic is selected first. More information about how to write and format position papers can be found in the NHSMUN Research Guide. To summarize, position papers should be structured into three sections: I: Topic Background – This section should describe the history of the topic as it would be described by the delegate’s country. Delegates do not need to give an exhaustive account of the topic, but rather focus on the details that are most important to the delegation’s policy and proposed solutions. II: Country Policy – This section should discuss the delegation’s policy regarding the topic. Each paper should state the policy in plain terms and include the relevant statements, statistics, and research that support the effectiveness of the policy. Comparisons with other global issues are also appropriate here. III. Proposed Solutions – This section should detail the delegation’s proposed solutions to address the topic. Descriptions of each solution should be thorough. Each idea should clearly connect to the specific problem it aims to solve and identify potential obstacles to implementation and how they can be avoided. The solution should be a natural extension of the country’s policy. Each topic’s position paper should be no more than 10 pages long double-spaced with standard margins and font size. We recommend 3–5 pages per topic as a suitable length. The paper must be written from the perspective of the your assigned country should articulate the policies you will espouse at the conference. Each delegation is responsible for sending a copy of its papers to their committee Directors via myDais on or before March 4, 2022. If a delegate wishes to receive detailed feedback from the committee’s dais, a position must be submitted on or before February 18, 2022. The papers received by this earlier deadline will be reviewed by the dais of each committee and returned prior to your arrival at the conference. Complete instructions for how to submit position papers will be sent to faculty advisers via email. If delegations are unable to submit their position papers on time, please contact us at info@imuna.org. Delegations that do not submit position papers to directors will be ineligible for awards.
UNFPA 8| Committee History Committee History The United Nations Fund for Population Activities was established by the United Nations Economic and Social Council (ECOSOC) in 1973 to promote awareness of and solutions to population problems and lead population programs in the UN. Then, in 1977, it was introduced into the United Nations Development Programme, and in 1987, it changed to its current name. The UNFPA is a subsidiary organ under the United Nations General Assembly, addressing population and development issues. Then, at the 1994 International Conference on Population and Development (ICPD) in Cairo, the UNFPA’s mandate was expanded to include gender equality and human rights as crucial parts of population management.1 Today, the UNFPA is committed to protecting reproductive rights and responding to changing demographic needs, and engaging young people in securing human rights, employment, education, and health care through political dialogue and other health programs.2 Currently, the UNFPA works in over 150 countries, including over 80 percent of the world’s population.3 Its work is grounded on the presumption that all humans are entitled to equal rights and protections, focusing on women and young people. The UNFPA has been instrumental in making progress towards the goals stated in the ICPD. The UNFPA’s adoption of a human rights-based approach in 2003 was essential to decision-making processes within the UNFPA since it helps focus the scope of its results on securing the rights of the people, rather than only addressing the needs of the beneficiaries. The human rights- based approach focuses on the most marginalized and excluded groups in society and evaluates what interventions are needed to help them.4 To continue expanding the scope of its work and achieve better results, it partners with civil societies, academic institutions, private NGOs, and other UN committees such as WHO, UNICEF, UNPD, and UNAIDS.5 The UNFPA is one of the four founding members of the UN Development Group created in 1997 to work at a more focused level to improve UN development within countries. The UNFPA is also a part of other interagency groups within the UN, including the UN Chief of Executives Board for Coordination, and it receives policy guidance from ECOSOC. While the UNFPA is not supported by the UN regular budget, it receives voluntary contributions from private and public parties.6 Even amid the COVID-19 pandemic, the UNFPA worked closely with member states, helping prevent over 14 million unintended pregnancies, almost 40,000 maternal deaths, and over 4 million unsafe abortions in 2020.7 From 2018 to 2020, the UNFPA also averted 367,000 new HIV infections and 16.3 million sexually transmitted infections. Additionally, the UNFPA provided 107 million women and young people with sexual health services and helped in 1.9 million safe deliveries in humanitarian or otherwise compromised situations.8 The health services and humanitarian aid provided by the UNFPA helps to empower women, secure their rights to bodily autonomy and improves the health of the entire population. The UNFPA is headquartered in New York City, but it also has regional offices across the globe. The majority of these offices are located in regions where the UNFPA primarily works, such as the Arab States, Eastern Europe, and Latin America. It also has a few sub-regional offices and liaison offices, as well as many offices within countries and territories. As a subsidiary organ of the UN General Assembly, the UNFPA follows proceedings to discuss agenda items and present their recommendations to the General Assembly for its consideration.9 1 “Frequently Asked Questions.” United Nations Population Fund. UNFPA. Last date modified January 2018. https://www.unfpa.org/frequently-asked- questions#mandate. 2 Benoit Kalasa, Overview of UNFPA Mandate and Thematic Areas: Executive Board Orientation. (New York: UNFPA Official, 2019), https://www.unfpa.org/ sites/default/files/event-pdf/UNFPA_mandate_and_thematic_areas.pdf. 3 “About Us.” United Nations Population Fund. UNFPA. Last date modified January 2018. https://www.unfpa.org/about-us. 4 “The Human Right-Based Approach.” United Nations Population Fund. UNFPA. Last modified November 2014. https://www.unfpa.org/human-rights- based-approach. 5 “How We Work.” United Nations Population Fund. UNFPA. Last date modified January 2018. https://www.unfpa.org/how-we-work. 6 “UNFPA in the UN System.” United Nations Population Fund. UNFPA. Last date modified January 2018. https://www.unfpa.org/unfpa-un-system. 7 “Annual Report 2020.” United Nations Population Fund. UNFPA. Last date modified April 2021. https://www.unfpa.org/annual-report. 8 “UNFPA Global Results.” United Nations Population Fund, UNFPA. Accessed September 14, 2021. https://www.unfpa.org/data/results. 9 “Subsidiary organs of the General Assembly.” United Nations Population Fund, UNFPA. Accessed September 18, 2021. https://www.un.org/en/ga/ about/subsidiary/index.shtml.
UNFPA NHSMUN 2022 Topic A: Poverty’s Effect on Women’s Health Photo Credit: AMISOM Public Information
Topic A: Poverty’s Effect on Women’s Health 10|C ommittee History Introduction The 1946 Constitution of the World Health Organization (WHO) recognized good health as a fundamental human right.1 Despite many other treaties addressing the right to health, women continue to face distinct challenges and obstacles that drastically affect their access to positive health outcomes.2 While poverty still serves as one of the most significant barriers to achieving adequate treatment, research has proven that poverty yields a much higher burden on women’s and girl’s health.3 This observable discrepancy can be accredited to the sociocultural factors present in society that severely hinder women’s health: gender-based power inequalities, the presence of gender-based violence, and social norms that decrease educational and paid employment opportunities for women.4 These unequal dynamics between genders subsequently create consequences on women’s wellbeing, and poverty only further restricts access to comprehensive healthcare. The effect poverty has on health is bidirectional. Not only of experiencing higher poverty levels. It is also essential to does it lead to adverse health outcomes, but adverse health consider overlapping vulnerabilities. Some women may outcomes can also exacerbate poverty levels.5 Women are belong to multiple vulnerable communities, increasing their more likely to experience poverty than men, which leads to risk for facing the harsh effects poverty has on their health. unfavorable effects on their health, which impacts women For example, transgender women of African descent are more directly and indirectly.6 Direct effects include high rates likely to live in poverty than cisgender or Caucasian transgender of malnutrition, lack of funds to pay for healthcare and women.9 This introduces the concept of intersectionality, treatments, and inadequate sanitation, and indirect effects which is the study of how an individual’s inclusion in more include increased rates of child marriages, lack of education, than one group that experiences discrimination can cause and where a woman resides.7 All the aforementioned effects compounded negative effects. Intersectionality is a vital theme require urgency to prevent future adverse health outcomes of this issue that must be considered during discussions. Risk stemming from poverty and exemplify how proposed solutions factors and specific health outcomes must be identified to must tackle a network of interconnected social issues. construct policies that help every woman suffering from the issue at hand.10 While all women experiencing poverty face adverse health outcomes, some populations are more vulnerable than others. Achieving good health should be a priority; positive health It is essential to recognize the different subgroups of women outcomes have strong correlations to a successful life.11 and the factors that make some vulnerable to more significant Without good health, escaping poverty becomes practically poverty and poor health impacts.8 For example, marginalized impossible since it prevents a woman from reaching her full communities face more significant barriers in accessing educational potential, leads to lifelong chronic conditions, and health services, such as discrimination and a greater chance can become fatal.12 Women have the right to long and healthy 1 Office of the United Nations High Commissioner for Human Rights, The Right to Health (Geneva: WHO, 2006), https://www.ohchr.org/ documents/publications/factsheet31.pdf. 2 Office of the United Nations High Commissioner for Human Rights, The Right to Health. 3 “Women’s health,” World Health Organization, accessed on July 30, 2021, https://www.who.int/health-topics/women-s-health/. 4 World Health Organization. “Women’s health.” 5 “Global HIV & AIDS statistics,” UN AIDS, accessed on June 19, 2021, https://www.unaids.org/en/resources/fact-sheet. 6 “Women & Girls,” Health Poverty Action, last modified 2018, https://www.healthpovertyaction.org/how-poverty-is-created/women- girls/. 7 Jo Bibby, “Why poverty is bad for the nation’s health,” The Health Foundation, last modified March 28, 2019, https://www.health.org.uk/ news-and-comment/blogs/why-poverty-is-bad-for-the-nation-s-health. 8 “Vulnerable Populations: Who Are They?” AJMC, last modified November 1, 2006, https://www.ajmc.com/view/nov06-2390ps348-s352. 9 “The Complexity of LGBT Poverty In The United States,” Institute for Research on Poverty, last modified June 2021, https://www.irp. wisc.edu/resource/the-complexity-of-lgbt-poverty-in-the-united-states/ 10 AJMC. “Vulnerable Populations: Who Are They?” 11 Tim Lipscombe, “The importance of women’s health,” St John, last modified October 9, 2018, https://www.stjohnhealth.com.au/blog/ medical/the-importance-of-womens-health/. 12 Lipscombe, “The importance of women’s health.”
Topic A: Poverty’s Effect on Women’s Health History and Description of the Issue |11 lives. However, this right is stripped by poverty and the lack Poverty denies women worldwide accessing vital welfare of attention and resources to combat this issue. This problem factors, and their work is often underpaid.17 Women and girls has circulated the global health community for several years, living in poor households usually perform most housework, and it must come to an end. Delegates must keep women including cooking, cleaning, caretaking, and water collection. at the forefront of their conversations and consider the All tasks are time and labor-intensive that greatly limit the status of vulnerable groups with intersecting identities when time to find other career opportunities.18 The value of unpaid determining viable solutions. Now is the time to make the care work has been calculated to be at least USD 10.8 trillion health of women and girls a priority. each year.19 Additionally, women worldwide able to work paid labor still earn 24 percent less than men, as women disproportionately occupy the lowest-paid positions.20 In cases History and Description of the Issue where women are employed and earning an income, drastic inequalities in the workforce, including pay gaps, differences Poverty as a Gendered Issue in hours, and lack of affordable childcare, still create obstacles The UN defines poverty as “more than the lack of income for women trying to escape poverty. and productive resources to ensure sustainable livelihoods. Its In impoverished households, women are more likely to be manifestations include hunger and malnutrition, limited access responsible for coping with poverty than men. This includes to education and other basic services, social discrimination women attempting to find income-earning opportunities and exclusion, as well as the lack of participation in decision- for themselves to help provide for their families.21 However, making.”13 Acknowledging that poverty as a gendered issue women experiencing poverty are more likely to work is essential to understanding the history and seriousness of informally, with 75 percent of women in low-income countries how poverty uniquely impacts women comparatively to working in the informal economy: selling goods at markets, men. Women constitute a disproportionate amount of those cleaning for others, doing factory jobs, and begging.22 Women overburdened by poverty and its impacts, revealing that gender often become exposed to a new set of abuses associated with can be considered a cause of poverty.14 Social norms that unregulated employment, such as the lack of employment elevate the status of men over women engraved in cultures contracts, legal rights, and social protection since informal worldwide affect women in almost every facet of life, whether jobs are less regulated by the government, offering fewer global, legal, political, cultural, and religious. Social inequality benefits and protections.23 stemming from patriarchal norms denies women opportunities and social movement. It heightens their risk of falling into The burden of poverty is unequal. As girls age, the poverty poverty.15 It is vital to note that common conceptualizations gender gap widens. Among children, there are 105 girls for of poverty often reduce poverty to solely relate to income every 100 boys living in extremely poor households. For level and lack the nuance necessary to incorporate the added individuals aged 25 to 34, there are 122 women for every stressors of societal inequalities experienced by women.16 100 men living in the same condition.24 Regionally, Europe 13 “Ending Poverty,” United Nations, accessed September 14, 2021, https://www.un.org/en/global-issues/ending-poverty. 14 Sylvia Chant, “Rethinking the “Feminization of Poverty in Relation to Aggregate Gender Indices,” Journal of Human Development 7, no. 2 (July 2006): 201-220, https://doi.org/10.1080/14649880600768538. 15 Chant, “Rethinking the “Feminization of Poverty in Relation to Aggregate Gender Indices,” 201-220. 16 Sarah Abercrombie and Sarah Hastings, The Wiley Blackwell Encyclopedia of Gender and Sexuality Studies, (John Wiley & Sons, 2016), https:// doi.org/10.1002/9781118663219.wbegss550. 17 “The Feminization of Poverty,” UN Women, last modified May 2000, https://www.un.org/womenwatch/daw/followup/session/ presskit/fs1.htm. 18 Bureau of International Information Programs and United States Department of State, Global Women’s Issues: Women in the World Today, extended version (United States: Bureau of International Information Programs and United States Department of State, 2012), chap. 1. 19 OXFAM International. “Why the majority of the world’s poor are women,” 20 OXFAM International, “Why the majority of the world’s poor are women.” 21 Abercrombie and Hastings, The Wiley Blackwell Encyclopedia of Gender and Sexuality Studies. 22 Abercrombie and Hastings, The Wiley Blackwell Encyclopedia of Gender and Sexuality Studies. 23 Abercrombie and Hastings, The Wiley Blackwell Encyclopedia of Gender and Sexuality Studies. 24 Carolina Sanchez-Paramo, and Ana Maria Munoz-Boudet, “No, 70% of the world’s poor aren’t women, but that doesn’t mean poverty
Topic A: Poverty’s Effect on Women’s Health 12|H istory and Description of the Issue Mother and children preparing a meal and Central Asia show the lowest extreme poverty rates and less than USD 33.26 per day and are considered to be living the smallest gender poverty gap, while Sub-Saharan Africa in poverty despite having much more income than the UN’s is home to the highest amount of the global extreme poor extreme poverty line.28 This demonstrates that poverty lines and the largest poverty gender gap in the world.25 Stemming are not the same in all countries, as higher-income countries from this regional observation, it is important to understand have a higher cost of living that leads to increased national that poverty manifests uniquely in every society. While half poverty lines.29 of the world’s poor live in just five countries (India, Nigeria, Regardless, neither higher-income nor lower-income countries Democratic Republic of Congo, Ethiopia, and Bangladesh), could avoid the devastation of the COVID-19 pandemic. there are distinct struggles of those experiencing poverty COVID-19 has recently caused disastrous impacts on poverty in every region, which brings up the concepts of relative rates worldwide, consequently broadening the gendered and extreme poverty.26 While relative poverty is dependent poverty gap. Before the pandemic, the poverty rate steadily on citizens of individual countries, extreme poverty is an decreased each year for decades. However, the rate at which international threshold. Presently, anyone living on less than poverty declined was slowing down. In 2017, the poverty USD 1.90 per day is considered living in extreme poverty.27 rate fell 1 percent, followed by 0.6 percent and 0.2 percent in In the United States, 11.8 percent of the population lives on 2018–2019. With COVID-19, there is now a severe risk for isn’t sexist,” World Bank Blogs, last modified March 8, 2018, https://blogs.worldbank.org/developmenttalk/no-70-world-s-poor-aren-t- women-doesn-t-mean-poverty-isn-t-sexist. 25 Sanchez-Paramo and Munoz-Boudet, “No, 70% of the world’s poor aren’t women, but that doesn’t mean poverty isn’t sexist.” 26 Roy Katayama and Divyanshi Wadhwa, “Half of the world’s poor live in just 5 countries,” World Bank Blogs, last modified January 9, 2019, https://blogs.worldbank.org/opendata/half-world-s-poor-live-just-5-countries. 27 Sanchez-Paramo and Munoz-Boudet, “No, 70% of the world’s poor aren’t women, but that doesn’t mean poverty isn’t sexist.” 28 Andrea Peer, “Global poverty: Facts, FAQs, and how to help,” World Vision, last modified October 16, 2020, https://www.worldvision. org/sponsorship-news-stories/global-poverty-facts. 29 Peer, “Global poverty: Facts, FAQs, and how to help.”
Topic A: Poverty’s Effect on Women’s Health History and Description of the Issue |13 those who have just escaped to fall back into poverty.30 Before displacement, unemployment, trauma, and grief arising from COVID-19, it was predicted that 219 million women would natural disasters exacerbate the severity and frequency of be experiencing poverty in 2021 and 206 million in 2030. domestic violence against women.38 Increased prevalence With the pandemic, these estimates were increased to 247 of waterborne pathogens is another issue exacerbated by million women in 2021 and 232 million women in 2030.31 As climate. Climate change diminishes water quality in low- a result, the effects of COVID-19 must be considered when income countries where diseases such as malaria and diarrhea constructing policy to consider the unique challenges faced by pose a high threat. Pregnant women are increasingly more women experiencing poverty.32 affected by these vector-borne diseases, putting women and children at severe risk.39 Additionally, shifting rainfall patterns Drug use and other addictive substances are other factors and temperatures can lead to agriculture failures, leading to that trap women in poverty.33 Addiction rates are twice as high among the unemployed than the employed, and those in increased rates of anemia and nutrient deficiencies in women.40 poverty are more likely to revert to substance abuse to cope Ultimately, climate change widens the gender poverty gap and with the stresses of poverty.34 In contrast to men, women tend increases the likelihood of several adverse health outcomes. to progress quickly from substance use to drug dependence Along with the direct and indirect health consequences, due to biological and sociological differences. Women’s brains poverty can also lead to women not seeking adequate health are more vulnerable to the reinforcing effects of stimulants, services. Their access to healthcare is hindered by a lack of and often gender differences such as child care responsibilities transportation or even knowledge surrounding their health.41 and addiction stigma contribute.35 Levels of education correspond directly to poverty levels. Poor In addition to COVID-19 and drug use, climate change women often do not know how to seek the health services they disproportionately affects women more than men by need. They lack information on health services they need, such deepening existing inequalities.36 Changes in climate can as gynecology check-ups, mammograms, and others, making lead to women being forced to migrate, exposing them to these services inaccessible.42 Location also plays a vital role in violence from strangers and consequences from damaged deciding access to treatments, with drastic quality differences infrastructure. Tanna Women’s Counselling Centre found between communities often only a few kilometers apart. For that reports of new domestic violence cases increased by example, there was a 25-year difference in the life expectancy 300 percent after two cyclones in Vanuatu.37 Tensions from found of those residing in New Orleans in the United States 30 World Bank Group, Reversals of Fortune (Washington: International Bank for Reconstruction and Development, 2020), https:// openknowledge.worldbank.org/bitstream/handle/10986/34496/211602ov.pdf. 31 Magdalena Szmigiera, “Gender poverty gaps worldwide in 2020 and 2021,” Statista, last modified March 30, 2021, https://www.statista. com/statistics/1219896/gender-poverty-gaps-worldwide-by-gender/. 32 World Bank Group, Reversals of Fortune. 33 Ann O’Leary and Paula Frew, Poverty in the United States, (Atlanta: Springer Nature, 2017), https://doi.org/10.1007/978-3-319-43833-7. 34 “Addiction and Low-Income Americans,” Addiction Center, accessed on June 22, 2021, https://www.addictioncenter.com/addiction/ low-income-americans/. 35 “Sex and Gender Differences in Subtance Use,” National Institute on Drug Abuse, last modified April 2020, https://www.drugabuse.gov/ publications/research-reports/substance-use-in-women/sex-gender-differences-in-substance-use; “The Differences in Addiction Between Men and Women,” Addiction Center, accessed on June 22, 2021, https://www.addictioncenter.com/addiction/differences-men-women/. 36 Joe McCarthy, “Understanding Why Climate Change Impacts Women More than Men,” Global Citizen, March 5, 2020, https://www. globalcitizen.org/en/content/how-climate-change-affects-women/. 37 Gender-Based Violence Area of Responsibility, Climate Change and Gender-Based Violence: What are the links? (Geneva: UNFPA, 2021), https://gbvaor.net/sites/default/files/2021-03/gbv-aor-helpdesk-climate-change-gbv-19032021.pdf. 38 Jennifer Boddy and Celeste Harris, “Domestic violence soars after natural disasters. Preventing it needs to be part of the emergency response,” last modified January 26, 2021, https://theconversation.com/domestic-violence-soars-after-natural-disasters-preventing-it-needs- to-be-part-of-the-emergency-response-151838. 39 Cecilia Sorensen, Virginia Murray, Jay Lemery, and John Balbus, “Climate change and women’s health: impacts and policy directions,” PLOS Medicine 15, no. 7 (July 2018), https://dx.doi.org/10.1371%2Fjournal.pmed.1002603. 40 Sorensen, Murray, Lemery, and Balbus, “Climate change and women’s health: impacts and policy directions.” 41 “Poverty and Health - The Family Medicine Perspective,” American Academy of Family Physicians, accessed on July 7, 2021, https:// www.aafp.org/about/policies/all/poverty-health.html. 42 “Poverty and Health,” The World Bank, last modified August 25, 2014, https://www.worldbank.org/en/topic/health/brief/poverty- health.
Topic A: Poverty’s Effect on Women’s Health 14|H istory and Description of the Issue between inner city and suburban neighborhoods.43 Since considered. Although poor women face increased negative poverty dictates where a woman resides, poor women usually health consequences, some poor women face more health live in neighborhoods and communities with access to less disparities than others. Health disparities are preventable than adequate healthcare, if any.44 Additionally, even when burdens of disease, injury, violence, or opportunities to impoverished women can find a way around these obstacles, achieve optimal health experienced by socially disadvantaged finding the time to visit health services acts as a significant populations.49 They are directly connected to historical and barrier. Working women must either miss work or find current inequitable distributions of social, political, economic, someone to watch their children, sometimes both, making and environmental resources contributing to adverse health visits to a doctor or other health service extremely hard and outcomes. These populations are defined by various factors: economically taxing.45 race, gender, education level, disability, geographic location, and sexual orientation.50 It is vital to observe the structural Due to the influence gender has in poverty, increasing women’s inequalities present in society that significantly limit the access economic equality reduces global poverty in general. Gender and control women and girls have over material resources, inequality costs women in developing countries around USD their bodies, and their lives.51 nine trillion a year.46 Statistics have shown that countries that have higher levels of gender equality end up having higher Where a woman resides, for instance, can increase her income levels. For example, in Latin America, there was an susceptibility to certain illnesses, depending on the access increase in the number of women in paid work between they have to resources and healthcare. Research shows that 2000 and 2010, ultimately leading to a 30 percent increase women living in rural settings have a 64 percent higher in the overall reduction of poverty and income inequality.47 rate of pregnancy-related deaths than those living in urban The President of the World Bank Group stated that “when settings.52 Rural residents face more barriers that prevent we promote true equality…we all stand to benefit, because housing, transportation, and water from being healthy, safe, better-educated mothers produce healthier children and and affordable. They are also exposed to increased risks of women who earn more invest more in the next generation.”48 water-borne pathogens, the effects of climate change, and To adequately provide accessible and quality health services environmental risks such as lead poisoning.53 Additionally, the to women, it is necessary to understand poverty as a gendered lack of health infrastructure in rural communities presents issue and create solutions aiming for increased gender equality. another barrier preventing poor rural women from obtaining adequate health care.54 A study found that there are nearly 35 Social Determinants of Health for Poor Women obstetric providers per 1,000 residents in urban counties, far While it is essential to understand poverty’s impact on more than the 2 per 1,000 residents in rural counties. This women’s health, many other additional factors must be represents a critical disparity in health service access for rural 43 The World Bank, “Poverty and Health.” 44 American Academy of Family Physicians, “Poverty and Health - The Family Medicine Perspective.” 45 “It’s Harder for People Living in Poverty to Get Healthcare,” The Commonwealth Fund, last modified April 19, 2019, https://www. commonwealthfund.org/publications/podcast/2019/apr/its-harder-people-living-poverty-get-health-care. 46 https://www.worldbank.org/en/news/feature/2015/07/14/investing-women-vital-ending-poverty-boosting-needed-growth 47 OXFAM International, “Why the majority of the world’s poor are women.” 48 “Investing in Women is Vital to Ending Poverty, Boosting Needed Growth,” The World Bank, last modified July 14, 2015,https://www.worldbank.org/ en/news/feature/2015/07/14/investing-women-vital-ending-poverty-boosting-needed-growth. 49 “Social determinants of health and health inequalities,” Government of Canada, accessed on June 27, 2021, https://www.canada.ca/en/ public-health/services/health-promotion/population-health/what-determines-health.html. 50 “Health Disparities,” Centers for Disease Control and Prevention, last modified November 24, 2020, https://www.cdc.gov/healthyyouth/ disparities/index.htm. 51 Vivienne Walters, “The Social Context of Women’s Health,” BMC Women’s Health 4, no. 1 (August 2004): 2, https://doi.org/10.1186/1472- 6874-4-S1-S2. 52 Judy Stone, “Disparities In Access to Health Care for Women,” Forbes, last modified November 22, 2017, https://www.forbes.com/ sites/judystone/2017/11/22/disparities-in-access-to-health-women/?sh=7466ac0d4783. 53 “Social Determinants of Health for Rural People,” Rural Health Information Hub, last modified March 24, 2020, https://www. ruralhealthinfo.org/topics/social-determinants-of-health. 54 Beverly Leipert and Julie George, “Determinants of rural women’s health: a qualitative study in Southwest Ontario,” Journal of Rural Health 24, no. 2 (April 2008): 210-218, https://doi.org/10.1111/j.1748-0361.2008.00160.x.
Topic A: Poverty’s Effect on Women’s Health History and Description of the Issue |15 women.55 Since there is a lack of safe transportation and Ultimately, women with disabilities face poor health status available time to reach these health services that are rarely and insufficient access to health care, leading to further social found in rural areas, women are at risk of going untreated exclusion further aggravated by their gender status.64 for their medical ailments.56 More than 40 percent of women Women who are a part of a racial or ethnic minority also face living in rural areas have to travel between 50 and 100 miles increased barriers to obtaining accessible health resources, to access care, while 30 percent have to travel more than facing higher morbidities and comorbidities. Morbidity is 100 miles.57 Plus, after-hour clinics and ambulance services defined as the state of having a specific illness or condition, are often far away, leading to the problem of services “not and comorbidity means having more than one morbidity at the getting there in time.”58 In the United States, 28 million same time.65 Compared to Caucasian populations in developed women living in rural areas still need quality and accessible countries, minority women are less likely to be insured, more health care services. To make the problem worse, 19 percent likely to receive health care in less optimal settings, and lack of these women do not have health insurance, compared to continuity in health care.66 African American women in the 16 percent of urban residents, making health services even US have a much higher risk of diabetes, high blood pressure, more inaccessible. certain pregnancy complications, and hemorrhaging.67 Apart The presence of a disability can also act as a determinant from lack of access to health care and continued treatment of health. Disability rates among women are much higher that make them more susceptible to illnesses and diseases, than those in men, standing at 19 percent compared to minority women face increased neglect when receiving 12 percent.59 Additionally, women with disabilities are treatment due to structural and societal racism present within significantly more likely to have untreated healthcare needs society. In Latin America, Black Brazilian women are the than men with disabilities and women without them.60 Not group least satisfied with health treatment provided and are only that, the presence of disabilities can greatly increase the 2.6 times more likely to not receive the requested care than rates of dangerous behavior among women and girls, such as Caucasian men. At the same time, a study showed that many early sexual experiences, fighting, and bullying.61 Women with Afro-Peruvian women do not attend health institutions due disabilities are also more likely to be obese, with 29 percent to discriminatory treatment.68 This further demonstrates the of women with intellectual disabilities developing obesity effects of poverty on women’s health as well as race, ethnicity, compared to 15 percent of men.62 Women with intellectual and other individual characteristics. This affects more than disabilities have much lower levels of physical activity and just womens’ access to care. It also affects the quality of care less incentive to do so, leading to higher rates of obesity.63 and attention given by medical professionals. 55 Bennett, Lopes, Spencer, and van Hecke, Rural Women’s Health. 56 Rural Health Information Hub, “Social Determinants of Health for Rural People.” 57 “Going Rural: The Case for Access to Reproductive Health Care,” International lWomen’s Health Coalition, March 6, 2018, https://iwhc. org/2018/03/rural-case-access-reproductive-health-care/. 58 Leipert and George, “Determinants of rural women’s health: a qualitative study in Southwest Ontario,” 210-218. 59 Sophie Brown, “Issue brief: Making the SDGs count for women and girls with disabilities,”UN Women, Accessed September 14, 2021, “https://www.unwomen.org/en/digital-library/publications/2017/6/issue-brief-making-the-sdgs-count-for-women-and-girls-with- disabilities 60 Behzad Matin, Heather Williamson, Ali Karyani, Satar Rezaei, Moslem Soofi, and Shahin Soltani, “Barriers in access to healthcare for women with disabilities,” BMC Women’s Health 21, (January 2021): 44, https://doi.org/10.1186/s12905-021-01189-5. 61 Michaela Palfiova, Zuzana Veselska, Daniela Bobakova, Jana Houlbcikova, Ivo Cermak, Andrea Geckova, Jitse Dijk, and Sijmen Reijneveld, “Is risk-taking behaviour more prevalent among adolescents with learning disabilities?” European Journal of Public Health 27, no. 3 (June 2017): 501-506, https://doi.org/10.1093/eurpub/ckw201. 62 Asit Biswas, Syeda Shaherbano, and Avinash Hiremath, “Obestiy in people with intellectual disabilities,” last modified June 2016, http:// www.intellectualdisability.info/physical-health/obesity-in-people-with-intellectual-disabilities. 63 Matin, Williamson, Karyani, Rezaei, Soofi, and Soltani, “Barriers in access to healthcare for women with disabilities,” 44. 64 Matin, “Barriers in access to healthcare for women with disabilities,” 44. 65 David Williams, “Racial/Ethnic Variations in Women’s Health,” American Journal of Public Health 92, no. 4 (April 2002): 588-597, https:// dx.doi.org/10.2105%2Fajph.92.4.588; Jill Seladi-Schulman, “What’s the difference between morbidity and mortality?” Healthline, last modified November 11, 2020, https://www.healthline.com/health/morbidity-vs-mortality. 66 Williams, “Racial/Ethnic Variations in Women’s Health,” 588-597. 67 Stone, “Disparities In Access to Health Care for Women.” 68 Afrodescendent women in Latin America and the Caribbean: debts of equality (Santiago: Project Documents, 2018), https://repositorio.cepal.org/ bitstream/handle/11362/44387/1/S1800725_en.pdf.
Topic A: Poverty’s Effect on Women’s Health 16|H istory and Description of the Issue Educating women experiencing poverty in Tanzania about malaria High levels of discrimination within health services can be example, the LGBTIQ+ community is less likely to receive observed towards women, affecting their health outcomes and screening for cancer and have health insurance due to legal attitudes towards the health system. Research has observed, discrimination.72 There is also a lack of knowledge within for example, that physicians are more likely to legitimize the healthcare field of the unique health risks within the men’s symptoms with a diagnosis and prompt treatment LGBTIQ+ community, including an increased risk of HIV/ while women are not taken as seriously.69 Women, especially AIDS.73 While discrimination in healthcare settings can lead women of color, are misdiagnosed at higher rates than men, to a lack of treatment for these populations of women, the killing between 40,000 and 80,000 female patients a year in fear of mistreatment can lead to hesitancy in initially seeking medical care. Women of color and those in the LGBTIQ+ the US.70 Experiences of discrimination within health services community face the utmost risk for discrimination, adverse are different among populations of poor women. Women medical experiences, and poor health outcomes.74 belonging to the LGBTIQ+ community are more likely to be exposed to harassment, mistreatment, and denial of services, Education levels also act as a fundamental contributor to ultimately leading to the endangerment of their lives.71 For poverty levels. There is a clear link between countries with 69 Leipert and George, “Determinants of rural women’s health: a qualitative study in Southwest Ontario,” 210-218. 70 “The Social Determinants of Women’s Health,” Privia Health, last modified May 22, 2020, https://www.priviahealth.com/blog/the- social-determinants-of-womens-health/. 71 Shabab Mirza and Caitlin Rooney, “Discrimination Prevents LGBTQ People From Accessing Healthcare,” Center for American Progress, last modified January 18, 2018, https://www.americanprogress.org/issues/lgbtq-rights/news/2018/01/18/445130/discrimination-prevents- lgbtq-people-accessing-health-care/. 72 Privia Health, “The Social Determinants of Women’s Health.” 73 Mirza and Rooney, “Discrimination Prevents LGBTQ People From Accessing Healthcare.” 74 Mirza and Rooney, “Discrimination Prevents LGBTQ People From Accessing Healthcare.”
Topic A: Poverty’s Effect on Women’s Health History and Description of the Issue |17 low female literacy rates and high female poverty rates. to do so.” There are many barriers to obtaining adequate SRH For example, in Niger, where 42.9 percent live in extreme for women worldwide, regardless of their socioeconomic poverty, the literacy rate is only 19 percent.75 On the other status. Poverty acts as an amplifier to these already existing hand, Canada has a poverty rate of 10 percent and a literacy obstacles, becoming one of the most important determinants rate of 99 percent.76 Worldwide, 781 million people over of poor SRH. In low-income countries, Sexual and the age of 15 are illiterate; 63 percent of them are female.77 reproductive health services are often either absent or of Increasing literacy rates for women would ultimately elevate inadequate quality, leaving women at higher risk of acquiring them from poverty by increasing economic opportunities, several adverse SRH outcomes such as HIV, sexual abuse, and fostering better health knowledge, and building self-esteem.78 harmful pregnancies.81 The knowledge and skills received through education can also increase an individual’s cognitive function. Literate women Unsafe sex continues to be one of the most impactful risk are more receptive to health education messages, equipping factors for death and disability in the poorest communities in them with the communication tools needed to communicate the world.82 Around the world, more than one million sexually their health issues. Literacy also leads to decreased behaviors transmitted infections (STIs) are diagnosed every day.83 HIV/ that put their health at risk, such as unprotected sexual activity AIDS has strong bidirectional linkages with poverty, both a or substance abuse.79 Increasing the access to education for manifestation and a cause of impoverishment. Every week, women worldwide would inevitably lead to healthier women 5,000 young women worldwide become infected with HIV, across the globe.80 and in 2020, women accounted for about 50 percent of new HIV infections.84 Poverty influences where these numbers are While discussing and thinking about the effect of poverty on concentrated. For example, in Sub-Saharan Africa, women women’s health, it is imperative to think about the intersections account for 63 percent of all new HIV infections.85 This of this issue with other social problems. Social determinants ultimately shows that higher levels of HIV correspond to of health, poverty, and structural issues must be considered to lower levels of economic performance, as countries with high develop inclusive and effective policies. poverty rates cannot invest in infrastructure to substantially Sexual and Reproductive Health (SRH) help. Sexual and reproductive health (SRH) are both deeply Alongside increasing the concentration of STIs among poor connected to poverty. WHO states that reproductive health women, poverty is a barrier for women to receive adequate is achieved when “people are able to have a responsible, sexual health. Women facing poverty often experience delayed satisfying and safe sex life and that they have the capability to treatment due to a lack of employment opportunities, limited reproduce and the freedom to decide if, when and how often health care, and limited transportation. Additionally, lower- 75 “Literacy Rate by Country 2021,” World Population Review, accessed on July 4, 2021, https://worldpopulationreview.com/country- rankings/literacy-rate-by-country. 76 “Canadian Income Survey 2019,” Statistics Canada, last modified March 23, 2021, https://www150.statcan.gc.ca/n1/daily- quotidien/210323/dq210323a-eng.htm 77 Olivia Giovetti, “6 Benefits of Literacy in the Fight Against Poverty,” Concern Worldwide US, last modified August 27, 2020. https:// www.concernusa.org/story/benefits-of-literacy-against-poverty/. 78 Giovetti, “6 Benefits of Literacy in the Fight Against Poverty.” 79 World Health Organization, A Conceptual Framework for Action on the Social Determinants of Health, (Geneva: WHO, 2010), https://www.who. int/sdhconference/resources/ConceptualframeworkforactiononSDH_eng.pdf. 80 “Girls’ education,” United Nations Children Fund, accessed on June 27, 2021, https://www.unicef.org/education/girls-education. 81 World Health Organization, Social determinants of sexual and reproductive health (Geneva: WHO 2010), http://154.72.196.19/sites/default/ files/resources/Social%20determinants%20of%20sexual%20and%20reproductive%20health.pdf#page=81. 82 United Nations Department of Economic and Social Affairs, World Fertility and Family Planning 2020 (New York: United Nations, 2020), https://www.un.org/en/development/desa/population/publications/pdf/family/World_Fertility_and_Family_Planning_2020_Highlights. pdf. 83 United Nations Department of Economic and Social Affairs, World Fertility and Family Planning 2020. 84 UN AIDS, “Global HIV & AIDS statistics.” 85 UN AIDS, “Global HIV & AIDS statistics.”
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