The views expressed in this presentation are the views of the author and do not necessarily

reflect the views or policies of the Asian Development Bank Institute (ADBI), the Asian
Development Bank (ADB), its Board of Directors, or the governments they represent. ADBI
does not guarantee the accuracy of the data included in this paper and accepts no
responsibility for any consequences of their use. Terminology used may not necessarily be
consistent with ADB official terms.

Gender Dimensions in
Sexual and
Reproductive Health &
SDGs:
Experience from the Pacific
Region
Inez Mikkelsen-Lopez
Pacific Department, Asian Development Bank
25th March 2019
ADB Pacific Department
2
 Maternal mortality and per capita incomes
400 AFG
Maternal mortality ratio (per 100,000 live births) ADB Developing Member Countries
2015

300 Higher-than-average
maternal mortality

TIM PNG
200

Lower-than-average TON
maternal mortality
100 SOL KIR FSM
SDG Target <
VAN SAM 70 by 2030
FIJ
SIN
0
400
6 1,000
7 83,000 8,000
9 22,000
10 60,000
11
(Log of) GNI per capita, current $
 Socioeconomic factors influencing women’s access to
health services and health outcomes include:
- subordination of women in society and politics
- violence
- traditional beliefs

Gender and What women want are accessible services that are:
- safe, friendly, provide quality antenatal care, respect
health in PNG privacy, qualified supervised delivery and post-
partum care
- access to effective contraception.

The result: Rural Primary Health Services Delivery

Project (2011) - Financed by GoPNG, ADB, DFAT and
OPEC
 Rural Primary Health Services
Delivery Project (RPHSDP):
Community Health
Community
Post (CHP) Health Post
Stockouts

6
Family planning services
7
 Innovations: 1. Let’s not forget the S in SRH: Promote healthy sex
education to women, men, girls and boys
PNG Rural 2. Including fathers in maternal health. Investing in
Primary Health men for improved women’s health outcomes

Services 3. Revolution in birthing practices in PNG with men

being actively invited into the delivery room
Delivery Project 4. Respectful person care: in both maternal and
(RPHSDP) reproductive health
• Build district hospitals and health centers
around the same principles of respectful patient
care
• Document sex specific health care seeking and
PNG: Health
receiving, for example: “did the nurse talk to Services Sector
you about doing your own breast
examination?”, “how to use a condom?”, “When Development
your wife was about to deliver your baby, did
you get invited in” etc
Program
• Health promotion course with comprehensive (HSSDP)
sex education. How to negotiate sex in a
relationships, sexual reproductive health etc.
 ADB Pacific regional
vaccines project

2019 – 2023: Samoa, Tonga, Tuvalu and

Vanuatu
Introducing three new vaccines into health
systems: HPV, RV and PCV
Project will invest in vaccines hesitancy and
child and adolescent health promotion.
Project will integrate immunization programs
into health systems
 Countries will continue to use pooled
procurement from UNICEF

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 HPV and the Pacific
Cervical cancer and HPV
 Pacific leaders identified HPV as a regional priority
 Almost no screening across the Pacific so patients present late for treatment
 Almost no surgical or radiotherapy services for cervical cancer across the Pacific
 Cervical cancer is a leading cause of death in women and hospital
admissions/overseas referral

ADB Regional new vaccines project:

 Project countries strongly support HPV introduction (MOF and MOH)
 Priority is given to primary target populations girls (9-14years) , but request for
all countries to give to boys
 Project will build new delivery strategy – schools
 Project will invest in communication to address negative beliefs on vaccines and
HPV

11
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Thank you from the Pacific