005-SheDecides_ConferenceBrussels2-mars17.jpgThe She Decides initiative, launched in February 2017, brings together stakeholders who are working together so that aid organisations in developing countries can carry on their work in the area of family planning and women's and girls' rights. The main idea is to allow each woman to decide freely if she wants to have children and when, how many and with whom she wants to have them. But how and why did this movement see the light of day?


The context

Every year, more than 15 million girls are forced into marriage before the age of 18. Every year, 16 million young girls between the ages of 15 and 19, and 1 million girls younger than 15, give birth. Most of them are in developing countries. In addition, 3 million of these girls under the age of 19 undergo abortions in inadequate conditions. Every year, 22 million unsafe abortions are carried out around the world. A large majority of these take place in developing countries. The consequences: 5 million hospitalisations due to complications and 3 million women suffering from untreated complications. The statistics are as numerous as they are alarming. Human tragedies are hidden behind these figures.

On the ground, priority is given to health and sexual and reproductive rights, as well as to the right to choose: this involves access to information and to family planning services, including for young people.


Many civil society organisations (NGOs, universities, etc.), multilateral organisations (UNFPA, UN Women, WHO, etc.) and governments are working to raise awareness, educate at-risk populations, change mentalities and promote high quality healthcare in good conditions. This is long-term work that requires permanent contact with the populations and an active and continual presence in the field. The areas of intervention are immense: they extend to the most remote rural areas. Huge budgets required to achieve the goals set in the United Nations 2030 Agenda and create a significant drop in these worrying statistics. No fewer than five Sustainable Development Goals are directly related to this.

This demonstrates the extent and cross-cutting nature of the problem and the need for significant investment. Up until 2016, stakeholders from the sector could rely on traditional donors to fund their budgets.

But the tide has turned in the United States.

003_UNFPA_BENIN_health%20facility%20visit%2C%20So-ava%20commune.jpgThe international aid allocated to family planning is subject to significant pressure due to President Trump's reinstatement of the Mexico City Policy, also known as the Global Gag Rule (GGR). This rule means that organisations providing information on medical abortion or directing women towards the appropriate aid services are excluded from US development aid.

The consequence is that by drastically cutting essential funding, the GGR affects the rights of women and children and the entire public health sector, since the organisations that defend medical abortion are also those working in the areas of family planning, health and sexual and reproductive rights.

This means, for example, that a health centre in Benin which uses a budget from the US to vaccinate against malaria, as well as a budget from the Netherlands to develop family planning, will no longer receive its American funding. This is due to its advisory activities in the areas of the control and regulation of childbirth and safe abortion. It runs the risk of having to significantly reduce its activities, and may even be forced to close its doors. The impact of this decision is huge, as the United States is one of the leading donors to the many development bodies. It will result in more unwanted pregnancies, unsafe abortions, diseases and deaths. The consequences will be devastating for women and their communities. And the most vulnerable will be the first victims.


The solution

006_UNFPA_NEPAL_dep-provera%20injection%2C%20Gauri%2C%20Nepal.jpgThere was an immediate reaction to this United States U-turn, which threatens the activities and survival of a number of organisations. In March 2017 Belgium, in collaboration with the Netherlands, Denmark and Sweden, organised the international "She Decides" conference in Brussels. The event kick-started a fund-raising campaign intended to finance the organisations affected by the American decision, whilst also gaining strong support for the defence of the rights of women and girls.

Support has grown in the field since then and has transformed into a movement. The "She Decides" movement currently comprises a large number of 'Friends of She Decides', amounting to more than 150 organisations and 50,000 members.

"She Decides" is defined as a firm declaration in support of the rights of women and girls and, more specifically, in support of their health and their sexual and reproductive rights. The main idea is to allow each woman to decide freely if she wants to have children and when, how many and with whom she wants to have them.

To support this global movement, in 2017 Belgium made a commitment to allocate an additional 10 million euros to the issues of health and sexual and reproductive rights. Initial contributions were allocated directly to the organisations affected by the US measures, including the UNFPA and IPPF. This commitment has been met and even exceeded, since Belgium granted a total of 16.5 million euros in 2017. In 2018, new financing decisions were made, involving a total of 12.4 million euros spread over several years, as the CGR will remain in force for several years.


The result


Examples of Belgian support include the UNFPA Supplies programme and its results: in 2017, 2 million euros were granted to the "UNFPA Supplies" programme, a multi-donor thematic fund whose goal is to increase the use of contraception by supporting primarily the poorest and most marginalised women and girls.

The demand is huge: in 2018, 214 million women and girls wanting contraception had no access to it. This is why Belgium has renewed its support by granting an additional contribution of 4 million euros for the period 2018-2019.

The programme highlights 46 countries with the greatest need, including 12 of Belgium's partner countries; it also operates in humanitarian crisis situations. Currently, "UNFPA Supplies" procures around 43% of all contraceptives in developing countries and provides them free of charge to their national health structure.

The programme also helps countries to strengthen the supply chain so that women and girls can access modern contraception where they live. This involves developing capacities by providing training in planning, the management of the supply chain, stock management, data collection, computerised management systems, etc.


A few figures

In 2017, thanks to "UNFPA Supplies", 17.9 million more women and girls aged between 15 and 49 in more than 46 countries were able to use modern contraception.

According to estimates, the use of this contraception made it possible to avoid:

  • 7.5 million unwanted pregnancies
  • 18,000 maternal deaths
  • 114,000 child deaths
  • 2.3 million unsafe abortions

The goal of "UNFPA Supplies" is to allow an additional 120 million women and girls to use contraception by 2020. The Belgian contribution is now a major support to the 2030 Agenda. Access to contraception is essential for the achievement of sustainable development goals 1, 3, 4 and 5.



  • Pictures/videos: © UNFPA Supplies - © SheDecides.org – © FPS Foreign Affairs

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