Sexual and reproductive rights for all are fundamental to transforming the lives of millions of adults and young people. Changes in legislation, access to information and provision of services provide an essential route to bringing about wider change. But alone, they are not enough for the most vulnerable to see themselves as having rights to safer and more fulfilling sexual and reproductive lives and to be able to claim them.

In a collection of experiences of using participatory approaches for work on sexual and reproductive health and rights, researchers from the UK's Institute of Development Studies and the International Community of Women Living with HIV and AIDS (ICW), show how involving vulnerable groups more directly in efforts to improve their well-being can make a real difference.

The key lesson that emerges from these experiences is the importance of 'listening to and involving those who are affected directly in the process of research, design and intervention, using media and messages that they can relate to.

The book offers a host of inspiring ideas and examples of innovative practice:

• Popular theatre in northern Nigeria brought the issue of vesico-vaginal fistula (VVF), a condition affecting mainly very young women who are left incontinent after childbirth, into the public arena.
• In Gambia, the use of an innovative combination of assertiveness training, participatory analysis and role-play offered new spaces for women and men of different ages to reflect on and analyse their sexual and reproductive lives, and begin to create and assert the things they wanted to change.
• The use of hip hop music in South Africa to break taboos and speak to thousands of young people about HIV.
• Photo novellas produced by young women for others like them to talk to them about sexual and reproductive health in Brasil.

Participation has more to offer than improving the quality and usefulness of information, or making interventions fit better with the realities of those they are aimed to help. It also offers a way to bridge the gap between service providers and users, creating services for people rather than trying to fit people into services. And by enabling people to gain the confidence to speak out and act, participatory approaches can provide a formidable way for those with the least power to claim their rights - as in the case of the Zambian women whose participatory analysis of issues of gender violence led them to mobilise to attend court hearings to seek to ensure justice was done.

Whether through involving auxiliary nurse midwives in Mumbai or clinic workers in Nepal, community-based distribution agents (CBDs) in Zimbabwe or midwives in Myanmar, or through new and exciting forms of planning in Egypt or health communication in the rural Andes, these studies offer food for thought about how to make the most of service provider involvement, improving the working environment for providers themselves as well as their relationships with users, their morale and the quality of care that they can provide.

Participation can provide a bridge between the promise of international rights conventions and debates and the realities of people's lives. Making these connections is essential if sexual and reproductive rights are to be realised.

Source(s):
Introduction to 'Realizing Rights: Transforming Approaches to Sexual and Reproductive Well-being', edited by A. Cornwall and A. Welbourn, Zed Books, 2002 Full document.

Funded by: Sida; Swiss Agency for Development and Co-operation; UK Department for International Development

id21 Research Highlight: 2 February 2004

Further Information:
Andrea Cornwall
Institute of Development Studies
University of Sussex
Falmer, Brighton
BN1 9RE
UK

Contact the contributor: A.Cornwall@ids.ac.uk

Institute of Development Studies (IDS), UK

International Community of Women Living with HIV/AIDS

Other related links:
'Stepping stones to HIV prevention: working with communities in the Gambia' >

'Planning together: women, decision-making and health in Egypt' >

'Learning to listen: training nurse midwives in India' >

'Voices and choices: speaking-up for HIV-positive women in Zimbabwe' >

'On best behaviour: men's attitudes to sexual health in Cambodia' >

See id21's collection of links relevant to sexual and reproductive health.

See id21's collection of links relevant to HIV/AIDS.