Institute of Women's Health, University College London, London, UK
International Development Department, The London School of Economics and Political Science, London, UK.
BMJ Glob Health. 2023 Nov;8(11). doi: 10.1136/bmjgh-2023-012652.
Frontline workers for sexual and reproductive health and rights (SRHR) provide life-changing and life-saving services to millions of people every year. From accompanying the pregnant, delivering babies and caring for the newborn to supporting those subjected to sexual violence; from treating debilitating infections to expanding contraceptive choices; from enabling access to safe abortion services to countering homophobia: all over the world frontline SRHR carers and advocates make it possible for so many more to experience dignity in sex, sexuality and reproduction. Yet they are also subjected to hostility for what they do, for whom they provide care, for where they work and for the issues they address. From ostracistion and harassment in the workplace to verbal threats and physical violence, hostilities can extend even into their private lives. In other words, as SRHR workers seek to fulfil the human rights of others, their own human rights are put at risk. Yet, as grave as that is, it is a reality largely undocumented and thus also underestimated. This scoping review sets out to marshal what is known about how hostilities against frontline SRHR workers manifest, against whom, at whose hands and in which contexts. It is based on review of six sources: peer-reviewed and grey literature, news reports, sector surveys, and consultations with sector experts and, for contrast, literature issued by opposition groups. Each source contributes a partial picture only, yet taken together, they show that hostilities against frontline SRHR workers are committed the world over-in a range of countries, contexts and settings. Nevertheless, the narratives given in those sources more often treat hostilities as 'one-off', exceptional events and/or as an 'inevitable' part of daily work to be tolerated. That works in turn both to divorce such incidents from their wider historical, political and social contexts and to normalise the phenomena as if it is an expected part of a role and not a problem to be urgently addressed. Our findings confirm that the SRHR sector at large needs to step-up its response to such reprisals in ways more commensurate with their scale and gravity.
性与生殖健康和权利(SRHR)的一线工作者每年为数百万的人提供改变生活和拯救生命的服务。从陪伴孕妇、接生婴儿和照顾新生儿,到支持那些遭受性暴力的人;从治疗使人衰弱的感染,到扩大避孕选择;从使人们能够获得安全的堕胎服务,到反对恐同:世界各地的性与生殖健康和权利一线工作者和倡导者使更多的人能够在性、性行为和生殖方面体验到尊严。然而,他们也因为自己所做的事情、为谁提供护理、在何处工作以及所处理的问题而受到敌意。从工作场所的排斥和骚扰,到言语威胁和身体暴力,敌意甚至可能延伸到他们的私人生活中。换句话说,当性与生殖健康和权利工作者试图实现他人的人权时,他们自己的人权就会受到威胁。然而,尽管情况如此严重,但这在很大程度上是未被记录在案的,因此也被低估了。本范围界定审查旨在整理关于针对性与生殖健康和权利一线工作者的敌意是如何表现的、针对谁、由谁实施以及在哪些情况下发生的已知信息。它是基于对以下六个来源的审查:同行评议和灰色文献、新闻报道、部门调查,以及与部门专家的协商,以及为了对比,还包括反对团体发布的文献。每个来源都只提供了部分信息,但综合起来,它们表明,针对性与生殖健康和权利一线工作者的敌意在世界各地、在一系列国家、背景和环境中都存在。然而,这些来源中的叙述往往将敌意视为“一次性”、例外事件,和/或视为日常工作中“不可避免”的一部分,需要容忍。这反过来又将这些事件与其更广泛的历史、政治和社会背景分开,并将这些现象正常化,仿佛这是角色的预期部分,而不是一个需要紧急解决的问题。我们的调查结果证实,整个性与生殖健康和权利部门需要以更符合其规模和严重性的方式,加强对这些报复行为的应对。