Your Excellency, Minister of Health of Samoa, Afioga ia Valasi Luapitofanua To’ogamaga Tafito Selesele,
Honorable President of the Pacific Society of Reproductive Health, Dr. Gunzee Gawin,
Honorable President of RANZCOG, Dr. Benjamin Bopp,
Distinguished Members of PSRH Executive Board and other members of PSRH,
Distinguished delegates from the Health Ministries of Samoa, as well as Fiji, Kiribati, Solomon Islands, Tonga, and Vanuatu,
Esteemed midwives from various Pacific countries, along with other SRH practitioners, nurses, OB/GYNs, Medical Doctors, public health specialists,
Distinguished participants, my dear friends, my beloved colleagues from UNFPA,
Ladies and Gentlemen,
Talofa! Or, Bula, from where I work, or “Kombanwa” as we say where I was born.
What a moment tonight. What wonderful past couple of days that we have spent together. On behalf of the entire United Nations system in the Pacific, especially UNFPA, I would like to place on record my sincere appreciation and congratulations to the organizers of this significant gathering - the 2022 PSRH Conference - that has brought together, here in Apia, Samoa, the best and the brightest of Reproductive Health practitioners, managers, and activists from across the Pacific. I would like to pay tribute to all our colleagues from the organizing committee, without whose tireless and sleepless work, much done behind the scene, this conference would not have been made possible, so I believe those colleagues deserve a huge round of applause to signify our huge gratitude.
Indeed, the combined intellectual assets and knowledge in this room, collected through Faith and Wisdom, and the vast and deep network and bonding among us, the Comrades and staunch advocates for Sexual and Reproductive Health and Rights for the Pacific women and girls, will no doubt, go forward to lead our collective continuous journey to transform into action, those fabulous ideas, solutions, good practices, and lessons for evidenced-based interventions garnered from this conference. We, feeling more empowered and inspired through this conference, will start our joint battle again from tomorrow, together, now to further shape and influence national policies, sectors plans, programmes, and annual budgets, to compel those decision-makers, their turn, to re-imagine what could be done and should be done for the benefit and well-being of millions of Pacific Islanders, both women and girls, men and boys, youth and adolescents, those with disabilities, other marginalized populations, especially in the emerging context of the pandemic, climate change, and the rippling effects of the war in Ukraine and other geo-politics in play in this sub-region as well.
Two years ago, in 2019, when you gathered for the last PSRH conference in Papua New Guinea, it was the same year when the global community gathered to celebrate 25-years anniversary from the International Conference on Population and Development in 1994, and during this ICPD+25 Summit, governments of Pacific Island Countries too, alongside other Member States, committed themselves to intensify and accelerate system-wide efforts to strive to achieve “3 Zero’s” by 2030, namely to (1) eliminate unmet need for family planning, and (2) eliminate all preventable maternal mortality and morbidities, and (3) eradicate gender based violence, as it hinders women and young people from discharging their full potential, as you heard from my colleague Dr. Titilola Duro-Aino, UNFPA Pacific Chief of Health, yesterday, who also highlighted a diversity, a varied degree of success in improving SRHR indicators among different countries in the Pacific.
The unforeseen COVID-19 pandemic, increasing negative effects of climate change, and the recent war in Ukraine have been posing a critical blow to many countries in the world, and unfortunately, the Pacific countries are not the exception, suffering from a huge set-back in terms of losing the previous development gains. And now, we all must bounce back and build back better. This is why the theme of this year’s conference “Re-imagination and Actions” is not only apt, but very timely, because it reinforces the sense of urgency to think differently and act innovatively, so as to really advancing the SRHR agenda for women’s and girls health and rights to be respected, prioritized and ensured.
As Dr. Lisi Kalisi Petaia said yesterday, “People do not stop engaging in having sex even during crises,” and women’s pregnancy and childbirth do not stop either, only because there is a war going on or a cyclone strikes. When a crisis hits - like the pandemic or manmade conflict or natural disaster - it is usually maternal health and family planning services that receive a reduced priority, if not the least priority. And it is always women and girls who bear the brunt and suffer the most.
And this also explains why I am a true believer that midwifery is the most sacred and precious job of all – I really think it is the most noble job – midwives, and also OB/GYNs, nurses, and other professionals, who help deliver a life into this world – you are my hero, you have my deepest respect and biggest admiration. To come to think of it, all of us here - and everybody else in this world - no matter which country you are from, no matter whether you are a woman or a man, no matter which religion you follow, whether you are old or young, rich or poor, we have one thing in common – that is, all of us are born from our mother, as our dear colleague Fuimaono Karl Pulotu-Endemann said yesterday too. And you – all of us here - are working for those mothers and mothers-to-be and adolescent girls, making sure that all childbirths are safe and clean, all pregnancies are wanted, and all young people can fulfill their full potential.
Yesterday, distinguished Professor Rajat was talking about the SDGs, which reminded me that we have only 7 years+ left till the target year of Agenda 2030. If we want to collectively make a meaningful contribution to the Pacific women and girls to get to the closest in achieving those SDGs by 2030, then we don’t want to face a situation where in 2 years time when we gather again for the 15th biennial conference in New Zealand, we talk about the same issues, the same problems. No, we cannot. Therefore, in addition to continuing what we have to do and what we have done well, we also should be able to come up with actionable new ideas, new models, new solutions – and the last couples of days really provided us with those insights and perspectives. In this connection, I would like to make a humble attempt at summarizing a few of those points that I felt have emerged from this conference as some of ways forward;
The most fundamental one is that, now more than ever, we need a more comprehensive, integrated, holistic approach to addressing gaps in the delivery of SRHR interventions and remove the barriers, both on the supply side and demand side that prevent women and young people in the Pacific from fully accessing quality SRHR information and services, so as to reach the furthest behind first and truly leave no one behind.
This also means ensuring inclusivity and equity in access to quality care and information about SRHR and gender-based violence, including for the persons with disabilities, and also young people. Coming from an aging and shrinking society, I envy Pacific countries for having such youthful population. Indeed 50% of our populations in this region are under 25 years of age. But the number or ratio is less important for your country to reap the so-called demographic dividend or demographic bonus, than the quality of young people. Therefore investing in this cohort of young generation is critically important for the future of the Pacific, including through the provision of age-appropriate SRH info and services and what’s called Comprehensive Sexuality Education globally, or often referred to as Family Life Education in many countries in the Pacific.
I mentioned the importance of integrated services, because if you can indeed truly integrate SRH services more and better with other areas of health services, you can expect to increase clients access to SRH, for instance, integrating maternal health into primary health, or Family Planning with vaccination and immunization, STI/HIV services, programs on gender-based violence, and even workplace-based services.
Innovation is another important element – globally, evidence shows that the use of digital health technologies increase access to SRH services including Family Planning. Digital transformation for health, such as “tele-health,” may offer solutions, as more efficient ways of delivering services in resource-constrained settings and otherwise hardest-to-reach areas in the Pacific.
Another area where more breakthroughs are needed is logistics, looking at the whole supply chain including cold chain and warehouse management and stock management, and also logistics information management system. Procurement is one thing, but delivering the procured contraceptives and life-saving maternal health medicines to the last mile in time, is a totally different ballgame.
Another important area is governance, including both horizontal and vertical coordination. We often talk about accountability, but in order for national and local governments to be able to be accountable as the duty-bearer, you have to have at least 5 elements in place. The first is, you have to have a legal and policy framework – a government authority can be held accountable only when there is a law or policy that dictates that it must do certain things, or it cannot do certain things. The second is, you have to have an institutional set-up to be the custodian and focal point of that law and policy. The third is human resources of that institution, who actually implement the law and policy. And the fourth is, not only human resources, you will need financial resources. And the last not the least, the fifth is data and evidence, with which to plan, set targets, allocate budget, execute projects, monitor the implementation, and report on the results.
And in terms of human resources in the context of SRHR in the Pacific and elsewhere, more investment in SRH workforce is crucial, including the doctors, obstetricians, nurses, midwives who deliver these services. There is increasing global evidence that shows that especially midwifery is the major solution to saving the lives of women and newborns at scale, and this is exactly why UNFPA in the Pacific is focusing its assistance on ensuring high quality midwifery education and training, as you heard this morning in a break-out session too. And with regard to financial resources, we need more domestic financing for SRHR and GBV.
This morning I was really moved and inspired by the personal testimonies from the presenters, and very interesting interactions that followed, with our esteemed midwife from Tokelau, Ms. Hela Poasa, and was amazed with the magnitude of solidarity and empathy that you showed among yourselves. And I would like us to remind ourselves of the important point that Asiata Joseph Aukuso, registered midwife from Samoa, made during that session when he highlighted the importance of messaging, and more effective behavioral change communications strategies, which can indeed be another potential area where we can collectively contribute to.
And throughout the conference, we also discussed the importance of prioritizing the provision of SRH and GBV services in emergencies, especially in the context of the ongoing pandemic and also climate-induced disasters. The global evidence has shown that a lack of access to essential health services due to shutdown of services during the pandemic, can actually result in more deaths, than the pandemic itself. Limited access to essential SRH services including family planning, intra-partum care, antenatal care, emergency obstetric and new-born care, clinical care for sexual violence survivors, post abortion care, prevention and treatment for HIV and sexually transmitted infections, can lead to significant increase in morbidity and mortality, compounded by the fear of people of contracting the virus and becoming hesitant in accessing health services. This was exacerbated by the diversion of SRH personnel and re-purposing of health facilities for COVID-19 prevention and response activities, as was discussed yesterday. Hence my emphasis on the integration - SRH and GBV services must be integrated into our national and local emergency preparedness and response plans and protocols.
Here, I would like all of us to re-collect an excellent example as to how the SHR workforce in the Pacific can indeed contribute to a national emergency response. Back in November 2019 when Samoa was hit by a measles outbreak, UNFPA worked closely with the Samoa Ministry of Health, Red Cross, Samoa Family Health Association, along with WHO and UNICEF, and deployed 10 midwives from Fiji, as South-South Corporation to provide life-saving SRH services, information and referral support to women of reproductive age, including those pregnant women and with new-borns.
We in UNFPA stand ready to provide more of these technical and coordination support to the Pacific countries with a view to inviting the governments to invest more in addressing the so-called ‘continuum’ or the ‘nexus’ between socio-economic development efforts and humanitarian action with a specific focus on sexual and reproductive health and gender-based violence.
Standing in front of all of you today, I feel so humbled, and in awe, and full of admiration. Despite all the challenges posed by the pandemic and the recurring natural disasters that have made those challenges even worse, you the distinguished and admirable women and men seated here today, have fought to make sure Sexual and Reproductive Health services would go on, you have fought to keep your clinic doors open, you have fought to ensure that no mother would die giving life during pregnancy or childbirth, and ensure as fewer women and girls as possible would experience unintended or unwanted pregnancies and as many women and girls as possible would access care for gender-based violence. That is why I said earlier, you are my hero. To you, our hats are off, and we sincerely salute your courage and commitment.
But, like Professor Rajat underscored yesterday, what about the care for the caregivers like your good selves? When you take care of the other women and girls, who are taking care of you, including your mental health? In this regard, I would like to make a renewed call and plea for increased support from the governments, from the hospital managements, from the general publics, and us the development partners, including MHPSS mental health and psychosocial support to our SRHR champions and comrades like your good selves, namely, midwives, nurses, doctors, OB/GYNs, anesthetists and others who are in the frontline of delivering much needed lifesaving SRH and GBV services even during the most difficult situations.
Before I complete my speech, I would like us all to watch short videos that are a testament to your service and sacrifice. I wish to reiterate UNFPA’s unflinching commitment to strengthening partnerships with and among institutions across the Pacific, most notably, the “Pacific Society for Reproductive Health” and governments and communities, in carrying forward your legacy from this conference and translate it into action, so that all of us will be remembered as the game-changers who actually made a difference in the lives of women and young people in the Pacific.
Once again, thank you all the participants and all in the organizing committee who have made this conference another success.
Fa'afetai lava, Thank you very much.
Related Videos:
UNFPA Pacific Humanitarian Family Planning Video
