We have found over the years that there are two crucial factors that determine good health and wellbeing: sexual and reproductive health and rights (SRHR), and water, sanitation and hygiene (WASH). That is why we have been working on WASH and SRHR for many years. Over the past few decades Simavi has developed extensive knowledge and work experience in both fields. Our niche expertise is implementing a combination of WASH and SRHR in our programmes, with a focus on women and girls. Instead of working through the lens of either SRHR or WASH, Simavi will focus on the WASH/SRHR nexus, drawing on our expertise at all levels.
Five key expertise areas define our work in the nexus of SRHR and WASH. Our programmes will be centred around one or more of these themes.
Many women and girls in low-resource settings lack the knowledge and access to products and infrastructure to manage menstruation with dignity. Furthermore, taboos, stigma and cultural and religious norms throw up barriers to women participating in normal daily life, going to school, working or participating in religious ceremonies during menstruation. This has a severe impact on their health and wellbeing and on the realisation of their rights. Good menstrual health leads to improvements in women’s and girls’ wellbeing, access to education and gender equality. Menstrual health is a key entry point to addressing SRHR, WASH and women’s social and economic empowerment.
Bodily integrity – the right to govern and control one’s own body – is an innate human right. Any violation of this personal autonomy is unethical, intrusive and, at times, criminal. Women are most affected by violations to their bodily integrity and autonomy. To address this issue, Simavi focuses on a woman’s right to bodily autonomy, self-determination and safety. Our interventions address women’s health, specifically their reproductive and sexual rights, and empower women and girls to be able to make informed decisions about their own body and how to spend their time. We also strive to address the safety concerns and psychosocial stress issues related to the lack of SRHR and WASH services that respond to women’s and girls’ needs.
Although maternal mortality has nearly halved since 1990, the number of maternal deaths around the world remains unacceptably high. The underlying causes of maternal morbidity and mortality can be traced back to poverty, inequality and, in many cases, a number of interrelated delays that ultimately prevent women and girls from accessing the health services (both WASH and SRHR) that they need. Simavi promotes reproductive rights and improves maternal and neonatal (the first 28 days of life) health by improving knowledge of and creating access to safe and hygienic antenatal, delivery and post-natal health services, including safe and legal abortion and post-abortion services.
Water and sanitation
The United Nations has recognised that access to water and access to sanitation are human rights, reflecting the fundamental nature of these basics in every person’s life. Women and girls are disproportionally affected by the lack of access to water and sanitation. Not only do women and girls bear the responsibility for fetching water, they also pay the heaviest price for poor sanitation. For example, when latrines are not available in households, women and girls may seek privacy by walking to isolated areas, or by restricting themselves to only going after dark. In both these cases, they are exposed to greater risk of harassment, violence and sexual assault. Simavi empowers women and girls to claim their right to water and sanitation and take part in decision-making processes that affect access to sustainable and inclusive WASH services. We ensure WASH services are in place and address the prevailing gender norms and values in order to remove the barriers that women face. Our rights-based approach targets duty-bearers to fulfil their obligations and rights-holders (in particular women and girls) to claim their rights regarding access to and the use of safe and sufficient water and sanitation – at an affordable cost and without discrimination, coercion or violence.
Hygiene is the theme that unites all the work we do. We define hygiene as the conditions and practices that help maintain health and prevent the spread of disease. Good hygiene consists of personal hygiene and adopting practices to keep all homes and workplaces, including sanitation, clean and germ free. Our expertise in hygiene has been developed and integrated in all our WASH and SRHR programmes.
Having an ambitious mission and a broad understanding of health, we approach our work in a holistic way. Simavi has defined three principles that will guide us towards adding value within our mission – while at the same time giving focus and clarity to the way we design our programmes.
In our programme design we build on the realities we see in the communities where we work, where social norms and values often restrict opportunities for women and girls. By creating space for women’s voices to be heard, we can challenge deep-rooted discrimination and norms to create greater equality for all. For that reason, we will take a women-centred approach in our programmes and place women’s and girls’ needs, rights and priorities at the centre of our programmes.
Health is a human right. Human rights are inherent to all human beings, regardless of race, sex, nationality, ethnicity, language, religion or any other status. Yet for many millions of people around the world this right is not fulfilled. That is why we use a rights-based approach in all our work to empower women and girls, and their communities. We help them to understand their rights and support them in claiming these rights from duty-bearers. Duty-bearers (often governments or service providers) have a responsibility to ensure these rights are respected, protected and fulfilled. Furthermore, rights give us a clear and less subjective understanding of where to focus our efforts, without imposing our Western standards of needs on the communities we work in.
Simavi believes that to ensure lasting change we need to think in a sustainable way: all our programmes and activities need to be efficient and effective. This means thinking about both behaviour and systems change. We strive to empower women and girls to make decisions about their own health and the health of their families. They need not only to be properly informed about their health and rights, but also to be socially and economically empowered. We also seek to create lasting change in the systems around them, to create a supportive environment in which their needs and rights are respected and upheld. The norms and attitudes held by men and women, community stakeholders, service providers and duty-bearers have to change so that women and girls have the freedom and opportunity to make such decisions. To this end we work with service providers to improve service provision and lobby duty-bearers to ensure women-friendly policies are in place and fully implemented.