model united nations mun study guide for who

Chair:

Assistant Chairs:

Celestine Lian

Kellynn Khor, Priscilia Goh and Kenneth Chong

World Health Organization Study Guide

Sexual and Reproductive Health World Health Organization

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CONTENTS PAGE

Introduction 3

Statement of the Problem 5

Historical Background 7

Key Topic: Female Genital Mutilation 8

Subtopic: Abortion 11

Subtopic: HIV/AIDS and Sexual and Reproductive Health 13

Subtopic: Sexual and Reproductive Health in Crisis Situations 14

Subtopic: Improvement of infrastructure in relation to sexual and

reproductive health

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Concluding remarks 20

Bibliography 21


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INTRODUCTION

Welcome to the World Health Organization (WHO) committee of 2013! I am Celestine, your

chair for SMUN 2013 and one of the writers of this study guide.

The WHO is the international organization in charge of health within the United Nations.

The role of the WHO is to direct as well as coordinate efforts related to health, such as

setting and leading global health agendas, collecting and giving information to member

states as well as setting the norms and rules both for healthcare and healthcare

professionals, amongst other things. As the world is constantly changing and modernizing,

the organization has also evolved in order to meet the medical challenges of the 21st

century.

Founded on 7th April 1948, the WHO started out with 55 members. As of today, the WHO

has 193 states and 2 associate members, who come together every year during the World

Health Assembly to discuss and approve budgetary measures, set the annual global health

agenda and also elect a new Director-General once every five years.1 The Health Assembly

is the ultimate decision-making entity within the organization, but the WHO also employs

about 8000 staff all over the world in order to carry out the WHO objectives, which may

range from strengthening healthcare systems all the way to providing emergency medical

care in crisis situations.2

1 “Working for health: An Introduction to the World Health Organization”. WHO. 2007. WA 530.1. http://www.who.int/about/brochure_en.pdf. 4, accessed on 15/05/2013 2 Ibid., 6,8.


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The WHO has been instrumental in reducing disease all over the world, notably for

illnesses such as polio, smallpox as well as yaws, which have either been eradicated

entirely or reduced by more than 90%.3

Now that we have an understanding of what WHO does, we can move on to the main focus

of the conference. This study guide will provide you with essential information about our

topic on sexual and reproductive health so as to aid your participation during committee

sessions and crafting of resolutions.

The study guide consists of:

Statement of the Problem

Historical Background

Key Topic: Female Genital Mutilation

Subtopic: Abortion

Subtopic: HIV/AIDS and Sexual and Reproductive Health

Subtopic: Sexual and Reproductive Health in Crisis Situations

Subtopic: Improvement of infrastructure in relation to sexual and reproductive health

The Statement of the Problem serves to layout the challenges that will be faced by

participants. Next, we will provide a brief historical background of sexual and reproductive

health to allow participants a better understanding of how the status quo came about. After

3 Ibid., 7.


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that, we will continue with our main topic before exploring the different facets of the problem

through subtopics.

STATEMENT OF THE PROBLEM

The topic of sexual and reproductive health (SRH) is one of WHO’s biggest concerns. While

the topic is often avoided and rarely discussed in many countries due to certain cultural

taboos, the implications of SRH are vast. For example, having a good system of maternal

and perinatal health can greatly reduce the infant mortality rate, which thus has economic

consequences for the country involved. Since the act of procreation is an integral part of

human life, it stands to reason that anything related to this topic may have an effect on all

parts of society.

In modernity, the topic is inexorably linked with the concept of human rights, and is

considered the basis of all action and recommendations given by the WHO. This topic

covers many issues from maternal health, abortion, sexual behavior and sexually

transmitted infections to family planning, and female genital mutilation, which include both

genders and individuals from all around the world, regardless of their socio-economic

status. As stated by the WHO, “it strives for a world where all women’s and men’s rights to

enjoy SRH are promoted and protected, and all women and men, including adolescents

and those who are underserved or marginalized, have access to sexual and reproductive

health information and services.” 4

4 Department of Reproductive Health and Research. “ WHO: About us”. WHO, http://www.who.int/reproductivehealth/about_us/en/, accessed on 15/05/2013


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Following the (non-binding) Proclamation of Teheran in 1968, the topic of reproductive

rights was increasing linked by to human rights.5 Despite efforts by some countries and

non-governmental organizations, SRH was not added to the UN Millennium Development

Goals in 2000, and yet it is still a key component to achieving them. The 2005 World

Summit however, produced a commitment to achieving universal access to SRH services

by 20156.

The WHO is a vast and powerful organization, if used and directed properly. As delegates

of the WHO, you have the power to set the course of WHO policy on sexual and

reproductive health. What issues within this key topic do you consider the most salient?

Very importantly, which issues should or should not be focused on to bring the most benefit

as well as maximum efficiency? WHO resolutions have often been instrumental in shaping

domestic policy as well as providing guidelines for the medical industry and healthcare

professionals in terms of ethical and technical issues. Your resolutions should discuss

methods to increase the general standards of SRH, but you can also focus on certain topics

(including the ones suggested here), which you believe can benefit not just your country but

also other member states and bring about better standards of living for all. In drafting your

resolutions, you should also keep in mind WHO’s role in global health governance, its

linkages with other multilateral organizations/agencies, NGOs and donors (commercial and

non-commercial alike), and possible conflicts of interests with local governments and other

stakeholders.

5 Momtaz, Djamchid. “Proclamation of Teheran”. United Nations Audiovisual Library of International Law. 2009. http://untreaty.un.org/cod/avl/pdf/ha/fatchr/fatchr_e.pdf . accessed on 15/05/2013 6 The Lancet (2006). Executive Summary of Lancet Sexual and Reproductive Health Series. <http://www.who.int/reproductivehealth/publications/general/lancet_exec_summ.pdf> accessed on 15/05/2013


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HISTORICAL BACKGROUND

At the beginning of the 20th century, people did not even think about or consider sexual and

reproductive health in the way we do today. The 1968 Proclamation of Teheran was the first

international legal document to consider the right to reproduce as a basic human right. This

laid the groundwork towards the changing of the academic and legal viewpoints towards the

issue.7 Population growth was a key concern for the UN and WHO post WW2, because

they understood that unchecked growth would strain the little and finite resources that

developing countries had, ultimately crippling their growth and letting the populace languish

in poverty.8 These are the technical arguments for the promotion of sexual and reproductive

health.

In 1972, the WHO set up the special program of research, development and research

training in human reproduction (HRP) in conjunction with other international organizations

such as the World Bank. HRP is the official research branch of the Invalid source

specified.WHO and its reproductive health department. In 1994, the 4th International

Conference on Population and Development in Cairo finally recognized that proper

education and prevention of individuals on their sexual and reproductive health was a key

way to reducing population growth as well as improving the standard of living. Despite their

efforts, this point was not put into the UN MDG.9 It did however lead to a growing

international awareness about the importance of the subject. The WHO has been

7 Proclamation of Teheran”. International Conference of Human Rights. 1968. http://www1.umn.edu/humanrts/instree/l2ptichr.htm. Accessed April 1, 2013. 8 Glasier, Anna, A; Metin, Gülmezoglu; Schmid, George P.; Moreno, Claudia Garcia; Van Look, Paul FA. “Sexual and Reproductive Health: A matter of Life and Death”. The Lancet. 2006. http://www.who.int/reproductivehealth/publications/general/lancet_1.pdf. Accessed February 28, 2013. 9 Ibid., 1595-1595.


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instrumental in championing sexual and reproductive rights for all individual, though more

visibly on women and children’s rights. On the technical side, it continually provides

technical advice on SRH to health agencies and healthcare providers around the world, as

well as frameworks to help individuals in certain kinds of situations (e.g. crisis and conflict

situations.)

KEY TOPIC: FEMALE GENITAL MUTILATION

No such topic has had so much involvement as well as condemnation as the issue of

female genital mutilation (FGM). Ever since the 1960s, when doctors started to speak out

about the practice, the WHO has been actively involved in both the education as well as the

eradication of the practice. While efforts to ban or outlaw it stretch back in time to colonial

periods of many of these countries, the movement has only truly gained strength in the

1970s and 1980s when it became a human rights issue as well as a important cause for the

feminist movement.10

FGM is officially defined as the “all procedures that involve partial or total removal of the

external female genitalia, or other injury to the female genital organs for non-medical

reasons. Estimates put the number of girls and women living with the consequences of

such procedures between 100 to 140 million, mostly in the African continent as well as the

Middle East. FGM is classified into four general types of procedures, but all are equally

condemned. Generally, the clitoris as well as other genitalia is removed, leaving no

erogenous zones in that area.11

10 Rahman, Anika; Toubia, Nahid. “Background and History”. Female Genital Mutilation: A practical guide to worldwide laws and policies. 2000. 9-13. 11 “Female Genital Mutilation”. WHO. February 13, 2013. http://www.who.int/mediacentre/factsheets/fs241/en/index.html. Accessed April 2nd, 2013.


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Defenders of such practices often cite religious, social and cultural reasons for it. They

contend that FGM is an old tradition that goes back hundreds of years, and has cultural as

well as religious motivations behind such practices. They also point out that the outlawing of

FGM has not eliminated the practice, but instead has driven the practice underground,

where there are no regulation as well as a high possibility of unsanitary conditions, leading

to infection and sickness later on. Within each culture still practicing FGM, there are a

myriad of reasons for such, including beliefs relating FGM to purity and fertility. Often, the

people who support the continuation of such practices are the women in these cultures

themselves who have had the procedures practiced on them.12

Research has shown that such procedures do not bestow on the females any medical

benefit whatsoever. Opponents of such practices say that there is no rational benefit to

undergo such a painful procedure, and that such operations after often done

unprofessionally and in unsanitary conditions.13 The girls and women who undergo these

procedures often suffer from extreme pain and discomfort. From a human rights

perspective, such practices are seen as a form of sexism and discrimination against the

female gender that infringe on their sexual rights and the right to enjoy sex.14

12 “Eliminating Female Genital Mutilation: An interagency statement.” OHCHR, UNAIDS, UNDP, UNECA, UNESCO, UNFPA, UNHCR, UNICEF, UNIFEM, WHO. 2008. 5-7. http://www.un.org/womenwatch/daw/csw/csw52/statements_missions/Interagency_Statement_on_Eliminating_FGM.pdf. accessed on 15/05/2013 13 Ibid., 11-12. 14 Ibid., 8-10


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This issue has not been without significant amounts of controversy. While defenders of

FGM are often painted as people who support barbaric practices, the criticism and the

movement to eliminate FGM has often suffered from the charge of cultural imperialism. The

approach of many NGOs and organization working to eliminate FGM has often consisted of

them telling these cultures that their culture is inherently bad due to their support of FGM

and that the western conception of human rights is culturally superior and better.15

There have been quite a few resolutions on the topic of FGM. The 1993 Vienna World

Conference on Human Rights was an international statement that FGM was against human

rights.16 In 2003, the African Union adopted the Maputo Protocol, which covers FGM and its

elimination.17 For the WHO, in 2008, it passed a resolution on the topic, covering various

sectors as well as addressing the important ethical issue on the increasing number of

healthcare professionals carrying out FGM in countries around the world.18 In 2012, the

General Assembly passed a resolution (A/C.3/67/L.21/Rev.1) that was cosponsored by 2/3

of the committee, banning the practice of female genital mutilation that aims to end the

harmful practices. Although there is growing support for the cause, what the council should

still address is the practicality of implementing policies supporting such a vision.

15 Abusharaf, Rogaia Mustafa. “Revisitng Feminist Discourses on Inbulation: The Hosken Report”. Female “Circumcision” in Africa: Culture, Controversy, Change. 2000. 160-163. http://books.google.com.sg/books?id=rhhRXiJIGEcC&pg=PA160&redir_esc=y#v=onepage&q&f=false. accessed on 15/05/2013

16 UN General Assembly. “Report on the World Conference on Human Rights”. UNHCHR. http://www.unhchr.ch/huridocda/huridoca.nsf/(Symbol)/A.CONF.157.24+(PART+I).En?OpenDocument accessed on 15/05/2013 17 “Protocol on the Rights of Women”. African Union. Maputo, 2003. http://www.africa-union.org/root/au/Documents/Treaties/Text/Protocol%20on%20the%20Rights%20of%20Women.pdf. accessed on 15/05/2013 18 “Female Genital Mutilation”. WHO WHA 61.16. 2008. https://apps.who.int/gb/ebwha/pdf_files/A61/A61_R16-en.pdf. accessed on 15/05/2013


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SUBTOPIC: ABORTION

Abortion was, and still remains a highly controversial as well as divisive issue around the

world. While there are groups and organizations that support a ban on the practice of

abortion for religious, cultural and moral reasons, the WHO has stood firmly by their ideal of

safe abortions and the right of all women to have access to this procedure.19 Abortion is an

important subset in the topic of family planning, often eclipsing the other issues within family

planning. In the Cairo International Conference on Population and Development (ICPD), it

was recognized that giving individual as and when they could have family and plan out their

lives somewhat was another alternate as well as effective way of reducing population

explosion, instead of using coercive methods as seen in India and China.20

Such a stance does invite criticism from these particular groups above, stating that the

WHO is supporting what amounts to nothing more than murder of children and the

defenseless. Certain blocs, such as the Holy See, catholic-majority countries as well as

Islamic states form some of the most vehement opposition to the topic of abortion on the

international stage, citing religious and moral reasons against abortion and family planning

on whole. Other critics also point out that abortion is very much open to abuse, especially in

the case of sex-selective abortion, where women actively choose to abort female fetuses in

favor of trying for a male child.

19 Grimes, David, et al (2006). “Unsafe abortion: the preventable pandemic”. The Lancet Sexual and Reproductive Health Series. http://www.who.int/reproductivehealth/topics/unsafe_abortion/article_unsafe_abortion.pdf accessed on 15/05/2013 20 UNFPA (1995). International Conference on Population and Development - ICPD - Programme of Action. http://www.unfpa.org/public/home/publications/pid/1973 accessed on 15/05/2013


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Supporters of abortion include economists, policy makers which contend that having family

planning (including abortion) have material benefits, allowing couple to plan their family

better, having benefits for female reproductive health in some cases. Additionally, as

affirmed in the Cairo ICPD, policy makers were increasingly turning to family planning as a

form of population control, as well as the right of an individual over their own body. They

also argue that making abortion illegal would be (like FGM) driving the practice

underground, where nothing can be regulated and subjecting women to very dangerous

and unsanitary conditions. Some proponents consider the issue to be one of healthcare,

that women should have that option available to them if they should need it. Some feminists

view it from the perspective of women taking control of their bodies back from a male-

dominated society, being in line with the third Millennium Development Goal, to empower

women. In contrast to the previous issue, the WHO has refrained from making overt

statements on the morality of abortion, choosing instead to speak up against unsafe

abortion and concentrating on building up a fixed framework for healthcare professionals

and systems all over the world to follow.

What delegates should address in the issue of abortion is how the WHO should deal with its

stance on abortion and its implications. Should aid be given for abortions? Should personal

circumstances be taken into account? Delegates are expected to bear in mind their

country’s stance on the topic itself and then use it to shape their resolutions.


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SUBTOPIC: HIV/AIDS AND SEXUAL AND REPRODUCTIVE HEALTH

Studies have proven that it is highly important to integrate the treatment and prevention of

HIV/AIDS with a sexual and reproductive health strategy at large. Despite efforts and

advancements of treatment of those affected by HIV/AIDS, HIV infects more people as

compared to ones that attain access to treatment.21 Prevention in this care is way more vital

than the cure to contain the spread of HIV/AIDS. Additionally, by integrating treatment and

prevention into a broader healthcare system has benefits for both for the HIV/AIDS initiative

and for the health of the targeted population as well. For example, preventing the

transmission of the disease from mother to unborn child often covers other antenatal,

maternal and child health needs as well.22

HIV/AIDS is special in the reality that it has its own UN Organization (UNO) to deal with the

disease in the form of UNAIDS. However, with the focus of the autoimmune disease has

often to be to the detriment of other sexually transmitted infections (STIs). Both UNAIDs

and WHO have both in turn introduced strategies for to deal with HIV/AIDS, but without any

attempt to coordinate their response. In fact, their responses have been remarkably

similar.2324 Preventing HIV/AIDS is the same as preventing most other STIs. Instead of

UNAIDS’ goal of creating a unique authority and personnel to deal specifically with

HIV/AIDS, integrating their approach not only makes the actions more effective, but more

cost effective as well (both economically and politically), allowing the cost savings to go

21 Buse, Kent; Sidibé, Michel. “Strength in Unity”. Bulletin of the WHO. November 2009. 806. http://www.who.int/reproductivehealth/publications/linkages/who_bulletin_8711.pdf. Accessed 3 March 2013. 22 Ibid. 23 Wilcher, Rose; Cates, Willard. “Reproductive Choices for Women with HIV”. Bulletin of the WHO. November 2009 835-836. 24 Germaine, Adrienne; Dixon-Mueller, Ruth; Sen, Gita. “Back to basics: HIV/AIDS belongs with sexual and reproductive health”. Bulletin of the WHO. November 2009. 842.


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back into the program and improving the healthcare response to sexual and reproductive

health. The population at high risk for HIV/AIDS is also often the same group at the same

kinds of risk for other STIs. The prevalence of STIs often serves as a warning signal for the

potential transmission of HIV/AIDS for these at-risk individuals. Through STI control, the

success of the HIV/AIDS initiatives can be judged as well.25 There are huge benefits to the

coordination of the HIV/AIDS responses, but there has been little political will to change the

system from the current deadlock. This is in part due to the reluctance by various interest

groups with the idea of contraception.26

For this issue, delegates should address the issues preventing the problem of HIV from

being effectively dealt with. What part does WHO play in this topic? What are the possible

solutions and drawbacks? What can individual countries do to help alleviate the situation or

advance their interests? Is contraception a viable solution in the eyes of your country’s

policy? What are the implications for WHO?

SUBTOPIC: SEXUAL AND REPRODUCTIVE HEALTH IN CRISIS SITUATION

Crisis situations can be regarded as “an event or series of events which have resulted in a

critical threat to the health, safety, security or well-being of a community or other large

group of people” such that the affected community is unable to cope and requires external

assistance27. Humanitarian settings are often the result of conflicts (e.g., war), complex

25 Ibid. 26 Wilcher, Rose; Cates, Willard. “Reproductive Choices for Women with HIV”. Bulletin of the WHO. November 2009 835-837. 27 World Health Organization (2010). Inter-agency Field Manual on Reproductive Health in Humanitarian Settings. <http://www.who.int/reproductivehealth/publications/emergencies/field_manual_rh_humanitarian_settings.pdf> accessed on 15/05/2013


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emergencies28, natural disasters, epidemics and famine, among others, all of which can be

protracted or otherwise. WHO has been very active in this field, such that coverage of SRH

services in crisis situations has increased substantially since 1994. Still, the difficultly in

implementing SRH services in such situations even today can be attributed to the “lack of a

universal understanding of health recovery in general”29, limiting provision and accessibility

of SRH services and thereby hampering human development.

The main SRH issues in crisis situations are:

High maternal mortality rates of 1000 per 100,000 births (adjusted, in Sub-Saharan Africa,

compared to 690 per 100,000 births in peacetime countries) as health systems lack the

capacity to respond to the needs of pregnant women30 and newborn care.

Gender-based violence (SGBV), and sexual exploitation, e.g., in exchange for aid, and

stemming from crowded conditions – especially for displaced populations, separation from

family as well as trauma and alcohol abuse31

Sexually-transmitted infections (STI) such as HIV increasing, wherein SGBV can be the risk

factor in such transmissions.

28 Complex emergencies are defined as “a situation with complex social, political and economic origins which involves the breakdown of state structures, the disputed legitimacy of host authorities, the abuse of human rights and possibly armed conflict that creates humanitarian needs.” Source: WHO (n.d.). Definitions: emergencies. <http://www.who.int/hac/about/definitions/en/> accessed on 15/05/2013 29 World Health Organisation (2011). Sexual and reproductive health during protracted crisis and recovery. http://whqlibdoc.who.int/hq/2011/WHO_HAC_BRO_2011.2_eng.pdf accessed on 15/05/2013 30 Ibid 31 Ibid


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Unmet needs for family planning – and consequentially, unsafe abortions – and intermittent

supply of contraceptives.

WHO has been working with other multilateral organizations such as UNFA and the Inter-

agency Working Group for Reproductive Health in Crises (IAWG), a coalition of 450

agencies representing the UN, government, non-governmental, research and donor

organizations32, including WHO.

The Minimum Initial Service Package (MISP) for reproductive health in crisis situations was

developed by WHO and the IAWG in 1999, and recognized as the Sphere standard in 2004

as a priority intervention to be implemented at the onset of every new emergency33. MISP,

as its name suggest, serves to provide the minimum level of SRH services, including

prevention of excess neonatal and maternal mortality, reduce HIV transmission, managing

sexual violence, among others34.

However, while MISP is recognized, it is not institutionalized. MISP implementation in crisis

situations is spotty at best: the level of MISP knowledge of health staff and the degree of

which MISP is implemented varies, with managerial, policy and donor barriers such that the

Package is often not fully implemented or undersupplied35. Other agencies may also

implement their own packages instead of using MISP which may not necessarily provide full

MISP coverage, e.g., Médecins Sans Frontières (MSF, or Doctors Without Borders) has its

own package, “Sexual and reproductive health core package of activities in MSF projects”.

32 IAWG (n.d.). About IAWG. <http://iawg.net/about-iawg/> accessed on 15/05/2013 33WHO (2011). 34 World Health Organisation (n.d.). The Minimum Initial Service Package For Reproductive Health In Crisis Situations. <http://www.who.int/disasters/repo/7345.doc> accessed on 15/05/2013 35 WHO (2011).


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The Granada Consultation was undertaken in 2009 to review experiences, challenges and

lessons on SRH service provision in protracted crises and better integration of MISP to

facilitate transition into comprehensive SRH provision36. This resulted in the Granada

Consensus37 – a statement highlighting four priority areas which needed to be addressed to

ensure the sustainable provision of SRH services in protracted crises, and progression from

MISP to comprehensive services. Despite the Consensus, government failure, presence of

external agencies and fragmented coordination, and the lack of institutionalization of MISP

prove to be obstacles in ensuring SRH provision in crisis situations.

Delegates are to consider the challenges to implementing programs such as MISP. Are

there political, social or economic implications of implementing such programs or even just

providing aid? Does providing aid actually help more than harm or vice versa? Delegates

of the WHO committee should explore the sensitivities of the issue on aid and attempt to

address it through a practical and politically viable solution that fits with your country’s

stance.

SUBTOPIC: IMPROVEMENT OF INFRASTRUCTURE IN RELATION TO SEXUAL AND REPRODUCTIVE HEALTH

Poor infrastructure is one of the characteristics of weak health systems – it hampers service

delivery and performance such that healthcare may be limited in terms of access and/or

capacity, where a comprehensive package of SRH interventions are not implemented.

Inadequate infrastructure can range from lack of public health knowledge to the tangible

dimensions of insufficient health systems development and organization (e.g., clinics, 36 WHO (2011). 37 World Health Organisation (2009). Granada Consensus on Sexual and Reproductive Health in Protracted Crises and Recovery. <http://www.who.int/hac/techguidance/pht/reproductive_health_protracted_crises_and_recovery.pdf> accessed on 15/05/2013


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laboratories, equipment) and healthcare personnel development (doctors, nurses etc)38,39.

Due to limited resources, developing countries are only able to offer the basic package of

SRH services usually focused around maternal, newborn and child health40, which does not

extend to services such as HIV screening, abortion management, SGBV prevention, among

others.

WHO, to that effect, works to promote partnerships at the country and regional level, as well

as strengthening the institutional infrastructure in these countries41. The WHO regional

office in Africa for example, has developed a 10-year framework for accelerated action till

2014, focusing on multilateral partnership and coordination, and strengthening current

capacities, both within provision agencies and existing infrastructure in the country of

concern. It also emphasizes monitoring and data collection for more effective impact

evaluation. WHO also collaborates with UNFPA through the WHO-UNFPA Strategic

Partnership Programme (SPP) to offer support to Ministries of Health through introduction,

adaptation and adoption of selected practice guides in SRH such as family planning, STI

prevention and maternal and newborn health42. Their activities are also harmonized through

the United Nations Development Assistance Framework, and practical engagement of

38 Powles, John, and Flavio Comim (n.d.). “Public Health Infrastructure and Knowledge”. World Health Organisation. <http://www.who.int/trade/distance_learning/gpgh/gpgh6/en/index7.html> accessed on 15/05/2013 39 IMVA (n.d.). The Major International Health Organisations. <http://www.imva.org/Pages/orgfrm.htm> accessed on 15/05/2013 40 Williams, Katherine, Charlotte Warren and Ian Askew (October 2010). Planning and Implementing an Essential Package of Sexual and Reproductive Health Services. <http://www.ctc-health.org.cn/file/Essential_Package_Integration.pdf> accessed on 15/05/2013 41 World Health Organisation (n.d.). “Objectives and Functions”. WHO Regional Office for Africa. <http://www.afro.who.int/en/clusters-a-programmes/frh/sexual-and-reproductive-health/srh-country-profiles/830-home.html> accessed on 15/05/2013 42 Department of Reproductive Health and Research (2008). WHO-UNFPA Strategic Partnership Programme (SPP). <http://www.unfpa.org/rh/docs/brochure_spp.pdf> accessed on 15/05/2013


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technical working groups43. WHO is also part of “Health Eight” (H8), an informal group of 8

health-related organizations which also includes UNICEF, UNFPA, UNAIDS, GFATM,

GAVI, Bill and Melinda Gates Foundation (BMGF), and the World Bank44. Created in mid-

2007, H8 looks at horizontal approaches in support of national health process, for the

improvement of service delivery including strengthening infrastructure and support.

Although there has been some progress made in strengthening health systems

infrastructure and capacity in Africa, the majority of the countries in that region still have

inadequate policy frameworks and resources necessary for sustainable health services,

much less comprehensive provision of SRH activities. Again, the heavy fragmentation of

health infrastructure is also contributing to the prevalence of HIV in places like Sub-Saharan

Africa. Efforts by external actors – NGOs, multilateral agencies etc – do not often result in

increased accessibility45 as they often lack coordination, resulting in duplication, inefficient

utilization of resources, wastage and missed opportunities 46 and hence, gaps in

comprehensive provision and accessibility.

In addressing this issue, delegates should consider how to deal with the problem of

infrastructure. Should the more economically developed countries take on the obligation to

43 World Health Organisation (March 2011). Strengthening country office capacity to support Sexual and reproductive health in the new aid environment. <http://www.unfpa.org/webdav/site/global/shared/documents/publications/2011/SRH%20in%20New%20Aid%20Environment_GlionMeeting_Oct2011.pdf> accessed on 15/05/2013 44 Ibid 45 Moten, Asad, Daniel Schafer and Elizabeth Montgomery (December 2012). “Building public health infrastructure in resource-poor settings”. Journal of Global Health 2(2). <http://www.jogh.org/documents/issue201202/6-Viewpoint%20Moten.pdf> accessed on 15/05/2013 46 World Health Organisation Regional Office for Africa (2004). Repositioning Family Planning In Reproductive Health Services: Framework For Accelerated Action, 2005–2014. <http://www.afro.who.int/index.php?option=com_docman&task=doc_download&gid=3532> accessed on 15/05/2013


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help the less developed countries with their healthcare? What are the implications of that in

our current climate? Do the less developed countries want help from the WHO? What are

the key problems underlying the slow development of healthcare systems in places that

need it the most? What would be the most practical solution?

CONCLUDING REMARKS

Overall, delegates should strive to dig beneath the surface, unearth the root cause of the

problem and then propose politically, socially and economically viable solutions to deal with

the issue at hand. Also, bear in mind each country’s policy and the sensitivities regarding

each issue in order to craft good resolutions and solve the world’s most pertinent health

issues of today.

Best of luck!


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BIBLIOGRAPHY

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REPRODUCTIVE HEALTH IN ACCRA, GHANA. Ghana Medical Journal, 46(2), 58-65.

• Hindin, M. J., Christiansen, C., & Ferguson, B. (2013). Setting research priorities for adolescent

sexual and reproductive health in low- and middle-income countries. Bulletin Of The World Health

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model united nations mun study guide for who

Documents

reproductive health

charge of health

world health assembly

annual global health

leading global health

abortion subtopic

international organization

crisis situations subtopic