Inclusion at all stages – FCDO’s approach to Sexual and Reproductive Health

Posted on: Thursday, July 13th, 2023

On 4 July, the International Development Committee (IDC) invited CBM UK to give oral evidence as part of their inquiry into whether UK aid spent by the Foreign, Commonwealth and Development Office (FCDO) on sexual and reproductive health (SRH) programmes in lower-income countries could be targeted more effectively. This was the second evidence hearing within the inquiry and focused specifically on marginalised groups – including people with disabilities.

While CBM UK celebrates FCDO’s commitment to act as a global leader in disability inclusion, CEO Kirsty Smith, who appeared before the committee, highlighted three core areas in which FCDO’s approach to SRH is failing to take the needs of women and girls with disabilities into account – strategy, programming, and funding.

“The barriers that women in marginalised communities face are exacerbated still further for women with disabilities.” – Kirsty Smith

Strategy

In 2022, FCDO published its ambitious Disability Inclusion and Rights Strategy 2022-2030 (DIRS) making a firm commitment to listening to the voices of people with disabilities, and giving Organisations of People with Disabilities (OPDs) a seat at the table to influence FCDO decision-making. This was an encouraging signal that disability inclusion would be integrated across subsequent FCDO strategies. Sadly, this has not yet proved to be the case.

It was especially disappointing, just one year later, that FCDO’s International Women and Girls Strategy 2023-2030 referenced women and girls with disabilities only a handful of times. Even though the strategy identified critical points for advancing the rights of women and girls with disabilities, it did not make clear reference to the DIRS or reference the UK’s own commitments at the Global Disability Summit to meaningfully embed people with disabilities in their strategic priorities (see footnote 1)

FCDO’s aspiration to reach the most marginalised people will fall short if they do not give strategic consideration to women with disabilities. This does not only mean including women and girls with disabilities in the text of their policies, but also involving them in capacity and needs assessments, as well as planning from the outset. The unique challenges women with disabilities face, especially when accessing SRH services, will not be overcome unless they can shape the strategies designed to have an impact on them.

Programming

The same holds true for FCDO-funded programming. The Development Assistance Committee (DAC) marker suggests that between 25% and 33% of current FCDO programming incorporates a disability-inclusive activity (see footnote 2). Whilst the UK’s record in this area is better than many, this still means that up to 75% of programming does not put an explicit focus on making sure people with disabilities can access FCDO programmes which has very serious implications for women and girls with disabilities.

Women and girls with disabilities often do not access mainstream SRH programmes because of the many barriers they face. Information shared in communal spaces is often inaccessible or hard to follow, especially for blind and deaf people when talking about a topic as sensitive as SRH. Women and girls are also often dependent on their husbands or a male member of the family, meaning they need permission when trying to access SRH services. In turn, women and girls with disabilities who are able to seek out SRH services often find the building itself inaccessible with no ramps for wheelchairs, doorways that are too narrow, or signs that are too small. Lastly, they often encounter severe attitudinal barriers from hospital staff themselves, who view women with disabilities as non-sexual and carry much stigma for those who do want to access SRH.

Only by being intentional and deliberately emphasising the need for disability inclusion across the whole of FCDO programming will the remaining two-thirds of programmes be inclusive, and the FCDO’s ambition to reaching the most marginalised realised.

Many of these barriers could easily be identified and challenged if FCDO actively included women with disabilities as key actors in the needs assessment and planning stages of its programmes. If the UK is to retain its leadership role, we urge FCDO to maintain momentum and make women with lived experience fundamental to all aspects of SRH programming, from the earliest stages on.

Funding

Finally, the UK’s sudden and severe funding cuts to FCDO aid spending have had a detrimental impact on some of the world’s most marginalised communities (see footnote 3). These cuts came at a critical time for many grassroots, and often small, OPDs that had already been deeply challenged by the COVID-19 pandemic. Not only did this abrupt breach of trust lead to relationship breakdowns with local partners, but the impact on women and girls with disabilities who lost safe and inclusive access to SRH services was devastating.

Furthermore, the performance target-driven style of remaining FCDO funding has reshaped how international organisations, including CBM, are obliged to approach SRH programming. The pressure to demonstrate that aid funding is reaching the highest number of people risks pushing programmes away from reaching the most marginalised. This disproportionately leaves women and girls with disabilities behind, as SRH initiatives that are designed to deliberately seek them out and accommodate their needs may be more complex, time-consuming, and expensive than mainstream aid programmes.

Instead, FCDO needs to be transparent in both its indicators and targets to ensure funding reaches those in greatest need, and to follow through on its commitment to leave no one behind – not even the most marginalised.

Our call to action

Much is to be celebrated in the UK’s approach to disability inclusion, especially its commitment to being a global leader and championing the rights and freedoms of people with disabilities. Nevertheless, a lack of joined up thinking in FCDO’s approach to SRH for women and girls with disabilities indicates that we must not lose momentum now. It is time to demonstrate the Government’s stated commitment by creating a space for people with disabilities to be included at all levels of decision-making. Only together will we be able to have a meaningful impact in creating a world where all people with disabilities can achieve their full potential.

Watch the IDC’s evidence hearing on SRH, Tuesday 4 July 2023

Read CBM UK’s written evidence to the IDC on SRH

Footnotes:

1 https://www.cbmuk.org.uk/blog/will-fcdos-women-and-girls-strategy-result-in-change-for-women-and-girls-with-disabilities/

2 Refer to the Organisation for Economic Cooperation and Development’s (OECD) Creditor Reporting System (CRS) to explore the percentage of UK Overseas Development Assistance (ODA) categorized using  the disability inclusion policy marker: Creditor Reporting System (CRS) (oecd.org)

3 https://www.rescue.org/uk/press-release/uk-aid-cuts-will-negatively-impact-women-and-girls-around-world