Banjarmasin, 24 March 2022. The third meeting of the Women20 (W20) took place in Banjarmasin, South Kalimantan, 23-24 March 2022. The two-day meeting resulted in a number of recommendations emphasizing on fighting for gender equality in the health sector that could be followed up for leadership commitments. The meeting also identified challenges for women in accessing health services during the pandemic with a focus on maternal health, sexual health, and reproductive health. In addition, gender gaps were also identified, especially in responding to health related to Covid-19. The meeting in the capital city of South Kalimantan Province is also as a follow-up to one of the discussion points in the Indonesian Presidency at the G20 2022 which carries the theme "Global Health Architecture".
In the opening session of the second panel, Tuesday (23/3), the Minister of Health of the Republic of Indonesia, Budi Gunadi Sadikin also revealed about the focus of the G20 Presidency of Indonesia in the field of global health architecture. He revealed that every woman should have equal and balanced access to quality and affordable health services. When Covid-19 hits and disrupts access to health services, it is women who face challenging socio-economic conditions that even have an impact on discrimination.
“Therefore, we are from the Ministry of Health take an important part in promoting the strengthening of the global health architecture by focusing on 3 priorities. First, the commitment to build the resilience of the global health system through a financing mobilization mechanism and a genome surveillance platform. Second, the commitment to harmonize global health protocol standards. Third, a commitment to expand global research and manufacturing center including actions for pandemic prevention, preparedness and response in the form of vaccines, therapies and diagnoses."
In line with this focus, the Deputy for Gender Equality, Ministry of Women's Empowerment and Child Protection of the Republic of Indonesia, Lenny N. Rosalin said, "Women, with their role as women are very important and strategic in handling the Covid-19 pandemic situation in the family. In this abnormal situation and condition, women are required to be able to take care not only of their own health but also of ensuring the health of all members of their family. The bad impact of the pandemic occurs in certain groups such as the elderly, people with comorbidities, and other vulnerable categories, such as pregnant women and breastfeeding mothers.”
Lenny added that in addition to access to health services that became difficult and public concerns about the spread of the Covid-19 virus, the Covid-19 pandemic also had an impact on decreasing access to contraception and community participation in participating in the family planning program. UNFPA (2021) estimates the pandemic disrupts contraceptive use for an estimated 12 million women with a consequence of nearly 1.4 million unintended pregnancies during 2020 in 115 low- and middle-income countries.
Chair of Women20 Indonesia, Hadriani Uli Silalahi, said, “The main focus of this third meeting is how W20 can prioritize the response to health issues to jointly encourage the recovery process in various sectors. W20 is committed to leading advocacy that rebuilds better practices, a more equal and inclusive future, particularly on the issue of gender equality in the health sector.”
Furthermore, Uli explained that there were three main points that had been explained by all the participants involved in it. First, identify challenges for women to access health services during the pandemic, focusing on maternal and sexual and reproductive health. Second, identification of gender-related gaps in the COVID-19 health response. Third, recommendations to be followed up as a form of leader commitment.
In conveying the conclusion of the third meeting of the W20 Presidency of Indonesia, the Co-Chair of W20 Indonesia, Dian Siswarini, said, "Throughout this session we heard how Covid-19 has had a negative impact on women and girls, especially in health issues. Women's mental health is also affected. Sexual and reproductive health care services are hit hard under the pressures of the pandemic. Access restriction and the obligation to maintain social distance hinder access to health care related to Social, Reproductive Health and Rights (SRHR). In fact, based on WHO 2021 data, more than 800 women die every day globally due to pregnancy and childbirth."
Therefore, Dian emphasized that G20 leaders must immediately take action to provide more investment and ensure that essential sexual and reproductive health services, including maternal health, are available and improved. Invest in digital information and technology that enables the development of telemedicine that is accessible to women, including ensuring that digital infrastructure is available and affordable. Finally, ensuring to end the gender pay gap, particularly in the health sector and health service provision where women work predominantly.
Having a good gender sensitive policies can ensure that we reduce the digital gender gap and support women's participation in the economy. In line with the G20 Presidency theme, W20 will lead advocacy to rebuild a better, more equal, inclusive future, especially in this event, the issue of gender equality in the Health sector.
The third meeting in the W20 series was held on a hybrid basis which was attended by around 1,000 participants, including 200 people who attended offline in Banjarmasin. The participants came from various institutions including representatives from G20 member countries. There were 21 speakers consisting of women's experts and activists from various agencies and institutions.
In her presentation, Petra ten Hoope-Bender as Technical Adviser for Sexual and Reproductive Health and Rights of UNFPA Office Geneva, said, "There are several things that have changed along with the development of Covid-19. The fulfilment of women's rights, including girls' sexual and reproductive rights, has decreased. Services for sexual and reproductive health have also experienced a decline due to the number of service providers who have shifted to the Covid-19 emergency response. Barriers to transportation and mobility also encourage people to stop seeking care services related to sexual, reproductive, pregnancy, birth-related.”
Therefore, more attention is needed to health service providers, especially those related to mental health. The work environment also provides a high risk of infection, pressure to give the best performance, lack of supporting equipment, to lack of time to socialize with family and friends. Some of these things are a health threat in the midst of the current crisis, explained Petra further.
Meanwhile, Professor of Public Health at the University of Indonesia, Meiwita Budiharsana explained that naturally, women are in the most vulnerable condition during pregnancy and childbirth. Men will never feel the risk of pregnancy and childbirth so they do not need Ante-Natal Care (ANC) services. The measure of the fulfilment of women's reproductive rights must look at the gap of ANC services in various parts of Indonesia, or gender inequity according to the location of residence. ANC data shows gender inequity, where pregnant women in West and Central Indonesia have 70%-90% ANC access which is higher than pregnant women in East Indonesia provinces where ANC is only between 43% and 68% (BKKBN data, 2018). In addition, because the number of private primary health facilities is more or equal to the government primary health facilities (community health centers/puskesmas), then women in Western and Central Indonesia can also choose ANC by midwives/doctors in private or public practice (puskesmas). The opening hours of the puskesmas which are very short, making it more comfortable for pregnant women to go to private ANC services. However, because the majority in Eastern Indonesia are public health facilities, they cannot choose. Choice is something that fulfills women's reproductive rights.
Meiwita Budiharsana also explained that the impact of the COVID-19 pandemic was that home was no longer a safe place for women (a telephone survey of 866 women by the World Bank East Asia and Pacific Gender Innovation Lab (2020). Nearly half (43%) of them felt that the pandemic COVID-19 exacerbates insecurity at home, and 46% say this pandemic exacerbates insecurity in the environment, in the 6 months prior to the survey in August 2020. This clearly reflects women's lower bargaining position than men, which is reinforced by local culture. The 2017 Indonesian Demographic and Health Survey data also strengthens the attitude of 'accepting' domestic violence (KDRT) treatment in around 31% of women. It is a tough task for the W20 delegates to ensure that the G20's “Global Health Architecture” theme reflects political will to increase the availability of health facilities with ANC services in Eastern Indonesia as well as educate women about their rights to change the attitude of 'accepting' the risk of domestic violence. Both are absolute requirements in controlling the risk of maternal death.
Sehati Indonesia's Co-Founder, Anda Waluyo Sapardan, said, "Indonesia's presidency at this year's G20 has a strong value proposition for health diplomacy by placing digital transformation as one of the priority topics for this year's G20. Indonesia understands the importance of shared prosperity that must be achieved. Therefore, real roles and actions are needed to improve the health response so that we can recover together.”
He gives concrete examples such as Sehati TeleCTG, one of the technologies made in Indonesia that has the qualifications to be used globally. The results of technology development in the health sector can strengthen Indonesia's position in supporting the development of a global health architecture, while making a real difference and contribution to the world in helping to reduce maternal mortality rate, neonatal and stunting intra uterine.
As the host, the Governor of South Kalimantan, H. Sahbirin Noor, was also present at the opening ceremony. The choice of the City of Banjarmasin as the venue for the third W20 meeting is certainly inseparable from the various efforts that have been made by all city and provincial governments to continue to build this city. In 2019, the province of South Kalimantan received an award from the Ministry of PPPA regarding the Best Coach of the Children's Forum.
Furthermore, in 2021, the City of Banjarmasin received the Main Level Parahita Ekapraya (APE) Award. This award is given to ministries/agencies and local governments who are considered committed to achieving and realizing gender equality, empowering women and protecting children, as well as meeting the needs of children. Meanwhile, in the same year, the City of Banjarmasin received the Middle-level Child Eligible City award.
The entire W20 agenda until October 2022 is held in stages at several priority destination points in Indonesia. The implementation is in collaboration with International Knowledge Partners, UN agencies, civil society organizations, academia, government agencies and the private sector.
After the first and second meetings were held in Likupang, North Sulawesi in February 2022 and Batu East Java in March 2022, the next plenary W20 to W20 Summit will be held in Manokwari, West Papua, in May 2022, at Lake Toba, North Sumatra in July 2022, and Denpasar, Bali from September to October 2022.