Make a move: advocating
for the female condom
Index
Introduction to the Advocacy Toolkit
4
1. The importance of choice; background information about the female condom
6
1.1 Why is universal access to female condoms urgently needed?
6
1.2 Female condoms in the international human rights framework
6
1.3 The global development agenda
7
2. Variety of female condoms
2.1 The need for female condom variety
9
9
2.2 Different types of female condoms available and how to demonstrate them
9
2.3 Female condom programming
14
3. Advocacy strategies and actions for female condoms
15
3.1 Developing an advocacy strategy
15
3.2 Preparing to advocate: Advocacy Asks
24
4. Doing Media Advocacy
26
4.1 Introduction
26
4.2 Letters to the Editor
26
4.3 Writing an Op-Ed
26
4.4 Pitching a story
27
4.5 Being interviewed
28
4.6 Making your own media
28
5. The International Advocacy Platform for Female Condoms
30
Universal Access to Female Condoms (UAFC) Joint Programme
31
Annex 1 Questions and Answers for Female Condom Advocates
32
Annex 2 International agreements relevant to female condom advocacy
36
3
Introduction to the Advocy toolkit
This advocacy toolkit contains tools to support your advocacy
efforts for female condoms. It has been compiled for you: you
are eager to advocate for the female condom, to take action and
to positively change the current situation in your country.
Increasing access to the female condom is important because it
is the only contraceptive that offers dual protection against both
pregnancy and STIs, including HIV/AIDS, and is available now.
Nonetheless, the female condom is not yet widely available and
accessible to women around the world. So, although women
face the consequences of unprotected sex and bare the huge
burden of unintended pregnancy and the risk of infection, the
only tool for protection they can use themselves is inaccessible.
That is why advocating for the female condom to decision
makers and gatekeepers is necessary: to convince them that the
availability of female condoms is essential for the health of your
community.
This booklet provides you with the basics that you need
to design your advocacy strategy. It contains important
information about the female condom, which will equip and
support you to start advocating for the female condom to
gatekeepers and decision makers at the community, regional
and national levels.
All of the information has been written down as concisely
as possible. For more back-ground information, stories and
articles, we direct you to our website: www.condoms4all.org. If
you have any additional questions on advocacy, the Universal
Access to Female Condoms (UAFC) Joint Programme can provide
technical assistance. Please contact us at: info@condomsforall.
org. We will be happy to assist you.
The advocacy toolkit caters to all advocates that would like to
start advocating for the female condom. The items available in
the toolkit are:
a. Make a move: advocating for the female condom
This is the booklet you are currently reading. This booklet
contains background information about the female condom,
information on how to give a female condom demonstration
and concrete tools for female condom advocacy. This
booklet is especially useful for advocates in the area of HIV/
AIDS, family planning or sexual and reproductive health and
rights who would like to advocate specifically for the female
condom.
4
b. Information booklet on the Universal Access to Female
Condoms (UAFC) Joint Programme
This booklet provides an overview of the work that is being
done in the framework of the Universal Access to Female
Condoms Joint Programme. Universal Access to Female
Condoms (UAFC) is our overall goal that we aim to achieve
by executing three different types of program activities:
(1) country programs; (2) research & development and; (3)
advocacy, linking and learning and communication.
i. Advocacy statement on variety, price and accessibility of the
female condom
This advocacy statement has been developed in close
cooperation with the UAFC International Advocacy Platform
in 2009. It contains a strong message on the importance
of the universal availability of female condoms, as well
as recommendations with regard to how to achieve this.
You can use this document in your advocacy towards
gatekeepers and decision makers. The statement is available
in four languages: English, Spanish, French and Portuguese.
c. A sample of the Female Condom 2 (FC2)
This condom is produced by the Female Health Company
and is used in most female condom programming. When
giving a female condom demonstration on how to use the
female condom, this is the most convenient condom to use
with the demonstration model provided in this toolkit (g).
j. Condom gadgets
The condom gadget is a colorful envelope. In the envelope
there is an FC2, including some tips on how to increase
sexual pleasure when using it. It may be useful to hand it
out to gatekeepers and decision makers that are seriously
interested in the female condom in general and whom you
expect to be particularly interested in the additional benefit
of increased sexual pleasure (next to e.g. the benefit of dual
protection).
k. Poster
The poster can be used in public presentations. You can
write your own advocacy message in the white box.
d. A sample of the Cupid condom
This condom is produced by Cupid Ltd. and is expected to
gain World Health Organization (WHO) pre-qualification in
2012. This condom will be launched as the second available
female condom on the market in Mozambique and is
expected to be increasingly used in other country programs.
e. A sample of the VA w.o.w. Feminine Condom
This latex female condom is included in order for you to be
able to demonstrate to your audience that a variety in female
condoms is available.
A female condom demonstration in Nigeria
f. A sample of the PATH Woman’s Condom
This condom shows the potential of innovation when it
comes to the female condom. Although this condom is not
yet available on the market (expected in China at the end
of 2011, and available on the worldwide market at the end
of 2012), demonstrating it will attract more interest and will
direct attention to the fact that there are new developments
on the female condom market.
g. Female condom demonstration model
The female condom demonstration model provided in this
toolkit is a pelvic model especially developed for advocates
and community-based educators. The model is very useful in
visualizing the insertion and use of FC2.
h. Instructions for female condom use from manufacturers
The instruction sheets provided by the manufacturers offer
useful information and tips for using the different types of
female condoms.
5
1. The importance of choice; background
information about the female condom
1.1 Why is universal access to female condoms urgently
needed?
The consequences of the unmet need for contraception
Despite the range of highly effective contraceptive options
available, there is nonetheless a great unmet need for
contraception, particularly in the developing world. The United
Nations Population Fund (UNFPA) estimates that there are
around 215 million women worldwide who would like to limit
or plan the number of children they have, but who are not
currently using any form of contraception.1
The World Health Organization (WHO) estimates that, in
developing countries, more than one-third of all pregnancies
are unintended, with major implications for each child, each
woman, each family, and wider repercussions on overall
society related to population growth. A fifth of all pregnancies
end in induced abortion. 2 Of these abortions, more than half
is executed by unsafe means. Worldwide, 21,6 million unsafe
abortions cause 5 million women to be hospitalized each
year, and account for 13 percent of maternal deaths. 3 While
global contraceptive prevalence has increased slowly from 55
percent of women of reproductive age in 1990 to 64 percent
in 2005, it remains low in sub-Saharan Africa at just 22,8
percent.4 Meeting the current need for contraception would
reduce maternal deaths by around a quarter. Making the female
condom available to all women and men would increase the
instances of protected sex and thus contribute to the reduction
of unintended pregnancies and maternal deaths.
The consequences of HIV/AIDS transmission
HIV/AIDS infections were initially concentrated among men, but
women and girls now account for slightly more than half of all
infections. In sub-Saharan Africa, more women than men are
living with HIV/AIDS, and young women aged 15–24 years are as
much as eight times more likely than men to be HIV-positive. 5 In
some countries, even being married is a risk factor for women
to acquire HIV/AIDS. The consequences of HIV/AIDS infection
are also skewed against women and girls, who do most of the
caring, but are more likely to miss out on schooling, experience
gender-related violence, and loss of property as a result of HIV/
AIDS infection.
Although the supply of anti-retroviral treatment is helping to
reduce the number of deaths due to HIV/AIDS, AIDS is still a
leading cause of mortality worldwide with an estimated 1.8
million deaths in 2009. 6 Three-quarters of these were in subSaharan Africa where HIV/AIDS is the primary cause of death.
Although the number of people on treatment has increased by
30% in 20097, there are still two new infections for every person
starting treatment. Actions to prevent HIV/AIDS are 28 times
more cost-effective than treatment. 8 Investment in prevention is
urgently needed in order to reduce the number of new HIV/AIDS
infections and to curb the epidemic. Making the female condom
available to all women and men would increase the instances of
protected sex and thus contribute to the reduction of HIV/AIDS
infections.
1.2 Female condoms in the international human rights
framework
Sexual and reproductive health and rights in general and access
to the female condom in particular are reflected in several
important human rights documents. As an advocate, you can
use the international frameworks that your state has committed
to as an argument in favor of the implementation of a female
condom program in your country. It is important to know
whether your state has ratified the document you are referring
to. You may check this via the United Nations website.9
• According to article 12 of the International Convention
on Economic, Social and Cultural Rights, states have the
obligation to ensure the enjoyment of the highest attainable
standard of physical and mental health and specifically
to reduce maternal and infant mortality. By giving women
access to female condoms, they can space the births of their
children better, which leads to more healthy infants.10
• Article 16 of the Convention on the Elimination of All
Forms of Violence Against Women states that women
have “the rights to decide freely and responsibly on the
number and spacing of their children and to have access
to the information, education and means to enable them
to exercise these rights”. Of course, women need access to
contraceptives in order to be able to decide freely on the
number and spacing of their children.
• According to the International Conference on Population and
Development (ICPD) Programme of Action, “reproductive
health is a state of complete physical, mental and social wellbeing in all matters relating to the reproductive system and
to its functions and processes. It implies that people have the
capability to reproduce and the freedom to decide if, when
and how often to do so. Implicit in this is the right of men and
women to be informed and to have access to safe, effective,
affordable and acceptable methods of family planning of
their choice, as well as other methods of their choice for
regulation of fertility, which are not against the law, and the
right of access to healthcare services that will enable women
to go safely through pregnancy and childbirth.” The female
condom is such a safe, effective, affordable and acceptable
method and should therefore be a an option for all women
and men.
• The Beijing 1995 World Conference on Women states
that reproductive rights “rest on the recognition of the
basic right of all couples and individuals to decide freely
and responsibly the number, spacing and timing of their
children and to have the information and means to do so,
and the right to attain the highest standard of sexual and
reproductive health”. It also includes their right to “make
decisions concerning reproduction free of discrimination,
coercion and violence, as expressed in human rights
documents.” Since the female condom is a dual protection
method, it contributes to sexual and reproductive health at
the same time and can be used as a contraceptive method
as well as a method of protection against STIs. Therefore, it
should be available in order to attain the highest standard of
sexual and reproductive health.11
• The United Nations General Assembly Special Sessions
(UNGASS) on HIV/AIDS have led to the adoption of a
Declaration of Commitment (2001) and a Political Declaration
(2006), both of which call for the expanded access to
essential commodities such as the female condom as
mentioned explicitly in Operational Paragraphs 52 and 22
respectively.12
Now, it is obvious that the fact that a state has committed to
these international agreements does not necessarily lead to
the commitments being implemented. In fact, in reality there
is a vast gap between the commitment to rights on paper and
the implementation of these rights in reality. That is why we, as
advocates, have to remind our governments of their obligations
and convince them to take action to meet these obligations.
1.3 The global development agenda
The female condom contributes highly to the Millennium
Development Goals, which are currently shaping the global
development agenda. The Millennium Development Goal (MDG)
on maternal health (MDG 5), as well as on HIV/AIDS (MDG
6) will not be achieved if existing technologies, such as the
female condom, remain out of reach of the women who need
it. With gender inequality being an important driver of the
HIV/AIDS epidemic, the feminization of HIV/AIDS has become
a reality: in 2010, 76% of HIV-positive youth in sub-Saharan
Africa were female.13 Women and girls face the consequences
of unprotected sex and bear the huge burden of unintended
pregnancy and risk of infection. The female condom is thus
an essential tool to reach global development goals. When
talking to decision makers working in development, such as
Ministries of Health and UNFPA, it is important to know about
the contribution the female condom can make to development.
MDG Target 1 – Reduce by half the number of people living on $1
per day
Falling fertility rates in low-income countries have been
correlated to a decline in poverty. Provision of reproductive
health services and supplies has helped to reduce fertility by
43 percent in developing countries from 1965-1990.14 These
vital contraceptive supplies are structurally underfunded by
hundreds of millions of dollars annually and 215 million women
worldwide do not have access to contraceptives at all.15 The
female condom, which could make an important contribution to
reducing fertility is often not available at all.
MDG Target 3 – Promote gender equality and empower women
Studies demonstrate an increased sense of empowerment
in women’s negotiation of safe sex as well as a greater sense
of control and safety during sex, among women using female
condoms.16 This is particularly the case where women learn
about female condoms as part of an empowerment process. As
such, the female condom is a tool that can encourage women’s
empowerment.
11 Background information on these documents can be found in Annex 2
1
UNFPA Contraceptives save lives factsheet, page 1: http://www.unfpa.org/webdav/site/global/shared/safemotherhood/docs/contraceptives_factsheet_en.pdf
WHO and the Guttmacher Institute, Facts on induced abortion worldwide, page 2: http://www.who.int/reproductivehealth/publications/unsafe_abortion/abortion_facts.pdf
3 WHO, Unsafe abortion: Global and regional estimates of the incidence of unsafe abortion and associated mortality in 2008, sixth edition, page 14: http://whqlibdoc.who.int/
publications/2011/9789241501118_eng.pdf
4 Data from Trading Economics available at http://www.tradingeconomics.com/sub-saharan-africa/contraceptive-prevalence-percent-of-women-ages-15-49-wb-data.html
5 UNAIDS Global Report 2010, page 10: http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf
6 UNAIDS Global Report 2010, page 19: http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf
7 UNAIDS Global Report 2010, page 5: http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf
8 Fact sheet for the High-level Event on the Millennium Development Goals, United Nations Headquarters, New York, 25 September 2008? http://www.un.org/millenniumgoals/2008highlevel/pdf/newsroom/
Goal%206%20FINAL.pdf
9 See http://treaties.un.org
10 See UNFPA fact sheet on MDG4, page 255: http://www.unfpa.org.br/lacodm/arquivos/mdg4.pdf and S.O. Rutstein, Effects of preceding birth intervals on neonatal, infant and under-five years mortality and
nutritional status in developing countries:evidence from the demographic and health surveys, International Journal of Gynecology and Obstetrics (2005) 89, S7óS24. Available online at: http://factsforlife.
org/pdf/BIRTH%20SPACING%20AND%20NUTRITION%20IN%20DEVELOPING%20COUNTRIES.pdf
2
6
12 [Declaration of Commitment on HIV/AIDS A/Res/S-26/2 OP 52] By 2005, ensure: that a wide range of prevention programmes which take account of local circumstances, ethics and cultural values, is
available in all countries, particularly the most affected countries, including information, education and communication, in languages most understood by communities and respectful of cultures, aimed at
reducing risk-taking behaviour and encouraging responsible sexual behaviour, including abstinence and fidelity; expanded access to essential commodities, including male and female condoms and sterile
injecting equipment; harm reduction efforts related to drug use; expanded access to voluntary and confidential counselling and testing; safe blood supplies; and early and effective treatment of sexually
transmittable infections;
[Political declaration on HIV/AIDS A/RES/60/262 OP 22] Reaffirm that the prevention of HIV infection must be the mainstay of national, regional and international responses to the pandemic, and therefore
commit ourselves to intensifying efforts to ensure that a wide range of prevention programmes that take account of local circumstances, ethics and cultural values is available in all countries, particularly
the most affected countries, including information, education and communication, in languages most understood by communities and respectful of cultures, aimed at reducing risk-taking behaviours
and encouraging responsible sexual behaviour, including abstinence and fidelity; expanded access to essential commodities, including male and female condoms and sterile injecting equipment; harmreduction efforts related to drug use; expanded access to voluntary and confidential counselling and testing; safe blood supplies; and early and effective treatment of sexually transmitted infections;
13 UNAIDS Global Report Factsheet, page 2, http://www.unaids.org/documents/20101123_FS_SSA_em_en.pdf
14 Data from World Population Data Sheet, Population Reference Bureau, Washington, D.C., 1998.
15 UNFPA Contraceptives save lives factsheet, page 1, http://www.unfpa.org/webdav/site/global/shared/safemotherhood/docs/contraceptives_factsheet_en.pdf
16 Gollub EL. The female condom: tool for women’s empowerment. American Journal of Public Health 2000;90(9):1377ñ81.
7
2. Variety of female condoms
MDG Target 4 – Reduce by two-thirds the mortality rate among
children under 5 years of age
Almost 11 million children under 5 years of age die each year,
mainly in developing countries. Infant mortality rates can
decrease by as much as 45 percent when births are spaced
more than 2 years apart.17 The use and availability of family
planning methods, such as the female condom, is critical to
successful birth spacing and increased infant survival.
to condoms. Female and male condoms are currently the only
product able to prevent sexually transmitted HIV/AIDS and have
the added advantage of protection against pregnancy. Yet, on
average, just 4.6 condoms are available per year to each African
man. 21 In 2009, only 1 female condom was available for every
36 women worldwide. 22 Because the female condom is the only
women initiated and controlled prevention tool it is crucial that
it becomes widely available.
MDG Target 5 – Reduce by seventy-five per cent the maternal
mortality ratio
In industrialized countries a woman has only a 1 in 4,100
chance of dying in pregnancy or childbirth over the course
of her lifetime; in the developing world, that risk is estimated
at 1 in 60, and in sub Sahara Africa that risk is 1 in 13.18 The
use of contraceptives to space births is also a critical factor in
reducing maternal mortality, yet 215 million women who want
to use contraception are unable to do so.19 The relationship
between maternal mortality, contraceptives and family
planning is acknowledged in MDG 5b, which aims to achieve
universal access to reproductive health. Again, the availability
of contraceptives such as the female condom is vital to reduce
unintended pregnancies and contributes to reductions in
maternal mortality.
From 1993 to 2005, the only female condom available was the
Female Health Company’s FC (also referred to as FC1) which is
made of polyurethane and has an outer and inner ring. It is now
being replaced by FC2, which employs the same design but uses
a less expensive material (nitrile) as well as more cost-effective
production methods. FC1 and FC2 are the only female condoms
approved by WHO for purchasing by UN agencies. However,
new developments are on the way, and the WHO is currently
reviewing several dossiers of other female condoms for prequalification. Soon, female condom variety will be a reality in
many countries. For updates on which female condoms are prequalified by the WHO please check www.condoms4all.org.
2.1 The need for female condom variety
Different manufacturers are currently developing more
female condom models. This indicates that manufacturers are
beginning to recognize the potential of the female condom.
With more different types of female condoms gaining access
to the market, there will be more choice for women and men to
opt for a female condom that they like and there will be more
competition on the market, leading to lower prices.
Female condom rally at the International Aids Conference in Vienna 2010
MDG Target 6 – Halt and begin to reverse the spread of HIV/AIDS
2.6 million people were infected with HIV/AIDS in 2009. 20 80
per cent of these infections occur through sexual intercourse.
That is why it is essential that people have safe sex and access
Parallel programming of different types of female condoms will
make it possible for each specific consumer to decide which
female condom he or she prefers. People differ and preferences
differ. Therefore, it is important that people can choose a
condom that fits their preferences as best as possible. If there
is only one female condom on the market, and a person does
not like using that particular type, it is important to offer an
alternative.
Also, different types of female condoms can lead to lower
prices. Currently the FC2 female condom is the only condom
widely available because it is the only female condom approved
by the World Health Organization. WHO qualification is needed
as a prerequisite for UN organizations, which is the most
important distributor of female condoms. If other condoms
are tested and approved by the World Health Organization,
there will be more competition between the manufacturers of
condoms. More competition will lead to lower prices of female
condoms and thus wider availability.
17 UNFPA fact sheet on MDG4, page 255: http://www.unfpa.org.br/lacodm/arquivos/mdg4.pdf
18 UNICEF, Maternal Mortality, http://www.unicef.cz/download/MaternalMortality_D7341Insert_English.pdf
In 2009, a study conducted by Family Health International
(FHI), which was commissioned by the United States Agency for
International Development (USAID), looked at which of three
female condoms is generally preferred by South African women.
The outcomes show that the Woman’s Condom produced by
PATH was preferred over the FC2; alternatively, the FC2 was
preferred over the VA w.o.w. Feminine Condom. However, the
women who preferred the VA w.o.w. did have quite a strong
preference for it. All three condoms were well accepted,
frequently used and caused few adverse effects. 23 By ensuring
access to a variety of female condoms, women will be able
to find out which condom suits them best and use the female
condom of their preference.
2.2 Different types of female condoms available and how
to demonstrate them
Demonstrating the female condom to gatekeepers and policy
makers can really contribute to their enthusiasm and willingness
to work with you on the female condom. They will have a
concrete idea of the look and feel of the condom and see how it
works in practice. This will make it easier for them to explain the
importance of the female condom to others – which will in turn
be helpful for your advocacy.
Below, you will find specific information about different types
of female condoms as well as instructions regarding how to
demonstrate them. The actions as well as the explanations
which are needed for a female condom demonstration are
described below. Information written between brackets (()) is
meant as an instruction for the person that is demonstrating.
For additional information about the different female condoms,
please see the sheets provided by the manufacturers included
in this toolkit.
Needed for a female condom demonstration:
• Samples of female condoms (such as the FC2, the Cupid
female condom, the VA w.o.w. female condom and PATH
Woman’s Condom).
• A female condom demonstration model, which is most
convenient to show the use of FC2 and is less suitable for the
demonstration of other female condoms which you can also
show by using your hands.
• Location where many people are able to come to your
demonstration session. If possible, place chairs at the
location so that people can sit while you give your
demonstration.
• Effective communication skills.
• Good understanding of your target audience/message
beneficiaries.
• Good voice and confidence.
How you use the female condom depends on which female
condom you are using. Each condom requires its own
instruction. The thing that all female condoms have in common
is the fact that they are a ‘barrier contraceptive’: they physically
prevent sperm from entering the uterus, thereby preventing
pregnancy. Unlike other barrier methods such as the cervical
cap and the diaphragm, the female condom covers the inside
and part of the outside of the vagina and is thus also prevents
sexually transmitted infections such as HIV/AIDS.
19 UNFPA Contraceptives save lives factsheet, page 1,
20 UNAIDS Global Report 2010,
http://www.unfpa.org/webdav/site/global/shared/safemotherhood/docs/contraceptives_factsheet_en.pdf
page 15, http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf
21 Making condoms work for HIV prevention, UNAIDS Best Practice Collection, page 21, http://data.unaids.org/publications/irc-pub06/jc941-cuttingedge_en.pdf
22 HIV Prevention gains momentum: successes in female condom programming, UNFPA 2011, available at:
http://www.unfpa.org/webdav/site/global/shared/documents/publications/2011/MomentumPDFforWeb.pdf
8
23 Three new female condoms: which do South African women prefer? Carol Joanis, Mags Beksinska, Catherine Hart, Katie Tweedya, Jabu Linda, Jenni Smit, Contraception (2010).
9
For a video that demonstrates several different female condom
models, see: http://www.youtube.com/watch?v=5JYKnaL6Afw
FC1 and FC 2
The FC, made by the Female Health Company, is a strong, soft,
transparent polyurethane (FC1) / nitrile (FC2) sheath that is 17
centimetres long (about 6.5 inches, the same length as a male
condom) with a flexible ring at each end. The inner ring helps
insertion and secures the device in place during intercourse
while the softer outer ring remains outside the vagina.
The Female Health Company stopped producing the FC1 in
2009, after the cheaper FC2 was approved by both WHO and the
United States FDA. The FC1 is still for sale in some countries. The
Female Health Company holds a series of patents on the design
of the FC2 female condom and has been making a profit since
2006. Its sales went up from 13.5 million in 2005 to almost 26
million in 2007, largely due to increased procurement by UNFPA
and key donors. In 2009, the FC2 has been approved by the
United States Food and Drug Administration (FDA), which makes
it possible for USAID to procure the FC2 for its programs. The
FC1 and FC2 are the only female condoms currently approved
(pre-qualified) by the WHO for purchase by United Nations
agencies. The FC2 is registered in 114 countries and sold under
many brand names, including Reality, Femidom, Dominique,
Femy, Myfemy, Protectiv, Elegance, and Care.
Demonstrating the FC2
Before you open the package, tell people that they should look
at the expiry date on the package. If the expiry date has passed,
the condom should not be used. By pressing the package
between your fingers and thumbs, you can spread the lubricant
inside the package. When opening your package, do so gently
from the corner indicated on the package. Do not use scissors or
your teeth.
(show female condom in the package, open it gently and take
the female condom out of package)
This is a female condom, it has an inner ring (show) and an
outer ring (show). The female condom can be inserted up to four
hours before sexual intercourse. It is lubricated and adopts the
body temperature.
Insertion can be done by lying in a relaxed position, lying on
your back, squatting, or raising one leg by standing on a chair.
For insertion, squeeze it or turn the inner ring into an 8 with two
fingers (show) and insert it gently with two fingers in the vagina
(show by using demonstration model). Push it in until it does
not go any further: the inner ring is now touching the uterus
(show by using demonstration model). This position of the
female condom will ensure that it remains inside during sexual
intercourse. The outer ring stays on the outside and gives extra
protection for the external genitalia and protects against STIs
that may occur on the outside of the vagina, such as herpes. The
insertion can be part of foreplay and does not have to happen
in the “heat of the moment”. This is an advantage of the female
condom over the male condom, as the male condom needs an
erect penis to be put on. The FC2 comes pre-lubricated and both
water-based and oil-based lubricants can be used as additional
lubricants. Please be aware that latex condoms, such as most
male condoms, cannot be used with oil-based lubricants.
To make sure the FC is properly used and to make sure the penis
does not slide outside the female condom, guide the penis
inside the female condom (show with demonstration model)
into the vagina at the moment of penetration. After intercourse
you do not have to hurry to take the condom out. Take your time
and once you are ready twist the outer ring of the condom twice
and slowly remove it (show), wrap it in the wrapper or roll it
up in some paper or tissue and properly dispose of it safely in
a closed bin so that children cannot access it. Do not throw the
female condom in the toilet. Just like with the male condom,
its use should be practiced a couple of times before you use it
during intercourse for the first time. The first time that you try
this condom, it is important that you practice a bit with inserting
the condom and taking it out again. That way, when you try it
with your partner, you feel more secure about the use of the
female condom. Because the female condom will be new to you
and your partner, its use may take some practice. Try it a couple
of times and you—and your partner—may find that you prefer
the female condom over other contraceptive methods.
Website of the Female Health Company: http://www.
femalehealth.com
VA w.o.w.
The VA w.o.w. female condom is made by Medtech Products
Ltd. in India. It is made of natural latex and has a triangular
outer frame and an inner sponge to hold the latex pouch in
place in the vagina. It has been approved for use throughout
Europe, in Brazil, India, Indonesia, South Africa and Swaziland,
and is available under brand names such as Dr. Reddy,
V-Amour, Feminine condom, and Sutra. It has not yet fulfilled
all the requirements of the WHO pre-qualification procedure
and, therefore, has not been approved for purchasing by UN
agencies. The condom has quality approval of the European
Commission, the so-called CE quality guarantee. UAFC is
currently making an effort to introduce this condom in
Cameroon.
Demonstrating the VA w.o.w.
Before you open the package, tell people that they should look
at the expiry date on the package. If the expiry date has passed,
the condom should not be used. When opening your package,
do so gently from the corner indicated on the package. Do not
use scissors or your teeth.
Website of Medtech Products ltd:
http://medtechproducts.net
Cupid female condom
(show female condom in the package, open it gently and take
the female condom out of package. The demonstration model
currently available is not easy to use with VA w.o.w. female
condom. Hence, it is better to demonstrate this condom by using
your hands.)
This is a latex female condom, it has an outer ring but the female
condom is held in place by the inner sponge (show). This female
condom can be inserted as part of foreplay, but because it
is made of latex it cannot be inserted long before the actual
intercourse. It is lubricated with a silicone-based lubricant
and may also be used with a water-based lubricant. Like most
male condoms, it cannot be used with an oil-based lubricant
as this will break the condom. The condom is not as long as
other female condoms, but will easily stretch during intercourse
(show).
This condom has some features that may enhance sexual
pleasure. The outer ring is a triangle that stimulates the clitoris
while the inner sponge may give pleasure to the man.
10
For insertion, open the package carefully and only when you
are about to use the female condom. Take the sponge with
two fingers, and fold in half (show) so you can insert it, like
a tampon in case you have used that before. While sitting or
squatting, push the sponge inside the vagina as far as possible.
Make sure that the sponge is deep inside the vagina, and well
placed (show in your hand). The condom is now ready for use.
To make sure the condom is properly used and to make sure
the penis does not slide outside the female condom, guide
the penis inside the female condom (show in your hand) into
the vagina at the moment of penetration. After the man’s
ejaculation, twist the outer ring twice to prevent any spillage
(show in your hand). Wrap the condom in the wrapper or roll it
up in some paper or tissue and properly dispose of it safely in
a closed bin so that children cannot access it. Do not throw the
female condom in the toilet. When you try this condom for the
first time, it is important that you practice a bit with inserting the
condom and taking it out again. That way, when you try it with
your partner you feel more secure about the use of the female
condom. Because the female condom will be new to you and
your partner, its use may take some practice. Try it a couple of
times and you—and your partner—may find that you prefer the
female condom over other contraceptive methods.
The Cupid female condom is produced by Cupid Ltd. in India.
This is a latex female condom and has an octagonal outer frame
and a donut-shaped sponge inside the condom to hold the
condom in place during intercourse. The Cupid female condom
has CE approval for use in Europe and is currently being
considered for WHO qualification. The Cupid female condom
is currently sold in India, plus small-scale distribution in Brazil
and Indonesia and there are limited private market sales in
Europe. The Cupid condom is also available in pink with vanilla
scent.
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Demonstrating the Cupid female condom
Before you open the package, tell people that they should look
at the expiry date on the package. If the expiry date has passed,
the condom should not be used. Always open the package
(show female condom in the package, open it gently and take
the female condom out of package. The demonstration model
currently available is not easy to use with the Cupid female
condom. Hence, it is better to demonstrate this condom with
your hands.)
This is a latex female condom. It has an outer ring but the female
condom is held in place by a round inner sponge (show). This
female condom can be inserted as part of foreplay, but because
it is made of latex it can only be inserted a couple of minutes
before the actual intercourse. It is lubricated with a siliconebased lubricant and can also be used with a water-based
lubricant. It cannot be used with an oil-based lubricant as this
will break the condom (this is the same for male condoms!). The
outer ring is octagonal and may stimulate the clitoris while the
inner sponge may give pleasure to the man.
For insertion, open the package carefully and only when you
are about to use the female condom. Take the sponge with two
fingers, and squeeze it tight so you can insert it - like a tampon
if you have used that before. While sitting or squatting, push
the sponge inside the vagina as far as possible. Make sure that
the sponge is deep inside the vagina, and well placed (show
with demonstration model or in your hand). The condom is now
ready for use. After your partner’s ejaculation, twist the outer
ring twice to prevent any spillage (show with demonstration
model or in your hand). Wrap the condom in the wrapper or roll
it up in some paper or tissue and properly dispose of it safely in
a closed bin so that children cannot access it. Do not throw the
female condom in the toilet. When you try this condom for the
first time, it is important that you practice a bit with inserting the
condom and taking it out again. That way, when you try it with
your partner you feel more secure about the use of the female
condom. Because the female condom will be new to you and
your partner, its use may take some practice. Try it a couple of
times and you—and your partner—may find that you prefer the
female condom over other contraceptive methods.
Website: http://www.cupidltd.com
PATH Woman’s Condom
The Woman’s Condom was developed by PATH, an international
health nonprofit organization, in collaboration with researchers
at CONRAD and with input from women and couples on four
continents. It is manufactured and distributed by Dahua Medical
Apparatus Company of Shanghai, China.
The Woman’s condom was desinged in close cooperation with
female condom users. It has a dissolving tampon-like capsule
for easier insertion. The Woman’s Condom consists of a ring,
thin polyurethane pouch, and dissolving capsule that holds
four foam shapes. All parts of the Woman’s Condom are made
of medical grade material that is safe and has been used in
medical products for years. The dissolving capsule is made
of PVA or polyvinyl alcohol which is the same product that
contraceptive spermicide c-film is made of and is completely
safe for your body. The PVA in the Woman’s Condom does not
have any active ingredient in it. The capsule provides a discreet
and easy way to handle and insert the condom. The capsule
dissolves on contact with the vaginal fluids that are normally
present in a woman’s body. Four foam shapes on the vaginal
side of the pouch help to hold the condom stable in the vagina
during use. A separate sachet of lubricant is included with the
condom.
ring should lie snug against your genitals (show). The capsule
begins to dissolve as soon as it comes into contact with the
vaginal fluid that is normally present in a woman’s body. The
capsule will dissolve in about 30-60 seconds allowing the pouch
to unfurl inside the vagina. Inserting the condom 5 to 15 minutes
before sex will help make sure that the condom is ready before
use.
The Woman’s Condom does not come with lubricant already
applied. The woman (or her partner) needs to apply lubricant
inside the condom pouch (like this! - demonstrate with hand).
Lubricate the inside of the condom pouch with your finger. You
may also want to apply lubricant to the penis before penetration.
The lubricant will make the penis slide better in the condom and
could enhance sensations during sex. The Woman’s Condom
comes packaged with a small sachet of water-based lubricant, so
you and your partner can choose the amount of lubricant that is
right for you.
To make sure the condom is properly used and to make sure the
penis does not slide outside the female condom, guide the penis
inside the female condom (show in your hand) into the vagina
at the moment of penetration. Remove the condom after sex
by twisting the ring and pulling the condom out gently (Show).
Wrap the condom in the wrapper or roll it up in some paper or
tissue and properly dispose of it safely in a closed bin so that
children cannot access it. Do not throw the female condom in the
toilet. When you try this condom for the first time, it is important
that you practice a bit with inserting the condom and taking it
out again. That way, when you try it with your partner you feel
more secure about the use of the female condom. Because the
female condom will be new to you and your partner, its use may
take some practice. Try it a couple of times and you—and your
partner—may find that you prefer the female condom over other
contraceptive methods.
Website: www.path.org
Availability of a variety of female condoms in your country
Only a small percentage of all condoms produced are female
condoms. The FC2 is currently the only female condom that
is qualified by the WHO. Still, specific regulations may be
applicable in your country concerning the import and testing
of female condoms. In order to increase variety (and thus
competition on the market and more choice for women), it is
crucial that different types of female condoms will be qualified
by the WHO. But WHO qualification alone may not be sufficient.
It is important to know whether testing by your local Food and
Drug Administration is a prerequisite for female condoms to
enter the country.
female condoms demonstration
in Cameroon
Demonstrating the PATH Woman’s Condom
Before you open the package, tell people that they should look
at the expiry date on the package. If the expiry date has passed,
the condom should not be used. When opening your package,
do so gently from the corner indicated on the package. Do not
use scissors or your teeth.
(show female condom in the package, open it gently and take
the female condom out of package. The demonstration model
currently available is not easy to use with the PATH female
condom. Hence, it is better to demonstrate this condom with
your hands.)
To use the Woman’s Condom, get into a comfortable position
(standing with one leg raised, squatting, or semi reclined).
Reach through the condom and grasp the end of the condom
(demonstrate entire sequence using your hand). Then, insert the
dissolving capsule into your vagina. Use your finger to continue
pushing the capsule as deeply as you can into the vagina. The
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3. Advocacy strategies and actions for
female condoms
The WHO is currently reviewing several female condoms. The
information below was compiled in the fall of 2011. Please
check www.condoms4all.org for the latest developments in the
area of WHO qualification of female condoms.
When you see something that’s wrong, no matter how big
the problem is, think “Who else would like to change this?
How can we work together?”
UN Secretary-General Kofi Annan
• FC1 is now being replaced by FC2. FC1 and FC2 are the only
two female condoms with WHO pre-qualification.
• The VA w.o.w. female condom has not yet fulfilled all the
requirements of the WHO pre-qualification procedure.
It did obtain CE approval for use throughout Europe and
other countries. Around five million were sold commercially
between 2003 and 2007.
• The PATH Woman’s Condom is being developed and is
currently in the process of gaining WHO approval.
• The Cupid female condom is currently in the process of
fulfilling the requirements of the WHO pre-qualification.
• Other manufacturers, such as Origami and Phoe Nurse
Female Condoms are expected to enter the market soon.
2.3 Female condom programming
Simply making female condoms available on the market is not
enough to stimulate its use. It is crucial to include training on
insertion as well as communication and negotiation skills in
female condom programming. Therefore, every female condom
program should budget for activities related to information
sharing, education and communication.
Efforts to make the female condom more accessible have
been made for the past 15 years. This effort has been
accelerated since the launch of the United Nations Population
Fund’s (UNFPA) global Female Condom Initiative in 2005. A
consequence of this initiative has been the rapid expansion
of sales and free distribution of female condoms (samples)
in the countries that were at the forefront of female condom
programming. UNFPA Comprehensive Condom Programming
integrates various activities, including male and female condom
promotion, communication aiming at behavioral change, market
research, segmentation of messages, advocacy and coordinated
management of supply and distribution. Despite all efforts of
the UNFPA, a massive unmet demand for female condoms still
exists today.
The relatively high cost of the female condom, the relatively
low numbers of female condoms produced, and the general
lack of competition in the market have so far been major
bottlenecks toward universal accessibility. Upscaling female
condom programming and thereby increasing demand and
sales, is expected to decrease the price. Therefore, national
governments, civil society organizations and the private sector
should collaborate on comprehensive long-term integrated
female condom programming, making female condoms
available to all women and men, given their universal relevance
as a contraceptive and STI prevention method, including HIV/
AIDS.
If you are interested in knowing more about programming
please visit www.condoms4all.org to download the UAFC
Implementation Guide “Making female condoms available and
accessible. A guide on implementing female condom programs.”
Advocacy is both a science and an art. From a scientific
perspective, there is no universal formula for effective
advocacy. Nevertheless, experience shows that an advocacy
campaign is most effective when it is planned systematically.
Advocacy networks frame their issue, set an advocacy goal
and measurable objectives, identify sources of support and
opposition, research the policy audience, develop compelling
messages, and mobilize necessary funds. At each step of
the way, they collect data and monitor their plan of action to
evaluate if they are making the desired progress. Each of these
steps requires specific knowledge and skills to ensure effective
and efficient implementation.
Advocacy is also an art. Successful advocates are able to
articulate issues in ways that inspire others and motivate them
to take action. They have a keen sense of timing and are able
to recognize and act as opportunities present themselves.
Successful advocates are skilled negotiators and consensus
builders who look for opportunities to affect modest but
3.1 Developing an advocacy strategy
Advocacy requires proper planning and a comprehensive
strategy. The ten-step process described below will help you
to develop an appropriate advocacy strategy to encourage the
policy or decision making change you need to successfully
promote female condom use.
strategic policy changes, while simultaneously creating
opportunities for larger victories. Artful advocates incorporate
creativity, style, and even humor in their advocacy efforts in
order to draw public and media attention to their cause. The
art of advocacy cannot be taught through a training workshop.
Rather, it emerges from the network members themselves.
Advocacy training provides the tools, but participants must add
the spark.
Female Condom rally in Nairobi, Kenya, organized by Imagine Kenya,
Bar Hostess Empowerment and Support Programme, SWAK, G-Rise and
Mwiki Hope during the Paper Doll Campaign.
describes short-term, specific, measurable achievements
that contribute to the overall advocacy goal.
3. Identify your target audience
The desired policy change is facilitated by specific decision
makers or other influential people. Assess their positions
and relative powerbase and find out whether or not
they support, oppose, or are neutral to the issue you are
advocating for.
The 10 steps of your advocacy process24
1. Define the issue
Advocacy begins with identifying the issue or problem that
requires a policy or decision making change.
2. Set goal and objectives
A goal is a general statement of what you hope to achieve in
the long term (three to five years). The advocacy objective
4. Build support
Find supporters to strengthen your advocacy message within
NGOs, networks, donors, coalitions, civic groups, journalists,
churches, professional associations, women’s groups,
activists, and individuals.
5. Develop your message
Advocacy messages need to be adjusted according to the
24 Based on the 10 Steps in the Advocacy Process of the Policy Project: Networking for Policy Change: An Advocacy Training Manual by POLICY (January, 1999), http://www.policyproject.com/pubs/
AdvocacyManual.cfm
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target audience and include the problem statement, facts,
persuasion and the desired action of the policy and decision
maker.
6. Select channels of communication
Common advocacy channels are position papers, letters, fact
sheets, public debates, public media outlets, the press and
conferences targeting policy makers. Your target audience
determines the most appropriate medium for your advocacy
message.
7. Raise funds
Advocacy campaigns always benefit from external funding
and other resources. Identify possible donors for the
campaign.
Ongoing activities:
Collect data
Advocacy objectives, advocacy messages, and identifying the
policy and decision makers and your supporters require data
collection. This is an ongoing process.
Monitor and evaluate
Monitoring and evaluating the advocacy process is about
measuring your progress and results. What achievements are
you aiming for? When defining your advocacy objectives, make
sure to consider how to measure them.
• In country X, there are [number] unintended pregnancies
due to a lack of access to contraceptives;
• In our country, women and men do not have access to
contraceptives;
• In our province, many girls are getting pregnant because they
lack knowledge and access to contraceptives;
• Over the last 5 years, the number of people in our country
contracting HIV/Aids has increased;
• Men and women in region X express a demand for the
female condom, but it is not available;
• In our region, many people lack the skills to protect
themselves against HIV infection.
Your advocacy issue should be supported by research data
which may include focusing on the user level and/or analyses
of public health reports by government, NGOs and research
institutions. 25
Achievable: The objective has to be ambitious, but not overly
ambitious so that it is impossible to reach. It has to motivate
people to do their best and know that they can achieve the
stated goal.
Realistic/Relevant: The objective has to aim towards achieving a
real win, so that people working on this goal see the purpose of
working on it.
Time bound: By stating a target deadline for the objective, and
later on a time-line, there will be a sense of urgency and you will
be in a position to track whether you are on schedule.
8. Develop your implementation plan
Develop an implementation plan that identifies activities
and tasks, responsible persons/committees, the desired time
frame, and required resources.
1. Defining the issue
When developing your advocacy strategy, you should
determine a problem or an issue in your environment, region or
country that you expect may be positively influenced by policy.
In the field of female condom promotion, the problem is likely
to be related to sexual and reproductive health and HIV/Aids.
Examples of the advocacy issue could be:
Measurable: In order to know if you have achieved your
objective, it is best to have quantitative goals, e.g. indicating by
how much funding should be increased.
In addition to the use of the SMART-elements, you may add the
policy actor or decision maker that you will target to make the
objective even more specific. For instance:
2. Set overall goal and objectives
The problem that you have determined to be your advocacy
issue needs a solution. Your advocacy is geared towards
positively influencing the problem. You will set a goal, which is
always long-term and which addresses your advocacy issue. For
instance, your goal might be:
• In 5 years’ time, the government of country X has integrated
female condom programming in their national condom
strategy and has allocated sufficient resources to sustain it.
Your long-term goal reminds you of where you are headed and
when you would be satisfied about the impact of your advocacy
efforts. It is important to remember that your advocacy goal
represents a policy change. It should include the action of
decision makers, e.g. in this case, they have integrated female
condom programming into one of their policies and provide
sufficient financial resources to sustain it.
In order to achieve your overall goal, you need short-term
objectives that will lead you there. When identifying your shortterm objectives, you should specify them according to SMARTcriteria26:
Specific: The objective has to be clear and say exactly what the
outcome should be.
• In one year’s time, female condom promoters have had one
or more contact moment(s) with relevant representatives
of the Ministry of Health to discuss commitment to female
condom programming.
• In two year’s time, the Ministry of Health in country
X publicly supports female condoms as a modern
contraceptive choice.
• In four year’s time, the Ministry of Health has committed
to including female condoms into the next multi-annual
national condom strategy.
You can also select objectives that will support your advocacy
to decision makers, for instance by involving media or by
identifying influential “female condom champions” who have
access to decision makers:
• In one year’s time, at least 10 media outlets (radio, TV,
magazines, newspapers) have expressed themselves
positively with regard to the female condom.
• In two year’s time, at least three champions have been
identified and have committed to promoting the integration
of female condoms in the national condom strategy within
government structures.
Needless to say, the identification of the advocacy goal and
objectives is very context-specific and needs to be supported
by research and data collection. If you ask for an increase of
funding for female condom promotion, you need to know how
much funding is spent on female condom promotion today. You
need to be aware of existing policies, committees, strategies
and programs that involve the government and are influencing
the playing field for female condom promotion. Some countries
already have condom strategies that could perfectly fit in
female condom promotion. Most countries have a national
reproductive health or HIV/Aids policy. This data collection
should be done as a baseline study: you will need to assess
and document the current situation so that, when you evaluate
the impact of your advocacy strategy, you will know if you
have had any impact. It needs to be noted however that budget
analysis is extremely difficult as many governments are not very
transparent in publishing these figures.
What is more, you should reflect on the skills, knowledge and
resources that are available in your operational team and what
you will need to be able to achieve your objectives and your
overall goal. At the same time, be aware that your environment
may change, e.g. elections may be held or policy priorities might
change. Include this type of risk analysis in the documentation
of your goal and objectives by trying to anticipate these
changes.
Setting the goal and objectives is strongly related to the third
step, identifying the target audience. When you know whom to
target, you may include that decision maker in your objectives.
3. Identify Target Audience: advocacy towards the government
Who are the people or institutions that have the power that
is required to bring about the desired policy change? This
question is important when identifying your target audience.
As advocacy is a process aimed at decision makers and
policy actors, your target audience is always someone in the
government or parliament, for example: Ministry of Health,
Ministry of Finance or Planning, Ministry of Women and Gender,
parliamentarians or parliamentarian groups, national HIV/Aids
committees, national HIV/Aids technical bodies, or reproductive
health/family planning technical bodies or working groups.
In order to target the policy makers who are in a position to
contribute to positively influencing the position of the female
condom in your country, it is helpful to identify and analyze
them on the basis of certain criteria.
For example:
1. The status they enjoy nationally;
2. Their political influence;
3. Objectives that they aim to achieve in their personal and/or
professional lives that relate to the areas of intervention of
your organization or the female condom programming;
4. Their participation in programming focused on HIV/Aids
control and/or sexual and reproductive health and family
planning;
5. Their past collaboration with the implementation
organizations involved.
25 Refer to the chapter 1: Process for more information on data collection to inform the design of your female condom program. This data may also be applicable to your advocacy strategy.
26 For more information on defining SMART advocacy objectives, please refer to: Networking for Policy Change: An Advocacy Training Manual by POLICY (January, 1999), page III-28. http://www.policyproject.
com/pubs/AdvocacyManual.cfm.
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You should have a clear understanding of the decision making
processes in your country27: in some countries, all decisions are
made in national ministries which give orders to their localized
ministries. Alternatively, in other countries, the decision making
power lies with the decentralized ministries or parliaments.
In addition, you should anticipate decision making moments
so that you can plan well in advance in order to influence the
outcome of the decision making process. For instance:
In country X, the national Ministry of Health revises the national
condom strategy every 5 years, starting the process two years
before the current strategy ends.
In this case, you know when to start your advocacy (at least
2 years before the strategy ends). At the same time you need
to know how the government facilitates this revision process:
is it open to civil society participation? Or is the new strategy
written without any consultations?
Or:
In region Y of country X, the local Ministry of Health drafts the
annual plan and budget for the public health facilities in that
region in October of each year.
In this case, you need to target the local Ministry of Health
before and around October to have it include female condoms
in the plans and budget for the public health facilities.
Knowing who is the ultimate decision maker and when decision
are being prepared and taken will help you to identify your
target and plan the timing of your advocacy efforts.
Global Campaigning for Female Condoms
Zawadi Smartlove travels all over the world to tell people about
the importance of the female condom. Zawadi is a paper doll,
and there are thousands more like her. She is the heart of the
Female Condom Paper Doll campaign of the Universal Access
to Female Condoms Joint Programme. The campaign aims to
combine awareness-raising in different countries and advocacy
efforts at national and United Nations level.
People from all over the world write down their message
demanding female condoms on Zawadi paper dolls. These dolls
are then collected and made into a long chain, representing
4. Build support
Advocacy is not a process that should be executed in isolation.
Finding supporters strengthens the advocacy message and
increases the credibility of the organizations that are advocating
for your cause. Supporters can be found in women’s groups,
youth groups, men’s groups, among parliamentarians, health
practitioners, community leaders, gatekeepers and the
program’s peer educators. Choosing the right people with the
appropriate networks and contacts will contribute to reaching
out to policy makers and other influential leaders. Members
of the advisory board or the steering committee may fulfill this
role, as well as the executive directors of the organizations
involved. Every person or organization has certain skills,
contacts, and expertise that complement others.
In the advocacy network, it is recommended to come up with
a joint advocacy strategy to maximize impact and to avoid
a variety of messages being delivered to decision makers.
There may be challenges, too: people and organizations in
your network may have conflicting ideas or expectations of
the advocacy process. You may avoid conflicts by making
agreements amongst each other before starting your advocacy
strategy together.
You may also find support among influential independent
individuals in society, who have access to decision makers and
are willing to support your cause publicly. These people are
often referred to as “champions”; they may be First Ladies, exmembers of parliament or government, or religious leaders.
18
Local advocacy
Once an NGO has gathered 50 messages or more, they are sent
back to the Netherlands, from where the campaign is organized.
However, before the dolls are sent back, they can be made into
a chain and a ‘fare-well party’ can be organized after inviting
local stakeholders, politicians and the media. This provides
an advocacy moment and an opportunity to ask local leaders
to write a commitment concerning female condoms on a doll.
It also provides a good photo opportunity for the media as the
dolls make a beautiful colorful chain.
International advocacy
An initial collection of 400 Zawadi paper dolls from over 20
countries were presented at the United Nations High Level
Meeting on HIV/Aids in New York in June 2011. This collection
was used to bring the demand for female condoms to the
attention of world leaders. The complete collection of dolls
comprising of more than 4,000 dolls will be presented at the
‘Prevention, Pleasure and Protection’ International Conference
on Female Condoms in The Netherlands in November 2011
where they will be presented to UNFPA, the Dutch politicians
and others.
Local awareness raising
The NGOs participating in the campaign use the paper dolls
in their sensitization and awareness- raising meetings. The
participants of such meetings can then have an active role
by writing their message on a paper doll knowing that these
messages will be presented to local as well as international
IPPF (2009), Generating Political Change, using advocacy to create political
A participative campaign
Local NGOs were not only asked to use the dolls in awareness
raising and sensitization meetings. Because the paper dolls
were designed taking into account input from NGOs from
different parts of the world, the dolls are, in this way, ‘owned’
by them. The names of the dolls – three women and one man
– were also proposed and voted on by the participating NGOs
and on Facebook. Representatives of participating NGOs spoke
at the event at the United Nations in New York. These and other
forms of participation have been used to strive for ownership of
the campaign by its participants.
Examples of local advocacy in the Paper Doll Campaign
ACORD/Oxfam
Rwanda
ACORD group with the paper dolls
ACORD organized female condom education sessions (using
the Paper Doll Campaign as the occasion) with rural community
leaders. ACORD also integrated advocacy for female condoms
into ACORD’s on-going programming on HIV/AIDS in the
workplace. ACORD’s work with SIPETRA, an organization serving
street children exposed to HIV and unwanted pregnancies,
generated some powerful messages on the dolls that can be
used in advocacy as illustrations of the urgent need for female
condoms. For example the message: “The female condom could
help me when I’m still alive, it could help me to protect me from
HIV and unwanted pregnancy”. This message was written by a
15 year old girl living on the street and frequently engaging in
survival sex.
the worldwide demand for female condoms. The strings of
dolls send the powerful message that there is a great demand
for female condoms, from people all over the world. Female
condoms can help to solve two of the greatest challenges the
world faces today: HIV/AIDS and unintended pregnancy.
27 Refer to IPPF (2009) for an example of how to do analyze decision making processes and to assess where you can have influence:
commitment, page 35.
leaders later on. The Paper Doll Campaign now has over 30
NGOs participating, from Argentina, Australia, Cameroon,
Costa Rica, Kenya, Lesotho, Liberia, Mexico, Mozambique, New
Zealand, Nigeria, Rwanda, South Africa, Tanzania, Thailand,
United Kingdom, United States of America, Venezuela and
Zimbabwe.
SafeGuards LGBT Health Project
U.S.A.
Dutch parliamentarian Kathleen Ferrier at a female condom event in
New York
In 2011, the city of Philadelphia launched a city-branded
condom promotion project (like New York City’s successful
NYC condom campaign). The SafeGuards LGBT Health Project
advocated vigorously for the inclusion of female condoms in the
city-wide campaign. The Philadelphia Health Commissioner said
he hadn’t even considered this possibility before SafeGuards
raised it – but information about the use of the female condom
is now available on the campaign’s website and free female
condoms can be picked up from two city Health Centers.
19
Health and Opportunity Network (HON)
Thailand
MUSAS
Venezuela
The one minute message:
STATEMENT + EVIDENCE + EXAMPLE + ACTION DESIRED
Statement. In a couple of strong sentences, you express the essence of your message
Evidence. The statement should be supported by facts and/or figures to show the importance and urgency of the problem.
Example. Facts are important but also abstract. You should add a human face to your story, which can be an anecdote based
on a personal experience.
Action desired. Explain what the decision maker should do. It should be an invitation to act!
Participant of paper doll event organized by HON
The Health and Opportunity network organized a paper doll
event to bring the demand for female condoms to the attention
of the Mayor. Mr.Itthiphol Kunpuome, mayor of Pattaya City in
Thailand, attended the event and wrote a message on a paper
doll expressing his support for female condoms.
5. Develop your message
Your advocacy message should be adapted to every specific
target audience. Messages should ideally link to wider policy or
public debates. You may do this by taking a specific angle that
will allow you to connect the female condom to a wider debate
e.g. by demonstrating how the female condom is complementary
to the male condom, by discussing the involvement of men as
partners and role models, by addressing the empowerment of
women to negotiate and use the condom, by emphasizing the
importance of the integration of the female condom into existing
HIV/Aids and sexual and reproductive health initiatives, or by
advocating for the involvement of specific populations like
people living with HIV/Aids, youth or women. Depending on the
current policy debates and developments, your message may
be more specific. Advocacy messages should always demand a
policy change.
There are different kinds of messages that will enable you to
reach your objectives and overall goal. This depends on the
level of support of the target audience:
You can use sensitization messages to reach those decision
makers who do not know much about the problem, or the
solution, or to what extent he/she has an influence in changing
it. It is not likely that this category of decision makers will
support female condom promotion. Therefore, your messages
should be more descriptive but nonetheless convincing and
MUSAS made a full-page statement in nationally circulated
print media about the importance of the national government
implementing a program of access to female condoms and other
actions. The coordinator of MUSAS also discussed the Paper
Doll Campaign and the female condom on a live television
program. Photos of this are posted on Zawadi Smartlove’s
Facebook page.
supported by evidence. Factsheets or sensitization meetings
are helpful. You may also involve media in this sensitization by
publishing items about the female condom. 28
Let the facts speak for themselves: the facts and figures
on female condom programming’s effectiveness and
its relation to achieving the MDGs will take away the
prejudices people may have regarding female condoms.
These facts can be used in one-minute messages to
decision makers to influence their perception on the
importance of female condom use and programming. After
learning about the facts, the only conclusion to draw is that
political and financial support to make female condoms
accessible to all is urgently needed!
The facts:
• The feminization of the HIV/AIDS epidemic is a fact. In
sub-Saharan Africa, 61 percent of adults and 75 percent
of young people infected with HIV/AIDS are female. 29
• HIV/AIDS is a leading cause of mortality worldwide,
with an estimated 2.1 million deaths in 2007. 30
• Investment in prevention will reduce the number of
new HIV/AIDS infections and, consequently, reduce the
cumulative growth in the number of people in need of
(far more expensive) anti-retroviral treatment. 31
• UNFPA estimates that there are around 200 million
women worldwide who would like to limit or plan
the number of children that they have, but who are
nevertheless not using any form of contraception. 32
• WHO estimates that, in developing countries, more than
one-third of all pregnancies are unintended. 33
• A fifth of those unintended pregnancies are being
aborted, more than half of those by unsafe means. 34
• Unsafe abortions cause five million women to be
hospitalized each year, and account for 13 percent of
maternal deaths. 35
• Global contraceptive prevalence has increased to 64
percent in 2005, whereas it remains low in sub-Saharan
Africa at just 22,8 percent. 36
• Condoms—male and female—are currently the only
available technology that gives users simultaneous
protection against unwanted pregnancy and Sexually
Transmitted Infections (STIs), including HIV/AIDS.
• Throughout the developing world, an individual has
easier access to anti-retroviral treatment than to a
reliable supply of female condoms. 37
• For every person who is put on anti-retroviral
treatment, another two new HIV/AIDS infections occur. 38
• Long experience in family planning shows that
increasing the choice of available contraceptive
methods leads to increased uptake and more consistent
and continued overall contraceptive use. 39
Manu Dibango, Jazz artist from Cameroon, is supporter of the UAFC Joint
Programme
29 UNAIDS Global Report Factsheet, page 2, http://www.unaids.org/documents/20101123_FS_SSA_em_en.pdf
When the decision makers or policy actors have gained more
understanding of the problem and your advocacy goal, you may
start to convey messages with a specific ‘ask’. You will need to
let them know how they can take action. The elements of a oneminute-message (or elevator pitch) may be helpful:
30 UNAIDS Global Report 2010, page 19,
http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf
31 UNFPA Contraceptives save lives factsheet, page 1, http://www.unfpa.org/webdav/site/global/shared/safemotherhood/docs/contraceptives_factsheet_en.pdf
and Adding it Up : The Cost and Benefit of Investing in Family Planning and
32 Maternal and Newborn Health. Guttmacher Institute/UNFPA, 2009, https://www.unfpa.org/public/global/publications/pid/4461
33 WHO and the Guttmacher Institute, Facts on induced abortion worldwide, page 2, http://www.who.int/reproductivehealth/publications/unsafe_abortion/abortion_facts.pdf
34 WHO and the Guttmacher Institute, Facts on induced abortion worldwide, page 2, http://www.who.int/reproductivehealth/publications/unsafe_abortion/abortion_facts.pdf
35 WHO and the Guttmacher Institute, Facts on induced abortion worldwide, page 2, http://www.who.int/reproductivehealth/publications/unsafe_abortion/abortion_facts.pdf
36 Data from Trading Economics available at http://www.tradingeconomics.com/sub-saharan-africa/contraceptive-prevalence-percent-of-women-ages-15-49-wb-data.html
37 As of the end of 2007, approximately 31 per cent of people in need of anti-retroviral treatment in developing nations were accessing it (data.unaids.org/pub/PressRelease/2008/20080602_treatment_
report_en.pdf). By comparison, in 2007 roughly 22 million female condoms were distributed to less-developed countries with a combined population of approximately 1.4 billion women aged 15ñ49 (esa.
un.org/unpp/index.asp?panel=2). This is equivalent to 1.6 per cent of those women each having access to a single female condom.
page 5, http://www.unaids.org/globalreport/documents/20101123_GlobalReport_full_en.pdf
39 Fontanet AL, Saba J, Chandeling V, et al. Protection against sexually transmitted diseases by granting sex workers in Thailand the choice of using the male or female condom: resuilts from a randomized
controlled trial. AIDS 1998; 12 (14): 1851-59
38 UNAIDS Global Report 2010,
28 Based on IPPF (2009), Generating Political Change, using advocacy to create political commitment, page 12.
20
21
Example of a one-minute message about the female condom:
“Female condom programming is important for the health
and well-being of our population and urgently needed. In our
country, one out of every twenty people is infected with HIV/
Aids. Each day, 100 unintended pregnancies occur. The female
condom protects against HIV/Aids as well as unintended
pregnancy. The provision of female condoms would thus help
to keep our population healthy, but is not yet widely available.
Zawadi, a woman who visits our clinic, recently found out that
she is HIV-positive, while her husband is not. She finds that
her husband does not like to use male condoms, but he is not
opposed to female condoms. So they use them, but they are not
regularly available. This increases the risk of infection with HIV/
Aids as well as unintended pregnancy. We need to protect our
population and you could play an important role in achieving
this. Your support to a higher budget allocation to female
condom procurement and programming would be of great help
and we would like to ask you to share your expertise with us on
the budget process and to support the amendment to the budget
that we are proposing.”
Another way to involve influential people is to have them take
part in the official launch of your female condom program.
Ministry officials, parliamentarians, or members of national
technical or implementing bodies could also be invited to
become members of your program’s steering committee or
advisory board.40
7. Raise funds
The funding of your advocacy efforts should be included
and budgeted for in your overall program design. In specific
cases, additional campaigns that you did not anticipate may be
necessary, which would merit a search for additional funding.
When advocating in a network of organizations and individuals,
you may make agreements on who funds what and how much
when executing the advocacy strategy.
• Analysis of the external environment, including political,
economic, social, and other factors
• Organizing issue identification meetings
• Collecting and analyzing data about the local, national or
regional situation
Keep in mind that the way in which you deliver the message
is as important as the content of the message itself. When
presented orally, the message should be supported with
convincing body language and use of voice. When the message
is written on paper, it should look attractive, the “tone” of the
language and use of sentences should appeal to the target
audience.
6. Channels of communication
Messages may be disseminated in different ways. The channel
you choose depends on what would be most effective to reach
your target audience. As discussed in the previous section, for
the purpose of sensitization factsheets, policy reviews and
informative workshops are a good way to convince decision
makers. When a person that you are targeting is knowledgeable
on the subject already, he or she may alternatively be reached
with specific ‘asks’ in letters and face-to-face meetings.
Decision makers and policy actors need information,
publications and samples of female condoms. They should be
sent or given relevant material about your organizations and
your goals, like an information sheet presenting the cause,
its goals, objectives, and target groups, areas of intervention,
intervention strategies and implementation partners. Face-toface meetings are important to build relationships. Sometimes
it helps to invite foreign guests or media to the meeting to give
the decision makers an opportunity to commit publically. Media
involvement is important in positively influencing opinions
about the female condom of government and the general public.
Therefore, media publications may strengthen your advocacy
efforts by raising public awareness about the importance of the
issue and by holding government accountable.
Meeting in Cameroon with the UNAIDS country representative at which
the importance of the availability of female condoms was discussed and
the UNAIDS country representative expressed his support for the female
condom.
• Identify NGOs, networks, donors, coalitions, civic groups,
professional associations, women’s groups, activists, and
individuals who support the issue and will work with you to
achieve your advocacy goals.
• How do you identify potential collaborators? Members can
attend conferences and seminars, enlist the support of the
media, hold public meetings, review publications, and use
the Internet.
28 Based on IPPF (2009), Generating Political Change, using advocacy to create political commitment, page 12.
22
8. Develop your implementation plan
All of the above steps compiled will result in your
implementation plan, indicating the issue at stake, your overall
goal and objectives, your time frame and budget, who will be
providing support, whom you will be targeting, how you are
going to identify messages and which communication channels
you will use. Specific activities may be added. See Annex 4 for
an example outline of an advocacy plan.
It is important to try and document commitments from decision
makers so you can hold them to account. When a minister
gives a speech about his support of the female condom, you
may publish an article quoting him/her on your website or in
media publications. Crucial in advocacy is the follow-up on
commitments to make sure that they are actually translated into
real actions. Keep reminding relevant decision makers about
your cause, what they may do to contribute, and what they have
committed to.
9. Ongoing steps: Data Collection and Monitoring.
All steps in the advocacy process are to be supported by
relevant data. The environment in which you are executing your
advocacy plan is dynamic. This means that the policy arena
needs to be monitored closely. Also, you need to keep a close
eye on staff turn-over in the government. What is more, new
trends may gain popularity or new factual information may
Advantages of female condom use that you can use in
your message:
a. The female condom offers dual protection, against
unwanted pregnancy as well as STIs, including HIV/AIDS.
b. Women have greater ownership over their own
contraception when using the female condom as they
themselves can initiate its use.
c. There is considerable flexibility regarding the timing of
inserting the condom and taking it out.
d. Within each sexual relationship, the use of the female
condom has to be negotiated just once. Once the male
partner agrees to its use, the woman can insert it herself
before sex. Some male partners may prefer to hand over
responsibility for protection to the woman.
e. Men often prefer female condoms because they have a soft,
moist texture that feels more natural during sex. Also, an
erect penis is not a precondition at the moment of insertion.
f. Nitrile condoms have the added benefit of a lack of smell
and are suitable for people who are allergic to latex.
g. For some people, the female condom offers additional
sexual pleasure.
come up that requires you to adapt your original plan to fit the
new situation. You should check your progress on your shortterm objectives bi-annually. If necessary, you may have to adapt
your short-term objectives to the changing circumstances that
your monitoring assessment may reveal.
10. Evaluation
Evaluating advocacy is difficult: you cannot know for sure if
a policy has been changed due to your efforts alone. There
are new trends in evaluating advocacy, which look at other
outcomes apart from the policy outcomes.41 At the start of your
advocacy process, you should identify indicators that allow you
to evaluate your progress a couple of years later. Examples of
indicators are:
•
•
•
•
•
Level of funding for female condoms increased
# of decision makers or policy actors reached
# of public commitments of decision makers or policy actors
# of occasions in which you participated in policy dialogue
# of media articles published which are calling for policy
change
For more information on advocacy strategies, please visit the
following website:
http://www.policyproject.com/pubs/AdvocacyManual.cfm
h. Among women using female condoms, qualitative studies
demonstrate an increased sense of empowerment in
negotiation for safer sex and a greater sense of control and
safety during sex.42
i. Effective female condom programming enables
women, men and health professionals to gain a better
understanding of women’s bodies and a greater ability to
discuss sexuality and safer sex.
j. Female condoms have the advantage of not having any side
effects, they provide a reversible form of contraception, and
can be used without interference by a healthcare provider.
k. Unlike latex condoms, synthetic female condoms are not
sensitive to damaging by oil-based lubricants, nor are they
affected by changes in temperature and humidity so they
can be safely stored almost anywhere. Please note that both
the Cupid and the Dr. Reddy / VA w.o.w. condom are made
of latex! Oil-based lubricants and changes in temperature
and humidity therefore affect those specific female condoms
in the same way as male condoms!
41 The publication of IPPF (2009) refers to good literature in this field. IPPF (2009), Generating Political Change, using advocacy to create political commitment, page 13.
42 Gollub EL. The female condom: tool for women’s empowerment. American Journal of Public Health 2000;90(9):1377ñ81.
23
3.2 Preparing to advocate: Advocacy Asks
The following information was compiled to support
advocates that participated in the Paper Doll Campaign, in
which 40 organizations from 20 countries came together to
raise awareness and advocate for the female condom using
paper dolls on which messages about the female condom
were collected. Advocacy is all about changing the minds
of ‘gatekeepers’ and get them to take action in favor of your
cause. ‘Advocacy asks’ will help you to achieve this. You can
present your advocacy ask during a meeting with a ‘gatekeeper’
or during an event at which a ‘gatekeeper’ is present. A
‘gatekeeper’ may be a local leader, someone from the Ministry
of Health, a procurement agency, or a representative from a
health clinic.
To advocate effectively, it is important to have a detailed idea
about what a specific gatekeeper may do to help out advancing
your cause. What is their sphere of control? What can they
realistically do to make female condoms accessible and
affordable?
Step 1: Identify what the gatekeeper can do to make female
condoms accessible and affordable.
E.g. A Ministry of Health official may be able to help you to
make female condoms available in hospitals and government
clinics. Alternatively, an organization involved in the Country
Coordinating Mechanism for the Global Fund to Fight Aids,
Tuberculosis and Malaria may be able to include female condom
procurement and programming in their proposal to the Global
Fund.
infection prevalence of 5%. That means that currently 50.000
people are living with HIV/AIDS. Also, families in our region have
problems regarding family planning: ‘spacing’ their children is
proving a challenge, which results in families not always being
able to provide for all of their children. That is why we want the
female condom to be available. It protects against HIV/AIDS
infection as well as unintended pregnancy. In our community,
there is a girl called Zawadi. She was in school and wanted to
be a nurse when she grew up. Then she got pregnant and had to
leave school to take care of her baby. She cannot be a teacher
now. She had no means to protect herself from pregnancy.
There are many girls in our community who do not finish school
because they become pregnant early. The female condom is
female-initiated, which means that couples have more options
for protection. The Ministry of Health needs to make female
condoms available in government clinics and educate our
community about female condoms so that we can better protect
ourselves and live in a healthier community.
The next step is to inform the gatekeeper and persuade him/her.
Step 3: Give a persuasive presentation about the need for
female condoms and state your ask.
The available Powerpoint presentation may be used to inform
the gatekeeper about the female condom. It includes notes and
can be found at: http://www.condoms4all.org/document/461.
You can add a slide and put the core of your ask on the slide.
E.g. We need the help of the Ministry of Health to keep our
community healthy by making the female condom available in
government clinics and by educating people in our communities
about the use of the female condom.
The next step is to formulate your ‘advocacy ask’:
Step 2: Formulate what you want the gatekeeper to do exactly:
a. Make sure your ask is simple and straightforward: it is better
to have one clear ask instead of confusing the gatekeeper
with many different requests.
b. Include convincing data to support your message, e.g. the
number of unwanted pregnancies and HIV/AIDS infections
in your region that may be significantly decreased by the
successful female condom programming.
c. Include an anecdotal example of a local situation: this will
stick to their minds and help them to remember you.
d. Make sure that the gatekeeper knows what you want him/her
to do.
e. Make sure to practice delivering your message! You may
ask colleagues to role play with you. Do they think your
message is clear and convincing? What do they think can be
improved?
Example of a message targeting a Ministry of Health:
We want female condoms to be available and affordable in
our region (name region). In our region, we have an HIV/AIDS
24
Response of the gatekeeper: If the gatekeeper expresses any
commitments, such as that he/she will talk to his/her boss
about your idea, it is important to follow up with them. If the
gatekeeper makes no concrete commitments, but expresses
support, this is also a good outcome as you can mobilize this
support later on.
Step 4: Make an appointment.
It is important to make an appointment right away about when
you will be in touch again to find out whether the gatekeeper
has followed up on his/her expressed commitment. In case of
an expression of support, you can make an appointment to talk
about how this support can lead to increased access to female
condoms: what action can you take together?
Step 5: Follow up: move the gatekeepers into action
From this point on, it is important to be persistent when you
follow up on the commitments made. This is an important
part of your work: to make sure that gatekeepers stick to their
commitments, you will have to be diligent to get real results. It is
very inspiring to see real change in your community as a result
of your advocacy efforts and it will very much benefit your
community if you do!
Countering misconceptions and prejudices about the
female condom
Everywhere in the world, prejudices against female condom
use exist. It is important to adequately address those
prejudices, because they form an obstacle on the road to
achieving universal female condom access.
So do you think the female condom is:
• Noisy?
FC1 was made of polyurethane and made some crunchy
noises. In Zimbabwe, this fact was successfully incorporated
in a female condom slogan: “the female condom only makes
noise if you are with a real man”. The new FC2 that is now
used in most female condom programs is made of nitrile and
does not make any noise. (Show with FC2)
• Ugly?
When you saw a male condom for the first time, did you
think it was pretty? No. You had to get used to it. Most
probably, this is the first time you are seeing a female
condom. However, by using it more often you will start
viewing it as just another product that can be used by
everyone.
• Too expensive?
Yes, we think so too! Therefore we are working very hard,
together with many partners all over the world to advocate
for a cheaper female condom. The FC2 female condom
is now 0,60 dollar cents at procurement price. When
demand for the female condom increases, so will market
competition. And by having more female condom models on
the market, the price will eventually decrease. However, the
cost of the female condom should not strictly be compared
to the price of the male condom but, rather, to the price
The Advocacy Manual from The Policy Project was a great help
to set up this two-pager. For more examples and information on
steps, please refer to:
http://www.policyproject.com/pubs/advocacy/English/
Policy%20Proj%20Sec%20III-4.pdf
of HIV/AIDS treatment and unintended pregnancy. In that
comparison, the female condom is a real bargain!
• Unsafe?
There have been rumors that the female condom is not
safe. The opposite is true. The female condom is made
of a very strong material and therefore difficult to break.
It also protects the vagina on the outside. It needs to be
highlighted that the female condom offers perfect dual
protection: against unintended pregnancy and sexually
transmitted infections, including HIV/AIDS.
• Not accepted?
Studies have repeatedly shown high levels of
acceptability of the female condom. 41 studies of the
FC1 showed acceptance levels ranging from 41 percent
to 95 percent. In 2006, reviewers of 60 acceptability
studies recommended that research on the female
condom must move away from assessing acceptability
and focus on assessing effectiveness and improving
impact in settings.
• Difficult to use?
It is true that inserting the female condom and
using it requires some practice. Just as is the case
for the male condom, it is recommended that you
familiarize yourself with the use of the condom
before using it during intercourse. Thus, we
ask people to try it the first time when they are
by themselves and have some time to practice
insertion. That way you will feel more secure when
you are trying it together with your partner. When
trying it with your partner, you allow yourself the
opportunity to get used to the condom and to try it
again even if the first time is a bit uneasy.
E.g. A Ministry of Health representative states that he/she is
aware of the advantages that female condom use offers and
will talk with the head of the HIV/AIDS division about providing
female condoms. After the statement, talk to the representative
and set a date for your next meeting. For example, agree to come
see him/her in his office in two weeks’ time.
25
4. Doing Media Advocacy
4.1 Introduction
The ability to engage with the media and
get more people to learn about your issues
and perspective is an important piece of
any advocate’s tool box. The International
Women’s Health Coalition (IWHC) has
developed a media advocacy tool kit
to give sexual rights and reproductive
health advocates the resources needed
to develop an effective media strategy as
you plan your work. Originally created for
our Advocacy in Practice trainings, IWHC
is collaborating with Universal Access to Female Condoms Joint
Programme to make the toolkit available to advocates working
to increase access to female condoms.
Advocates for female condoms face some unique challenges
when working with the media. Most media coverage begins
with negative comments about female condoms –their price,
noisiness, and the assumption that there is no demand for the
devices. When you engage with journalists to promote female
condom initiatives, be prepared to meet these biases head
on. Talk about the positive steps your organization, policy
advocates, or grassroots groups are taking to make universal
access to female condoms a reality. The facts provided
elsewhere in the UAFC toolkit serve as an excellent basis for
talking points. Know this information well so you can return to it
when an interview gets challenging.
This media advocacy kit includes best practices for pitching a
story to a reporter, writing press releases (with good and bad
examples), tips for succeeding in an interview, plus information
about making your own media, including blogs and online
videos. We hope it helps move your advocacy efforts forward!
Press Release
A press release is a pseudo-news story, written in the third
person, which seeks to demonstrate to an editor or reporter the
newsworthiness of a particular event, person, service, product
or point of view.
What Should I Put In My Press Release?
• Be “newsworthy” The purpose of a press release is to
inform the world of your news item. A good press release
answers all of the “W” questions (who, what, where, when
and why), providing the media with useful information about
your organization, issue or event.
• Start strong. Your headline and first paragraph should tell
the story. The rest of your press release should provide the
detail. You have a matter of seconds to grab your readers’
attention. Do not blow it with a weak opening.
• Write for the Media. On occasion, media outlets, especially
online media, will pick up your press release and run it
in their publications with little or no modification. More
26
•
•
•
•
•
•
•
•
•
•
commonly, journalists will use your press release as a
springboard for a larger feature story. Develop a story as you
would like to have it told.
Not everything is news. Present new facts about the issue,
not existing information.
Stick to the facts. Tell the truth. Avoid fluff, embellishments
and exaggerations.
Pick an angle. Try to make your press release timely. Tie
your news to current events or social issues if possible. Make
sure that your story has a good news hook.
Use active, not passive, voice.
Economics of words. Use only enough words to tell your
story. Avoid using unnecessary adjectives, flowery language,
or redundant expressions such as “added bonus” or “first
time ever”.
Beware of jargon. Only use words that are known to the
general population, do not use abbreviations or words that
are specific to your sector.
Avoid the hype. The exclamation point (!) is your
enemy!!!!!!!
Get Permission to use quotations from other people or
materials from other organizations.
Tell the reporter about who you are. Include information
about your organization (boilerplate). Your press release
should end with a short paragraph that describes you.
Target reporters and editors to whom the release will be
relevant. If your release is about international news, make
sure it ends up in the right person’s hands, not the hands of
the editor of the arts and entertainment section.
4.2 Letters to the Editor
• When: Letters to the editor respond to articles that the paper
recently published. They are time sensitive, and you should
draft and send as quickly as possible.
• Keep it short. Most letters to the editor are 200 words or less.
If you keep it within the paper’s word count there is less of a
risk of your piece being drastically edited to mean something
other than what you intended.
• Make a single point. A letter to the editor is not the time for
nuance or complex, multilayered arguments.
• Directly reference article you’re responding to. The subject
of the email should be formatted: “Re: Article Title, date.”
• Don’t title it. This is the editor’s job. You’re wasting your time
thinking of something clever that will just be replaced.
profit, politician, or person with a leadership affiliation with
an organization of significance.
• Although an op-ed typically has only one person’s name on
it, they are usually written and edited by a number of people.
Collaborative op-eds can be a good way to build coalitions.
• Op-eds are usually between 500-750 words, and should be
pitched to the editor before submitted in whole.
A few more tips:
• Use short sentences and avoid jargon.
• Make your position strong and clear: explicitly oppose or
support something. Feel free to use anecdotes or personal
stories in the op-ed.
• Link an op-ed to something that’s currently in the news
• Follow the submission guidelines provided by the
publication.
• For more tips on writing op-eds and examples, visit: http://
www.dukenews.duke.edu/duke_community/oped.html
4.4 Pitching a story
Tips:
• Get to the point: If you don’t know the reporter, you will
have about 30 seconds to get her/his attention. Get to the
point quickly. Know the answer to the question “why should
this reporter be interested” and tailor your pitch accordingly.
• You’re on the record: Remember that anything can be
quoted in isolation, so think through everything you say and
consider how it might be used.
• Be ready: Have your talking points and your facts in front of
you, including contact information for spokespeople so you
don’t sound disorganized.
• Be specific: Don’t say “we are doing interesting things.”
Instead, say “we have a new report that found a higher
uptake of female condoms in our region in 2010 than in any
previous years.”
• Be honest: If you don’t know the answer to a question, don’t
lie. Tell them you will try and find out the answer and call
them back. Anything you say is on the record so choose your
words carefully—“I have to double-check that, is it ok if I call
you back?”
• Respect deadlines: Much of media outreach is best made
in the morning or early afternoon when reporters are not
on deadline—always ask if they are on deadline before you
begin. If they are, ask when a better time would be to talk to
them.
• Make it newsworthy: Tie the story to something timely
or newsworthy: “As you know, world leaders are gathered
at the UN this week for the Commission on the Status of
Women. One of the things they’re considering is XXX which
would mean XXX…”
• Be helpful: Provide them with all of your contact
information and always offer additional information or
background info. If the questions they are asking are out of
your area of expertise, offer to link them with a colleague
who can answer their questions.
• Practice: Write out what you’re going to say or practice it
with a colleague.
• No: If a reporter says no, respect that. It doesn’t mean you
can’t try to get them to cover something else in the future, but
do not keep pitching them with the same story or angle.
Female condom advocate showing a female
condom to a journalist
4.3 Writing an Op-Ed
• Where: Most daily and weekly newspapers accept outside
submissions for publication on their opinion pages.
• When: Op-eds are written by experts to offer their
perspective in response to a topic that is being actively
debated. Doesn’t need to respond to a particular article, but
should have a current news hook. Often newspapers publish
op-eds on multiple sides of an issue.
• Writer should be an academic, executive director of non-
27
Who to Pitch: Developing a Press List
• Press lists are available for purchase – depending on the
reach you want, and the budget you have, this may be an
option.
• Look at bylines in articles you read about sexual rights and
reproductive health and HIV/AIDS, add these journalists to
your press list, with notes about their angle.
• Keep track of all journalists from whom you get media
inquiries, record their contact info and make brief notes
about their approach, the beat they cover, etc.
• When adding a journalist or editor to your list, include: full
name, title, beat, email, fax, phone, time zone, best time and
best way to contact.
• When you send press releases, send to staff/freelance
journalists as well as editors.
• Familiarity with your local media landscape is your best
asset in learning about who is out there and may be
receptive to your message.
• Do not assume that a complex story will be reported
accurately. In fact, assume the opposite.
• If you fluff an answer, re-state it correctly.
• Do not speculate, joke or be sarcastic.
• Give positive messages to any negative questions.
• Immediately and politely refute any untrue statements.
• Do not guess at an answer. Say you don’t know and will call
them back.
• If a reporter should interrupt you in mid-sentence, do
not acquiesce. When he finishes, continue with “As I was
saying…”
• If a reporter asks a series of rapid-fire questions, answer the
one question that will strengthen your point. Do not attempt
to respond to them all.
• If a reporter should use hostile or negative language, defuse
the situation by a positive statement and say something like,
“Let’s not get off the important message here...”
• Do not lose your temper, become angry or try to debate a
journalist. You won’t win.
• When possible, it’s good to have a picture at the top of the
blog post – images attract attention even if they aren’t a
perfect illustration of what the post is about.
Writing Blog Posts
• Make it current. Blogging is very much an “of the moment”
phenomenon, and people typically are not as interested in
reading older posts.
• Make it conversational. While your post may include
straight reporting, commentary and analysis, think of
your blog as a conversation between you and the reader.
A story or anecdote can connect the reader to a tough or
complicated issue.
• Make it personable. Give your opinion on the subject
you’re writing about. Unlike journalistic pieces, blog posts
are very much about the author’s personal perspective and
personal opinion.
• Add links and photographs. These give readers additional
resources and another way of thinking about your subject.
• Spell out acronyms and avoid jargon. For example, use
“World Health Organization (WHO)” the first time you
mention it in your piece, then “WHO” afterwards. Do not
assume the reader will understand technical terms, such as
“microbicide”.
• Make it short. Posts are generally 500-700 words long.
Readers have a short attention span online and will not read
posts over 1,000 words.
• Make it clear and clean. Write it in simple language,
proofread and factcheck your own work. Avoid personal
attacks, which are generally not acceptable in blogs.
• Go viral. Once your article is published, forward it to your
network in order to increase its visibility and promote your
work. Post it on your Facebook or MySpace page.
4.5 Being interviewed
Before the interview:
• Media calls and requests need immediate responses.
• Check on what the reporter has previously written before
talking with them.
• Questions to ask the Reporter:
• What is your name, outlet, when are you writing for, and
what is your deadline?
• What were you thinking I would contribute to your story?
• What is the angle of your story?
• Are you looking for background for your story or a direct
quote?
During the Interview:
• Once you agree to an interview, anticipate a reporter’s
questions and formulate effective answers.
• Narrow your message to three or four key points and stick to
them.
• The interview is “on” as soon and as long as you’re talking to
a journalist.
• EVERYTHING you say is on the record. If you do not want it in
the story, do not say it.
• Mention your organization at least twice.
• Be confident. Take charge in the beginning. You definitely
know more than the reporter.
• Always advance YOUR story or point of view.
• Enhance the chance that you’ll be quoted by offering
arresting facts and colorful, descriptive anecdotes.
• Use statistics but do not get mired in them.
• Use active verbs, complete sentences and positive phrases.
• Clear, simple sentences are the most effective.
• Be pointed and concise. Move quickly through each point
and don’t ramble.
• Avoid jargon and explain all abbreviations if you have to use
them.
• Do not make your story too complex or overloaded.
28
4.6 Making your own media
With the decrease in news outlets’ budgets for in-depth
coverage of international issues, many advocates are beginning
to see the value of producing their own coverage on the
Internet, via blogs and short videos. Online media advocacy can
be a great way to connect directly with other advocates and is
the best way to control the message – you can’t be misquoted if
you’re the one making the statement and doing the editing.
Blogging on Sexual and Reproductive Rights and Health
What is a blog? A blog, or a “weblog,” is a short article or commentary
published on the Web in the author’s own site or that of
others. The power of weblogs is that they allow everyone to
have a voice. They allow millions of people to easily publish
and promote their ideas, and millions more to comment on
them. Many blogs are highly influential and have enormous
readerships, while others are intended for people to write for a
small audience on a specific issue or interest.
Society for Women and AIDS in Kenya (SWAK)
Kenya
Alice Machichi wrote an article called “Women Need Female Condoms Now” for the Key Correspondants Network, an
independent team of 250 citizen journalists in 50 countries that is supported by the International AIDS Alliance. You can find it
here: http://www.keycorrespondents.org/2011/10/10/women-need-female-condoms-now. The article describes her use of the
UAFC paper doll campaign in education about FCs in a Kibera slum in Nairobi. The article, posted on the KC blog has elicited
several comments and was listed at the “Editor’s Choice” shortly after posting.
Characteristics of blogs:
• Blog posts (or entries) are published on a regular and often
frequent basis (sometimes even several times a day). Posts
have a headline—just as newspaper articles do.
• The body of the blog post is short (200-500 words) often
conversational in tone.
• Instead of footnotes or references, blogs almost always
include links to other relevant information on the Web.
• They most usually provide the opportunity for readers to
post comments—a way that readers can respond to what
has been said. This is an important part of blogging, which is
much more conversational than print media. As soon as you
write something, your readers have a chance to respond to it.
• Each post has a time and date so that readers know how
recent the post is.
29
5. The International Advocacy Platform
for Female Condoms
Universal Access to Female Condoms
(UAFC) Joint Programme
This platform is a collective of organizations and individuals
that are advocating for availability, accessibility and
affordability of female condoms.
The UAFC Joint Programme started in 2008 with the aim of
making female condoms accessible, affordable and available
for all. Thus it would contribute to a decrease in new HIV
infections, STIs and mistimed and unintendedpregnancies and
enable women to exercise power over their own sexual and
reproductive health.
The aim of the platform is to broaden and strengthen the
support base for female condoms, share knowledge and
expertise among actors, and solicit explicit commitment.
The programme donors are Danida, the Netherlands Ministry of
Foreign Affairs, The William and Flora Hewlett Foundation, Sida,
Oxfam Novib and Norad (for 2008).
http://www.condoms4all.org
The programme is an initiative of Oxfam Novib, Rutgers WPF, i+
solutions, and the Netherlands Ministry of Foreign Affairs and
consists of three components:
1. Research and Development, including procurement,
2. Large-scale female condom country programmes in Nigeria
and Cameroon, implemented by the Society for Family
Health (SFH) and ACMS respectively, in cooperation with
other civil society organisations, the government, UN
agencies and the private sector and supervised by a national
steering committee and
3. International advocacy, Linking & Learning and
Communication.
The platform’s objectives are:
• To generate maximum attention for the female condom at all
decision making levels
• To exchange information and know-how
• To share lessons learned and best practices
• To achieve optimal coordination of international advocacy
efforts
• To give credibility and ‘the power of numbers’ to advocacy
efforts
• To support each other in our strive for female condoms
Platform members communicate via a ‘list serve’ on which they
share information and ask for input, as well as through regular
conference calls. In these calls they strategize about upcoming
advocacy opportunities, such as the International AIDS
Conference (IAC).
If you are interested to join the advocacy platform, please send
an email to [email protected].
30
UAFC International Advocacy Platform at the Platform meeting in
Amsterdam, 2009
31
Annex 1 Questions and Answers
for Female Condom Advocates
Which developments in the field of female
condoms are on their way?
Why should the female condom be universally
accessible?
The female condom offers women and men dual protection.
The female condom protects against all sexually transmitted
infections (also on the outside of the vagina), including HIV/
AIDS. Furthermore, it prevents pregnancy. 215 million women in
developing countries would like to use contraception but have
no access to it.
The female condom contributes to meeting international
commitments on development. The Millennium Development
Goals (MDGs) on maternal and child mortality and morbidity
rates, as well as HIV/AIDS will not be attained if existing
technologies, such as the female condom, remain out of reach
for those women who need it.
Gender inequality is an important driver of the HIV/AIDS
epidemic. The feminization of HIV/AIDS has become a reality.
Women make up considerably more than half of the 33 million
people worldwide that are currently infected with HIV/AIDS.
In Sub-Saharan Africa, 76% of HIV-positive youth are female.
Women and girls face the consequences of unprotected sex and
bear the huge burden of unwanted pregnancy and the risk of
infection. The female condom is the only device that offers dual
protection, is female-initiated and is available now. Universal
access to female condoms should therefore be a priority.
by the World Health Organization. WHO qualification is needed
as a prerequisite for UN organizations, which is the most
important distributor of female condoms. If other condoms
are tested and approved by the World Health Organization,
there will be more competition between the manufacturers of
condoms. More competition will lead to lower prices of female
condoms and thus wider availability.
What models of female condoms are available?
The Dr. Reddy condom and the Cupid condom have approval
from the European Commission, but not yet from the World
Health Organization. If we are successful in advocating for
the testing of these condoms at national Food and Drug
Administrations or at the World Health Organization, they
will become much more widely available than they are today.
Currently, the Woman’s Condom, developed by a global health
non-profit organization, PATH, is going through the steps
needed for its introduction on the market.
At this moment, the FC2, the VA w.o.w. female condom (also
known as: Dr. Reddy / V-Amour / L’amour), and the Cupid Ltd.
Latex Female Condom are available.
Not all three varieties are available yet in all countries.
Woman´s Condom
Cupid Female Condom
• Made of latex (rubber).
• Has one octagonal ring and one sponge
to keep it in place.
• Lubricant included.
• The condom will unfold
automatically with penetration.
• Little sponges on the side keep
the condom in place.
• Lubricant is included in a
separate sachet in order to
protect the cap.
before sex), compared to the male condom which needs
to be put on just before intercourse, “in the heat of the
moment”, so to speak.
• Female condoms (compared to the male condom) give
women more power to negotiate safer sex and a greater
sense of control and safety. Many women find them easier
to use because they:
• can initiate their use themselves;
• have greater ownership of the use of the female condom
as they can insert it themselves, even before foreplay;
• do not require the same degree of co-operation from
their partners, since the latter does not need to put it on;
• do not have to repeatedly negotiate use, as with the male
condom, particularly at the moment when it must be
inserted;
• think that their partners prefer to transfer responsibility
for contraception to them;
• think that their partners prefer the female condom
because it can give them greater pleasure.
• For men the sensation is closer to that of sex without a
condom, because female condoms do not fit tightly around
the penis as male condoms do.
• Many users believe that female condoms are stronger and
thus safer than male condoms, which helps them to relax
and enjoy sex.
Do women really want to use the female condom?
Studies have repeatedly shown high levels of acceptability of
the female condom. Since 1997, a WHO review of 41 studies of
the FC1 showed acceptance levels ranging from 41 percent to
95 percent.43 Since then, many additional studies have been
conducted. In 2006, reviewers of 60 such studies recommended
the following: “research on the female condom must shift focus
from assessing acceptability to assessing effectiveness and
improving impact in diverse settings”.44
Dr. Reddy Female Condom
Woman´s Condom
• Made of latex (rubber).
• Has one triangular ring and one
sponge to keep it in place.
• Lubricant included.
• Made of very thin polyurethane.
• Can be inserted like a tampon.
• The little cap will dissolve within
minutes when in contact with
any liquid (e.g. bodily fluid or
lubricant).
Why is it important that there are different types of
female condoms on the market?
FC2 Female Condom
There are two reasons why there should be different types
of female condoms on the market. First, people differ and
preferences differ. Therefore, it is important that people can
choose a condom that fits their preferences as best as possible.
If there is only one female condom on the market, and a person
does not like using that particular type, it is important to offer
an alternative.
Second, different types of female condoms can lead to lower
prices. Currently the FC2 female condom is the only condom
widely available because it is the only female condom approved
•
•
•
•
•
Made of nitrile, a synthetic latex.
Conducts heat.
Has two rings to keep it in place.
Lubricant included.
Since it is made of synthetic
material, it is also suitable for
people with a latex allergy. Also, it is not affected
by temperature and humidity so it can be stores almost
anywhere.
What is the advantage of the female
condom over the male condom?
• Female condoms offer more flexibility regarding the timing
of insertion and removal. The condom can be inserted prior
to intercourse and even before foreplay (the length of time
before intercourse and foreplay depending on the type of
female condom. However, latex is weaker and deteriorates
faster. Insertion should, therefore, not take place too long
• Although female condoms were not designed for anal sex,
some couples prefer them to male condoms when having
anal sex.
Why is the female condom relatively expensive?
High prices (up to 20 times the price of the male condom45)
and very limited or irregular access, as well as insufficient
training in insertion and negotiation skills, have inhibited the
female condom from becoming a widespread reproductive
health commodity. This is a missed opportunity and cannot be
justified, since the female condom is the only female-initiated
method that offers dual protection: it protects both against
unwanted pregnancy as well as sexually transmitted infections,
including HIV/AIDS. Also, the female condom is often used in
instances in which a male condom is not used. Hence, the cost
of the female condom should not strictly be compared to the
price of the male condom but, rather, to the price of HIV/AIDS
treatment and unintended pregnancy. In that comparison, the
female condom is a real bargain. A recent study published in
The Lancet confirms that female condom programming should
be part of the improved investment approach for an effective
response to HIV/AIDS.46
45 UNAIDS fact sheet on the female condom: http://data.unaids.org/Topics/Gender/femalecondom_en.pdf
46 Dr Bernhard Schwartl‰nder MD, John Stover MA, Timothy Hallett PhD, Prof Rifat Atun FFPHM, Carlos Avila MD, Eleanor Gouws PhD, Michael Bartos MEd, Peter D Ghys MD, Marjorie Opuni PhD, David Barr
43 UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. The Female Condom: A Review. Geneva: World Health Organization, 1997.
44 G. Vijayakumar, Mabude, Z., Smit, J., et al. A review of female-condom effectiveness: patterns of use and impact on protected sex acts and STI incidence. International Journal of STD & AIDS 2006; 17: 652-59.
32
JD, Ramzi Alsallaq PhD, Lori Bollinger PhD, Marcelo de Freitas MD, Prof Geoffrey Garnett PhD, Charles Holmes MD, Ken Legins MPH, Yogan Pillay PhD, Anderson Eduardo Stanciole PhD, Craig McClure PGCE,
Gottfried Hirnschall MD, Prof Marie Laga MD, Nancy Padian PhD, Towards an improved investment approach for an effective response to HIV/AIDS, The Lancet, http://www.thelancet.com/journals/lancet/
issue/vol377no9782/PIIS0140-6736(11)X6024-5, Pages 2031 - 2041, 11 June 2011.
33
There are three main reasons for the current price level of the
female condom:
a. Use of Materials
More materials are needed for the production of the
female condom (compared to that of the male condom).
Furthermore, the material itself can be more expensive. The
FC2, for example, is made of nitrile, which is more expensive
than latex. The packaging and the placing of rings and/or the
sponge make the production process more complicated and
labor-intensive and thus more expensive. More research and
development is needed to work towards cheaper female
condom types.
b. Economies of scale
Female condoms are not produced on a very large scale.
Because relatively few female condoms are produced, their
price is higher. For example, roughly 423 male condoms
are produced for every female condom. If more large-scale
female condom programs were to be implemented and the
procurement and production of female condoms were to
increase, the price would decrease.
c. Dominant position of one manufacturer
The FC2 is produced by the manufacturer Female Health
Company. This condom is the only one on the market with
World Health Organization (WHO) certification. Other
manufacturers have not yet fulfilled all the requirements
of the WHO certification procedure. This means that only
FC2 is purchased by donor agencies and international
organizations, which enables the Female Health Company
to dominate the market and keep the price artificially high.
Introducing competition into the female condom market
would help to lower unit prices. Therefore, it is important
that more condoms are prequalified (certified) by the WHO.
Can the female condom add pleasure during sex?
Yes, the pleasure one experiences depends on the type of
female condom used and on your personal preferences. Since
all female condoms offer dual protection, one can relax and one
does not need to worry about becoming pregnant or getting a
sexually transmitted infection such as HIV/AIDS while having
sex. Some couples have found that the inner and outer ring of
the FC2 adds pleasure to the sexual experience. The same goes
for the outer ring of the Dr. Reddy and Cupid condoms. Some
men prefer the female condom to the male condom because it
does not fit tightly around the penis. Also, the sponge in the Dr.
Reddy condom can add pleasure for the man. Since the material
used to make the FC2 is not latex but nitrile, it conducts heat,
which can make sexual intercourse feel very sensitive and
natural.
34
Whom can you recommend to use the female
condom?
The female condom is suitable for all women and men. For
some couples, it is a huge advantage that it can be inserted even
before foreplay (and not in the ‘heat of the moment’). Just like
the male condom, you need to practice using it. Therefore, we
advise you to try it several times before making up your mind
about whether the female condom works for you.
It can be used:
• With other contraceptives including the pill and intra-uterine
devices
• During menstruation
• After having recently given birth
• During menopause
What kind of lubricant can be used with the female
condom?
The FC2, Dr. Reddy and Cupid condom come pre-lubricated. It
is of course possible to use extra lubrication on the inside of
the female condom or on the penis. With the FC2 you can use
water-based silicone as well as oil-based lubricants. With the
Dr. Reddy and Cupid condoms you can only use water-based
lubricants or silicone lubricant, not oil-based lubricants. This is
because if you use oil-based lubricants with latex condoms they
may tear. If you want to keep it simple, only recommend the use
of water-based and silicone lubricants with female condoms.
Does the female condom make noise?
None of the female condoms are noisy. FC1 (the first FC model
produced by the Female Health Company) was made of rather
thick polyurethane and was known for the “crispy” sound.
The FC1 has, however, been replaced by the FC2 (the newer
FC model of the Female Health Company) almost everywhere.
The FC2 is made of nitrile, which is a synthetic latex that feels
very natural. It adapts to body temperature. The Dr. Reddy and
Cupid condoms are made of latex, which is not noisy. The PATH
Woman’s Condom is made of such thin polyurethane that you
can hardly hear it.
How can one insert the female condom?
The way to insert and remove the female condom depends on
the type of female condom you are using. In general, any female
condom is not difficult to use although it does require some
practice. It is recommended that first-time users review the
detailed instructions, and take time to practice insertion and
removal before actually using a female condom during sexual
intercourse. Fears that the female condom might enter the
womb/cervix are, however, fully unjustified. Both the outer and
the inner rings and the sponge(s) prevent this from happening.
Where can one buy female condoms?
This differs per country. In some countries, the female
condom can be bought in pharmacies, commercial outlets,
at hairdressers, etc. Sometimes the female condom is also
distributed in the public sector. Unfortunately, there are often
stock-outs making it difficult to obtain condoms.
35
Annex 2 International agreements
relevant to female condom advocacy
Convention on the Elimination of All Forms of Discrimination
against Women (CEDAW) 1979
The Convention on the Elimination of All Forms of Discrimination
against Women (CEDAW), adopted in 1979 by the UN General
Assembly, is often described as an international bill of rights for
women. Consisting of a preamble and 30 articles, it defines what
constitutes discrimination against women and sets up an agenda
for national action to end such discrimination. As of 26 March
2004, 177 countries - over ninety percent of the members of the
United Nations - are party to the Convention.
The Convention defines discrimination against women as “...
any distinction, exclusion or restriction made on the basis of sex
which has the effect or purpose of impairing or nullifying the
recognition, enjoyment or exercise by women, irrespective of
their marital status, on a basis of equality of men and women,
of human rights and fundamental freedoms in the political,
economic, social, cultural, civil or any other field.”
By ratifying the Convention, States commit themselves to
undertake a series of measures to end discrimination against
women in all forms, including:
• to incorporate the principle of equality of men and women in
their legal system, abolish all discriminatory laws and adopt
appropriate ones prohibiting discrimination against women;
• to establish tribunals and other public institutions to ensure
the effective protection of women against discrimination; and
• to ensure elimination of all acts of discrimination against
women by persons, organizations or enterprises.
The Convention provides the basis for realizing equality
between women and men through ensuring women’s equal
access to, and equal opportunities in, political and public life
-- including the right to vote and to stand for election -- as well as
education, health and employment. States parties agree to take
all appropriate measures, including legislation and temporary
special measures, so that women can enjoy all their human rights
and fundamental freedoms.
Aside from civil rights issues, the Convention also devotes major
attention to a most vital
concern of women, namely their reproductive rights. The
preamble sets the tone by stating that “the role of women in
procreation should not be a basis for discrimination”. The link
between discrimination and women’s reproductive role is a
matter of recurrent concern in the Convention. For example, it
advocates, in article 5, ‘’a proper understanding of maternity as a
social function”, demanding fully shared responsibility for childrearing by both sexes. Accordingly, provisions for maternity
protection and child-care are proclaimed as essential rights
and are incorporated into all areas of the Convention, whether
dealing with employment, family law, health care or education.
Society’s obligation extends to offering social services,
36
especially child-care facilities, that allow individuals to combine
family responsibilities with work and participation in public life.
Special measures for maternity protection are recommended
and “shall not be considered discriminatory”. (article 4). “The
Convention also affirms women’s right to reproductive choice.
Notably, it is the only human rights treaty to mention family
planning. States parties are obliged to include advice on family
planning in the education process (article l O.h) and to develop
family codes that guarantee women’s rights “to decide freely and
responsibly on the number and spacing of their children and to
have access to the information, education and means to enable
them to exercise these rights” (article 16.e).
The Convention is the only human rights treaty which affirms the
reproductive rights of women and targets culture and tradition
as influential forces shaping gender roles and family relations.
It affirms women’s rights to acquire, change or retain their
nationality and the nationality of their children. States parties
also agree to take appropriate measures against all forms of
traffic in women and exploitation of women.
Countries that have ratified or acceded to the Convention are
legally bound to put its
provisions into practice. They are also committed to submit
national reports, at least every four years, on measures they
have taken to comply with their treaty obligations. Individuals
or groups in states that have ratified the Optional Protocol of
the Convention can – if certain conditions are fulfilled – bring a
complaint to the CEDAW Committee.
International Conference on Population and Development
(ICPD), 1994
The International Conference on Population and Development
(ICPD) was held in Cairo in
1994. It was the largest intergovernmental conference on
population and development ever held, with 11,000 registered
participants, from governments, UN specialized agencies
and organizations, intergovernmental organizations, nongovernmental organizations and the media. More than 180 states
took part in negotiations to finalize a Programme of Action (PoA)
in the area of population and development for the next 20 years.
Non-governmental organizations played a very important role
at the ICPD. About 4200 representatives from over 1200 NGOs
were represented in Cairo, and especially women’s groups were
very organized. Their success was apparent as the ICPD PoA
addresses the importance of women’s empowerment and gender
equity in a broader way than any international document had
done so far. 179 States reached crucial compromises to finalize
a document -Programme of Action endorsing a new strategy
that emphasizes the integral linkages between population and
development and focuses on meeting the needs of individual
women and men, rather than on achieving demographic targets.
The key to this new approach is empowering women and
providing them with more choices through expanded access
to education and health services, skill development and
employment, and through their full involvement in policy- and
decision-making processes at all levels. Indeed, one of the
greatest achievements of the Cairo Conference has been the
recognition of the need to empower women, both as a highly
important end in itself and as a key to improving the quality of
life for everyone.
One of the primary goals of the Programme of Action is to make
family planning methods universally available by 2015 as part
of a broadened approach to reproductive health and rights. It
also includes goals in regard to education, especially for girls,
as well as goals to further reduce levels of infant, child and
maternal mortality. It addresses issues relating to population,
the environment and consumption patterns; the family; internal
and international migration; prevention and control of HIV/AIDS;
technology, research and development; and partnership with
the non-governmental sector. The Programme of Action provides
estimates of the levels of national resources and international
assistance required and calls on governments to make those
resources available. Governments are urged to commit the
necessary funds in this regard, estimated at $17 billion annually
in 2000 and $21.7 billion in 2015.
The Programme of Action builds upon the World Population
Plan of Action, adopted at the World Population Conference
held in Bucharest in 1974, and the recommendations adopted
at the International Conference on Population, held in Mexico
City in 1984. It also builds on the outcomes of the World Summit
for Children (1990), the UN Conference on Environment and
Development (1992), and the World Conference on Human Rights
(1993). In turn, the ICPD’s major emphases were reaffirmed at
the World Summit for Social Development and the Fourth World
Conference on Women, both held in 1995.
Countries were urged to include population factors in all
development strategies, and to act to eliminate gender-based
violence and harmful traditional practices, including female
genital mutilation.
The Programme of Action set out 20-year goals in four related
areas:
1. Universal Education
2. Reduction of Infant and Child Mortality
3. Reduction of Maternal Mortality
4. Universal Access to Reproductive and Sexual Health Services
Including Family Planning.
For a full version of the Plan of Action, please see: http://www.
unicef.org/lac/spbarbados/Planning/Global/Youth/icpd-poa94reprint_eng.pdf
Every 5 years, there is an ICPD+ meeting at which new language
is adopted. Some of this language mentions female condoms
specifically:
ICPD+5 paragraph 53 – Government, with assistance from the
international community, should develop and use indicators
that measure access to and choice of family-planning and
contraceptive methods and indicators that measure trends in
maternal mortality and morbidity and HIV/AIDS and use them
to monitor progress towards the Conference’s goal of universal
access to reproductive health care. Governments should strive
to ensure that 2015 all primary health-care and family planning
facilities are able to provide, directly or through referral, the
widest achievable range of safe and effective family planning
and contraceptive methods; essential obstetric care; prevention
and management of reproductive tract infections, including
sexually transmitted diseases, and barrier methods (such as
male and female condoms and microbicides if available) to
prevent infection. By 2005, 60 percent of such facilities should
be able to offer this range of services, and by 2010, 80 percent of
them should be able to offer such services.
ICPD +10 (UNESCAP Bangkok Plan of Action on Population
and Poverty) H.3 –Establish (a) national prevention
programmes, recognizing and addressing the factors leading to
the spread of the epidemic, reducing HIV incidence for those
identifiable populations with high or increasing HIV infection
or indicated through public health information as at the highest
risk of infection, (b) information and education programmes
aimed at reducing risk-taking behaviour and encouraging
responsible sexual behaviour and expanded access to essential
commodities, including male and female condoms and sterile
injecting equipment, and (c) harm-reduction efforts related to
drug use;
Fourth World Conference on Women, Platform for Action and
Declaration, 1995
The Beijing Platform for Action is an agenda for women’s
empowerment. It aims at removing all the obstacles to women’s
active participation in all spheres of public and private life
through a full and equal share in economic, social, cultural
and political decision-making. This means that the principle of
shared power and responsibility should be established between
women and men at home, in the workplace and in the wider
national and international communities. Equality between
women and men is a matter of human rights and a condition
for social justice and is also a necessary and fundamental
prerequisite for equality, development and peace. Platform for
Action calls for the improvement of women’s health, access to
education and the promotion of their reproductive rights.
Basis for the Platform of Action, acknowledging and combating:
1. The persistent and increasing burden of poverty on women
2. Inequalities and inadequacies in and unequal access to
education and training
37
3. Inequalities and inadequacies in and unequal access to
health care and related services
4. Violence against women
5. The effects of armed or other kinds of conflict on women,
including those living under foreign occupation
6. Inequality in economic structures and policies, in all forms of
productive activities and in access to resources
7. Inequality between men and women in the sharing of power
and decision-making at all levels
8. Insufficient mechanisms at all levels to promote the
advancement of women
9. Lack of respect for and inadequate promotion and protection
of the human rights of women
10.Stereotyping of women and inequality in women’s access to
and participation in all communication systems, especially in
the media
11.Gender inequalities in the management of natural resources
and in the safeguarding of the environment
12.Persistent discrimination against and violation of the rights
of the girl child The Beijing Conference was considered
a great success, both in terms of its size and its outcome.
It was the largest gathering of government and NGO
representatives ever held, with 17,000 in attendance,
including representatives of 189 governments. The NGO
Forum held parallel to the Conference also broke all records,
bringing the combined number of participants to over
47.000. The presence and influence of NGOs, one of the most
active forces in the drive for gender equality, had increased
dramatically since the Mexico City Conference in 1975. In
Beijing, NGOs directly influenced the content of the Platform
for Action and they would play an important role in holding
their national leaders accountable for the commitments they
had made to implement the Platform.
The fundamental transformation that took place in Beijing was
the recognition of the need to shift the focus from women to
the concept of gender, recognizing that the entire structure of
society, and all relations between men and women within it, had
to be re-evaluated. Only by such a fundamental restructuring of
society and its institutions could women be fully empowered to
take their rightful place as equal partners with men in all aspects
of life. This change represented a strong reaffirmation that
women’s rights were human rights and that gender equality was
an issue of universal concern, benefiting all.
The legacy of the Beijing Conference was to be that it sparked
a renewed global commitment to the empowerment of women
everywhere and drew unprecedented international attention.
The Conference unanimously adopted the Beijing Declaration
and Platform for Action, that was in essence an agenda for
women’s empowerment and stands as a milestone for the
advancement of women in the twenty-first century. The Platform
for Action specified twelve critical areas of concern considered
to represent the main obstacles to women’s advancement and
which required concrete action by Governments and civil
society:
38
Declaration
“We, the Governments participating in the Fourth World
Conference on Women, gathered here in Beijing in September
1995…
…We are determined to:
Ensure women’s equal access to economic resources, including
land, credit, science and technology, vocational training,
information, communication and markets, as a means to further
the advancement and empowerment of women and girls,
including through the enhancement of their capacities to enjoy
the benefits of equal access to these resources, interalia, by
means of international cooperation;
For more information about UAFC Joint Programme,
advocacy or feedback on this toolkit, please contact:
the UAFC advocacy officer at [email protected]
Photos:
Robbert Bodegraven
Guus Schoonewille
Partners of the Paper Doll Campaign
Ensure the success of the Platform for Action, which will require
a strong commitment on the part of Governments, international
organizations and institutions at all levels. We are deeply
convinced that economic development, social development
and environmental protection are interdependent and mutually
reinforcing components of sustainable development, which is
the framework for our efforts to achieve a higher quality of life
for all people. Equitable social development that recognizes
empowering the poor, particularly women living in poverty,
to utilize environmental resources sustainably is a necessary
foundation for sustainable development. We also recognize
that broad-based and sustained economic growth in the context
of sustainable development is necessary to sustain social
development and social justice.
The success of the Platform for Action will also require adequate
mobilization of resources at
the national and international levels as well as new and
additional resources to the developing countries from all
available funding mechanisms, including multilateral, bilateral
and private sources for the advancement of women; financial
resources to strengthen the capacity of national, subregional,
regional and international institutions; a commitment to equal
rights, equal responsibilities and equal opportunities and to the
equal participation of women and men in all national, regional
and international bodies and policy-making processes; and the
establishment or strengthening of mechanisms at all levels for
accountability to the world’s women;
Ensure also the success of the Platform for Action in countries
with economies in transition, which will require continued
international cooperation and assistance;
We hereby adopt and commit ourselves as Governments
to implement the following Platform for Action, ensuring
that a gender perspective is reflected in all our policies and
programmes. We urge the United Nations system, regional
and international financial institutions, other relevant regional
and international institutions and all women and men, as well
as nongovernmental organizations, with full respect for their
autonomy, and all sectors of civil society, in cooperation with
Governments, to fully commit themselves and contribute to the
implementation of this Platform for Action”
39
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