In its latest report, ‘My Body is My Own: State of the World Population Report 2021’, the United Nations Population Fund (UNFPA) has revealed that, in 57 developing countries for which adequate data is available, only 55% of women are able to make fully autonomous decisions regarding health care, agreeing or refusing to have sex, and contraception. The countries concerned are located in Eastern and South Eastern Asia, Central and Southern Asia, sub-Saharan Africa and Latin America and the Caribbean. Sub-Saharan Africa is further subdivided into Eastern, Middle, Southern and Western Africa.

Of the 57 countries, 29% still do not guarantee access to comprehensive maternity care and 25% do not have laws ensuring full and equal access to contraception. About 20% still lack laws supporting sexual health and wellbeing, and some 44% lack laws and policies that support comprehensive sexuality education. Twenty of the countries still have legislation allowing rapists to escape prosecution if they marry their victims (what UNFPA calls ‘marry-your-rapist’ laws) while in 43 of these countries rape within marriage by a spouse is not illegal. In more than 30 countries, women’s rights to move around outside the home are restricted. And while both boys and girls with disabilities are almost three times likely to be subject to sexual violence, girls are at the greatest risk.

“The fact that nearly half of women still cannot make their own decisions about whether or not to have sex, use contraception or seek health care should outrage us all,” stressed UNFPA executive director Dr Natalia Kanem. “In essence, hundreds of millions of women and girls do not own their own bodies. Their lives are governed by others. The denial of bodily autonomy is a violation of women and girls’ fundamental human rights that reinforces inequalities and perpetuates violence arising from gender discrimination. It is nothing less than the annihilation of the spirit, and it must stop. By contrast, a woman who has control over her body is more likely to be empowered in other spheres of her life. She gains not only in terms of autonomy, but through advances in health and education, income and safety. She is more likely to thrive, and so is her family.”

Regarding sub-Saharan Africa, 70% of women have the power to say no to sex, 92% can make their own decisions on contraception and 71% can make their own decisions on their own health care. Or, to put it differently, 30% of women do not have the power to say no to sex, 8% cannot make their own decisions on contraception, while 29% cannot make their own decisions on their own health care. And only 48% have the power to make their own decisions on all three of these issues. (The only region which scores worse on women’s autonomy over all three issues is Central and Southern Asia, with a figure of just 43%.)

But there are considerable differences between Africa’s subregions, with Southern Africa scoring the best, followed by Eastern Africa, with Western and Middle Africa lagging. Thus, while in Southern Africa, the proportion of women who have the power to make their own decisions on all three issues is only 64%, and in Eastern Africa 53%, it is much worse in Western Africa at only 38% and in Middle Africa, where it is just 36%. There are also difference within the subregions. Thus, in each of the Western African countries of Mali, Niger and Senegal, only 10% of women have autonomy regarding decisions on these issues, while in each of Ghana and Nigeria the proportion is 50%.

South Africa was one of the countries included in the survey. And only 65% of South African women have the power to make their own decisions on all three issues. Just 75% have the power to say no to sex, although 89% have the power to decide on contraception (although that means that one-in-ten South African women do not have such power) and 95% have the power to decide on their own health care.