Despite the Sustainable Development Goals (SDGs 3.7.1 and 3.7.2) aiming to reduce adolescent fertility and ensure that all women have access to modern methods of contraception,
Fiji faces a complex challenge beneath its idyllic surface. The lack of sexual and reproductive health and rights (SRHR) impacts countless Fijians, especially women, youth, and people with disabilities. From low contraceptive use to high rates of gender-based violence, several pressing concerns mark Fiji’s SRHR landscape.
Teen pregnancy and early marriage
Youth in Fiji face unique barriers, with high adolescent pregnancy rates and limited access to accurate SRHR information. During 2016-2019, the annual adolescent fertility rate (15-19 years) increased from 30 to 38 births per 1,000 among mothers of iTaukei children, and from 19 to 24 births per 1,000 among mothers of non-iTaukei children. The adolescent fertility rate is ten times higher in the poorest quintile compared to the richest and 35% higher in rural compared to urban areas.
Low contraceptive use contributes to teen pregnancy rates: 81% of married women aged 15–19 and 68% of those aged 20–24 do not use any contraceptive method. Unmarried adolescent girls have the highest unmet need for contraception in Fiji; only 19% can access modern methods when they want them.
Although legally accessible, unmarried women find it difficult to obtain emergency contraception due to social stigma, provider biases, and lack of awareness. Judgmental attitudes from pharmacists and concerns about privacy deter many women from seeking this essential service.
For adolescent girls, the situation is even more challenging. They face greater stigma, social consequences, and parental control, while boys experience fewer restrictions and less accountability.
Social stigma, taboos, and cultural expectations often silence crucial conversations, leaving young people vulnerable and uninformed. Additionally, people with disabilities encounter significant hurdles in accessing SRHR services; they frequently feel judged or receive inadequate care. Cultural and religious beliefs further complicate matters, with some groups discouraging contraceptive use altogether
Good Practice example: Community-Based Sexual and Reproductive Health Officers Programme
Launched in 2022 through a partnership between Women Enabled International, the Fijian Ministry of Health, UNFPA Pacific, the Pacific Disability Forum, and the Fiji Disabled People’s Federation, this initiative trains women with disabilities as SRH officers to deliver accessible sexual health information and outreach in their communities, while also educating healthcare providers on disability inclusion. The program has empowered over 100 women with disabilities, many of whom had never previously accessed such information or services, and significantly improved their confidence to exercise their sexual and reproductive rights. Its inclusive, rights-based approach and measurable impact have made it a model for replication across the Pacific region.
Cultural and Religious Taboos: The Elephant in the Room in SRHR awareness
A significant cultural taboo preventing access to Sexual and Reproductive Health and Rights (SRHR) in Fiji is the silence and shame surrounding discussions about sexual and reproductive health. This taboo makes it difficult for many Fijian women, particularly iTaukei, to openly discuss topics like menstruation, contraception, and sex within their families. This results in a lack of accurate information and prevents women and girls from seeking the necessary SRHR services, perpetuating knowledge gaps and inhibiting their ability to make informed decisions about their reproductive health, despite the inclusion of SRHR education in school curricula.
Men are typically viewed as household heads and primary decision-makers, which often translates into their control or heavy influence over family planning and contraception choices. This limits women’s autonomy over their own bodies and reproductive health, as they need to seek their partner’s approval for contraception. This patriarchal structure restricts women’s decision-making power mainly to domestic affairs, preventing them from advocating for their reproductive health needs or independently accessing services. This leads to practical barriers, such as time constraints and travel costs, for women, which are compounded by a lack of recognition of their work and needs in national planning.
GBV
Over half of Fijian women aged 15 and above have experienced sexual or gender-based violence at least once in their lifetime, which far exceeds the global average. A climate of fear caused by gender-based violence (GBV) prevents women from accessing SRHR services due to several interconnected factors:
Firstly, the pervasive threat or experience of violence itself can instil immense fear, shame, and stigma in women. This psychological burden can make them reluctant to seek any health services, including SRHR, as they may fear further judgment, blame, or exposure if their experiences of violence become known. The social stigma associated with sexual violence or unintended pregnancies can also deter women from discussing their SRHR needs with healthcare providers, family, or community members.
Secondly, Traditional gender roles reinforce male dominance, which can manifest in intimate partner violence, sexual violence, and coercive control over women’s reproductive choices. The control exerted by perpetrators of GBV often extends to women’s mobility and decision-making, including their access to healthcare. Women may be physically prevented from attending clinics, or they may face threats of violence, abandonment, or economic deprivation if they attempt to access SRHR services without their partner’s or family’s permission. This lack of autonomy, combined with the fear of repercussions, effectively traps women in a cycle where their health needs are secondary to their safety and adherence to controlling norms.
Overcoming SRHR Barriers
Recognising and understanding these barriers is the first step to solving them. Culturally sensitive education, supportive healthcare environments, and open communication are crucial to empowering individuals to make informed decisions about their sexual and reproductive health. However, just building a new health centre will not be enough if people feel too ashamed to visit it. Teaching rights to health care is not sufficicent if women are beaten for attending clincis, or if teachers are hesitant to discuss certain topics.
Includovate is conducting research in Fiji to better understand the deep-rooted stigma, misinformation, and lack of accessible services. By using a Community-Based Participatory Research (CBPR) approach we aim to understand the intersections of religion, culture, and traditional norms and practices in Fiji and how they affect access to sexual and reproductive health rights for young people in different locations. Our research aims to identify positive case studies and pave the way for real, lasting change.
A Real-World Example: Water Resource Management
Consider a water management project in Ghana. Initially, women’s deep knowledge of water sources was undervalued, and they were often excluded from decision-making. By implementing strategies such as capacity building, policy changes (including gender quotas), and community dialogues, the project helped shift social norms. Women gained confidence and leadership roles, leading to improved access to clean water and increased community ownership. Changing gender inequities takes time. It can’t be rushed, and you can’t assume that all norms are bad – there are many positive norms to build upon and strengthen.
Building Bridges, Not Just Structures
Ultimately, development is about building bridges—bridges of understanding, collaboration, and empowerment. When we actively seek out and value diverse voices, we create projects that are not only more effective but also more equitable and sustainable. Let’s commit to listening, learning, and working together to build a better future for all.
Fiji’s beauty isn’t just in its landscapes but in its people. By acknowledging and addressing these SRHR gaps, we can ensure that every Fijian, regardless of gender, age, or ability, has the opportunity to lead a healthy and fulfilling life. It’s time to break the silence and build a future where sexual and reproductive health is a right, not a privilege.
Footnotes