{"id":1863,"date":"2017-09-22T21:30:11","date_gmt":"2017-09-23T01:30:11","guid":{"rendered":"https:\/\/natural-womanhood.local\/?p=1863"},"modified":"2024-04-03T14:28:37","modified_gmt":"2024-04-03T19:28:37","slug":"investir-dans-ce-que-les-pauvres-du-monde-veulent-vraiment-repondre-bill-et-melinda-gates","status":"publish","type":"post","link":"https:\/\/naturalwomanhood.org\/fr\/investing-in-what-the-worlds-poor-really-want-response-bill-and-melinda-gates\/","title":{"rendered":"Investir dans ce que les pauvres veulent vraiment : une r\u00e9ponse \u00e0 Bill et Melinda Gates"},"content":{"rendered":"

Dans un article paru en 2017 dans la revue Wall Street Journal<\/a> (paywall), Bill et Melinda Gates ont fait part de leur soutien \u00e0 la poursuite des investissements dans le domaine de la sant\u00e9 comme moyen de r\u00e9duire la pauvret\u00e9 dans les pays en d\u00e9veloppement. Ils consid\u00e8rent comme une pr\u00e9occupation majeure la recommandation budg\u00e9taire du pr\u00e9sident de cesser de financer la contraception, m\u00eame si le Congr\u00e8s continuera probablement \u00e0 financer la contraception. L'essai sensibilise \u00e0 l'aide indispensable apport\u00e9e \u00e0 certains des pays les plus pauvres du monde, mais passe \u00e0 c\u00f4t\u00e9 de ce dont les femmes et les familles de ces pays ont r\u00e9ellement besoin et de ce qu'elles souhaitent.<\/p>\n

Pourquoi les femmes s\u00e9n\u00e9galaises ne sont-elles pas plus nombreuses \u00e0 utiliser des contraceptifs ?<\/strong><\/p>\n

Les Gates pr\u00e9sentent les efforts d\u00e9ploy\u00e9s pour am\u00e9liorer l'acc\u00e8s \u00e0 la contraception et la sensibilisation au S\u00e9n\u00e9gal comme un exemple de r\u00e9ussite en mati\u00e8re d'aide \u00e9trang\u00e8re. Le gouvernement s\u00e9n\u00e9galais a clairement fait de la fourniture de contraceptifs une priorit\u00e9, mais il n'est pas du tout certain que les femmes s\u00e9n\u00e9galaises soient d'accord. Selon l'article, seulement 10% des femmes en \u00e2ge de procr\u00e9er au S\u00e9n\u00e9gal prenaient un moyen de contraception en 2011. Pourtant, malgr\u00e9 une \"campagne massive de sensibilisation\" et une r\u00e9duction drastique des p\u00e9nuries, cinq ans plus tard, le nombre de femmes utilisant des contraceptifs n'est toujours que de 15% (d\u00e9crit dans l'article comme un pourcentage d'augmentation de \"plus de la moiti\u00e9\").<\/p>\n

L'article indique que les choix des femmes sont limit\u00e9s par des facteurs culturels, ce qui peut \u00eatre en partie le cas. Mais il existe \u00e9galement de bonnes preuves que la \"culture\" n'explique pas tout. A 2016 rapport<\/a> publi\u00e9 par l'Institut Guttmacher, un fervent partisan de l'augmentation de l'utilisation de la contraception, a r\u00e9v\u00e9l\u00e9 que la plupart des femmes des pays d'Afrique subsaharienne \u00e9tudi\u00e9s connaissaient les contraceptifs et pouvaient y avoir acc\u00e8s (p. 28). Le rapport se pr\u00e9sente comme une r\u00e9ponse aux \"besoins non satisfaits en mati\u00e8re de contraception\", un chiffre calcul\u00e9 en fonction du nombre de femmes fertiles qui sont sexuellement actives, souhaitent retarder une grossesse, mais n'utilisent pas de \"m\u00e9thodes modernes de contraception\". Ce chiffre est souvent utilis\u00e9 pour justifier l'augmentation des fonds destin\u00e9s \u00e0 am\u00e9liorer l'acc\u00e8s \u00e0 la contraception.<\/p>\n

Pourtant, la plupart des femmes interrog\u00e9es avaient des raisons que l'augmentation de l'acc\u00e8s ne r\u00e9soudra pas. Il s'agit notamment de rapports sexuels peu fr\u00e9quents, de l'absence de retour \u00e0 la f\u00e9condit\u00e9 apr\u00e8s une grossesse et de la sous-f\u00e9condit\u00e9 (p. 35). Un quart des femmes mari\u00e9es ont \u00e9galement cit\u00e9 des objections personnelles \u00e0 l'utilisation de contraceptifs, et parmi ces femmes, trois sur cinq ont d\u00e9clar\u00e9 qu'elles s'opposaient personnellement \u00e0 l'utilisation de contraceptifs (id.<\/em>). Parmi les femmes c\u00e9libataires, tr\u00e8s peu ont cit\u00e9 le co\u00fbt ou le manque de sensibilisation pour expliquer la non-utilisation, mais plus d'un quart des femmes c\u00e9libataires des pays africains \u00e9tudi\u00e9s ont d\u00e9clar\u00e9 qu'elles \u00e9taient pr\u00e9occup\u00e9es par les effets secondaires, les risques pour la sant\u00e9 ou les inconv\u00e9nients (p. 37). Ces chiffres se retrouvent plus ou moins dans d'autres pays en d\u00e9veloppement, o\u00f9 de nombreuses femmes abandonnent ou changent de m\u00e9thode contraceptive en raison des effets secondaires.<\/p>\n

Pourquoi disons-nous aux femmes qu'elles se trompent dans leurs choix et leurs priorit\u00e9s ?<\/strong><\/p>\n

Comme l'indique le rapport susmentionn\u00e9, de nombreuses femmes des pays en d\u00e9veloppement (comme leurs homologues des pays d\u00e9velopp\u00e9s) ont des pr\u00e9occupations d'ordre sanitaire et \u00e9thique. De nombreuses femmes ont subi des effets secondaires dus \u00e0 l'utilisation de contraceptifs. Les campagnes d'information peuvent r\u00e9pondre \u00e0 ces pr\u00e9occupations, mais une information compl\u00e8te sur le fonctionnement des contraceptifs hormonaux peut \u00e9galement soulever de nouvelles questions. En outre, la transposition de notre approche m\u00e9dicamenteuse de la planification familiale dans des pays o\u00f9 l'assistance m\u00e9dicale de base et les options sont rares ne r\u00e9pond pas aux besoins de sant\u00e9 les plus urgents. La pr\u00e9vention de la grossesse n'est qu'un aspect des soins de sant\u00e9 g\u00e9n\u00e9sique ; un acc\u00e8s parfait \u00e0 la contraception ne remplace pas la pr\u00e9sence d'accoucheuses qualifi\u00e9es, les soins pr\u00e9nataux ou des cliniques d'accouchement bien \u00e9quip\u00e9es.<\/p>\n

Les valeurs \u00e9thiques ne m\u00e9ritent pas moins de consid\u00e9ration que les pr\u00e9occupations relatives aux effets secondaires ; en fait, comme les droits de conscience sont inscrits dans la l\u00e9gislation internationale sur les droits de l'homme, ils m\u00e9ritent davantage. Lorsque les femmes nous disent qu'elles ne sont pas int\u00e9ress\u00e9es par les contraceptifs, nous devrions trouver des moyens de les aider \u00e0 atteindre leurs objectifs de planification familiale et \u00e0 r\u00e9pondre \u00e0 leurs besoins en mati\u00e8re de sant\u00e9 d'une mani\u00e8re qui soit acceptable pour elles, plut\u00f4t que de faire pression sur elles pour qu'elles se conforment \u00e0 certaines valeurs et id\u00e9ologies.<\/p>\n

Toute campagne visant \u00e0 promouvoir un produit de sant\u00e9 particulier doit respecter la dignit\u00e9 et l'autonomie des patients. Le consentement \u00e9clair\u00e9 est un principe fondamental de cet imp\u00e9ratif. Savoir qu'une m\u00e9thode contraceptive emp\u00eachera une grossesse, expliquer les effets secondaires et les risques potentiels pour la sant\u00e9, tels que les caillots sanguins, et donner des instructions pour g\u00e9rer ou arr\u00eater le traitement sont des \u00e9l\u00e9ments essentiels pour r\u00e9aliser le droit de l'homme au meilleur \u00e9tat de sant\u00e9 possible. Les pays d\u00e9velopp\u00e9s ne parviennent souvent pas \u00e0 garantir que les femmes disposent des informations dont elles ont besoin pour faire un choix \u00e9clair\u00e9 ; nous ne devrions pas exporter ce probl\u00e8me dans les pays en d\u00e9veloppement.<\/p>\n

\"Bill
Bill et Melinda Gates<\/figcaption><\/figure>\n

Comment r\u00e9pondre aux besoins des femmes ?<\/strong><\/p>\n

Nous devons rencontrer les gens l\u00e0 o\u00f9 ils sont, en tenant compte de leurs valeurs, de leur culture, de leurs priorit\u00e9s et de leur environnement. Des informations sensibles \u00e0 la culture et aux valeurs sont le meilleur moyen de s'assurer que les femmes et les couples font les meilleurs choix pour eux-m\u00eames. La connaissance de la fertilit\u00e9 permet aux femmes (et aux hommes) de comprendre le fonctionnement de leur corps, le lien entre la sant\u00e9 et les hormones, et la mani\u00e8re dont les diff\u00e9rentes m\u00e9thodes de planification familiale affectent leur sant\u00e9 et leurs niveaux hormonaux.<\/p>\n

Les m\u00e9thodes de planification familiale fond\u00e9es sur la connaissance de la f\u00e9condit\u00e9 fournissent souvent ces informations essentielles, ont fait leurs preuves en mati\u00e8re d'utilisation durable dans les pays pauvres et sont compatibles avec les normes culturelles des populations locales. Ces programmes enseigner aux femmes et aux couples<\/a> sur leur sant\u00e9 hormonale et sur le cycle ovulatoire, sur ce \u00e0 quoi ressemble un cycle sain, sur le moment o\u00f9 il convient de consulter un m\u00e9decin en cas de d\u00e9s\u00e9quilibre hormonal et sur la mani\u00e8re d'utiliser ces connaissances pour obtenir ou \u00e9viter une grossesse. De nombreuses femmes et de nombreux couples consid\u00e8rent que ces connaissances les rendent plus autonomes et plus utiles, et que les d\u00e9cisions qu'ils prennent par la suite sont r\u00e9ellement \u00e9clair\u00e9es. Les campagnes m\u00e9diatiques de promotion de l'utilisation des contraceptifs ne peuvent tout simplement pas rivaliser avec les connaissances et la compr\u00e9hension r\u00e9elles des patients en termes de prise de d\u00e9cision \u00e9clair\u00e9e et de meilleurs r\u00e9sultats en mati\u00e8re de sant\u00e9 et d'\u00e9ducation.<\/p>\n

Les patients inform\u00e9s ne font pas seulement des choix \u00e9clair\u00e9s ; ils b\u00e9n\u00e9ficient de meilleurs soins de sant\u00e9 parce qu'ils savent quand ils en ont besoin. La pilule contraceptive a \u00e9t\u00e9 utilis\u00e9e pour traiter un large \u00e9ventail de probl\u00e8mes de sant\u00e9, allant de la douleur d\u00e9bilitante \u00e0 l'acn\u00e9 persistante, sans que l'on se pr\u00e9occupe vraiment de la cause de ces probl\u00e8mes. Si la pilule permet de g\u00e9rer les sympt\u00f4mes, la suppression de l'activit\u00e9 hormonale naturelle ne permet pas de traiter les d\u00e9s\u00e9quilibres hormonaux. Diagnostiquer et traiter les d\u00e9s\u00e9quilibres hormonaux sp\u00e9cifiques<\/a> est le seul moyen de r\u00e9tablir r\u00e9ellement la sant\u00e9.<\/p>\n

Avec 14% des femmes am\u00e9ricaines qui prennent un moyen de contraception principalement comme traitement, et 58% qui disent qu'elles g\u00e8rent des sympt\u00f4mes de sant\u00e9 en plus d'\u00e9viter une grossesse, le nombre de femmes qui prennent un moyen de contraception est en augmentation.<\/a>La question que nous devrions nous poser n'est peut-\u00eatre pas de savoir pourquoi si peu de femmes africaines utilisent des contraceptifs, mais pourquoi tant d'Am\u00e9ricaines comptent sur la pilule pour g\u00e9rer leurs sympt\u00f4mes au lieu de se faire soigner. \u00c0 tout le moins, nous ne devrions pas imposer nos solutions en mati\u00e8re de soins de sant\u00e9 et de planification familiale aux femmes par le biais de l'aide \u00e9trang\u00e8re. Si nous ne respectons pas ces diff\u00e9rences de culture et de valeurs, nous risquons de transformer nos bonnes intentions en une nouvelle forme de colonialisme.<\/p>\n

Lorsque nous cessons de mettre l'accent sur la pilule et que nous le pla\u00e7ons sur les femmes, l\u00e0 o\u00f9 il doit \u00eatre, il devient clair que la v\u00e9ritable p\u00e9nurie est celle de la connaissance. En \u00e9duquant les femmes et les m\u00e9decins sur la sant\u00e9 hormonale, nous pouvons aider les femmes \u00e0 am\u00e9liorer leur sant\u00e9 et \u00e0 atteindre leurs objectifs de fertilit\u00e9. Voil\u00e0, Monsieur et Madame Gates, quelque chose qui vaut la peine d'\u00eatre investi.<\/p>\n

cr\u00e9dit photo : Wikimedia Commons https:\/\/commons.wikimedia.org\/wiki\/File:Femmes_senegalaises.jpg<\/p>","protected":false},"excerpt":{"rendered":"Dans un article paru en 2017 dans le Wall Street Journal (paywall), Bill et Melinda Gates ont fait part de leur soutien...","protected":false},"author":26,"featured_media":1864,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_kad_blocks_custom_css":"","_kad_blocks_head_custom_js":"","_kad_blocks_body_custom_js":"","_kad_blocks_footer_custom_js":"","csco_singular_sidebar":"","csco_page_header_type":"","csco_page_load_nextpost":"","csco_post_video_location":[],"csco_post_video_url":"","csco_post_video_bg_start_time":0,"csco_post_video_bg_end_time":0,"footnotes":""},"categories":[5183,5266],"tags":[5929,4421,6023],"class_list":{"0":"post-1863","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-birth-control-issues","8":"category-in-the-news","9":"tag-health-benefits-of-charting","10":"tag-natural-birth-control","11":"tag-natural-family-planning-18","12":"cs-entry","13":"cs-video-wrap"},"acf":[],"yoast_head":"\nInvesting in what the world's poor really want: a response to Bill and Melinda Gates - 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