SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS: THE

June 2013ISSUE 1Sexual and reproductive health and rights arealso important to a country’s development andare still a leading development challenge.Global Consensus on Universal Access to Reproductive Health:“All countries should, over the next several years,assess the extent of national unmet need for goodquality family-planning services and its integrationin the reproductive health context, paying particular attention to the most vulnerable and underserved groups in the population. All countriesshould take steps to meet the family-planningneeds of their populations as soon as possible andshould, in all cases by the year 2015, seek to provide universal access to a full range of safe andreliable family-planning methods and to relatedreproductive health services which are not againstthe law. The aim should be to assist couples andindividuals to achieve their reproductive goals andgive them the full opportunity to exercise the rightto have children by choice.” ICPD Programme ofAction paragraph 7.16In wealthy donor countries such as in Western Europeand North America, sexual and reproductive healthand rights are widely garanteed by a range of statepolicies, legislation and public health and educationprogrammes which are relatively well funded. Whilechallenges remain and a good state of sexual and reproductive health and rights requires constant attention from policy-makers, this ensures that citizens inWestern Europe and North America are able to choseif and whom they will marry, how many children theywill bring into the world, it ensures that pregnancy is asafe experience and that people will have theknowledge and access to the necessary supplies toplan a pregnancy and protect themselves from STIand HIV infections. While there is a global consensuson this among the nations of the world, it is far fromreality for many people living in developing countries.Unmet Need for ContraceptionUnmet need for contraception is a measure of the proportion of women who would prefer to postpone oravoid pregnancy but are not using contraceptives.‘Unmet need’ as a concept illustrates the gap betweena woman’s fertility preferences and what she doesabout them: she wants to avoid conceiving but fails todo what is needed to prevent pregnancy.The unmet need for contraception throughout the worldis staggering. An estimated 222 million women who wantto avoid a pregnancy are not using an effective methodof contraception. The United Nations Population Fund(UNFPA) and the Guttmacher Institute estimate thatmeeting the needs of these 222 million women who lackreproductive healthcare and effective contraception couldeach year prevent 21 million unwanted pregnancies, 26million abortions, and 1.1 million infant deaths.1At the same time, investing in sexual and reproductivehealth of people is one of the most effective ways to promote sustainable development. Investing in sexual andreproductive health contributes to overall developmentefforts in a range of ways, for example: 4Reduces poverty:Having fewer children, with more time betweentheir births, enables families to invest more ineach child’s education and health. It also putsfewer demands on household and community resources. Enabling women to take decisions aboutwhether and when to bear children creates opportunities to pursue activities such as education

June 2013ISSUE 1and employment, which contributes to povertyreduction. In Honduras and Columbia, for example, family income has been shown to increase bybetween 10 and 20% in cases where women havefewer children and are able to work. 2 Women,when given the opportunity, are also more likelythan men to use family resources in ways thatbenefit children and improve development prospects in their communities. Increases levels of education:This is especially important for girls, whose education is often sacrificed when resources are limited. Avoiding early marriage and unwantedpregnancy enables girls to stay in school in primary grades and beyond. The UNFPA State ofWorld Population Report 2005 shows that educated women and girls are likely to marry later andto have smaller and healthier families.Everythree years of education correlates with approximately one fewer child per woman.Promotes women’s rights & gender equality:The right to make decisions and to access information and services relating to partnerships,marriage, sexual relations and the bearing ofchildren are fundamental to women’s equalityand well-being. Having choices in the sphere ofsexuality and reproduction can empower womento pursue other opportunities and to participatein social and economic life outside the home.Improves health:Death and disability due to sexual and reproductive ill-health account for one-third of the globalburden of disease among women of reproductiveage (15-44 years) and close to 20% of the overallburden of disease according to the World HealthOrganisation (WHO). 3 Care before and duringpregnancy and delivery and after childbirth saveswomen’s and children’s lives and prevents disabilities. USAID had estimated that every year, USD 15 billion in productivity is lost due to maternaland newborn death and disability.44. GLOBAL FRAMEWORK: WHAT HAS BEENAGREED?From Numbers to People - a new InternationalConsensusIn 1994, at the International Conference on Populationand Development (ICPD) in Cairo, 179 governmentsacknowledged that empowering women and meetingpeople’s needs for education and health, including sexualand reproductive health, are necessary for sustainabledevelopment.Governments agreed that they should advance genderequity, eliminate violence against women and ensurewomen’s control over their own fertility, and that theseprinciples are the cornerstones of population and development policies. More specifically they confirmed that: All couples and individuals have the right to decidefreely and responsibly the number, spacing and timing of their children, and to have the information andmeans to do so.Decisions concerning reproduction should be madefree from discrimination, coercion and violence.The ICPD shifted the emphasis of population programmes from reaching demographic targets to promoting human rights and sustainable development, changingthe focus from numbers to people.The 20-year ICPD Programme of Action placed humanrights and well-being explicitly at the centre of all population and sustainable development programmes. Emphasizing the health, education and empowerment ofwomen, the ICPD endorses an approach to reproductivehealth that meets family planning needs as part of abroader health package. This package also includes careduring and after delivery, prevention and treatment ofinfertility and STIs including HIV/AIDS, sexual health,and related information and counseling. A major breakthrough of the ICPD, reaffirmed repeatedly since, is thatthese services are essential for all people, including adolescents and youth. Governments also agreed that abortion, when not against the law, should be safe and thatpost-abortion care should be available.The goals and principles of the ICPD have been incorporated into the Millennium Development Goals (MDGs),5

June 2013ISSUE 1which provide a unifying framework for international development cooperation. In December 2010, the UnitedNations General Assembly decided to extend the 20-yearICPD Programme of Action beyond 2014.Millennium Development Goals (MDGs)In 2000, world leaders adopted the MDGs, eight goalsincluding concrete targets for tackling poverty in itsmany dimensions. In 2005, universal access to reproductive health was included in the MDG framework astarget 5b. In 2010, Heads of States and Governmentsgathered at the UN in New York to take stock of progressin achieving the MDGs.Sexual and reproductive health and the MDGs5. HOW TO TALK ABOUT SEXUAL ANDREPRODUCTIVE HEALTH AND RIGHTSThis section aims to provide the reader with ready-touse arguments in favour of prioritizing and advancingsexual and reproductive health and rights. Each SRHRrelated topic is briefly introduced and underpinned bydigestible arguments and facts that policymakers mayuse during conversations, speeches or discussions.Human rightsAll human beings are born free and equal in dignity andrights. The rights to life and health are central to theenjoyment of all other rights and are protected by international law. Three of the eight MDGs - reducing child mortality(MDG4), improving maternal health (MDG5) and combating HIV/AIDS (MDG6) - are components of sexual and reproductive health, while others - eradicating extreme poverty (MDG1), achieving universal primaryeducation (MDG2) and promoting gender equality andempowering women (MDG3) - are closely related.At this summit, Member States agreed that progress onMDG 5 is lagging behind and that increased investments areneeded to reduce maternal, newborn and child mortality andachieve universal access to reproductive health by 2015. Onthis occasion, the UN Secretary General Ban Ki-moonlaunched the Global Strategy for Women’s and Children’sHealth, which spells out what needs to be done to accelerateprogress in improving the health of women and children.Gender equalityGender Equality means that women and men have equalconditions for realizing their full human rights and forcontributing to and benefiting from economic, social, cultural and political development. While a solid policy foundation has been laid in the last15 years, there remains a large gap between what worldleaders have committed their countries to and people’sdaily realities. The Guttmacher Institute calculates thatthe total global cost of investing in family planning andpregnancy related care, would be USD 24.6 billion annually, a little more than double the current spending onthese services.56Advancing the right to health (including sexual andreproductive health) necessitates its inclusion into allrelevant policy-making processes including policiesfor poverty reduction and international development.Focussing on technical and medical inter

tions defines reproductive health is “a state of complete physical, mental and social well-being in all matters relating to the reproductive systems and to its functions and pro-cesses ”. Reproductive health includes sexual health, which “concerns the enhancement of life and personal