Sexual and Reproductive Health for All: 20 Years of The Global Strategy

Thirty years ago, the International Conference on Population and Development (ICPD), held in Cairo, Egypt, underscored the right of all people to attain the highest standard of sexual and reproductive health and rights (SRHR). In 2004, WHO published a reproductive health strategy – validated by 191 Member States at the Fifty-seventh World Health Assembly – that strengthened the centrality of SRHR to societies and economies (Resolution WHA57.12). These frameworks are grounded in gender equality and acknowledge the unchanging importance of sexual health in attaining health for all.

WHO scientists worked with Member States, civil society and neighborhoods throughout all areas to operationalize an International Strategy to cover the five key pillars for improving SRHR:

– enhancing antenatal, perinatal, postpartum and newborn care

– providing family planning services

– eliminating risky abortion

– combatting sexually sent infections (STIs).

– promoting sexual health.

Resolution WHA57.12 additional informed SRHR policies and directing documents in several areas and Member States. For instance, Latin America’s 2013 Montevideo Consensus and Africa’s Maputo Strategy from 2016 (building upon the initial 2006 plan) both consist of language and concepts reinforcing and upholding SRHR.

” The international strategy is the fundamental policy file that centres WHO’s required for sexual and reproductive health to date,” stated Dr Pascale Allotey, Director of the UN Special Programme on Human Reproduction (HRP) and WHO’s Department of Sexual and Reproductive Health. “The text stays essential in contributing to directing research top priorities and working with nations to develop beneficial resources to ensure thorough SRHR across the life course.”

Significant progress has actually been made over the last twenty years within each of the five pillars, consisting of these examples.

– The Global method happened as the world was reeling from the HIV and AIDS epidemic. Today, the variety of individuals acquiring HIV has fallen by 38% since 2010 alone, due in part to the Strategy’s emphasis on removing STIs consisting of HIV.

– Since March 2022, 60% of WHO Member States have actually included the human papillomavirus vaccine (HPV) in their regular immunization schedules, greatly advancing efforts to eliminate cervical cancer as a public health danger.

– Prioritizing family preparation services and birth control gain access to caused WHO’s Family planning: an international handbook for providers referral guide, which has actually been distributed over a million times. Accordingly, the percentage of females using modern-day contraceptive methods increased from 467 million in 1990 to 874 million in 2022, while a broader range of contraceptive alternatives is now readily available.

A 2020 study found that there has actually been a worldwide decrease in unintended pregnancy. Furthermore, evidence-based medical abortion regimens have actually enhanced worldwide access to abortion, and over 60 countries have liberalized abortion laws in the previous 30 years in line with evidence on the value of such efforts to make sure the health of females and teen women.

Professor Kate Gilmore, co-chair of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for helping create important clinical evidence on SRHR that has added to some of these shifts. “A few of the great advances that we have actually seen – consisting of the method civil society has actually taken up the cause to argue for access to safe and legal abortion – are because of the Strategy and the systematic generation of proof over these previous 20 years,” she stated.

Despite early gains, however, current years have actually seen signs of stagnancy. From 2000 to 2020, the maternal death rate dropped by 34% worldwide – however a 2023 report discovered that progress has actually mainly stalled given that. The worrisome trend was shown during a current occasion showcasing worldwide datasets on the development of SRHR since ICPD. High maternal mortality rates persist in a couple of nations and sexual health concerns, such as endometriosis, infertility and sexual erectile dysfunction, are frequently ignored or stabilized.

Dr Allotey and Dr Manjulaa Narasimhan, scientist at WHO and HRP, noted in a current commentary in the WHO Bulletin that the SRHR agenda stays unfinished and in some instances has fallen back due to geopolitical stress, financial declines, the worldwide food crisis, climate change, humanitarian crises and COVID-19.

There are emerging chances to catalyse development – for instance, by boosting human rights-based methods in SRHR and embedding concepts like non-discrimination, consisting of in crisis scenarios. systems with a main health-care approach can enhance equity and expand access to detailed SRHR services. New technologies and alternative service delivery methods can enhance SRHR by expanding access, choice and autonomy.

Other future-looking focus areas within SRHR consist of research on the transformative role of expert system and ingenious birth control techniques, more work on strengthening health systems, and the withstanding prioritization of positive pregnancy and childbirth experiences.

At a more comprehensive level, Dr Allotey required a continued focus on the fundamental importance of SRHR. “Sexual and reproductive health need to never be relegated to the margins of health care, however acknowledged as important for the overall well-being of individuals and the communities in which they live,” she said.