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

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

WHO researchers worked with Member States, civil society and neighborhoods across all regions to operationalize a Worldwide Strategy to cover the five crucial pillars for enhancing SRHR:

– enhancing antenatal, perinatal, postpartum and newborn care

– supplying household preparation services

– eliminating unsafe abortion

– combatting sexually transmitted infections (STIs).

– promoting sexual health.

Resolution WHA57.12 more informed SRHR policies and guiding documents in several areas and Member States. For example, Latin America’s 2013 Montevideo Consensus and Africa’s Maputo Strategy from 2016 (building upon the original 2006 strategy) both include language and ideas reinforcing and maintaining SRHR.

” The worldwide strategy is the foundational policy document 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 remains crucial in contributing to assisting research concerns and dealing with countries to develop helpful resources to make sure comprehensive SRHR throughout the life course.”

Significant progress has actually been made over the last 20 years within each of the 5 pillars, including these examples.

– The Global technique came about as the world was reeling from the HIV and AIDS epidemic. Today, the variety of individuals acquiring HIV has actually fallen by 38% because 2010 alone, due in part to the Strategy’s focus on eliminating STIs consisting of HIV.

– As of March 2022, 60% of WHO Member States have actually included the human papillomavirus vaccine (HPV) in their regular immunization schedules, considerably advancing efforts to get rid of cervical cancer as a public health threat.

– Prioritizing household preparation services and birth control gain access to caused WHO’s Family planning: a worldwide handbook for companies reference guide, which has actually been distributed over a million times. Accordingly, the percentage of females utilizing contemporary contraceptive techniques increased from 467 million in 1990 to 874 million in 2022, while a broader series of contraceptive options is now readily available.

A 2020 research study found that there has actually been a worldwide decrease in unexpected pregnancy. Furthermore, evidence-based medical abortion regimens have enhanced worldwide access to abortion, and over 60 countries have liberalized abortion laws in the past thirty years in line with evidence on the of such efforts to ensure the health of women 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 produce important scientific proof on SRHR that has added to some of these shifts. “Some of the excellent advances that we’ve seen – including 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 twenty years,” she stated.

Despite early gains, however, recent years have seen signs of stagnancy. From 2000 to 2020, the maternal mortality rate dropped by 34% worldwide – but a 2023 report discovered that development has actually largely stalled since. The uneasy trend was shown throughout a recent occasion showcasing worldwide datasets on the development of SRHR given that ICPD. High maternal mortality rates continue a couple of countries and sexual health concerns, such as endometriosis, infertility and sexual erectile dysfunction, are typically overlooked or stabilized.

Dr Allotey and Dr Manjulaa Narasimhan, scientist at WHO and HRP, kept in mind in a current commentary in the WHO Bulletin that the SRHR agenda stays unfinished and in some circumstances has actually fallen back due to geopolitical tensions, financial recessions, the worldwide food crisis, environment modification, humanitarian crises and COVID-19.

There are emerging opportunities to catalyse development – for example, by boosting human rights-based methods in SRHR and embedding concepts like non-discrimination, consisting of in crisis scenarios. Improving health systems with a primary health-care method can boost equity and expand access to extensive SRHR services. New technologies and alternative service shipment techniques can enhance SRHR by expanding access, choice and autonomy.

Other future-looking focus areas within SRHR include research on the transformative function of expert system and innovative birth control methods, more deal with enhancing health systems, and the withstanding prioritization of positive pregnancy and giving birth experiences.

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