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

Thirty years back, 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 released a reproductive health strategy – ratified 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 structures are grounded in gender equality and recognize the constant significance of sexual health in achieving health for all.

WHO scientists worked with Member States, civil society and communities across all areas to operationalize a Global Strategy to cover the 5 essential pillars for enhancing SRHR:

– improving antenatal, perinatal, postpartum and newborn care

– supplying household planning services

– getting rid of hazardous abortion

– fighting sexually transmitted infections (STIs).

– promoting sexual health.

Resolution WHA57.12 SRHR policies and directing documents in numerous areas and Member States. For example, Latin America’s 2013 Montevideo Consensus and Africa’s Maputo Plan of Action from 2016 (structure upon the original 2006 strategy) both consist of language and ideas enhancing and promoting SRHR.

” The international strategy is the fundamental policy document that centres WHO’s required for sexual and reproductive health to date,” said 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 adding to assisting research study priorities and dealing with nations to establish beneficial resources to guarantee comprehensive SRHR throughout the life course.”

Significant development has been made over the last twenty years within each of the five pillars, including these examples.

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

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

– Prioritizing family preparation services and birth control access caused WHO’s Family planning: a global handbook for providers referral guide, which has been disseminated over a million times. Accordingly, the percentage of ladies utilizing modern-day contraceptive methods increased from 467 million in 1990 to 874 million in 2022, while a broader range of contraceptive alternatives is now offered.

A 2020 study found that there has actually been an around the world reduction in unintentional pregnancy. Furthermore, evidence-based medical abortion programs have actually enhanced international access to abortion, and over 60 nations have liberalized abortion laws in the past 30 years in line with evidence on the value of such efforts to guarantee the health of females and adolescent ladies.

Professor Kate Gilmore, co-chair of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for assisting create crucial scientific evidence on SRHR that has actually contributed to a few of these shifts. “A few of the terrific advances that we’ve seen – consisting of the way 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 past 2 years,” she stated.

Despite early gains, nevertheless, current years have seen indications of stagnation. From 2000 to 2020, the maternal mortality rate visited 34% around the world – however a 2023 report found that progress has mostly stalled considering that. The uneasy pattern was shown during a recent event showcasing international datasets on the evolution of SRHR considering that ICPD. High maternal death rates continue in a few nations and sexual health problems, such as endometriosis, infertility and sexual erectile dysfunction, are frequently ignored or normalized.

Dr Allotey and Dr Manjulaa Narasimhan, scientist at WHO and HRP, noted in a recent commentary in the WHO Bulletin that the SRHR agenda stays unfinished and in some instances has actually regressed due to geopolitical tensions, economic declines, the worldwide food crisis, environment change, humanitarian crises and COVID-19.

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

Other future-looking focus areas within SRHR consist of research on the transformative role of synthetic intelligence and innovative contraception approaches, additional deal with strengthening health systems, and the enduring prioritization of positive pregnancy and giving birth experiences.

At a more comprehensive level, Dr Allotey called for a continued emphasis on the foundational value of SRHR. “Sexual and reproductive health should never ever be relegated to the margins of healthcare, however acknowledged as critical for the overall wellness of people and the communities in which they live,” she stated.