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

Thirty years ago, the International Conference on Population and Development (ICPD), kept in Cairo, Egypt, highlighted the right of all individuals to attain the highest standard of sexual and reproductive health and rights (SRHR). In 2004, WHO published a reproductive health strategy – ratified by 191 Member States at the Fifty-seventh World Health Assembly – that reinforced the midpoint of SRHR to societies and economies (Resolution WHA57.12). These frameworks are grounded in gender equality and recognize the constant importance of sexual health in attaining health for all.

WHO scientists dealt with Member States, civil society and communities across all areas to operationalize an International Strategy to cover the five essential pillars for improving SRHR:

– improving antenatal, perinatal, postpartum and newborn care

– supplying family preparation services

– eliminating hazardous abortion

– combatting sexually transferred infections (STIs).

– promoting sexual health.

Resolution WHA57.12 further informed SRHR policies and assisting 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 plan) both include language and concepts enhancing and maintaining SRHR.

” The international technique is the fundamental policy file 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 remains essential in contributing to directing research top priorities and dealing with countries to establish beneficial resources to guarantee detailed SRHR across the life course.”

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

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

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

– Prioritizing family preparation services and birth control gain access to led to WHO’s Family preparation: a global handbook for service providers reference guide, which has been disseminated over a million times. Accordingly, the percentage of females utilizing contemporary contraceptive methods increased from 467 million in 1990 to 874 million in 2022, while a wider series of contraceptive options is now offered.

A 2020 research study discovered that there has been a worldwide reduction in unintended pregnancy. Furthermore, evidence-based medical abortion routines have actually improved international access to abortion, and over 60 countries have liberalized abortion laws in the previous thirty years in line with evidence on the significance of such efforts to make sure the health of women and adolescent girls.

Professor Kate Gilmore, co-chair of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for helping produce important clinical evidence on SRHR that has actually contributed to some of these shifts. “A few of the great advances that we’ve seen – including the way civil society has used 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 2 years,” she stated.

Despite early gains, however, recent years have seen signs of stagnation. From 2000 to 2020, the maternal mortality rate dropped by 34% worldwide – however a 2023 report discovered that progress has mainly stalled given that. The uneasy pattern was highlighted throughout a current occasion showcasing international datasets on the evolution of SRHR considering that ICPD. High maternal mortality rates continue a few nations and sexual health concerns, such as endometriosis, infertility and sexual erectile dysfunction, are often neglected or normalized.

Dr Allotey and Dr Manjulaa Narasimhan, researcher at WHO and HRP, kept in mind in a recent commentary in the WHO Bulletin that the SRHR program remains unfinished and in some instances has actually fallen back due to geopolitical stress, financial slumps, the international food crisis, climate modification, humanitarian crises and COVID-19.

There are emerging chances to catalyse development – for example, by improving human rights-based approaches in SRHR and embedding principles like non-discrimination, consisting of in crisis circumstances. Improving health systems with a main health-care method can boost equity and broaden access to extensive SRHR services. New innovations and alternative service delivery techniques can improve SRHR by broadening gain access to, choice and autonomy.

Other future-looking focus areas within SRHR consist of research study on the transformative role of expert system and ingenious contraception methods, more deal with enhancing health systems, and the enduring prioritization of favorable pregnancy and childbirth experiences.

At a more comprehensive level, Dr Allotey required an ongoing focus on the foundational significance of SRHR. “Sexual and reproductive health must never be relegated to the margins of health care, however acknowledged as vital for the total wellness of individuals and the communities in which they live,” she said.