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 achieve 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 reinforced the centrality of SRHR to societies and economies (Resolution WHA57.12). These frameworks are grounded in gender equality and acknowledge the imperishable importance of sexual health in achieving health for all.

WHO scientists worked with Member States, civil society and communities across all regions to operationalize a Worldwide Strategy to cover the 5 crucial pillars for improving SRHR:

– enhancing antenatal, perinatal, postpartum and newborn care

– providing household preparation services

– eliminating hazardous abortion

– combatting sexually transferred infections (STIs).

– promoting sexual health.

Resolution WHA57.12 more notified SRHR policies and directing files in a number of regions and Member States. For example, Latin America’s 2013 Montevideo Consensus and Africa’s Maputo Strategy from 2016 (structure upon the original 2006 strategy) both include language and concepts strengthening and maintaining SRHR.

” The worldwide technique is the fundamental policy document that centres WHO’s mandate 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 important in adding to guiding research study priorities and working with countries to establish useful resources to guarantee extensive SRHR throughout the life course.”

Significant development has actually been made over the last 20 years within each of the five pillars, consisting of these examples.

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

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

– Prioritizing family planning services and birth control access led to WHO’s Family preparation: a global handbook for service providers referral guide, which has actually been shared over a million times. Accordingly, the percentage of females using contemporary contraceptive techniques increased from 467 million in 1990 to 874 million in 2022, while a wider series of contraceptive alternatives is now offered.

A 2020 research study discovered that there has actually been an around the world decrease in unintentional pregnancy. Furthermore, evidence-based medical abortion programs have enhanced international access to abortion, and over 60 nations have actually liberalized abortion laws in the previous 30 years in line with proof on the importance of such efforts to ensure the health of females and teen ladies.

Professor Kate Gilmore, co-chair of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for helping produce crucial scientific proof on SRHR that has added to a few of these shifts. “A few of the fantastic advances that we have actually seen – including the method civil society has taken up the cause to argue for access to safe and legal abortion – are because of the Strategy and the methodical generation of evidence over these previous twenty years,” she stated.

Despite early gains, nevertheless, recent years have seen indications of stagnation. From 2000 to 2020, the maternal mortality rate dropped by 34% worldwide – but a 2023 report discovered that progress has actually mostly stalled considering that. The uneasy trend was illustrated during a recent event showcasing global datasets on the evolution of SRHR because ICPD. High maternal mortality rates persist in a few nations and sexual health concerns, such as endometriosis, infertility and sexual erectile dysfunction, are frequently overlooked or stabilized.

Dr Allotey and Dr Manjulaa Narasimhan, scientist at WHO and HRP, kept in mind in a recent commentary in the WHO Bulletin that the SRHR program stays unfinished and in some instances has regressed due to geopolitical tensions, economic declines, the global food crisis, climate modification, humanitarian crises and COVID-19.

There are emerging chances to catalyse progress – for example, by improving human rights-based techniques in SRHR and embedding concepts like non-discrimination, consisting of in crisis circumstances. Improving health systems with a main health-care approach can enhance equity and expand access to detailed SRHR services. New technologies and alternative service delivery approaches 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 birth control methods, further work on strengthening health systems, and the withstanding prioritization of positive pregnancy and giving birth experiences.

At a broader level, Dr Allotey called for an ongoing focus on the importance of SRHR. “Sexual and reproductive health should never be relegated to the margins of health care, however acknowledged as important for the total wellness of individuals and the communities in which they live,” she stated.