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, underscored the right of all people to achieve the greatest 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 structures are grounded in gender equality and acknowledge the unvarying value of sexual health in achieving health for all.

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

– improving antenatal, perinatal, postpartum and newborn care

– offering household planning services

– getting rid of hazardous abortion

– fighting sexually transmitted infections (STIs).

– promoting sexual health.

Resolution WHA57.12 further informed SRHR policies and guiding files in several areas 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 consist of language and concepts enhancing and upholding SRHR.

” The global method is the foundational 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 remains crucial in adding to directing research concerns and working with countries to establish helpful resources to ensure detailed SRHR across the life course.”

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

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

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

– Prioritizing family planning services and contraception access led to WHO’s Family planning: an international handbook for companies recommendation guide, which has been shared over a million times. Accordingly, the percentage of women using contemporary contraceptive techniques increased from 467 million in 1990 to 874 million in 2022, while a larger variety of contraceptive choices is now available.

A 2020 study discovered that there has been an around the world decline in unexpected pregnancy. Furthermore, evidence-based medical abortion programs have actually enhanced worldwide access to abortion, and over 60 nations have liberalized abortion laws in the previous thirty years in line with evidence on the value of such efforts to make sure the health of women and teen girls.

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

Despite early gains, however, current years have actually seen indications of stagnancy. From 2000 to 2020, the maternal mortality rate dropped by 34% worldwide – but a 2023 report that progress has actually mainly stalled given that. The uneasy pattern was illustrated throughout a recent event showcasing global datasets on the development of SRHR given that ICPD. High maternal mortality rates persist in a few nations and sexual health problems, such as endometriosis, infertility and sexual erectile dysfunction, are often ignored 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 program stays unfinished and in some circumstances has actually regressed due to geopolitical stress, financial slumps, the worldwide food crisis, environment change, humanitarian crises and COVID-19.

There are emerging chances to catalyse progress – for example, by improving human rights-based techniques in SRHR and embedding principles like non-discrimination, including in crisis circumstances. Improving health systems with a primary health-care approach can boost equity and expand access to comprehensive SRHR services. New technologies and alternative service delivery techniques can improve SRHR by broadening access, choice and autonomy.

Other future-looking focus locations within SRHR consist of research on the transformative role of expert system and innovative birth control techniques, further deal with strengthening health systems, and the withstanding prioritization of favorable pregnancy and childbirth experiences.

At a wider level, Dr Allotey called for a continued focus on the foundational importance of SRHR. “Sexual and reproductive health need to never be relegated to the margins of healthcare, but acknowledged as critical for the total well-being of people and the communities in which they live,” she stated.