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

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

– enhancing antenatal, perinatal, postpartum and newborn care

– offering family planning services

– removing unsafe abortion

– fighting sexually sent infections (STIs).

– promoting sexual health.

Resolution WHA57.12 more notified SRHR policies and guiding documents in a number of regions and Member States. For instance, Latin America’s 2013 and Africa’s Maputo Strategy from 2016 (building upon the original 2006 strategy) both consist of language and ideas strengthening and upholding SRHR.

” The international strategy is the foundational 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 remains essential in adding to guiding research study top priorities and working with countries to develop useful resources to make sure extensive SRHR throughout the life course.”

Significant development 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 individuals acquiring HIV has fallen by 38% given that 2010 alone, due in part to the Strategy’s focus on eliminating STIs consisting of HIV.

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

– Prioritizing household preparation services and birth control gain access to led to WHO’s Family planning: an international handbook for service providers reference guide, which has been disseminated over a million times. Accordingly, the percentage of women utilizing modern-day contraceptive methods increased from 467 million in 1990 to 874 million in 2022, while a wider series of contraceptive choices is now offered.

A 2020 study found that there has been an around the world decline in unintended pregnancy. Furthermore, evidence-based medical abortion regimens have improved 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 ensure the health of females and teen women.

Professor Kate Gilmore, co-chair of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for assisting produce essential scientific proof on SRHR that has actually added to some of these shifts. ”A few of the great advances that we’ve seen – including the way civil society has actually taken up the cause to argue for access to safe and legal abortion – are due to the Strategy and the methodical generation of proof over these previous 2 decades,” she stated.

Despite early gains, however, current years have actually seen indications of stagnancy. From 2000 to 2020, the maternal death rate come by 34% around the world – however a 2023 report found that development has mostly stalled since. The uneasy pattern was shown throughout a current occasion showcasing international datasets on the evolution of SRHR since ICPD. High maternal mortality rates continue a few nations and sexual health concerns, such as endometriosis, infertility and sexual erectile dysfunction, are often overlooked 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 remains incomplete and in some instances has fallen back due to geopolitical tensions, financial downturns, the international food crisis, climate modification, humanitarian crises and COVID-19.

There are emerging chances to catalyse progress – for example, by enhancing human rights-based approaches in SRHR and embedding principles like non-discrimination, including in crisis situations. Improving health systems with a primary health-care method can enhance equity and broaden access to extensive SRHR services. New innovations and alternative service delivery approaches can enhance SRHR by broadening gain access to, choice and autonomy.

Other future-looking focus locations within SRHR consist of research on the transformative function of synthetic intelligence and ingenious contraception approaches, additional deal with strengthening health systems, and the sustaining prioritization of positive pregnancy and childbirth experiences.

At a broader level, Dr Allotey required an ongoing focus on the foundational importance of SRHR. ”Sexual and reproductive health must never be relegated to the margins of health care, however recognized as important for the total well-being of people and the neighborhoods in which they live,” she said.