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 people to accomplish 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 importance of sexual health in attaining health for all.

WHO scientists worked with Member States, civil society and neighborhoods throughout all areas to operationalize a Global Strategy to cover the 5 key pillars for improving SRHR:

– improving antenatal, perinatal, postpartum and newborn care

– providing household preparation services

– getting rid of risky abortion

– fighting sexually transferred infections (STIs).

– promoting sexual health.

Resolution WHA57.12 additional notified SRHR policies and guiding 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 concepts strengthening and upholding SRHR.

” The worldwide method is the foundational policy document that centres WHO’s required for sexual and reproductive health to date,” stated 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 top priorities and dealing with countries to develop beneficial resources to make sure extensive SRHR across the life course.”

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

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

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

– Prioritizing family preparation services and birth control gain access to caused WHO’s Family planning: a worldwide handbook for companies reference guide, which has been shared over a million times. Accordingly, the percentage of ladies utilizing modern contraceptive techniques increased from 467 million in 1990 to 874 million in 2022, while a larger series of contraceptive alternatives is now readily available.

A 2020 research study discovered that there has actually been an around the world decline in unexpected pregnancy. Furthermore, evidence-based medical abortion regimens have enhanced international access to abortion, and over 60 nations have liberalized abortion laws in the previous thirty years in line with proof on the importance of such efforts to guarantee the health of ladies and adolescent girls.

Professor Kate Gilmore, co-chair of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for assisting generate important scientific evidence on SRHR that has added to a few of these shifts. “Some of the terrific advances that we’ve seen – consisting of 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 methodical generation of evidence over these past twenty years,” she stated.

Despite early gains, however, recent years have actually seen signs of stagnation. From 2000 to 2020, the maternal mortality rate dropped by 34% around the world – but a 2023 report discovered that development has largely stalled considering that. The uneasy trend was illustrated throughout a recent occasion showcasing international datasets on the advancement of SRHR given that ICPD. High maternal mortality rates continue a couple of nations and sexual health problems, such as endometriosis, infertility and sexual erectile dysfunction, are frequently neglected 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 agenda stays unfinished and in some circumstances has actually regressed due to geopolitical stress, economic slumps, the international food crisis, environment change, humanitarian crises and COVID-19.

There are emerging chances to catalyse development – for instance, by enhancing human rights-based techniques in SRHR and embedding principles like non-discrimination, including in crisis situations. Improving health systems with a primary health-care technique can improve equity and broaden access to detailed SRHR services. New innovations and alternative service delivery methods can improve SRHR by expanding access, choice and autonomy.

Other future-looking focus areas within SRHR include research on the transformative role of expert system and innovative contraception approaches, further deal with enhancing health systems, and the sustaining prioritization of favorable pregnancy and giving birth experiences.

At a wider level, Dr Allotey called for an ongoing emphasis on the foundational value of SRHR. “Sexual and reproductive health should never be relegated to the margins of health care, however recognized as important for the general well-being of people and the communities in which they live,” she said.