Sexual and Reproductive Health for All: 20 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 individuals to attain the highest requirement of sexual and reproductive health and rights (SRHR). In 2004, WHO released a reproductive health method – validated by 191 Member States at the Fifty-seventh World Health Assembly – that enhanced the centrality of SRHR to societies and economies (Resolution WHA57.12). These structures are grounded in gender equality and recognize the unchanging value of sexual health in achieving health for all.

WHO researchers dealt with Member States, civil society and neighborhoods across all regions to operationalize an International Strategy to cover the five key pillars for enhancing SRHR:

– improving antenatal, perinatal, postpartum and newborn care

– offering family preparation services

– getting rid of risky abortion

– fighting sexually transferred infections (STIs).

– promoting sexual health.

Resolution WHA57.12 further notified SRHR policies and assisting documents in a number of regions and Member States. For example, Latin America’s 2013 Montevideo Consensus and Africa’s Maputo Plan of Action from 2016 (structure upon the initial 2006 plan) both include language and ideas reinforcing and supporting SRHR.

» The international method is the fundamental policy document that centres WHO’s mandate 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 contributing to assisting research priorities and dealing with countries to establish beneficial resources to guarantee detailed SRHR across the life course.»

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

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

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

– Prioritizing household planning services and birth control access resulted in WHO’s Family preparation: a global handbook for suppliers reference guide, which has been distributed over a million times. Accordingly, the percentage of ladies using contemporary contraceptive techniques increased from 467 million in 1990 to 874 million in 2022, while a wider range of contraceptive options is now offered.

A 2020 research study discovered that there has actually been a worldwide decrease in unintentional pregnancy. Furthermore, evidence-based medical abortion programs have actually enhanced international access to abortion, and over 60 nations have liberalized abortion laws in the previous 30 years in line with evidence on the significance of such efforts to guarantee the health of females and adolescent ladies.

Professor Kate Gilmore, co-chair of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for helping create crucial clinical proof on SRHR that has actually contributed to some of these shifts. «A few of the terrific advances that we have actually seen – including the method civil society has actually taken up the cause to argue for access to safe and legal abortion – are due to the Strategy and the organized generation of proof over these past 2 decades,» she stated.

Despite early gains, nevertheless, current years have actually seen indications of stagnancy. From 2000 to 2020, the maternal death rate dropped by 34% worldwide – but a 2023 report discovered that development has actually mostly stalled because. The worrisome trend was illustrated throughout a current occasion showcasing global datasets on the evolution of SRHR considering that ICPD. High maternal mortality rates continue a few nations and sexual health problems, such as endometriosis, infertility and sexual erectile dysfunction, are frequently neglected or normalized.

Dr Allotey and Dr Manjulaa Narasimhan, researcher at WHO and HRP, kept in mind in a current commentary in the WHO Bulletin that the SRHR program stays incomplete and in some circumstances has actually fallen back due to geopolitical tensions, financial recessions, the global food crisis, environment change, humanitarian crises and COVID-19.

There are emerging chances to catalyse development – for example, by improving human rights-based techniques 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 thorough SRHR services. New innovations and alternative service delivery methods can improve SRHR by expanding gain access to, choice and autonomy.

Other future-looking focus areas within SRHR consist of research study on the transformative function of artificial intelligence and innovative birth methods, more work on reinforcing health systems, and the sustaining prioritization of positive pregnancy and giving birth experiences.

At a wider level, Dr Allotey called for a continued emphasis on the foundational value of SRHR. «Sexual and reproductive health need to never be relegated to the margins of health care, but acknowledged as critical for the total wellness of people and the communities in which they live,» she stated.