Sexual and Reproductive Health for All: twenty Years of The Global Strategy

Thirty years back, the International Conference on Population and Development (ICPD), held in Cairo, Egypt, underscored the right of all people to achieve the greatest requirement of sexual and reproductive health and rights (SRHR). In 2004, WHO published a reproductive health method – ratified by 191 Member States at the Fifty-seventh World Health Assembly – that reinforced the midpoint of SRHR to societies and economies (Resolution WHA57.12). These frameworks 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 communities throughout all areas to operationalize a Global Strategy to cover the 5 key pillars for enhancing SRHR:

– improving antenatal, perinatal, postpartum and newborn care

– supplying family preparation services

– getting rid of risky abortion

– combatting sexually transmitted infections (STIs).

– promoting sexual health.

Resolution WHA57.12 additional notified SRHR policies and assisting documents in numerous regions and Member States. For instance, Latin America’s 2013 Montevideo Consensus and Africa’s Maputo Strategy from 2016 (building upon the original 2006 strategy) both include language and ideas strengthening and upholding SRHR.

” The international strategy 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 crucial in contributing to assisting research concerns and dealing with countries to develop useful resources to make sure detailed SRHR throughout the life course.”

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

– The Global method came about as the world was reeling from the HIV and AIDS epidemic. Today, the variety of individuals acquiring HIV has actually fallen by 38% given that 2010 alone, due in part to the Strategy’s emphasis on eliminating STIs including HIV.

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

– Prioritizing household planning services and contraception gain access to resulted in WHO’s Family preparation: a worldwide handbook for suppliers reference guide, which has actually been distributed over a million times. Accordingly, the proportion of women utilizing modern-day contraceptive approaches increased from 467 million in 1990 to 874 million in 2022, while a wider variety of contraceptive choices is now readily available.

A 2020 study discovered that there has been an around the world reduction in unintentional pregnancy. Furthermore, evidence-based medical abortion programs have improved global access to abortion, and over 60 countries have liberalized abortion laws in the past 30 years in line with evidence on the significance of such efforts to guarantee the health of women and adolescent ladies.

Professor Kate Gilmore, co-chair of the Gender and Human Rights Advisory Panel of HRP, credited the Strategy and WHO for assisting create essential clinical proof on SRHR that has actually added to a few of these shifts. “Some of the excellent advances that we have actually seen – including the method civil society has actually used up the cause to argue for access to safe and legal abortion – are due to the Strategy and the organized generation of evidence over these previous 20 years,” she said.

Despite early gains, nevertheless, current years have seen indications of stagnation. From 2000 to 2020, the maternal mortality rate visited 34% worldwide – but a 2023 report found that progress has actually mostly stalled given that. The worrisome pattern was highlighted throughout a recent event showcasing global datasets on the development of SRHR considering that ICPD. High maternal death rates continue in 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, scientist at WHO and HRP, kept in mind in a recent commentary in the WHO Bulletin that the SRHR agenda stays unfinished and in some circumstances has regressed due to geopolitical tensions, economic declines, the worldwide food crisis, environment change, humanitarian crises and COVID-19.

There are emerging opportunities to catalyse progress – for instance, by improving human rights-based approaches in SRHR and embedding concepts like non-discrimination, including in crisis scenarios. Improving health systems with a primary health-care method can boost equity and expand access to detailed SRHR services. New technologies and alternative service shipment methods can improve SRHR by expanding access, choice and autonomy.

Other future-looking focus areas within SRHR consist of research on the role of synthetic intelligence and innovative contraception techniques, further deal with enhancing health systems, and the enduring prioritization of favorable pregnancy and giving birth experiences.

At a wider level, Dr Allotey called for a continued emphasis on the fundamental importance of SRHR. “Sexual and reproductive health should never be relegated to the margins of healthcare, but recognized as critical for the overall wellness of individuals and the communities in which they live,” she said.