Taking action: achieving gender equality and empowering women

Guarantee sexual and reproductive health and rights
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Counseling,
prevention,
and treatment
services
for sexually
transmitted
infections and
HIV should
be integrated
with other
reproductive
health services
Interventions for family planning and safe abortion services
Access to quality family planning services that provide women with a range
of contraceptive options and informed choice helps reduce high-risk pregnancies
associated with multiple pregnancies and helps women avoid unwanted
and unsafe abortions (Lule and others 2003). In developing countries family
planning programs were responsible for an estimated 43 percent of the decline
in fertility between 1960 and 1980 (Bongaarts and Bruce 1995). If the unmet
need for contraception were met so that women could have only the pregnancies
they wanted, maternal mortality would drop by an estimated 20–35 percent
(Doulaire 2002; Maine 1991).
The WHO estimates that safe abortion services could prevent at least 13 percent
of maternal deaths worldwide (WHO 1998b). In almost all countries abortion
to save a woman’s life is legal. In more than three-fifths of countries abortion
is also permitted to preserve women’s physical and mental health, and in 40
percent of countries, abortion is allowed in cases of rape, incest, or fetal malformation.
One-third of countries allow abortion on socioeconomic grounds, and
one-quarter allow abortion on request (Barroso and Girard 2003). But in many
cases where abortion is legal, safe services are unavailable (WHO 2003).
Interventions for prevention and treatment of sexually transmitted
infections and HIV/AIDS
Counseling, prevention, and treatment services for sexually transmitted infections
and HIV should be integrated with other reproductive health services and
made available through the primary healthcare system, which is most likely to
reach populations in greatest need, such as adolescents and the poor. Singlepurpose
programs for preventing and treating sexually transmitted infections
almost always fail to reach women because many women are asymptomatic,
and seeking treatment is socially stigmatized.
Women urgently need a female-controlled method of prevention for sexually
transmitted infections, and programs need to target men as well as women
for prevention and treatment of such infections. The female condom, now
available in industrialized countries and in some countries in the developing
world, needs to be made more accessible and affordable. The male condom,
the only widely available method of prevention, requires the cooperation of the
male partner. Women worldwide report that male opposition is a significant
hurdle to using a condom.
Simultaneously, investment is needed in research and development to produce
a safe and effective microbicide that women can use to protect themselves
against a wide range of sexually transmitted pathogens, including HIV. There
are some 60 different compounds in the pipeline with potential microbicidal
properties, but substantial funding is required to test them for efficacy and
bring the effective compounds rapidly to market. The benefits to low-income
countries could be enormous. For example, researchers at the London School