Public Choices, Private Decisions: Sexual and Reproductive Health ...

26 Sexual and Reproductive Health and the Millennium Development Goals
“Parents
have a basic
human right
to determine
freely and
responsibly
the number
and spacing of
their children”
protection of human rights, especially – but not only – in regard to sexuality and
personal relationships.”
Given the broad definition of SRH, a wide range of interventions and
program activities are needed for its promotion. Interventions are needed, for
example, to ensure access to SRH information and services, to promote gender
equality and women’s empowerment and to eliminate gender-based violence and
sexual coercion (see Appendix 2 for a list of interventions). Programs, therefore,
must involve many different actors – from government officials to community
and cultural leaders to civil society and the private sector down to families and
individuals (both men and women). Finally, SRH programs are committed to
strengthening healthcare delivery in developing countries, and are working to
ensure that SRH activities are fully integrated into these systems.
Recently, in an attempt to further refine this broad definition as it relates to
the health system, WHO (2004a) identified five key interventions that, although
not comprehensive, are key to successful SRH programs:
1. Ensuring contraceptive choice and safety
2. Improving maternal and newborn health
3. Reducing sexually transmitted and other reproductive tract infections
and HIV/AIDS
4. Eliminating unsafe abortion
5. Promoting healthy sexuality.
Reproductive rights
SRH goes well beyond simply delivering services and information about disease
prevention and risk reduction (although these activities are essential aspects of
SRH programming). At its core is the promotion of healthy, voluntary and safe
sexual and reproductive choices for individuals and couples, including such decisions
as those on family size and timing of marriage.
The International Conference on Human Rights in Tehran in 1968 was
the first international forum to explicitly state that “Parents have a basic human
right to determine freely and responsibly the number and spacing of their children”.
And this was reaffirmed at the 1975 First World Conference on Women,
which argued that the right to family planning was essential for gender equality.
The 1984 International Conference on Population again endorsed this right, and
further concluded that men shared responsibility for family planning and child
rearing.
These references to reproductive rights are not new, but instead bring together
long-standing accepted norms from various internationally agreed human rights
frameworks that are relevant to SRH. The Universal Declaration of Human
Rights (1948) put forth a common standard of achievement for all peoples and
all nations that included certain fundamental political, social, economic and cultural
rights and freedoms. Based on this, the International Covenant on Civil
and Political Rights (1976) and the International Covenant on Economic, Social