Sexual and Reproductive Health Framework - UNFPA

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Carina Wint/UNFPAPART 1A RATIONALE FOR IMPLEMENTING THESTRATEGIC PLAN IN REPRODUCTIVE RIGHTSAND SEXUAL AND REPRODUCTIVE HEALTHA. Definition of reproductive rightsand sexual and reproductive health9. More than a decade ago, at the ICPD, held in Cairo,179 countries agreed that:(a) All couples and individuals have the right todecide freely and responsibly the number,spacing and timing of their children, and to havethe information and means to do so;(b) Decisions concerning reproduction should bemade free from discrimination, coercion andviolence. 110. A major breakthrough at the ICPD, reaffirmedrepeatedly since, is that these services are essentialfor all people, married and unmarried, includingadolescents and youth. For people to realize theirreproductive rights, the ICPD Programme of Actioncalls for and defines reproductive and sexual healthcare in the context of primary health care to include(Para 7.6):(a) Family planning;(b) Antenatal, safe delivery and post-natal care;(c) Prevention and appropriate treatment ofinfertility;(d) Prevention of abortion and management of theconsequences of abortion;(e) Treatment of reproductive tract infections;(f) Prevention, care and treatment of STIs and HIV/AIDS;(g) Information, education and counselling,as appropriate, on human sexuality andreproductive health;(h) Prevention and surveillance of violence againstwomen, care for survivors of violence andother actions to eliminate traditional harmfulpractices, such as FGM/C;(i) Appropriate referrals for further diagnosis andmanagement of the above.11. At the Fourth World Conference on Women,held in Beijing (1995), governments recognizedthat entrenched patterns of social and culturaldiscrimination are major contributors to sexualand reproductive ill health, along with the lackof information and services. SRH efforts are tobe coordinated with interventions that addressthe patterns of social discrimination, genderinequalities and exclusion that hinder women, menand adolescents from exercising their reproductiverights.6MAKING REPRODUCTIVE RIGHTS AND SEXUAL AND REPRODUCTIVE HEALTH A REALITY FOR ALL
B. Progress since the InternationalConference on Population andDevelopment in 199412. In the years since the ICPD, at the global level,various meetings and pronouncements havereaffirmed the central role of reproductive rightsand reproductive health in achieving humanrights, reducing poverty, attaining gender equality,building a world free of violence against womenand girls, preventing HIV/AIDS and attaining theMDGs. Such events included ICPD+5, ICPD+10 andthe United Nations General Assembly Special Session(UNGASS) on HIV/AIDS and the political Declarationin 2006.13. In 2000, world leaders met at the United Nationsin New York to commit their countries to achievingthe MDGs. In 2005, the World Summit reaffirmedthat universal access to reproductive health iscritical to achieving the MDGs. In October 2007, ofthe target of universal access to reproductive healthwas added to MDG 5, for improving maternal health.By this action, countries validated once more thecritical importance of SRH programmes to meetingthe MDGs. The inclusion of the target on universalaccess to reproductive health is an opportunity fora renewed commitment to further advance the SRHagenda.14. Based on this global political reaffirmation ofthe ICPD agenda, reproductive rights are nowconsidered a human right for all people, includinguniversal access to reproductive health throughouttheir life cycle. In addition, family planning isnow understood within the broader frameworkof reproductive health and rights and not as apopulation control instrument.15. After the ICPD, many countries passed laws andenacted policies on SRH and began to implementSRH programmes within the health-care system.According to a 2004 UNFPA survey on progress sinceCairo, about 86 per cent of countries had adoptedpolicy measures, laws or institutional changes atnational levels to promote or enforce reproductiverights, and 54 per cent had formulated new policies. 216. Where country policies, budgets and programmeshave reflected the ICPD goals, there has beenprogress. More girls are now in school, and abouttwo thirds of countries that had data for 2004 hadachieved gender parity in primary education. 3 Morewomen now have access to contraceptives. 4 At least adozen middle-income countries and even a few lowincomecountries have reduced maternal mortality. 5In Eastern Europe, there has been a decline by halfin abortion rates due to increased contraceptiveuse. 6 In 2006, HIV prevalence decreased for the firsttime in some countries of sub-Saharan Africa.17. Nevertheless, assessing progress is not simplya matter of identifying statistical indicators orsupportive international statements or evenpublic policies. SRH programmes have generallydeveloped slowly. They seldom have sustainableinstitutionalization and adequate outreach. As aresult, SRH programmes have often failed to helpdisadvantaged women and adolescents, who areless able than others to exercise their rights andmore vulnerable to poor health outcomes. 7 As thefollowing section indicates, there is a strong casefor increased investments in SRH information andservices.C. Sexual and reproductive health inthe new millennium: challenges andtrends18. There is an urgent need for dramatically increasedinvestments in SRH information and servicesto address the global SRH challenges and thereproductive rights of populations and, particularly,the most vulnerable:(a) Poor SRH accounts for an estimated one thirdof the global burden of illness and early deathamong women of reproductive age. 8(b) About 201 million married women in developingcountries still have an unmet need for moderncontraceptives. Data from 94 national surveysindicate that the unmet contraceptive needamong sexually active adolescents is more thantwo times higher than that among marriedwomen. In sub-Saharan Africa, for example, asmany as 46 per cent of women face this problem. 9Globally, 37 countries have an unmet need forfamily planning that is greater than 20 per centand 24 countries have a contraceptive prevalencerate for modern methods that is less than 10 percent. 10(c) Every day over 6,000 people are infected withHIV, of which over two-thirds occur in sub-Saharan Africa. 11 In Swaziland, an estimatedone in three adults now lives with HIV. Globally,there are about 340 million new cases of STIsMAKING REPRODUCTIVE RIGHTS AND SEXUAL AND REPRODUCTIVE HEALTH A REALITY FOR ALL7
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Sexual and Reproductive Health Framework - UNFPA

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