To be empowered, every girl and woman needs to decide and control her body and sexuality. She needs to be able to choose if, when and with whom she wants to engage in safe and healthy sexual relations, and if and when she wants to have children in safe and healthy conditions free of coercion, discrimination and violence. Although at the heart of women’s empowerment and thus of sustainable development, Sexual and Reproductive Health and Rights (SRHR) are often misunderstood. This panel will present an evidence-based definition with the new Guttmacher-Lancet Commission on SRHR (European exclusive launch) and will discuss how to ensure a human-rights based approach to the continuum of care for all women and girls, and what the benefits are to do so.
- In developing countries, 214 million women want to avoid pregnancy but lack access to modern contraception; more than 45 million receive inadequate or no antenatal care.
- Sexual and reproductive health is a rights issue, not just a health or gender issue – empowering women through access to information and services is vital.
- Abortion for under-18s is a contentious issue that needs addressing. Contraception is a very cost-effective policy.
- Just US$ 9 per person per year is needed to ensure women’s sexual and reproductive health, but currently only half that amount is invested.
- This is not just about money but about commitment. Parliamentarians and leaders at all levels need to commit and to be held accountable.
Each year in developing regions, 214 million women want to avoid pregnancy but cannot access modern contraception, leading to 25 million unsafe abortions worldwide. More than 45 million women a year receive inadequate antenatal care, or none at all. At some point in their lives, about one in three women experiences gender-based violence, usually from an intimate partner.
The Guttmacher-Lancet Commission on sexual and reproductive health and rights (SRHR), in a major report published in May 2018, criticised policymakers for viewing sexual and reproductive health too narrowly as a health or women’s issue and argued that improving health depends on advancing rights.
This requires promoting sexual equality and empowering women through access to information and services. Women and girls should make their own decisions on whether and when to have sexual relations, get married, keep a pregnancy and have children – and they should be able to make those decisions free from coercion and violence.
But this is easier said than done. Abortion and contraception are highly contentious, especially in countries dominated by traditional religious values. In Chile, for example, it took 30 years of debate to arrive at legislation that allows abortion simply in emergency cases – when a mother’s life is in danger, if the foetus is not viable or in the case of rape or very young pregnancies. This legislation is a small step but it does enable leaders to start a more in-depth discussion around women’s sexual and reproductive rights, something that has never happened in Chile.
In Senegal, the government has committed to improving women and girls’ access to contraception, a very cost-effective policy. Within three years, coverage has more than doubled from 10 % to 25 %.
Money is part of the solution. Meeting the needs for contraception, abortion, and maternal and newborn healthcare in developing regions would cost just US$ 9 per person per year – double the amount currently being spent. But money alone will not change attitudes or enshrine women’s sexual and reproductive rights. It will take the full-bodied commitment of leaders at all levels – from parliamentarians to religious leaders to civil society and parents.
Chile is an interesting example of how bottom-up and top-down approaches combined to bring a partial legalisation of abortion. While President Michelle Bachelet was personally committed to pushing sexual and reproductive rights, the political classes were less convinced. It took pressure from civil society – fuelled by 70 % to 80 % support among the general population for abortion – to put this issue on the political agenda.
Meanwhile in Senegal, progress is slow. But the country recently passed a law requiring full gender parity in parliament, so as women take their place as decision-makers, they will be able to bring sexual and reproductive rights issues to the table.
Abortion is going on regardless of whether it is legal or not. But when countries decriminalise the termination of pregnancies, mortality rates as a result of abortion are far lower than in countries where the practice is illegal.