Sexual and reproductive health and rights in the post-2015 development agenda

Abstract

Women's health is currently shaped by the confluence of two important policy trends – the evolution of health system reform policies and from the early 1990s onwards, a strong articulation of a human rights-based approach to health that has emphasised laws and policies to advance gender equality and sexual and reproductive health and rights (SRHR). The drive for sexual and reproductive rights represents an inclusive trend towards human rights to health that goes beyond the right to health services, directing attention to girls' and women's rights to bodily autonomy, integrity and choice in relation to sexuality and reproduction. Such an expanded concept of the right to health is essential if laws, policies and programmes are to respect, protect and fulfil the health of girls and women. However, this expanded understanding has been ghettoised from the more mainstream debates on the right to health and was only partially included in the Millennium Development Goals. The paper argues in favour of a twofold approach in placing SRHR effectively in the context of the post-2015 development agenda: first, firmly ground it in an inclusive approach to the right to health; and second, drawing on two decades of national-level implementation, propose a forward-looking agenda focusing on quality, equality and accountability in policies and in programmes. This can build on good practice while addressing critical challenges central to the development framework itself.

Keywords:

• sexual and reproductive health and rights
• post-2015 development agenda
• right to health
• Millennium Development Goals

Notes

1. Definition of reproductive health including sexual health in paragraph 7.2 of the POA.

2. I use “quality” here as shorthand for AAAQ – Availability, Access, Acceptability and Quality.

3. The most recent evidence of this is the global report on ICPD implementation (UNFPA, 2013b) which was published after the first version of this paper was written.

4. UNFPA has recently come out in support of a goal for adolescents (UNFPA, 2013a) that is cogent and well argued; how much momentum it is able to pick up in the post-2015 discussions remains to be seen. Although there was a full track on inequalities in these discussions culminating in a multi-stakeholder consultation in Copenhagen, in early 2013, inequality has not picked up much momentum so far in the larger discussion except among civil society.

5. Family Planning 2020 (FP2020) is an initiative of the Bill and Melinda Gates Foundation launched in 2011 with multiple donors to provide new funding and momentum to family planning.