Shifting the conversation on Sexual and Reproductive Health and Rights

Reproductive rights have become a political bargaining tool. From the reinstatement and expansion of the Global Gag rule by President Trump; the continued inaction for women in Northern Ireland; and the bill passed in Alabama last week, ordering an almost blanket ban on abortion; sexual and reproductive rights are being slowly eroded.

Last week, I attended an event to mark 25 years since the International Conference on Population and Development (ICPD), a landmark event for women’s rights. Panellists spoke of the increasing level of opposition to SRHR and the polarisation of opinions that has occurred since 1994.

As a key topic on the global health agenda, it can be difficult to understand why there is opposition to an area so critical for a country’s development. I want to suggest that we need to shift the conversation. We must demonstrate how SRHR is a critical component of the right to health, and necessary for achieving health for all, to protect SRHR from its current state as a political bargaining tool.

Legal (safe) abortion .v. unsafe abortion

The narrow focus on safe abortion can suggest that either abortion is legal, or it does not happen at all. Abortion will happen regardless. The choice is between regulated, accounted for abortion with minimal risk to the women accessing services, or unregulated, back street abortions that can be exceptionally high risk. 25 million unsafe abortions take place each year and this is one of the three leading causes of maternal mortality. Making abortion illegal does not reduce abortion rates. Instead, it increases the number of women who die from unplanned pregnancy.

SRHR as a choice .v. SRHR as a critical component of health

Sexual and reproductive health and rights is a broad ranging term. It includes the treatment of reproductive cancers; sexual pleasure; contraceptive services; prevention and control of STIs; and maternal and new born care; and safe abortion, to name only a few elements. Denying a person their SRHR, means denying a baby a safe delivery; denying a man HIV medication; and denying a woman treatment for ovary cancer. Denying a person their SRHR, means denying them their health.

Some health for some people .v. Health for all

Every woman, man, and child has the right to health. 81 countries have signed up to the UHC2030 agenda, which means that they are all committed to providing high quality health care, without the risk of financial hardship, to all by 2030. A country where women do not have access to safe abortion, as part of a package of comprehensive SRHR services, will never achieve health for all, because at least half the population are not able to receive the health services they need.

Reasons to be hopeful

Despite the regression in some parts of the world over the last few weeks, there are reasons to hope SRHR isn’t always being regarded as a means to gain power. When I read of women in Alabama being denied a right to their body, I remember that teenagers in Kenya, Tanzania, and South Africa are busy designing solutions to reduce unsafe abortions in difficult political climates. When I hear of citizens from my own country risking their lives because of inequitable access to safe abortion; I think of brave politicians across Africa and Asia, committing to financially support sexual and reproductive rights, because it is part and parcel of health. It should be noted that no country in Africa has regressed in their efforts to legalise abortion.

Next week, world leaders, influencers, advocates, academics and journalists will come together for the largest conference on gender equality and the health, rights, and well-being of girls and women; Women Deliver. It is so important that the global health community uses opportunities like this to shine a light on these issues, to hold politicians and policy makers to account for ensuring SRHR and health rights are protected.

Of course, there is a long way to go, but at Options, we believe that progress is being made. We will continue to support governments to integrate sexual reproductive health into their provision of health care, to encourage young women and girls to identify their own solutions to protecting their futures; and ensure that in all countries we work in; everyone- regardless of gender, need, or circumstance, receives their right to health.