Let UHC include sexual health, rights

Wednesday March 18 2020

Activists protest in Nairobi on April 10, 2019, calling for health stakeholders to ensure all women have access to sexual and reproductive health services indiscriminately. Sexual and reproductive health are matters of fundamental human rights. PHOTO | FILE | NATION MEDIA GROUP


Next week, Nairobi plays host to global leaders, policymakers and influencers to mark the 25th anniversary of the International Conference on Population and Development (ICPD) which, in 1994, established an ambitious programme of action to achieve comprehensive sexual and reproductive health and rights for all.

The Nairobi summit, to be held from Tuesday to Thursday, takes place at a time of critical importance for sexual and reproductive health and rights.

Ideologically driven forces are seeking to roll back hard-won gains; to slash funding for essential services and to remove references to these services and rights from international agreements.

The summit must emphatically restate that sexual and reproductive health are matters of fundamental human rights — and they are critical for women’s, children’s and adolescents’ health.


At a time when there is growing political momentum in countries to provide affordable, quality health for all — universal health coverage (UHC) — we must ensure that the full panoply of sexual and reproductive health interventions are included in national health plans, with the financial resources to back them up.

We also must direct urgent attention to the ways in which discrimination and stigma prevent the most marginalised groups — including adolescents, migrants, people with disabilities, lesbian, gay, bisexual and transgender persons, minorities and indigenous peoples, among others — from accessing sexual and reproductive health services.

It is fitting that ICPD+25 is being held in the part of the world most vulnerable to the negative effects of cuts to sexual and reproductive health and rights.

Sub-Saharan Africa accounts for two-thirds of the annual maternal deaths (196,000). The rate of stillbirths, often seen as an indicator of the quality of care around the time of birth, is more than eight times that of high-income regions.

Undermining sexual and reproductive health services and rights will place more women, infants, children and adolescents at risk.


Rather than cut back on these, we need to accelerate global efforts to bring them to everyone.

By enshrining them into their national health plans, governments can accelerate progress towards UHC, establish accountability mechanisms for such progress and improve the health and lives of women, children and adolescents.

This is not only good public health; it makes economic sense as well.

Countless studies have shown, for example, that investing in family planning is one of the most cost-effective development interventions with both immediate savings and long-term benefits — including from reduced infant and maternal mortality and stronger economic growth.

Furthermore, providing a comprehensive package of sexual and reproductive health interventions is affordable and attainable.

In low- and middle-income countries, the Guttmacher-Lancet Commission (2018) estimated, the cost of meeting all women’s needs for contraceptive, maternal and newborn care (excluding HIV treatment and care) amounted to less than $9 per capita annually. This is affordable.

As young women in our respective countries, we three fought against entrenched gender norms in order to live independent and fulfilling lives with decision-making power over our bodies and the ability to make personal and professional life choices.


This generation should not have to be fighting these battles. Sadly, decades on, millions of the world’s women are still denied autonomy over their own bodies, including access to sexual and reproductive health services, to enable them to control whether or when to have children.

They lose out on education; their health suffers, and they are denied opportunities to earn and control their income. This is holding back not only them but us all.

In the quarter century of ICPD, more women (though still too few) have earned their place at the top decision-making table — in governments, legislatures, civil society, academia, the media and other institutions with power and influence.

They achieved that because of, at least in part, being able to pursue the highest educational and professional attainment while exercising their reproductive choices.


On the eve of the Nairobi summit, as current and past leaders of the Partnership for Maternal, Newborn and Child Health (PMNCH), we call on other leaders, in all their diversity, to unite their voices behind fully financed health plans to ensure universal access to sexual and reproductive health and rights.

The bright future of girls and women in every corner of the globe depends on our collective action.

Ms Clark, former New Zealand Prime Minister, is PMNCH board chair. Ms Bachelet, United Nations High Commissioner for Human Rights and former President of Chile, is a former PMNCH board chair. Dr Machel, the Graça Machel Trust founder, is a former PMNCH board chair.


This article was first published by the Thomson Reuters Foundation.