Sexual and reproductive health and rights

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Sexual and reproductive health and rights or SRHR is the concept of human rights applied to sexuality and reproduction. It is a combination of four fields that in some contexts are more or less distinct from each other, but less so or not at all in other contexts. These four fields are sexual health, sexual rights, reproductive health and reproductive rights. [1] In the concept of SRHR, these four fields are treated as separate but inherently intertwined. [2]

Contents

Distinctions between these four fields are not always made. Sexual health and reproductive health are sometimes treated as synonymous to each other, as are sexual rights and reproductive rights. In some cases, sexual rights are included in the term sexual health, or vice versa. [3] Not only do different non-governmental organisations (NGOs) and governments organisations [ citation needed ] use different terminologies, but different terminologies are often used within the same organization.

Some of the notable global NGOs that fight for sexual and reproductive health and rights include IPPF (International Planned Parenthood Federation), ILGA (International Lesbian and Gay Alliance), WAS (World Association for Sexual Health - formerly known as World Association for Sexology), the Center for Health and Gender Equity, and International HIV/AIDS Alliance. [4] [5]

History

Government-run family planning programs first began in the 1950s[ where? ]. [6] However, the main objectives of these programs were often centered around population control for economic growth and development. [7] In 1994, the International Conference on Population and Development (ICPD) in Cairo, Egypt marked a significant shift in perspective in regards to reproductive health and is considered to be the birth of the modern SRHR movement. [8] Over the course of the conference, debates surrounding family planning shifted from that of economics to that of public health and human rights. [9] A Program of Action (PoA) was developed by the end of the ICPD and was approved and adopted by 179 countries. [10] The PoA affirmed sexual and reproductive health as a universal human right and outlined global goals and objectives for improving reproductive heath based around central themes of free choice, women's empowerment, and viewing sexual and reproductive health in terms of physical and emotional well-being. [9] The PoA outlined a series of goals, based on a central mission of achieving universal access to reproductive health worldwide, that were aimed to be accomplished by 2015. [11] In 2000, the Millennium Development Goals (MDGs) were developed, [12] and although reproductive health was not explicitly stated as one of the goals, it became an important component to Goals 3, 4, and 5. [8] In 2010, the original PoA was revisited by the United Nations and updated to reflect their objective of achieving universal reproductive health care by 2015. [10] When the MDGs and ICPD PoA phased out in 2015, the next objectives for SRHR were folded into the Sustainable Development Goals, the next iteration of the MDGs which outline objectives to combat poverty through 2030. [13]

Sexual health

The World Health Organization [14] defines sexual health as: "Sexual health is a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence."

Sexual rights

Unlike the other three aspects of SRHR, the struggle for sexual rights include, and focus on, sexual pleasure and emotional sexual expression. One platform for this struggle is the WAS Declaration of Sexual Rights.

The World Association for Sexual Health (WAS) was founded in 1978 by a multidisciplinary, world-wide group of NGOs to promote the field of sexology. 

The Platform for Action from the 1995 Beijing Conference on Women established that human rights include the right of women freely and without coercion, violence or discrimination, to have control over and make decisions concerning their own sexuality, including their own sexual and reproductive health. [15] This paragraph has been interpreted by some countries [16] as the applicable definition of women's sexual rights. The UN Commission on Human Rights has established that if women had more power, their ability to protect themselves against violence would be strengthened. [17] [18]

A significant shift occurred in the Association's history when in 1997, the World Congress of Sexology issued the Valencia Declaration of Sexual Rights. This was a visionary move on the part of María Pérez Conchillo and Juan José Borrás Valls (congress presidents) that shifted WAS to more of an advocacy organization championing sexual rights as fundamental to the promotion of sexual health and the field of sexology.  A press conference was held during the Congress to publicize the adoption of the Valencia Declaration and received world-wide attention.

This declaration has had world-wide impact in the recognition of the importance of sexual rights as human rights.  Besides the tremendous impact on WHO, our[ who? ] declaration provoked IPPF to issue its own declaration of Sexual Rights in 2008.

Subsequently, WAS made some revisions to the Valencia Declaration and proposed a WAS Declaration of Sexual Rights which was approved by the General Assembly at the 14th World Congress of Sexology (Hong Kong, 1999). The WAS adopted the Declaration of Sexual Rights, which originally included 11 sexual rights. It was heavily revised and expanded in March 2014 by the WAS Advisory Council to include 16 sexual rights: [19]

  1. The right to equality and non-discrimination
  2. The right to life, liberty and security of the person
  3. The right to autonomy and bodily integrity
  4. The right to be free from torture and cruel, inhuman, or degrading treatment or punishment
  5. The right to be free from all forms of violence and coercion
  6. The right to privacy
  7. The right to the highest attainable standard of health, including sexual health; with the possibility of pleasurable, satisfying, and safe sexual experiences
  8. The right to enjoy the benefits of scientific progress and its application
  9. The right to information
  10. The right to education and the right to comprehensive sexuality education
  11. The right to enter, form, and dissolve marriage and similar types of relationships based on equality and full and free consent
  12. The right to decide whether to have children, the number and spacing of children, and to have the information and the means to do so
  13. The right to the freedom of thought, opinion, and expression
  14. The right to freedom of association and peaceful assembly
  15. The right to participation in public and political life
  16. The right to access to justice, remedies, and redress

This Declaration influenced The Yogyakarta Principles (which were launched as a set of international principles relating to sexual orientation and gender identity on 26 March 2007), especially on the idea of each person's integrity, and right to sexual and reproductive health. [20]

In 2015 the U.S. government said it would begin using the term "sexual rights" in discussions of human rights and global development. [21]

Reproductive health

Within the framework of the World Health Organization's (WHO) definition of health as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene, addresses the reproductive processes, functions and system at all stages of life. [22] Reproductive health, therefore, implies that people are able to have a responsible, satisfying and safer sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. One interpretation of this implies that men and women ought to be informed of and to have access to safe, effective, affordable and acceptable methods of birth control; also access to appropriate health care services of sexual, reproductive medicine and implementation of health education programs to stress the importance of women to go safely through pregnancy and childbirth could provide couples with the best chance of having a healthy infant. On the other hand, individuals do face inequalities in reproductive health services. Inequalities vary based on socioeconomic status, education level, age, ethnicity, religion, and resources available in their environment. It is possible for example, that low income individuals lack the resources for appropriate health services and the knowledge to know what is appropriate for maintaining reproductive health. [23]

Reproductive rights

Reproductive rights are legal rights and freedoms relating to reproduction and reproductive health. [24] The World Health Organization defines reproductive rights as follows:

Reproductive rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. They also include the right of all to make decisions concerning reproduction free of discrimination, coercion and violence. [25]

The area of sexual and reproductive rights is influenced by contextual cultural and social norms, socioeconomic factors and existing laws and regulations. The social-structural climate may affect both the access to and quality of sexual and reproductive health care and interventions. [26]

Goals and objectives

Despite frequent changes to frameworks, overall goals for SRHR remain little changed. As first stipulated at the ICPD, universal reproductive health care remains the ultimate objective, and with each new framework, targets are developed to progress towards this. [13] In the original ICPD Program of Action, the primary call was for universal access to healthcare, including reproductive healthcare, family planning and sexual health. [9] Over time, these have expanded to include the right to access education regarding sexual and reproductive health, an end to female genital mutilation, and increased women's empowerment in social, political, and cultural spheres. [8] [9]

Special goals and targets were also created to address adolescent sexual and reproductive health needs. Adolescents are often the most vulnerable to risks associated with sexual activity, including HIV, due to personal and social issues such as feelings of isolation, child marriage, and stigmatization. [27] Governments realized the importance of investing in the health of adolescents as a means of establishing future well-being for their societies. [28] As a result, the Commission on Population and Development developed a series of fundamental rights for adolescents including the right to comprehensive sex education, the right to decide all matters related to their sexuality, and access to sexual and reproductive health services without discrimination (including safe abortions wherever legal). [28]

See also

Related Research Articles

<span class="mw-page-title-main">Sexology</span> Scientific study of human sexuality

Sexology is the scientific study of human sexuality, including human sexual interests, behaviors, and functions. The term sexology does not generally refer to the non-scientific study of sexuality, such as social criticism.

Women's health differs from that of men's health in many unique ways. Women's health is an example of population health, where health is defined by the World Health Organisation as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity". Often treated as simply women's reproductive health, many groups argue for a broader definition pertaining to the overall health of women, better expressed as "The health of women". These differences are further exacerbated in developing countries where women, whose health includes both their risks and experiences, are further disadvantaged.

Reproductive rights are legal rights and freedoms relating to reproduction and reproductive health that vary amongst countries around the world. The World Health Organization defines reproductive rights as follows:

Reproductive rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. They also include the right of all to make decisions concerning reproduction free of discrimination, coercion and violence.

<span class="mw-page-title-main">Millennium Development Goals</span> Eight international development goals for the year 2015 by the United Nations

In the United Nations, the Millennium Development Goals (MDGs) were eight international development goals for the year 2015 created following the Millennium Summit, following the adoption of the United Nations Millennium Declaration. These were based on the OECD DAC International Development Goals agreed by Development Ministers in the "Shaping the 21st Century Strategy". The Sustainable Development Goals (SDGs) succeeded the MDGs in 2016.

The United Nations coordinated an International Conference on Population and Development (ICPD) in Cairo, Egypt, on 5–13 September 1994. Its resulting Programme of Action is the steering document for the United Nations Population Fund (UNFPA).

<span class="mw-page-title-main">Sexual and reproductive health</span> State of the reproductive system without evidence of disease, disorders, or deficiencies

Sexual and reproductive health (SRH) is a field of research, health care, and social activism that explores the health of an individual's reproductive system and sexual well-being during all stages of their life. Sexual and reproductive health is more commonly defined as sexual and reproductive health and rights, to encompass individual agency to make choices about their sexual and reproductive lives.

<span class="mw-page-title-main">United Nations Commission on the Status of Women</span> Advisory board

The Commission on the Status of Women is a functional commission of the United Nations Economic and Social Council (ECOSOC), one of the main UN organs within the United Nations. CSW has been described as the UN organ promoting gender equality and the empowerment of women. Every year, representatives of Member States gather at United Nations Headquarters in New York to evaluate progress gender equality, identify challenges, set global standards and formulate concrete policies to promote gender equality and advancement of women worldwide. In April 2017, ECOSOC elected 13 new members to CSW for a four-year term 2018–2022. One of the new members is Saudi Arabia, which has been criticised for its treatment of women.

The International Planned Parenthood Federation (IPPF) is a global non-governmental organisation with the broad aims of promoting sexual and reproductive health, and advocating the right of individuals to make their own choices in family planning. It was first formed in 1952 in Bombay, India, by Margaret Sanger and Lady Rama Rau at the Third International Conference on Planned Parenthood with support of an expanding population with limited resources. Presently, it consists of more than 149 Member Associations working in more than 189 countries. The IPPF is highly developed and organised into six regions. The organisation is based in London, England.

Comprehensive Sexuality Education (CSE) is a sex education instruction method based on a curriculum that aims to give students the holistic knowledge, attitudes, skills, and values to make healthy and informed choices in their sexual lives. The intention is that this understanding will help students understand their body and reproductive processes, engage in safer sex by reduce incidents of contracting sexually transmitted infections (STIs) such as HIV and HPV, reduce unplanned and unwanted pregnancies, as well as lowering rates of domestic and sexual violence.

<span class="mw-page-title-main">Reproductive justice</span> Social justice movement

Reproductive justice is a critical feminist framework that was invented as a response to United States reproductive politics. The three core values of reproductive justice are the right to have a child, the right to not have a child, and the right to parent a child or children in safe and healthy environments. The framework moves women's reproductive rights past a legal and political debate to incorporate the economic, social, and health factors that impact women's reproductive choices and decision-making ability.

Population Action International (PAI) is an international, civil society organization that uses research and advocacy to improve global access to family planning and reproductive health care. Its mission is to "advance universal access to sexual and reproductive health and rights through advocacy, partnerships and the funding of changemakers". PAI's headquarters is in Washington, D.C.

<span class="mw-page-title-main">Marleen Temmerman</span> Belgian gynaecologist and politician

Marleen Temmerman is a Belgian gynaecologist, professor and former Senator, currently heading the Centre of Excellence in Women and Child Health at Aga Khan University in Nairobi, Kenya.

Research Action and Information Network for the Bodily Integrity of Women is an international non-governmental organisation working to eliminate female circumcision and female genital mutilation.

The Declaration of Sexual Rights is a statement on sexual rights that was first proclaimed at the 13th World Congress of Sexology, run by the World Association for Sexual Health (WAS), in Valencia 1997. A revised version was approved in 1999 in Hong Kong by the WAS General Assembly, and reaffirmed in 2008. It was revised and expanded in 2014.

<span class="mw-page-title-main">Reproductive rights in Latin America</span>

Latin America is home to some of the few countries of the world with a complete ban on abortion and minimal policies on reproductive rights, but it also contains some of the most progressive reproductive rights movements in the world. With roots in indigenous groups, the issues of reproductive rights include abortion, sexual autonomy, reproductive healthcare, and access to contraceptive measures. Modern reproductive rights movements most notably include Marea Verde, which has led to much reproductive legislation reform. Cuba has acted as a trail-blazer towards more liberal reproductive laws for the rest of Latin America, while other countries like El Salvador and Honduras have tightened restrictions on reproductive rights.

Rutgers WPF Indonesia is the Indonesian branch of Rutgers WPF, an international center of expertise on Sexual and Reproductive Health and Rights (SRHR) founded and based in the Netherlands. The Indonesian branch was established in 2007, founded under the name "WPF".

Sex education is controversial subject in India, sometimes viewed as a taboo topic; across the country and within the community, opinions on how or whether to deliver it are divided. The states of Gujarat, Maharashtra, Madhya Pradesh and Chhattisgarh have banned or refused to implement sex education in schools. The Hindu nationalist government in Madhya Pradesh said sex education had "no place in Indian culture" and plans to introduce yoga in schools instead. On the global level, India has notably fallen behind numerous countries, including underdeveloped and significantly smaller countries such as Sudan and the Congo Republic, where sex education is first taught at the primary level.

Radhika Chandiramani is the founder of TARSHI, a New Delhi–based NGO that works on issues of sexual and reproductive health and rights. She is a clinical psychologist, writer and editor. Her published works on sexuality and human rights have been covered in media and scholarly reviews. Chandiramani received the MacArthur Fellowship in the year 1995 for leadership development. She is also the recipient of the 2003 Soros Reproductive Health and Rights Fellowship from Columbia University Mailman School of Public Health.

The State of the African Woman Campaign (SoAWC) is funded by the European Union, and its implementation is led by the International Planned Parenthood Federation Africa Region. The project is a communication tool, an advocacy campaign and awareness creation that focuses on the implementation of girls and women's rights, particularly the Maputo Protocol and Maputo Plan of Action, in Africa.

<span class="mw-page-title-main">Lizzie Kiama</span> Kenyan disability rights activist

Lizzie Kiama is a Kenyan disability rights activist. She is the founder and managing trustee of This Ability Trust, a Kenyan disability rights organization.

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