Political factors
Whilst reproductive health targets and rights have been agreed in international negotiations and universal access to reproductive health services incorporated into the MDG5, many countries do not recognise sexual health as being distinct from reproductive health and the need for sexual health services and information as going beyond those concerning reproduction and HIV. Sexual health services have generally been neglected because providing them requires governments to acknowledge sexual rights including sexual pleasure and sexual orientation; and address issues such as gender roles and power imbalances within relationships.
At national levels, there is a general lack of political will to implement international policy and amend laws to improve access, especially on sensitive issues such as abortion, and services that are not related to reproductive health, such as facilities for MSM or transgender people. Recently, some countries have implemented regressive laws which further restrict women from accessing safe abortions. For instance, in 2006 Nicaragua passed a law forbidding abortion under any circumstances, including cases where women’s lives are at risk from continuing pregnancy.
National laws concerning SRH issues often remain ambiguous and inconsistent. For example, in Zimbabwe whilst 16 and 17 year olds are legally capable of consenting to sex, they are not permitted to use services and information regarding contraception and STI prevention. Such ambiguities can provide a foundation for service providers to use their discretion and restrict access to some groups of people based on personal prejudices.
In many countries accountability mechanisms are not in place to ensure an acceptable quality of services, and there are limited opportunities for civil society groups to participate in policy debates. However, there are examples where social mobilisation has been successful in pushing issues onto the political agenda and helped to achieve increased access to services. In South Africa women’s activists and health advocates successfully campaigned for abortion services to be legalised. As a result of this legalisation, it is estimated that access to safe abortions has reduced abortion deaths by over 90 per cent.
At national levels, there is a general lack of political will to implement international policy and amend laws to improve access, especially on sensitive issues such as abortion, and services that are not related to reproductive health, such as facilities for MSM or transgender people. Recently, some countries have implemented regressive laws which further restrict women from accessing safe abortions. For instance, in 2006 Nicaragua passed a law forbidding abortion under any circumstances, including cases where women’s lives are at risk from continuing pregnancy.
National laws concerning SRH issues often remain ambiguous and inconsistent. For example, in Zimbabwe whilst 16 and 17 year olds are legally capable of consenting to sex, they are not permitted to use services and information regarding contraception and STI prevention. Such ambiguities can provide a foundation for service providers to use their discretion and restrict access to some groups of people based on personal prejudices.
In many countries accountability mechanisms are not in place to ensure an acceptable quality of services, and there are limited opportunities for civil society groups to participate in policy debates. However, there are examples where social mobilisation has been successful in pushing issues onto the political agenda and helped to achieve increased access to services. In South Africa women’s activists and health advocates successfully campaigned for abortion services to be legalised. As a result of this legalisation, it is estimated that access to safe abortions has reduced abortion deaths by over 90 per cent.
Recommended reading
- Reproductive health supplies in Central and Eastern Europe
- ( ASTRA - Central and Eastern European Womens Network for Sexual and Reproductive Health and Rights , 2007)
- Recommended reading
- This ASTRA network paper examines barriers to accessing reproductive health services and supplies in Central and Eastern Europe (CEE). The paper finds that reproductive health is not prioritised in go...
- Cairo after twelve years: successes, setbacks and challenges
- ( A. Langer / The Lancet , 2006)
- Recommended reading
- This Lancet paper describes the achievements, setbacks and challenges that have been faced since the UN International Conference on Population and Development (ICPD) in Cairo. The conference placed se...
- Sexual and reproductive health for all: a call for action
- ( M. F. Fathalla; S. W. Singing; A. Rosenfield; M. M. F. Fathalla / The Lancet , 2006)
- Recommended reading
- This article is the final paper in a series on Sexual and Reproductive Health published in the Lancet. It outlines what needs to be done to achieve universal access to sexual and reproductive health s...
- State of denial: adolescent reproductive rights in Zimbabwe
- ( Center for Reproductive Rights, formerly known as the Center for Reproductive Law and Policy, New York , 2002)
- This report, produced by the Center for Reproductive Rights, documents the legal, policy and social barriers which prevent Zimbabwean adolescents from accessing dual protection methods and information...
