Sexual and Reproductive Health and Rights: The Cornerstone of Sustainable Development

Natalia Kanem (left) at the ECOSOC Youth Forum with Nikki Fraser, National Youth Representative, Native Women’s Association of Canada and Young Leader for the SDGs. © PVBLIC Foundation/Elsa Barb

Shortly after the Sustainable Development Goals (SDGs) were adopted in 2015, we spoke to 10 ten-year-old girls from around the globe, asking them what their one wish was. Their answers affirmed what the American poet Maya Angelou once wrote: “We are more alike, my friends, than we are unalike.” Daline from Cameroon and Hiba from Jordan both wanted everyone in their family to be all together. Tuong Anh from Viet Nam and Ortilla from Guatemala both wanted a bicycle. Ingeborg from Norway and Temawelase from Eswatini (formerly Swaziland) both wanted a decent future for themselves.

While the SDGs are universal in nature, with the aim of leaving no one behind, inequalities stemming from nationality, ethnicity, gender, sexual identity and orientation, marital status, age and other factors influence one’s access to resources and the ability to exercise basic rights, including the right to sexual and reproductive health. In most developing countries, the poorest girls and women have the least power to decide whether or when to become pregnant. They also have the least access to quality care during pregnancy and childbirth, and this often results in maternal death. This inequality has lasting repercussions for girl’s and women’s health, educational opportunities, career and earning potential, and for their contribution to their respective nations’ development and the elimination of poverty. Reproductive health and reproductive rights are not only an issue for girls and women living in poverty, they are relevant to every single one of us—women and men, girls and boys—now more than ever, in the era of the SDGs.

Reproductive health and rights allow women to be in control of their own bodies and decide if, when, with whom and how often to bear children. The rights include having a safe pregnancy and safe delivery, with adequate antenatal and postnatal care, as well as access to family planning counselling and a range of modern contraceptive methods. Reproductive health and rights also depend on timely, comprehensive sexuality education that allows adolescents and young people to learn about their bodies, understand relationships, make informed decisions about their sexuality, and stand up against sexual harassment, exploitation and abuse. Reproductive rights include support in how to become pregnant, and care and counselling in the case of a miscarriage or for women suffering post-partum depression. Being able to exercise these rights also prevents unsafe abortions.

Reproductive rights are human rights, and gender equality, which depends on women’s ability to fully exercise them, is key to sustainable development. The Programme of Action of the 1994 Cairo International Conference on Population and Development (ICPD) was the first international agreement recognizing the right to sexual and reproductive health. The United Nations Population Fund (UNFPA) is the guardian of this mandate globally, and although the world has made progress towards universal access to sexual and reproductive health and rights since 1994, it is not enough. To achieve the SDGs, we need to accelerate progress significantly.

There are 1.8 billion young people between the ages of 10 and 24 in the world today, all with unique aspirations and needs. Too many of them, particularly adolescent girls, continue to be left behind. As they enter their childbearing years, ensuring they have access to the information and services they need for their sexual and reproductive health is especially urgent. The 2030 Agenda offers an unprecedented opportunity for young people to be heard, to claim their rights and to realize their aspirations. The SDGs are already making headway by including a specific focus on adolescents in a number of SDG targets. However, adolescents are rarely explicitly mentioned in the SDG indicators.

UNFPA works with Governments to ensure age- and sex-disaggregated data, and we are advancing data collection for very young adolescents. Traditionally, data collection has focused on married women of reproductive age (15 to 49-year-olds), not on 10- to 14-year-olds or unmarried women. Furthermore, data is typically not age-disaggregated. Increased efforts to develop methodologies and systematic data collection that includes adolescents of all ages, regardless of marital status, are imperative to identify and address their needs.

We at UNFPA are convinced that by measuring the progress of adolescents we can monitor our progress towards the SDGs. A girl who was 10 years old when the global goals were adopted in 2015 will be a young woman by our 2030 finish line. While we work to implement the SDGs, these girls will go through some of the most crucial and defining times of their lives, such as puberty, with all that it entails, including identity formation, body changes, the onset of menstruation, exploration of relationships, increased autonomy and independence, and the transition into adulthood.

In some parts of the world, the onset of puberty equals adulthood, and disproportionate responsibilities are placed on young girls, including heavy domestic labour, child marriage, the early onset of sexual activity, and consequently, early childbearing. This has far-reaching repercussions for health and sustainable development.

When a teenager gets pregnant, she may be forced to drop out of school, diminishing her job prospects and making her more vulnerable to poverty and exclusion. When her body is not mature enough to bear a child, her health suffers. In fact, complications from pregnancy and childbirth are the leading killer of 15- to 19-year-old girls globally.

In many places, girls may be exposed to pressure from social media about how they should look and behave, perpetuating sexual double standards that reinforce gender stereotypes. Social media has also enabled #MeToo and other social movements that emphasize the scope and universality of sexual harassment and abuse and the urgency of addressing these issues. Violence against women and girls, which knows no social, economic or national boundaries, remains one of the most prevalent human rights violations in the world. An estimated one in three women will experience physical or sexual abuse in her lifetime.

The global community has recognized sexual and reproductive health and rights as a cornerstone of sustainable development. At UNFPA, we are determined to make sure that every woman and adolescent girl who wants modern contraception has access to it. We are working to guarantee an environment for safe birth everywhere and to end violence against women and girls, including child marriage and female genital mutilation.

We know what is needed to realize sexual and reproductive health and rights for all:

  • an enabling legal and policy environment to address inequalities;
  • strengthened health and education systems;
  • sex- and age-disaggregated data to ensure no one is left behind;
  • targeted investments in women and girls;
  • changing social norms that limit girls’ and women’s autonomy and ability to make independent
  • decisions regarding their own bodies, while raising awareness among boys and men; and
  • partnerships and greater collaboration across the health, education, gender, population and development sectors.

If we are serious about achieving the Sustainable Development Goals, the time to act is now! Next year, 2019, marks 25 years since the International Conference on Population and Development and the fiftieth anniversary of UNFPA. We hope that Member States will seize this opportunity to reaffirm their commitment to the Cairo consensus—that reproductive rights are human rights and that they are essential to building a decent future for all.