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Sexual and reproductive health and rights

The sexual and reproductive health of women and girls is improving globally. At the same time, conservative forces are threatening people’s rights in some countries. Defending everyone’s right to their body and sexuality is an important issue for Sida.

Progress has been made

Right to abortion

Countries such as Colombia and Argentina have decriminalized abortion and the World Health Organization has published new abortion guidelines in which abortion is described as a right.

Increasing numbers of people are receiving antiretroviral drugs for HIV

Half as many people are dying of AIDS today as in 2010. More than 27 million of the 38 million people living with HIV in 2020 have access to antiretroviral drugs.1 In 2010, only 8 million people had access to medicines.

The number of child marriages is decreasing

The number of girls married off before the age of 18 has fallen by 15% over the past decade. The biggest decline has been in South Asia. Despite this, twelve million girls under 18 are married off every year, a figure that is expected to rise as a result of the Covid-19 pandemic.2

Many challenges remain

Millions of children and mothers are dying every year

Every 11 seconds a woman or baby dies in childbirth, the majority in low- and lower-middle-income countries.3 Most of these lives could be saved with knowledge and good care. The Covid-19 pandemic has made it more difficult for countries to maintain both access to and quality of care for mothers and newborns, which risks increasing maternal mortality.

Illegal to be an LGBTQI+ person

Sex between men is illegal in more than 70 countries and sex between women in more than 45 countries.4 Organisations working for the rights of LGBTQI+ people are finding it increasingly difficult to operate. At the same time, more and more countries are decriminalising sex between consenting adults of the same sex and more and more are banning discrimination on the basis of sexual orientation.

Covid-19 having serious consequences

The Covid-19 pandemic has had a serious impact on people’s sexual and reproductive health. The pandemic has led to an increase in unplanned pregnancies, gender-based violence and child marriage.5

Sida's work with sexual and reproductive health and rights

Through the United Nations, the countries of the world have established that all people in the world must be guaranteed sexual and reproductive health and rights (SRHR) by 2030. Despite advances, many people, especially women and young girls, are not allowed to take control of their own bodies. They are not allowed to decide whether and whom they will marry or whether they will have children and, if they do, how many.

Many people are victims of harassment and violence on the basis of their gender identity or sexual orientation. People living in poverty are particularly vulnerable. Violations of people’s sexual and reproductive rights lead to ill health, both physical and psychological, and threaten the development of countries.

Improving sexual and reproductive healthcare and knowledge

Most women and young girls who have unsafe abortions live in low- and lower-middle-income countries. Restrictive laws, gender norms, values, stigma around abortion and lack of contraceptives and information lead to unsafe abortions. 13% of the world’s maternal mortality is linked to unsafe abortions.6

At the same time, pressure is mounting on countries with restrictive abortion laws. The UN and WHO emphasize the importance of access to safe abortions and countries gather to discuss how to strengthen the global work for the right to safe abortion.

Despite advances, 680,000 people died from HIV in 2020, and 1.5 million people were infected. This represents a reduction by half since 1997. In sub-Saharan Africa in particular, HIV remains a major development issue. 25% of those infected are young women, even though they represent only 10% of the population.7

Improving knowledge about abortion

There is still a lack of systematic knowledge about which initiatives work in practice. There is also a lack of research to strengthen the possibilities for safe abortion. Sida collaborates with the UN’s research program for sexual and reproductive health and rights, Human Reproduction Program (HRP). The program provides new knowledge about how we ensure that there is access to safe abortion. It also provides a basis for guidelines and decisions at both national and global levels.

DKT International works in Tanzania, Ethiopia, Kenya, Uganda, the Democratic Republic of Congo and Mozambique to train healthcare professionals to perform safe abortions, distribute medicines and conduct campaigns to reduce negative attitudes and improve knowledge about abortion.

Increased access to safe abortions south of Sahara

In sub-Saharan Africa, only 55 percent of women who do not want to become pregnant have access to contraception.

The organization Ipas works globally, regionally and nationally to ensure the sexual and reproductive health and rights of women and girls with a focus on the right to safe abortion and contraception. Through knowledge dissemination, advocacy work and training of health personnel, Ipas works to increase the acceptance of and access to contraceptive counseling and abortion in health care systems and in humanitarian aid.

The organization Marie Stopes contributes to increasing access to contraception and safe abortion in Zambia.

Healthcare for people living with HIV

One third of people living with HIV do not have access to medicines.8 The Covid-19 pandemic is expected to reduce access even further, which could lead to more people dying. Frontline AIDS works to prevent the disease and provide healthcare and antiretroviral drugs. The organisation also makes it possible for more people to be tested, including at mobile clinics that reach particularly vulnerable groups.

Frontline AIDS’ website

Sex education and the health of young people

More than half of the world’s population is under 25, and in low-income countries the proportion is even higher.9 Educating young people about sexual and reproductive health and rights is crucial to empowering them to take control of their bodies and their lives. In many parts of the world, young people receive no sex education or inadequate sex education.

 

Students learning about child marriage and violence

Zambia and Liberia are both countries in which many girls have children before the age of 18.10 In Zambia, UNESCO is training healthcare professionals to respond well to young people and teachers so that they in turn can teach students about sexual and reproductive health and rights. In Liberia, the United Nations Population Fund (UNFPA) is working to improve young people’s knowledge of SRHR to reduce child marriage, maternal mortality and gender-based violence.

Engaging decision-makers for young people’s health

In several countries in sub-Saharan Africa, conservative forces are making it increasingly difficult for civil society organisations to promote sexual and reproductive rights. Sida supports SAfAIDS, which works to engage decision-makers in the region to reduce teenage pregnancy and unsafe abortion, and to strengthen organisations working on these issues. SAfAIDS also disseminates knowledge about SRHR directly to young people, including through sports, youth clubs and the media.

SAfAIDS’ website

Gender-based violence

More than one in three women in the world experience physical or sexual violence at some point in their lives.11 Women and girls living in areas of crisis or conflict are particularly affected. In addition to psychological trauma, gender-based violence causes many health problems, such as sexually transmitted infections, unwanted pregnancies, premature births and, in the worst cases, maternal mortality.

Gender-based violence includes:

  • Violence in close relationships
  • Sexual violence
  • Human trafficking for sexual purposes
  • Child marriage
  • Forced marriage
  • Honour violence
  • Female genital mutilation
  • Violence against LGBTQI+ persons (lesbian, gay, bisexual, transgender, queer and intersex persons)
Working to prevent child marriage

In Sudan, almost 90% of women up to the age of 49 and a third of girls up to the age of 14 are subjected to FGM. One in three girls marry before they turn 18.12 UNICEF works for children’s rights in Sudan, so that no one is subjected to violence or is forced to marry or have children when they are still children themselves.13

UNICEF’s website for Sudan

Support for women who are subjected to violence

Sexual and gender-based violence is common in Myanmar, and when it occurs in armed conflict, the perpetrator is almost never punished. UNFPA’s Women and Girls First programme promotes sexual and reproductive health and rights and combats gender-based violence, focusing on women and girls in conflict zones. Among other things, the programme funds safe spaces that can be compared to women’s refuges, and runs men’s and youth groups.

About Women and Girls First on the UNFPA website

LGBTQI+ persons’ rights

LGBTQI (lesbian, gay, bisexual, transgender, queer and intersex) people are subjected to physical and psychological violence, discrimination and gross violations all over the world. As a result of this oppression, many LGBTQI people live with mental illness. In many countries, it is not uncommon for LGBTQI people to be denied healthcare due to the discriminatory attitudes of healthcare professionals.

 

Increasing engagement for the rights of LGBTQI+ people

In many countries in Africa, the situation for LGBTQI persons’ rights has worsened in recent years and even more so as a result of the Covid-19 pandemic. Through the UN Development Programme (UNDP), Sida supports the Inclusive Governance Initiative, which aims to reinforce respect for the rights of LGBTQI people in sub-Saharan Africa. The work is done by improving knowledge of and engagement for the rights of LGBTQI people among decision-makers such as members of parliament, judges and religious leaders, and strengthening cooperation between LGBTQ+ activists to increase their ability to influence legislation.

UNDP’s website

Legal support and therapy for the vulnerable in Moldova

In Moldova, there is a strong resistance to people with non-normative sexuality or gender identity. Sida supports GenderDoc-M, Moldova’s only organisation working for the rights of LGBTQI people. Its activities include political advocacy, legal support for victims of crime and health and therapy services.

GenderDoc-M’s website

Scope and governance of Sida’s work with sexual and reproductive health and rights

Sexual and reproductive health and rights (SRHR) are one of Sida’s top priorities. Nearly SEK 1.7 billion (3.8%) of Sida’s total aid in 2021 was spent on SRHR. 49 percent of Sida’s health aid focuses on SRHR.

Sida’s support in this area is governed by strategies at various levels, including the global development cooperation strategy for sustainable social development and the regional strategy for sexual and reproductive health and rights in sub-Saharan Africa.

What is SRHR?

Sexual and reproductive health means physical, emotional, psychological and social well-being in relation to all aspects of sexuality and reproduction. All people should have the right to control their own bodies and have access to healthcare and other health promotion services. Sida uses the Guttmacher-Lancet Commission’s definition of SRHR.

Achieving sexual and reproductive health requires that all people:

  • have their physical integrity, privacy and personal autonomy respected
  • are free to define their own sexuality, sexual orientation, gender identity and gender expression
  • may decide if and when they want to be sexually active
  • have the right to choose their sexual partners
  • have safe and pleasurable sexual experiences
  • may choose whether, when and whom to marry
  • decide whether, when and how they want to have children and how many children they want to have
  • have access throughout their lives to the information, resources, services and support needed to achieve the above, without risk of discrimination, coercion, exploitation and violence

The Guttmacher-Lancet Commission’s website

Updated: October 3, 2022