Sida's work with sexual and reproductive health and rights
People's sexual and reproductive health is improving globally. At the same time, conservative forces are threatening human rights in some countries. Defending everyone's right to their body and sexuality is an important issue for Sida. Sida strengthens people's sexual and reproductive health and rights in the long term and provides humanitarian support to those in crisis situations.
Why does Sida work for SRHR
Restricting rights
In many countries, conservative forces try to restrict people’s sexual and reproductive rights (SRHR), such as restricting the right to abortion. Having your rights violated and not being able to control your own body leads to ill health, both mental and physical, and threatens the country’s development. Many people face harassment and violence because of their gender identity or sexual orientation. People living in poverty are particularly vulnerable.
Millions of children and mothers die each year
Every 11 seconds, a woman or a newborn child dies in childbirth, the vast majority in low- and lower-middle-income countries.1 Most lives could have been saved with the right knowledge and care. Since the pandemic, several countries have struggled to maintain access to maternal and childbirth care. The quality of care has also deteriorated, leading to more maternal and child deaths in some countries.
Discrimination against LGBTI people
Sex between men is illegal in more than 70 countries and sex between women in more than 45 countries.2 In societies and countries that are not gender equal, LGBTI people (lesbian, gay, bisexual, transgender, queer and intersex) are more likely to face oppression and discrimination.
Examples of what Sida contributes to
More women have the right to abortion
The World Health Organisation (WHO) has adopted new global guidelines that state that abortion is a right and should be a natural part of health care.3 In sub-Saharan Africa, for example, access to medical abortion has increased. Sida has supported the WHO for 75 years.
Making SRH services available in primary health services
Sida works to ensure that SRH (sexual and reproductive health) services become part of the health care system and are accessible to all. Among other things, Sida has contributed to Bangladesh making sexual and reproductive health care available within the health care system, which has helped to reduce maternal and infant mortality. Through a Sida partner, Malawi has developed a plan for people to have access to SRH services free of charge as part of the general health care system.
Banning female genital mutilation
Fourteen of the 17 countries that Sida supports through a UN programme have introduced legal and policy frameworks that prohibit female genital mutilation. Around half a million girls have escaped FGM thanks to the programme. Sida has also contributed to 83 villages in Sudan declaring a ban on FGM, tripling the number of villages compared to 2021.
Sida's work with sexual and reproductive health and rights
Sexual and reproductive health and rights (SRHR) are fundamental to health and well-being, gender equality, democracy, peace and security and sustainable development. SRHR is about the right of all people to control their own bodies and to live a healthy and productive life.
Access to SRHR is not fairly distributed. It is determined by various factors such as who has power in communities (mostly men and older people), where people live, and their economic situation and status. Factors such as gender, sexuality, ethnicity and education also affect access to SRHR. Inequalities reinforce each other and lead to people being trapped in poverty.
Sida’s work for SRHR should strengthen the rights of the people in society who are most affected: for example, women living in poverty, young people, teenage mothers, those living with a disability, indigenous peoples and those discriminated against because of their gender identity or sexual orientation.
Access to sexual and reproductive health care is a prerequisite for the fulfilment of sexual and reproductive rights. Sida works to change discriminatory laws, improve health care and increase access to knowledge about sexual and reproductive health and rights. Sida provides both long-term assistance for SRHR and humanitarian support in crisis situations. Here are the areas that Sida supports and some examples of programmes and projects in each area:
Improving sexual and reproductive health care and knowledge
Most of those forced to have unsafe abortions live in low and lower middle income countries. Restrictive laws, gender norms, values, stigma around abortion and lack of both contraception and information lead to unsafe abortions. Between 5-13 per cent of global maternal mortality is linked to unsafe abortion.
At the same time, there is increasing pressure on countries with restrictive abortion laws, not least from the World Health Organisation (WHO) and the new guidelines stating that abortion is a right that should be part of health care. Countries such as Colombia and Argentina have decriminalised abortion and adopted new guidelines describing abortion as a right.
The number of people dying annually from HIV has halved since 1996. Although HIV is declining, one person dies every minute from the disease. Today, around 650 000 people die each year and 1.5 million are affected by HIV and AIDS. Many of those affected are young women, even though they represent only 10 per cent of the population.
Sida works to increase knowledge, access to care and services, including maternity care, HIV testing and medication, safe abortion and contraception.
Here are some examples of projects and programmes that Sida supports:
People in southern and eastern Africa often have poor access to services such as contraception, maternity care and safe abortion. Sida supports the UN’s 2gether 4 SRHR programme, which is working on a joint strategy to improve sexual and reproductive health and rights, combat HIV and gender-based violence in eastern and southern Africa, especially for teenage girls and young people.
Midwives often lack the necessary conditions and resources to carry out their work. Sida supports the International Confederation of Midwives (ICM), which strengthens and promotes the midwifery profession globally. Their work includes raising the quality of education and ensuring that job descriptions are available. They work to ensure that midwives have a good working environment and the resources to practise the profession safely.
Research on abortion care is often de-prioritised and funding for abortion work is limited in the world. Sida plays an important role in raising the issue in various contexts and ensuring that the work continues. Sida cooperates with the UN’s research programme for sexual and reproductive health and rights, the Human Reproduction Programme (HRP). The programme provides new knowledge on how to ensure access to safe abortion. It also contributes to guidelines and decisions at both country and global level.
DKT International works in Tanzania, Ethiopia, Kenya, Uganda, the Democratic Republic of Congo and Mozambique to train health workers in safe abortion, prescribe medication and conduct campaigns to reduce negative attitudes and improve knowledge about abortion.
The organisation Ipas works at global, regional and national level to improve 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 and training of health professionals, Ipas works to increase the acceptance of and access to contraceptive counselling and abortion within health systems and humanitarian aid.
DKT International works in Tanzania, Ethiopia, Kenya, Uganda, the Democratic Republic of Congo and Mozambique to increase access to contraception.
Sida supports IPA’s global work, in sub-Saharan Africa and Latin America. In Latin America, the work has contributed to a change in Mexico’s contraceptive policy. This means that public and private healthcare providers can prescribe contraceptives on prescription. Guidelines for abortion care have also been improved and follow WHO recommendations. In Argentina, guidelines on abortion have been improved, giving women the legal right to terminate pregnancy and the right to abortion care. Colombia and Ecuador have also developed similar guidelines.
The organisation Marie Stopes is helping to increase access to contraception and safe abortion in Zambia.
The International Planned Parenthood Federation (IPPF) is a global health care provider and organisation working to make SRHR part of the health care system and available to all who need it. IPPF is present in 146 countries. Their work is extensive: sex education, access to contraception, safe abortion and maternity care. It also works in humanitarian crises and maintains a large network of organisations in the countries where it works.
Amplify Change supports local civil society organisations to carry out their work at the grassroots level. They work to increase access to safe abortion, support LGBTI people and sex education.
Only half of the children living with HIV have access to medicine. Frontline AIDS works to prevent the disease and provide care and antiretroviral drugs. The organisation also enables more people to get tested, including through mobile clinics that reach particularly vulnerable groups.
More than half of the world’s population is under 25, and in low-income countries the proportion is even higher. Providing young people with knowledge 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 little or no sexuality education.
Here are some examples of programmes and projects that Sida supports:
Zambia and Liberia are both countries in which many girls have children before the age of 18. 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.
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 the number of teenage pregnancies and unsafe abortions. Strengthening organisations working on these issues is also part of the work. SAfAIDS also spreads knowledge about sexual and reproductive health and rights directly to young people, including through sports, youth clubs and the media.
The United Nations Educational, Scientific and Cultural Organisation (UNESCO) is working on sexuality education in 31 countries to promote gender equality and reduce teenage pregnancy.
More than one in three women worldwide experience physical or sexual violence at some point in their lives. 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)
Sida helps to combat child marriage, female genital mutilation and gender-based violence. Here are some examples of programmes and projects that Sida supports:
One in three girls is married before her 18th birthday. The UN Children’s Fund (UNICEF) promotes children’s rights in Sudan so that no one is subjected to violence or forced to marry or have children when they are still children. Through the UN Population Fund, Sida supports the work against child marriage.
Four million girls are mutilated every year. The practice of FGM is deeply rooted in many countries and efforts to change attitudes are slow. Sida supports the fight against FGM and sexual violence in 17 African countries by preventing the procedure and providing quality care to those who have already been affected.
The interventions are implemented by the UN Children’s Fund (UNICEF) and the UN Population Fund (UNFPA) in collaboration with many local civil society organisations. The work is based on the challenges and needs of each country, with a focus on putting legislation and regulations in place. Preventive work in health care and in schools and support for victims are also included.
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.
LGBTI people’s rights are restricted by discriminatory laws and attitudes, gross violations and physical and psychological violence. As a result, many people live with mental health problems and are denied care because of the discriminatory attitude of healthcare staff. Even those who work for the rights of LGBTI 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 countries are prohibiting discrimination on the basis of sexual orientation.
Sida contributes to strengthening the rights of LGBTI people, the right to exist and express their identity and to have access to sexual and reproductive health services and social protection.
Sida defends the rights of all people including those who experience a gender identity that is neither male nor female or beyond both sexes.
Sida collaborates with civil society organisations and influences laws in society. Here are some examples of programmes and projects that Sida supports:
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.
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.
Almost 80 per cent of the 26 million people estimated to be displaced by climate change are women. Women are also most affected when health services (including SRHR) are not available in disaster-affected areas. Disasters related to climate change increase the strain on already weak health systems and reduce women’s access to sexual and reproductive health care. Strong and resilient health systems are essential for functioning during a crisis.
Sexual and gender-based violence also increases during crises and when people are forced to flee. As the effects of the climate crisis become more severe, the situation for SRHR is deteriorating.
Here are some examples of programmes and projects that Sida supports:
Through support to the organisation Ipas, Sida contributes to the work of making the link between sexual and reproductive health and rights (SRHR) and climate change visible. The work focuses on access to safe abortions. The work includes supporting and creating conditions for women and young people to design communities that can cope with change.
Sexual and reproductive health and rights (SRHR) is one of Sida’s most prioritised issues. Sida’s support in this area is governed by strategies at different levels, including the strategy for global development cooperation in sustainable social development and the regional strategy for sexual and reproductive health and rights in sub-Saharan Africa.
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
- Statistics maternal mortality on WHO web site
- Number of countries where same-sex sex is illegal in the Ilga database
- WHO global guidelines on abortion on the WHO website
- Proportion of maternal mortality linked to unsafe abortion on the WHO website
- Statistics on the number of people dying from HIV each year on the World Population Review website
- World population age statistics (2022) on the Statista website
- Country-by-country statistics on girls having children before the age of 18 on the UNICEF website
- Percentage of women exposed to violence in their lifetime on the WHO website
- Statistics on girls in the world married before the age of 18 on the UNICEF website
- Statistics on the number of girls subjected to genital mutilation each year on the UNICEF website
- Proportion of people displaced globally due to climate change who are women on the OHCHR website
Updated: June 9, 2023