'Miles to go' before we achieve universal access to SRHR services

Swapna Majumdar - CNS
[7th APCRSHR Images] Twenty years after the path breaking International Conference on Population and Development (ICPD) held in Cairo, millions of women and adolescents, particularly the poor and marginalised, in Asia and the Pacific continue to face inequalities in access to reproductive and sexual health and rights.

"This is unconscionable" said Professor Gita Sen, Centre for Public Policy, Indian Institute of Management, Bangalore. Speaking at the plenary on the opening day of the ongoing 7th Asia Pacific Conference on Reproductive and Sexual Health and Rights (7th APCRSHR) being held in Manila, Philippines, Professor Sen said that the lack of accountability mechanisms to track progress made in addressing gaps and preventing inequalities to universal access had dented some of the gains made in achieving the millennium development goals (MDGs) related to sexual and reproductive health (SRH) rights.

The 7th APCRSHR is examining the achievements, good practices and challenges faced in the region in realising the ICPD's Programme of Action and attaining the sexual and reproductive health and rights (SRHR) related MDGs to develop strategies  to bridge the implementation gaps.

Reviewing the gains made in the last 20 years, she said that ICPD had pushed many countries in the region to pay greater attention to these issues. While India put greater focus on maternal and newborn health, Bangladesh expanded its family planning services to include contraception and nutrition and HIV/AIDS were put on the agenda. "It brought down its maternal mortality rate to 194 and the abortion related deaths came down to just 1% compared it being one third of all maternal deaths earlier, which is a big achievement" she said.

Further, in Nepal, abortion had been decriminalised and Philippines had brought in a Reproductive Health Bill although its implementation is dependent on the outcome of a Supreme Court hearing.

A major gain of the ICPD process was the articulation of demand for SRHR services by adolescents, said Professor Sen. She said that the region could benefit from Thailand's success in reaching out to adolescents by recognising their needs and bringing about health sector reforms to include suitable SRHR services.

Despite these gains much more needed to be done to reach out to the vulnerable and hard-to-reach population. There were no special policies and programmes on sexual health in South Asia, home to one fifth of the world's population of which 487,000 were young people in the age group of 10-24, stated Kalpana Apte, Family Planning Association of India (FPAI), during her presentation at the conference.

Ms Saramma Mathai, a regional expert on SRHR and family planning, who also spoke at the plenary, pointed out a reality check was necessary because despite making progress in reducing maternal mortality, increasing family planning services and reducing fertility, countries in the region were still vulnerable. "The quality of services still does not meet acceptable medical and ethical standards. To achieve universal access to SRH rights and services, not only is there a need to improve the quality of services in the region, but also to ensure greater engagement of men," she said.

Swapna Majumdar, Citizen News Service - CNS
January 2014

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