Investment in Sexual and Reproductive Health and Rights

In 2022, UN Women reported that at the current rate of progress it will take close to 300 years to achieve global gender equity. It’s easy to feel disheartened and frustrated by this prediction, but one way to make tangible and practical headway towards this goal is through investment into sexual and reproductive health and rights (SRHR). The research speaks for itself: when women and girls are best supported to exercise their rights to access quality health care, everyone is best set up to live healthy, well, and full lives. It’s a critical opportunity.

Sexual and reproductive health (SRH) is a core element of quality healthcare. SRH not only provides individual benefits, but also has the potential to support broad and wide-reaching societal benefits. For example, SRH access means that girls are likely to stay in school for longer, and women can access increased employment opportunities, and are more likely to participate meaningfully in decision-making processes. With SRH, people can plan their families based on their values and personal circumstances. Climate resilience and access to SRHR are also inextricably linked, with access to SRH detrimentally impacted in times of natural disaster. Alternatively, when people can realise their SRHR, they have increased capacity to engage in and support climate adaption action. It’s not an overstatement to claim that SRHR is at the very heart of equity.

Hearteningly, the gender equity conversation is increasing in volume across the development sector. Particularly exciting is the more visible and vocal recognition of the importance of gender equity in development by the New Zealand Government and the explicit mention of the role of SRHR in achieving this. The establishment of a Pacific Gender Equity Ambassador is another visible move reinforcing this commitment to centring gender equity in development, as effective relationship building at the diplomatic level can be a catalyst to build support for SRHR, shift norms, and contribute to enabling environments.

It’s good to see New Zealand speaking out and making a difference on these issues. The Gender Action Plan, released by the Ministry of Foreign Affairs and Trade (MFAT) further operationalises the rhetoric outlining a pathway for development activity to be considered with a gendered lens. The development sector is starting to see proposed activities being assessed with greater weighting placed on the activity’s gendered considerations. Even more heartening is the financial backing of these statements and plans through the announcement of increased development assistance for SRHR in the Pacific region.

These positive steps should nonetheless be celebrated with caution. In development, the devil lies in monitoring evaluation and accountabilities. There is a real need to see and understand exactly how this investment measures up to overall Official Development Assistance spending.

Ensuring resources are used meaningfully and effectively remains the perennial conundrum, likely persisting for the next 300 years. So, how to take in investment in SRHR and support it to thrive? The answer is to ground action within the relevant context, and ensure the commitment is consistent and unwavering. Global examples reinforce that support for SRHR is tenuous, and rights can never be taken for granted.

We must become even more uncomfortable with ambiguity. Working to support global realisation of SRHR is unlikely to be filled with linear and direct relationships between outputs and outcomes. For example, across the Pacific, SRH clinics are often plugging the gaps for under-resourced health systems. On any given day, clinicians are likely to be providing people with pain relief, bandages, and tending to general medical concerns. However, in providing a safe and non-judgmental space for clients to experience care, the end of consultation is when a patient is likely to ask a question about contraception or raise a concern about an STI.

It boils down to an investment in relationships.

In Vanuatu, a nation made up of approximately 80 islands with vast and deep diversity in kastom, language, and geography, access challenges remain persistent. Rural and remote communities may have limited contact (if any) with urban centres. Myths remain rife, rendering trust the lynchpin in providing SRH services and information. And trust takes time. Time to build relationships, to socialise ideas, and to grow understanding of the ways that SRHR (a typically taboo concept) can exist in harmony with cultural values and systems.   

To build these relationships, the Vanuatu Family Health Association staff travel to people in where they live, carrying supplies by boat, horseback, and on foot in the most remote locations. Through the MFAT-funded Planem Gud Famili Bong Yumi project (Planning Our Families Well project)*, this outreach supports access to the services and information that allow people to realise their rights to sexual and reproductive health. The challenges in this way of working are persistent, but are matched by dedication, passion and knowledge of the staff setting up tents to offer contraceptive counselling and analysing cervical smears into the night. 

At present, these efforts do well to knock a decade or two off the 300-year timeframe prediction. However, without a global scale up in investment, I’m not holding my breath for the achievement of gender equity (or universal access to health care) by 2030. At just over halfway to this deadline, this International Women’s Day feels an apt moment to champion that investment in SRHR is a cost-efficient and effective means to help achieve global equity – and pick up the pace!

*Planem Gud Famili Blong Yumi is implemented in partnership with Family Planning New Zealand, with support from the New Zealand Aid Programme.