Sexual and Reproductive Health and Rights

Medicus Mundi Schweiz Young people face considerable challenges in addressing their SRHR needs, encompassing prevention of unintended pregnancies, sexually transmitted infections, early marriage, and sexual coercion and violence. In many countries in the global South there is an overarching issue exacerbating these SRHR challenges which is the lack of solutions tailored to the youth's unique needs and societal contexts. The MMS SRHR Conference 2024 explored what kind of locally led and low cost innovations are in place to reach young people, who are the drivers of such projects and initiatives and how can these locally led innovations be scaled up.

• Medicus Mundi Schweiz

MMS In countries around the world, opposition to sexual and reproductive rights is intensifying. Conservative, right-wing and religious fundamentalist circles are attacking the gains of the women's movement and LGBTQIA+ communities head-on. Be it the restrictions on the right to safe abortions or the attack on women's bodily autonomy as well as discrimination against LGBTQIA+ communities, they all constitute violations of human rights, endanger social peace and have serious health consequences for those affected. At this year's Medicus Mundi Switzerland conference, experts from Europe, Senegal and Zimbabwe discussed the consequences of conservative activism on sexual and reproductive rights and shared their views on the strategies needed to successfully counteract the anti-gender movement. Read in this MMS Bulletin issue why strong international engagement is necessary.

• Bulletin MMS

Medicus Mundi Schweiz Access to the full range of quality sexual and reproductive health care is still not guaranteed, and the lack of access to safe, timely, affordable, and respectful abortion care is a critical public health and human rights issue. Pro-life movements, political action against gender equity and enforced discrimination of people based on their sexual orientation are threatening sexual and reproductive health of people around the world. The MMS Conference on sexual and reproductive health and rights explored what the drivers are behind these developments and how they are linked. It reflected on the role of the international health cooperation in addressing these trends.

• Medicus Mundi Schweiz

Journal of Adolescent Health "Comprehensive sexuality education (CSE) “aims to equip children and young people with knowledge, skills, attitudes and values that will empower them to: realize their health, well-being and dignity; develop respectful social and sexual relationships; consider how their choices affect their own well-being and that of others; and, understand and ensure the protection of their rights throughout their lives”. However, the implementation and scale-up of CSE programs are hampered by several challenges including deeply rooted opposition to CSE that has gained traction in recent years."

• Journal of Adolescent Health
• FALSE PRETENSES: The Anti-Comprehensive Sexuality Education Agenda Weaponizing Human Right

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World Health Organization (WHO) Case studies gathered by the Department of Sexual and Reproductive Health and Research (SRH) and the Human Reproduction Program (HRP) and first published on the website of Medicus Mundi Switzerland. (...) This Bulletin contains a collection of these case studies from 16 countries. The case studies demonstrate how organisations adapted their efforts nimbly to provide adolescents with SRH information and education, health services, and commodities in the context of the restrictions in place. Each case study describes how were these adaptations developed, how were they put in place, and how organizations assessed whether they were in fact responding to adolescents' needs.

• Case Studies

People's Health Dispatch "Thousands of people around the world joined protests in support of safe abortion on September 28. In some countries, for example in Colombia, the mobilization took place after the women's movement secured progress in the field of sexual and reproductive health rights. Protesters in the United States, on the other hand, marched in a situation where the right to abortion is under attack. We bring a snapshot of this year’s International Safe Abortion Day in our photo gallery."

• People's Health Dispatch

Medicus Mundi Switzerland Globally, the adolescent birth rate (ABR) has decreased from 64.5 births per 1000 women aged 15-19 years in 2000 to 42.5 births per 1000 women in 2021 (1 - UNDESA, 2021). However, rates of change have been uneven across regions, with the sharpest decline in South Asia (SA), and slower declines in the Latin American and Caribbean (LAC) and sub-Saharan African (SSA) regions. Although declines have occurred in all regions, SSA and LAC continue to have the highest rates globally at 101 and 53.2 births per 1000 women aged 15-19 years, respectively, in 2021 (1 - UNDESA, 2021).

• Medicus Mundi Switzerland

Medicus Mundi Switzerland Adolescent pregnancies are a global problem but occur most often in poorer and marginalised communities. Many girls face considerable pressure to marry early and become mothers while they are still a child. Approximately 90% of births to girls aged 15-19 in low- and middle-income countries occur within early marriage where there is often an imbalance of power, no access to contraception and pressure on girls to prove their fertility. Although there are huge differences between countries and regions, since the outbreak of COVID-19, the number of teenage pregnancies has increased worldwide. The contributions in this bulletin discuss why the sexual and reproductive rights and needs of teenage girls need to be better protected and what measures are needed to prevent teenage pregnancies. (Photo by Chris Benson on Unsplash)

• Medicus Mundi Switzerland

Medicus Mundi Switzerland Every year, an estimated 21 million girls aged 15–19 years in developing regions become pregnant and approximately 12 million of them give birth (Guttmacher Report, 2016)1. At least 777,000 births occur to adolescent girls younger than 15 years in developing countries. The COVID-19 pandemic has increased the number of teenage pregnancy due to lockdowns and other restrictions.

• Medicus Mundi Switzerland

Graduate Institute Geneva - Global Health Centre Discussion of the menstrual hygiene needs of women & girls and shared experiences from Africa, Asia and Europe. This event was co-organised by the Gender, Diversity and Inclusion Initiative together with the Gender Centre, the Global Health Centre, the City of Geneva and the World Health Organization.

• Global Health Centre - Recording

Global Health 50/50 report “The fifth annual Global Health 50/50 report, Boards for all?, presents our first-ever analysis of the gender and geography of who governs global health. Through an examination of the demographics of over 2,000 board members of the most influential organisations active in global health, the report warns that global health is not living up to its name. The report further presents its annual review of the equality- and gender-related policies and practices of 200 global organisations. Building on five years of evidence, it finds signs of rapid progress in building more equitable and genderresponsive global health organisations, while also revealing stagnating progress among a large subset of global health organisations. For the first time, the Index categorises all organisations by performance and presents dedicated pages for each organisation to explore and compare findings. Boards for all? is a call to realise a globally representative and equitable global health governance that can deliver health for all…..”

• Global Health 50/50 report

Health Policy Watch "As much as 99% of the world population breathes in air with pollution levels higher than WHO’s permissible limits. The majority of the world’s most polluted cities are in South Asia. Air pollution is linked to higher rates of miscarriages, pregnancy complications and stillbirths, affecting women’s reproductive health."

• Health Policy Watch

World Health Organization (WHO) "As part of a rights-based approach to improve sexual, reproductive, maternal, newborn, child and adolescent health (SRMNCAH), health policies and programmes must prioritize measures that ensure the needs of the most vulnerable are fully and equitably met, while upholding the core human rights principles of accountability, equality and non-discrimination, and participation. These are the basis of the WHO Thirteenth General Programme of Work, which promotes gender equality, human rights and equity. Inequalities affecting access to SRMNCAH services remain a particularly pressing concern as the world continues to respond to the COVID-19 pandemic and other health emergencies. (...) This step-by-step manual describes the process of health inequality monitoring for SRMNCAH using a five-step cycle. This manual and its companion workbook are valuable resources to guide the workof people undertaking monitoring and evaluation, programme planning and/or policy development."

• World Health Organization

Heinrich Böll Stiftung "The COVID-19 pandemic has heightened many of the challenges that mothers around the world face as the global health threat and resulting economic downturn have created a caregiving crisis that has disproportionately affected women and motherhood."

• Heinrich Böll Stiftung - Nairobi

Global Health Action "Poor performance among health service providers is a key barrier to high quality, adolescent- responsive health services. Collaborative learning has been shown to strengthen health service provider performance, but few studies have examined its implementation in adoles- cent health services. In this paper, we describe a collaborative learning approach for adoles- cent health service providers implemented as part of a project aiming to prevent HIV in adolescent girls and young women in the Democratic Republic of the Congo (DRC) and explore its feasibility, acceptability, benefits and challenges. To do so, we reviewed plans, budgets and progress reports, as well as nested implementation research related to the project."

• Global Health Action

UNESDOC "Comprehensive sexuality education (CSE) is central to children and young people’s well-being, equipping them with the knowledge and skills they need to make healthy and responsible choices in their lives. This report draws on multiple data sources to provide analysis of countries’ progress towards delivering good quality school-based CSE to all learners. 85 per cent of 155 countries surveyed have policies or laws relating to sexuality education, with considerably more countries reporting policies to mandate delivery at secondary education level than at primary level. However, the existence of policy and legal frameworks do not always equate to comprehensive content or strong implementation. Most countries report that they have some curricula in place but more detailed analysis suggests that it often lacks the breadth of topics needed to make sexuality education effective and relevant."

• UNESDOC

MMS For too long, mental disorders have been largely overlooked by health systems. This is despite the fact that mental disorders are found in all countries and in women and men regardless of their status or living condition. If people with mental disorders fail to receive the treatment and care they need, they risk becoming marginalized from society; many descend into poverty and homelessness. According to a recent WHO survey, The COVID-19 pandemic has disrupted or halted critical mental health services in 93% of countries worldwide while the demand for mental health is increasing. With the COVID-19 epidemic, there was an escalation in the risk millions face, mainly women from being affected by domestic and gender-based violence which does not only leave a scare on the physical body but also on the mental body. This MMS Bulletin edition highlights the consequences of the COVID-19 pandemic on mental health, missed opportunities and the need to invest in mental health.

• MMS Bulletin

World Health Organization (WHO) "International Youth Day is held on the 12th August every year. This important event brings global attention to the specific and diverse issues which young people face and shines a spotlight on the power and potential of young people to speak for themselves and to make lasting change. In recognition of the considerable challenges faced by adolescents to their sexual and reproductive health and rights, WHO has published a series of “country profiles” to summarise data on key issues."

• World Health Organization (WHO)

STAT "The furor about vaccine nationalism and sharing doses of Covid-19 overshadows a fundamental issue: What is an equitable definition of what counts as a pandemic? The use of that word isn’t just semantics: It’s about who we care lives or dies. As high levels of vaccination coverage in high-income countries enable their citizens to gradually resume normal life, much of the focus in the capitals of G7 countries is shifting from fighting Covid-19 to preventing future pandemics. It makes sense for them to seize the moment to make themselves safer from future threats."

• STAT

Medicus Mundi Switzerland At our conference it became evident that the pandemic reinforces the deficiencies in health care for people with mental illness that have been prevalent for years. Neglected, repressed, forgotten - mental health is reluctantly addressed in international politics. This is devastating for women who suffer from various forms of violence but also for men who need equally support. Internationally and nationally, there is a need for greater commitment to mental health. This will be an important contribution to transforming existing taboos towards more social openness. And more international and national investment in prevention, treatment and rehabilitation is needed to counteract shame, stigmatisation and discrimination of those affected.

• Documentation SRHR Conference

Global Health 50/50 Initiative "The 2021 Global Health 50/50 report, “Gender equality: Flying blind in a time of crisis,” reviews the gender-related policies and practices of 201 global organisations active in global health. (...) The latest data also suggest, however, that rhetoric is often used as a substitute for action. The report reveals that the vast majority of programmatic activity to prevent and address the health impacts of COVID-19 largely ignores the role of gender. Evidence gathered by the GH5050 collective of researchers, strategists and practitioners shows that gender influences everything from who gets tested for COVID-19 to risk of severe disease and death."

• Global Health 50/50 Report 2021

ALJAZEERA "One in three women worldwide have been subject to sexual or physical violence during their lifetime, according to a new report by the World Health Organization (WHO). The UN agency released the study on Tuesday urging governments to prevent violence, improve services for victims, and tackle economic inequalities that often leave women and girls trapped in abusive relationships."

• AlJazeera
• WHO Press release
• WHO report: Violence against women, prevalence, estimates 2018

Medicus Mundi Switzerland he MMS “Health for All” podcast brings you stories of people who are fighting for gender equality, health for all and a world of justice and hope. It features strong-minded people who stand up for their beliefs and are seeking to make this world a better place, demonstrating how dedication can lead to “health for all”. The podcast is produced by Medicus Mundi Switzerland and is hosted by Carine Weiss.

• MMS "Health for All" Podcast
• Episode 1 with Anne Philpott: It’s all about pleasure – putting the sexy back into safer sex
• Episode 2 with Georgia Arnold: Sex, desire and daily life: A TV show that takes young people seriously
• Episode 3 with Allan Maleche: Lawyers for health - harnessing the power of law
• Episode 4 with Dr. Venkatraman Chandra-Mouli: Let’s not shy away from sexuality education
• Episode 5 with Vithika Yadav: Love matters! Let’s talk about sex
• Episode 6 with Khushboo: Domestic violence, puberty and first love: let’s lift the curtain

International Journal for Equity in Health "Single aggregate figures for adolescent pregnancy may fail to demonstrate particular population groups where rates are very high, or where progress has been slow. In addition, most indicators fail to separate younger from older adolescents. As there is some evidence that the disadvantages faced by adolescent mothers are greatest for those at the younger end of the spectrum, this is an important omission. This paper provides information on levels and trends of adolescent first births in 22 countries (at national and regional level) disaggregated by age (< 16 years, 16/17 years and 18/19 years), socio-economic status and place of residence. It highlights differences and similarities between countries in the characteristics of women who experience first birth during adolescence, as well as providing information on trends to identify groups where progress in reducing adolescent first births is poor."

• International Journal for Equity in Health

MMS The year 2020 will mark several important milestones for gender equality and sustainable development, including the 25th anniversary of the Beijing Declaration and Platform for Action, one of the most comprehensive blueprints for women’s rights worldwide. Gender inequality and gender norms impede progress on the global goal to achieve health for all. A gender transformative approach aspires to change this reality. Read more about how gender transformative approaches can contribute to realising gender equality in this bulletin. (Photo by Tim Mossholder on Unsplash)

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MMS As the International AIDS Conference holds its first virtual meeting, it’s time to consider the politics that create gaps in data for the fight against HIV, writes Sara L.M. Davis

• www.medicusmundi.ch

souffle2vie

• www.souffle2vie.ch

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MMS Middle childhood is often referred to as the ‘forgotten years’ of development because the majority of research has focused on development in early childhood or on adolescent growth. It is evident that there is a lack of data and information about this age group, the 5-10 year olds, and in many ways even up to the age of 15. This MMS Bulletin addresses the main topics of middle childhood: from the consequences of child marriage and the overburdening of parents bringing up their children, to better hygiene during menstruation. The Bulletin reveals the knowledge gaps, missed chances and challenges in reaching this age group in order to provide them with more effective prevention, healthcare, treatment and rehabilitation. (Photo by Alex Radelich on Unsplash)

• www.medicusmundi.ch

MMS At this year’s Medicus Mundi Switzerland Network’s conference, young people from Zimbabwe, Paraguay, India, Germany and Switzerland demonstrated that the battle for sexual and reproductive health and rights can only be won if young people themselves take on the responsibility for programmes and projects. There is ample evidence that overcoming young people’s health problems across the globe is hampered by the lack of effective communication about sex and sexuality. This means young people prefer to suffer in silence to avoid shame rather than to seek advice, information and help. Read for yourself the inspiring contributions from our young speakers in the current edition of our MMS Bulletin. (Photo: Timothy Choy-695130-unsplash)

• www.medicusmundi.ch

MMS Many young people struggle with their HIV infection and the lifetime of antiretroviral therapy that it means. They need particularly close support to ensure that their treatment continues uninterrupted. The need to understand and comprehensively address the health care needs of this key population is vital to the epidemic.

• www.medicusmundi.ch

Devex Report by Fondation Botnar, Devex, PATH, Women Deliver & The Partnership for Maternal, Newborn & Child Health. The report surveyed over 1,500 young people around the world to shed light on what young people really think about technology in global health. What´s inside: - What are young people’s top health concerns? - How many young people use technology for their health-related needs? - Are young people’s health concerns being adequately addressed? - How does the future of health look like? (Photo: Devex)

• pages.devex.com

Devex "People aged 15-29 years old make up nearly one-quarter of the world’s total population, yet less than 2% of global development assistance for health is allocated toward young people and their needs. Universal health coverage, as part of the Sustainable Development Goals, cannot be achieved if anyone is left behind. But if the global development community is to follow the mantra “nothing about us, without us,” the health care needs of today’s young people must be catered for and they should be a part of conversations around how to improve their own access to health care." (Photo: MMS)

• www.devex.com

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MMS At this year's conference of the Network Medicus Mundi Switzerland (MMS) in Bern, the experts were unified in their view that gender-based violence (GBV) must be combated at all levels. The #MeToo movement has revealed that GBV is prevalent at all levels of society. Nevertheless, in many countries this violence remains hidden. It is inadequately tackled by the authorities and legal structures to protect victims are too weak. The conference gained further insights and supported exchange and mutual learning about a topic to which there are no simple solutions. Read the interesting contributions in the latest edition of our bulletin. (Photo: tdh)

• www.medicusmundi.ch

SDC Mid March, the 31. Board meeting of the Human Reproduction Programme (HRP) took place in Geneva. HRP’s mandate is to promote, coordinate, support, conduct and evaluate research in sexual and reproductive health and rights, with particular focus on developing countries. The programme is hosted and executed by WHO and co-sponsored by UNFPA, UNICEF, the World Bank, UNDP and WHO. Numerous observers, including Medicus Mundi Switzerland, participated in the Board meeting. Switzerland, through SDC, supports HRP with CHF 1.25 Mio annually and has a seat in the Board. To learn about the latest HRP products which have been presented at the Board, check out the HRP Website and HRP Annual Report and subscribe to the HRP Newsletter. (Photo: Mission to Sikikédé/hdptcar/flickr, CC BY-NC-SA 2.0)

• www.who.int

BioMedCentral Universal access to contraceptives is still no reality at all. Adolescents are affected disproportionately from this gap, with far-reaching consequences for their reproductive and economic development as well as for their children and the society in which they live. The international community has recognized this and declared it to a top priority in the SDGs as well as in the recently held family planning summit: Through action, new methods and extended approaches, everything have to be done to enable the right for contraception to all young people. (Photo: TIZEZEW, campaigns to end child marriage, Ethiopia / UK Department for International Development / flickr, CC BY 2.0)

• link.springer.com

World Health Organisation (WHO) The working group's report stresses that governments do not pay enough attention to the link between health and human rights and should invest much more in the implementation of human rights, in particular to improve the health of women, children and adolescents. If we do not put human rights and the right to health, which are mutually dependent, at the center of our work, we will not reach the Sustainable Development Goals (SDGs) by 2030, warns the high-level commission. As an example, they remind at the current threats to the sexual and reproductive rights of women and adolescence worldwide, including the right of safe abortion, which attack the hard-won advantages. (Photo: The wedding night: "It was such a shock" / DFID / flickr, CC BY 2.0)

• www.ohchr.org

MMS/aidsfocus.ch MMS/aidsfocus.ch participated at the Global Fund Board Meeting, Kigali, 3 – 4 May 2017 - At the beginning of May the board of the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) met in Kigali. Martin Leschhorn Strebel, civil society representative in the Swiss delegation reports.

• www.aidsfocus.ch

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Medicus Mundi Switzerland The Network Medicus Mundi Switzerland is proud to present the “Survey among Medicus Mundi Switzerland Members on Human Rights-Based Approaches to Sexual and Reproductive Health”. The main purpose of this survey was to explore the experiences of MMS network members, including their partner organisations in operationalizing the human rights-based approach (HRBA) in the field of sexual and reproductive health.

• www.medicusmundi.ch

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MMS/aidsfocus.ch UNAIDS has set ambitious targets for 2020: 90% of all people living with HIV will know their HIV status, 90% of all people diagnosed with HIV will have access to treatment, and 90% of the people receiving treatment will have suppressed the virus to an undetectable level. Using this 90-90-90 strategy, UNAIDS aims to end the HIV epidemic by 2030. This target can only be achieved through concentrated efforts.

• www.aidsfocus.ch

MMS Gender equality, abortion, child marriage, quality of maternal care, violence against women and investment in Sexual and Reproductive Health and Rights, new technology and innovative solutions were just some of the topics discussed at Women Deliver 2016, the world's largest conference on women's and girls’ health, rights and wellbeing. A total of 5’700 participants from 194 countries joined the event - including government ministers, policy makers, business leaders and representatives of non-governmental organisations, members of civil society organisations, youth, activists, royal family members and celebrities - to discuss how to improve the lives of girls and women by the SDG target date of 2030. A report written by Carine Weiss, Carolyn Blake and Leah F. Bohle.

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The Guardian A recent Lancet study showes that children who are breastfed for longer have higher IQs, lower death rates and less risk of infection than those who are breastfed for shorter periods or not at all, the research found. Breastfeeding may also protect against diabetes and obesity later in life. Despite these proven benefits, however, only 37% of children aged six months and under in lower- and middle-income countries are exclusively breastfed. This failure of breastfeeding should not be seen solely as the responsibility of the woman, but also in the lack of support for mothers and aggressive formula milk industry, research finds. (Photo Unicef Ethiopia / flickr)

• www.theguardian.com

Reproductive Health Journal "Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents." (Photo: bass_nroll / flickr)

• reproductive-health-journal.biomedcentral.com

The Guardian Pregnancies and childbirth in humanitarian crises pose disproportionate risk on women and adolescent girls. Sixty percent of preventable cases of maternal mortality attribute to women who have been affected by conflict, natural disasters or flight. The World Population Report 2015 appeals to protect the rights of women and girls in humanitarian crises. (Photo © flickr)

• www.theguardian.com

World Health Organisation (WHO) As an expert in adolescent sexual and reproductive health, Dr. V. Chandra – Mouli from the World Health Organisation (WHO), explains that sexuality education is not just teaching about sex, reproduction or how to avoid problems. It’s actually much more than giving information, it aims to prepare young people for a healthy sexual and reproductive life, but also a happy sexual and reproductive life.

• www.who.int

The Lancet Healthy women, valued and respected, are a win for societies and a crucial prerequisite in order to reach the sustainable development goals. The new concept of the Lancet Commission on "Women and Health" takes a completely different view on female health. So far reproductive health of women was the most important issue, now by using a more holistic approach all influences on women's health in the course of her life should be considered. Women's health is disporportionaly influenced by gender, social and societal determinants, which represent a particular challenge.

• www.thelancet.com

MMS It has now been twenty years since the International Conference on Population and Development (ICDP) in Cairo set up new measures and principles concerning sexual and reproductive health. This conference showed how questions of population growth and social and economic development can only be tackled by taking up a rights-based approach.

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In addition to our MMS Symposium 2014 we produced a Take Home Message Film on the lessons learned.

WHO Addressing adolescents is key to strengthen sexual and reproductive health. A WHO-led Special Supplement to the Journal of Adolescent Health, states "that progress for adolescent sexual and reproductive health and rights (ASRHR), has been ‘limited and patchy’." (Photo: WHO/Hauranitai Shulika)

• www.who.int
• www.jahonline.org

MMS It has now been twenty years since the International Conference on Population and Development (ICDP) in Cairo set new principles and criteria on sexual and reproductive health and rights. The ICDP exposed the fact that issues of population increase and social as well as economic growth can only be brought forward with a rights based approach. At this year’s symposium we will be addressing these obstacles and emphasising that the results of Cairo 1994 are still of utmost importance to international health cooperation. At the centre of our discussions we have set young people, who are the key group we need to be working with in order to improve health for women and girls, mothers and children. Which obstacles do we need to overcome in order to grant youth’s access to health services? How should health services for sexual and reproductive health be modelled in order to be more youth-friendly? What kind of social environment is required for youths themselves to be able to stand up for their right to health?

CRR "Since 1998, the Center for Reproductive Rights has produced The World’s Abortion Laws map to visually compare the legal status of induced abortion in different countries—and to advocate for greater progress in ensuring access to safe and legal abortion services for all women worldwide. The World Abortion Laws Map 2014 was launched in commemoration of the 20-year anniversary of the International Conference on Population and Development Programme of Action. The legal status of abortion is an important indicator of women’s ability to enjoy their reproductive rights. Legal restrictions on abortion often cause high levels of illegal and unsafe abortion, and there is a proven link between unsafe abortion and maternal mortality. We offer this publication as a resource for human rights advocates working on abortion law reform—and as a means of both tracking progress and identifying the challenges that must still be overcome."

• www.worldabortionlaws.com