POLICY BRIEF

Realizing Sexual and Reproductive Health
and Rights Across the Life Course for All

Sexual and reproductive health and rights (SRHR) are central to human dignity, gender equality, and the realization of Universal Health Coverage (UHC), and they encompass access to accurate information, quality health services, and the freedom to make decisions about one’s body and life without coercion, discrimination, or violence. Despite global commitments through the International Conference on Population and Development (ICPD), the Beijing Platform for Action, and the Sustainable Development Goals (SDGs), progress on SRHR remains uneven and fragile. At the same time, there is growing recognition that advancing SRHR is not only a matter of health, but also of social and economic development. Ensuring women, girls, and marginalized populations can exercise their reproductive rights improves maternal and child health, strengthens families, and contributes to more resilient societies. Advances in digital health, community-led models of care, and integration of SRHR into broader health systems provide new opportunities to accelerate progress. This Fast-Track Health policy brief explores best practices through five case studies, discusses challenges and opportunities, and provides actionable recommendations for municipal, national, and regional health authorities.

Universal Access to Contraception in Rwanda: Rwanda expanded access to modern contraceptives through community health workers, integration of family planning into primary health services, and sustained political commitment. This approach helped reduce unmet need for contraception, contributed to lower maternal mortality, and demonstrated how decentralization can advance SRHR in resource-limited settings. By engaging men and community leaders, Rwanda also advanced shared responsibility in family planning, fostering more gender-equitable decision-making. (UNFPA, 2021)

Comprehensive Sexuality Education in The Netherlands: The Netherlands has long implemented age-appropriate, evidence-based sexuality education across schools, paired with easy access to youth-friendly health services. This approach contributed to some of the world’s lowest rates of unintended teenage pregnancies and sexually transmitted infections, underscoring the value of early, rights-based education. This holistic model has been shown to normalize open dialogue, reduce stigma around sexuality, and strengthen intergenerational trust between young people and adults. (WHO, 2020)

Integration of SRHR into HIV Services in South Africa: South Africa pioneered integration of family planning and SRHR services into HIV care sites, ensuring women living with HIV could access contraceptives and reproductive counseling without stigma. The program improved contraceptive uptake, reduced unintended pregnancies, and enhanced holistic care for women affected by HIV. The integrated model demonstrated efficiency in service delivery while responding to the complex, intersecting needs of women and key populations. (UNAIDS, 2022)

Safe Abortion Services in Nepal: Following legalization in 2002, Nepal invested in scaling up safe abortion services through training, public awareness, and integration into national health programs. The intervention contributed to reduced maternal mortality and morbidity from unsafe abortions, highlighting the role of rights-based legal frameworks. The initiative also highlighted the importance of embedding abortion care into broader SRHR services to ensure sustainability and equity of access. (Guttmacher Institute, 2017)

Menstrual Health and Dignity in Kenya: Kenya introduced policies ensuring access to menstrual products in schools, addressing stigma, absenteeism, and gender inequities in education. The program improved attendance and wellbeing for adolescent girls, while promoting dignity and normalizing menstruation as a health and human rights issue. The program  also catalyzed wider public discourse on menstrual equity, inspiring similar initiatives in other African countries and strengthening advocacy around the right to health for girls and women.(UNESCO, 2020)

Despite progress, significant barriers remain to advancing SRHR globally. Persistent stigma around sexuality, reproductive choices, and gender norms limits access to services, particularly for adolescents, LGBTQ+ populations, and marginalized groups. Health systems often face gaps in financing, trained providers, and integration of SRHR into primary care, resulting in fragmented services. Legal and policy restrictions – such as abortion bans, limited contraceptive availability, and age-of-consent laws – further constrain equitable access. Weak data collection on SRHR, especially disaggregated by age, gender, and socioeconomic status, impedes evidence-based planning and accountability. In addition, climate change and humanitarian crises are exacerbating vulnerabilities by disrupting SRHR service delivery and straining already fragile health systems. Without urgent investment and reform, these barriers threaten to widen existing inequities and stall global progress toward achieving the health-related SDGs.

Opportunities exist to accelerate progress by embedding SRHR firmly within the framework of human rights, gender equality, and UHC. Expanding community-based and digital delivery models can extend services to adolescents and marginalized populations, while also addressing stigma through culturally sensitive engagement. Stronger political leadership and financing commitments at national and municipal levels can help close persistent gaps and ensure continuity of care. Integration of SRHR into broader health and development agendas, including education and climate adaptation planning, offers synergistic gains. Emerging innovations – such as self-care technologies, telehealth, and mobile-based information platforms – are making SRHR more person-centered and accessible. Moreover, investing in SRHR yields cross-cutting benefits for maternal health, child survival, gender equality, and economic resilience, making it a cornerstone for sustainable development. Harnessing these opportunities requires multisectoral collaboration and sustained accountability mechanisms to ensure that commitments translate into measurable improvements in people’s lives.