Chapter 4: Securing rights
Gender-based violence
Sexual and reproductive health and rights

Sexual and reproductive health and rights are central to empowering women and adolescent girls, fulfilling their human rights, ensuring their health and well-being, and creating gender-equal societies and economies. Investments in sexual and reproductive health yield enormous social and economic returns for women in all of their diversity, and for their families and societies, paying dividends across generations.

In much of the world, women continue to have insufficient access to high-quality sexual and reproductive health information, education and services—including family planning—all of which are central to realizing and protecting their sexual and reproductive rights and reducing HIV risk. According to recent population-based surveys, the percentage of women (aged 15 to 49 years) who had their demand for family planning satisfied by modern methods ranged from 6.3% in Albania to 86.6% in Colombia.

Access to sexual and reproductive health information and services is often impeded by multiple intersecting forms of inequality and stigma and discrimination, creating barriers at the individual, interpersonal, community and societal levels. Rural and urban poor, minority ethnic groups, adolescents and lesbian, gay, bisexual, transgender and intersex (LGBTI) people are particularly underserved. In the majority of countries with recent survey data, women are less likely to have their demand for family planning satisfied by modern methods if they live in rural areas, have not attained a secondary or higher level of education, and/or are in the lowest wealth index quintile. The fact that the poorest women in some countries (e.g., Zimbabwe) have greater access to family planning than the wealthiest women in other countries (e.g., Columbia) suggests that good policies and programmes can expand service access across all income levels.

Women living with HIV face particular challenges, as HIV stigma and gender inequality intersect and negatively impact their health. While health-care settings should be safe spaces, as many as one in three women living with HIV across 19 countries reported experiencing at least one form of discrimination related to their sexual and reproductive health in a health-care setting within the past 12 months. Health rights abuses documented by various studies include unauthorized disclosure of status, being advised to not have children, forced and coerced sterilization or termination of a pregnancy, denial of sexual and reproductive health services, and related psychological violence.