A series of international agreements reached in the past decade has affirmed that national development and global health depend on fostering the full capacity of all citizens. Essential to this is the empowerment of women.

The empowerment of women has been recognized through many international, regional and national conferences as a basic human right—and also as imperative for national development, population stabilization and global well-being. Reproductive and sexual health and rights are essential for the empowerment of women and to all quality of life issues concerning social, economic, political and cultural participation by women.

Empowerment of women was a central policy goal of both the International Conference on Population and Development (ICPD) in Cairo in 1994 and the Fourth World Conference on Women (FWCW) in Beijing in 1995. Both conferences recognized and reaffirmed that reproductive health is an indispensable part of women’s empowerment.

Women’s empowerment is the process by which unequal power relations are transformed and women gain greater equality with men. At the government level, this includes the extension of all fundamental social, economic and political rights to women. On the individual level, this includes processes by which women gain inner power to express and defend their rights and gain greater self-esteem and control over their own lives and personal and social relationships. Male participation and acceptance of changed roles are essential for women’s empowerment.

This report, a contribution to the "Beijing+5" review of progress since the FWCW, focuses on reproductive and sexual health and rights as necessary and vital components of women’s empowerment throughout the life cycle.

What Are Sexual and Reproductive Rights?

International understanding about sexual and reproductive rights has broadened considerably in recent years. The ICPD Programme of Action 1 and the Beijing Platform for Action 2 recognize sexual and reproductive rights as inalienable, integral and indivisible parts of universal human rights. Sexual and reproductive rights are also a cornerstone of development. Attaining the goals of sustainable, equitable development requires that people are able to exercise control over their sexual and reproductive lives. The most important sexual and reproductive rights include:

• Reproductive and sexual health as a component of overall health, throughout the life cycle, for both men and women;
  
  
• Reproductive decision-making, including voluntary choice in marriage, family formation and determination of the number, timing and spacing of one’s children; and the right to have access to the information and means needed to exercise voluntary choice;
  
  
• Equality and equity for men and women, to enable individuals to make free and informed choices in all spheres of life, free from discrimination based on gender;
  
  
• Sexual and reproductive security, including freedom from sexual violence and coercion, and the right to privacy.

The neglect of sexual and reproductive health and rights lies at the root of many problems the international community has identified as in need of urgent action. These include gender-based violence, HIV/AIDS, maternal mortality, teenage pregnancy, abandoned children and rapid population growth. This massive denial of human rights causes the death of millions of people every year; many more are permanently injured or infected. Most are in developing countries—and most are women. Sexual rights and health are not just an individual concern. Rather, they can have direct impact on the economy of a country—as clearly evidenced in the African countries hardest hit by the AIDS pandemic.

Defining Concepts and Rights

The United Nations conferences of the 1990s reached agreement on the following key concepts and definitions:

• Reproductive health is a state of complete physical, mental and social well-being (not merely the absence of disease or infirmity) in all matters related to the reproductive system and to its functions and processes. (FWCW Platform for Action, paragraph 94; ICPD Programme of Action, paragraph 7.2)
  
  
• Sexual health means that people should be able to have safe and satisfying sex lives. Gender relations should be equal, responsible and mutually respectful. Sexual health encompasses behaviours essential to countering sexually transmitted diseases (STDs), including HIV/AIDS. Sexual health aims at the enhancement of life and personal relations, and sexual health services should not consist merely of counselling and care related to reproduction and sexually transmitted diseases. (FWCW Platform for Action, paragraph 94; ICPD Programme of Action, paragraph 7.2)
  
  
• Reproductive rights include "the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so. It also includes their right to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights documents". (FWCW Platform for Action, paragraph 95)
  
  
• Sexual rights include "the human right of women to have control over and decide freely and responsibly on matters related to their sexuality, including sexual and reproductive health, free of coercion, discrimination and violence". (FWCW Platform for Action, paragraph 96)

Reproductive Health and the Life Cycle

Reproductive health is not just a concern during a woman’s so-called "reproductive years", customarily defined as ages 15 to 45. Rather, reproductive health is a lifetime concern for both women and men, from infancy to old age. In many cultures, discrimination against girls and women begins in infancy and determines their life course. Issues of education and appropriate health care arise in childhood and adolescence. These continue to be issues in the reproductive years, along with family planning, STDs and reproductive tract infections, adequate nutrition and care in pregnancy, and the social status of women. Issues in old age include chronic infection and increasing concerns about cervical and breast cancer. Male attitudes towards gender and sexual relations arise in boyhood, when they are often set for life. Men need early socialization in concepts of sexual responsibility and ongoing education and support for healthy sexual and family formation behaviour. Women and men both need reproductive health care appropriate to their situation in the life cycle.