NEW YORK —- Progress in improving access to reproductive health, as called for by Target 5.B of the Millennium Development Goals, has slowed dramatically, according to two new UNFPA reports. Moreover, evidence suggests that inequalities are widening both among and within countries.
Data from two dozen sub-Saharan African countries show that women who are urban, educated and relatively wealthy have far greater access to reproductive health information and services than their rural, less educated and poorer counterparts. Access to reproductive health has remained the same or declined for the least advantaged women, especially adolescents.
The new publications are being released for one of the largest-ever meetings of heads of state, who are gathering next week to review the Millennium Development Goals and fast-track progress towards the 2015 deadline. Universal access to reproductive health was included as a second target of Millennium Development Goal 5 (Improve maternal health) in 2007. A third new publication, Eight Lives, examines how reproductive health issues afffect individuals and their families. Each story gives a voice and a face to those most affected by the failures of dysfunctional health systems.
“My hope is that these publications will contribute to a deeper understanding of the complexity and centrality of reproductive health,” says UNFPA Executive Director Thoraya Ahmed Obaid, “and that they will lead to accelerated progress, along with heightened commitment and an all-too-real sense of urgency.”
The first report, How Universal is Access to Reproductive Health? A review of the evidence, analyses three often-overlooked measures: the adolescent birth rate, the contraceptive prevalence rate, and the unmet need for family planning.
While there has been major progress in nearly every region in reducing the adolescent birth rate since 1990, only two regions – Latin America and the Caribbean and Southern Asia – have made marked progress since then, data reveal. In Southern Asia, the overall progress was swayed by big improvement in a single country, India. In contrast, adolescent births, with their attendant risk factors, remain high in most of the least developed countries.
Progress in increasing family planning coverage and reducing unmet need has stalled in the last decade compared to the previous one. This has coincided with a reduction in funding levels and political priority. Total investment in family planning is now lower in all respects than in 2000: in absolute terms, as a proportion of total health spending, and in the level needed to meet current demand, according to the report. Meanwhile, in large swaths of sub-Saharan Africa, only half of women who want to space or limit their births are using a method of contraception.
The complexity and centrality of reproductive health is richly detailed in the second UNFPA publication, entitled Sexual and Reproductive Health for All: Reducing poverty, advancing development and protecting human rights. The report asks – and answers – three fundamental questions: Why invest in sexual and reproductive health? What have we achieved so far? And where do we go from here?
The report demonstrates that much progress has been made in awareness creation, policy development and evidence-based programmatic approaches. Among the report’s other main messages:
- Interventions in sexual and reproductive health not only save lives and prevent illness but also reduce poverty, spur economic growth and promote environmental sustainability.
- Reproductive health is increasingly recognized as a central element in the continuum of care to advance women’s and children’s health.
- Investing is sexual and reproductive health would more than pay for itself in progress made and resources saved across all the MDGs. Providing family planning information and services as part of a package addressing maternal and newborn health dramatically reduces total costs.
- Reaching adolescents with reproductive health information and services is critical: pregnancy-related risks, including unsafe abortion, are the leading cause of death for women aged 15 to 19 worldwide.
Progress in increasing access to reproductive health, particularly family planning, is entirely possible, according to the report, but attention must be paid to meeting the needs of all groups. Among those reached, many lives have been saved and countless others changed for the better.