The Evolution of Sexual and Reproductive Health and Rights

The journey walked by women, Civil Society Organizations, human rights treaties, international laws bodies and governments, and persons of interests to realize sexual and reproductive health and rights has been long and mucky, flawed by threats and controversies mostly for its relating landscapes of interest such as politics, economies, religions, cultures and taboos, and demographics. It has also presented strengths and opportunities towards realization of women’s human’s rights. Thus, looking at sexual reproductive health and rights as a creation of history rather than timeless givens creates opportunities to take stock of the covered milestones while identifying gaps for improvement.

What are Sexual and Reproductive Health and Rights? 

The United Nations Population Fund defines sexual and reproductive health and rights as a complete state of physical, mental and social well- being in all matters relating to the reproductive system. This implies people have safe and satisfying sex, capability to reproduce, and have the freedom to decide if, when and how often to. Sexual and reproductive health and rights also emphasizes on the need to access accurate information, safe, effective, affordable and acceptable contraceptive method of choice.

It further stretches to empowerment for women and girls to protect themselves from sexually transmitted diseases. Sexual reproductive health cannot be fully meaningful without access of some fundamental rights such as freedom from sexual violence, discrimination against women and girls and coercion. Lastly, sexual and reproductive health and rights encompasses the rights of women to access services to enable them have a safe pregnancy, delivery and health babies. 

The Population Control Paradigm Shift! The 1954 Population Conference to the 1994 International Conference on Population and Development

A journey of thousand miles starts with a single step. First was the Conference on Population of Rome 1954 whose objective looked into discussing population in general terms not as a policy-the issues of population growth therefore were not conceptualized on the grounds of human rights-but as an independent capacity of demographers. In 1965, the Population Conference was held in Balgrade, a disturbing body of literature was bursting with population control ideas citing the world population was growing like a bush fire that would lead to mass starvation. 

Most governments supported the idea of family planning agreeing to neo-Malthusian belief that population growth is the cause of poverty and a hindrance to development. In pursuit of population control women became victims of coercive practices such as forced abortions and social pressure to monitor and control individual fertility. The 1968 UN Teheran International Conference on Human Rights gave sexual and reproductive health and rights another turn-population control was linked to human.

The reason behind adopting to this resolution was better opportunities to enjoy human rights and living standards for all. Therefore, the Teheran International Conference on Human Rights demonstrated population as a problem in a manner so embryonic. It was later adopted by all population control paradigms as an affirmation that its possible to realize human rights while identifying gaps such as coercive and discriminatory practices.

The Bucharest Population Council- Birth of a New Model…

The abovementioned narrative brought a new twist- the first World Conference on Population where high-ranked government officials gathered to discuss a matter considered so sensitive-population and its relation to development. Following hard discussion by 137 UN member states, a Plan of Action was adopted (The World Population Plan of Action). Just a flashback- the Malthusian theory perceived “population issue” as a consequence not a cause of underdevelopment. They also argued the distribution of resources was issue not the scarcity. This is the conference that hosted many undeveloped countries compared to the previous ones, bringing out a clear picture of human rights issues towards population and development. 

The World Population Plan of Action established three significant changes. Foremost, population policies must be consistent with human rights. Second, states must respect and guarantee citizens the right to determine the number of their children and spacing without discrimination and coercion, and access accurate information and services. Did the two recommendations outweigh the governments’ wish to control population? The provision of all couples and individuals was not in the original Bucharest Conference, although majority of the delegates were in its favour, others felt it was a way for the unmarried to access contraceptives. This was a perfect breather as the matter was put to vote-48 voters were in support, 41 against while 6 did not vote.

This affirmation has stood the test of time in the history of women’s human rights with efforts to change or revise it failing. Lastly, the World Population Plan of Action drew attention on the connectedness of the role played by women in population policies “equal status of men and women in the society improves the general quality of life”.  In other words, “improvement status of women means contributing to family/society general welfare, the opportunity to have planned births and improved individual status”. United Nations Population Department 1974).

They say the older the fiddle, the sweeter the tune. After the Bucharest Conference in 1974 feminist criticism of fertility control politics matured to a hot topic. During the 1975 International Women’s Year Conference in Mexico many women human rights organizations denounced coercive practises in contraceptive research, stating that reproductive rights are of bodily integrity and control. This was the beginning of many backs and forth deliberations, although finally it marked a turning point in policy directives on women’s issues. The second International Conference on Population took place in Mexico City in 1984 where UN member states adopted Recommendations for Further Implementation of World Population Plan of Action. Members categorically confirmed on the significance of human rights in population control.

However, it could not just be without abortion and coercive practises such as sterilization sparking the controversies to achieve demographic population targets. The Recommendations of World Population Plan of Action was without doubts a reflection of human rights approach. In tandem, abortion and coercive practises were an opener if really the international commitment and possible political will of states to implement Recommendation 30 and 31 respectively. Recommendation 31 demands that all legislations and policies concerning family incentives and disincentives must be consistent with internationally recognized human rights, and should neither be discriminatory nor coercive.

America’s reception of abortion and coercive practices was cold, turning it into the mantra “abortion is not a family planning method” that continued to be an international agenda decade after decade. The Pro-life movement of 1973 became a universal as reproductive politics. America’s then President Charles Reagan, made it clear only foreign NGOs without intents of promoting abortion as a family planning method would access the federal family planning funds.

Nevertheless, legalized abortion as “legal and safe abortion” according Swedish delegate was met by disagreements. Recommendation 18(e) of World Population Plan of Action states “To take appropriate action to help women avoid abortion, which in no case should be considered a family planning method (UN Second Conference on Population). China’s one child policy became a thorn in the flesh for the conference. Not only had it gained international attention but also undermined the concept of family planning as a human right accepted in the Bucharest Population Council.

The role of men in family planning was not also left out. Paragraph 7 of the World Population Plan for Action Recommendation is clear “In order to provide women the freedom to participate fully in the life of society, it is equally necessary for men to share with women responsibilities in family planning, child bearing and other family life aspects.” The question in my at this point is, have men honoured the recommendation? It is a crucial statement especially for success of women controlling reproduction while attaining other potentials fully. There were concerns on the population control paradigm though that have shaped the landscape of woman women rights to date, its overriding of women’s reproduction, in that:-

  • Was it a polite manner of overlooking other structural issues
  • Was it a way of experimenting women’s bodies to reach population targets
  • Why the constistency towards birth control rather than a sexual and reproductive and health rights

The outcome? Gender neutralism where other women’s sexual and reproductive health and rights were ignored. Women’s organizations rised their dissatisfaction with the argument the population control approach definition made women factors and not actors. Cook in his book, Reproductive Health and Human Rights (2003), asserts women were beneficiaries, while they were not at the centre, they were objects not subjects. The approach focused on the poor women but failed to address social inequality. This largely birthed for women rights movements/ organizations to call for health care, mass education, women emancipation and resource allocation.

Accelerating The Promise-Nairobi ICPD25

The recently concluded 25th anniversary of the International Conference on Population and Development was much anticipated; the deliberations should have left a watershed moment for girls and women across the world. The struggle for realization of women and girls’ rights remain. We cannot play blind and deaf any longer. Just quick reminder-the International Conference on Population and Development is the resulting Programme of Action hosted by Cairo in 1994 bringing together 179 states with the agenda to improve human lives, rather than population control targets. Like a basket-ful of moonlight, different perspectives of sexual and reproductive health, human rights, gender equality, discrimination, coercive practices, sustainable development and women empowerment were merged to a remarkable international consensus.

The sentimental logo that unified many from all walk of life for realization of women’s rights

The Nairobi Summit: International Conference on Population and Development’s Main Agendas

Nothing more was added to the table from the ICPD’s agenda of 1994! It was a re-commitment to Accelerate a Promise made back then. After years of actions, the gains have been considerably felt. Africa, South America, Antarctica and Asia still lack behind in matters of urgency, sexual and reproductive health and rights, health care and education according to Gross Domestic Product by International Monetary Funds and World Bank. Unquestionably, this stagnates progress towards Sustainable Development Goals. Therefore, Nairobi Summit on ICPD25 mobilized for political and financial commitments needed urgently t implement the International Conference on Population and Development Program of Action aimed at:-

Universal access to sexual and reproductive health and rights as a part of universal health coverage.

Financing the requirements to complete the International Conference on Population and Development Action of Plan, and sustain the made gains.

Draw on the demographic diversity economic growth and achieve sustainable development.

End gender-based violence and harmful practices.

Upholding the right to sexual and reproductive health care even in humanitarian and fragile contexts.

The Nairobi Summit on ICPD25: Grassroots Women’s Organizations

I advocate sexual and reproductive health and rights-the ICPD’s core agenda. The summit’s zeal was felt globally. What an an opportunity to take stock of our successes and lost grounds, while working forward it was. My wish to attend the summit at the main venue was futile. Still luck found me presenting the chance to attend a side event organized by grassroots women’s organizations from Mathare and Kibera, the largest informal settlements in Africa.


Our venue was Geevanjee Gardens. I fell into a conversation on whether the weather could ruin our event. Shortly, deviated to the cost of living, one of us pointing out leadership under the retired President Moi was better…food was surplus “Bora uhai, na ile story ya aflotoxin?” Another one lamented. I bring up the agenda of the day, explaining sexual and reproductive health and rights is at the core of International Council Population and Development’s agenda, why its very important for us women. “Form yangu ni pesa tu”. Another interrupted.

He stole the day away; an advocate of pro-life

Shortly the event started with zeal, we were over sixty women, welcoming the International Council for Population and Development Summit in our way-songs and dance with placards in the air under light downpour between the canopy of purple haze.  Nothing deterred us from the commemoration.

We had one speech and a press statement from which I got to understand the lives of girls/ women in informal settlements are complex. Many of them are adults at childhood, poverty and injustices have manifested themselves in many faces, human rights are wrongs-they are vulnerable to sexually transmitted diseases, unsafe abortions, teenage motherhood, maternal deaths, extra judicial killings, sexual violence, poor healthcare and education, political violence, poor sanitation and housing,accessibility of services and information, crimes, drug and substance abuse while remaining  at the bottom of all economic and development spheres.

Thank you Mr. President: The Kenyan President’s Commitments

I remember one of the grassroots women’s representative addressing to the media, “ Hii ifikie prezzo, some women in this country have suffered great pains, you have made a promise; tumekusikia, kunakucheki.” In his speech, President Uhuru Kenyatta spoke of a re-dedication towards the incomplete 1994 agenda. He spoke for women and girls vulnerable to gender violence, maternal deaths, female genital mutilation, early marriages, infant and child mortality, and unemployed youth with less opportunities for growth.

Women and girls from grassroots organization were as optimistic as everyone else in accelerating the promise

He noted the ordinary citizen me and maybe you are the most important participants of the summit, while reminding the participants who were mostly policy makers and influencers to be guided by the our needs, aspirations and hopes for unrealized potentials. He also encouraged equal inclusion of women participation and presentation at all levels. Importantly, he recognized the strength of women as gatekeepers and backbones for families and nations. His parting words were rather doom in future if we fail accelerate the Cairo Promise, warning a risk of giving our children a less secure future than we inherited.

Given the pervasive poverty, and poor quality of health facilities maternal mortality have gone as high as 560 per 1000 live births!

My Thoughts After the Nairobi ICPD Summit: Women Rights Not a Floor for Debate!

The revolutionary Programme of Action called for women’s sexual and reproductive health and rights, and were placed at heart of global development. It affirmed full and equal participation of women in economically, politically and socially without any form of discrimination, 25 years on the affirmation sounds like a beautiful legend in a world apart.

Standing for the rights of women is not giving up men’s opportunities, social valued goods, rewards or resources

Walking the Talk:A Road Map to Transformation for Women and girls

The re-commitments at the International Conference for Population and Development felt like an achievable brainteaser- governments, civil society organizations, faith-based organizations and others groups of interests stepped up with pledges. The United Nations Sexual and Reproductive Health Agency mobilized more than 1,200 universal commitments, it also voiced for the marginalized and grassroot groups for their engagements with policymakers towards realizing sexual and reproductive health and rights for all.

Maternal deaths particularly in informal settlements are contributed by unsafe abortions, hemorrhage and hypertensive disorders.

The Summit research showed to achieve the “Three transformative Results” (need for family planning, maternal deaths and harmful practices) will cost the world $264 billion (United Nations Population Fund and Johns Hopkins University).

Quote of the day

“There will be no ICPD 5. Women and girls have waited long enough to have their rights and choices. Looking towards 2030, we are entering a decade of delivery, during which we will walk the talk and hold ourselves accountable for the promises we have made.” Ambassador Ib Petersen, Denmark’s Special Envoy for ICPD25.