In 1994 at the International Conference on Population and Development (ICPD), governments worldwide recognized that ensuring access to sexual and reproductive health and protecting reproductive rights are essential strategies for improving the lives of all people. A core strategy to achieve the MDGs is to ensure universal access to sexual and reproductive health services for all by 2015. In 2006, The United Nations General Assembly included universal access to reproductive health by 2015 as one of the international community's Millennium Development targets.

Facts at a Glance

• More than 120 million couples worldwide have an unmet need for contraception.¹
• Lack of access to family planning is a major factor behind the 76 million unintended pregnancies every year in the developing world. These lead to 19 million unsafe abortions, causing some 68,000 deaths.²
• Most people become sexually active during adolescence, yet most young people do not have access to prevention programs.³
• In Africa, only 20% of married women use modern contraception; in some parts of the continent, the proportion drops to under 5%.⁴
• One in ten pregnancies end in an unsafe abortion.⁵
• Nearly half of all people living with HIV are women.⁶
• Women aged 15-24 are three times more likely to be infected with HIV than men of the same age.⁷
• Less than 10% of HIV positive pregnant women needing PMTCT (Prevention of Mother to Child Transmission) services currently receive them.⁸
• At least two-thirds of all reported sexually transmissible infections occur among men and women under age 25. Many sexually transmitted infections affect the outcome of pregnancy and some are passed to unborn and newborn babies.¹⁰

The Costs of Poor Sexual & Reproductive Health

• Worldwide, an estimated 250 million years of productive life are lost annually as a result of reproductive health problems.¹¹
• Sexual and reproductive ill health, such as complications from pregnancy and childbirth, sexually transmissible infections, including HIV, and reproductive cancers, accounts for over one-third of the global burden of disease of women of child-bearing age, and one-fifth of the burden for the whole population.¹²
• One study estimated the economic impact of maternal and newborn mortality at more than US$15 billion annually worldwide in lost potential productivity, of which about half was associated with women and half with newborns.¹³
• Maternal ill health results in much of the toll of 2.7 million stillbirths and the death of a further 3 million babies in the first week of life.¹⁴

Practical Solutions

• Education can inform women about their bodies and give them options beyond childbearing. Of 137 million illiterate young people in the world, 63% are female.¹⁵
• Access to effective contraception could avert an estimated 90 percent of deaths from unsafe abortions and 20% of other obstetric deaths.¹⁶
• Access to emergency contraception reduces unintended pregnancies and abortions.
• Ensuring skilled care during and immediately after pregnancy and childbirth, backed up by emergency obstetric care, would reduce maternal mortality by about 75 per cent as well as save thousands of children’s lives.¹⁷
• Treatment for HIV-positive mothers as well as their children is the most cost-effective approach, as motherless children are far less likely to survive to adulthood.
• WHO studies show that sex education delays the onset of sexual activity and increases safer sexual practice.¹⁸
• Investment in comprehensive reproductive health is cost-effective. As well as direct health gains, better access to services can enable completion of education, especially for women, higher productivity, greater involvement in the community and workforce and better family care.¹⁹

For Further Information

• Millennium Development Goals & Sexual and Reproductive Health Briefing Cards
• The Lancet Executive Summary for the Sexual and Reproductive Health Series

References

¹ Ross JA, Winfrey WL. Unmet need for contraception in the developing world and the former Soviet Union: an updated estimate. Int Fam Plan Perspect 2002; 28: 138-14
² Ibid.
³ UNFPA, State of World Population 2005, (Accessed 5/11/08).
⁴ Ibid.
⁵ Ibid.
⁶ Joint United Nations Population Programme on HIV/AIDS, AIDS Epidemic Update December 2004 (Geneva: UNAIDS, 2004).
⁷ UNAIDS 2004.
⁸ D. Mbori-Ngacha. Keynote Address. The 2006 HIV/AIDS Implementers Meeting of the President’s Emergency Plan for AIDS Relief, Durban, South Africa.
⁹ Population Reference Bureau, The World’s Youth 2000 (Washington, DC: PRB, 2000)
¹⁰ Mullick S, Watson-Jones D, Beksinska M, Mabey D. Sexually transmitted infections in pregnancy: prevalence, impact on pregnancy outcomes, and approach to treatment in developing countries. Sex Transm Infect 2005; 81: 294-302
¹¹ UNFPA, State of World Population 2005, (Accessed 5/11/08).
¹² Alan Guttmacher Institute and UNFPA, Adding it Up: The Benefits of Sexual and Reproductive Health, (New York: AGI and UNFPA, 2004).
¹³ USAID. 2001. “USAID Congressional Budget Justification FY2002: Program,Performance and Prospects – The Global Health Pillar.” Accessed on April 13, 2007.
¹⁴ Department for International Development, Reducing Maternal Deaths: Evidence and Action. (London: DFID, 2004).
¹⁵ UNFPA, State of World Population 2005.
¹⁶ Shaw, D., Sexual and Reproductive Health: Rights and Responsibilities.” The Lancet, Sexual and Reproductive Health 4, October 2006, p. 7.
¹⁷ UNFPA. Easing the PERILOUS Passage.
¹⁸ Baldo M, et al. Does Sex Education Lead to Earlier or Increased Sexual Activity in Youth? Presented at the Ninth International Conference on AIDS, Berlin, June 6-19, 1993.Geneva WHO, 1993
¹⁹ DFID, Sexual and Reproductive Health and Rights, A Position Paper.