Consensus documents and conference agreements, expressing political will to implement certain decisions but not legally binding, are strong advocacy tools that can influence the formulation of national laws and policies. The most important consensus documents in relation to SRHR are the Programme of Action adopted at the International Conference on Population and Development (ICPD) and the Platform for Action of the Fourth World Conference on Women (FWCW) held in Beijing in 1995.
Other notable consensus documents include the Declaration and Programme of Action of the World Conference on Human Rights held in Vienna in 1993 and the MDGs. The Abuja Declaration adopted in 2001 at a Special Summit of the Organisation of African Unity (OAU) was devoted specifically to address the exceptional challenges of HIV/AIDS, tuberculosis and other related infectious diseases.
Millennium Development Goals
Improving SRHR is an essential condition for achieving all the MDGs – not only MDGs 3, 4, 5 and 6. The realisation that the MDGs would not be reached without universal access to reproductive health led to the late addition of target 5B (achieving universal access to reproductive health) in 2007.41 However some believe that this target remains the most off-track. If prevailing trends persist, the target will only be met in Eastern Asia by 2015 and not in Africa, Latin America and the Caribbean, the Caucasus, Central Asia or Southern, Western and South Eastern Asia. It is essential that any new framework does not make the same mistake and includes specific sexual and reproductive health targets from the outset.
Key issues of concern in achieving MDG 5B include:
- Deep inequalities in access to services and awareness of rights between and within countries.
- Inadequate funding and priority given to family planning.
- Progress in increasing and expanding access to contraceptives has slowed; use of contraception is lowest amongst poorer women.
- Progress has stalled in reducing the number of teenage pregnancies. Poverty and lack of education perpetuate high adolescent birth rates. Although there has been some limited progress in reducing adolescent pregnancies among richer, urban and secondary educated adolescents, this has not been matched among poorer, rural, and less educated adolescents. As a result, disparity has increased rather than decreased over time.42 Complications in pregnancy and childbirth are the leading cause of death amongst adolescent girls in the majority of developing countries.
The ability of individuals or couples to pursue a fulfilling and safe sex life is central to achievement of sexual health. Creation of enabling environments in which safe sexual behaviour can take place is vital if the MDGs for sexual equality, maternal health and HIV/AIDS are to be achieved.