Universal access to sexual and reproductive health services

Salud sexual y reproductiva

Region countries have Instruments on Sexual and reproductive health

Policies and instruments

This chapter of the Montevideo Consensus on Population and Development recognizes sexual rights and reproductive rights as an integral component of human rights, going a step further than the recognition of reproductive rights in the Programme of Action of the International Conference on Population and Development and placing Latin America and the Caribbean at the global vanguard in terms of rights recognition. As a result, sexual rights, reproductive rights, sexual health and reproductive health overlap, sometimes intricately, in the priority measures.

Progress towards the target of universal access to reproductive health services, as set forth in the Cairo Programme of Action and reiterated in target 5B of the Millennium Development Goals, has been insufficient and uneven. For example, the target on maternal mortality contained in the Millennium Development Goals is one of those that have not been met in Latin America and the Caribbean. According to the 2014 report on the Millennium Development Goals, maternal mortality in the Caribbean remains high, at a rate of 190 maternal deaths per 100,000 live births in 2013, compared to a goal of around 80 maternal deaths per 100,000 live births. In Latin America, the maternal mortality rate is much lower, at 72 maternal deaths per 100,000 live births in 2010, but it too is very far from the target. Moreover, these averages mask great inequalities that cut across the sexual and reproductive health agenda. These inequalities relate to age, race, ethnicity or area of residence, and they affect in particular certain groups of women, for whom many of the indicators, in particular those for maternal mortality, are poor. It is estimated that 8,800 women die every year in Latin America and the Caribbean from causes related to pregnancy, childbirth or post-partum, and most of these deaths are preventable, which betrays a gap in the protection of women’s rights in many spheres of their life, such as lack of education, scant empowerment, lack of adequate and timely health services, and lack of quality statistics that would give visibility to the problem.

Priority Measures

  • Policies for the exercise of sexual rights

    Promote policies that enable persons to exercise their sexual rights, which embrace the right to a safe and full sex life, as well as the right to take free, informed, voluntary and responsible decisions on their sexuality, sexual orientation and gender identity, without coercion, discrimination or violence, and that guarantee the right to information and the means necessary for their sexual health and reproductive health.
  • Access to information

    Review legislation, standards and practices that restrict access to sexual and reproductive health services, including the provision of comprehensive user-friendly services for adolescents and youth, and guarantee access to full information on all of the service options available to all persons, without any form of discrimination, in order to ensure that the highest international standards of protection of human rights and fundamental freedoms are met in the region.
  • Universal access to quality sexual and reproductive health services

    Guarantee universal access to good-quality sexual health and reproductive health services, bearing in mind the specific needs of men and women, adolescents and young people, lesbian, gay, bisexual and transgender persons, older persons and persons with disabilities, with special attention to vulnerable persons, persons living in rural and remote areas and to the promotion of citizen participation in the follow-up to commitments.
  • Eliminate causes of maternal morbidity and mortality

    Eliminate preventable cases of maternal morbidity and mortality, including, within the set of integrated benefits of sexual health and reproductive health services, measures for preventing and avoiding unsafe abortion, including sexual health and reproductive health education, access to modern and effective contraceptive methods, counselling and comprehensive care in cases of unwanted and unaccepted pregnancy, as well as comprehensive post-abortion care, where necessary, on the basis of a risk- and harm-reduction strategy.
  • Safe and quality abortion services in legal or decriminalized abortion settings

    Ensure, in those cases where abortion is legal or decriminalized under the relevant national legislation, the availability of safe, good-quality abortion services for women with unwanted and unaccepted pregnancies, and urge all other States to consider amending their laws, regulations, strategies and public policies relating to the voluntary termination of pregnancy in order to protect the lives and health of women and adolescent girls, improve their quality of life, and reduce the number of abortions.
  • Comprehensive health care in the reproductive process for all women

    Ensure that all women have effective access to comprehensive health care during the reproductive process and specifically to skilled, institutional, compassionate obstetric care and to the best possible maternal health services during pregnancy, childbirth and the puerperium, as well as to services that include the termination of pregnancy in those cases where the law provides for such services, and guarantee universal access to assisted fertility treatments.
  • Detection of pregnancy disorders

    Formulate plans for strengthening mechanisms for detecting problems during pregnancy, including at the preconception stage, improve the quality of antenatal care to include an intercultural perspective, guarantee the provision of a safe supply of blood for care during pregnancy, childbirth and the post-partum and puerperium period, and enhance compassionate care during delivery and birth and comprehensive perinatal care, bearing in mind the needs of women, boys, girls and families.
  • Resources for universal access to sexual and reproductive health

    Guarantee sufficient financial, human and technological resources in order to provide universal access to sexual health care and reproductive health care for all women, men, adolescents, young people, older persons and persons with disabilities without any form of discrimination.