Universal access to sexual and reproductive health services. Key Issues guide.


In September 2006, as a result of advocacy by international and national non-governmental organisations (NGOs), the United Nations (UN) General Assembly finally adopted the target of universal access to reproductive health. This Health Key Issues Guide explores issues relating to universal access to sexual and reproductive health (SRH) services using a rights-based approach. The guide examines factors that inhibit access to and use of SRH services, and discusses methods for removing barriers to care and improving access.

Lack of access to SRH services and information contributes to high levels of morbidity and mortality for largely preventable SRH problems, particularly in developing countries. Every year, half a million women die during childbirth because there is not a skilled attendant present at the birth, and insufficient provision of condoms has contributed to the spread of sexually transmitted infections (STIs), including HIV. Restrictions on information about sexuality, contraception, prevention and healthcare, limit people’s ability to make choices regarding their own sexual and reproductive health and rights (SRHR).

Whilst the importance of reproductive health has been acknowledged in international agreements, many countries do not consider sexual health as a legitimate health issue, and conservative ideology emanating particularly from current US policy prevents it from receiving global recognition. Donor support for SRH services (apart from HIV) has been falling; and stigma, discrimination and restrictive laws and policies continue to prevent many people from utilising services. A rights-based approach to access draws attention to the inequities in service delivery and the discriminatory practices that marginalise people and deny them the opportunity to seek care. It also justifies prioritising efforts towards fulfilling their SRH needs and rights.

This Guide is based on a literature review written by Sally Griffin for the PANOS Relay Programme in association with the Realising Rights Consortium.


Eldis Health Key Issues Guide, 24 pp.

Universal access to sexual and reproductive health services. Key Issues guide.

Published 1 January 2008