Sexual and reproductive health and rights (SRHR): recommendations for greater impact

Belgium’s long-standing efforts to promote sexual and reproductive health and rights (SRHR) in the Global South are receiving plaudits, according to a review by our Special Evaluation Office. Better coordination of these actions can increase their impact. Meanwhile, growing anti-gender movements make effective advocacy for SRHR all the more urgent.

A satisfying and safe sex life

Sexual and reproductive health and rights (SRHR) is a bit of mouthful. What does it mean? Sexual and reproductive health refers to a wide range of services, such as contraception, fertility care, maternal and newborn health, prevention and treatment of sexually transmitted infections (STIs), protection against sexual and gender-based violence, and education about safe and healthy relationships.

A person who is sexually and reproductively healthy is more than just physically healthy. They enjoy complete physical, mental, and social well-being in all matters related to reproductive function. These are people who have a fulfilling and safe sex life, who can have healthy pregnancies and births, and who can decide if, when, and how often they want to have children.

Moreover, all of these things are also human rights. Everyone has the right to sexual and reproductive health services as part of universal healthcare. This is not only crucial for health, but also contributes to greater gender equality and to development in general.
 

SheDecides

Belgium gives high priority to gender equality, including in its international cooperation. SRHR are an important part of that. Various Belgian organisations are each contributing in their own way to improving sexual and reproductive health and rights in the Global South.

The Belgian Agency for International Cooperation (Enabel), for example, is very active in areas such as maternal and newborn health, sexual and reproductive health and rights (SRHR) for young people, family planning, and sexual and gender-based violence.

Civil society is also paying attention to this issue. NGOs such as WSM and Louvain Coopération are investing in more robust health insurance funds. The Institute of Tropical Medicine and the universities are conducting research in a wide range of areas. At Ghent University, the International Center for Reproductive Health even focuses specifically on SRHR.

Another crucial pillar is Belgium's support for international institutions. Examples include the United Nations Population Fund (UNFPA), the United Nations Children's Fund (UNICEF), UN Women, and UNAIDS.

Finally, we certainly must not forget SheDecides. Through this 2017 initiative, a number of countries — including Belgium — sought to provide additional support to women to help them with family planning. This includes, among other things, education on birth control, contraception, sexuality, and safe abortion. Our Minister of Foreign Affairs, Maxime Prévot, is, in fact, a SheDecides champion!
 

Prevention of gender-based violence

All of these players have been committed to SRHR for years. But have their actions really made a difference? Have women experienced improvements as a result? The Special Evaluation Office (SEO) recently completed a detailed investigation into this question. This office within our FPS regularly evaluates the actions of the Belgian Development Cooperation.

The research team not only grilled all the Belgian players, but also conducted on-site investigations in four partner countries: Benin, Burkina Faso, Uganda, and the Democratic Republic of Congo. The objective was to assess the overall outcomes of SRHR projects between 2014 and 2024.

They found that all these efforts to promote SRHR have certainly borne fruit, including improved access to health services, a decline in maternal mortality, increased use of family planning, better prevention and response to gender-based violence, and changes in behaviour and social norms related to SRHR services.

Parent committees

These excellent results are due, in part, to a holistic approach. For example, attention is being paid to strengthening both the supply of SRHR services and the demand for them within the community, with a strong focus on building more robust health systems and improving healthcare. The actions align as closely as possible with the national priorities of the countries involved.

A change in social and cultural norms also proved to be a decisive factor: various on-the-ground initiatives encouraged the breaking of taboos relating to sexual and reproductive rights.

Committees for parents and husbands focused on SRHR have been established in Benin and Burkina Faso, for example. In Beni, clubs have been established with male role models, while neighbourhood watch groups (in Congo) and village committees (in Benin) are working to prevent and combat gender-based violence. This means that, while women were being empowered, men were often involved as well.
 

Sensitive SRHR issues

It is also striking how complementary the various channels are. Enabel has experts who are integrated into the ministries and in the field units. This allows us to carefully keep SRHR and sensitive SRHR issues — such as abortion and LGBTQI+ issues — on the agenda, even in challenging contexts, such as in Burkina Faso, Senegal, and others.

Research institutions, in turn, contribute to the development of national policy and create innovative tools to improve the quality of SRHR services. NGOs, for their part, can reach the most marginalised groups fairly easily, even in remote areas and conflict zones.

And thanks to our support for the core budget, international institutions remain an important tool for helping governments formulate their policies.
 

Crowdfunding

However, while complementarity is a strength, it is also a weakness: it is still underutilised. As is often the case, there is still a great deal to be gained if all these diverse efforts were better coordinated. In addition, there are still too few NGOs dedicated to SRHR.

There are insufficient resources available due to factors such as declining international funding and a shift toward military purposes. Alternative mechanisms may offer a solution, such as crowdfunding or partnerships with the private sector (pharmaceutical companies, etc.) and development banks. Human resources management in the healthcare sector could also be significantly improved.

The SEO also proposes making SRHR much more visible in its communications. We can also make even more effective use of the bridging role played by our embassies and Enabel. After all, they are ideally positioned to strengthen the synergies among the various stakeholders.
 

Headwind

SRHR has faced additional headwinds in recent years. Anti-gender and anti-rights movements are emerging all over the world. The call to roll back women's rights — to send women back to traditional domestic roles — is growing louder. Here, too, Belgium’s diplomatic efforts to promote greater understanding of SRHR could be highlighted more.

With our focus on strong health systems, vulnerable groups, and the needs of boys and men, we have certainly been on the right track. The SEO hopes that its recommendations will help our SRHR initiatives have an even greater impact. After all, growing anti-gender movements make effective advocacy for SRHR all the more urgent.