Universal access to reproductive health is key to achieving the Millennium Development Goals by 2015. Reproductive health is critical for reducing maternal mortality, preventing unwanted pregnancies, curbing STIs including HIV/AIDS, and empowering women. However, progress on MDG 5, which aims to improve maternal health, has been slow. Urgent action is needed to scale up efforts to provide a full package of reproductive health services to all women, in order to meet the 2015 targets and promote sustainable development for all.

1. A PROMISE IS A PROMISE
UNIVERSAL ACCESS TO REPRODUCTIVE HEALTH by 2015
UNIVERSAL ACCESS to reproductive health is WHY UNIVERSAL ACCESS TO
key to achieving the Millennium Development REPRODUCTIVE HEALTH?
Goals (MDGs). In October 2007, the UN General
Assembly integrated target 5b, “Achieve, by 2015, MDG 5 is not only about reducing maternal
universal access to reproductive health” within deaths, it is about improving the reproductive
the revised MDG framework as a component of health and quality of life for women in the years
Goal 5, thus achieving recognition of the target before they become mothers and throughout
as a key element underpinning development. adulthood. MDG 5b recognizes that the health
and well-being of mothers and their children is
MDG 5, “Improve maternal health”, particularly influenced significantly by the health, knowledge
target 5b, is the most underachieved of all and choices available to women. Particularly
MDGs, even though the critical importance of while they are adolescents, and during times
reproductive health to development has been that they may be in a sexual relationship but are
widely acknowledged. Universal access to not pregnant and do not wish to become so.
reproductive health is the key to: MDG 5b aims to empower girls and women by
giving them the freedom to exercise their sexual
• reducing maternal mortality
and reproductive rights. Sexual and reproductive
• preventing unwanted pregnancies
choices, represented and measured by the
• curbing the spread of sexually transmitted
indicators of MDG 5b, will give women and girls
infections, including HIV and AIDS
greater decision-making and negotiation power
• empowering women and girls
within the sexual and intimate relationships that
• reducing socioeconomic disparities
shape their health and their lives, and enable
• building a more sustainable world for all
them to ensure their own health and well-being
people.
to choose their own life path.
However, evidence shows that progress towards
MDG 5 has been slow and uneven. Efforts to UNIVERSAL ACCESS TO REPRODUCTIVE
achieve MDG 5b must be scaled up considerably HEALTH refers to a full package of services
in order to meet the needs of all women and including comprehensive sexuality education,
mothers. Addressing the needs of vulnerable access to contraception, maternity care
populations such as poor women and girls will (ante and post natal care and skilled birth
be of particular importance in achieving universal attendance), emergency obstetric care,
access in Asia. and safe abortion services, as well as the
prevention and treatment of sexually
transmitted infections, including HIV, and
programs that address violence against
URGENT - There was an average annual
women and promote gender equality.
decline of 2.3% in the global maternal
mortality ratio between 1990 and 2008.
This is far from the 5.5% annual decline
required to achieve the MDG target of
reducing maternal mortality (Target 5a) by
three quarters between 1990 and 2015.

2. MDG 5b is a building block for the other
Up to 137 million couples in developing countries
MDGs and countries in transition have an unmet need for
contraception.
Maternal health services are too often offered in
“Promotion of family planning in countries with
isolation, despite evidence which shows that the
high birth rates has the potential to reduce poverty
greatest impact is made when a comprehensive and hunger and avert 32% of all maternal deaths
package of sexual and reproductive health and nearly 10% of childhood deaths. It would also
services is available at one site. MDG 5b, which contribute substantially to women’s empowerment,
champions the comprehensive approach within achievement of universal primary schooling, and
long-term environmental sustainability”.
MDG 5, will make a substantial contribution
(Lancet series on sexual and reproductive health published in 2006)
towards the other MDGs.
Goal 1: Eradicate extreme poverty and hunger Reproductive self-determination and health allows women and couples to
escape poverty by planning their families according to their financial situation.
It also allows people to save money and increase their income by having time
and energy to engage in income-generating and/or educational activities.
Goal 2: Achieve universal primary education When women and couples can plan their families, they are better able to
manage resources and finance their children’s education. When girls and
young women can prevent unwanted pregnancies, they often achieve higher
levels of education.
Goal 3: Promote gender equality and Comprehensive reproductive health programmes empower women, giving
empower women them the freedom to make informed choices about their lives.
Goal 4: Reduce child mortality Healthy women are able to provide better care for their children. When
women can space their births, each child benefits through better nutrition
and more attention.
Goal 6: Combat HIV and AIDS, malaria and When HIV, AIDS and reproductive health services are integrated, stigma is
other diseases reduced and people have greater access to services and support.
Goal 7: Ensure environmental sustainability Families that can choose whether and when to have children are better able
to manage scarce resources, including food, land and water.
Reference: Sippel, S (2009) Change for her starts with us. Monday Developments.
Act NOW to raise the priority of MDG 5b
• Work with government leaders to ensure that
Barriers to be tackled at various levels if their efforts under MDG 5 include activities
UNIVERSAL ACCESS is to be achieved: that contribute towards MDG 5b. The universal
User level: Delays and high costs, limited access to reproductive health target is not
service choices, exclusion or discrimination optional!
from services for some groups. • Advocate for governments to include MDG
Service delivery level: Inadequate funding, 5b in their national MDG progress reports,
absence of comprehensive one-stop quality including references to the challenges faced
care facilities, inaccessibility, non-evidence and their commitment to specific actions to
based interventions, inadequately trained achieve this target.
(and underpaid) service providers, lack of • Advocate for governments, service providers
appropriate equipment including essential and NGOs to acknowledge the socio-cultural,
drugs. legal and political barriers to universal access
Global level: financial constraints, politicization and work towards a shared vision through
of sexual and reproductive health, gender evidence-based policy and interventions.
inequality, infringement of human rights. Translate policies into ACTIONS!
• Advocate for health ministries and other
(Source : WHO 2011. Universal Access to Reproductive Health: Accelerated
Actions to Enhance Progress on MDG 5 Through Advancing Target 5b)
relevant ones to integrate MDG 5b in all health
and development initiatives.
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