Sexual and reproductive health and rights (SRHR) encompasses several different fields and is relevant for family planning, maternal, newborn and child health, as well as public health. However, despite its importance, it is often neglected due to social, cultural and religions reasons.
Young people are most often deprived of their right to access information on SRHR and there is a lack of quality Youth-Friendly Sexual and Reproductive Health (YFSRH) services in the country.
As a result, the country has high rates of teenage pregnancies and unsafe abortions. Moreover, due to lack of knowledge on the matter, the risk of contracting HIV/AIDS and STIs is high as well.
SRHR is also crucial in order to achieve gender equality and women’s empowerment. In particular, goal 5 of the Sustainable Development Goals (SDG 5) aims to achieve gender equality and empower all women and girls.
Under SDG 5, 3 targets are related to SRHR. Target 5.2 aims to eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation.
SRHR knowledge is quantifiable through several indicators
such as risk period for pregnancy, safe sexual practices,
menstrual hygiene and SRH delivery points.
Target 5.3 addresses the need to eliminate all harmful practices, such as child, early and forced marriage. Target 5.6 is to ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences.
Bangladesh has a large adolescent population comprising of around 23 per cent of its total population. Majority of these adolescents and young adults lack access to basic SRHR knowledge, which contributes to many health problems and adversely affects their quality of life.
SRHR knowledge is quantifiable through several indicators such as risk period for pregnancy, safe sexual practices, menstrual hygiene and SRH delivery points.
Sexually transmitted infection knowledge, HIV/AIDS awareness and knowledge, and family planning knowledge are also useful indicators to track the level of knowledge.
According to a UNAIDS report in 2016, only 12.8 per cent of adolescents and youth have comprehensive knowledge on HIV/AIDs. Those living in rural regions, urban poor and minorities are more likely to have barriers to SRHR knowledge and services.
Comprehensive SRHR education must be incorporated into the school curriculum in all boards of the country. There is also a need for counseling services, as well as community-level discussions in order to lift the stigma associated with SRHR knowledge.
The government of Bangladesh, along with NGOs, is working to provide reliable sources of SRHR-information to oppose popular myths and misconceptions, in order to help overcome youth’ uncertainties.
Knowledge on SRHR is needed to dealing with gender-based violence, which is prevalent in the country. There is a gap between policy framed by the government and the ground-level services being offered.
Those in remote regions are still unable to access SRHR services, provided by the Directorate General of Family Planning (DGFP). Moreover, marginalized populations are also unaware of their basic rights and therefore unable to access these services.
In Bangladesh, health, population and education services are focused on reproduction and medically-oriented. There is a strong need for reform in the training of health and frontline workers. They need to be better equipped in dealing with gender, sexuality and human rights through training.
On a global scale, the Commission on Population and Development developed a series of fundamental rights for adolescents including the right to comprehensive sex education, the right to decide all matters related to their sexuality and access to sexual and reproductive health services without discrimination.
In order to progress as a nation and achieve the SDGs, sexual and reproductive health and rights of each and every citizen must be ensured.
Policy makers must be aware of the needs of different demographics in the country, particularly of marginalized populations, in order to address the unmet need in SRHR.
The Government of Bangladesh sees reproductive health as a priority. It’s Health Population and Nutrition Sector Development Programme (HPNSDP) 2011-2016 has a strong focus on maternal and child health, as well as tuberculosis and reducing the spread of HIV.
Despite full-fledged support from the government, local level service implementation and knowledge dissemination is being prevented by various socio-economic factors.
The government must therefore equip district level and local level administration to facilitate SRHR services to people of all ages and backgrounds.
Moreover, SRHR knowledge material should be introduced both in and out of school and should become accessible to not only adolescents but adults as well.
The implications for ensuring sexual and reproductive health and rights are far-reaching. Through ensuring SRHR, we will be able to significantly reduce the level of STIs and HIV/AIDs.
Early marriage and pregnancy will be significantly reduced as well. In turn, maternal mortality and neonatal mortality will be greatly reduced. Policy reform, as well as private sector participation is greatly needed to ensure the sexual and reproductive wellbeing for all.
Synthia Kainath Nur is working with Bangladesh Post