Inclusion of human rights in sexual and reproductive health programming: Facilitators and barriers to implementation

Abstract

The need to prioritise those furthest behind is well understood in global health circles, and how human rights norms and standards can help often touted. As rights concerns are particularly recognised in sexual and reproductive health (SRH) programming, as part of a larger exercise, a review was conducted to identify documented barriers and facilitators to implementation. Given the role global guidance plays in implementing rights-based approaches to SRH, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP) guidelines, tools, recommendations and guidance that include the explicit mention of human rights principles served as the basis for this exercise. This was followed by an extensive review of the literature. Sources reviewed confirmed barriers include not only broad structural, policy and health systems barriers but financial, staffing and time constraints, as well as lack of understanding of concretely how to include human rights in these efforts. Facilitators include the existence of human rights champions, leadership, strong civil society participation, training, and funding made available specifically for implementation. Investment in indicators and documentation sensitive to human rights is warranted in sexual and reproductive health, as well as other health topics, to best serve populations who need them most.

Integrating human rights into sexual and reproductive health research: moving beyond the rhetoric, what will it take to get us there?

“…Many of the issues that surfaced in previous literature reviews were found to translate to SRH research, but additional issues surfaced including a lack of understanding of how to operationalise specific human rights principles, and how to use rights not only as part of the conceptual background to research being undertaken but to practically support research questions and implementation of a research study, as well as the approach taken to data analysis and writing up the work for publication. 9 Further points noted in the literature, and reiterated through the interviews, include the short timeframes imposed by many donors for demonstrating research outcomes, that inhibit the ability to truly understand and write-up the longer-term changes that might be possible through the inclusion of rights. 6 …”

“…The literature review noted earlier was used to frame and analyse interview data, including attention to potential tools and approaches to take this work forward. 9 …”

“…Identified barriers to implementing rights in SRH programming included broad structural, policy and health systems barriers as well as perceived financial cost, staffing and time constraints and a lack of understanding of how concretely to include human rights, while facilitators included the existence of human rights champions and leadership, strong civil society participation, training, guidelines and funding made available specifically for implementation. 9 Additional key issues identified included the understanding of what human rights are and what they offer, awareness of appropriate methodologies, political will, the need for an enabling environment and clear accountability mechanisms. 9 Identified barriers and best practices were utilised to set the parameters for this study.…”

“… 9 Additional key issues identified included the understanding of what human rights are and what they offer, awareness of appropriate methodologies, political will, the need for an enabling environment and clear accountability mechanisms. 9 Identified barriers and best practices were utilised to set the parameters for this study.…”

To effectively reduce violence against women living with HIV, we must make healthcare systems places of safety

“…The Centre for Reproductive Rights and Vivo Positivo represented Francisca for over a decade to achieve this outcome. Proper investigation of human rights violations is a critical first step in confronting gender‐based violence in institutional settings [ 19 ].…”