The right of everyone to enjoy the highest attainable standard of physical and mental health is an inherent human right as recognized in major human rights instruments, including the Universal Declaration of Human Rights, the International Covenant on Economic, Social and Cultural Rights, the Convention on the Rights of the Child, the Convention on the Elimination of All Forms of Discrimination Against Women, and the International Convention on the Elimination of all forms of Racial Discrimination, among others.
The right to reproductive health is an integral element of this right. Because reproductive health has different implications for a woman or a girl than for a man or boy, it also encompasses a gender perspective. Moreover, the full respect of the right to reproductive health depends on the enjoyment of other rights, including the right to appropriate information. As the Special Rapporteur on Health has stated, “The right to reproductive health care includes freedoms, such as the freedom from discrimination and forced sterilization. It also includes entitlements such as the right to a system of health protection.”
International standards regarding health have implications for reproductive health care that guide almost every aspect of the delivery of care, defining what services (including information, education and counselling) must be offered, to whom and in what fashion. Three principles are key in the right-based approach to reproductive health:
Individuals have the right to control their sexual and reproductive lives and make reproductive decisions without interference or coercion. This principle underpins provision of family planning services as well as efforts to prevent child or coerced marriages, sexual violence, HIV/AIDS and other sexual transmitted diseases as well as to treat reproductive tract infections that cause infertility.
The right to non-discrimination and respect for difference requires governments to ensure equal access to health care for everyone and to address the unique health needs of women, men and adolescents. The right to non-discrimination implies that reproductive health services should be accessible to all groups, including adolescents, unmarried women, indigenous people and migrants, including refugees. It also implies that services should be available to meet the distinct needs of women and men.
Governments are obliged to make comprehensive reproductive health services available and remove barriers to care, in order to fulfil people’s rights to life and health. This principle is crucial in reducing maternal mortality, preventing HIV and ending pre-natal sex selection. When they allocate budgets and implement policies, States should address the rights to reproductive health of the most vulnerable women, men and youth.
A human rights-based approach works for the reinforcement of the health system as a whole, through legislation that complies with international standards, effective mechanisms for law implementation, and accountability and monitoring tools. A human rights-based approach to reproductive health services looks also for alliances to provide affordable, acceptable and comprehensive health services for the people, with particular focus on the most vulnerable sectors of the population. This approach also empowers clients (who are the subjects of rights) to define what kinds of information and services they need, enabling them to seek out and claim them.
The UN Rapporteur on Health focuses on the right of everyone to enjoy the highest attainable standard of physical and mental health. The rapporteur has a mandate to report on the status, throughout the world, of the right to health, including laws, policies, good practices and obstacles, and to make recommendations on appropriate measures that promote and protect the right to health. The Special Rapporteur has recommended that increased attention be devoted to a proper understanding of reproductive health and reproductive rights, among others.
UNFPA advocates at many levels for the right of all to reproductive health. A major breakthrough in this area was the inclusion of universal access to reproductive health by 2015 in the Outcome Document of the 2005 World Summit. UNFPA works through its country programmes to make this a reality, with a focus on those who are most disenfranchised and vulnerable.
Stronger Voices for Reproductive Health is a good example of a rights-based programme in action. This UNFPA-led, interagency initiative supports partnerships and empowers communities to improve the quality of sexual and reproductive health care in six countries: India, Kyrgyzstan, Mauritania, Nepal, Peru and Tanzania.