International framework

With the Agenda 2030 and the SDGs 5.6 and 3.7 the international community has pledged to ensure universal access to sexual and reproductive health and rights. The global maternal mortality rate is to be reduced and universal health coverage, access to quality health care services and essential medicines and vaccines for all people is to be achieved by 2030.1

“Everyone has the right to the enjoyment of the highest attainable standard of physical and mental health. States should take all appropriate measures to ensure, on a basis of equality of men and women, universal access to health-care services, including those related to reproductive health care, which includes family planning and sexual health. All couples and individuals have the basic right to decide freely and responsibly the number and spacing of their children and to have the information, education and means to do so.”2

Leading causes of death in women in their reproductive age

Low income countries:

High income countries:3

Sexual and Reproduction Health and Rights

Contraceptive prevalence rate, married or in-union women aged 15–49, who are using a modern method of contraception (in %)7

“Sexual and reproductive health and rights mean unrestricted physical and emotional wellbeing in relation to all aspects of sexuality and human reproduction”.4

This includes among others:5

  • Pleasurable and safe sexual experiences, free of coercion, discrimination and violence.
  • The right to decide freely about the number, spacing and timing of children and to have the information and means to do so.
  • To have access to safe, effective, affordable and acceptable methods of family planning.
  • The right of access to appropriate health-care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant.

“Sexual and reproductive health and rights are important ends in themselves and can have valuable benefits for women’s own health, nutrition, education, and livelihoods and for the well-being of their children“.6

Maternal Health

Maternal mortality has declined by 44% globally from 1990 until 2015. However, ratios differ widely across regions:8 99% of all maternal deaths occur in developing countries.9 Maternal mortality is 19 times higher in developing regions than in developed regions (239 vs. 12 deaths per 100.000 live births).10

Maternal mortality (modelled estimate per 100.000 live births) over time 1990-201511

Africa
South-East Asia
Global
Eastern Mediterranean
Western Pacific
Americas
Europe

Percentage of births attended by skilled health personnel (urban vs. rural, in %, 2010-2015)12

Total
Urban
Rural

The lifetime risk of dying during pregnancy and childbirth is:13
1 in 54 in fragile settings (countries experiencing crisis and conflict)
1 in 4900 in developed countries.14

Gender and HIV/AIDS

In many countries HIV and AIDS disproportionately affect women and girls. Globally, almost half of the 36,7 million people living with HIV/AIDS are women.15 Women are more likely than men to acquire HIV at an early age because, among others, they lack access to health information, education and economic opportunities and face barriers in accessing and controlling resources.16

  • The worldwide incidence of HIV among women has risen from 41% since the mid-1990s to almost 52% in 2013.17
  • In Sub-Saharan Africa women still account for 58% of all people living with HIV and AIDS.18
  • Women who have experienced intimate partner violence are 50% more likely to be living with HIV.19
  • The global HIV prevalence among girls and young women is greater than among males of the same age.20
  • In Sub-Saharan Africa and in Latin America there are even more than double as many young women (aged 15-24) than young men living with HIV.21
  • Almost 47% of HIV new infections are among women and about 20% are among young women.22
  1. UN (2015): Transformation unserer Welt: die Agenda 2030 für nachhaltige Entwicklung. http://www.un.org/depts/german/gv-70/a70-l1.pdf; p. 15
  2. ICPD (1994): “Programme of Action of the International Conference on Population and Development”. http://www.un.org/popin/icpd/conference/offeng/poa.html Principle 8.
  3. WHO (2013): “Women’s Health Fact Sheet”. http://www.who.int/mediacentre/factsheets/fs334/en/.
  4. BMZ: „Sexual and Reproductive Health and Rights“. http://www.bmz.de/en/what_we_do/issues/Health/reproduktive_gesundheit/hintergrund/index.html.
  5. Program of Action International Conference on Population and Development Cairo (1994): http://www.un.org/popin/icpd/conference/offeng/poa.html Chapter VII.
  6. World Bank (2014): “Voice and Agency”. https://openknowledge.worldbank.org/handle/10986/19036 p. 94
  7. UN (2015): Trends in Contraceptive Use Worldwide 2015. http://www.un.org/en/development/desa/population/publications/pdf/family/trendsContraceptiveUse2015Report.pdf; p. 7
  8. UN (2016): The Sustainable Development Goals Report 2016. http://unstats.un.org/sdgs/report/2016/The%20Sustainable%20Development%20Goals%20Report%202016.pdf; p.17
  9. WHO (2016): Fact Sheet Maternal Health. http://www.who.int/mediacentre/factsheets/fs348/en/
  10. WHO (2015): Trends in maternal mortality: 1990 to 2015; http://apps.who.int/iris/bitstream/10665/194254/1/9789241565141_eng.pdf?ua=1; p. 21
  11. World bank Group (2016): maternal mortality: http://apps.who.int/gho/data/view.main.1370?lang=en
  12. UNICEF (2016): “Skilled attendant at birth, Percentage“. http://data.unicef.org/maternal-health/delivery-care.
  13. Unicef (2015): “Current Status + Progress” http://data.unicef.org/maternal-health/maternal-mortality.html.
  14. WHO (2016): Infographik Saving Mothers’ Lifes. http://www.who.int/reproductivehealth/publications/monitoring/infographic/en/
  15. UNAIDS (2016): Aids by the numbers. http://www.unaids.org/sites/default/files/media_asset/AIDS-by-the-numbers-2016_en.pdf ; p.7
  16. UNAIDS (2013): “Global Report 2013”. http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/UNAIDS_Global_Report_2013_en.pdf p. 78.
  17. UNAIDS (2013): “Global Report 2013”. http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/UNAIDS_Global_Report_2013_en.pdf p. 78.
  18. UNAIDS (2014): “The Gap Report”. http://www.unaids.org/sites/default/files/media_asset/UNAIDS_Gap_report_en.pdf p. 18.
  19. UNAIDS (2013): “Global Report 2013”. http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/UNAIDS_Global_Report_2013_en.pdf p. 7.
  20. UNAIDS (2013): “Global Report 2013“. http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/UNAIDS_Global_Report_2013_en.pdf p. 78.
  21. UNAIDS (2013): “Global Report 2013”. http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/UNAIDS_Global_Report_2013_en.pdf Table A 134ff.
  22. UNAIDS (2016): Aids by the numbers. http://www.unaids.org/sites/default/files/media_asset/AIDS-by-the-numbers-2016_en.pdf ; p.7