Universal Access to Reproductive Health: Accelerated Actions to Enhance Progress on Millennium Development Goal 5

This 36-page report contains case studies from seven countries, illustrating the application of a variety of strategies to improve access to sexual and reproductive health, including lessons learnt during implementation and results achieved. The addition of Target 5B – "Achieve, by 2015, universal access to reproductive health" – to Millennium Development Goal (MDG) 5, with indicators to track global progress, followed the recognition by world leaders that increased attention to sexual and reproductive health is a prerequisite for achieving MDG 5 on improving maternal health. In response to this, the World Health Organization (WHO) Department of Reproductive Health and Research convened a technical consultation involving stakeholders from countries, regions, and partner agencies to review strategies applied within countries for advancing universal access to sexual and reproductive health with a view to identifying strategic approaches to accelerate progress. This report was published following this meeting.

According to the report, in order to achieve Millennium Development Goal (MDG) 5, a holistic approach to sexual and reproductive health is necessary, so that programmes and initiatives will need to expand beyond focusing only on maternal health and also address family planning, sexual health, and prevention of unsafe abortion. A key aspect of universal access to sexual health is ensuring that services are available every day, reliably, which is possible with ensuring availability of commodities. Education and training specifically focused on health-care workers at the primary-healthcare level are crucial for expanding access in sexual and reproductive health services.

Based on case studies from seven countries, actions are suggested at financing, policy, human resources, and service delivery levels for improved access to reproductive health. The report makes the following recommendations, among others:

Strengthen policies for improving sexual and reproductive health delivery:

• develop a country action plan immediately to accelerate progress towards achievement of MDG Target 5B within five years;
• engage government sectors and civil society to mobilise and promote political will for development of supportive policy and legislation;
• clarify the process of translating policy into law;
• review documents, policies and laws pertaining to sexual and reproductive health, with a view to accelerating progress;
• introduce and implement targeted approaches to achieve universal access.

Strengthen and maintain valuable human resources:

• improve and strengthen education at all career phases;
• review guidelines for integration into the curriculum;
• develop special programmes for managers to be trained in issues of supportive supervision
• give attention to health work force motivation.

Improve service delivery by managing and integrating services:

• develop and implement innovative community outreach programmes;
• expand method choice for family planning;
• innovate (communicate, adapt, implement new technologies), for example through introduction of new practices such as m-health (use of mobile phones for health) and new products for family planning including emergency contraception;
• enhance the quality of services especially by ensuring the use of evidence-based recommendations and clinical guidelines;
• adapt and explore new avenues to scale up good practices; and
• monitor and evaluate;