Making Sexual and Reproductive Health Services Accessible for Everyone, Everywhere

At the end of this month, government leaders from around the world will gather in New York to adopt the 2030 Agenda—the most comprehensive framework for global sustainable development ever designed. The Agenda includes a set of 17 goals and 169 targets—the Sustainable Development Goals (SDGs)—that all countries will commit to working toward. 

Earlier this summer, in a quaint colonial building off a busy Buenos Aires street, over 60 Argentine public health workers and lawyers sat in a circle discussing the difficulties they face when providing legal abortion services. At times, tears were shed as they shared their stories about adolescents who came to them after being raped or women who arrived at the hospital too far along in their pregnancy to be helped. At other times they beamed with pride, talking about when they pushed back against discriminatory practices in their clinics or won a particularly challenging case to ensure a woman could access a legal abortion. Currently, abortion is permitted in Argentina when the life or the health of the woman is in danger, and in the case of rape.

This was not a typical government workshop, but rather a meeting facilitated by a group of feminist researchers and activists from IWHC’s partners Centro de Estudios del Estado y Sociedad (CEDES) and Equipo Latinoamericano de Justicia y Género (ELA). In 2013, this group of women launched a network of public health providers and lawyers called Red Nacional de Referentes de Acceso al Aborto (REDAAS) as a response to demand from those working within the public health system for more sustainable and long-term support. The network, made up of more than 100 public-sector medical and legal professionals from 12 Argentine provinces, aims to increase access to safe and legal abortion, while at the same time legitimizing the work they do on abortion and taking pride in the role they play in providing a safe and legal service. The network provides technical support on topics such as conscientious objection and second-trimester abortion, but it also creates a safe space for providers to share their thoughts and support each other.

It is networks and groups like these that will be central as the global community moves to translate the 2030 Agenda into reality on the ground. Both goals 3 and 5 of the Sustainable Development Goals include targets to ensure universal access to sexual and reproductive health care. To meet these targets, governments will need trained providers committed to providing these services, including safe abortion, to all. Each year, 6.9 million women in developing countries are treated for complications from unsafe abortion. Even in places where abortion is legal, the procedure is often carried out under dangerous conditions, by unqualified and ill-equipped providers—putting women’s lives at risk.

In order to truly expand access to safe reproductive health services for all women, especially poor women, advocates have started to recognize that they need to work with the public sector. Traditionally, many feminist organizations in the region chose to work around the public sector, seeing the government as more of an obstacle than a resource—an assessment that was often accurate.

Feminist groups tended to focus their efforts on supporting initiatives that allowed women to bypass the public sector and autonomously terminate a pregnancy, promoting hotlines, websites, and other sources of information. While these strategies are critical, and often times the only option in severely restricted contexts, they are not sufficient to meet the demand. Women need and have a right to the full range of services their governments have committed to providing, including safe abortion. When the government refuses to provide legal abortion services under the same standards that they provide any other medical service, they further stigmatize abortion.

But this is beginning to change. By expanding a network of public officials in the health and legal systems who are sensitized and empowered to be agents of social change, CEDES and ELA are facing these challenges head on and demonstrating to other women’s organizations that this type of collaboration is possible.

As Silvina Ramos, Senior Researcher at CEDES, explained after a day working with the health care providers, “The workshop showed that you don’t have to be for or against the state in order to work with the state.” And in order to meet the Sustainable Development Goal targets on universal access to sexual and reproductive health services, this type of collaboration is absolutely essential.

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