Sexual & reproductive health

 “We’ve made great progress on maternal health in many areas of the world, but our leaders need to realize that this issue is at the core of global development, economic well-being, and even national security. When women survive, families and societies thrive.”

— Jill Sheffield, President of Women Deliver, speaking at the Women Deliver Conference in Washington DC on June 2010

A full sexual and reproductive health package includes:

 “We’ve made great progress on maternal health in many areas of the world, but our leaders need to realize that this issue is at the core of global development, economic well-being, and even national security. When women survive, families and societies thrive.”

— Jill Sheffield, President of Women Deliver, speaking at the Women Deliver Conference in Washington DC on June 2010

A full sexual and reproductive health package includes:

  1. Family planning/birth spacing services
  2. Antenatal care, skilled attendance at delivery, and postnatal care
  3. Management of obstetric and neonatal complications and emergencies
  4. Prevention of abortion and management of complications resulting from unsafe abortion;
  5. Prevention and treatment of reproductive tract infections and sexually transmitted infections including HIV & AIDS
  6. Early diagnosis and treatment for breast and cervical cancer;
  7. Promotion, education and support for exclusive breast feeding;
  8. Prevention and appropriate treatment of sub-fertility and infertility;
  9. Active discouragement of harmful practices such as female genital cutting;
  10. Adolescent sexual and reproductive health;
  11. Prevention and management of gender-based violence.  

Reproductive health (RH) is defined as a state of physical, mental, and social well-being in all matters relating to the reproductive system, at all stages of life. Everyone has the right to enjoy reproductive health, which is the basis for having healthy children, intimate relationships and happy families.

Reproductive health encompasses key areas of the UNFPA vision: that every child is wanted; every birth is safe; every young person is free of HIV; and every girl and woman is treated with dignity and respect.

Egypt has achieved remarkable progress with respect to its national health indicators over the past decades. Availability of basic health services is almost universal. Ninety-five percent of the population is now living within 5km of primary health centers.

The results of the 2014 EDHS show that several key reproductive health indicators including antenatal care coverage, medical assistance at delivery, and infant and child mortality have improved. 

Reproductive Health is a core area for UNFPA, as well as a priority for the Egyptian Government. UNFPA strives to support a sound RH policy that promotes access to quality RH services to broaden the opportunities of women and men to enjoy healthy lives.

Every minute, another woman dies in pregnancy or childbirth. Every minute, the loss of a mother shatters a family and threatens the well-being of surviving children. For every woman who dies, 20 or more experience serious complications. These range from chronic infections to disabling injuries such as obstetric fistula. Maternal death and disability rates mirror the huge discrepancies that exist between the haves and the have-nots both within and between countries.

Working for the survival of mothers is a human right imperative. It also has enormous socio-economic ramifications and is a crucial international development priority. Both the International Conference on Population and Development and the Millennium Development Goals call for a 75 percent reduction in maternal mortality between 1990 and 2015.

This three-pronged strategy is a key to the accomplishment of the goal: all women should have access to contraception to avoid unintended pregnancies; all pregnant women should have access to skilled care at the time of birth; all those with complications should have timely access to quality emergency obstetric care.

Situation in Egypt

Egypt has achieved a significant improvement in the past 20 years in matters related to maternal health. The coverage of maternal health services has expanded substantially. The percentage of medically assisted births for instance, tripled from 35 percent in 1988 to 92 percent in 2014. According to the 2014 Egypt Demographic Household Survey, 90 percent of mothers received antenatal care from a trained provider.

Over a twenty year period, Egypt also experienced a very significant reduction in the maternal mortality ratio, from 174 per 100,000 live births in 1992 to 54 by 2010.  However, over the last two years, the ratio has increased to 57 per 100,000, with significant increases in Upper Egypt governorates, including Assiut (83) and Sohag (63). Lack of compliance with regulations by private practitioners and inadequate enforcement of the law have contributed to this increase. In 23.5 per cent of reported mortalities, delivery was initiated in a private clinic, which is illegal. 2008 data show that regular antenatal care visits stand at 67 per cent nationwide, with Sohag having one of the lowest figures at 50 per cent. Medically assisted deliveries stood at 79 per cent nationwide with one of the lowest figures in Sohag and Assiut at 56 per cent.

A woman’s residence and education status are strongly associated with the receipt of maternity care. According to the 2008 DHS, the percentage of births in which the mother receives regular antenatal care is 57 percent among rural births compared to 80 percent among urban births. Coverage of maternity care services is especially low in rural Upper Egypt, where regular antenatal care is received for 49 percent of births, and 59 percent of deliveries were medically assisted. Regular antenatal care is received for just over 40 percent of births to women.

“Reproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other consensus documents. These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes the right of all to make decisions concerning reproduction free of discrimination, coercion and violence as expressed in human rights documents. “

-- ICPD Programme of Action, para 7.3

During the 1990s, a series of important United Nations conferences emphasized that the well-being of individuals, and respect for their human rights, should be central to all development strategies. Particular emphasis was given to reproductive rights as a cornerstone of development, and to empowerment of women as being an important element in ensuring the exercise of these rights.

Incorporating the human rights-based approach into programming requires a shift from thinking in terms of satisfying needs to designing interventions based on fulfilling rights.

Guided by the International Conference on Population and Development in Cairo in 1994, and other international mandates, UNFPA takes a rights-based approach to reproductive and sexual health. This includes support for reproductive health services that protect a woman's general health and well-being, that allow for well- informed decisions, and are respectful of individual choices.

What are reproductive rights?

Attaining the goals of sustainable, equitable development requires that individuals are able to exercise control over their sexual and reproductive lives. This includes the rights to:

  • Reproductive and sexual health as a component of overall health, throughout the life cycle, for both men and women
  • Reproductive decision-making, including voluntary choice in marriage, family formation and determination of the number, timing and spacing of one's children and the right to have access to the information and means needed to exercise voluntary choice
  • Equality and equity for men and women, to enable individuals to make free and informed choices in all spheres of life, free from discrimination based on gender
  • Sexual and reproductive security, including freedom from sexual violence and coercion, and the right to privacy.