By A Representative
With World Contraception Day observed on September 26 and International Safe Abortion Day on September 28, global health and gender rights advocates have called for urgent action to ensure universal access to contraception and safe abortion services, warning that progress towards health and gender equality goals remains dangerously off track.
Speaking at a recent SHE & Rights (Sexual Health with Equity & Rights) dialogue, Shobha Shukla, Coordinator and Host of SHE & Rights and Executive Director of CNS, stressed that safe abortion and contraception are fundamental components of healthcare and human rights.
"We demand accessible, safe, legal and stigma-free abortion care for all. Safe abortion is an essential and lifesaving sexual and reproductive healthcare and a fundamental human right, as well as central to reproductive freedom and justice," said Shukla. She added that access to a full range of scientifically proven contraceptive options is equally critical for ensuring sexual and reproductive health and rights (SRHR).
With only 51 months remaining to achieve the Sustainable Development Goals (SDGs), Shukla warned that attacks on bodily autonomy, gender equality and health rights are increasing worldwide, undermining efforts to advance reproductive justice.
Investing in SRHR Yields Major Health and Economic Returns
Evidence presented from the Guttmacher Institute's landmark "Adding It Up 2024" global study highlighted that investing in SRHR is not only a health imperative but also an economically sound decision.
The report, which covers 128 low- and middle-income countries, estimates that meeting the full need for modern contraception, maternal and newborn care, abortion services and treatment of four curable sexually transmitted infections would generate substantial health and economic benefits.
Presenting key findings, Dr Elizabeth A. Sully, Director of International Research at the Guttmacher Institute, said that in low- and middle-income countries across Asia, annual investment in these services would need to increase from US$5.87 to US$8.61 per person, requiring an additional US$12.4 billion each year.
According to the study, every additional dollar invested in family planning and contraceptive care can save US$1.97 in pregnancy-related and newborn healthcare costs. Meeting SRHR needs across Asia could also reduce unintended pregnancies by 26%, maternal deaths by 65% and newborn deaths by 62%.
The report further noted broader economic gains associated with contraceptive access, including greater workforce participation and increased control over personal income and savings.
From "Unmet Need" to Rights, Choice and Demand
A major theme of the discussion was moving beyond traditional measures of "unmet need" for contraception towards a more person-centred approach that prioritises individual choice, rights and preferences.
Although an estimated 129 million women of reproductive age in Asia are classified as having an unmet need for modern contraception, the report notes that many women using traditional methods may not wish to switch to modern methods. As a result, the Guttmacher Institute proposes focusing on "unmet demand" - women who want to avoid pregnancy, are not currently using contraception and express a desire to use family planning in the future.
Based on this approach, approximately 36 million women in low- and middle-income Asia are estimated to have unmet demand for contraception.
Dr Sully also reported that Asia experiences approximately 120.6 million pregnancies annually. Of these, 63% result in live births, while 19.4% end in safe abortions, 21.3% in unsafe abortions, and 16.7% in miscarriages or stillbirths.
Need to Track Commitments Against Budgets
Riju Dhakal, Programme Officer at the Asian-Pacific Resource and Research Centre for Women (ARROW), questioned whether governments are translating international commitments on SRHR into actual budget allocations.
ARROW is currently working with partners in 12 countries, including India, Nepal, Bangladesh, Pakistan, Sri Lanka, Indonesia and the Maldives, to analyse government financing for sexual and reproductive health and rights.
Highlighting concerns over a reported 46% decline in official development assistance for SRHR between 2024 and 2026, Dhakal urged advocates and policymakers to utilise tools such as the Guttmacher Institute's Family Planning Investment Impact Calculator and Safe Abortion Calculator to monitor spending commitments and assess whether they are reflected in approved budgets and implemented programmes.
Rights Must Translate into Services
From Kenya, Jane Nyanjom, Associate Director for Advocacy and Partnerships at Reproductive Health Network Kenya, said financing gaps often become access gaps, especially for women and girls in rural and underserved communities.
She highlighted recurring contraceptive stock-outs and stressed that rights guaranteed through legal frameworks must be supported by reliable supplies, trained health providers, referral systems and adequate financing.
Similarly, Nawmi Naz Chowdhury, Executive Director of the Women's Global Network for Reproductive Rights (WGNRR), said that despite legal advances in many countries, multiple barriers continue to limit access to safe abortion services. These include political backlash, humanitarian crises, shrinking civic space, provider shortages, high costs, stigma, misinformation and weak referral systems.
"Reproductive rights must translate into actual access," she said.
Vulnerable Communities Must Remain a Priority
Representing Indonesia's Ministry of Health, Dr Imran Pambudi, Director of Vulnerable Groups Health Services, emphasised that the strength of a health system should be measured by how effectively it serves vulnerable populations, including persons with disabilities, survivors of violence, remote communities, older people and marginalised women and adolescents.
He called for stronger integration of SRHR services into primary healthcare systems, greater investment in healthcare workers, improved referral mechanisms and person-centred approaches that uphold dignity and rights.
Call for Evidence-Based Action
Experts participating in the SHE & Rights session agreed that financing alone is insufficient. Investments must be accompanied by policies and services that are affordable, accessible, adequately staffed and responsive to the needs of diverse communities.
They also encouraged journalists, advocates and policymakers to use country-specific evidence tools developed by the Guttmacher Institute to analyse national gaps in contraception and abortion care and support evidence-based decision making ahead of World Contraception Day and International Safe Abortion Day.
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