When national and regional experts in sexual and reproductive health from 21 countries met in Stockholm, Sweden, on 30–31 August 2018, a success story from Portugal illustrated how policy changes in this area can make a huge difference.
In the late 1970s in Portugal, the maternal mortality rate was over 40 per 100 000 live births; in 2017, following the implementation of wide-ranging sexual and reproductive health reforms, the rate had dropped to 6.9. The country also saw a dramatic decrease in the infant mortality rate (to 2.6 per 1000 live births), which is currently among the lowest in the WHO European Region.
The reforms that changed the scenario in Portugal are among the recommendations of the Action plan for sexual and reproductive health, which Member States endorsed at the WHO Regional Committee for Europe in 2016. In Portugal, these reforms focused on:
providing quality preconception information and services and strengthening antenatal care;
reorganizing health services to ensure availability, accessibility, acceptability and quality of services for obstetric and newborn care;
facilitating access to safe abortion and providing free contraceptive services and commodities;
offering adolescent health services with personalized care and sexuality education; and
taking additional measures to strengthen sexual and reproductive health and rights.
This was one of the success stories presented at the meeting, which aimed to assess how well countries have managed to implement the Action plan in the 2 years since its endorsement. A wide range of key professionals with roles in health policy-making and sexual and reproductive health discussed progress, successes and barriers to implementation.
The meeting was rich with examples from countries at different stages of implementation. This gave countries an opportunity to learn from each other and inspired further action to:
address the challenges in delivering universal access to sexual and reproductive health and rights;
strengthen the role of primary health care in promoting sexual health, from the perspective of both the health workforce and health-care users;
increase health literacy to improve sexual and reproductive health, promote equity, and support the achievement of the Sustainable Development Goals (SDGs);
develop monitoring and accountability for sexual and reproductive health and rights; and
build stronger health systems for universal access to sexual and reproductive health.
Alanna Armitage, United Nations Population Fund (UNFPA) Regional Director for Eastern Europe and Central Asia, underscored that sexual and reproductive health is a cornerstone of reaching the SDGs. “There is no health without sexual and reproductive health,” she stated.