What do 2030 Global Goals on

Sustainable Development mean for

sexual and reproductive health and
rights in Andhra Pradesh?

Post-2015 sustainable development agenda

Transforming our world: the 2030 Agenda for Sustainable Development was
adopted by the UN at its 70th General Assembly in New York in September 2015.
The core of this new universal agenda consists of 17 Sustainable Development
Goals (SDGs) and 169 targets. They seek to realize the human rights of all and to
achieve gender equality and the empowerment of all women and girls. They are
integrated and balance the three dimensions of sustainable development: the
economic, social and environmental.
Preamble: This Agenda is a plan of action for people, planet and prosperity. It also
seeks to strengthen universal peace in larger freedom. We recognize that
eradicating poverty in all its forms and dimensions, including extreme poverty, is
the greatest global challenge and an indispensable requirement for sustainable
development... As we embark on this collective journey, we pledge that no one
will be left behind.

PAGE 1

Sexual and Reproductive Health and Rights

(SRHR)
Sexual and Reproductive Health and Rights (SRHR) encompass the right of all
individuals to make decisions concerning their sexual activity and reproduction free
from discrimination, coercion, and violence. Specifically, access to SRHR ensures
individuals are able to choose whether, when, and with whom to engage in sexual
activity; to choose whether and when to have children; and to access the
information and means to do so. SRHR includes the right of all persons to1:

Seek, receive, and impart information related to sexuality;

Receive sexuality education;
Have respect for bodily integrity;
Choose their partner;
Decide to be sexually active or not;
Have consensual sexual relations;
Have consensual marriage;
Decide whether or not, and when, to have children; and
Pursue a satisfying, safe, and pleasurable sexual life.

Sexual and reproductive health and rights (SRHR) embrace human rights. SRHR
include the right to equality, equal protection of the law and freedom from all
forms of discrimination based on sex, sexuality or gender.

SRHR & 2030 sustainable development agenda

Exercising SRHR is about planning for safer sex, planning for pregnancy, planning
for parenthood, communication in relationships, and fostering societies that
support diverse sexual identities and expressions.
SRHR cut across the three dimensions of sustainable development economic,
social and environmental. There is a strong connect between the global sustainable
development goals and SRHR, in so much as the latter are critical to reducing
poverty and hunger; achieving better health; accessing quality education by
women/girls; ensuring gender equality; and empowering women and girls.
When individuals can control their choices about sex and reproduction, and be safe
and healthy in their sexual and reproductive lives, they are better able to
participate in education and the labour market, to care for their families, and have
more capacity to contribute to their communities and social life. When women
have access to SRH services, and are able to exercise autonomy over their bodies
and reproductive health, they are more likely to delay marriage and pregnancy,
and to have fewer children. Consequently, girls are more likely to enter and stay in
education. This, in turn, can have a positive impact on their future earnings and
participation in the labour market.
There is also a need to acknowledge that climate change affects the health of
individuals specifically sexual and reproductive healthdue to a variety of
reasons including gender inequality, migration, and breakdown of
resources/services to access services.

1 World Health Organization. (2014). Sexual and reproductive health. Retrieved from:
http://www.who.int/reproductivehealth/topics/sexual_health/sh_definitions/en/

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Gender Equality and SRHR

Gender equality and SRHR are crucial components of the post-2015 sustainable
development goals, particularly SDG 5.
Marginalized populations are vulnerable to human rights violations, such as forced
abortion and sterilization of women with disabilities and women living with HIV,
forced pregnancy and HIV testing of migrants, and criminalization of consensual
sexual relations and sex work. Women with lower or no education, poor women,
women who live in remote, hard-to-reach areas have less access to contraception
and other sexual and reproductive health services and find it hard to realize the
autonomy of their bodies. Young people are unable to access critical sexual and
reproductive health services because of the need for parental and/or marital
consents.
Realization of full gender equality and the human rights of women and girls,
including SRHR, are essential to achieve sustainable development. Sexual and
reproductive health problems take a huge toll on lives, families, societies and
economies and public budgets yet they are preventable, with proven, costeffective solutions. Investing in sexual and reproductive health and rights have
high payoffs for poverty eradication, social, economic and sustainable
development, and for equality and equity. For example:

Meeting the unmet need for modern contraception and achieving universal access
to SRH services by 2030 is estimated to yield impressive returns of US $120 for
every dollar spent, and over US$400 billion in annual benefits.
Integrating life-saving antiretroviral treatment to people living with HIV will yield
US$10 for every US$1 spent.
Satisfying demand for contraception in low & middle-income countries could save
US$5.7 billion in maternal and newborn healthcare costs alone. Increasing health
expenditure for reproductive, maternal & newborn health by just US$5 per person
per year through 2035 in 74 countries with high child and maternal mortality, could
yield up to 9 times that value in economic and social benefits, including by
preventing the deaths of 147 million newborns and children and 5 million women
and increasing labour force participation and productivity.
There are similar arguments for achieving gender equality, addressing gender-based
violence, & investing in young people.

Unmet need for contraception

Worldwide, at least 222 million women have an unmet need for FP. Also there are
80 million unintended pregnancies and 40 million abortions every year. If unmet
need for contraception is not addressed, globally some 55 million unplanned births
will continue to take place each year, 79,000 women will die from pregnancy,
childbirth-related complications and from unsafe abortions, and girls will continue
to be denied access to education and employment. In India 12.8% of the women
have reported unmet FP needs. Abortion, though legal in India, is still the cause of
death for close to 3500 women each year and many more women face morbidity as
a result of unsafe abortion. Thus, nearly 10 women die due to unsafe abortions
each day. Abortion complications are the third major cause of maternal death,
after haemorrhage and sepsis. In 2010, unsafe abortions caused 9% of all maternal
deaths.
In India unmarried adolescents risk unsafe abortions. A study found that 92% of
unmarried adolescents chose to terminate the pregnancy, with 18% reporting that
it resulted from non-consensual sex. It is estimated by the government that about

PAGE 3

9% of the abortions in the country are for the purpose of sex-selection, even
though the Pre-Conception, Pre-Natal Diagnostic Technique (PCPNDT) Act makes
sex selective abortions illegal in India.
Providing safe abortion can ensure healthy lives, help to achieve gender equality
and by reducing unintended pregnancies help to end poverty.
There is also a need for expanding the existing basket of choices in the National
Family Welfare programmes, as well as the need for supply chain management of
reproductive health related commodities.
There is an urgent need to address the unmet need of adolescent boys and girls,
which is more often than overlooked. They too require SRH related information,
education and services. Many of them face early marriage and child bearing,
incomplete education and also the threat of HIV and other sexually transmitted
infections. Evidence shows that scientifically accurate, culturally appropriate,
gender sensitive and life skills based comprehensive sexuality education can equip
young people with knowledge, skills and values for their emotional and social
development. It can help them make informed decisions about sexuality, while
reducing risk taking behaviours.
Some targets of SDG 8

8.3- Promote development-oriented policies that support productive activities, decent

job creation, entrepreneurship, creativity and innovation, and encourage the
formalization and growth of micro-, small- and medium-sized enterprises, including
through access to financial services
8.5- By 2030, achieve full and productive employment and decent work for all women and
men, including for young people and persons with disabilities, and equal pay for work of
equal value
8.6- By 2020, substantially reduce the proportion of youth not in employment, education
or training
8.7- Take immediate and effective measures to eradicate forced labour, end modern
slavery and human trafficking and secure the prohibition and elimination of the worst
forms of child labour, including recruitment and use of child soldiers, and by 2025 end
child labour in all its forms
8.8- Protect labour rights and promote safe and secure working environments for all
workers, including migrant workers, in particular women migrants, and those in
precarious employment

Unique SRHR needs of people living with HIV

Unprotected sex is the main driver of the HIV epidemic in India, which has an
estimated 21 lakh people living with HIV (PLHIV). It remains a concentrated
epidemic with key populations like female sex workers (2.6%), men who have sex
with men (4.4%), transgender (8.8%) and people who inject drugs (7.1%). While the
annual incidence of HIV in India is estimated to have reduced by 57% between 2000
and 2011, stigma and discrimination as well as lack of correct information
negatively impact the uptake of HIV prevention and treatment services. SRH
services for PLHIV and key populations are still not very accessible. Effective
integration of SRH and HIV services could go a long way in bringing down HIV
prevalence in the country.

PAGE 4

Ensuring free trade should not be at the cost of SRHR

SDG 17 is for strengthening the means of implementation and revitalizing the
global partnership for sustainable development. It also focusses on trade among
other related issues.
Whereas SDG 17.10 recognizes the target of promoting a universal, rules-based,
open, non-discriminatory and equitable multilateral trading system under the
World Trade Organization, including through the conclusion of negotiations under
its Doha Development Agenda, SDG 3.b also calls on providing access to
affordable essential medicines and vaccines, in accordance with the Doha
Declaration which affirms the right of developing countries to use to the full the
provisions in the TRIPS (Trade-Related Aspects of Intellectual Property Rights)
agreement regarding flexibilities to protect public health and, in particular,
provide access to medicines for all.
We believe that free trade should not be at the cost of compromising SRHR, which
includes ensuring uninterrupted access to essential and affordable medicines for
those in need.

Effect of Climate change (such as extreme weather, drought, floods,

food security, health, migration) on SRHR
Climate-related events and conflict exacerbate existing inequalities. This worsens
an already precarious environment for achieving gender equality, SRHR, and
poverty eradication. Women of all ages in all their diversity are disproportionately
negatively impacted by climate disasters and conflict, and are particularly
vulnerable to gender-based violence. Intensified levels of insecurity on roads and
lack of transport may limit womens mobility and therefore be a barrier to
accessing to healthcare. The lack of access to contraceptives, safe abortion and
skilled delivery services may expose women to unwanted pregnancies, unsafe
abortions and childbirth in dire situations. Pregnant women are affected more as
they are more prone to water/vector-borne diseases and also because lack of
food/safe drinking water results in low birthweight and increased miscarriages/
perinatal mortality. Climate induced migration puts women more at risk of
trafficking and restricts access to services that are available to other citizens.

Targets which the governments have promised

to achieve in order to meet Global Goals 2030
The 17 Global Goals for Sustainable Development have specific 169 targets for
governments to meet by 2030. These are available online at:
https://sustainabledevelopment.un.org/topics

It will be prudent for us to contextualize these 2030 Global Goals and targets to
monitor our states progress.
Some targets associated with Global Goal 5

5.1 End all forms of discrimination against all women and girls everywhere
5.2 Eliminate all forms of violence against all women and girls in the public and private spheres, including
trafficking and sexual and other types of exploitation
5.3 Eliminate all harmful practices, such as child, early and forced marriage and female genital mutilation
5.6 Ensure universal access to sexual and reproductive health and reproductive rights as agreed in
accordance with the Programme of Action of the International Conference on Population and Development
and the Beijing Platform for Action and the outcome documents of their review conferences

Snapshot of SRH-related data from India and

Andhra Pradesh
India
Total expenditure on health 1% of
GDP
Sex ratio
Literacy rate
Persons below poverty line (BPL)
Total Fertility Rate (TFR)
Maternal Mortality Rate (MMR)
Infant Mortality Rate (IMR)
Under 5 mortality rate
Age at marriage of females (2013)
Mean age at effective marriage
Median age of mother at 1st
pregnancy
%of women age 15-19 who have
begun child bearing
Unmet need of family planning
Knowledge about female condom in
women
Knowledge about female condom in
men
Women using any modern FP
method
Female sterilization
Male sterilization
Pill usage
Male condom usage

Andhra Pradesh
1% of GDP

940 (2011)
73% (Male 80.9%,
Female 64.6%) (2011)
29.5% (2014)
2.4 (2012)
178 per 100000 births
(2010-2012)
40 per 1000 live births
(SRS 2013)
49 per 1000 births
(2013)
61% get married at <16
years (69% in rural, 31%
in urban)
21.3 years (2013)
19.2 years

992 (2011)
68% (Male 76%, Female
60%)
9.2% (78.8 lakhs)
1.8 (2012 lowest in
country)
92 per 100000 births
(2013)
39 per 1000 live births
(SRS 2013)
41 per 1000 births
(2013)

16%

18.1%

21.3% (DLHS 2007-2008)

8.3%

16%
6.9%

17%

17.1%

47% (DLHS 2007-2008)

65% (DLHS III)

37%
1.0%
3.1%
5.2%

62.9%
2.9%
0.3%
0.5%

Some targets connected to Sustainable Development Goals 2 & 3

2.1 By 2030, end hunger and ensure access by all people, in particular the poor and people in vulnerable situations,
including infants, to safe, nutritious and sufficient food all year round
2.2 By 2030, end all forms of malnutrition, including achieving, by 2025, the internationally agreed targets on stunting and
wasting in children under 5 years of age, and address the nutritional needs of adolescent girls, pregnant and lactating
women and older persons
3.1 By 2030, reduce the global maternal mortality ratio to less than 70 per 100,000 live births
3.2 By 2030, end preventable deaths of new-borns and children under 5 years of age, with all countries aiming to reduce
neonatal mortality to at least as low as 12 per 1,000 live births and under-5 mortality to at least as low as 25 per 1,000 live
births
3.3 By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, waterborne diseases and other communicable diseases
3.4 By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment
and promote mental health and well-being
3.7 By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning,
information and education, and the integration of reproductive health into national strategies and programmes
3.8 Achieve universal health coverage, including financial risk protection, access to quality essential health-care services
and access to safe, effective, quality and affordable essential medicines and vaccines for all

References
http://nrhm.gov.in/nrhm-in-state/state-wise-information.html
http://rchiips.org/state-fact-sheet-rch3.html
http://censusindia.gov.in/2011-common/AHSurvey.html
https://nrhm-mis.nic.in/SitePages/DLHS4.aspx?RootFolder=%2FDLHS4%2FState%20and%20District%20Factsheets&FolderCTID=0x0120
00742F17DFC64D5E42B681AB0972048759&View={F8D23EC0-C74A-41C3-B676-5B68BDE5007D}

Why sustained media engagement is crucial to

increase accountability as we progress
towards Global Goals 2030?
Staying informed on the Global Goals as well as progress our governments have
made to achieving them is of utmost importance for accountability. The post-2015
framework presents a unique opportunity to build on the achievements of the
Millennium Development Goals (MDGs), while also addressing the dimensions that
lag behind. It is time to act now to increase both the political will and the
resources to achieve full and lasting gender equality, womens empowerment and
womens rights.
Access to information, freedom of expression and an independent media are
important for a sustainable future. The mass media is an excellent potential to
prioritize SRHR issues or report them in an accurate manner. However, often due
to lack of understanding and conceptual clarity the SRHR issues are not projected
or highlighted.
That is why Family Planning Association of India (FPA India) would like to engage
with journalists to advocate on post 2030 outcome with a focus on sustainable
development goals in seven cities: Ahmedabad, Bengaluru, Chennai, Hyderabad,
Kolkata, Lucknow and Ranchi.

For further information please contact:

Dr Renu Kapoor
FPA India
6-3-883/F, Adjacent to Topaz Building,
Punjagutta Officers Colony Lane,
Punjagutta, Hyderabad 500082
Email: hyderabad@fpaindia.org

Shobha Shukla
CNS
C-2211, Indira Nagar, Lucknow-16.
Email: shobha@citizen-news.org

Headquarters
Bajaj Bhawan, Nariman Point,
Mumbai-400021.
Tel: +91-22-022029080/4086-3101
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Email: fpai@fpaindia.org
Website: www.fpaindia.org