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Bangladesh Journal of Bioethics 2019; 10(2): 1-6 

 

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Sexual and Reproductive Health and Rights of Women: A Rights-based 

Approach 

 

Shaorin Tanira1, Raihana Amin2, Sanchita Adhikary3, Khadiza Sultana4, Rashida Khatun5 

1. Graduate student, School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, 

ON, Canada. Email: shaorin.tanira@queensu.ca  (corresponding author) 

2. Junior Consultant (Gynaecology), Geriatric Hospital, Bangladesh Association for the Aged and Institute of 

Geriatric Medicine (BAAIGM), Agargaon, Dhaka-1207, Bangladesh. Email: raihanaamin205@gmail.com  

3. Junior Consultant (Obstetrics & Gynaecology), Jessore Sadar Hospital, Jessore-7400, Bangladesh. Email: 

drsadhikary@gmail.com  

4. Medical Coordinator, Bangladesh Women’s Health Coalition (BWHC), Adabor, Dhaka-1207, Bangladesh. 

Email: chhonda17@gmail.com  

5. Graduate student, Department of Population Sciences, University of Dhaka, Dhaka-1000, Bangladesh. Email: 

rashidakhatun6135@gmail.com  

DOI: https://doi.org/10.3329/bioethics.v10i2.50667  

 

Abstract: Violations of women’s sexual and reproductive health and rights are frequent all over the world. 

Women’s sexual and reproductive health is related to multiple human rights. The term ‘rights-based’ has 

become increasingly linked to the concept of a more comprehensive approach to sexual and reproductive 

rights of women around the globe. The rights-based perspective is derived from the treaties, pacts and other 

international commitments that recognize and reinforce human rights, including the sexual and reproductive 

rights of women. We conducted an extensive review of the guidelines, frameworks, research reports and 

published articles that have been cited as informing the rights-based approach. The findings of the review 

highlights what is meant by sexual and reproductive health and rights by the stakeholders, why this matter 

is important, and what can be done. It demands more partnerships with human rights, women’s and other 

civil society organizations, increased number of successful national policies, initiatives and/or legislative 

changes, increased budget and other resources at national and/or local community level, mass 

communication and engagement of men to promote and advance women’s sexual and reproductive health 

and rights. Achievement of gender equality is very crucial, because it is a human right that advances 

women’s empowerment; and is interlinked with sexual and reproductive health and rights. 

 

Key words: Sexual and reproductive health and rights, gender equality, women empowerment, 

women’s rights. 

 

Introduction: Access to comprehensive 

sexual and reproductive health and rights is a 

basic human right. However, violations of 

women’s sexual and reproductive health 

rights are frequent all over the world1. The 

International Conference on Population and 

Development (ICPD) Programme of Action 

recognizes that realizing the right to 

reproductive health is a critical element of 

guaranteeing reproductive rights1. The ICPD 

Programme of Action broadly defines 

reproductive health as “a state of complete 



Bangladesh Journal of Bioethics 2019; 10(2): 1-6 

 

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physical, mental and social well-being and 

not merely the absence of disease or 

infirmity, in all matters relating to the 

reproductive system and to its functions and 

processes”2. Moreover, according to the 

ICPD Programme of Action, sexual and 

reproductive 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”2 and also 

include the right "to make decisions 

concerning sexuality and reproduction free of 

discrimination, coercion and violence, as 

expressed in human rights documents"2. The 

rights-based perspective is derived from the 

“treaties, pacts and other international 

commitments that recognize and reinforce 

human rights”3, including the sexual and 

reproductive rights of women. This paper is 

the outcome of an extensive review of the 

guidelines, frameworks, research reports and 

published articles that have been cited as 

informing the rights-based approach to 

women’s sexual and reproductive health and 

rights. 

 

Current situation and challenges: Maternal 

mortality, gender-based violence, lack of 

access to appropriate health care and an 

absence of family planning services drive 

violations of reproductive rights across the 

world4. An estimated 287,000 maternal 

deaths occurred worldwide in 2010; most of 

them were preventable. However, the 

aggregate data masks gross inequalities both 

within and between countries. For instance, 

the risk of dying during pregnancy, and when 

giving birth, for a woman in a developing 

region is 15 times higher than in developed 

regions. In total, 99% of maternal deaths 

occur in the developing world, mainly in 

Africa and South Asia5. In addition, more 

than 200 million women annually are 

estimated to experience life-threatening 

complications in connection with pregnancy, 

often leading to serious disability6. 3 million 

babies die in the first week of life and even 

more are stillborn every year7. The main 

reason behind the large number of 

preventable maternal and infant mortality, 

underpinning the disparities between and 

within the world’s regions, is a lack of quality 

health care8. Despite an increased focus on 

voluntary family planning, among other 

interventions, there are still large gaps in the 

availability of contraceptive services, 

especially in sub-Saharan Africa and other 

developing countries where unmet need is 

near about 25%, while the global average is 

around 11%9. It has been estimated that more 

than 120 million women have unmet needs 

for family planning services9. Those women 

hardly decide freely on whether to have 

children and the number and timing of child 

bearing, and are more vulnerable to 

contracting sexually transmitted infections 

(STIs), including HIV/AIDS4,8. Lack of 

access to family planning services also 

increases the rate of abortions, including 

unsafe abortions – an estimated yearly 80 

million unwanted or unintended pregnancies 

each year and an estimated 45 million are 

terminated. Of those, 19 million are unsafe 

with almost 40% done on women below 25 

years of age. About 68,000 women die each 

year from complications of unsafe abortion6. 

Lack of formal education (especially primary 



Bangladesh Journal of Bioethics 2019; 10(2): 1-6 

 

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and secondary) for girls not only reflects 

insufficient access to health education 

(especially sexual health and family 

planning), but also illustrates the behind the 

scene facts: a world in which adolescent girls 

are forced or otherwise coerced into sex 

and/or marriage4,9. Child, early and forced 

marriages (and early unions without 

marriage) are among the many harmful 

practices affecting young girls, primarily in 

the developing world9. These violations of 

reproductive rights – childbirth before 

physical and mental readiness – a common 

consequence of early marriages, can lead to 

obstetric fistula and other detrimental health 

consequences for both babies and mothers. 

Additionally, evidence shows that adolescent 

mothers are much less likely to have access 

to formal and health education than 

adolescent girls not affected by 

motherhood11. Moreover, patriarchal 

concepts of women’s roles within the family 

mean that women are often valued based on 

their ability to reproduce10. Women are also 

often blamed for infertility. Besides, early 

marriage and pregnancy, or repeated 

pregnancies spaced too closely together, 

often as the result of efforts to produce male 

offspring because of the preference for sons, 

has a devastating impact on women’s health 

with sometimes fatal consequences9-11. 

Therefore, international community has 

acknowledged that maternal mortality and 

other associated vulnerabilities are primarily 

a human rights challenge and a social justice 

issue12. 

 

Rights-based approach: The term ‘rights-

based’ has become increasingly linked to the 

concept of a more comprehensive approach 

to sexual and reproductive rights of women 

around the globe. Reproductive rights are a 

constellation of freedoms and entitlements 

that are already recognized in national laws, 

international human rights instruments and 

other consensus documents. Reproductive 

rights refer to a diversity of civil, political, 

economic, social and cultural rights affecting 

the sexual and reproductive life of 

individuals and couples2. The Universal 

Declaration of Human Rights (UDHR) is a 

milestone document in the history of human 

rights. Drafted by representatives with 

different legal and cultural backgrounds from 

all regions of the world, the Declaration was 

proclaimed by the United Nations General 

Assembly in 1948, as a common standard of 

achievements for all peoples and all 

nations13. It has been further shaped by major 

United Nations conferences of the 1990s that 

focused on human rights, gender equality, 

sexual and reproductive health, and HIV and 

AIDS, as well as by the most important 

document, the 1994 International Conference 

on Population and Development (ICPD), 

which was adopted by consensus and later 

endorsed by the United Nations General 

Assembly2. Another important document, 

also adopted by consensus and endorsed by 

the United Nations General Assembly, is the 

Beijing Declaration and Platform for Action, 

adopted in 1995 at the Fourth World 

Conference on Women14. Furthermore, the 

2005 World Summit Outcome, adopted by 

the United Nations General Assembly in 

2005,15 and the commitment to both sexual 

and reproductive health in the outcome 

document of the 2010 United Nations 

Summit on the Millennium Development 

Goals, adopted by the United Nations 



Bangladesh Journal of Bioethics 2019; 10(2): 1-6 

 

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General Assembly in 2010,16 further 

confirmed the commitment to reproductive 

health. In June 2012, the United Nations 

reaffirmed its commitment to reproductive 

rights in the United Nations Conference on 

Sustainable Development, Rio+20.17 

Women’s sexual and reproductive health is 

related to multiple human rights, including 

the right to life, the right to be free from 

torture, the right to health, the right to 

privacy, the right to education, and the 

prohibition of discrimination1,10,18. 

Achievement of gender equality is very 

crucial, because it is a human right; advances 

women’s empowerment; and is interlinked 

with sexual and reproductive health and 

rights19,20. Effectively addressing 

reproductive health problems calls for an 

integrated, rights-based approach that draws 

on the fields of health, ethics, law and human 

rights. This approach can provide analytical 

tools to identify root causes and inequities, 

shape humane and effective programmes and 

policies, and pressure governments into 

working proactively18. 

 

Implementation mechanisms: While hard-

won gains for sexual and reproductive health 

and rights often face backlash and set-backs, 

several organizations around the globe, 

together with UN Agencies, are determined 

and fighting to change the status quo19. 

Gender equality, the concept that all 

individuals should be treated in a way that 

ensures equal opportunities and outcomes, is 

a human right. The highest attainable 

standard of sexual and reproductive health is 

not possible without gender equality5 and this 

has been recognized at the level of 

international policy. For example, the 

Sustainable Development Goals (SDGs) 

recognize that sustainable development 

cannot be achieved without gender 

equality21. Not only is gender equality a goal 

in itself i.e. goal 5, but there is a specific 

target within this goal on universal access to 

SRH (target 5.6), in addition to a target on 

SRH in the health goal (target 3.7)21. Hence, 

addressing gender inequality is a pre-

requisite for respecting, protecting and 

fulfilling the right to sexual and reproductive 

health. It demands more partnerships with 

human rights, women’s and other civil 

society organizations, increased number of 

successful national policies, initiatives and/or 

legislative changes, increased budget and 

other resources at national and/or local 

community level, mass communication and 

engagement of men to promote and advance 

women’s sexual and reproductive health and 

rights1. 

The provision of reproductive health services 

must conform to the international human 

rights framework comprising the right to 

health such as the standards guaranteeing 

availability, accessibility, acceptability, and 

quality of health facilities, goods, and 

services22. These are regarded as core 

components of the right to sexual and 

reproductive health. 

a) Availability: States must ensure that there 

are an adequate number of functioning health 

care facilities, services, goods and programs 

to serve the population, including essential 

medicines such as contraception and 

emergency contraception. 

b) Accessibility: States must ensure that 

health facilities and services are accessible 



Bangladesh Journal of Bioethics 2019; 10(2): 1-6 

 

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both physical and economically to their 

populations without any discrimination. 

Information also must be accessible so that 

individuals and groups must be able to seek, 

receive, and disseminate information and 

ideas on health issues. 

c) Acceptability: Health facilities, services, 

and goods must be culturally appropriate and 

should take into account the interests and 

needs of minorities, indigenous populations, 

and different genders and age groups. 

d) Quality: Reproductive health care must be 

of good quality, meaning that it is 

scientifically and medically appropriate and 

that service providers receive adequate 

training. 

To summarize the above discussions, we may 

say that through all those treaties, meetings 

and conferences, three points of focus forged 

a new consensus on reproductive rights16 – i) 

Individuals have the right to control their 

sexual and reproductive lives without 

interference, while governments must ensure 

equal access to health care, including 

comprehensive reproductive health services; 

ii) A rights-based approach can provide 

health practitioners with an ethical 

framework and understanding of societal 

factors. It can improve the effectiveness of 

interventions and empower clients; and iii) 

international human rights treaty obligations 

can increase pressure on governments, as 

well as raise the visibility of sexual and 

reproductive health problems. 

 

Conclusion: All the above discussions can 

be summarized as violations of the major 

human rights concepts of liberty 

(incorporating autonomy), social justice, and 

equality around the globe, while we talk on 

sexual and reproductive health and rights of 

women. Moreover, the discourse of human 

rights cannot provide readymade answers to 

the problems and dilemmas that arise in any 

given context. However, where several 

measures present themselves as comparably 

effective, the preference should be for the 

alternative that is the least detrimental to the 

enjoyment of human rights. Struggles over 

women's rights to sexual and reproductive 

health have also been crucial in advancement 

of women's rights movement. For decades, 

women's rights advocates have drawn 

attention to the ways in which the status of 

women is fundamentally linked with their 

sexuality and reduction. This sort of approach 

means trusting women as autonomous beings 

who can actively exercise control over their 

sexual and reproductive lives and to make 

decisions on these matters on the basis of 

access to adequate information. To conclude, 

improvement of reproductive and sexual 

health and rights directly affects equitable 

and sustainable development, the attainment 

of various Millennium Development Goals 

(MDGs). 

 

References: 

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for Reproductive Rights (CRR). ICPD and human 

rights: 20 years of advancing reproductive rights 

through UN treaty bodies and legal reform. 2017. 

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https://www.unfpa.org/sites/default/files/pub-

pdf/icpd_and_human_rights_20_years.pdf 

(Accessed August 27, 2017). 

2. United Nations. Report of the International 

Conference on Population and Development 

(ICPD), Cairo, 1994. 1995. Available from: 

https://www.un.org/development/desa/pd/sites/w



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August 9, 2017). 

 

Authors’ contribution: S Tanira was involved in 

conception of the paper; S Tanira, R Amin, S 

Adhikary, K Sultana and R Khatun were equally 

involved in the literature search, manuscript writing 

and revision. 

Conflict of interest: None to disclose. 

 


