This article was written by Emilie Filmer-Wilson, the Human Rights Adviser at UNFPA, and Luis Mora, the Chief of the Gender, Human Rights and Culture Branch at UNFPA.
The United Nations Population Fund’s (UNFPA’s) approach to public health is grounded in the premise that women’s sexual and reproductive health is determined not only by their access to health services but also by their ability to freely decide on all matters related to their sexual and reproductive health and rights.
I. Evolving Emphasis on the Rights-Based Dimensions of Sexual and Reproductive Health
This rights-based approach to population issues has evolved since UNFPA’s creation in 1967, which coincided with the increasing concerns of the time: on the one hand, spiraling world population growth and resource limits, and on the other hand, an increasing attention to women’s rights as a whole and reproductive rights in particular.
The gradual shift in the population field—from an emphasis on demographic targets aimed at population control and toward girl’s and women’s rights to bodily autonomy, integrity, and choice—culminated in 1994 at the International Conference on Population and Development (ICPD) in Cairo. The 1994 ICPD reflected a new global consensus that individual human rights and dignity, including the equal rights of women and girls and universal access to sexual and reproductive health and reproductive rights, are a necessary precondition for sustainable development. Subsequent to the ICPD, empowering women and strengthening their autonomy became an end in itself and central to UNFPA’s mission.
While the ICPD set a powerful normative and guiding framework for UNFPA’s work on sexual and reproductive health and reproductive rights, global advances to strengthen the link between sexual and reproductive health and rights since 1994 have been slower than anticipated. At the ICPD Beyond 2014 International Conference on Human Rights, it was acknowledged that “far too often, human rights have been underplayed or ignored altogether in designing and implementing health and population policies and services.
II. UNFPA’s Efforts to Mainstream Human Rights
In efforts to translate the rights-based vision of the ICPD into sexual and reproductive health policy, UNFPA has pursued two principle strategies: (a) engaging with the human rights system to strengthen accountability for sexual and reproductive health and rights and (b) advancing operational clarity on the links between human rights and sexual and reproductive health.
A. Engaging with International, Regional, and National Human Rights Mechanisms
UNFPA has engaged with human rights mechanisms at global, regional, and country level, with the overall aim to strengthen accountability for gender equality, sexual and reproductive health, and reproductive rights.
At the global level, UNFPA has worked closely with the UN human rights treaty bodies and the UN special procedures mandate holders to strengthen their understanding of, and attention to, reproductive rights in their interpretation of treaties and monitoring of states. Through this proactive engagement, treaty bodies have increasingly asserted and advanced sexual and reproductive health and reproductive rights. This has in turn strengthened the normative foundation of, and accountability for, reproductive rights.
At the country level, UNFPA was quick to recognize the opportunity of human rights mechanisms for multi-stakeholder national dialogue, advocacy, and accountability. UNFPA’s engagement with the Universal Periodic Review exemplifies this. A forthcoming UNFPA analysis has found that over 28% of all recommendations from the UPR relate to sexual and reproductive health and rights and gender equality. These recommendations are valuable tools to accelerate the implementation of the ICPD by identifying critical issues and groups that need attention and requiring that states take action. UNFPA country offices proactively engage with national partners to maximize the opportunity created by the UPR recommendations and ensure follow up.
As part of efforts to strengthen national accountability for reproductive rights, UNFPA also partners with National Human Rights Institutions (NHRIs). UNFPA has been working around the world to increase the attention that NHRIs bring to sexual and reproductive health and reproductive rights issues and strengthen their capacity to engage in this area. With the support of UNFPA, 36 NHRIs have engaged on sexual and reproductive health and reproductive rights since 2012 as part of their human rights monitoring role.
B. Advancing Operational Clarity Between Human Rights and Sexual and Reproductive Health and Reproductive Rights
Yet UNFPA, similar to other development organizations, has faced challenges in demystifying how to translate human rights norms and principles into concrete policies and programs. An internal 2002 review of the use of the human rights-based approach in UNFPA programming concluded that while UNFPA country offices “are using human rights language, the conceptualisation and the linkages to UNFPA’s programming areas is weak.”
Important milestones have since been made by UNFPA. In 2010, UNFPA developed its own manual for UNFPA staff on a Human Rights-Based Approach to Programming. This UNFPA manual, developed in collaboration with the Harvard School of Public Health, provides a conceptual overview of the human rights-based approach, programming guidance, and training materials. The development of these human rights mainstreaming tools has provided an important step in elaborating, both conceptually and practically, the challenge of integrating human rights into UNFPA’s work.
More specific advances have also been achieved in UNFPA’s work on maternal health and family planning. The 2012 Technical Guidance on Maternal Health and Human Rights-Based Approach, developed by the UN Office of the High Commissioner for Human Rights (OHCHR) at the request of the Human Rights Council and with technical assistance from UNFPA, provides the first operational framework that outlines the steps by which to make women’s agency, accountability, and non-discrimination central to advancing maternal health outcomes. In UNFPA’s work in family planning, where once human rights were seen only as protection against coercive family planning policies and practices, UNFPA has invested in learning how human rights principles can systematically improve the way that clinic-based family planning programs are planned, implemented, monitored, and evaluated. In 2015, UNFPA together with WHO developed an implementation guide on Ensuring Human Rights Within Contraceptive Service Delivery. This guide changes the mind-set by which family planning is viewed: from a focus on products to a focus on empowerment and choice.
A major contribution to strengthening operational clarity in implementing the human rights-based dimension of the ICPD has been the ICPD Beyond 2014 International Conference on Human Rights (mentioned above), organized by UNFPA in partnership with OHCHR and the Government of the Netherlands in 2013. The Conference identified three fundamental challenges to realizing the human rights dimensions of the ICPD Programme of Action:
- Equality – making progress toward social justice and ending discrimination in all its forms.
- Quality – meeting human rights standards in sexual and reproductive health services, information, and education.
- Accountability – identifying responsibilities of key actors and enforcing rights.
These three components have provided UNFPA with a valuable compass for its efforts to mainstream human rights. They have guided UNFPA’s current Strategic Plan (2018-2021), which anchors accountability, non-discrimination, and quality of care within the work of the organization over the next four years.
Conclusion
UNFPA has played an important role in transforming the perception of sexual and reproductive health and reproductive rights from a focus on numbers to human rights. It has also made much progress in mainstreaming human rights in its work, so that today, UNFPA is widely recognized as a human rights-based organization. Yet the organization has struggled to fully shift its underlying approach to public health to reflect the human rights dimensions of the ICPD. To do so, a more deliberate and intentional effort is required. The 2030 Sustainable Development Agenda, on which UNFPA’s new Strategic Plan is based, provides a powerful framework for UNFPA to scale up efforts to translate the rights-based dimensions of the ICPD into action. Focusing on equality, quality, and accountability for sexual and reproductive rights provide UNFPA with the road map to bring human rights to the center of its work on sexual and reproductive health and rights.
Read more about UNFPA’s efforts to mainstream sexual and reproductive health and rights in:
Human Rights in Global Health: Rights-Based Governance for a Globalizing World (2018)
available from Oxford University Press or Amazon.com
