Ahead of World Contraception Day on September 26 and International Safe Abortion Day on September 28, reproductive health advocates have called for accessible, safe, legal and stigma-free abortion care and wider access to proven contraception options.
Shobha Shukla, Coordinator and Host of SHE & Rights and Executive Director of CNS, said safe abortion is an essential and lifesaving sexual and reproductive healthcare service and a fundamental human right, adding that it is central to reproductive freedom, gender equality and the achievement of the Sustainable Development Goals.
“With just 51 months left to deliver on the SDG goals and targets of gender equality and health rights, not only is the progress way off the mark, but attacks against bodily autonomy and gender and health rights have been growing around the world,” Shukla said.
She spoke at a SHE & Rights session organised ahead of the two international observances by the Global Center for Health Diplomacy and Inclusion (CeHDI), Guttmacher Institute, Asian Pacific Resource and Research Centre for Women (ARROW), International Planned Parenthood Federation, CNS and partners.
Investment could save lives, reduce costs
Presenting findings from the Guttmacher Institute’s Adding It Up 2024 report, Dr Elizabeth A. Sully, Director of International Research at the institute, said increased investment in sexual and reproductive health and rights could deliver significant health and economic benefits.
The report, covering 128 low- and middle-income countries, estimates that meeting the full need for modern contraception, maternal and newborn care, abortion services and treatment for four curable sexually transmitted infections in low- and middle-income countries in Asia would require increasing annual spending from US$5.87 to US$8.61 per person.
This represents an additional US$2.74 per person, or US$12.4 billion annually, according to the report.
It also estimates that every additional US$1 invested in family planning and contraceptive care could save US$1.97 in pregnancy-related and newborn care costs.
Meeting sexual and reproductive health and rights needs across Asia could also result in a 26 per cent reduction in unintended pregnancies, a 65 per cent decline in maternal deaths and a 62 per cent decline in newborn deaths, the report said.
Sully said the study estimated 120.6 million pregnancies occur annually in Asia, with 63 per cent resulting in live births, while 19.4 per cent result in safe abortions, 21.3 per cent in unsafe abortions and 16.7 per cent in miscarriages and stillbirths.
Report shifts focus to individual choice
The Guttmacher report also introduces a more person-centred approach to assessing contraceptive need by placing individual preferences, rights and choice at the centre.
While an estimated 129 million women of reproductive age in Asia have an unmet need for modern contraception, the figure includes women using traditional methods who may not want to switch to modern methods.
The report therefore uses the concept of “unmet demand”, focusing on women who want to avoid pregnancy, are not currently using contraception but express a desire for future family planning.
On that basis, an estimated 36 million women in low- and middle-income countries in Asia have an unmet demand for contraception.
Riju Dhakal, Programme Officer at ARROW, called for international commitments on sexual and reproductive health and rights to be reflected in national budgets.
Dhakal said ARROW was working with partners in 12 countries to examine financing for sexual and reproductive health and rights and engage governments on investment and impact.
She cited concerns over a reported 46 per cent decline in official development assistance for sexual and reproductive health and rights between 2024 and 2026, urging advocates to use the Guttmacher Institute’s investment calculators to track government commitments and determine whether pledged funds are budgeted, released and ultimately reach communities.
Kenya highlights gap between rights and access
Jane Nyanjom, Associate Director for Advocacy and Partnerships at Reproductive Health Network Kenya, said translating reproductive health rights into practice requires alignment between law, policy, financing and service delivery.
She highlighted contraceptive commodity stock-outs in Kenya, particularly their impact on women and girls in rural and hard-to-reach areas, while stressing the need for youth-friendly services, accurate information, effective referral systems and informed choice.
Nyanjom also pointed to the gap between Kenya’s legal framework on abortion and the services women can actually access.
“Rights committed on paper must be matched by actions for commodities, trained providers, financing, referral systems and accessible services on the ground,” she said.
Nawmi Naz Chowdhury, Executive Director of Women’s Global Network for Reproductive Rights (WGNRR), said reproductive rights must translate into actual access to abortion care.
She identified political and anti-rights backlash, conflict, humanitarian crises, displacement, shrinking civic and funding space, shortages of trained providers and medicines, weak referral systems, administrative requirements, cost, geographical barriers, stigma and misinformation as factors limiting access.
Experts seek stronger health systems
Dr Imran Pambudi, Director of Vulnerable Groups Health Services at Indonesia’s Ministry of Health, said a health system’s strength should be assessed by how effectively it protects and serves vulnerable populations.
He identified persons with disabilities, remote island communities, survivors of violence, older people, marginalised women and adolescents among groups requiring particular attention.
Pambudi called for sexual and reproductive health and rights to be integrated into primary healthcare, alongside person-centred approaches that protect dignity, a strengthened healthcare workforce and reliable access to medicines and referral services.
The experts stressed that financing alone is insufficient, saying services must also be accessible, affordable, adequately staffed and responsive to the needs of vulnerable populations.
The Guttmacher Institute’s Family Planning Investment Impact Calculator and Safe Abortion Calculator were also highlighted as tools for estimating the potential health and financial impact of increased investment in contraception and safe abortion services.
