Highlighted results

4,965,666 young people received correct SRHR information

2,499,288 additional women and girls with access to modern contraception

2,081,823 abortion and post-abortion care services provided

Changes of laws and international guidelines

Additional sources

Policy document

Read the policy document on SRHR

Letter to Parliament on Dutch policy in relation to health syste

Read the Letter to Parliament on Dutch policy in relation to health systems

Theory of Change

Download PDF document on the Theory of Change, including SRHR

Introduction

The Netherlands is committed to respect, protect and fulfill universal access to sexual and reproductive health and rights, including issues related to HIV/AIDS, with respect for human rights and in collaboration with our partners. We aim to be a connector, donor, watchdog, knowledge broker and diplomatic negotiator.

The policy document ‘Investing in Perspective’, published on 18 May 2018, introduced new fields of focus, including SRHR in focus regions, access to contraception for girls and women in West Africa and gender equality and empowerment of women and girls.

The Dutch commitment to SRHR stands for freedom of choice for women and young people. We invest in information, health products and quality health services and work to secure the rights of all individuals. This contributes to the empowerment of women and girls and thereby more sustainable growth in the target countries. The activities undertaken by the Netherlands provide a high return on investment in education and employment and contribute to poverty reduction and economic development.

Relevant events in this context included the first She Decides Day in South Africa on 2 March 2018 and the international AIDS conference in Amsterdam in July 2018. Despite the positive effects of movements such as She Decides and #MeToo, there was still noticeable opposition to women's rights in 2018. Resistance to issues such as abortion and comprehensive sexuality education was particularly strong.

Results 2018

The Netherlands is particularly committed to sensitive topics and has achieved substantial results in this context. Its inclusive and people-oriented approach and political courage give the Netherlands an internationally valued and distinctive added value.

The Dutch commitment to SRHR, including HIV/AIDS, has contributed to improved knowledge and access to information, resources and services for more people worldwide, which enables them to assert their rights in this field. The Netherlands contributes to the development of relevant products and services and their affordability, accessibility and distribution, especially in vulnerable countries and groups.

The Netherlands strives to ensure that women and young people have freedom of choice, that they have direct access to the products and services with which they can shape their future. Dutch efforts also succeeded in reaching the specific groups for which this is often difficult, such as unmarried girls and women, men who have sex with men and sex workers. The legal and cultural barriers that prevent these individuals from exercising their rights were addressed in partnership with NGOs and eliminated where possible.

Result areas

Young people, information and choices Access to health products Quality of health care Rights and respect

Featured project sexual and reproductive health and rights including HIV / AIDS

Guttmacher – Evidence to advance SRHR

The Guttmacher Institute is an American scientific organisation that conducts research into SRHR worldwide. Guttmacher works together with local researchers and governments, and the Netherlands helps to finance Guttmacher's international work outside of the United States. The results of the research form a basis for policy development and implementation, as well as for discussions between supporters and opponents of SRHR. Examples of recent Guttmacher reports include Adding it up (about the cost-effectiveness of meeting women’s and girls’ demand for contraceptives) and Induced abortion worldwide (on global abortion figures).

In May 2018, the Guttmacher-Lancet Commission on SRHR published the report Accelerate progress – sexual and reproductive health and rights for all. In this report, the commission demonstrates that SRHR is a central condition for achieving the Sustainable Development Goals in general, and certain specific goals in particular.

Guttmacher Institute website

Read more about the work of the Guttmacher Institute

Young people, information and choices

Young people in Madagascar. Source: Amplify Change

Better information and greater choice for young people

This result area aims to give more young people, between the ages of 10 and 24, access to correct information on sexual and reproductive health and rights. So far, we have provided correct SRHR information to 4,965,666 young people. Many young people currently have no access to this information, leading to unsafe choices or a lack of choice, for example in the case of forced marriages. The Netherlands supports a range of organisations in increasing access to information and freedom of choice. The importance of freedom of choice for young people is also discussed with their parents, teachers, religious leaders and health workers. They play an important role in facilitating freedom of choice for young people.

Open result area

Young people in Madagascar. Source: Amplify Change

Comprehensive sexuality education (CSE) is sex education that covers more than just the biological aspects of reproduction. It also deals with resilience, the right to say no, romantic love, different sexual orientations (straight, gay, bisexual) and how to have safe and pleasant sex. Informing young people at school and elsewhere in this way enables them to make better, freer choices. Efforts spearheaded by the Netherlands have provided 4,965,666 young people with complete and correct information about sexuality, HIV/AIDS, STDs, pregnancy and birth control. Nearly two million of these young people have been reached through embassy programmes. Also programmes such as GUSO, More Than Brides, Her Choice, Yes I do and JeuneS3 reached young people with CSE.

Schools can make CSE a fixed part of their curriculum. In addition, CSE can also be provided outside of schools, often to girls and boys separately, with peer educators talking to young people in a safe environment about topics that are important to them.

More knowledge will enable more young people to protect themselves against unplanned pregnancy and STDs. It is important that they are able to go somewhere to talk about these topics and have access to contraceptives. This is not always easy and therefore the Netherlands has made more than 10,000 clinics more youth-friendly.

In some countries, it is uncommon to talk about sex: the topic is taboo for unmarried youngsters and there are hardly any youth-friendly clinics. This is the case in Mozambique, for example. Part of the Population Services International (PSI) Ignite programme, which organised youth-friendly services in schools, was discontinued by parents who did not want their children to receive sex education.

The Netherlands is committed to continuing to facilitate and improve access to comprehensive sexuality education for young people in the coming years.

Results

Indicator

Reaching young people with correct information on sexuality, HIV/AIDS, STDs, pregnancy and contraceptives

Progress

On track

Our partners reached almost five million young people during the reporting period by training and supervising professors and teachers in and outside of school. They also trained peer educators (other young people) and provided them with educational material.

Young people face disproportionate obstacles. HIV is especially likely to affect young girls, for example, and is one of the main causes of death for this demographic. Knowledge is essential for young people to prevent pregnancy, sexual exploitation or HIV infection and to make healthier choices with regard to treatment and sexuality.

A prerequisite for this is access to information, not least about sexuality. Recent figures show that only 30% of women and 37% of men aged 15 to 24 in Sub-Saharan Africa had good knowledge about HIV/AIDS.

Indicator

Youth-friendly health services

Progress

On track

Many of the barriers that young people encounter within health care systems are specific to them. They are related to their stage of life, local communities and specific needs, experiences and capabilities. Youth-friendly services attract young people, meet their needs and bind them to receive further care.

In the reporting period, more than 10,000 clinics, health centres or school clinics have become youth-friendly, enabling young people to visit them without fear.

Young people need access to health services in order to make informed choices regarding their sexual and reproductive health. That is why care providers must be familiar with HIV and SRHR, offer youth-friendly services and pass on knowledge.

Youth ambassadors in francophone West Africa

Funding from the Dutch embassy in Benin enabled the training of 122 new youth ambassadors in Côte d'Ivoire, Guinea, Mauritania and Niger. They are part of a larger network of young activists in West Africa whose activities include talking to government officials, teachers and religious leaders to communicate their vision of their own future and the importance of freedom of choice.

What do young people from Niger want?

Clip for and by young people about the importance of sex education. Several youth ambassadors from countries such as Niger, Mali and Senegal can be seen and heard in the clip.

UNICEF/UNFPA Global Programme to Accelerate Action to End Child Marriage

The UNICEF-UNFPA programme is supported by the Netherlands and other countries and focuses on combating child marriages in 12 countries in which it is most common. The programme deploys a range of strategies to prevent the marriage of girls before they reach adulthood in Bangladesh, Burkina Faso, Ethiopia, Ghana, India, Mozambique, Nepal, Niger, Sierra Leone, Uganda, Yemen and Zambia. This includes informing them about their rights, making them more resilient and teaching them how to assert their rights. Parents and teachers are also made aware about the negative consequences of getting married too early and having children too young for girls, as well as for their communities and ultimately the whole of society.

In Yemen, for example, more than 100,000 religious leaders, local leaders and other people from the community have received training on the importance of access to education for girls.

UNICEF/UNFPA Global Programme to Accelerate Action to End Child Marriage

Read more about the project UNICEF/UNFPA Global Programme to Accelerate Action to End Child Marriage

Youth participation

Nothing about us without us, the importance of youth participation

Access to health products

Contraceptives are transported by boat to the island of Idjwi in the Democratic Republic of Congo. Source: I+ Solutions

Better access to affordable, high-quality health products

The Netherlands wants to make more contraceptives, medical drugs, diagnostics, vaccines and other preventives available to women, young people and specific risk groups. But it is important to ensure that these products actually meet their needs. For example, antiretroviral drugs must also be suitable for children, and women must be able to opt for birth control that matches their stage of life.

Open result area

Contraceptives are transported by boat to the island of Idjwi in the Democratic Republic of Congo. Source: I+ Solutions

Contraceptives

The availability of contraceptives increases the options of women and girls in terms of education, work, sexuality and family size. Birth control is an important condition for gender equality. Since 2012, the number of contraceptive users in the 69 poorest countries has increased by 46 million. In total, 317 million women and girls use birth control. This has prevented 119 million unwanted pregnancies, 20 million unsafe abortions and 137,000 maternal deaths.

HIV treatment

HIV/AIDS still has a major impact on individuals and the social and economic development of societies. To prevent new infections and give people with HIV access to medication, the Netherlands invests in international programmes (such as Bridging the Gaps and PITCH), organisations (such as the International HIV AIDS Alliance and the Aidsfonds) and the Global Fund to fight AIDS, Tuberculosis and Malaria (GFATM). There is a special focus on specific risk groups such as sex workers, intravenous drug users, transgender people, prisoners and men who have sex with men.

Medical drugs

The Netherlands contributes to better availability of drugs in multiple ways. Through Product Development Partnerships (PDPs), we invest in research into and development of cheaper and effective drugs, vaccines and diagnostics for diseases that mainly occur in poor parts of the world. Moreover, the Netherlands supports the Access to Medicines Index, which charts the efforts of pharmaceutical companies to make drugs affordable and accessible to poor population groups. The Netherlands also contributes to the Global Alliance for Vaccines and Immunisations (GAVI) to protect children in the poorest 73 countries with vaccinations against serious preventable diseases.

Results

Indicator

Additional women and girls with access to modern contraceptives

Progress

Progress, not on track

In 2012, it was agreed under the Family Planning 2020 initiative (FP2020) that 120 million additional women and girls should have access to contraceptives worldwide. The stated number is the Dutch contribution to the total number of additional users, calculated on the basis of FP2020 data.

FP2020 keeps track of the number of new users and the spending by donors, private organisations and countries. These figures show that, in 2016, 5.43% of the additional contraceptives used in the 69 FP2020 countries were financed by the Netherlands.

Reasons for falling behind schedule are related to the accessibility of places where modern contraception is provided, the inefficiency of distribution channels in the relevant countries and the national policies that make access to modern contraception difficult.

Indicator

Number of people with HIV receiving antiretroviral treatment

Progress

On track

280,610

This indicator shows the number of people receiving antiretroviral treatment through Dutch funding for GFATM.

In 2017, 17 million people received antiretroviral therapy via GFATM. The Dutch share in this is 1.6% (280,000). Although the GFATM has not set a specific target for the number of people receiving antiretroviral therapy, it did set the target of at least half of people living with HIV receiving treatment in 2017. According to figures from GFATM, this figure is currently 52%. In other words, the programme is on schedule.

Indicator

Number of children fully vaccinated

Progress

Progress, not on track

The Netherlands is one of the donors to GAVI. The Dutch contribution has financed some of the vaccinations provided by this organisation and the associated training, purchasing, transport and storage.

GAVI and its partners, such as health ministries, continued to focus strongly on increasing the number of children included in the national government vaccination programmes in the various countries over the past year. This involves all new-born children receiving their measles and pentavalent (five immunisations in one, including whooping cough, tetanus and hepatitis B) vaccines in timely fashion. GAVI aims to increase the percentage of children vaccinated, but this has proven to be more difficult in practice than expected. Although more and more children are receiving the measles vaccine, there were still many measles epidemics in the past year. The percentage of children protected against this fatal disease in GAVI countries is still only 78%. On a global scale, we are therefore on schedule for some vaccines, but not yet for others.

Progress in result area Access to health products

Contraceptives

Although the number of women and girls using modern contraception increases, the rate is insufficient to reach the global target of 120 million by 2020. The most important reason is that worldwide there is not enough funding for contraceptives. Local legislation, culture, religion and sub-optimal distribution channels also play a role.

To improve the availability of contraceptives, the Netherlands works closely with UN organisations like UNFPA, Dutch and international NGOs like PSI, the International Planned Parenthood Federation (IPPF), Marie Stopes International (MSI), governments and knowledge institutes like Share-Net and Guttmacher. Innovative ways to make distribution within countries more efficient are important points of focus. These can, for example, take the form of social marketing or technical support to governments. Increased financial resources are requested in political and diplomatic discussions with donors and the countries themselves.

HIV treatment

According to UNAIDS figures, there are 36.9 million HIV-positive people in the world today. Some 59% of these people were treated with antiretrovirals in 2017, up from 25% in 2010. If this trend continues, the world is on track for the global target of 30 million people in treatment in 2020. In the coming years, the Netherlands will continue to focus on prevention (including harm reduction) as well as the rights of marginalised groups and young people, especially girls and young women, and their access to medication.

Medical drugs

One Product Development Partnership (PDP) funded by the Netherlands is the TB Alliance. This partnership led to the very first market launch of a drug for children in 2017, which is now being used in 36 countries. There is now a suitable pharmaceutical treatment for the more than one million children that contract tuberculosis every year. A range of inexpensive diagnostic tests have also been developed and the introduction of new and better products is in progress. Because the introduction of new drugs is a lengthy process, some will only reach the market in a few years.

Ignite

Ignite

PSI is implementing Project Ignite with Dutch support. Activities within this project are designed with a strong focus on the needs and experience of young women and girls, according to human-centred design principles. The project provides information as well as contraceptives and reached a total of 181,405 young people under the age of 25 in 2017. A total of 66,923 young couples used contraceptives throughout the year (couple year protection).

Part of Project Ignite in Mozambique has been halted by parents who did not wish their children to receive sexual education and therefore blocked youth-friendly services in schools. However, Ignite has continued to provide information and contraceptives close to schools rather than inside schools.

Where schools fit into youth-friendly health services

Blog about one of the ways in which Project Ignite reaches young people in Mozambique

Jeune S3

Jeune S3 is a project by Cordaid, PSI Europe and the Swiss Tropical and Public Health Institute (TPH). In 2017, Jeune S3 supplied 249,074 condoms to health centres. It is also developing innovative ways to distribute contraceptives in hard-to-reach areas with technical support from I+ Solutions.

More information on Jeune S3

Jeune S3 website with background information and young people’s personal stories.

UNFPA supplies programme

More information on the UNFPA supplies programme

Family Planning 2020 initiative

The worldwide Family Planning 2020 initiative

The Global Fund to Fights AIDS, Tuberculosis and Malaria (GFATM)

The Global Fund to Fights AIDS, Tuberculosis and Malaria (GFATM)

UNAIDS

UNAIDS background and data

Netherlands Enterprise Agency

Site of the Netherlands Enterprise Agency with more information on the PDPs

Access to Medicines Foundation

Access to Medicines Foundation

GAVI

GAVI Access to Medicine

Quality of health care

Source: AMREF Flying Doctors

Better public and private health care, in particular for family planning, pregnancy and childbirth, including safe abortions

Robust SRHR, including treatment for HIV/AIDS, can only be delivered if there is a properly functioning health system. The Netherlands contributes to strengthening health systems worldwide with special attention to family planning and the quality of care during pregnancies, births and safe abortions.

To ensure sustainable health systems, it is important that the relevant countries themselves give more guidance regarding what is needed. They also have the option to involve the private sector more actively.

The Netherlands is also committed to strengthening life-saving SRHR including HIV/AIDS care in humanitarian and fragile settings.

Open result area

Source: AMREF Flying Doctors

A well-functioning health system is indispensable for ensuring proper SRHR. Some 830 women die every day from conditions related to pregnancy or childbirth. In almost all cases, this could be prevented with a properly functioning health system.

Strengthening health systems

Large global funds such as the Global Fund for Aids, Tuberculosis and Malaria (GFATM) and GAVI contribute to strengthening health systems through disease-specific programmes. The United Nations Population Fund (UNFPA) and the World Health Organization (WHO) are also working on improving systems, for example by training health workers, drawing up guidelines for prevention, treatment of disorders and research into better interventions.

Pregnancy and birth-related care

The United States’ Mexico City Policy, adopted in January 2017, has put pressure on the financing of SRHR services, including safe abortions. Partly thanks to additional support, for instance by and through the SheDecides movement, the Netherlands has been able to compensate for the shortfall in care in a number of countries. We have also argued for less dependence on donors, more self-reliance and sustainable financing of health care.

Role of the private sector

The private sector is an important sector that can provide health care directly, or can contribute to innovation in health care. Through Triggerise, for example, micro-entrepreneurs offer accessible care.

Health among vulnerable groups and in humanitarian settings

The Netherlands has ensured that health is included in the programmes being implemented among vulnerable groups and in humanitarian and fragile settings. MSI is a partner that actively supplies SRHR products and services in countries in crisis. In Yemen for example, the Dutch programmes offer SRHR products and services as well as mental health services.

Results

Indicator

Number of safe abortion and post-abortion care services provided

Progress

On track

The Netherlands funded 2,081,823 safe abortion and post-abortion care services. These were provided by partners such as MSI, IPAS and IPPF member organisations, as well as many other providers working through embassy programmes. In addition, care providers have been trained, technical support provided and infrastructure improved to guarantee robust abortion and post-abortion care.

Ideally, this number should be small, due to people having access to modern contraceptives to help them avoid unwanted pregnancies. But if an abortion is performed, it should be safe. More providers of safe abortion and post-abortion care can mean that people have better access to safe care. However, it can also mean that people do not have access to modern birth control, for example because it is unavailable where they live, it is out of stock or its use is taboo. This can lead to more unwanted pregnancies and therefore more abortions.

Indicator

Health workers trained in prenatal care, maternity care, obstetrics and abortion care

Progress

On track

Good prenatal care and the presence of highly qualified personnel during childbirth make a major contribution to reducing maternal mortality.

The percentage of deliveries supervised by qualified health-care staff is 59% in Sub-Saharan Africa. In the rest of the world, it varies from 68 to 99%. It remains important to train staff that can provide high-quality care.

Progress in result area Quality of health care

Strengthening of health systems

Nearly 30% of the total GFATM budget is spent on strengthening health systems. While the progress made so far has been good, it could be even better, especially in countries that will soon be too wealthy to rely on a financial contribution from GFATM and will have to finance their own health systems .

Through country programmes, the Netherlands helps governments to make their health systems stronger and better. This is going well in Ethiopia and Bangladesh, in particular, and also in Burundi, where almost every health district now has at least two trained health professionals that specialise in stock management. As a result, 75% of facilities have a sufficient stock and choice of contraceptives. In Mali, however, the implementation of the national plan is lagging behind, partly due to increased insecurity.

Care related to pregnancy and childbirth

Where possible, the Netherlands has compensated for the gaps in the financing of abortion care that have arisen due to the Mexico City Policy. For example, the financing of the Family Guidance International Association in Ethiopia has been largely taken over by the Netherlands, ensuring continued SRHR care for thousands of sex workers.

International NGOs, such as the Safe Abortion Action Fund (SAAF), MSI, IPPF and IPAS, have also continued support to local initiatives in places like Mali and Zimbabwe, despite the Mexico City Policy. Increased conservatism in Yemen has led to the closure of facilities, but has not changed the continuing high need for care and contraceptives. Given the difficult context, it is still remarkable how good the results of MSI and others are.

Role of the private sector

With few exceptions, the lack of market incentives means it remains difficult to scale up health-care innovations. The efforts of the international business community to achieve SRHR objectives are also falling short of expectations. Innovations in health sector financing may be a way to involve the private sector more.

Health among vulnerable groups and in humanitarian settings

There has been increasing attention to health care and the provision of SRHR products and services among vulnerable groups and in humanitarian and fragile settings. Programmes are increasingly taking the specific issues into account and health and SRHR are included more often, both in practice and in discussions. In addition, efforts are being made to strengthen policies against sexual violence and for better mental health services in humanitarian and fragile settings.

PharmAccess

The PharmAccess Foundation uses digital platforms to connect health-care providers. This creates greater transparency: it is clearer in advance which care is reimbursed and offers better accountability for services provided (and paid for) afterwards. The data generated also contributes to improving the quality and effectiveness of care.

Mobile technology makes it possible to finance healthcare differently and with low transaction costs, for example through digital health insurance or mobile health contracts. Loans can also be provided to private health-care providers, enabling them to improve the quality of their care. Finally, this technology can be used to introduce international standards for safe care.

PharmAccess quality programme

Read more on how digital technology promotes financing and quality of care.

Triggerise

Triggerise develops digital platforms that motivate young people to make the right choices for their own health and makes it possible to request customised care. Moreover, it gives young people a small financial contribution if they recruit other young people for the provision of care. This creates a network that not only supports individual young people with their health, but also improves their economic position – something that is especially important in the case of girls and young women. In addition, the platform collects up-to-date information on behaviour so that the services offered can be better tailored to users. More than 200,000 girls and women are active in the network in Kenya alone.

More information on the Ignite approach

This site describes how PSI and Triggerise work together in Kenya and India to provide young people with easier access to birth control and safe abortions.

Global Fund for AIDS, Tuberculosis and Malaria

Global Fund for AIDS, Tuberculosis and Malaria

GAVI Vaccine Alliance

GAVI Vaccine Alliance

Global Financing Facility

Global Financing Facility

Marie Stopes International

Marie Stopes International

IPAS Health, Access, Rights (IPAS)

IPAS Health, Access, Rights (IPAS)

International Planned Parenthood Federation

International Planned Parenthood Federation

Safe Abortion Action Fund

Safe Abortion Action Fund

Population Services International

Population Services International

WHO’s Human Reproduction Programme

WHO’s Human Reproduction Programme

Interagency Working Group on Reproductive Health in Crises

Interagency Working Group on Reproductive Health in Crises

Dutch subsidies fund Life Sciences & Health for Development

Results of the Dutch subsidies fund Life Sciences & Health for Development

Rights and respect

During the international AIDS conference, sex workers from many countries participated in a protest and called on governments to introduce better legislation and policies to protect their safety. Source: International AIDS Society – Marten van Dijl

More respect for the sexual and reproductive rights of all individuals

More respect for the sexual and reproductive rights of all individuals and, in particular, those whose rights are often disregarded means less stigma and violence, better services, fewer HIV infections, greater gender equality and better health for all.

The Netherlands has achieved a great deal in this field. It has encouraged countries to amend discriminatory laws and policies. Through diplomacy, the Netherlands has contributed to the launch of new international guidance for comprehensive sexuality education. The international AIDS conference organised by the Netherlands included special attention for the rights of women, young people and key populations.

Open result area

During the international AIDS conference, sex workers from many countries participated in a protest and called on governments to introduce better legislation and policies to protect their safety. Source: International AIDS Society – Marten van Dijl

The Netherlands has made a great deal of progress in promoting freedom of choice for all individuals. The Netherlands leads the way as an advocate of sexual and reproductive rights – something that was clearly noticeable during the AIDS 2018 international conference organised in Amsterdam in July 2018. Great attention was paid to the rights of women, young people and key populations, such as sex workers, drug users and men who have sex with men. More young people attended the conference than ever before.

Laws and policies

Guidelines, laws and policies often stand in the way of the freedom of choice of certain groups. International and social partners in the Netherlands are committed to changing this. For example, the PITCH partnership in Kenya helped to change legislation that permitted anal examinations of men suspected of same-sex conduct. In Indonesia, the Ministry of Health is now supporting access to birth control for unmarried women – which used to be illegal – among others through the Right Here Right Now partnership. In May 2018, a large majority in Ireland voted in favour of legalising abortion.

Diplomacy

The Netherlands contributes to freedom of choice through silent and loud diplomacy. For example:

In January 2018, the Netherlands contributed to the successful launch of new United Nations guidance on comprehensive sexuality education. These help governments and organisations worldwide to include comprehensive sexuality education in their policies.

She Decides has continued to grow and now has 120,000 friends from 183 countries and 41 Champions.

In May 2018, the Guttmacher-Lancet Commission published an important report featuring scientific data and concrete recommendations that enable countries to integrate sexual and reproductive rights into their health systems, for example.

Following the international AIDS conference and at the initiative of the Netherlands, ministers from Eastern Europe and Central Asia exchanged experiences concerning HIV and AIDS in their respective regions.

Results

Indicator

Satisfaction of partners concerning the extent to which barriers to the SRHR of discriminated-against and vulnerable groups have been reduced in their focus countries

Progress

Progress, not on track

There are improvements, however, policy, cultural and religious barriers remain. There is still a lot of work to be done in all countries.

A range of partnerships aim to remove the barriers that make access to sexual health, awareness and services more difficult, especially for vulnerable groups, such as young women, LGBTI people, men who have sex with men and sex workers. Despite improvements, however, policy, cultural and religious barriers still exist. In Ethiopia, Niger, Benin and Mozambique, there were fewer successes than expected. There is still a lot of work to be done in all countries.

We achieve our results with our partners. We find it very important to hear from the partners themselves on how their work is valued and the contribution they make to the respect, protection and attainment of universal access to SRHR, including HIV/AIDS care.

An online survey has shown that the partnerships are well embedded in the communities in which they work. While this has contributed to the removal of some barriers, discriminatory practices persist: there is still substantial resistance to allowing access to SRHR for discriminated and vulnerable groups, and this has even increased in some countries.

More progress has been made in the removal of knowledge barriers. In addition to providing comprehensive sexuality education, the partners are helping to make people more aware of their right to high-quality sexual and reproductive and other health services. They are also raising awareness among communities of the negative consequences of excluding certain groups.

AmplifyChange

The Netherlands contributes to AmplifyChange’s multi-donor fund. This fund focuses on improving sexual and reproductive rights, especially among young people, girls and disadvantaged groups. More than 30% of the organisations that receive funding from AmplifyChange are active in countries in which freedom of choice and women's rights are poorly respected. An example is the Nigerian Safehaven Development Initiative, which aims to put an end to female genital mutilation in a region of Nigeria where it is common. The initiative stimulates discussion through radio shows and information dissemination and co-operates with the local government to include messages about female genital mutilation in vaccination campaigns. It has already shown results: following discussions between the community and local government leaders, the Ebam-Borum community in Boki decided to replace female genital mutilation with an alternative ritual.

Hear the voices of our beneficiaries

The video shows an anthology of AmplifyChange projects and how they contribute to the freedom of choice of young people, women, girls and other groups whose rights are often disregarded.

SheDecides

SheDecides website

Guttmacher-Lancet Commission Report on SRHR

Guttmacher-Lancet Commission Report on Sexual and Reproductive Health and Rights

UNESCO International Technical Guidance on Sexuality Education

UNESCO International Technical Guidance on Sexuality Education

Website of the International AIDS Conference 2018

Website of the International AIDS Conference 2018

AmplifyChange

AmplifyChange

Image: Carel de groot

Background information theme sexual and reproductive health and rights including HIV / AIDS

Background

The results show that there is added value in combining advocacy, service provision, research, innovation and policy implementation at local, national and international level.

The Dutch approach, which is based on human rights and in collaboration with like-minded people, has shown to be effective. We are working on achieving the same results in seven partner countries. Thanks in part to our understanding of local contexts and co-operation with local partners we are achieving good results at country level.

A remaining challenge – certainly for the large health funds and UN organisations – is to reach all individuals in need, especially among vulnerable groups, in rural areas but increasingly also in urban centres. This requires a tailored, innovative approach. National health funding is lagging behind and focus on sustainability and personal responsibility requires constant attention.

Progress is generating more resistance to SRHR among certain groups. Changed opportunities and future prospects for women and girls can be difficult to accept for those who prefer not to see change, often because they want to hold on to their own position of power.

Glimpse into the future

SRHR remains one of the themes of development policy. However, the deployment of the relevant policies will shift to achieving more results related to the fields of focus stated in the policy document. This includes intensifying efforts in focus regions such as West Africa and an even stronger commitment to freedom of choice and the rights of women and girls.

It is important that the Netherlands continues to deliver its distinctive added value in the field of SRHR, including HIV/AIDS, so that women, girls, young people and other vulnerable groups are given the choice to shape their own lives. The Netherlands focuses on areas in which we can really make a difference.

We try to address resistance and barriers to SRHR or to start productive conversations on these topics. This requires us to understand the resistance and barriers, enabling us to achieve even better results in the future for the sexual and reproductive health and rights of all individuals.

Additional sources

Facebook page

Follow this theme on Facebook

Evaluation by the Policy and Operations Evaluation Department

Read the evaluation by the Policy and Operations Evaluation Department (IOB) of the SRHR theme for 2007-2012

Expenditure by channel

Expenditure