Focus on young people

The Netherlands has long focused on the sexual and reproductive health and rights of young people, aiming to give them more access to accurate information on sexuality and to resources so that they can make their own choices, deciding whether and when they want to have children, how many and with whom, and whether, when and whom they marry.

To enjoy freedom of choice, young people not only need to know about sexuality, they also need access to contraception and healthcare services. At the same time, it is important that all involved have access to accurate information. It is sometimes very difficult for young people to make decisions that do not meet with the approval of their parents and key groups in their community. These include choices concerning contraception or arranged marriages for girls. Parents, teachers, religious leaders, health workers and other adults in the community therefore also need access to information.

It is not always easy to initiate discussion of these issues. However, our local partners know precisely how to conduct such discussions. They enter into dialogue with religious leaders on the prohibition of child marriage and with health workers on youth-friendly health centres. They also train teachers to make school safer for girls.

Youth participation

Young people themselves are often best placed to explain to adults what they need, but their needs are not always taken seriously. The Netherlands is therefore investing in meaningful participation by young people in decision-making, ensuring their views are considered in policy. This is the only way we can be sure that policy is in line with the reality experienced by young people in the programmes on which we focus. Our programmes got 1.5 million young people involved in SRHR activities, and 30,788 young people took part in policy- and decision-making bodies.

Results

Contraceptives

The availability of contraceptives gives women and girls more options in terms of education, work, sexuality and family size. Contraceptive use is an important precondition for gender equality. Since 2012, the number of contraceptive users in the 69 poorest countries has increased by 53 million. Last year alone, use of contraceptives prevented 119 million unplanned pregnancies, 21 million unsafe abortions and 134,00 maternal deaths.

HIV treatment

HIV/AIDS still has a major impact on individuals and on socioeconomic developments. To prevent new infections and give people with HIV access to medication, the Netherlands invests in international programmes (such as Bridging the Gaps and the Partnership to Inspire, Transform and Connect the HIV response (PITCH)), organisations (such as the International HIV/AIDS Alliance and the Dutch Aids Fund) and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). There is a special Dutch focus on specific risk groups such as sex workers, intravenous drug users, transgender people, prisoners and men who have sex with men.

Medicines

The Netherlands helps in various ways to make medicines more readily available. Through Product Development Partnerships (PDPs), we invest in research into and development of cheaper effective medicines, vaccines and diagnostic tools for diseases that are prevalent mainly in poor parts of the world. The Netherlands also supports the Access to Medicines Index, a publicly accessible online index which charts the extent of pharmaceutical companies’ efforts to make drugs affordable and accessible to poor population groups. Furthermore, we contribute to the Vaccine Alliance Gavi to protect children in low-income countries by vaccinating them against dangerous diseases.

Results

Around 800 women per day around the world die during pregnancy or childbirth, or shortly afterwards. Most of these deaths could be prevented with a properly functioning basic healthcare system. The sharp fall in HIV globally is due largely to specific measures to combat HIV. In some cases, however, this has diverted attention from other diseases. It is therefore important that systems be strengthened across the entire spectrum, and to ensure that everyone who needs medical care receives it.

Strengthening health systems

Large global funds such as the Global Fund to Fight Aids, Tuberculosis and Malaria (GFATM), the Vaccine Alliance Gavi and the Global Financing Facility (GFF) are making growing contributions to strengthening health systems through 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, conducting research into new or better medicines and other interventions.

Healthcare during pregnancy and childbirth

The United States’ Mexico City Policy (MCP) has put further pressure on the financing of SRHR services, including safe abortion. Dutch support for organisations that provide these services is now even more important, to continue guaranteeing good abortion- related services.

Health among vulnerable groups and in humanitarian situations

An estimated 60% of preventable maternal deaths occur in fragile and humanitarian settings. Access to safe abortion is often even more difficult in such circumstances, because of limited resources or social stigma for example. The Netherlands has ensured that sexual health is included in programmes being implemented in these difficult circumstances.

Sexual and reproductive rights for all are of great importance to the Netherlands. The international community agreed on these rights over 25 years ago. They are now in jeopardy, however. Nevertheless, the Netherlands has achieved a great deal, working with civil society and multilateral partners and with a network of like-minded countries from all regions. Laws and policies have been amended, rights are now better enshrined in international agreements, and a growing number of countries are defending these rights at the United Nations.

Laws and policies

Guidelines, laws and policies often stand in the way of freedom of choice for certain groups. The Netherlands’ international and civil society partners are committed to changing this. The regional programme Hands Off! in southern Africa successfully lobbied for a training manual for the South African police on the needs and rights of sex workers, LGBTI people and people who use drugs. In Nepal, thanks in part to the influence of the Right Here Right Now programme, a new law was adopted on safe maternity and reproductive health, with a reference to safe abortion. The JeuneS3 programme in Cameroon managed to persuade health clinics to introduce more flexible opening hours, making them much more accessible for young people.

Diplomacy

The Netherlands uses quiet, regular and public diplomacy in the interests of freedom of choice. Last year it mainly responded to the growing international pressure against sexual and reproductive rights. Dutch efforts in support of these rights in international negotiations resulted in a strongly-worded paragraph in the Political Declaration on Universal Health Coverage which calls on all countries, throughout the world, to ensure that everyone has access to sexual and reproductive health services. In June 2019 the UN Human Rights Council adopted a resolution on child, early and forced marriage promoted by the Netherlands. It drew specific attention to women and girls who are victims of child, early and forced marriage. The Netherlands also mobilised countries from several regions to stand up for sexual and reproductive rights at the UN. Minister for Foreign Trade and Development Cooperation Development and foreign trade minister Sigrid Kaag read a statement on these rights on behalf of 58 countries at the High-Level Meeting on Universal Health Coverage, which was featured in the Dutch media.

25th anniversary of ICPD

2019 saw the celebration of the 25th anniversary of the Programme of Action of the International Conference on Population and Development (ICPD). It was agreed in 1994 that everyone has the right to choose whether, when and how many children they want. At the meeting of the Commission on Population and Development (CPD) at the UN in New York the member states unanimously adopted a Political Declaration reaffirming their commitment to the Programme of Action, including freedom of choice. There, too, the Netherlands mobilised 50 countries to sign a joint declaration stressing the importance of this right.