The FCDO’s approach to sexual and reproductive health – Report Summary

This is a House of Commons Committee report, with recommendations to government. The Government has two months to respond.

Author: International Development Committee

Related inquiry: FCDO’s approach to sexual and reproductive health

Date Published: 25 January 2024

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Sexual and reproductive health and rights (SRHR) worldwide are vital for saving lives and achieving gender equality. Where a woman lives determines the likelihood of her and her baby surviving pregnancy and childbirth. In 2020, nearly 300,000 women died from pregnancy and childbirth globally, with almost 95% of maternal deaths taking place in low-income and lower-middle-income countries and around 70% occurring in Sub-Saharan Africa. In the same year, 2.4 million children died in their first month of life, with 43% of deaths occurring in Sub-Saharan Africa and 36% in central and southern Asia. Sexual and reproductive health must be seen as an issue of deep global inequality.

The Committee is proud that the UK has been a longstanding supporter of SRHR through its diplomatic support and aid programming. The UK has long supported organisations working on SRHR such as the United Nations Population Fund, which provides contraceptives, works to avert unsafe abortion, and supports support for maternal and newborn health. SRHR programmes are a ‘best buy’: they save the lives of women and babies and empower women by giving them choice about whether and when to have children.

Since 2020, the UK has slashed its spending on SRHR. This has had a devastating impact on the Foreign, Commonwealth and Development Office’s (FCDO) work on sexual and reproductive health. The FCDO cut the budgets of existing projects and cancelled others, often with little to no notice. It reduced funding to multilateral organisations working on sexual and reproductive health, including the United Nations Population Fund, UNAIDS and the Global Fund. The cuts had the deepest impact on the most marginalised, particularly affecting women and girls and people with disabilities. This damaged both the relationship between implementing partners and aid recipients, and the UK’s reputation as a credible and serious partner in advancing SRHR globally.

In light of the damage of these cuts, the UK Government should set targets for its bilateral spending on sexual and reproductive health and commit to consistent and multiyear funding. It should also adhere to its prior commitments to multilateral funds and raise discretionary funding to the same levels as pre-covid-19.

To build good health systems, the Committee heard that countries need three core elements: development of health personnel, medical education and training, and basic health infrastructure. The UK should commit to define spending levels on the development of health personnel in low-and-middle-income countries, as well as prioritising the development of health infrastructure. This should include a focus on infrastructure supporting access to water, sanitation and hygiene facilities (WASH).

UK aid programming would also benefit from a more integrated and complementary approach between different but overlapping aspects of sexual and reproductive health. For example, integrating services aimed at treating and preventing HIV and AIDS and those aimed at treating and preventing female genital schistosomiasis into SRHR service delivery offers benefits for women’s health and wellbeing, as well as accessibility, time and cost savings. There is also opportunity to integrate programming on SRHR with other aid programming such as on education and on WASH.

It is also vital that the UK includes marginalised and hard-to-reach people in the planning, development and delivery of SRHR aid programming. The FCDO should ensure that aid programme targets do not inadvertently have a de-incentivising effect in reaching the most marginalised. The merger of the Foreign and Commonwealth Office and the Department for International Development is an opportunity for the UK to better use its diplomatic work to support its development objectives on SRHR, including for marginalised groups.