Condensed: Sexual and reproductive health care services are a critical component of the right to health. The right to sexual health includes the right to seek, receive and impart information related to sexuality, sexuality education, respect for bodily integrity, free choice of partner and whether to be sexually active or not as well as access to sexual health care services. Such services include voluntary testing, counseling and treatment for sexually transmitted infections, including HIV/AIDS. The right to reproductive health requires States to provide access to reproductive health services (family planning), pre- and post-natal care and emergency obstetric services, which should be free where necessary. States should also ensure access to voluntary testing, counseling and treatments for breast and reproductive system cancers as well as infertility treatment. To make informed choices about reproductive health requires access to information as well as to resources necessary to act on that information. Comprehensive: Article 12(1) of the ICESCR provides for the ‘right of everyone to the enjoyment of the highest attainable standard of physical and mental health.’ The right to sexual and reproductive health is a component of the right to health.[1] Sexual health is is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.[2] The right to sexual health includes the right to seek, receive and impart information related to sexuality, sexuality education, respect for bodily integrity, free choice of partner and whether to be sexually active or not as well as access to sexual health care services.[3] Such services include voluntary testing, counseling and treatment for sexually transmitted infections, including HIV/AIDS.[4] Reproductive health means that women and men have the freedom to decide if and when to reproduce and the right to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice as well as the right of access to appropriate health-care services that will, for example, enable women to go safely through pregnancy and childbirth.[5] CEDAW requires States to ensure that women have appropriate ‘services in connection with pregnancy, confinement and the post-natal-period, granting free services where necessary as well as adequate nutrition during pregnancy and lactation.’[6] The right to reproductive health requires States to provide access to reproductive health services (family planning), pre- and post-natal care and emergency obstetric services.[7] States should also ensure access to voluntary testing, counseling and treatmentas for breast and reproductive system cancers, as well as infertility treatment.[8]To make informed choices about reproductive health requires access to information ‘as well as to resources necessary to act on that information.’[9] In AS v Hungary, the CEDAW Committee concluded that the failure of the government to provide necessary information to a woman to enable her to give consent to be sterilised violated CEDAW.[10] (See *forced pregnancy, forced abortion, forced sterilisation*). States must ensure that sexual and reproductive health care facilities, goods and services are not only sufficiently available but also physically and economically accessible to all, including adolescents and minors without discrimination.[11] Health centres providing reproductive health services should be available in rural areas and equitably distributed in the country. The state should not charge high user fees making essential drugs, contraceptives or pre or post natal services unaffordable for the poor. States are required to provide for the performance of certain sexual and reproductive health services for women having regard to the biological, socio-economic, and psychosocial factors that differ for women in comparison to men.[12] Access to reproductive health services (family planning) allows women and men to control the number and spacing of children. The denial of access to reproductive health services exposes women to having unwanted pregnancies. Accordingly, States must provide access to accurate information on contraceptives and other means of preventing unwanted pregnancies. In addition adolescents should have access to information on the dangers of early marriages and pregnancy.[13] Where abortion is legal, the state must provide access to safe abortion.[14] In KL v Peru the HRC affirmed the right of women to abortion in cases where pregnancy threatens their physical or mental health and concluded that the state was in breach of its obligations if it denied access to therapeutic abortion permitted by its own law.[15] The legal prohibition or criminalization of abortion in all circumstances is not only against sexual and reproductive freedom but also inconsistent with the right to health.[16]
[1] See CEDAW art 12(2); CEDAW General Recommendation 24 para 1; African Women’s Protocol art 14(1); CESCR General Comment 14 para 8: … The right to health contains both freedoms and entitlements. The freedoms include the right to control one's health and body, including sexual and reproductive freedom… ;
[4] Report of the Special Rapporteur on Health Paul Hunt UN Doc E/CN.4/2004/49 para 29.
[5] CESCR General Comment 14 fn 12. See also the definition of reproductive health in International Conference on Population and Development Programme of Action UN Doc A/CONF.171/13 (1994) para 7.2.
[13] CRC General Comment 4 para 28. In Carey v Population SCVS the US Supreme Court held as unconstitutional a law that sought to restrict the sale of contraceptives to minors.
[14] Report of the Special Rapporteur on Health Paul Hunt para 30 UN Doc/ E/CN.4/2004/49; The African Women’s Protocol art 14(2)(c) provides for medical abortions in cases of sexual assault, rape, incest, and where continued pregnancy endangers the life of the mother or that of the foetus.
[16] Report of the Special Rapporteur on Health Paul Hunt UN Doc/ E/CN.4/2004/49 para 30. The Protocol to the African Charter on Human and Peoples Rights on the Rights of Women in Africa affirms in art 14(c) the right of women to medical abortion in cases of ‘sexual assault, rape, incest and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus.’
Sexual and reproductive health care services are a critical component of the right to health. The right to sexual health includes the right to seek, receive and impart information related to sexuality, sexuality education, respect for bodily integrity, free choice of partner and whether to be sexually active or not as well as access to sexual health care services. Such services include voluntary testing, counseling and treatment for sexually transmitted infections, including HIV/AIDS.
The right to reproductive health requires States to provide access to reproductive health services (family planning), pre- and post-natal care and emergency obstetric services, which should be free where necessary. States should also ensure access to voluntary testing, counseling and treatments for breast and reproductive system cancers as well as infertility treatment. To make informed choices about reproductive health requires access to information as well as to resources necessary to act on that information.
Comprehensive:
Article 12(1) of the ICESCR provides for the ‘right of everyone to the enjoyment of the highest attainable standard of physical and mental health.’ The right to sexual and reproductive health is a component of the right to health.[1]
Sexual health is
is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.[2]
The right to sexual health includes the right to seek, receive and impart information related to sexuality, sexuality education, respect for bodily integrity, free choice of partner and whether to be sexually active or not as well as access to sexual health care services.[3] Such services include voluntary testing, counseling and treatment for sexually transmitted infections, including HIV/AIDS.[4]
Reproductive health
means that women and men have the freedom to decide if and when to reproduce and the right to be informed and to have access to safe, effective, affordable and acceptable methods of family planning of their choice as well as the right of access to appropriate health-care services that will, for example, enable women to go safely through pregnancy and childbirth.[5]
CEDAW requires States to ensure that women have appropriate ‘services in connection with pregnancy, confinement and the post-natal-period, granting free services where necessary as well as adequate nutrition during pregnancy and lactation.’[6]
The right to reproductive health requires States to provide access to reproductive health services (family planning), pre- and post-natal care and emergency obstetric services.[7] States should also ensure access to voluntary testing, counseling and treatmentas for breast and reproductive system cancers, as well as infertility treatment.[8]To make informed choices about reproductive health requires access to information ‘as well as to resources necessary to act on that information.’[9] In AS v Hungary, the CEDAW Committee concluded that the failure of the government to provide necessary information to a woman to enable her to give consent to be sterilised violated CEDAW.[10] (See *forced pregnancy, forced abortion, forced sterilisation*).
States must ensure that sexual and reproductive health care facilities, goods and services are not only sufficiently available but also physically and economically accessible to all, including adolescents and minors without discrimination.[11] Health centres providing reproductive health services should be available in rural areas and equitably distributed in the country. The state should not charge high user fees making essential drugs, contraceptives or pre or post natal services unaffordable for the poor. States are required to provide for the performance of certain sexual and reproductive health services for women having regard to the biological, socio-economic, and psychosocial factors that differ for women in comparison to men.[12]
Access to reproductive health services (family planning) allows women and men to control the number and spacing of children. The denial of access to reproductive health services exposes women to having unwanted pregnancies. Accordingly, States must provide access to accurate information on contraceptives and other means of preventing unwanted pregnancies. In addition adolescents should have access to information on the dangers of early marriages and pregnancy.[13]
Where abortion is legal, the state must provide access to safe abortion.[14] In KL v Peru the HRC affirmed the right of women to abortion in cases where pregnancy threatens their physical or mental health and concluded that the state was in breach of its obligations if it denied access to therapeutic abortion permitted by its own law.[15] The legal prohibition or criminalization of abortion in all circumstances is not only against sexual and reproductive freedom but also inconsistent with the right to health.[16]
[1] See CEDAW art 12(2); CEDAW General Recommendation 24 para 1; African Women’s Protocol art 14(1); CESCR General Comment 14 para 8: … The right to health contains both freedoms and entitlements. The freedoms include the right to control one's health and body, including sexual and reproductive freedom… ;
[2] WHO Defining sexual health (2006) 5.
[3] As above.
[4] Report of the Special Rapporteur on Health Paul Hunt UN Doc E/CN.4/2004/49 para 29.
[5] CESCR General Comment 14 fn 12. See also the definition of reproductive health in International Conference on Population and Development Programme of Action UN Doc A/CONF.171/13 (1994) para 7.2.
[6] Article 12(2).
[7] CESCR General Comment 14 para 14
[8] Report of the Special Rapporteur on Health Paul Hunt UN Doc E/CN.4/2004/49 para 29.
[9] CESCR General Comment 14 para 14.
[10] Communication 4/2004 (CEDAW 2006) para 11.3.
[11] CESCR General Comment 14 para 22
[12] CEDAW General Recommendation 24 paras 11-12.
[13] CRC General Comment 4 para 28. In Carey v Population SCVS the US Supreme Court held as unconstitutional a law that sought to restrict the sale of contraceptives to minors.
[14] Report of the Special Rapporteur on Health Paul Hunt para 30 UN Doc/ E/CN.4/2004/49; The African Women’s Protocol art 14(2)(c) provides for medical abortions in cases of sexual assault, rape, incest, and where continued pregnancy endangers the life of the mother or that of the foetus.
[15] Communication 1153/2003 (HRC 2005) para 6.4.
[16] Report of the Special Rapporteur on Health Paul Hunt UN Doc/ E/CN.4/2004/49 para 30. The Protocol to the African Charter on Human and Peoples Rights on the Rights of Women in Africa affirms in art 14(c) the right of women to medical abortion in cases of ‘sexual assault, rape, incest and where the continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus.’