A/69/62
3.
Strengthen specific sexual and reproductive health services.
Contraception 503. The availability and accessibility of the widest possible range of contraceptive methods, including emergency contraception, with adequate counselling and technical information, to meet individuals’ and couples’ contraceptive needs and preferences across the life course, are essential for reproductive health and reproductive rights. Yet some countries provide only a few methods, or do not make options or information widely available that would enable individuals to exercise free and informed choice, especially where health systems are weak, for example in rural areas. Decisions about what contraceptive mix to provide must be calibrated to the capacity of health service providers, while also building the health system and the capacity of health workers to provide a range of methods to meet the needs and preferences for everyone across the life course. Abortion 504. With increasing access to safe abortion and post-abortion care, abortion rates as well as rates of abortion-related deaths have decreased globally, with significant regional variation. However, progress is inadequate as death rates resulting from unsafe abortion remain unacceptably high in Africa and South Asia, with more than half of these deaths occurring among young women under 25 years. Concrete measures are urgently needed to: (a) Reduce unplanned pregnancies by increasing access to contraception and fulfilling the rights of women and girls to remain free from forced or coerced sex and other forms of gender-based violence; (b) Ensure access to quality post-abortion care for all persons suffering from complications of unsafe abortion; (c) Take action as indicated in the WHO publication Safe Abortion: Technical and Policy Guidance for Health Systems, to remove legal barriers to services; (d) services.
Ensure that all women have ready access to safe, good-quality abortion
Maternity care 505. Ninety per cent of maternal deaths are preventable, and the elimination of all preventable deaths requires a well-functioning and integrated primary health-care system that is close to where women live; effective referral mechanisms to respond to complications of pregnancy and delivery; and the availability and accessibility of functioning basic and comprehensive emergency obstetric care. To achieve universal availability and accessibility of quality maternity care requires strengthening the health system, particularly in sub-Saharan Africa and South Asia. 506. For each woman who dies of a pregnancy-related complication, an estimated 20 women suffer serious and often lifelong morbidities such as obstetric fistula, uterine prolapse, incontinence or severe anaemia. Maternal morbidity and case fatality rates should be increasingly utilized as indicators of the quality of sexual and reproductive health services and the progressive realization of women’s right to health.
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