current issues

• repoliticising sexual and reproductive health and rights – november 2011

In August 2010, a group of activists and researchers in the field of sexual and reproductive health and rights met in Langkawi, Malaysia, to discuss growing concerns about the fragmentation of work in the field and the absence of a collective critique of where it is heading. A report of that meeting was published in early 2011. The meeting found that there has been a backlash against many of the gains in sexual and reproductive health and rights made since the 1990s. The universality of human rights is being challenged. The comprehensive agendas of the Cairo and Beijing conferences were narrowed down and de-politicised in the Millennium Development Goals.  Attention to sexual health has been reduced mainly to surviving sex, and reproductive health to surviving pregnancy. Progressive donors have changed their agendas accordingly. Many NGOs, often the main advocates in the field, are being defunded. The papers in this journal issue show why the sexual and reproductive health and rights agenda needs to be re-politicised and re-prioritised – in countries and internationally.

• privatisation – may 2011

This is the second issue of RHM on privatisation in health systems and most of the qualitiative papers on this theme come from Asia and sub-Saharan Africa, including Bangladesh, India, Madagascar, Malawi, Nepal, Thailand, and in Europe from the Netherlands and Poland. They address the role of the public vs. the private sector in dealing with maternal mortality and morbidity, antenatal care and delivery, family planning, unsafe abortion, reproductive tract infections and gynaecological morbidity. They reveal how little is known about the standards of care in the private sector in middle- and low-income countries and even more starkly, just how much women and young people still have to depend on the so-called informal sector for any treatment and care at all, from traditional birth attendants to drug sellers. They reveal that not enough is being invested by countries in public health services or in the education and training of new generations of health professionals, and that the private sector does not appear to be making up for what the public sector is not providing and cannot afford to provide, especially for the poor and rural populations.

• privatisation – november 2010

Private health care used to be available only to the rich. Today, in almost every country, privatisation in health services, through deliberate policies, is taking place, in which the financing of health services and their ownership, management and training are being handed over to private sector entities. The private sector is seeing more and more patients, even in the poorest countries, and among the poor in more affluent societies, some funded through development aid. This is happening across sexual and reproductive health care, from small private hospitals offering antenatal and delivery care and NGO clinics offering safe abortion, to social marketing of contraception and much more, often alongside public services. The growth of the private sector has arisen from neoliberal economic policies, tied to development aid and loans, which require governments to hand over responsibility for health care to a range of organizations and agencies who may or may not work together and who may or may not agree to achieve a set of coherent, comprehensive public health goals and universal coverage. Privatisation has been aided by the failure of many public health systems to ensure universal access to health services with a good quality of care.

This journal issue also contains an in-depth analysis of second trimester abortion laws globally, the most up-to-date data on the extent of unsafe abortions globally, and papers on national abortion laws and policies in three countries and two major cities. In addition, there are two papers reporting research on the prevalence and consequences of violence during pregnancy and an evaluation of a domestic violence intervention in the maternity and sexual health services of a public hospital. Lastly, there is a paper on female genital mutilation and issues of sexuality, and a review of a new, comprehensive teaching resource for sexual and reproductive health for young people.