Sexual and reproductive health and rights in the sustainable development goals and the post-2015 development agenda: less than a year to go.

Since the International Conference on Population and Development (ICPD) in Cairo in 1994 there have been significant achievements in moving towards the goal of sexual and reproductive health and rights. Yet there have also been disappointments, as demonstrated in the Millennium Development Goals, even though in 2007 a target on reproductive health was added. Most recently, the 20-year review of the implementation of the ICPD Programme of Action, ICPD Beyond 2014, has taken place, which has moved forward the sexual and reproductive health and rights agenda. But, the main arena for future negotiations has changed and the UN is in the process of negotiating the post-2015 development agenda and the sustainable development goals (SDGs). This paper assesses what has been taking place since 2013 and provides information as to how the process for the post-2015 development agenda and the SDGs are likely to move forward. An understanding of what has been achieved, the processes as they are now proceeding and their future development are important for moving towards the ultimate goal of achieving sexual and reproductive health and rights in the next 15 years.

Ensuring the inclusion of sexual and reproductive health and rights under a sustainable development goal on health in the post-2015 human rights framework for development.

Since the 1994 International Conference on Population and Development (ICPD) in Cairo placed reproductive health and rights firmly on the international agenda, civil society and other advocates have worked ceaselessly to ensure that they remain central to women's empowerment and have taken all opportunities to expand the framework to include sexual health and rights. When the development process changed with the introduction of the Millennium Development Goals (MDGs) in 2000, sexual and reproductive health and rights were excluded, and only in 2007 was universal access to reproductive health added back in. In 2014 and 2015, the future of ICPD Beyond 2014, the MDGs and the post-2015 development framework will be decided, following consultations and meetings across the globe. This paper takes stock of the key influences on efforts to achieve the ICPD agenda and summarises the past, current and planned future events, reports and processes between 1994 and 2014, leading up to the determination of the post-2015 development framework and sustainable development goals. It concludes that the one thing we cannot afford to allow is what happened with the MDGs in 2000. We must not leave the room empty-handed, but must instead ensure the inclusion of sexual and reproductive health and rights as a priority under a new health goal.

Integrating sexual and reproductive rights into the medical curriculum.

All individuals and couples are entitled to enjoy reproductive rights, which are guaranteed through human rights that are already recognized in national laws, international human rights documents and other consensus documents. Indeed, they are essential for the attainment of the goal of the International Conference on Population and Development Goal of universal access to reproductive health through the primary healthcare system by 2015. However, reproductive rights are usually absent from the undergraduate curriculum in medical schools. This chapter examines the components that should be included in the curriculum, and ways in which reproductive rights can be integrated into medical education.

Implementing the ICPD Programme of Action: what a difference a decade makes.

The Programme of Action adopted at the International Conference on Population and Development in Cairo in 1994 was conceived as a 20-year programme. Now, at its mid-point in 2004, we have reached a time for assessment and re-commitment to its goals. This paper is a reflection on some of the political and other changes that have taken place during the first ten years of the Programme of Action and their implications for its implementation in the coming decade. Many countries have gone ahead and integrated sexual and reproductive health services into primary health care, whether or not the concept has been supported at the international level, and are doing what they can to accommodate the needs of those requiring information and services. The shape of the "playing field" has changed in the past ten years and the goal posts have moved. Yet many countries are adjusting and adapting. The big question, which has yet to be answered, is whether the international community will help or hinder the efforts at country level to achieve the goal of access for all to sexual and reproductive health by 2015.

Incorporating sexual and reproductive health care in the medical curriculum in developing countries.

Medical educators have a responsibility to train physicians and other health professionals in the core competencies needed to improve the sexual and reproductive health of their communities. Yet sexual and reproductive health care is significantly under-represented in the basic educational curriculum for medical and other health professionals, as well as in continuing medical education and professional development programmes for practising physicians and other health professionals. The Commonwealth Medical Association Trust is developing a model curriculum on sexual and reproductive health that can be integrated into undergraduate medical education and used with appropriate amendments for continuing medical education. This paper outlines topics for inclusion in the curriculum and three strategies for incorporating core components of sexual and reproductive health in the curriculum--by developing themes that can be integrated into the general curriculum in a multi-disciplinary fashion, adding free-standing modules as electives, and delegating cross-cutting issues such as gender issues and adolescent reproductive health to courses run by other departments. It argues for the use of problem-solving and case-based learning methodologies, as well as lectures, as the best way to teach health professionals how to provide information, counselling and support for sexual and reproductive health, as well as to cover the range of prevention and treatment needs of women and men seeking these services.