The year 2016 marks the starting point for the 2030 Agenda for Sustainable Development and the Sustainable Development Goals (SDGs) it aims to achieve. The 2030 Agenda, with its focus on interdependency and inclusiveness, serves as a new guide to align efforts for the universal realisation of Sexual and Reproductive Health and Rights (SRHR), and more generally gender equality, and the right to health. The universal goals demand action by all stakeholder groups, and close collaboration between stakeholder groups, to achieve a world that is sustainable, peaceful and prosperous and that leaves no one behind. SRHR is key to this vision. Experience with the implementation of previous goal sets related to SRHR, such as the Programme of Action of the International Conference on Population and Development (ICPD) and the Millennium Development Goals has shown that achievement of such goals is a persistent and enduring challenge.

With the High-level Political Forum (HLPF) as the main instrument for follow-up and review of the implementation of the 2030 Agenda, the UN system has established an open, inclusive, participatory and transparent process that will support reporting by all relevant stakeholders. The currently evolving architecture of accountability is complex in nature, consisting of efforts at national, regional and global levels, and includes UN functional commissions, multi-stakeholder and civil society initiatives. For the realisation of SRHR for all, accountability is an essential element: between governments, but also within countries, down to the level of communities, with all stakeholders involved.

This year’s International Dialogue on Population and Sustainable Development provided a timely opportunity to reflect on and discuss key themes for advancing accountability. Under the heading “Accountability to advance SRHR: Delivering on commitments together”, more than 100 key policy makers, experts and activists from all world regions working on SRHR came together to exchange best practices from national, regional and global follow-up and review mechanisms, and discussed how they can best be used for measuring progress in the realisation of SRHR in the context of the 2030 Agenda.

Parallel discussion groups brought forward the following recommendations, which are noted here to guide further reflections, action and policy decisions:

a. Address complexities and use synergies in the global accountability architecture

  • Identify opportunities to further coordinate and harmonise global accountability structures and instruments, addressing the complexity of the evolving SRHR accountability architecture under the SDGs.
  • Find ways to link the HLPF with ICPD follow-up mechanisms, with the Universal Periodic Review (UPR), the World Health Assembly and accountability mechanisms for women’s, children’s and adolescents’ health.
  • Incorporate international commitments, including SDGs and ICPD, in National Development Plans; aim to reduce the reporting burden on countries.

 b. Further strengthen reporting for international review fora

  • Involve relevant line ministries and local government units as well as key stakeholder groups in international reporting processes.
  • Enable meaningful participation of civil society and youth through improved country coordination and formalised, inclusive, and transparent processes.
  • Include information on implementation challenges in the narrative HLPF National Voluntary Review report, rather than focusing only on successes.
  • Initiate exchange between governments through regional and cross-regional HLPF-peer review elements for mutual support and peer-learning on strategies for improved SRHR results.
  • Encourage shadow reporting by Civil Society Organizations (CSO) to highlight emerging gaps. Explore options for shadow reports to be publicly available.
  • Aim for high-level participation (e.g. Ministers) in national delegations for stronger impact and promote CSO presence at all levels. 

c. Support in-country accountability

  • Support country-level follow-up of National Voluntary Reviews, ICPD follow-up and other regional and global accountability mechanisms. Use respective outcome documents and publicity for advocacy to support change at country level.
  • Promote accountability, responsibility and answerability of government to rights-holders at country level to counterbalance the non-binding nature of global commitments.
  • Build on existing in-country accountability mechanisms at national and sub-national level. These may include health committees and local health boards which ensure community participation in an oversight function of local health structures. Other examples include different kinds of audits such as maternal death audits and score card systems.
  • Consider using citizens’ hearings to surface issues that hamper SRHR implementation.
  • Develop platforms for improved dialogue between governments and relevant stakeholder groups, including CSOs, parliamentarians, religious and community leaders, the private sector and youth.
  • Capitalise on modern communication channels, including social media, to reach and educate a wider audience in order to mobilise citizens and to strengthen local follow-up.
  • Strengthen system-based accountability, remedy and course correction to ensure action when things do go wrong. While ensuring individual complaint mechanisms, protect the individual, for example by aggregating voices.

d. Make the case for SRHR

  • Adapt technical language to better communicate the components of SRHR and the SDGs for a wide audience at community level. Consider options for relabeling or re-packaging sensitive issues.
  • Clarify myths and misconceptions on SRHR to attract wider support and contribute to an open dialogue.
  • Showcase interlinkages between SRHR, human rights and population dynamics. Broaden reach and engage with sectors beyond health by connecting to other movements, including gender equality, inclusive societies, peace and human rights, climate change and economic justice groups.
  • Demonstrate how investments in SRHR contribute to realising human rights and contribute to a country’s development.
  • Make use of the interdependency of the SDGs and advocate mainstreaming of SRHR throughout different goals, such as SDG 10: reducing inequalities.
  • Counteract conservative stances by strengthening and amplifying progressive voices, particularly in an altered political environment.

e. Empower drivers of change

  • Empower youth by educating them about their rights, including sexual and reproductive rights. Ensure youth engagement in project design, implementation, data collection and monitoring.
  • Build capacity and strengthen advocacy of CSOs, parliamentarians, youth, community and religious leaders.
  • Engage ‘SDG champions’ who advocate strengthened accountability and implementation of SRHR in their sphere of influence, complementing CSO efforts.

 f. Strengthen the provision of services

  • Develop the capacity of government officials and service providers for SRHR, including on elements outside of the health system, such as comprehensive sexuality education, female genital mutilation and early and forced marriage.
  • Create a better understanding how Universal Health Coverage (UHC) can deliver for SRHR and work more closely with the health community and UHC advocates.
  • Move from a state-centric approach of accountability to also focus on non-state actors as duty-bearers, including the private sector. Include them in capacity strengthening efforts.

 g. Strengthen the evidence base and use of data

  • Strengthen health information systems, including at community level. Also include data from the private sector.
  • Use narratives to complement statistics when sensitizing duty bearers to the circumstances at grass root level.
  • Ensure key statistics are available, accessible and presented in a user-friendly format. Seek avenues to move the agenda based on facts, countering non-factual policy and decision-making.

The 14th International Dialogue facilitated dialogue on the evolving SRHR accountability architecture under the SDGs. By providing a platform for strategic reflection and in-depth analysis, the International Dialogue has sparked new insights and strengthened alliances. It will take concerted efforts by all stakeholders, including government, CSO, multilateral organizations, academia, private sector and youth, to take these recommendations forward within their sphere of influence to support the realisation of SRHR for women, men, girls and boys.