Background
The Universal Declaration of Human Rights (UDHR) acknowledges health as a fundamental right, underscoring access to sexual and reproductive health (SRH) information and services as essential for the right’s realization (3). SRH is multidimensional encompassing safe motherhood, family planning, STIs, and domestic violence. Supporting sexual and reproductive health (SRH) involves acknowledging the rights, knowledge, and capacity to make decisions and access services related to fertility and sexuality (1,4). The neglect of SRH and rights contributes to maternal mortality, poor health, and the disempowerment of women. Empowering people with SRH information and decision-making abilities leads to improved health outcomes, prevention of unwanted pregnancies, treatment of sexually transmitted infections (STIs), decreased gender-based violence, and enhanced economic and educational productivity (1,4). Further, the World Health Organization and the United Nations highlight the significance of women's health in promoting the health and well-being of populations as a whole (3). Therefore, access to SRH information and services is not only vital to individuals’ well-being, but is also crucial for reducing poverty and improving welfare globally.
Despite international law recognizing SRH as a human right, exemplified by the UDHR and the International Conference on Population and Development (ICPD), challenges in accessing reproductive health care services persist globally. In the context of Iran, a nation that has made strides in healthcare advancements, issues persist such as unequal distribution of resources, limited reproductive health education access, and prevailing gender prejudices.
The Iranian Context
A recent study, conducted by Joulaei et al. (2016), aimed to investigate the sexual and reproductive healthcare needs of Iranian women aged 15–49. Joulaei et al. (2016) shed light on the disparity between the sexual/reproductive healthcare needs of Iranian women and the limited resources to address those needs.
The study indicates that there are unequal improvements across different regions, particularly in addressing access issues, the availability of sexual health care, and HIV/AIDS services for women. Additionally, there remains a concerning difference between female's and male’s social, physical, and mental well-being. For example, women bear a significant burden of both chronic and communicable diseases. Notably, the amount of Iranian women with HIV/AIDS is growing, related to the increased prevalence of STIs amongst Iranian women and the sexual violence and social exclusion Iranian women experience. Even more concerning is the public health crisis of sexual violence against pregnant Iranian women (5).
Exploring SRH Needs in Urban Iran
Despite achieving an overall, but geographically varied, decrease in maternal mortality, maternal health disparities persist (2). For example, there were challenges related to appropriate emergency midwifery services, increased domestic violence, and poor mental health support. Moreover, the following findings in Iranian women further stressed the need for SRH care: early initiation of sexual activities, temporary marriages with multiple partners, and inconsistent condom use. Most disturbingly, a significant percentage of women experienced sexual coercion, often by husbands or partners. Gender disparities contribute to the complex landscape of Iranian women's health.
Call for Action
The study’s findings underscore the importance of understanding and addressing Iranian women's SRH needs comprehensively (Joulaei et al., 2016). The prevalence of SRH needs, coupled with factors like sexual coercion and limited condom use, necessitates urgent attention from healthcare professionals and policymakers. Such insights should guide resource allocation and the planning of educational programs to bridge gaps in sexual health care.
As we reflect on the global context of SRH as a human right, the call for action becomes even more clear. We must advocate for comprehensive, gender-sensitive health policies, legislative empowerment, and heightened public awareness for a more equitable and healthier future for Iranian women.
References
Government of Canada. (2022, August). Sexual and reproductive health and rights. https://www.international.gc.ca/world-monde/issues_development-enjeux_developpement/global_health-sante_mondiale/reproductive-reproductifs.aspx?lang=eng
Joulaei, H., Maharlouei, N., lankarani, K. B., Razzaghi, A., & Akbari, M. (2016). Narrative review of women’s health in Iran: Challenges and successes. International Journal for Equity in Health, 15(1). https://doi.org/10.1186/s12939-016-0316-x
Khani, S., Moghaddam-Banaem, L., Mohamadi, E., Vedadhir, A., Hajizadeh, E. (2018). Women’s sexual and reproductive health care needs assessment: An Iranian perspective. East Mediterr Health J, 24(7), 637–643. https://doi.org/10.26719/2018.24.7.637
Sen, G., & Govender, V. (2014). Sexual and reproductive health and rights in Changing Health Systems. Global Public Health, 10(2), 228–242. https://doi.org/10.1080/17441692.2014.986161
Bazyar, J., Safarpour, H., Daliri, S., Karimi, A., Safi Keykaleh, M., & Bazyar, M. (2018). The prevalence of sexual violence during pregnancy in Iran and the world: A systematic review and meta-analysis. Journal of Injury & Violence Research, 10(2), 63–74. https://doi.org/10.5249/jivr.v10i2.954