The Serbian Association for Sexual and Reproductive Health and Rights (SRH Serbia) teamed up with IPAK to challenge gender stereotypes in Serbian society through the act of theatre-based workshops. Boys and girls participate and literally walk in one another's shoes to help challenge and dismantle 'gender roles'. The workshop was funded by the IPPF Innovation Programme.

Today marks the International Day of the Girl Child. Girls are often the ones to suffer firsthand from the lack of access to sexual and reproductive services. We will continue to fight for girls everywhere to not only have access to health care services but to stand up and shout 'I Decide my future'.

The Global Sexual and Reproductive Health Service Package for Men and Adolescent Boys has been developed to support providers of sexual and reproductive health services. It aims to increase the range and quality of sexual and reproductive services provided that meet the specific and diverse needs of men and adolescents boys. It covers men and adolescent boys in all their diversity, and takes a positive approach to sexual and reproductive health, seeing this not just as the absence of disease, but the positive expression of one’s gender, sex and sexuality. Men have substantial sexual and reproductive health needs, including the need for contraception, prevention and treatment of HIV and other sexually transmitted infections (STIs), sexual dysfunction, infertility and male cancers. Yet these needs are often unfulfilled due to a combination of factors, including a lack of service availability, poor health-seeking behaviour among men, health facilities often not considered "male-friendly," and a lack of agreed standards for delivering clinical and preventative services to men and adolescent boys. 

IPPF recognizes that investing in gender equality is essential both as a means for fulfilling SRHR and as an end in itself. Sexual and reproductive health and rights will only be achieved when there is gender equality.  The report is available in English, French, Spanish and Arabic.

“After the earthquake, there were so many problems. So many homes were destroyed. People are still living in temporary homes because they’re unable to rebuild their homes.” Pasang Tamang lives in Gatlang, high up in the mountains of northern Nepal, 15 kilometres from the Tibetan border. It is a sublimely beautiful village of traditional three-storied houses and Buddhist shrines resting on the slopes of a mountain and thronged by lush potato fields. The 2000 or so people living here are ethnic Tamang, a people of strong cultural traditions, who live across across Nepal but particularly in the lands bordering Tibet. The earthquake of 25 April had a devastating impact on Gatlang. Most of the traditional houses in the heart of the village were damaged or destroyed, and people were forced to move into small shacks of corrugated iron and plastic, where many still live. “Seven people died and three were injured and then later died,” says Pasang. These numbers might seems small compared to some casualty numbers in Nepal, but in a tightknit village like Gatlang, the impact was felt keenly. Hundreds of people were forced into tents. “People suffered badly from the cold,” Pasang says. “Some people caught pneumonia.” At 2240 metres above sea level, nighttime temperatures in Gatlang can plunge.  Pregnant women fared particularly badly: “They were unable to access nutritious food or find a warm place. They really suffered.” Pasang herself was badly injured. “During the earthquake, I was asleep in the house because I was ill,” she says. “When I felt the earthquake, I ran out of the house and while I was running I got injured, and my mouth was damaged.” Help was at hand . “After the earthquake, there were so many organisations that came to help, including FPAN,” Pasang says. As well as setting up health camps and providing a range of health care, “they provided family planning devices to people who were in need.” Hundreds of families still live in the corrugated iron and plastic sheds that were erected as a replacement for tents. The government has been slow to distribute funds, and the villagers say that any money they have received falls far short of the cost of rebuilding their old stone homes. Pasang’s house stands empty. “We will not be able to return home because the house is cracked and if there was another earthquake, it would be completely destroyed,” she says. Since the earthquake, she has begun working as a volunteer for FPAN. Her role involves travelling around villages in the area, raising awareness about different contraceptive methods and family planning. Volunteers like Pasang perform a crucial function in a region where literacy levels and a strongly patriarchal culture mean that women marry young and have to get consent from their husbands before using contraception. In this remote community, direct contact with a volunteer who can offer advice and guidance orally, and talk to women about their broader health needs, is absolutely vital.

The April 2015 earthquake in Nepal brought death and devastation to thousands of people – from which many are still recovering. But there was one positive outcome: after the earthquake, thousands of young people came forward to support those affected as volunteers. For Rita Tukanbanjar, a twenty-two-year-old nurse from Bhaktapur in the Kathmandu Valley, the earthquake was an eye-opening ordeal: it gave her first-hand experience of the different ways that natural disasters can affect people, particularly women and girls. “After the earthquake, FPAN was organising menstrual hygiene classes for affected people, and I took part in these,” she says. The earthquake severely affected people’s access to healthcare, but women and girls were particularly vulnerable: living in tents can make menstrual hygiene difficult, and most aid agencies tend to neglect these needs and forget to factor them into relief efforts. “After the earthquake, lots of people were living in tents, as most of the houses had collapsed,” Rita says. “During that time, the girls, especially, were facing a lot of problems maintaining their menstrual hygiene. All the shops and services for menstrual hygiene were closed.” This makes FPAN’s work even more vital. The organisation stepped into the breach and organised classes on menstrual hygiene and taught women and girls how to make sanitary pads from scratch. This was not only useful during the earthquake, but provided valuable knowledge for women and girls to use in normal life too, Rita says: “From that time on wards, women are still making their own sanitary pads.” In an impoverished country like Nepal, many women and girls can simply not afford to buy sanitary pads and tampons. Nepal is one of the poorest countries in the world with gross domestic product per capita of just $691 in 2014. In this largely patriarchal culture, the needs of women often come low down in a family’s priorities. “This is very important work and very useful,” Rita says. The women and girls also learned about how to protect themselves from sexual violence, which saw a surge in the weeks after the earthquake, with men preying on people living in tents and temporary shacks. Rita and her family lived in a tent for 20 days. “There was always the fear of getting abused,” she says. Eventually they managed to return home to live in the ruins of their house: “one part was undamaged so we covered it with a tent and managed to sleep there, on the ground floor.” Seeing the suffering the earthquake had caused, and the work FPAN and other organisations were doing to alleviate it, cemented Rita’s decision to begin volunteering. “After the earthquake, when things got back to normal, I joined FPAN.” She also completed her nursing degree, which had been interrupted by the disaster. “Since joining FPAN, I have been very busy creating awareness about sexual rights and all kinds of things, and running Friday sexual education classes in schools,” Rita says. “And since I have a nursing background, people often come to me with problems, and I give them suggestions and share my knowledge with them.” She also hopes to become a staff nurse for FPAN. “If that opportunity comes my way, then I would definitely love to do it,” she says.

The United Nations Headquarters in New York is currently hosting the High-Level Political Forum on Sustainable Development, a ten-day gathering of government representatives, UN agencies, civil society and other stakeholders to review current global progress towards achieving the 2030 Agenda for Sustainable Development. The 2030 Agenda, with its 17 Sustainable Development Goals, is an ambitious global framework with the potential to change lives. It covers everything from health, gender equality, climate change, sanitation and energy, nutrition, poverty, and employment. Within the Agenda are specific targets to ensure universal access to sexual and reproductive health information and services and reproductive rights.   However, we still have a long way to go in this area. We still live in societies where heteronormative and patriarchal social norms police and stigmatize women’s sexuality, and prevent women and girls from seeking and accessing the information and services they need to protect themselves and live a healthy life. In many countries, governments have put into place laws, policies and practices that interfere with the lives of individuals whose sexual orientation, gender identity and expression or sex characteristics may not conform with a perceived “norm”. These laws only serve to perpetuate and increase inequalities by denying vital health care to people who are already vulnerable, for fear of harm, arrest or even death. Restrictive laws and policies limit women’s ability to access contraception and safe, legal abortion services. In over 70 countries, young people require a parent’s signature to access sexual and reproductive health care. Violence against women and girls is pervasive: around 120 million girls worldwide have experienced forced sex at some point in their lives, mostly at the hands of male partners who may be protected from prosecution by gender discriminatory laws.   Policies and laws that dictate sexual and reproductive choice can be harmful and coercive by restricting access to healthcare, limiting individuals’ ability to live their lives free from rigid and unrealistic societal standard. The 2030 Agenda presents a renewed opportunity for governments to achieve their sexual and reproductive health goals, and for advocates to hold governments to account for sexual and reproductive health and rights within this framework. Activists can use the 2030 Agenda to demand a more equitable legal system that protects their human rights, realises their right to health care, and ensures that they are able to prosper in the community.   During the High-Level Political Forum on Sustainable Development, IPPF partnered with OutRight Action International to host an event titled, “From Side-Line to Centre: Using the 2030 Agenda to Tackle Sexual and Reproductive Coercion.” The panel, made up of speakers from the Guttmacher Institute, OutRight, IPPF Western Hemisphere Region and IPPF Central Office, and moderated by a youth advocate from Bulgaria, explored how policies and practices that seek to restrict access to life-saving information and services, including modern contraception, abortion and comprehensive sexuality education, limit the ability of women, LGBTI people and their families to live free from harm, violence and coercion, and will hinder our ability to achieve the Sustainable Development Goals by 2030. Sexual and reproductive health and rights underpin every aspect of sustainable development and economic growth, and are especially central to eradicating poverty and promoting prosperity. When women and LGBTI people can control their choices about their bodies, and be safe and healthy in their sexual and reproductive lives, they are better able to participate in education and the labour market, to care for their families, and have more capacity to contribute to their communities and social life.   When Member States adopted the 2030 Agenda, they also adopted equity as a fundamental principle - “no one left behind”. However, we will not be able to realise this ambition if legal and policy barriers exclude millions of people, including the most marginalised and vulnerable people from all corners of the world, from accessing these services. Speakers emphasised the importance of data. We cannot act on inequality if we don’t have the data to show that it exists - and without accurate statistics, it’s hard to have a clear picture of who is being left behind, and who is not having their needs met. We have called on member states to collect comprehensive, accurate data which is disaggregated by age, sex, and key population status, as well as sexual orientation, gender identity or expression and sex characteristics (or other characteristics specific to national context) so that we can design effective and responsive programmes. In order to ensure that everyone, regardless of age, sexual orientation, gender identity or expression and sex characteristics is free to fully exercise their sexual and reproductive rights, we must not shy away from inequality or pretend it’s not happening. We need to recognise it, understand the drivers, and work from the ground up to uproot the social determinants and structural barriers that keep people at risk. We are not equal until we are all equal.

The past 15 years have been turbulent for this small, landlocked country. Poverty is widespread and the earthquake of 2015 had a devastating effect. Almost 9,000 people were killed and over 22,000 injured, while the effect on houses and buildings was catastrophic: around 800,000 homes were destroyed or damaged, and 3 million people were displaced.   The earthquake hit Nepal’s health sector hard. Clinics were destroyed up and down the country, and for the millions displaced from home and forced into tents, accessing health services – including family planning – became difficult, sometimes impossible.  Contraception and family planning: the issues  Even before the earthquake, family planning in Nepal was fraught with problems. Around 14 million Nepalis live in mountainous or hilly regions, often in small, remote villages many miles from the nearest town, where health facilities are often scarce, understaffed and poorly supplied with drugs. Where roads exist, they are often potholed, sometimes impassable, making road travel arduous. For the millions of Nepalis living beneath or near the poverty line, travelling on foot is the only option, and, even when they can afford to rent a space in a car, vehicles are scarce.  “When I was about to give birth, we called for an ambulance or a vehicle to help but even after five hours of calling, no vehicle arrived,” recalls 32-year-old Muna Shrestha. “The birth was difficult. For five hours I suffered from delivery problems.”  Every year, tens of thousands of Nepalis give birth without any medical help at all: just 36% of births are attended by a doctor, nurse or midwife. Maternal mortality is one of the leading causes of death among women.  Myths, misconceptions and cultural resistance to contraception  A lack of knowledge about family planning and contraception compounds the issue – a problem that becomes even greater among Nepal’s many rural communities and certain ethnic groups.  In thousands of households, hostility towards family planning has its roots in deep-rooted customs and beliefs. In Nepal’s largely patriarchal culture, it remains the norm for couples to have four or more children: preference for sons means women are forced to go on having children until boys are born. Contraception remains an alien, uncomfortable idea for millions of Nepalis and is tightly controlled by men: women often need consent from their husbands to use contraception.  Misconceptions are also rife. “I’ve heard the coil can cause cancer,” says Muna Shrestha, a farmer from Kavre district. “There are so many side effects to these devices.”  In many households, contraception is deemed to fly in the face of ancient cultural traditions. “It’s thought that men who have had vasectomies won’t be able to perform the rituals after their parent’s death,” explains Binu. “Parents think that  God won’t accept that, so they don’t allow men to have vasectomies.”  Pasang Tamang, an FPAN volunteer in Gatlang, tells of one man who threatened to kill his wife, the doctor and any health worker who provided family planning services to his wife.  Spreading knowledge to remote regions  Meeting the family planning needs of Nepal’s 28 million people, particularly those living in remote mountain villages, takes careful planning, complex logistics, skilled staff and money. Since 1959, the Family Planning Association of Nepal (FPAN), has been providing better access to family planning and maternal health, ensuring its services penetrate even the most remote corners of this rugged mountain country.  Reaching communities in far flung parts of this mountainous country is a logistical challenge, but one FPAN sees as crucial to its work. Teams of staff and volunteers spend days travelling by vehicle or, if necessary, on foot to make sure they reach people.  “Accessibility is a big challenge, especially in rainy season when the road gets blocked and our staff have to walk carrying all the devices,” says Devendra Amgaim, FPAN’s project coordinator in Rasuwa, northern Nepal.  “I go to remote places, where people and don’t know about family planning,” says Binu Koraila, an FPAN staffer in Rasuwa. Her role is spread knowledge about family planning and contraception among rural communities and to train the government workers who staff the health posts, many of which are many hours’ walk from the hamlets and villages that perch on the Langtang mountains.  Cultural beliefs  High up in the mountains of northern Nepal, close to the border with Tibet, lies the village of Gatlang. This cluster of timber-framed houses and Buddhist stupas is home to some of Nepal’s 1.5 million Tamang people, an ethnic group with cultural traditions stretching back centuries.  Life here is strictly patriarchal. Marriage often takes place young – from around 14 years old – and girls are given little choice about when or whom they will marry.  “My parents forced me to get married,” says 20-year-old Jomini.  Jomini married at the age of sixteen, to a man eight years her senior. “It’s not easy being married, it’s difficult,” she says. “When I got married, I didn’t know anything about what happens after marriage, about the physical side … and after the birth of my first child I had many difficulties.”  According to Nepali law, marriage under the age of 20 is illegal. But over 40% of 20 to 24 year olds are married before they turn 18. The effect on girls’ lives can be devastating: physical problems from teenage pregnancy, psychological trauma, thwarted education and employment opportunities are widespread, particularly in remote regions.  Access to contraception means nothing unless people understand why it is important and make the decision – armed with the correct information – to use it freely themselves.  Busting the myths that can shape people’s ideas about family planning is complex but vital. FPAN does it by spending time and resources on teams who go in and talk to women and families in ways that are tailored to their needs.  “Rasuwa district has a very low literacy rate, so FPAN … gives people the right information about family planning using visual aids, images and charts,” Devendra Amgaim explains. “Reproductive health female volunteers also translate information into local languages. All this helps make information simpler, more effective and easily understandable.”  The organisation strives to make sure it is sensitive to the structures that shape life in Rasuwa. This is also pragmatic: once you have won the trust and confidence of community leaders, it is much easier to talk to the rest of their community.  “FPAN seeks out the people who have influence in the communities – the religious leaders, the teachers, the female voluntary workers,” Devendra says. “We give them orientation and knowledge regarding those misconceptions. They then create awareness.”  Stories Read more stories from Nepal

Safe abortion is heavily restricted in Uganda, yet gender inequality and sexual violence are widespread. Hosted by IPPF, the Safe Abortion Action Fund is helping vulnerable women to turn their lives around. People are learning about safe abortion and fewer girls are dying. Community attitudes have been transformed and social stigma has started to give way to human rights and understanding. Read the success stories and meet the people behind the scenes

The Safe Abortion Action Fund (SAAF) which is hosted by IPPF was set up in 2006 in order to support grass-roots organisations to increase access to safe abortion. One such organisation which received support under the last round of funding is called Lady Mermaid's Bureau. I am Pretty Lynn, aged 25. I am a sex worker but I went to university. I graduated with a Bachelor's Degree in Tourism in 2013. But now, during the day I’m sleeping and during the night I’m working. That is how my day goes every day. I got into sex work through friends. Okay it is not good but I am earning.  I tried to get a job when I graduated. I have been applying since I graduated in 2013. I’m still applying but I’m not getting anywhere. You know to get jobs in Uganda; you have to know someone there and no one knows me there. To be a sex worker is like a curse. People look at you like, I don’t know, as someone that has no use in society. People look at you in a bad way. They even don’t consider why you are selling. They just see you as the worst thing that can happen in the society. So it is not comfortable, it is really hard but we try and survive. The fact sex working is illegal means you have to hide yourself when you are selling so that police cannot take you. And then you get diseases, men don’t want to pay. When the police come and take us, sometimes they even use us and don’t pay. So it is really hard. They want a free service. Like if they come and take you and pay that would be fair. But they say it is illegal to sell yourself. But they still use you yet they are saying it is illegal. You can’t report the police because there is no evidence.  Abortion and unwanted pregnancies are really common because men don’t want to use condoms and female condoms are really rare and they are expensive. Though at times we get female condoms from Lady Marmaid’s Bureau (LMB) because there are so many of us they can’t keep on giving you them all the time. At times when we get pregnant we use local methods. You can go and use local herbs but it is not safe. One time I used local herbs and I was successful. Then the other time I used Omo washing powder and tea leaves but it was really hard for me. I almost died. I had a friend who died last year from this. But the good thing is that LMB taught us about safe abortion. I have had a safe abortion too. There are some tabs they are called Miso (misoprostol). It costs about fifty thousand shillings (£10 pounds or $20.) It is a lot of money. But if I’m working and I know I’m pregnant, I can say, "this week I’m working for my safe abortion". So if I’m working for twenty thousand, by the end of the week I will have the money. It is expensive compared to Omo at five hundred shillings but that is risky. So if I say I will work this whole week for Miso (misoprostol) it is better. But I'm working and I'm not eating. A project like this one from Lady Mermaid's can help young girls and women. But to take us from sex work, it would really be hard. They would not have enough money to cater for all of us. So what they have to do is to teach us how to protect ourselves, how to defend ourselves. Safe abortion yes. They will just have to sensitise us more about our lives, protection, female condoms and all that. I don't have a boyfriend but maybe when I get money and leave this job I will. But for now, no man would like a woman who sells. No man will bear the wife selling herself. And that will happen only if I get funds, settle somewhere else and become responsible woman. I don’t want this job. I don’t want to be in this business of sex work all the time. I want be married, with my children happily, not selling myself. Stories Read more stories about the amazing success of SAAF in Uganda