Aligning human rights and social norms for adolescent sexual and reproductive health and rights

The 10th of December 2018 marks the 70th anniversary of the adoption of the Universal Declaration of Human Rights by the United Nations (UN) General Assembly. On the 20th November, the United Nations Convention on the Rights of the Child (CRC) reached its 29th anniversary. In September, 24 years had passed since the International Conference on Population and Development in Cairo introduced the term sexual and reproductive health and rights (SRHR) and declared SRHR as a fundamental human right, including for adolescents. Only three years ago, all UN Member States adopted the 2030 Agenda for Sustainable Development that included a specific target for achieving universal access to SRHR (Gender Equality Goal 5). Despite these important efforts to create consensus around human rights frameworks and steps to secure universal access to SRHR, the promise of child rights and adolescent girls’ and boys’ evolving capacities to claim SRH rights remains unrealised. For instance, a recent review of evidence on the SRHR of adolescent girls highlighted that many lowand middle-income countries have not yet made significant progress in delaying marriage and childbearing, reducing unwanted childbearing, or narrowing socioeconomic, health and gender gaps that could reduce girls’ risks of adverse adolescent sexual and reproductive health and rights (ASRHR) outcomes and related health effects over the life course. Multiple converging factors contribute to an ongoing lack of prioritisation of SRHR, which is defined, following the recent Guttmacher-Lancet report (see Panel 1), as a “... state of physical, emotional, mental, and social well-being in relation to all aspects of sexuality and reproduction, not merely the absence of disease, dysfunction, or infirmity”. However, ASRHR is seemingly often relegated to a lower priority or is entirely absent from discussions on SRHR. Barriers to international and local prioritisation of (A)SRHR range from global political and economic trends, such as the shift towards farright and populist politics in high-income countries and in regions that push international health policy and aid investment toward the bottom of foreign policy agendas, to local inequitable social norms that define social expectations for adolescents boys’ and girls’ behaviours according to restrictive, binary gender roles and identities.