Answer: Sexual and reproductive health and rights (SRHR) refer to promotion of reproductive health, voluntary and safe sexual and reproductive choices for individuals and couples, including decisions on family size and timing of marriage. It makes them critical for attainment of SDGs because of their linkages with gender equality and women’s wellbeing, their impact on maternal, child, newborn and adolescent health, and their roles in shaping future economic development and environmental sustainability. For instance, right to access to contraception, safe abortions, safe pregnancies aim at ensuring healthy lives and promoting well-being for all persons (SDG-3) and achieving gender equality by empowering all women and girls (SDG-5). Impediments in fulfillment of SRHR in India:

• Social stigma attached to SRHR: Stigma associated with teenage pregnancy, cultural taboos about young people’s sexuality etc. in India often impede access to SRHR services.
• Lack of funds: Financial shortfalls lead to chronic underfunding of reproductive health care, particularly in areas like safe abortion and family planning.
• Lack of awareness: Poor awareness of lawful abortion care and contraception is pervasive in India. Further, both the availability and accessibility of abortion services in rural districts are an issue.
• Barriers to reproductive rights: India has amongst one of the highest numbers of maternal deaths (103 in 2017-19) worldwide due to poor quality health services and denial of women’s and girls’ decision-making authority. The MMR, however, dropped from 122 in 2015-17, and continues to drop further.
• Failure of implementation of standards and guidelines: Public policies surrounding reproductive rights are still largely focused on sterilization as opposed to other methods of contraception.

Steps that can be taken to address above impediments:

• SRHR information and services should be made accessible and affordable to all individuals regardless of their sexual orientation, gender identity or socio-economic status to exercise their reproductive autonomy. Further, incentive schemes for sterilization must be made gender neutral.
• Programmes initiated by the government related to family planning, encouraging contraceptive options etc. should engage men to become supportive partners in SRHR while protecting women’s autonomy in sexual and reproductive decision-making.
• Comprehensive sexuality education needs to be disseminated to address widespread taboos and misconceptions around sexuality. NGOs and civil society organisations can aid the government in this regard.
• There is a need to address the acute shortfall of public health care infrastructure in the primary, secondary, and tertiary-level services, which includes access to free medicines, free diagnostics, and availability of skilled human resources.

The Supreme Court judgments such as Puttaswamy v. Union of India, Navtej Singh Johar v. Union of India and Independent Thought v. Union of India have rightly highlighted the right to dignity, privacy, autonomy and bodily integrity and their relationship to sexual and reproductive rights. There is a need to involve all stakeholders (government, citizens, civil society, private sector) for effective implementation and governance in the discourse of universalization of SRHR.