Almost half of women and girls living in more than 50 countries around the world are not able to make their own decisions about their reproductive rights, with up to a quarter saying they are unable to say no to sex, a new survey has found.
The findings, published by the UN population fund (UNFPA) on Wednesday, have been described as a “big wake-up call” in global efforts to achieve gender equality by 2030.
Only 55% of women and girls in the 57 countries surveyed said they could make autonomous decisions about accessing healthcare, whether to use contraceptives and whether to have sex.
Across regions, 76% of women surveyed in east and south-east Asia and 74% in Latin America and the Caribbean said they had autonomy over their sexual and reproductive health and rights, while in sub-Saharan Africa and central and southern Asia, the figures fell to 48% and 43% respectively. In Mali, Niger and Senegal, fewer than 10% of women said they could make decisions regarding their reproductive health.
The figures showed that– overall – older, more educated women living in urban areas were more likely to be able to make their own decisions.
The findings are based on demographic and health surveys conducted among girls and women aged 15 to 49 who were married or in a relationship.
For the first time, the survey results have been used to help calculate progress towards achieving universal access to sexual and reproductive health and reproductive rights, which is a target in the UN sustainable development goals.
UNFPA hopes to gather data from more countries in the future.
“It’s a big wake-up call,” said Emilie Filmer-Wilson, UNFPA’s human rights adviser. “In UNFPA it’s opening doors to having discussions looking at what it is that we need to do more of, and better.”
Filmer-Wilson said previous measures of women’s reproductive health and rights have tended to focus on the services available, rather than looking at whether women were able to access them.
“We need to look at both sides of the coin. The demand and supply. The demand side is not being addressed as much as it should be, and we are seeing a risk of us going backwards.”
The past few years have seen a rise in conservative movements and governments, across the world, including in the US, which are attempting to roll back women’s rights. The pushback largely centres on abortion laws, but has had a knock-on effect on other healthcare services.
UNFPA also looked at how many countries had laws and policies that guarantee full and equal access to sexual and reproductive healthcare and education.
Gathering data from 107 countries, which are home to 75% of the world’s population, researchers found that more than 90% had laws guaranteeing rights to maternity care, abortion, contraceptive services and voluntary access to HIV counselling and testing.
But only 62% had laws or national policies making sex education mandatory in the school curriculum. Just 76% had laws ensuring access to post-abortion care, and 28% of countries where abortion was legal required a husband to consent to the procedure.
Filmer-Wilson said the data marked an important “step forward” in accurately accessing women’s experiences.
“We had a strong feeling that women were not empowered in this area [sexual and reproductive health and rights] but we’ve not had the data to back that up. Now we have.”