Sexual and Reproductive Health and Rights: Overseas Aid

Dan Poulter Excerpts

Wednesday 12th July 2023 Westminster Hall

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

Will the hon. Member give way?

[Sarah Champion]

I will, of course, give way to a former IDC member.

[Dr Poulter]

I thank the hon. Member for giving way. She is making a good speech, and I congratulate her on securing the debate. One area that the Royal College of Obstetricians and Gynaecologists has focused on in the past, and rightly so, is the high rates of maternal and new-born baby morbidity and mortality in many low and middle-income countries, particularly in Africa. Will the hon. Member address that point and make some suggestions to the Minister about how Britain can better support that agenda through its aid strategy and improve safety around pregnancy and childbirth?

[Sarah Champion]

I will indeed cover that, and also benign gynaecological conditions, which are another major killer for women. I congratulate the hon. Member on all his work on global health over the years. He continues to be an advocate in this place.

UK aid has contributed significantly and meaningfully towards ensuring that all women and girls can access their sexual and reproductive health and rights, and we should all be proud of that track record. RCOG members in Pakistan who had been providing training as part of the UK’s women’s integrated sexual health—WISH—programme reported dramatic increases in access to safe abortion care, post-abortion care and family planning by those who participated in their schemes. However, the decision to cut ODA threatens to stall or even reverse that progress around the world.

WISH is supposed to be the Government’s flagship sexual and reproductive health programme, but even that is not safe from the cuts. MSI Reproductive Choices had its funding under the WISH programme slashed by 78%. My Committee has also heard that a three-year health programme for the most marginalised communities in Bangladesh received a £1.1 million cut to its £2 million budget two years in, with no notice whatsoever. A direct grant in Ghana, which was providing safe birth, child health and psychoeducation for pregnant women and mothers through building new maternal health self-help support groups and outreach clinics, received a 25% cut.

The Government are not putting their money where their mouth is. The most recent data shows that bilateral spending on SRHR decreased by more than 50% from £515 million in 2019 to £242 million in 2021. The Minister is aware that it is not good enough, and I am aware that he is trying to change it, so I look forward to hearing more about that in his remarks.

Estimates by the Guttmacher Institute suggest that the cuts could already have resulted in 9.5 million fewer women and girls having access to modern methods of contraception, 4.3 million more unintended pregnancies, 1.4 million more unsafe abortions and, as the hon. Member for Central Suffolk and North Ipswich (Dr Poulter) said, a possible 8,000 more avoidable maternal deaths.

Countries with the greatest need for SRHR funding and programmes have been hit the hardest by the cuts, and within those countries, the most marginalised are often the most affected. Professor Friday Okonofua, an obstetrician and gynaecologist based in Benin City, Nigeria, said in RCOG report that it is the most marginalised people who are reliant on donor-funded services. In Nigeria, where nearly 80% of health payments are out of pocket, the loss of funding from the UK Government has only widened this dire gap in services.

Making donations towards SRHR in humanitarian crises is welcome, but not enough. UK support must be in the form of sustained programming that delivers against the UK’s commitments to the UN sustainable development goals, and promoting the health of women and girls must be the backbone of international development. As RCOG recommends, will the Minister commit to restoring funding for SRHR, and spend £500 million each year for the next three years on SRHR programming and supplies?

RCOG is calling on the Government not only to restore investment in SRHR, but to strengthen their global advocacy on SRHR by investing in new and existing global partnerships and collaborations. The UK’s financial commitment to the Family Planning 2020 initiative had a significant impact on the global funding landscape for SRHR. It contributed to enabling an additional 24 million women and girls to access family planning services. I ask the Minister again to make a financial commitment to the Family Planning 2030 initiative, so that we can continue the programme’s success.

Only by linking our national actions to global goals and commitments can we hope to achieve truly universal access to SRHR for every woman and girl. As well as being one of the largest donors of support for SRHR supplies, the UK has been one of the most progressive in its advocacy. RCOG is calling on the Government to strengthen their global advocacy on SRHR by championing stigmatised issues such as abortion care. That is something I care about deeply, particularly as abortion rights are being rolled back around the world. I was proud that the UK co-led a statement at the UN General Assembly last year on the importance of respecting the bodily autonomy and SRHR of women and girls. It has also been reassuring to see the UK Government commit to prioritising safe abortion care as part of their commitment to supporting SRHR in the women and girls strategy.

Mainstreaming safe abortion services and post-abortion care is essential to reduce maternal morbidity and mortality. Unsafe abortion remains one of the world’s leading causes of maternal mortality. The risk of dying from an unsafe abortion is highest for women in Africa, where nearly half of all abortions happen in potentially dangerous circumstances. In his response, will the Minister say how the Government plan to champion safe abortion care in their programming, and in nations’ universal healthcare plans, as part of an effort to strengthen health systems?

We have seen the success of telemedicine in early abortion care in the UK. Guidance from RCOG, the World Health Organisation and other authorities on clinical standards affirms that telemedicine is a safe and effective delivery model for expanding access to abortion care. RCOG has encouraged the FCDO to invest in telemedicine and in self-management of abortion in settings where that can offer safe additional pathways to increased access. As RCOG has suggested, I would like the UK Government to champion the prioritisation of women’s and girls’ gynaecological health needs on the global health agenda.