Source · Select Committees · International Development Committee
First Report - The FCDO’s approach to sexual and reproductive health
International Development Committee
HC 108
Published 25 January 2024
Recommendations
2
Accepted
Para 16
Back up FCDO's renewed commitment to SRHR with consistent and long-term funding
Recommendation
The Committee welcomes the FCDO’s recent policy statements which have renewed the FCDO’s commitment to SRHR. To turn words into action, this should be backed up by consistent and long-term funding.
Government Response Summary
The FCDO agrees that consistent and long-term funding is necessary, highlighting ongoing long-term partnerships, renewed funding of £80m to the Global Financing Facility, and the next iteration of the Reproductive Health Supplies programme until 2030.
3
Rejected
Para 17
Calculate and commit minimum bilateral ODA for SRHR, ensuring multi-year programme funding
Recommendation
In order to meet previously set targets in this area, the FCDO should calculate a minimum percentage of bilateral Official Development Assistance to be spent on sexual and reproductive health and rights (SRHR). It should explain to the Committee why …
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Government Response Summary
The FCDO disagrees with setting minimum percentage spending targets for SRHR, arguing it would reduce budget flexibility, limit financial management capabilities, and lead to suboptimal programming.
4
Accepted in Part
Continue support and restore discretionary funding for key multilateral SRHR organisations to pre-pandemic levels
Recommendation
Multilateral organisations are sometimes best placed to act and implement aid programming on sexual and reproductive health. The UK has historically been a key donor to multilateral organisations working on sexual and reproductive health. Evidence to the Committee has shown …
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Government Response Summary
The FCDO partially agrees, acknowledging the importance of multilateral organisations and outlining its current support. However, it states it cannot commit to a set level of financial contribution or restore discretionary funding to pre-pandemic levels, preferring to assess funding based on impact and value for money.
5
Accepted in Part
Ensure FCDO meets UNFPA Supplies Partnership funding commitment and restore UNFPA core funding
Recommendation
The Committee is pleased to see the FCDO’s continuing commitment to family planning as a core part of its work on sexual and reproductive health, including the provision of safe and legal abortion services. However, the FCDO’s abrupt and sudden …
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Government Response Summary
The FCDO partially agrees, stating it has returned funding to the UNFPA Supplies Partnership to 2019 levels (£60m in 2022 and 2023). However, it is unable to restore core funding to the UNFPA to pre-Covid-19 levels, though it is increasing support by £4.25m for humanitarian efforts.
6
Accepted
Incorporate telemedicine and self-management of SRHR into aid programming, updating Committee by Autumn 2024
Recommendation
The use of telemedicine and self-management in SRHR programmes could increase the accessibility, reach and effectiveness of such programmes. The FCDO should consider how to incorporate the use of telemedicine and self-management of SRHR in its aid programming, such as …
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Government Response Summary
The FCDO agrees that telemedicine and self-management can improve SRHR programming, detailing how it already supports these approaches through initiatives like the UNFPA Supplies Partnership for self-managed medical abortions and the WISH programme for self-injectable contraception and telemedicine services.
7
Accepted in Part
Para 33
Publish annual key targets and achievements for FCDO's EPD and HSS approach papers
Recommendation
The FCDO’s approach papers on ending preventable deaths of mothers, babies and children by 2030 (EPD) and health systems strengthening (HSS) show a positive step in the right direction. However, in the absence of key targets for progress or regular …
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Government Response Summary
The FCDO will publish an Ending Preventable Deaths (EPD) narrative report in 2024 with progress, and will report against key EPD indicators through existing mechanisms like the FCDO Outcome Delivery Plan, rather than establishing a new annual reporting framework.
8
Accepted in Part
Para 38
Calculate and justify minimum bilateral ODA for WASH, ensuring integrated SRHR programmes
Recommendation
Access to clean water and the provision of adequate sanitation and hygiene reduces the risk of maternal and newborn mortality. In complementarity to its approach on SRHR spending, the FCDO should calculate and justify a minimum bilateral ODA percentage that …
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Government Response Summary
The FCDO partially agrees, committing to an integrated approach for WASH and SRHR and detailing its £18.5 million WASH Systems for Health programme. However, it rejects setting a minimum bilateral ODA percentage for WASH, citing the need for budget flexibility.
9
Accepted in Part
Calculate minimum ODA for training health personnel and invest in health infrastructure in LMICs
Recommendation
The involvement of trained health personnel and access to adequate health care facilities for maternal and newborn health improves health outcomes for the mother and child. The FCDO should support the strengthening of healthcare systems by prioritising investment in the …
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Government Response Summary
The government agrees to support healthcare systems, training, and WASH infrastructure through existing and new programmes like WISH Dividend and the new WASH Systems programme. However, it explicitly rejects setting a minimum percentage of ODA for health personnel training, citing a preference for budget flexibility.
11
Accepted
Para 43
Support menstrual health by providing WASH services, menstrual products, and age-appropriate education on menstruation.
Recommendation
The FCDO should support menstrual health by supporting the provision of WASH services and infrastructure and access to menstrual products. In particular, the FCDO should ensure that its work in the education and WASH sectors complement its SRHR work in …
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Government Response Summary
The FCDO agrees and states it is already supporting menstrual health through constructing menstrual-friendly toilets, providing reusable sanitary products, offering comprehensive sexuality education, and investing in reproductive health supplies via programmes like the Girls' Education Challenge.
12
Accepted
Para 46
Incorporate gynaecological disease care and HPV vaccine provision into FCDO SRHR programming.
Recommendation
The FCDO has not sufficiently addressed the threat of gynaecological disease in its SRHR programming, despite the risk it poses to the SRH of women and girls. The prevalence of cervical cancer among women and girls in lower-income countries is …
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Government Response Summary
The FCDO agrees, detailing its existing support for HPV vaccine rollout through Gavi and market shaping for cervical cancer screening via Unitaid. It also confirms the forthcoming WISH Dividend program will include treatment of benign gynaecological disease where feasible, and commits to continuously reviewing information to influence its work.
13
Accepted in Part
Para 50
Integrate female genital schistosomiasis care into UK SRHR programming with education and WASH.
Recommendation
Female genital schistosomiasis is a painful and debilitating but treatable condition affecting up to 56 million women. FGS is best tackled through an integrated approach with wider SRHR programming, as well as with other areas of programming such as education, …
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Government Response Summary
The FCDO partially agrees, noting existing research support and integration efforts for FGS with HIV/SRHR services via UNAIDS. It commits to including FGS treatment in the forthcoming WISH Dividend program where feasible and will explore further integration into SRHR programming.
14
Accepted
Renew commitment to preventing female genital mutilation through targeted multilateral and bilateral programmes.
Recommendation
The UK Government has long been an opponent of female genital mutilation (FGM) and has worked against FGM both bilaterally and multilaterally. The UK Government should renew its commitment to preventing female genital mutilation through funding multilateral and bilateral programmes, …
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Government Response Summary
The FCDO agrees and reaffirms its commitment to ending FGM, detailing ongoing funding for the Africa-led Movement (£35m) and the UN Joint Programme. It also commits to using diplomatic levers, potentially sanctions and travel bans, mobilising new funding for grassroots organizations, and stepping up international leadership on FGM.
17
Accepted
Para 66
Encourage effective integration of HIV into SRHR services, partnering with community-led organisations.
Recommendation
The FCDO should also actively encourage the effective integration of HIV into sexual and reproductive health services, by explicitly including HIV in SRHR policy documents and funding calls and requiring the inclusion of organisations with HIV expertise in the SRHR …
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Government Response Summary
The government agrees with the recommendation, stating its HIV support is part of comprehensive SRHR and it expects all health programming to become integrated. It highlights that bilateral programmes are designed with community engagement and that existing funding supports civil society in improving HIV access and challenging discrimination.
18
Accepted
Adopt a holistic and integrated 'one-stop shop' approach for FCDO SRHR programming.
Recommendation
The FCDO should have a holistic and integrated approach to all of its sexual and reproductive healthcare programming to enable recipients to live a healthy life and reach their full potential. When funding sexual and reproductive healthcare, the UK should …
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Government Response Summary
The FCDO agrees with a holistic and integrated approach to SRHR, detailing how its WISH programme and the upcoming WISH Dividend will provide integrated services, and how its Girls' Education Challenge offers comprehensive SRHR interventions. It notes that some targeted funding may be less integrated but still part of a wider comprehensive approach.
19
Accepted
Para 74
Embed comprehensive age-appropriate sex education into FCDO ODA-funded education programmes.
Recommendation
Access to SRHR services and comprehensive sex education is vital to adolescents; however, adolescents may often face barriers to accessing sexual and reproductive health services. Ensuring that women and girls are fully educated on sexual and reproductive health can empower …
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Government Response Summary
The FCDO agrees and states it is already supporting comprehensive sexuality education (CSE) through several programmes, including its Girls’ Education Challenge and the upcoming WISH Dividend programme, which will include CSE where appropriate.
20
Accepted
Para 75
Ensure FCDO-funded aid programme staff receive training to recognise and signpost safeguarding concerns.
Recommendation
People accessing SRHR services may be vulnerable, such as adolescents. The FCDO should ensure that staff who are delivering FCDO-funded aid programmes receive training to be able to recognise safeguarding concerns when interacting with aid recipients. These staff should be …
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Government Response Summary
The FCDO agrees with the recommendation, stating it already works closely with partners to ensure a strong safeguarding culture and systems, which includes responding to concerns and signposting vulnerable individuals to wider services.
21
Accepted in Part
Para 80
Ensure FCDO SRHR programmes include dedicated budget, targets, and disaggregated data for disabled people.
Recommendation
People with disabilities may face additional barriers to accessing SRHR programmes and providing services to people with disabilities may often take additional resources. Consequently, organisations implementing development programmes may be disincentivised from reaching marginalised groups as programmes are often required …
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Government Response Summary
The FCDO partially agrees, committing to embed disability inclusion by 2030 and ensure new SRHR programmes like WISH Dividend disaggregate data, have targets, and dedicated budgets. However, they state it is not possible to disaggregate data for all SRHR programming due to complexity and data limitations.
22
Accepted
Para 83
Include marginalised and excluded groups in SRHR programme planning and invest in their organisations.
Recommendation
People from marginalised groups, such as people with disabilities and LGBT+ people, may face additional and unique challenges in accessing SRHR services. The FCDO should ensure its commitment to the principle of ‘Leave No One Behind’ in all its SRHR …
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Government Response Summary
The FCDO agrees and, as outlined in its 2022 Disability Inclusion and Rights Strategy, commits to increasing consultation and active involvement of organisations of persons with disabilities in SRHR programs, strengthening their capacity, and partnering in delivery, citing the ongoing Disability Inclusive Development program.
23
Accepted
Ensure SRHR services in humanitarian contexts reach marginalised groups through FCDO knowledge-sharing.
Recommendation
The FCDO has made positive progress in tackling sexual and reproductive health in humanitarian contexts, such as by adopting the Minimum Initial Services Package. The FCDO should ensure that SRHR services in these contexts reach the most marginalised groups and …
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Government Response Summary
The FCDO agrees, committing to considering SRHR in all humanitarian funding, supporting MISP rollout, ensuring cross-working, and producing a technical guidance note. It states the WISH Dividend programme is designed to prioritise support to fragile states and ensure services reach marginalised groups, and commits to improving knowledge sharing across teams.
Conclusions (5)
1
Conclusion
Acknowledged
Para 15
The cuts to bilateral and multilateral Official Development Assistance on sexual and reproductive health and rights (SRHR) since 2020 have had a considerably negative impact upon the aid recipients of SRHR programmes, particularly on women and girls and those belonging to marginalised groups. The abrupt nature of the aid cuts …
Government Response Summary
The FCDO agrees with the committee's conclusions, acknowledging that cuts to UK ODA budgets have negatively impacted SRHR work and caused damage, while noting the UK remains a major SRHR donor.
10
Conclusion
Acknowledged
To meet menstrual health needs, women and girls must be able to access accurate, timely and age-appropriate information about menstruation. In addition, they need access to WASH services and inclusive infrastructure. Without adequate services and facilities, managing menstruation can be a challenge for women and girls in low-and-middle-income countries, preventing …
Government Response Summary
The FCDO agrees, affirming its belief in enabling women and girls to manage periods safely and with dignity, and recognising that inadequate WASH services in schools can lead to girls missing education.
15
Conclusion
Accepted
The goal of ending AIDS cannot be reached without access to proper care and treatment for all people living with HIV, and action to bring down the large numbers of people newly acquiring HIV (1.3 million in 2022, far above the global target of 500,000 by 2025). More than 40 …
Government Response Summary
The FCDO partially agrees the AIDS epidemic is a major barrier and acknowledges COVID-19's impact, stating it remains a significant funder in the HIV response and continues to support key partners like the Global Fund, WHO, Unitaid, and UNAIDS.
16
Conclusion
Acknowledged
Para 65
To support the achievement of global targets on ending AIDS, and to retain the UK’s historical leadership in this important area of SRHR, the FCDO should retain bilateral investments in HIV prevention and treatment, both through dedicated HIV programming and in its support for integrated SRHR, with a special focus …
Government Response Summary
The government gives a 'Partially Agree' response but provides no further details or specific commitments under this recommendation.
24
Conclusion
Acknowledged
Over recent years, there has been an alarming rollback on the rights of women and girls globally, of which SRHR are integral, and further criminalisation of LGBT+ people. The merger of the Foreign and Commonwealth Office with the Department for International Development offers an opportunity for the FCDO to better …
Government Response Summary
The government gives a 'Partially Agree' response but provides no further details or specific commitments under this recommendation.