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Sexual & Reproductive Health Services in South Asia: the need for an intersectional approach

In this article, GRRIPP South Asia's Programme Assistant, Abdullah Al Zubayer, writes about factors affecting access to Sexual and Reproductive Health Services across South Asia, the necessity of taking an intersectional approach, and opportunities for change.

Sexual and Reproductive Health (SRH) services have been a growing concern for many countries, especially in South Asia. With a population of over 1.7 billion people, the region has a diverse demographic, encompassing multiple religions, languages, and cultural practices. This diversity also means that the issues related to SRH are also diverse and complex and require a nuanced approach.

Intersectionality refers to the interconnected nature of social categories such as race, gender, class, and sexuality, and how they interact to shape individual experiences of oppression and privilege. In the context of SRH, this means that individuals can face unique access barriers and care challenges related to their specific identities, and that these cannot be understood in isolation.

White Ribbon Alliance India – West Bengal Training on Respectful Maternity Care at Balurghat Super Specialty Hospital West Bengal, February 2020. Photo credit: Sujoy Roy. Available on Flickr.

Despite the diversity in the region, South Asian countries share a common history of colonialism, which has had lasting effects on the region’s culture and attitudes towards SRH. For example, colonial laws criminalising homosexuality still exist in some countries, and traditional patriarchal attitudes often prevent women from accessing SRH services. The intersectionality of gender and sexuality can also result in discrimination and the marginalisation of LGBTQ+ individuals in accessing SRH services.

Another factor affecting access to SRH services in the region is poverty, which limits access to healthcare – especially specialist services that can have additional costs. Women, in particular, may not have control over their own bodies and reproductive choices due to economic dependence on men. The intersectionality of gender, class, and poverty can have severe consequences for SRH, as these individuals may not have the resources to access necessary services and may also face social stigma.

Poverty also limits access to education, which can be costly due to fees and having to purchase materials. Even where education is accessible, the lack of comprehensive SRH education perpetuates exclusion, discrimination, and knowledge gaps. In many South Asian countries, SRH education is not comprehensive or taught in schools, leading to a lack of information and myths surrounding SRH. This, in turn, can result in harmful practices, such as female genital mutilation and child marriage, which violate the SRH and human rights of individuals.

Despite these challenges, there have been recent developments in SRH services in South Asian countries, with a focus on intersectionality. For example, there have been efforts to increase access to SRH services for marginalised groups, such as LGBTQ+ individuals and women living in poverty. This has included the creation of inclusive health clinics and the training of healthcare providers to offer culturally sensitive and inclusive care. In between, GRRIPP is working to improve Gender Responsive resilience and is partially working to improve the SRH services by supporting and gathering information among different intersectional communities to enhance their reproductive health with keeping in mind about disaster.

One of the projects of GRRIPP South Asia, titled “Utilization of maternal healthcare services during COVID-19 pandemic in disaster-prone areas of Bangladesh”, has provided valuable insight into changes in maternal health trends, gender-specific vulnerabilities experienced by healthcare workers and caregivers, limitations of current institutional and regulatory frameworks, and has identified effective policy interventions and implementation strategies.

There have also been efforts to address the lack of comprehensive SRH education by incorporating it into school curricula and providing access to SRH information through technology. This has included the use of mobile phone applications and online resources, which can provide individuals with confidential and accessible information about SRH. For example, “MyPlan” provides users with personalised safety plans and referrals to local SRH services. MyPlan has been implemented in multiple countries in South Asia, including India and Nepal, and has been shown to be effective in increasing women's knowledge of and access to SRH services. Other apps include Clue, Planned Parenthood Direct, My pill reminder, among others.

In conclusion, the intersectionality of social categories such as race, gender, class, and sexuality must be considered when addressing SRH issues in South Asian countries. The emergence of SRH services in South Asian countries is a step towards addressing the unique and complex challenges faced by the region’s diverse population. However, much work still needs to be done to address the systemic issues affecting SRH, such as poverty and a lack of comprehensive education – and how access to these can be limited by intersectional inequality. By taking an intersectional approach, SRH services can better address the specific needs of marginalised groups and help create a more equitable and just society

Author’s Bio: Abdullah Al Zubayer is the Programme Assistant of GRRIPP South Asia. During his undergrad and postgrad at University of Barishal, where he majored in Sociology Department, Zubayer participated in diverse research projects. Zubayer has contributed to Q1 ranking articles on Public Health related issues; some have already been published, and others are under review. He has experience coordinating and communicating with different national and international research organisations and of organising events and programmes.


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