THE IMPACTS OF CLIMATE CHANGE ON SEXUAL AND REPRODUCTIVE HEALTH AND RIGHTS

The drivers of conflict and vulnerability to climate change are multiple, complex, and oftentimes, cyclical, making it difficult to analyze their differentiated impacts on Sexual And Reproductive Health And Rights(SRHR) in isolation. As such, evidence related to the impacts of climate change on SRHR is often discussed more broadly in the context of these drivers of vulnerability, without distinguishing between, for example, post-disaster and conflict-affected settings. However, it is clear that settings of conflict and fragility are areas of high vulnerability in relation to SRHR and it is expected that climate change is further exacerbating barriers to accessing Sexual And Reproductive Health (SRH) care in these settings.

During any natural or man-made crisis, there is typically a breakdown of governance, support systems, and services that impact girls’ and women’s SRHR. Crises such as conflict, natural disasters and global pandemics that produce weaknesses in health systems increase vulnerability to climate change. In turn, these weaknesses lead to gaps in access, availability, acceptability and quality of SRHR information and services. This, together with fear, stigma and harmful social norms that may be heightened in post-disaster settings can result in worsened SRH outcomes. In humanitarian crises, evidence shows that institutional medical priorities often do not consider sexual and reproductive health as essential emergency relief and therefore shift away from this lifesaving intervention. Further, in places where abortion services are legal, they may be defunded or under-resourced due to a number of reasons: abortion may be considered too complicated to provide in a crisis; donors may not be willing to provide emergency funding towards this end; or abortion may be believed to be illegal. For example:

• The COVID-19 pandemic has created a double burden in humanitarian settings. A qualitative study interviewing women from refugee, displaced, and post-conflict settings across 15 African countries found that 73 percent of respondents experienced an increase in intimate partner violence and 51 percent experienced sexual violence due to lockdowns and economic stresses caused by the pandemic.

• During the 2010 earthquake in Haiti, women reported having less access to contraceptives, even though emergency aid did include some SRHR funding.

• Evidence found that after the floods in the Sindh region in Pakistan, due to cultural norms, women were not allowed to leave temporary shelters to seek health services unless accompanied by a male relative, which, in turn, increased their difficulty in exercising their rights related to SRH.

While some efforts have been made to address SRHR in disaster response and recovery, including through the development and implementation of the Minimum Initial Service Package (MISP) for Sexual and Reproductive Health progress has been variable. In particular, adolescents; sex workers; people living with disabilities; or those of underrepresented sexual orientation, gender identity, gender expression, and sex characteristics (SOGIESC) face significant barriers in accessing SRHR information and services in humanitarian settings. This reduced access to SRHR services is a threat to the health and well-being of girls and women, in addition to impeding disaster recovery and longer-term development.

There is an inadequate foundation of information, guidance, and experience available for governments and other actors to pursue SRHR- related interventions as a basis for adaptation to climate change. There is no agreed-upon definition of gender-responsive climate action at the international level, let alone SRHR specific guidelines. However, a recent document produced by the Least Developed Countries Expert Group and the Adaptation Committee under the United Nations Framework Convention On Climate Change (UNFCCC) highlights three key elements of gender-responsive adaptation to climate change: (1) recognition of gender differences in adaptation needs and capacities; (2) gender-equitable participation and influence in adaptation decision-making processes; and (3) gender-equitable access to finance and other benefits resulting from investments in adaptation.Though the current WHO guidance for adaptation planning in the health sector does integrate gender considerations to a certain extent, it does not explicitly address SRHR issues beyond recognizing that pregnant women are vulnerable to malnutrition.

The literature on climate change and health, including the Lancet Countdown on health and climate change, primarily focuses on climate-sensitive diseases, heat stress, and to a certain extent, issues related to malnutrition and hunger.

It is therefore unsurprising that the adaptation responses focus on addressing these issues rather than explicitly focusing on SRHR. However, as noted in the section above, climate-related diseases, heat stress, and food insecurity can all impact everything from maternal health and vulnerability to Gender Base Violence(GBV). Similarly, despite some research highlighting that weaknesses in health systems and gaps in health services are a drivers of vulnerability to climate change, these issues have received relatively limited attention in discussions about adaptation and they rarely cover SRHR issues.