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Human Rights and Governance All regions concluded

Sexual and Reproductive Health and Rights

Strengthening the sexual and reproductive health and rights of people in partner countries is one of the major challenges of development cooperation. The aim of German development contributions is to reduce maternal and neonatal mortality, unwanted and early pregnancies as well as gender-based violence and harmful practices. DEval is analysing previous development engagement in this area in the evaluation “Sexual and reproductive health and rights in German development cooperation”.

Despite the progress made to date in strengthening sexual and reproductive health and rights (SRHR) worldwide, challenges remain. These include, for example, maternal and infant mortality, unintended and early pregnancies, or gender-based violence. Together with its partners, the Federal Ministry for Economic Cooperation and Development (BMZ) is working to bring about improvements in this field. As part of an evaluation, the German Institute for Development Evaluation (DEval) examined and assessed activities of development cooperation (DC) aimed at promoting SRHR worldwide.

Overall, the evaluation results show that most SRHR projects largely achieve their intended impacts. However, most projects focus mainly on enhancing women's and girls' health – for example by improving the quality of health services – but much less on enhancing women's and girls' rights. German DC projects achieve less goals in these areas. Furthermore, in practice, people from disadvantaged groups often still face barriers to accessing SRHR services and products.

Results and recommendations

Recommendations 1 and 2

While German DC contributes to strengthening sexual and reproductive health (SRH) in partner countries, it only partially contributes to strengthening sexual and reproductive rights (SRR) or to gender-transformative change. To counteract this, DEval makes two recommendations. The BMZ should develop options for action on SRHR that take into account the willingness of partner governments to also work on sexual and reproductive rights (Recommendation 1). Furthermore, the Ministry should define standardised indicators for the holistic approach to SRHR (Recommendation 2).

Recommendations 3 and 4

For the most part, projects in this field of action formally take into account numerically significant disadvantaged groups, such as young people. However, in terms of their SRHR, the measures only partially strengthen these groups. To counteract this, DEval recommends placing greater emphasis on directing efforts to empower disadvantaged groups. To this end, German DC should incorporate disaggregated indicators into logic models of projects, for example by listing impacts for young people separately (Recommendation 3). In addition, implementing organisations should continue refining evidence-based approaches to strengthening marginalised groups (Recommendation 4).

Recommendation 5

When it comes to strengthening SRHR in partner countries, TC and DC largely play different roles; however, their projects are rarely coordinated to achieve the higher-level objectives they share. As a result, the projects do not meet the standards of holistic and integrated implementation. They do not use the potential of projects that are complementary in content. DEval therefore recommends that the BMZ implement comprehensive DC programmes, thereby enabling TC and FC projects to interlink (Recommendation 5).

Recommendation 6

Some bilateral DC approaches are more resilient to challenging contextual conditions in partner countries than others. DEval therefore recommends a systematic and evidence-based examination of the context-specific effectiveness and sustainability of individual approaches (Recommendation 6).

Recommendation 7

Due to a variety of interactions with other sectors, the future environment for strengthening SRHR in partner countries is uncertain. This is due to diverse interactions with other sectors. For example, the success of SRHR projects is significantly influenced by the economic situation of women. The great importance of the diverse influencing factors allows for many different scenarios regarding the future development of the field. In order to be able to respond to future challenges, DEval recommends that the BMZ should address these factors and prepare for their occurrence (Recommendation 7).

Background

The sexual and reproductive health and corresponding rights of people in partner countries of German development cooperation are still severely restricted in many places. For example, according to current estimates, almost half of all abortions worldwide are unsafe and complications following pregnancy and childbirth are one of the main causes of death for girls between the ages of 15 and 19. An increase in gender-based violence was also observed during the COVID-19 pandemic.

German development cooperation is attempting to counteract this situation through projects in the field of action “Population dynamics; sexual and reproductive health and rights”. Sexual and reproductive health is to be strengthened in partner countries by expanding crisis-resilient structures for health and social security. In this way, development cooperation aims to improve the quality of and access to sexual and reproductive healthcare and strengthen sexual and reproductive rights, especially for vulnerable groups. As a result, the field of action should also contribute significantly to the objectives of the feminist development policy of the Federal Ministry for Economic Development and Cooperation.

Objectives

In its evaluation, DEval comprehensively analyses the activities of the field of action “Population policy; sexual and reproductive health and rights” and looks at its relevance, effectiveness and impact, sustainability, efficiency and coherence.

DEval thus pursues two objectives:

  • Comprehensive evaluation of the implementation of sexual and reproductive health and rights interventions in German development cooperation to date and transparent reporting on this.
  • The development of recommendations regarding how development interventions for sexual and reproductive health and rights can be improved in partner countries.

Overall, the evaluation is also intended to provide information for the design of a feminist development policy, for example by showing how development cooperation can contribute to strengthening rights and dismantling discriminatory structures.

Methods

In its theory-based evaluation, DEval follows the human rights-based evaluation approach, which aims to embed human rights standards and principles throughout the entire evaluation process.

The following data collection and analysis methods are used in a method-integrative approach to analyse the field of action:

  • In case studies selected based on certain criteria, bilateral development projects are analysed comparatively using qualitative methods. The focus here is on the relevance of the projects for people in the partner country, as well as on strengthening their sexual and reproductive health and rights. In the course of this, projects in Malawi and Togo are analysed by means of on-site interviews. Projects in Guinea, Cameroon, Yemen and Kyrgyzstan are analysed through remote interviews.
  • A secondary data analysis of data from the Demographic and Health Survey statistically analyses the effectiveness of German development cooperation on sexual and reproductive health and rights in all partner countries. To this end, changes in sexual and reproductive health and rights, such as a reduction in maternal mortality, are linked to development policy funding contributions from the BMZ.
  • Evaluation synthesis: The results of project evaluations by the implementing organisations are evaluated and analysed for all projects in the field of action using qualitative content analysis. This provides a complete and comprehensive picture of the success or failure of projects in the field of action. This analysis of content is preceded by an analysis of the quality of the evaluation reports and their findings.
  • Analysis of scientific evidence and the portfolio: The results of scientific studies focusing on the efficiency and sustainability of projects in the area of sexual and reproductive health and rights are systematically summarised. These results are compared with the German development cooperation portfolio.

To ensure that the evaluation’s recommendations remain valid against the background of future changes, a qualitative scenario analysis will supplement the evaluation’s survey methods. In this analysis, scenarios for future framework conditions for strengthening SRHR are developed and used as background information for recommendations derived from the results.

Team

Contact

Portrait von Dr. Jan Tobias Polak
© DEval

Dr Jan Tobias Polak

Senior Evaluator, Team Leader, Anti-Corruption Officer

Phone: +49 (0)228 336907-967

E-mail: tobias.polak@DEval.org

[Translate to Englisch:] Portrait Martin Bruder
© DEval

Dr Martin Bruder

Head of Department: Civil Society, Human Rights

Phone: +49 (0)228 336907-970

E-mail: martin.bruder@DEval.org

Sexual and Reproductive Health and Rights

Through its area of intervention “Population dynamics; sexual and reproductive health and rights”, Germany‘s Federal Ministry for Economic Cooperation and Development (BMZ) is working together with its partners to strengthen sexual and reproductive health and rights (SRHR). In this evaluation the German Institute for Development Evaluation (DEval) examines and assesses the activities in the area of intervention.

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