Reproductive health at the crossroads

Twenty-five years ago, in 1990, family planning (FP) professionals were concerned about the implications of European Community (EC) policies for future directions regarding service delivery. With budgetary threats in the UK, the value of contraceptive services for avoiding abortions and improving maternal health was highlighted. Twenty-five years on, in 2015, sexual and reproductive health (SRH) services are thriving internationally, as reflected in recent activities relating to the Millennium Development Goals (MDGs) and in their position within the Sustainable Development Goals (SDGs) during discussions at the United Nations (UN) on policy for cohesive approaches to international development assistance. In 1990, the profession was getting ready for the challenges of “Europe 1992”, the EC initiative aimed at creating a single market for the free movement of all services. This included directives for recognition of professional qualifications and harmonisation of standards for essential care. Vast differences existed between the 12 EC countries in the provision and utilisation of FP services and in provision for meeting the needs of certain groups such as the young, people with disabilities and HIV-positive individuals.1 Furthermore, there was apprehension regarding the role of the private sector, whether in decreasing access to clinical care or in the lowering of standards by the need to procure cheaper but potentially less effective drugs and other commodities due to the forces of competition. The Family Planning Association was alarmed at “unjustified cuts and closures across the country” in the provision of clinic services. They sought “vital information in confidence” on such threats from service providers at the grassroots level, with the guarantee that their interventions, with both health authorities and the media, would be carried out “without mentioning the source of the information”.2 Those concerns for the future funding of FP services in the UK led to a written reassurance …