As we marked the World Population Day on July 11th 2025, under the theme “Empowering young people to create the families they want in a fair and hopeful world,” the day invited reflection on a fundamental truth: the health and sustainability of our world depend on women’s and girls’ ability to access their sexual and reproductive health and rights (SRHR).
Every reproductive health journey is rooted in autonomy and dignity, and when those rights are upheld, communities thrive. SRHR is not only a health issue; it’s a powerful lever for gender equity, economic development, and population resilience. Across Africa, women are leading this work, designing solutions, shaping systems, and breaking barriers in some of the most challenging contexts.
At WomenLift Health, we are proud to spotlight two such leaders: Elizabeth Katunga, who is expanding family planning and contraceptive access in underserved communities in Malawi, and Brigid Waliuba, who is advancing SRHR in humanitarian settings in Kenya.
Their leadership reminds us that sustainable population futures are built not only through policy, but the voices, decisions, and actions of women on the frontlines.
What is the Cost of Exclusion When SRHR Services Are Out of Reach?
Elizabeth Katunga: Ensuring access to sexual and reproductive health and rights (SRHR) services is not just a health intervention, it’s a commitment to placing women and girls at the center of development. When they are empowered to make informed choices about their reproductive lives, they are better able to stay in school, participate in the workforce, and shape their communities. SRHR access builds agency, and with it, the potential for long-term social and economic transformation. But when SRHR is neglected, particularly in underserved or remote communities, the ripple effects are profound. Teenage pregnancies rise, unsafe abortions increase, and maternal mortality rates increase. Education systems are strained by dropout rates and overcrowding. Health systems buckle under the pressure of high fertility and limited resources. And entire generations of women are held back by poverty, gender inequality, and unmet potential.
The cost of inaction is more than statistical; it’s personal. It limits futures, deepens inequality, and delays progress on nearly every Sustainable Development Goal, from health and education to gender equality and poverty reduction.
Brigid Waliuba: Unlimited access to sexual and reproductive health and rights (SRHR) services, particularly in underserved, remote, and crisis-affected communities, has deep, cross-cutting impacts. In sub-Saharan Africa, the unmet need for family planning is 26.9%, with only 22% of women of reproductive age and 25% of adolescent girls using modern contraceptives. This contributes to unintended pregnancies, unsafe abortions, and maternal mortality, especially among adolescents. East Africa, for example, has the highest teenage pregnancy rate on the continent at 21.5%, exposing girls to serious complications like obstetric fistula, poor child health outcomes, and a maternal mortality risk of 1 in 39, compared to 1 in 4,700 in industrialized countries. Without access to accurate information and youth-friendly care, these risks remain unacceptably high.
The ripple effects are felt across sectors. Girls who become pregnant are more likely to drop out of school, limiting their future economic opportunities and reinforcing cycles of poverty. Women without access to contraception or safe abortion services face restricted choices and reduced productivity, placing additional strain on already overstretched public resources, especially in high-growth areas like informal settlements or refugee camps.
Social stigma, gender-based violence, and mental health challenges often go unaddressed, further compounding inequalities. These gaps undermine progress across multiple Sustainable Development Goals (SDGs), from health, education, and gender equality to poverty reduction and climate resilience. Without meaningful investment in SRHR and women’s leadership, population pressures will continue to outpace resources, and sustainable development will remain out of reach for the most vulnerable.
Advancing SRHR through a Human Rights Lens
Elizabeth Katunga: Integrating the Nine Human Rights Standards into SRHR programs ensures services are safe, respectful, and rooted in choice. It means women and girls receive accurate information and confidential care and can make informed decisions without pressure. In humanitarian and remote settings, this approach helps reach the most underserved through mobile clinics, trained providers, and community outreach. When rights are prioritized, trust grows, and so does access. Women are more likely to seek and use SRHR services when they feel respected and heard.
Brigid Waliuba: Applying the human rights principles to SRHR programs ensures services are inclusive, equitable, and responsive, especially in low-resource and humanitarian settings. It means no one is left behind, regardless of gender, age, disability, or location. A rights-based approach strengthens trust and uptake by promoting informed consent, privacy, and non-discrimination. It empowers communities, especially women and girls, to participate in shaping services that reflect their needs and realities. In low-resource settings, this approach helps rebuild disrupted systems with dignity at the core. Mobile clinics, community outreach, and feedback mechanisms make services more accessible and accountable, leading to better outcomes for those most at risk.
Designing Responsive, Accessible SRHR Services
Elizabeth Katunga: Ensuring women and girls can fully exercise their reproductive rights requires bold, people-centered shifts. First, they must be meaningfully included in decision-making, nothing for women and girls without them. Governments need to treat SRHR as a development priority, backed by political will and funding guided by data. Integration with broader health services and investment in self-care options can ease access, especially in hard-to-reach areas. In Malawi, youth-led, community-driven outreach models are proving effective—bringing mobile services to rural communities, reducing transport burdens, and creating safe spaces for young people to access accurate information and make informed choices.
Brigid Waliuba: Real reproductive rights go beyond access; they require bold, inclusive policies that give women and girls true agency over their bodies and lives. This starts with recognizing SRHR as a fundamental human right and embedding it into national health and social protection systems. Services must reach the last mile through mobile outreach, youth-friendly spaces, and trained community health workers, especially in rural, conflict-affected, or underserved areas.
Legal and policy reforms are also essential. Outdated laws that restrict access to contraception or criminalize abortion need urgent review. Programs must address harmful norms by engaging men and boys, prioritizing marginalized groups, and supporting feminist leadership that puts women’s voices at the center of decision-making.
To make these shifts sustainable, governments need to invest, not just financially, but structurally. This means building data systems that track gaps, financing models that protect SRHR even during crises, and accountability mechanisms that empower communities to shape and monitor services. In a world facing rising inequality and climate pressures, reproductive rights must be protected as part of a broader push for justice and resilience.
Putting Choice Within Reach: Centering Women and Girls in SRHR Delivery
Elizabeth Katunga: By bringing SRHR services closer to communities, including in districts like Nkhatabay, Mchinji, Dedza, Balaka, Phalombe, Chiradzulu, Chikwawa, and Mwanza, we reduce common barriers like transport costs and distance, especially for women and girls who often shoulder household responsibilities. This proximity increases access and gives them the space and time to receive clear, accurate information, empowering them to make informed decisions about their reproductive health. We also support youth-led outreach clinics, where young people, including adolescents and girls, organize through their own networks and request SRHR services. This model encourages autonomy from the start, allowing them to take ownership of their health and exercise their reproductive rights with confidence.
Brigid Waliuba: At the International Rescue Committee in Kenya, we ensure our SRHR programs align with national priorities by grounding them in key policies like the Reproductive Health Policy, UHC Policy, and PHC Act. Our technical teams stay up to date with these frameworks, allowing us to integrate program goals into national and county health strategies. We rely on routine data and client feedback to track progress and respond to community needs. Regular reviews with the Ministry of Health and partners help us identify gaps and make evidence-based adjustments that improve service delivery.
In refugee-hosting areas like Turkana and Garissa, we use inclusive, client-centered design, engaging women, girls, and persons with disabilities to shape services that reflect their lived realities. We also prioritize rights-based approaches and safe feedback channels to promote accountability and trust.
Policy and Leadership for a Rights-Based Future
Elizabeth Katunga: To uphold dignity, choice, and rights over the next decade, SRHR service delivery must be more innovative and integrated. We need to reframe SRHR as a multi-sectoral priority, embedded not just in health, but across education, gender, and even agriculture programs to drive broader development outcomes. Expanding mobile outreach clinics and investing in self-care options will be key to reaching women and girls in remote areas while easing the burden on health systems. Digital solutions, like service reminders and on-demand information, can also enhance access, especially for young people navigating their reproductive health journeys.
Brigid Waliuba: We need bold, feminist leadership that challenges structural inequalities and centers dignity, equity, and rights in SRHR policy. Women must be equipped and supported to lead at every level. Governments must prioritize domestic financing for SRHR and move away from donor dependence. Legal reforms, particularly around abortion and adolescent access to contraception, are urgent to remove barriers and stigma. To stay responsive, programs must be grounded in evidence and real community needs. That means stronger data systems, inclusive design, youth-led networks, and cross-sector collaboration to drive lasting, rights-based change.