Understanding and Applying the Sexual and Reproductive Health Equity (SRHE) Framework
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What is Sexual and Reproductive Health Equity (SRHE)?
SRHE means that systems ensure that all people, across the range of age, gender, race, and other intersectional identities, have what they need to attain their highest level of sexual and reproductive health. This includes self-determining and achieving their reproductive goals. Government policy, healthcare systems, and other structures must value and support everyone fairly and justly.
Background
CECA developed the SRHE framework as way to combine the health equity framework commonly applied in government and mainstream healthcare and core concepts from the sexual and reproductive health, rights, and justice movements. It is also a way to create philosophical alignment among diverse parties working to advance contraceptive access and to shift how this work is done.
The SRHE framework is based on foundational frameworks like reproductive justice, health equity, and reproductive autonomy and on ongoing discussions with diverse stakeholders. Resources on the CECA website include a crosswalk of these key terms and frameworks, and strategy to work toward SRHE.
Principles
CECA applies the SRHE framework by following three principles in our work:
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We explicitly acknowledge historical and contemporary context and harms
by talking clearly about the impacts of patriarchy, racism, colonialism, and capitalism – and trying to eliminate all of these.
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We examine and change existing practice, structures, and systems
by breaking down siloes; viewing people’s health in the holistic, integrated way that they experience it; and building in accountability for centering communities.
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We prioritize inclusion
by engaging more diverse and new voices in a meaningful way that includes the power to make decisions (e.g., inviting state, local, and community-based organizations and individuals into the discussion alongside national organizations who often tend to set the agenda).
Approach
CECA changes the conversation.
We ensure that efforts to expand access to contraception are grounded in the SRHE framework. Shifting toward more just and accurate frameworks and redressing past harms is a core element of CECA’s work. We host discussions; publish written work; serve as partners, expert panelists, and advisors; and offer tailored guidance about how to integrate SRHE in contraceptive access work.
CECA speaks and writes about SRHE to bring this framework into the public conversation.
For example, we have:
Coordinated, published, and co-authored two journals to share the SRHE framework broadly and address the potential of Contraceptive Access Initiatives (CAI) to integrate person-centered care and SRHE-focused approaches: 1) Contraception Journal special issue, and 2) American Journal of Public Health (AJPH) supplement
Co-authored and published a commentary with the Guttmacher Institute and others, Call to action: Bringing sexual and reproductive health equity into how we quantify the impact of contraceptive access.
Co-authored and published a commentary with CECA Core Member NPWH, Women’s Healthcare: What is Sexual and Reproductive Health Equity and Why Does it Matter for Nurse Practitioners?
Co-authored an op ed for NEWSONE about establishing an Office of Sexual and Reproductive Health and Wellbeing in the White House, Why the Nation and White House Need to Prioritize Reproductive Justice.
CECA offers concrete resources and approaches that we, our peers, and our government partners can use to realize SRHE, including:
Documented the principles and concrete actions CECA uses to advance equity through collaborative, effective partnerships and meetings.
Developed equity principles and used them to guide the Contraceptive Access Strategy activities.
Developed the Equity-Informed Principles for Contraceptive Access Research for the Research Roadmap.
Included SRHE as a guiding principle and identified potential actions in the Federal Process Recommendations.
CECA conducts Lived Experience Panels (LEPs) in collaboration with community partners to learn more about how impacted communities experience sexual and reproductive healthcare. LEPs are a way to infuse the voices of community members with lived experience as a critical source of expertise, alongside other sources of evidence like technical expertise and academic literature. Visit our LEP page to learn about examples of how LEPs have helped shape research, policy, and practice.
Future Directions
What happens next with the SRHE framework?
The SRHE lens also shapes several ongoing projects that will directly change the contraceptive access landscape. These include the development of a measure of sexual and reproductive health and wellbeing, the implementation of updated guidance on Providing Quality Family Planning, and work aimed at re-envisioning how contraceptive need, service delivery, and impact are measured.