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Title page 1

Contents 4

Foreword 7

Acknowledgements 8

Abbreviations and acronyms 10

Executive summary 13

1. Background 16

1.1. Introduction 16

1.2. Global and regional commitments 17

1.3. Reproductive health status of populations of the WHO SE Asia Region - progress and challenges 18

1.3.1. Maternal and perinatal health and well-being 19

1.3.2. Family planning 26

1.3.3. Infertility 28

1.3.4. Abortion 30

1.3.5. Reproductive tract cancers 30

1.3.6. Intimate partner violence and sexual violence 32

1.3.7. HIV/STI linkages to SRHR 32

1.3.8. Adolescent sexual and reproductive health and well-being 33

1.3.9. SRH needs of ageing population including those in late reproductive years 34

1.3.10. SRH needs of persons with disability 34

1.3.11. SRH needs of populations in urban slums and remote and hard-to-reach areas 34

1.3.12. SRHR in emergencies 35

1.4. Health systems in support of SRHR 35

1.4.1. Health system leadership/governance for SRHR 36

1.4.2. Human resources for SRHR 36

1.4.3. Health service delivery for SRH 37

1.4.4. Health management information system for SRH 39

1.4.5. Health financing 39

1.4.6. Medical products, vaccines and technologies for SRH 39

1.4.7. Universal Health Coverage 39

1.5. Empowering individuals, families and communities for reproductive health and well-being 40

1.5.1. Self-care 40

1.6. Emerging challenges impacting SRH and well-being in the WHO SE Asia Region 40

1.6.1. Declining fertility rates 40

1.6.2. Rising burden of NCDs among women of reproductive age 41

1.6.3. Increasing innovations related to digital health and artificial intelligence (AI) in SRH 42

1.6.4. Impact of climate change on SRHR 42

1.7. Opportunities for South-South and Triangular Cooperation (SSTC) and partnerships 43

2. Rationale, purpose and guiding principles 44

2.1. Rationale for updating the Strategy 44

2.2. Purpose 44

2.3. Process of SRHR Framework development 44

2.4. Guiding principles and approaches 45

3. Core elements of the Regional Strategic Framework for SRHR 46

3.1. Vision, mission, goal of the Regional Strategic Framework for SRHR 46

3.2. Strategic outcomes of the Regional Strategic Framework for SRHR 46

3.3. Strategic domains 47

3.4. Strategic Outcome 1, strategic domains and key actions 51

3.4.1. Maternal and perinatal health and well-being 52

3.4.2. Family planning 63

3.4.3. Prevention and management of infertility 65

3.4.4. Availability and access to Comprehensive Abortion Care (CAC) 66

3.4.5. Reproductive organ cancers 67

3.4.6. Health sector response to intimate partner violence (IPV) and sexual violence 69

3.4.7. Integrated SRH, HIV And STI services and elimination of mother-to-child transmission (EMTCT) Of HIV, syphilis and hepatitis B 70

3.4.8. Adolescent sexual and reproductive health services 71

3.4.9. SRH services for the ageing population and women in later reproductive life 72

3.4.10. SRH services for persons with disability 73

3.4.11. SRH services for urban slums and hard-to-reach populations 74

3.4.12. Climate-resilient SRH systems 75

3.4.13. SRH services during emergencies 76

3.5. Strategic Outcome 2: strategic domains and key actions 78

3.5.1. Leadership/governance (stewardship) 78

3.5.2. Human resources for health (HRH) 80

3.5.3. Health-care service delivery 82

3.5.4. Health Management Information System (HMIS) 86

3.5.5. Health Financing 87

3.5.6. Medical products, vaccines and technologies 88

3.6. Strategic Outcome 3, strategic domains and key actions 90

3.6.1. Engaging and empowering individuals and families for SRHR and well-being 90

3.6.2. Engaging and Empowering communities for SRHR 90

3.6.3. Promotion of self-care for SRHR and well-being 91

3.6.4. Improving male involvement and engagement for SRHR 92

3.7. Strategic Outcome 4, strategic domains and key actions 93

3.7.1. Harnessing knowledge and experience to strengthen collaboration within and beyond the region through South-South and Triangular... 93

4. Implementation of the Regional Strategic Framework for SRHR 95

4.1. Country leadership 95

4.2. Quality of care in SRHR 95

4.3. MNS Programmatic Transition Framework 96

4.4. Adaptation/implementation of the Regional Strategic Framework for SRHR 2026-2030 and MNS Programmatic Transition Framework 97

4.4.1. Steps in adapting and implementing the Regional Strategic Framework for SRHR (2026-2030) 98

5. Monitoring system for the Regional Strategic Framework for SRHR (2026-2030) 100

References 103

Annex 1. Population surveys used to synthesize SRH-related intervention coverage data for WHO SE Asia Region countries 110

Annex 2. Status of essential maternal and reproductive health policies and interventions in WHO SE Asia Region countries 111

Tables 6

Table 1. Maternal mortality ratio, trends and projections to 2030 in WHO SE Asia Region (2016-2023) 19

Table 2. Progress of stillbirth rates (SBRs) in WHO SE Asia Region (2016-2023) 21

Table 3. Progress of neonatal mortality rate in WHO SE Asia Region (2016-2024) 22

Table 4. Coverage of essential maternal health interventions in WHO SE Asia Region 23

Table 5. Total fertility rate and family planning coverage indicators in WHO SE Asia Region 27

Table 6. Contribution of contraceptive use, maternal care improvement and fertility decline to reduction of maternal deaths at country levels (2000-2023) 28

Table 7. Adolescent birth rate (ABR) and family planning coverage indicators among adolescents aged 15-19 years in WHO SE Asia Region 33

Table 8. Strategic outcomes and domains 48

Table 9. Impact and coverage targets to be achieved by 2030 50

Table 10. Summary of maternal and reproductive health situation in WHO SE Asia Region 99

Figures 5

Fig. 1. Centrality of SRHR to achieving SDGs 17

Fig. 2. Every Woman, Every Newborn, Everywhere targets 18

Fig. 3. Causes of maternal deaths in WHO SE Asia Region, 2023 20

Fig. 4. Causes of neonatal deaths in WHO SE Asia Region, 2024 22

Fig. 5. Prevalence of anaemia in pregnant and women of reproductive age (15-49 Years) in SE Asia Region, 2023 24

Fig. 6. Trends in institutional deliveries in WHO SE Asia Region 24

Fig. 7. Inequities in coverage of essential interventions by wealth and geography in WHO SE Asia Region, 2025 26

Fig. 8. Unmet need for family planning in WHO SE Asia Region 27

Fig. 9. Coverage of essential interventions on maternal health and family planning in WHO SE Asia Region, by intervention 29

Fig. 10. Percentage of new cases and causes of cancer in 2022 (females, all ages) in WHO SE Asia Region 31

Fig. 11. Cancer of the cervix (cervix uteri) mortality and incidence (females, all ages) in WHO SE Asia Region, 2022 31

Fig. 12. Prevalence estimates of lifetime and past 12 months of intimate partner violence against women ever married/partnered women aged 15-49 years, 2023 32

Fig. 13. Health system building blocks 35

Fig. 14. Trends in the availability of doctors, nurses and midwives among countries in WHO SE Asia Region (2014-2024) 36

Fig. 15. Density of nurses and midwives per 10 000 population, 2021-2024 37

Fig. 16. WHO Framework for the quality of maternal, newborn and child health care 38

Fig. 17. UHC service coverage index and UHC service coverage sub-index on RMNCH, 2023 40

Fig. 18. Total fertility rates among Member States of WHO SE Asia Region 41

Fig. 19. Prevalence rates of selected NCDs and risk factors for NCDs in WHO SE Asia Region 42

Fig. 20. Impacts of climate change across the life stages 43

Fig. 21. Outcomes and key strategic domains 49

Fig. 22. Maternal well-being concepts 52

Fig. 23. MNS Programmatic Transition Framework 96

Fig. 24. Programme planning and management cycle 97

Annex Tables 111

Table 2.1. Status of MPDSR in SE Asia Region countries - 2025 111

Table 2.2. Policies related to abortion in WHO SE Asia Region countries 114

Table 2.3. Cervical cancer screening and treatment of pre-cancerous lesions in WHO SE Asia Region countries (2025) 116

Annex Figures 113

Figure 2.1. Coverage of essential interventions on maternal health and family planning in the WHO SE Asia Region - by country 113

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