Sexual Health

Barriers to advancing the sexual and reproductive health agenda in Latin America: a qualitative study of key informants' perspectives.

TL;DR

Latin American and Caribbean countries face multifaceted barriers to sexual, reproductive, and maternal health and rights including lack of political will, insufficient funding, weak programs, data gaps, and low-quality service provision that disproportionately affect vulnerable populations.

Key Findings

Lack of political will, political instability, and opposition from civil society groups were identified as key barriers to establishing and sustaining sexual and reproductive health agendas in the LAC region.

  • 27 key informants were interviewed: six at the regional level and 21 at the country level
  • Countries included Argentina, Colombia, Peru, Mexico, Guatemala, Jamaica, and Guyana
  • Stakeholders came from government, civil organizations, and academia
  • Opposition from civil society groups was specifically identified as a barrier to SRMHR agenda advancement

Policy implementation was hindered by insufficient and unstable funding, weaknesses in sexual and reproductive health programs, unequal policy implementation in federal countries, and absence of evidence-based policies.

  • Unequal policy implementation was flagged as a particular issue in federal countries
  • Both insufficient and unstable funding were identified as distinct challenges
  • Weakness in existing SRH programs was noted as a structural barrier
  • Absence of evidence-based policies was identified as a separate and compounding challenge

The lack of high-quality data and quality indicators poses significant obstacles to evidence generation in the LAC region's sexual and reproductive health sector.

  • Limitations in evidence generation were directly linked to poor data quality and inadequate quality indicators
  • This finding emerged from semi-structured interviews analyzed via rapid content thematic analysis
  • The data gap was identified as a barrier category distinct from policy and access barriers

Access to sexual, reproductive, and maternal health services was impeded by low-quality service provision, discrepancies between legislation and effective access, insufficient healthcare resources, and resistance from healthcare providers.

  • Resistance from certain healthcare providers was explicitly identified as an access barrier
  • A gap between legal frameworks and actual access to services was noted
  • Insufficient healthcare resources contributed to access limitations
  • These barriers were found to disproportionately affect vulnerable populations including indigenous communities, Afro-descendants, LGBTQI+ populations, persons with disabilities, older adults, and migrants

Vulnerable populations in the LAC region, including indigenous communities, Afro-descendants, LGBTQI+ individuals, persons with disabilities, older adults, and migrants, endure discrimination and stigmatization that severely impacts their healthcare access and health rights.

  • Six distinct vulnerable population groups were identified
  • Discrimination and stigmatization were described as 'severely impacting' access to healthcare and health rights
  • Significant disparities in SRMHR exist both within and between LAC nations
  • A purposive sampling strategy was used to ensure representation from relevant regional organizations and local stakeholders across seven countries

The study used a qualitative approach with semi-structured interviews and rapid content thematic analysis as part of a broader mixed-methods scoping study to establish a priority research agenda.

  • Total of 27 key informants were interviewed
  • Purposive sampling included stakeholders from relevant regional organizations and local stakeholders
  • Seven countries were included: Argentina, Colombia, Peru, Mexico, Guatemala, Jamaica, and Guyana
  • The qualitative component focused on identifying challenges hindering progress in SRMHR and access to health services

What This Means

This research suggests that countries across Latin America and the Caribbean face a complex web of overlapping obstacles that prevent vulnerable populations from accessing sexual, reproductive, and maternal health services. Researchers interviewed 27 experts — including government officials, civil society representatives, and academics — from seven countries (Argentina, Colombia, Peru, Mexico, Guatemala, Jamaica, and Guyana) as well as regional organizations. Through these interviews, they identified four major categories of barriers: political challenges (such as lack of will and instability), policy implementation problems (like unstable funding and weak programs), data and evidence gaps, and direct service access barriers (including provider resistance and poor service quality). The study found that marginalized groups — including indigenous communities, Afro-descendants, LGBTQI+ individuals, people with disabilities, older adults, and migrants — face the harshest consequences of these barriers, often experiencing discrimination and stigmatization that further limits their already constrained access to care. A particularly notable finding is that even when laws exist to protect reproductive rights, there is frequently a wide gap between what is legally guaranteed and what people can actually access in practice. In federal countries, uneven implementation of policies across regions compounds this problem. This research suggests that advancing sexual and reproductive health in the region requires action on multiple fronts simultaneously — strengthening political commitment, securing stable funding, improving data collection systems, and addressing provider attitudes — rather than tackling any single issue in isolation. The findings are intended to help shape a regional research agenda that prioritizes the needs of the most vulnerable populations.

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Citation

Alonso J, Cejas C, Berrueta M, Vazquez P, Perrotta G, Formia S, et al.. (2024). Barriers to advancing the sexual and reproductive health agenda in Latin America: a qualitative study of key informants' perspectives.. Reproductive health. https://doi.org/10.1186/s12978-024-01927-6