Global Health and Development, Faculty of Health Sciences, Tampere University, Finland.
Global Health and Development, Faculty of Health Sciences, Tampere University, Finland.
Soc Sci Med. 2024 Oct;358:117232. doi: 10.1016/j.socscimed.2024.117232. Epub 2024 Aug 14.
Despite increasing contestations of agreed global commitments on sexual and reproductive health and rights (SRHR), our understanding of strategies of opposition in global health policymaking remains limited. This article explores the opposition to SRHR at the European level focusing on the decision-making institutions of the European Union (EU). The central research questions ask i) how SRHR opposition actors seek to influence EU institutions and ii) what challenges their actions pose for health policymaking at the EU level. Our empirical focus is based on the qualitative method of framework analysis, with data collected from multiple sources, including documentary data on European Parliamentary debates, Council conclusions of the European Union, reports of nongovernmental organisations, and key informant interviews. Our study is in line with observations on globally coordinated efforts to restrict access to SRH services. This is a challenge for specific forums and countries, but as well for European Union's wider internal and external policies. We present a toolbox of strategies and actors operational at the European Union level. Our findings on opposition to SRHR indicate that it can be seen as a political tool that is part of a broader anti-democratic movement. Understanding strategies of anti-SRHR opposition is important for health policymakers as it shapes debates and the achievement of universal health coverage (UHC).
尽管人们对性健康和生殖健康及权利(SRHR)方面的既定全球承诺的争议不断增加,但我们对全球卫生决策中反对策略的理解仍然有限。本文探讨了欧洲层面上对 SRHR 的反对,重点关注欧盟(EU)的决策机构。核心研究问题包括:i)SRHR 反对者如何试图影响欧盟机构,以及 ii)他们的行动对欧盟层面的卫生决策制定构成了哪些挑战。我们的实证重点基于框架分析的定性方法,数据来自多个来源,包括欧洲议会辩论的文件资料、欧盟理事会的结论、非政府组织的报告以及关键知情人的访谈。我们的研究符合对全球协调努力以限制获得 SRH 服务的观察。这不仅是特定论坛和国家的挑战,也是对欧盟更广泛的内部和外部政策的挑战。我们提出了一个在欧盟层面运作的策略和行为者的工具箱。我们对反对 SRHR 的研究结果表明,它可以被视为一种政治工具,是更广泛的反民主运动的一部分。了解反 SRHR 反对的策略对于卫生政策制定者来说很重要,因为它塑造了辩论和实现全民健康覆盖(UHC)的方向。