Autonomy and freedom of choice: A mixed methods analysis of the endorsement of SRHR and its core principles by global agencies.

Based on an adapted version of the conceptual framework used by the Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights (SRHR), this study sought to analyse to what extent seven global agencies, five of which belong to the UN family and the other two closely linked, incorporate women's autonomy and freedom of choice in accessing services into their SRHR policies, and how they operationalize these in their global SRHR programmes that target women and adolescent girls. Twenty-nine SRHR-related policy documents published in 2013-2020 and 17 independent evaluations of global SRHR programmes in the same period were analysed. They were found to fall short of considering women's individual autonomy and choice as the two core principles of SRHR. By ignoring autonomy and choice, global SRHR programmes missed the opportunity to incorporate activities that could enhance the emancipatory empowerment of women and girls to improve their sexual and reproductive wellbeing. The study identified concrete aspects on which global agencies, in view of their respective mandates, could have pronounced themselves more explicitly and might have been more effective in implementing SRHR programmes. In light of the international gender equality and women's empowerment discourse this suggests that donor countries could hold global agencies more accountable, bilaterally or jointly, for their SRHR performance, in particular their active endorsement and application of SRHR core principles.