Thirty years ago, governments around the world agreed that reproductive health and rights are foundation stones of global development – a groundbreaking consensus that paved the way for decades of progress. Since then, the global rate of unintended pregnancies has fallen by nearly 20 per cent globally. The number of women using modern contraceptive methods has doubled. Today at least 162 countries have adopted laws against domestic violence,and maternal deaths have decreased by 34 per cent since 2000. 

Yet that progress has not been fast enough, nor far-reaching enough. Gender-based violence remains rampant in practically every country and community. There has been zero reduction in maternal mortality since 2016, and in an alarming number of countries the rates are rising. Nearly half of women still are unable to make decisions about their own bodies — unable to exercise their sexual and reproductive health and rights. 

One important reason is inequality. New evidence in this report shows that although women across socioeconomic classes and ethnicities say barriers to health care have come down over time, the women most marginalized have experienced the least improvement. In other words, while the world has focused on serving the easiest to reach, we have neglected to confront the inequalities and disparities within our systems and societies, which has allowed gaps to widen into chasms.