Sri Lanka assesses status of policy related to adolescent sexual and reproductive health

Establishing an enabling legal, regulatory and policy environment for ensuring availability of and access to sexual and reproductive health services and information for adolescents is key to advancing adolescent health.

The recognition is growing, both internationally and nationally, that human rights standards and principles, as stipulated in international and regional human rights treaties, provide a useful legal and normative framework for identifying and addressing gaps and barriers in national laws, regulations and policies that may hinder adolescents’ adequate and equitable access to sexual and reproductive health services.

Sri Lanka has made great strides in recent years in improving the health of its child and adolescent population, in spite of formidable challenges. To take stock of its efforts to provide adolescents with the best possible health services and to ensure further improvements where needed, in 2008 the Ministry of Health Care and Nutrition of Sri Lanka joined with the World Health Organization (WHO) to undertake a comprehensive human rights-based assessment of its legal and policy environment for adolescent sexual and reproductive health. A team of prominent legal and public health researchers conducted the review, supported by a multi-stakeholders group, which included key ministries (e.g. Children and Youth Affairs, Education, Justice, Social Services, Women's Empowerment, Religion, Finance), United Nations agencies and civil society representatives.

Using WHO tools on the application of human rights standards and principles in furthering sexual and reproductive health, the assessment addressed:

• harmonization of domestic law with international human rights standards and principles—e.g. non-discrimination and equality (with a focus on vulnerable and marginalized population groups), best interest of the child, respect for the views of the child, informed consent, privacy and confidentiality—as expressed in treaties ratified by the government;
• analyzed the extent to which laws, regulations and policies were explicitly informed and guided by such standards and principles; and
• identified barriers in laws, regulations and policies that hindered adolescents’ access to sexual and reproductive health services and information.

The comprehensive review and analysis highlighted barriers, ambiguities and gaps, as well as positive provisions in laws, regulations and policies, which have a direct or indirect impact on adolescents' enjoyment of their sexual and reproductive health. The review also exposed discrepancies between adequate laws and policies and inadequate implementation/enforcement of the laws. In addition, it identified the stakeholders responsible for addressing the gaps and barriers.

Some of the key issues identified for further action included:

• inadequate legal protection and policy recognition of the needs of adolescents belonging to particularly vulnerable population groups, e.g. plantation workers and unmarried adolescents;
• inadequate legal protection for pregnant adolescents and adolescent living with HIV against discrimination in education settings, including expulsion from schools based on status;
• inadequate implementation of sexual and reproductive health education in schools, in spite of existing policies and supportive education laws;
• gaps between the realities of adolescent sexuality and restrictive or confusing laws and policies; and
• poor law enforcement against, and redress for, sexual violence.

The assessment highlighted the value of human rights standards as benchmarks against which countries' legal and policy measures can be reviewed. They allow for a more thorough analysis of how supportive or restrictive the laws and policies are concerning adolescents' sexual and reproductive health needs and rights, reveal possible discrepancies among laws and policies and provide a framework for rectifying the barriers and gaps identified through a participatory, inclusive and transparent process, thereby further enhancing accountability for adolescent health.