Who has been left out?

Who has been left out?

While people today live longer, healthier lives than ever before, millions remain far behind on the trajectory of progress.

SWOP 2024

Many people find themselves trapped by multiple, compounding forms of marginalization and discrimination, seeing little difference in their daily lives and continuing to struggle to realize their rights. Our global society’s most privileged have been easiest to reach with advancements.

In a world of tremendous wealth and proven solutions in sexual and reproductive health care, such disparity suggests a lack of will, not a shortfall of ideas or resources.

Where progress is stalling

Inequalities permeate every society, depriving millions of human beings of fundamental sexual and reproductive health and rights. Many forms of marginalization can overlap, including gender-based discrimination and inequality.

SWOP 2024

Around

800 women

die every day while giving birth, the majority of them in developing countries. Nearly every one of those deaths is preventable.

SWOP 2024

In 69 countries

a quarter of women still cannot make their own health-care decisions.

SWOP 2024

Nearly

1 in 10 women

have no choice in whether to use contraception.

SWOP 2024

Between 2016 and 2020, the global annual reduction in maternal death was

effectively zero.

SWOP 2024

Women with disabilities are up to

10 times

more likely to experience gender-based violence, including sexual violence.

SWOP 2024

New research from

25 countries

shows barriers to health-care have fallen more quickly for women of higher socio-economic status and for those belonging to ethnic groups that were already better off.

SWOP 2024

A quarter of women

cannot say no to sex with their husband or partner.

SWOP 2024

New trend data on women’s experience of bodily autonomy shows that, out of 32 countries, 19 have experienced progress but

13 countries have regressed

Factors of marginalization

In thirty years, we have learned a lot about how inequality works.

We see that the furthest behind often face intersecting disadvantages that combine to produce extreme hardship or exclusion. Importantly, this is context-specific; the circumstances that lead individuals to fall behind are determined by larger social, political and cultural factors, which can differ substantially from one place to another.

How factors of marginalization intersect

An individual’s gender can intersect with other aspects of their identity to produce additional layers of discrimination. Choose an example on the left to see how factors such as ethnicity, disability status or income can overlap with gender identity to create unique experiences of marginalization or oppression.

Select a square to see the intersections

How factors of marginalization intersect

An individual’s gender can intersect with other aspects of their identity to produce additional layers of discrimination. Choose an example on the left to see how factors such as ethnicity, disability status or income can overlap with gender identity to create unique experiences of marginalization or oppression.

Select a square to see the intersections

Disability:

Hearing or vision impairment, mobility, mental health

Age:

Children (under 18); Adolescents (10-19); Young adults (18-25); Older adults (over 60)

Migratory status:

Refugees, migrants, domestic workers, people in transit

Location:

Remote, informal settlements, disputed territories

Income:

Lowest wealth quintile

Culture, ethnicity, race, language, religion:

Indigenous peoples, people of African descent, religious minorities, disadvantaged castes

Sexual and gender identity:

Sexual orientation, gender identity, sex traits

HIV status:

Men who have sex with men, sex workers, people who inject drugs, people in detention

Factors of marginalization Factors of marginalization

Disability:

Hearing or vision impairment, mobility, mental health

Age:

Children (under 18); Adolescents (10-19); Young adults (18-25); Older adults (over 60)

Migratory status:

Refugees, migrants, domestic workers, people in transit

Location:

Remote, informal settlements, disputed territories

Income:

Lowest wealth quintile

Culture, ethnicity, race, language, religion:

Indigenous peoples, people of African descent, religious minorities, disadvantaged castes

Sexual and gender identity:

Sexual orientation, gender identity, sex traits

HIV status:

Men who have sex with men, sex workers, people who inject drugs, people in detention

Grass-roots activists raise visibility for missing and murdered indigenous women

We need to be able to have jurisdiction over crimes committed on our land. We’re nations within nations, sovereign nations within a nation, and we have the least ability to protect our people.

Carolyn DeFord, United States of America Read story

What does it feel like to be left out?

What does it feel like to be left out?

“I need a place to feel home – it’s too hard. You lose yourself, you’re suspended for a long time. You don’t feel you belong anywhere. You feel stateless, forgotten.”

Brian*, age 37

“I need a place to feel home – it’s too hard. You lose yourself, you’re suspended for a long time. You don’t feel you belong anywhere. You feel stateless, forgotten.”

“Discrimination will never end, because that is everywhere. White people, black people, indigenous people, discrimination in food, in clothing, in language, in everything.”

Gertrudis

“Discrimination will never end, because that is everywhere. White people, black people, indigenous people, discrimination in food, in clothing, in language, in everything.”

“I have no insurance. If you have no insurance, you have no medicine, if you have no HIV medicine, you die – finished. I know I have big problems, but I have to try and save my life at least. What should I do now? I can’t go to my country, and I can’t live in this country. I’m not safe.”

Ibrahim*, age 28

“I have no insurance. If you have no insurance, you have no medicine, if you have no HIV medicine, you die – finished. I know I have big problems, but I have to try and save my life at least. What should I do now? I can’t go to my country, and I can’t live in this country. I’m not safe.”

“I live in hiding, because we don’t have legal documents, we can’t go anywhere, we can’t work, we don’t enjoy the most basic rights that any human being deserves, like being able to afford to live and access medical aid.”

Azin*, age 45

“I live in hiding, because we don’t have legal documents, we can’t go anywhere, we can’t work, we don’t enjoy the most basic rights that any human being deserves, like being able to afford to live and access medical aid.”

“When I was pregnant, doctors told me that I was deaf and questioned how I would deliver a baby and appropriately raise this child. However, I now have two children whom I raised on my own.”

Ayjahan, age 35

“When I was pregnant, doctors told me that I was deaf and questioned how I would deliver a baby and appropriately raise this child. However, I now have two children whom I raised on my own.”

“I live with my family right now, my mother and brother. I can’t tell them or anyone that I’m gay, because of the stigma. And apart from that, society, I cannot say anything because it’s unacceptable. And also for the state issues. I mean, we are not recognised, we do not have any kinds of rights.”

Efram*, age 30

“I live with my family right now, my mother and brother. I can’t tell them or anyone that I’m gay, because of the stigma. And apart from that, society, I cannot say anything because it’s unacceptable. And also for the state issues. I mean, we are not recognised, we do not have any kinds of rights.”

“We had a spate of violence against people with albinism. Even murder cases.”

Isaac

“We had a spate of violence against people with albinism. Even murder cases.”

“I owe my life to the medical counsellor in this centre; without their help I would be dead by now. I owe the fact that I’m here and able to be there for my eight year old daughter to them – I am HIV positive and they helped me access these medicines here.”

Sheri*, age 48

“I owe my life to the medical counsellor in this centre; without their help I would be dead by now. I owe the fact that I’m here and able to be there for my eight year old daughter to them – I am HIV positive and they helped me access these medicines here.”
*Names changed for privacy

Reconciling with a history of inequality

Despite 30 years of consensus about the emancipatory power of sexual and reproductive health, health systems are still plagued by deep legacies of gender inequality, racial discrimination and misinformation. If health workers are to become enablers of human rights, health systems must reconcile with this history. Women have historically been marginalized within male-dominated health systems. A clear example of this inequality can be seen, today, in the treatment of midwives.

Research shows the midwifery workforce, which is largely female, suffers under occupational segregation, gender pay gaps, lack of leadership opportunities, and multiple forms of discrimination and harassment, including sexual harassment.

SWOP 2024

Female health workers earn, on average, 28 per cent less than males – and an 11 per cent gender pay gap persists among nurses and midwives even after adjusting for occupational segregation.

SWOP 2024

Reproductive health also bears deep scars from the world’s racialized colonial history, with Black and indigenous women often experiencing obstetric violence, exploitation and even experimentation.

Today, international health and human rights experts continue to express concern about persistent discrimination, unequal access to health care, and disparate health outcomes – including disproportionate maternal death rates – experienced by marginalized ethnic groups.

One important step towards realizing the rights of all people is to reject the view that developed countries are archetypes of inevitable progress, while framing developing countries as backward.

In fact, colonial projects often imposed rigid gender norms affecting millions of colonized people over centuries of control. Many of these legal frameworks and social norms continue to constrain the rights of women and LGBTQI people today.

African censuses strive to count everyone

Many people have problems walking around their communities or even going to school because they fear being attacked.

Anastazia Gerald, The United Republic of Tanzania/Malawi Read story

Artwork

Textiles blur the boundary between art and function, practicality and beauty. Women’s movements have long used textiles to draw attention to a range of issues – from body positivity to reproductive justice and systemic racism. Contemporary artists and women-led textile collectives continue this tradition by producing artwork which reflects their local environments and traditions. As it has for thousands of years, textile art continues to offer women around the world the means to connect with previous and future generations of women in their families and communities.

We would like to thank the following textile artists who contributed to the artwork for this report:

  • Nneka Jones

    Nneka Jones

  • Rosie James

    Rosie James

  • Bayombe Endani, represented by the Advocacy Project

    Bayombe Endani, represented by the Advocacy Project

  • Woza Moya

    Woza Moya

  • The Tally Assuit Women’s Collective, represented by the International Folk Art Market

    The Tally Assuit Women’s Collective, represented by the International Folk Art Market

  • Pankaja Sethi

    Pankaja Sethi