,i  #aacth ,,congress  #ast ,session    
,h4 ,r4 #cbjf  ,,in ,,the ,,house ,,of  
,,representatives  ,september #bg1      
#bjac,ms4 ,clarke 7for herself1 ,ms4    
,bass1 ,ms4 ,brown of ,florida1 ,mr4    
,clay1 ,mr4 ,conyers1 ,mrs4 ,davis of   
,california1 ,mr4 ,ellison1 ,mr4        
,enyart1 ,mr4 ,grijalva1 ,ms4 ,norton1  
,mr4 ,honda1 ,mr4 ,huffman1 ,ms4        
,jackson ,lee1 ,mr4 ,jeffries1 ,ms4 ,lee
 of ,california1 ,mrs4 ,carolyn ,b4     
,maloney of ,new ,york1 ,mr4 ,mc,govern1
 ,ms4 ,moore1 ,mr4 ,moran1 ,mr4         
,quigley1 ,mr4 ,rangel1 ,mr4 ,rush1 ,ms4
 ,schakowsky1 ,ms4 ,slaughter1 ,ms4     
,wasserman ,schultz1 ,ms4 ,waters1 and  
,mr4 ,bera of ,california7 introduced   
the following bill2 which was referred  
to the ,committee on ,foreign ,affairs  
,a ,,bill  ,to promote the sexual and   
reproductive health of individuals and  
couples in developing countries1 and for
 other purposes4  #a4 ,short title ,this
 ,act may be cited as the ,global       
,sexual and ,reproductive ,health ,act  

of #bjac4  #b4 ,findings and purposes   
7a7 ,findings ,congress makes the       
following findings3 7#a7 ,the           
advancement of sexual and reproductive  
health is central to the global         
development agenda and necessary to     
meeting most of the eight ,united       
,nations ,millennium ,development ,goals
 7,m,d,gs71 the current international   
development framework developed by #ahi 
countries1 including the ,united        
,states4 ,target #e;,b1 which is found  
under ,,mdg #e on improving maternal    
health and which requires achieving     
universal access to reproductive health1
 is an essential element in attaining   
,m,d,gs related to eradicating poverty  
7,,mdg #a71 achieving universal         
education 7,,mdg #b71 promoting gender  
equality 7,,mdg #c71 reducing child     
mortality 7,,mdg #d71 improving maternal
 health 7,,mdg #e71 combating           
,,hiv_/,,aids 7,,mdg #f71 and ensuring  
environmental sustainability 7,,mdg #g74
 ,furthermore1 advancement of sexual and

 reproductive health and rights will be 
critical in building on the achievements
 of the ,m,d,gs when they expire in     
#bjae and realizing the core goals of   
poverty reduction and sustainable       
development in the post-#bjae           
development agenda4  7#b7 ,the          
resolution of the #bjac ,united ,nations
 ,commission on ,population and         
,development recognizees that 4 4 4     
sexual and reproductive health and      
reproductive rights ''' as well as '''  
population and development1 education   
and gender equality1 are integrally     
linked to global efforts to eradicate   
poverty and achieve sustainable         
development ''' 44  7#c7 ,throughout    
much of the world1 the lack of access of
 women1 particularly poor women1 to     
basic reproductive health services and  
information contributes to death and    
suffering among women and their         
families1 undermines women's struggle   
for self-determination1 and vitiates the
 efforts of families to lift themselves 

out of the poverty in which over a      
billion of the world's people live4 ,by 
allowing individuals and couples to     
choose the number and timing of their   
children1 reproductive health care gives
 families and individuals greater       
control over their economic resources4  
7#d7 ,aspects of sexual and reproductive
 health1 including maternal mortality   
and morbidity1 reproductive cancers1 and
 sexually transmitted infections        
7,s,t,is71 including ,,hiv1 account for 
nearly #bj percent of the global burden 
of ill-health for women and some #ad    
percent for men1 according to the ,world
 ,health ,organization 7,,who74  7#e7   
,according to the ,joint ,united        
,nations ,programme on ,,hiv_/,,aids    
7,,unaids71 ,,hiv_/,,aids is the leading
 cause of death among women of          
childbearing age4  7#f7 ,school-based   
education and family planning play an   
interrelated role in lifting the status 
of women4 ,delaying sexual debut1 along 
with contraceptive use among young women

 already sexually active1 lowers the    
likelihood that young women will leave  
their schooling due to pregnancy1 and   
education increases the chances that    
young women will delay the age at which 
they marry and give birth4  7#g7 ,sexual
 and reproductive health programs can   
empower women to make informed decisions
 and better control their lives1 and by 
engaging men and boys in taking         
responsibility for the sexual and       
reproductive health of their partners1  
can contribute to greater gender        
equality4  7#h7 ,access to sexual and   
reproductive health services1 including 
family planning1 has a direct and       
important impact on infant and child    
mortality4 ,by allowing women to choose 
the timing1 number1 and spacing of their
 pregnancies1 high-risk births are      
averted1 and the children that are born 
have a greater chance of surviving to   
adulthood4 ,over #c1jjj1jjj newborns die
 in the first #d weeks of life1 which   
accounts for nearly #dj percent of all  

deaths of children under the age of #e4 
,by providing women family planning     
services to space their births #c years 
apart1 rates for under-#e mortality     
would drop by #be percent1 averting     
#a1hjj1jjj children's deaths each year4 
7#i7 ,increasing access to sexual and   
reproductive health could significantly 
decrease pregnancy-related mortality and
 morbidity by reducing the number of    
pregnancies that place women at         
increased risk of experiencing such     
complications4  7#aj7 ,an estimated     
#bbb1jjj1jjj women in developing        
countries have an unmet need for        
effective1 modern contraceptives and    
would like to postpone childbearing1    
space births1 or want no more children  
but are not using a modern method of    
contraception4 ,providing modern        
contraceptives to fill this unmet need  
would avert an estimated additional     
#ed1jjj1jjj unintended pregnancies each 
year1 including #ba1jjj1jjj unplanned   
births and #bf1jjj1jjj abortions1       

#af1jjj1jjj of which would be unsafe4   
,in turn1 this would prevent #gi1jjj    
maternal deaths and #a1ajj1jjj infant   
deaths4  7#aa7 ,complications due to    
pregnancy and childbirth are a leading  
cause of death among adolescent females 
ages #ae to #ai in low- and             
middle-income countries4 ,each year1 an 
estimated #bhg1jjj women worldwide die  
from complications related to pregnancy1
 childbirth1 or unsafe abortion4  7#ab7 
,unsafe abortion accounts for #ac       
percent of maternal deaths worldwide4   
,more than half of abortions 7#ef       
percent7 in the developing world are    
unsafe4 ,of the #bb1jjj1jjj unsafe      
abortions that take place each year1    
nearly all occur in the developing      
world4 ,around #dg1jjj women die and    
millions more suffer serious injuries   
from the complications of unsafely      
performed abortions4 ,abortion rates are
 similar in countries whether abortion  
is illegal or legal1 with evidence      
suggesting abortion rates may in fact be

 higher in countries where it is        
illegal4 ,regardless1 death and injury  
from unsafe abortion is greatly reduced 
where abortion is legal for a broad     
range of indications and where safe     
abortion is accessible4  7#ac7 ,meeting 
the need for family planning services   
and pregnancy-related care1 by doubling 
the current global investment for both1 
would prevent millions of needless cases
 of maternal and newborn deaths and     
disabilities4  7#ad7 ,worldwide1 women  
of childbearing age account for more    
than half of people living with         
,,hiv_/,,aids4 ,integrating reproductive
 health services1 including family      
planning1 with ,,hiv prevention         
programs1 such as those for voluntary   
counseling and testing and prevention of
 mother-to-child transmission1 is       
essential to effectively combating      
,,hiv_/,,aids and other ,s,t,is4  7#ae7 
,the world is witnessing the largest    
generation of young people in           
history--almost half of the world's     

population1 approximately #c1jjj1jjj1jjj
 people1 are under the age of #be4      
,unmet need for sexual and reproductive 
health services is highest among this   
age cohort4 ,fewer than #e percent of   
the poorest sexually active youth use   
modern contraception4  7#af7 ,the ,,who 
has identified unsafe sex as the second 
most important risk factor for          
disability and death among young people 
in the world's poorest communities4     
,forty percent of all new adult ,,hiv   
infections occur among young people ages
 #ae-bd4  7#ag7 ,sixty percent of unsafe
 abortions in ,africa1 #db percent in   
,latin ,america and the ,caribbean1 and 
#cj percent in ,asia are undergone by   
women under the age of #be4  7#ah7 ,the 
,,who has identified a #d-pronged       
approach to preventing ,,hiv infection  
in infants1 which includes prevention of
 unintended pregnancy among             
,,hiv-infected women as a key strategy  
to prevent mother-to-child transmission 
of ,,hiv4  7#ai7 ,according to the      

,world ,health ,organization1 enabling  
,,hiv-positive women who want to avoid a
 pregnancy access to contraceptive      
services can prevent as many as #afj1jjj
 additional ,,hiv-positive births each  
year in high ,,hiv prevalence countries4
  7#bj7 ,demographic factors exacerbate 
problems related to environmental       
sustainability4 ,the past century of    
population growth has put increasing    
pressure on natural resources as the    
scale of human needs and activities     
expands4 ,at the same time1 actual      
family size in most developing countries
 remains greater than the desired family
 size4 ,access to family planning       
services helps couples to determine     
their own family size1 hence mitigating 
the depletion of natural resources like 
clean water1 air1 and land4  7#ba7      
,practices like early and forced        
marriage1 female genital                
mutilation_/cutting1 and early sexual   
debut adversely impact the sexual and   
reproductive health of young people in  

many developing countries1 and strong   
barriers exist to providing the         
information1 services1 and other forms  
of support that young people need to    
lead healthy sexual and reproductive    
lives4  7#bb7 ,comprehensive sexuality  
education seeks to help young people    
develop the interpersonal skills        
necessary for the formation of caring1  
supportive1 and noncoercive             
relationships and the ability to        
exercise responsibility regarding sexual
 relationships by addressing such issues
 as abstinence and the use of condoms1  
contraceptives1 and other protective    
sexual health measures4  7#bc7 ,the     
,united ,nations has estimated that the 
minimum financial requirements for      
sexual and reproductive health1         
including family planning and maternal  
health1 are roughly #cb1gjj1jjj1jjj in  
#bjac and increase to approximately     
#cc1jjj1jjj1jjj in #bjae4 ,the minimum  
financial requirement for ,,hiv_/,,aids 
is estimated at #cd1gjj1jjj1jjj in      

#bjac1 and increases to #cf1bjj1jjj1jjj 
in #bjae4 ,as agreed in the             
,international ,conference on           
,population and ,development's          
,programme of ,action1 which the ,united
 ,states committed to1 developed-country
 donors are responsible for one-third of
 the total cost needed per year4        
,developing countries are responsible   
for the remaining two-thirds1 on        
average1 with low income countries      
requiring a larger share of external    
funding4  7#bd7 ,the ,united ,states has
 had a history of supporting and        
recognizing the fundamental health and  
human rights of all people through the  
signing or ratifying of various         
international agreements4 ,those        
agreements include the ,universal       
,declaration of ,human ,rights 7#aidh71 
the ,international ,covenant on ,civil  
and ,political ,rights 7#aiff71 the     
,international ,covenant on ,economic1  
,social1 and ,cultural ,rights 7#aiff71 
the ,convention on the ,elimination of  

,all ,forms of ,discrimination ,against 
,women 7#aigi71 the ,convention on the  
,rights of the ,child 7#aihi71 the      
,international ,conference on           
,population and ,development ,programme 
of ,action 7#aiid71 the ,united ,nations
 ,millennium ,development ,goals        
7#bjjj71 and the ,convention on the     
,rights of ,persons with ,disabilities  
7#bjji74  7#be7 ,the ,united ,states has
 been the largest donor to international
 family planning and reproductive health
 efforts over the last #dj years and has
 been an unparalleled source of         
leadership and innovation in the field4 
,nonetheless1 it has not met its fair   
share of financial assistance to global 
sexual and reproductive health programs4
 ,now is the time to shore up the       
,united ,states political and financial 
commitment in order to satisfy the large
 unmet need for these services1 thereby 
helping to improve women's and young    
people's sexual and reproductive health 
worldwide4  7b7 ,purposes ,the purposes 

of this ,act are to-- 7#a7 authorize    
assistance to improve the sexual and    
reproductive health of individuals and  
couples in developing countries2 and    
7#b7 implement comprehensive sexual and 
reproductive health programs offering a 
continuum of care that are responsive to
 the sexual and reproductive health     
needs of young people and adults4  #c4  
,statement of policy ,the following     
shall be the policy of the ,united      
,states ,government3 7#a7 ,all          
individuals and couples shall have the  
basic reproductive right to decide      
freely and responsibly the number1      
spacing1 and timing of their children   
and shall have the information and means
 to do so1 and the right to attain the  
highest standard of sexual and          
reproductive health4  7#b7 ,all         
individuals and couples also shall have 
the right to make decisions concerning  
reproduction free of discrimination1    
coercion1 and violence1 as expressed in 
human rights documents4  7#c7 ,the      

promotion of the responsible exercise of
 these reproductive rights for all      
people shall be the fundamental basis   
for sexual and reproductive health      
programs supported by ,united ,states   
,government assistance4  7#d7 ,the      
principle of free and informed consent  
must underlie all sexual and            
reproductive health programs and        
services4 ,this principle applies to    
individuals whether they choose to      
continue or terminate their             
pregnancies--thus1 forced pregnancies as
 well as forced abortions or            
sterilizations are prohibited4          
,decisions relating to contraceptive use
 should be made on an informed and      
voluntary basis after adequate          
information1 counseling1 and services   
are provided on a range of methods4     
7#e7 ,incentives and disincentives      
should not be used in family planning   
programs in order to meet numerical     
population targets or quotas for        
fertility goals4 ,instead1 governments  

should use other indicators1 such as    
unmet needs1 to define family planning  
goals4  7#f7 ,in sexual and reproductive
 health programs funded by the ,united  
,states ,government1 special attention  
should be paid to serving the needs of  
young people4  #d4 ,assistance to       
support the achievement of universal    
access to sexual and reproductive health
  7a7 ,assistance authorized ,the       
,president is authorized to provide     
assistance in order to support the      
achievement of universal access to      
sexual and reproductive health in       
developing countries and to ensure      
individuals and couples in developing   
countries can freely and responsibly    
determine the number1 timing1 and       
spacing of their children and have the  
means to do so4  7b7 ,activities        
supported ,assistance provided under    
subsection 7a7 may be used to-- 7#a7    
expand access to and use of voluntary   
family planning information and         
services1 to enable individuals and     

couples to avoid unintended pregnancies 
and other risks to sexual and           
reproductive health1 including those    
associated with pregnancy1 reproductive 
tract infections1 and sexually          
transmitted infections 7,s,t,is71       
including ,,hiv2  7#b7 improve public   
knowledge of contraceptives1 including  
where methods may be obtained1 and      
risk-reduction strategies1 and to       
promote the benefits of family planning 
and other sexual and reproductive health
 care to individuals1 families1 and     
communities1 including through the use  
of education and awareness programs1    
mass media1 and community mobilization  
and outreach2  7#c7 increase the        
responsiveness of sexual and            
reproductive health programs to the     
needs of the intended beneficiaries     
during the entirety of their sexual and 
reproductive lives1 including young     
people and older adults2  7#d7 reduce   
the incidence of unsafe abortion1       
including research on the health        

consequences of unsafe abortion1 and    
provide for the equipment and training  
necessary for medical treatment of the  
consequences of unsafe abortions2  7#e7 
notwithstanding any other provision of  
law1 provide safe abortion1 to the      
extent permitted by the laws of the     
recipient country2  7#f7 promote the    
integration of family planning services 
in ,,hiv and other ,,sti prevention1    
treatment1 care1 and support2  7#g7     
integrate family planning services with 
maternal and newborn health care1       
especially in antenatal1 post-partum1   
and post-abortion care settings2  7#h7  
ensure the consistent availability and  
affordability of high-quality sexual and
 reproductive health supplies and       
services1 including male and female     
condoms1 for the prevention of ,,hiv and
 other ,s,t,is2  7#i7 encourage the     
abandonment of female genital           
mutilation1 early marriage1 early       
childbearing1 and other harmful         
traditional practices that have negative

 reproductive health consequences2      
7#aj7 prevent and repair obstetric      
fistula2  7#aa7 promote the constructive
 engagement of men and boys1 the        
empowerment of women and girls1 and more
 equitable gender norms in order to     
improve health outcomes and support the 
adoption of healthy reproductive        
behaviors2  7#ab7 prevent and mitigate  
gender-based violence2  7#ac7 provide   
comprehensive sexuality education for   
young people2  7#ad7 prevent1 diagnose1 
and treat1 where appropriate1           
infertility and cancers of the          
reproductive system and refer as        
appropriate2  7#ae7 develop improved    
methods of safe and effective           
contraception and related disease       
control through investments in          
biomedical research1 with particular    
emphasis on methods which-- 7,a7 are    
likely to be safer1 easier to use1 more 
efficient to make available in          
developing country settings1 and less   
expensive than current methods2  7,b7   

are controlled by women1 including      
barrier methods and microbicides2  7,c7 
are likely to prevent the spread of     
,s,t,is2 and  7,d7 encourage and enable 
men to take greater responsibility for  
their own fertility and the protection  
of their partner2  7#af7 support an     
enabling environment for women to access
 sexual and reproductive health care    
services by working with communities to 
identify and lower or remove barriers to
 access1 including financial1 gender1   
sociocultural1 and transportation       
barriers2  7#ag7 train health care      
professionals on educating individuals1 
including young people1 about their     
sexual and reproductive health care     
options1 including family planning      
options2 and  7#ah7 foster conditions to
 create favorable policy environments1  
improve quality1 strengthen systems1 and
 contribute to the sustainability of    
family planning and other reproductive  
health programs4  #e4 ,assistance to    
reduce the incidence of unsafe abortion 

and its consequences  7a7 ,assistance   
authorized ,the ,president is authorized
 to provide assistance to reduce the    
incidence of unsafe abortion in         
developing countries and provide care   
for women experiencing injury or illness
 from complications of unsafe abortion  
in developing countries4  7b7           
,activities supported ,assistance       
provided under subsection 7a7 shall be  
used to-- 7#a7 ensure access to family  
planning services to prevent unintended 
pregnancies2  7#b7 ensure that women who
 experience an unintended pregnancy have
 access to reliable information and     
compassionate counseling on all of their
 options1 including access to antenatal 
care and safe abortion when permitted by
 the laws of the recipient country2     
7#c7 where local laws permit abortion1  
support safe abortion services1         
including referrals1 and support the    
training of abortion providers and the  
necessary equipment and commodities for 
surgical and medical abortion2 and  7#d7

 support emergency treatment for        
complications of induced or spontaneous 
abortion1 including provision of        
services and training and equipping of  
providers4  7c7 ,eligibility for        
assistance ,notwithstanding any other   
provision of law1 regulation1 or policy1
 in determining eligibility for         
assistance authorized under this        
section1 sections #ajd1 #ajd;,a1        
#ajd;,b1 and #ajd;,c of the ,foreign    
,assistance ,act of #aifa 7#bb ,u4,s4,c4
 #baea;b1 #baea;b-#b1 #baea;b-#c1 and   
#baea;b-#d71 foreign nongovernmental    
organizations-- 7#a7 shall not be       
ineligible for such assistance solely on
 the basis of health or medical         
services1 including counseling and      
referral services1 provided by such     
organizations with non-,united ,states  
,government funds if such services are  
permitted in the country in which they  
are being provided and would not violate
 ,united ,states ,federal law if        
provided in the ,united ,states2 and    

7#b7 shall not be subject to            
requirements relating to the use of     
non-,united ,states ,government funds   
for advocacy and lobbying activities    
other than those that apply to ,united  
,states nongovernmental organizations   
receiving assistance under part ,i of   
the ,foreign ,assistance ,act of #aifa4 
#f4 ,assistance to provide sexual and   
reproductive health services during     
emergency situations  7a7 ,assistance   
authorized ,the ,president is authorized
 to provide assistance1 including       
through international organizations1    
national governments1 and international 
and local nongovernmental organizations1
 to ensure that sexual and reproductive 
health services are provided in         
developing countries at every phase of a
 humanitarian emergency1 including early
 recovery4  7b7 ,priority ,in providing 
assistance authorized under subsection  
7a71 the ,president shall give priority 
to-- 7#a7 those reproductive health     
services that are essential in          

emergencies1 whether they are conflict  
or natural disaster settings1 to save   
lives and help survivors fulfill their  
potential even under the most difficult 
circumstances2 and  7#b7 building local 
capacity and improving national systems 
whenever possible during displacement   
and early recovery4  7c7 ,activities    
supported ,assistance provided under    
subsection 7a7 shall be used to-- 7#a7  
direct the ,secretary of ,state and the 
,administrator of the ,united ,states   
,agency for ,international ,development 
to implement the ,minimum ,initial      
,services ,package 7,,misp71 a set of   
life-saving priority activities that    
must be put in place in the earliest    
days of an emergency and that is set out
 in the ,sphere ,project's ,humanitarian
 ,charter and ,minimum ,standards in    
,disaster ,response2  7#b7 among other  
activities1 establish critical          
reproductive health coordination        
mechanisms1 prevent sexual violence and 
assist survivors by providing essential 

medical care including psychosocial     
services1 prevent transmission of ,,hiv 
and other sexually transmitted          
infections 7,s,t,is71 ensure access to  
emergency obstetric and newborn care1 to
 contraceptive methods1 and to treatment
 of ,s,t,is1 continue antiretroviral    
treatment1 and lay the groundwork for   
comprehensive reproductive health care2 
and  7#c7 as soon as conditions permit1 
ensure that comprehensive reproductive  
health care programs1 including         
comprehensive family planning1 are put  
in place for the duration of            
displacement and are maintained as the  
relief phase ends and communities       
transition to early recovery4  7d7      
,coordination ,assistance authorized    
under subsection 7a7 shall be           
coordinated in terms of policy1         
practice1 and funding across and within 
relevant ,united ,states ,government    
departments and agencies involved in    
emergency situations4  #g4 ,assistance  
to promote sexual and reproductive      

health care for young people  7a7       
,assistance authorized ,the ,president  
is authorized to provide assistance to  
ensure access to sexual and reproductive
 health care for young people in        
developing countries4  7b7 ,priority ,in
 providing assistance authorized under  
subsection 7a71 the ,president shall    
prioritize a plan to increase           
comprehensive knowledge about sexuality 
among young people and improve sexual   
and reproductive health outcomes among  
young people1 while improving           
coordination and implementation of host 
country and ,united ,states ,government 
activities focused on adolescent and    
youth sexual and reproductive health4   
7c7 ,activities supported ,assistance   
provided under subsection 7a7 shall be  
used1 among other things1 to-- 7#a7     
provide universal and affordable access 
to-- 7,a7 evidence-based comprehensive  
sexuality education and reproductive    
health education1 in consultation with  
local communities1 in and outside       

schools to ensure young people can delay
 sexual debut and make informed         
decisions about their sexual and        
reproductive health2 and  7,b7          
youth-friendly comprehensive sexual and 
reproductive health care1 including     
activities described in section #d7;b71 
as appropriate2  7#b7 coordinate the    
achievement of the goals of sexual and  
reproductive health programming for     
young people in ,united ,states         
,government-funded programs2  7#c7      
educate implementers on best practices  
in adolescent and youth programming and 
delivery and for effective dissemination
 of policy guidelines regarding         
adolescent and youth programming2 and   
7#d7 incorporate the recommendations of 
young people in program design and      
service delivery oriented for young     
people4  #h4 ,strategy to integrate and 
link sexual and reproductive health     
services  7a7 ,strategy required  7#a7  
,in general ,the ,president shall       
develop and implement a strategy to     

improve and create linkages among the   
various components of sexual and        
reproductive health with each other and 
with other global health care services1 
delivery1 and policies in order to meet 
the goal described in paragraph 7#b74   
7#b7 ,goal described ,the goal of better
 linkages and integration referred to in
 paragraph 7#a7 is to ensure that       
individual men and women are provided   
with a continuum of sexual and          
reproductive health services that meet  
their needs4 ,integration does not      
require that all of these services      
should be provided by the same clinician
 or even in the same setting2 rather1   
there should be a mechanism in place1 so
 that every person has access to the    
sexual and reproductive health services 
he or she needs1 either directly or by  
referral4  7b7 ,elements ,the strategy  
required by subsection 7a7 shall include
 the following3 7#a7 ,in general1 at the
 program level1 supporting health       
systems to link the various components  

of sexual and reproductive health       
services both in terms of health system 
management1 such as integrating         
commodity and supply systems1 training1 
supervision1 data collection and        
analysis1 and service provision1 to     
ensure that people have access to a full
 range of services in their community4  
7#b7 ,in general1 such services should  
include prevention of ill-health1       
provision of information and counseling1
 screening1 diagnosis and curative care 
and referral for a full range of sexual 
and reproductive health and other health
 and social services4  7#c7 ,with       
respect to linkages and program         
integration of sexual and reproductive  
health services1 such services shall    
include activities described in section 
#d7;b74  7#d7 ,with respect to linkages 
of sexual and reproductive health       
services with other global health       
services1 such services shall include-- 
7,a7 counseling about and referrals to  
other related health services such as   

addressing newborn1 infant1 and child   
health 7including educating families    
about proper antenatal and delivery     
care1 breastfeeding1 hygiene1 and       
interventions for neonatal infections   
and life-threatening childhood          
illnesses71 malaria1 tuberculosis1      
neglected tropical diseases1 and proper 
nutrition for all ages2 and  7,b7       
referrals to nearby quality services    
that cannot be provided by the primary  
provider and other social services4  #i4
 ,coordination2 research1 monitoring1   
and evaluation  7a7 ,coordination       
,assistance authorized under this ,act  
shall promote coordination between and  
among donors1 the private sector1       
nongovernmental and civil society       
organizations1 and governments in order 
to support comprehensive and responsive 
sexual and reproductive health programs 
in developing countries4  7b7 ,research1
 monitoring1 and evaluation  7#a7 ,in   
general ,assistance authorized under    
this ,act shall be used for the conduct 

of formative research and to monitor and
 evaluate the effectiveness and         
efficiency of programs4  7#b7           
,requirements ,in carrying out paragraph
 7#a71 the ,president shall ensure that 
there is-- 7,a7 support for formative   
research on the determinants of         
accessing sexual and reproductive health
 products and services1 and adopting    
healthy behaviors related to sexuality  
and reproduction1 to inform program     
design2  7,b7 support for the ongoing1  
regular1 and systematic collection of   
information to serve as the basis for   
monitoring change in population-based   
outcomes2  7,c7 support for evaluations 
of programmatic effectiveness by        
measuring the extent to which change in 
population-based outcomes can be        
attributed to program interventions or  
environmental factors2  7,d7 support for
 operations research that uses          
appropriate scientific methods to       
compare different interventions with the
 objective of increasing the efficiency1

 effectiveness1 and quality of programs2
  7,e7 support for field research on the
 characteristics of programs most likely
 to result in sustained use of effective
 family planning in meeting each        
individual's lifetime reproductive      
goals1 with particular emphasis on the  
perspectives of family planning users1  
including support for relevant social   
and behavioral research focusing on such
 factors as the use1 nonuse1 and unsafe 
or ineffective use of various           
contraceptive and related-disease       
control methods2 and  7,f7 support for  
the development of new evaluation       
techniques and performance criteria for 
sexual and reproductive health programs1
 emphasizing the user's perspective and 
reproductive goals4  #aj4 ,definitions  
,in this ,act3 7#a7 ,adolescent ,the    
term adolescent means an individual who 
has attained the age of #aj years but   
not #bj years4  7#b7 ,comprehensive     
sexuality education ,the term           
comprehensive sexuality education means 

helping young people develop the        
interpersonal skills necessary for the  
formation of caring1 supportive1 and    
non-coercive relationships and the      
ability to exercise responsibility      
regarding sexual relationships by       
addressing such issues as sexual        
diversity1 abstinence1 and the use of   
condoms1 contraceptives1 and other      
protective sexual health measures4  7#c7
 ,integration ,the term integration     
means joining together different kinds  
of services or operational programs1    
either directly or by referral1 to      
ensure more comprehensive services1     
promote a continuum of care1 and to     
maximize health outcomes4  7#d7         
,linkages ,the term linkages means--    
7,a7 the bi-directional synergies in    
policy1 programs1 services1 and advocacy
 related to sexual and reproductive     
health1 including ,,hiv_/,,aids2 and    
7,b7 refers to a broader human rights   
based approach1 of which service        
integration is a subset4  7#e7          

,reproductive health ,the term          
reproductive health-- 7,a7 means a state
 of complete physical1 mental1 and      
social well-being and not merely the    
absence of disease or infirmity1 in all 
matters relating to the reproductive    
system and to its functions and         
processes2 and  7,b7 implies that an    
individual is able to have a satisfying 
and safe sex life and that such         
individual has the capability to        
reproduce and the freedom to decide if1 
when1 and how often to do so1 including 
the right of men and women to be        
informed and to have access to safe1    
effective1 affordable1 and acceptable   
methods of family planning of their     
choice1 as well as other methods of     
their choice for regulation of fertility
 which are not against the law1 and the 
right of access to appropriate health   
care services that will enable women to 
go safely through pregnancy and         
childbirth and provide couples with the 
best chance of having a healthy infant4 

7#f7 ,reproductive rights ,the term     
reproductive rights-- 7,a7 means those  
rights that embrace certain human rights
 that are already recognized in national
 laws1 international human rights       
documents1 and other consensus          
documents2  7,b7 includes the           
recognition of the basic right of all   
couples and individuals to decide freely
 and responsibly the number1 spacing1   
and timing of their children and to have
 the information and means to do so1 and
 the right to attain the highest        
standard of sexual and reproductive     
health2 and  7,c7 further includes the  
right of all couples and individuals to 
make decisions concerning reproduction  
free of discrimination1 coercion1 and   
violence1 as expressed in human rights  
documents4  7#g7 ,sexual health ,the    
term sexual health-- 7,a7 means a state 
of physical1 emotional1 mental1 and     
social well-being in relation to        
sexuality and not merely the absence of 
disease1 dysfunction1 or infirmity2     

7,b7 includes a positive and respectful 
approach to sexuality and sexual        
relationships1 as well as the           
possibility of having pleasurable and   
safe sexual experiences1 free of        
coercion1 discrimination1 and violence2 
and  7,c7 further includes the sexual   
rights of all persons to be respected1  
protected1 and fulfilled4  7#h7 ,unmet  
need ,the term unmet need refers to     
nonuse of a modern contraceptive method 
by an individual who is married or      
unmarried and sexually active1 is able  
to become pregnant1 and wants to stop   
childbearing or to wait at least #b     
years before having a child4  7#i7      
,young people ,the term young people    
means those individuals who have        
attained the age of #aj years but not   
#be years4  7#aj7 ,youth ,the term youth
 means an individual who has attained   
the age of #ae years but not #be years4