Every month, young women and girls in the villages of Nepal make their way into makeshift huts where they will reside for the week until their menstruation has finished. Some of them will turn to nearby sheds whereas others will travel through dense forests to reach these huts. Venomous snake bites, asphyxiation, and rape are just a few of the harsh realities of living in these poorly ventilated and weakly protected menstrual huts. This practice of self-isolation called “chhaupadi” is an ancient tradition of “untouchability” rooted in the belief that menstruation is sinful and impure. Considered bringers of misfortune, menstruating girls and women are forbidden from taking part in any household, religious, and social activities under this tradition, forcing them to distance themselves from their family and community during this time. Although chhaupadi seems like an extreme case or isolated custom, it actually represents a common global issue—menstrual stigma.

Evidence shows that in low- and middle-income countries, the expansion of health coverage or access to care has not always reduced overall mortality, said Dr. Patricia Jodrey, Child Health Team Lead in the Office of Maternal and Child Health and Nutrition at the U.S. Agency for International Development (USAID). “However, the analysis also showed that when countries have progressed in improving the quality of their health systems, the survival rate tends to improve,” she said.

“The current pandemic is straining human resources, disrupting supply chains and service delivery, and negatively impacting service seeking among women and girls in countries across the globe,” said Sarah Barnes, Project Director of the Wilson Center’s Maternal Health Initiative. She spoke at a recent event, co-hosted by the UN Population Fund (UNFPA), on unintended pregnancies during the COVID-19 pandemic. The increasing rates of unintended pregnancies during the pandemic have exacerbated the vulnerabilities of many women, said Anneka Knutsson, Chief of the Sexual and Reproductive Health Branch at UNFPA.

Whether marginalized populations, such as adolescents, LGBTQ+ people, migrant workers, and sex workers are included in health services can be a “litmus test” of our progress towards universal health coverage (UHC), said Sivananthi Thanenthiran, Executive Director of Asian-Pacific Resource and Research Centre for Women (ARROW). Thanenthiran spoke at a recent Wilson Center event with the United Nations Population Fund (UNFPA) and the World Health Organization (WHO) Department of Sexual and Reproductive Health and Research about the importance of engaging stakeholders in sexual and reproductive health (SRH) to achieve UHC for all. In SRH services, the most marginalized and most vulnerable populations are often left out, she said. When engaging stakeholders, representatives from these groups must be included to ensure equity in healthcare services.

Pride month 2021 is underway, with parades, celebrations, and advocacy movements all over the world. Given the month’s celebratory nature—along with the increasing acceptance of and recent victories for LGBTQ+ * (lesbian, gay, bisexual, transgender, queer or questioning, and others) communities in some countries—it might be easy to assume that most lesbian, gay, and bisexual individuals are “out.” However, according to a study by the Yale School of Public Health, this is far from the case. The vast majority of lesbian, gay, and bisexual individuals remain in the closet, concealing their sexual orientation from “all or most” people in their lives.

In June 1969, the Stonewall Uprising in Manhattan served as a critical tipping point for the Gay Liberation Movement in the United States. Each June, communities around the world celebrate Pride Month to honor this struggle and continue fighting for a more equal future. More than 50 years after Stonewall, Lesbian, Gay, Bisexual, Transgender, and Queer or Questioning (LGBTQ+)* people in the United States struggle to access culturally competent and respectful sexual and reproductive health care.

“From birth, from almost from cradle to grave, girls have been seen as some sort of baggage,” said Shamsa Suleiman, Project Management Specialist for Gender and Youth at the U.S. Agency for International Development (USAID), Tanzania. Suleiman spoke at a recent Wilson Center event with USAID MOMENTUM Country and Global Leadership about balancing power dynamics to achieve equity for all women and children in maternal, child, and adolescent health, and family planning. Home should be a safe space, said Suleiman. But for many girls, it no longer is. To escape the poverty and pressures at home, including early marriage and other forms of gender-based violence, some girls leave, said Suleiman. “Girls are trying to escape the safe spaces.”

“As we’re talking, the bodily autonomy of millions of women and girls around the world is still denied,” said Klaus Simoni Pedersen, Acting Director of the Division of Communications and Strategic Partnerships for the United Nations Population Fund (UNFPA) at the recent U.S. launch event of the 2021 UNFPA State of the World Population report, hosted by the Wilson Center and UNFPA. The report, My Body is My Own: Claiming the Right to Autonomy and Self-Determination, examines the global status of women and girls as reflected in their agency and decision-making power.