4. Conclusion

A Report on Consultations for a Framework on Sexual and Reproductive Health offers a vision for those working in the area of sexual and reproductive health: healthy sexuality throughout life, based on development of personal capacities and coping skills, self-esteem and opportunities for individuals to make life-affirming choices about sexual experiences and reproduction; supportive family networks and communities; positive societal values and attitudes about sexuality and reproduction; economic, educational and occupational opportunities; and a healthy physical environment. To be realized, the vision requires healthy public policies, and programs and initiatives that impact broad populations across the entire range of risk factors and conditions that determine sexual and reproductive health. Action to develop this supportive framework must be based on collaboration by all levels of government and private organizations across Canada.

In a world of limited resources, few organizations have the capacity to cover the full spectrum of population health activities, nor it is practical for them to do so. Instead, strategic targeting of resources and expertise based on the principles and directions laid out in A Report on Consultations for a Framework on Sexual and Reproductive Health and collaboration with a range of partners inside and outside of government is the optimal approach for achieving the population health agenda for sexual and reproductive health.

In the Atlantic provinces, there already exist widespread understanding and adoption of the population health approach, and considerable capacity for addressing the most critical sexual health problems -- sexual violence, HIV/AIDS, STIs, teenage pregnancies. In every province there are innovative efforts, especially in HIV/AIDS prevention (e.g., PEI AIDS Service Committee, AIDS Committee of Newfoundland and Labrador) and harm reduction (Mainline Needle Exchange, Coverdale Centre); cutting edge initiatives with youth (e.g., Lesbian, Gay and Bisexual Youth Project); action research in building community capacity (e.g., Amherst Association for Healthy Adolescent Sexuality); and inter-sectoral processes to tackle major problems and promote health (Nova Scotia Roundtable on Youth Sexual Health, Provincial Strategy Against Violence, Provincial Association Against Family Violence, Coalition Against Abusive Relationships, Amherst Association for Healthy Adolescent Sexuality and Cape Breton Youth Health Centres).

Inter-sectoral processes provide strategic entry points for program planning, evaluation and policy development. Established inter-sectoral processes provided opportunities for implementing A Report on Consultations for a Framework on Sexual and Reproductive Health, especially with respect to sexual violence and youth sexual health. Resources for implementation include education curricula, stakeholder networks and training capacity.

The biggest challenge for implementing the Framework is to move towards action on the upstream conditions that determine the sexual and reproductive health of broad populations: income, education, employment, social status, values and attitudes, etc. The foundation is laid: most organizations know and understand the population health approach. Building the structure will require making the most of existing resources as well as targeting new resources to support activities with demonstrable population health impacts.

 

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