Does reproductive health refer to individual reproductive health?

Of course not. The scope of reproductive health is much broader than the common understanding of “no disease in the individual’s reproductive system”. It is a comprehensive concept covering individuals, partners, families and even the public level of society.

Most people’s first impression of reproductive health is indeed at the individual level: for example, whether there is inflammation of the reproductive system, abnormal reproductive function, and whether there are any obstacles to sexual function. Many people come into contact with reproductive health-related medical services for the first time, either by themselves to check for irregular menstruation and prostate problems, or for couples to prepare for pregnancy and undergo eugenic screening. These are the basic content of the individual dimension and are the core implementation carrier of reproductive health, but they are far from everything.

As early as the 1994 International Conference on Population and Development in the last century, WHO had already clarified the complete definition of reproductive health. In addition to the absence of individual diseases, it also requires people to have a satisfactory and safe sex life, and to have the right to independently decide whether to have children, when to have children and how many children to have. When it comes to "autonomous decision-making", it has jumped out of the purely individual medical category. For example, whether partners can reach a consensus on contraceptive methods, whether anyone is forced to have unprotected sex, whether women are forced by their families to have two or three children, and are completely unable to make reproductive decisions on their own. These rights issues at the partner and family level directly determine whether an individual's reproductive health can be protected, and of course they are also part of reproductive health.

Going a step further, the public services and rights protection of the entire society are important supports for reproductive health. In the past two years, many places have promoted free HPV vaccination for women of appropriate age, as well as free annual two-cancer screening for women of childbearing age in the community, free hygiene kits for girls in remote mountainous areas, popular menstrual health knowledge, and even employment protection for pregnant women in the workplace and the implementation of maternity and paternity leave. These things that seem to have nothing to do with "individual medical treatment" are actually public-level reproductive health services. For example, if a woman has cervical cancer that can be cured, but there is no free screening policy in her place, and she cannot afford the medical examination fee, and by the time it is discovered, it is already at an advanced stage, then no matter how advanced individual medical technology is, her reproductive health has actually been damaged.

There are indeed different voices in the industry. Some clinicians believe that reproductive health should focus on medical treatment itself. Excessive extension of social issues will dilute the priority of medical resources. However, more public health practitioners will feel that the two are simply inseparable: if the problem of girls dropping out of school because of menstrual shame is not solved, and if women are not relieved of their fear of being dismissed due to pregnancy, no matter how advanced the hospital's reproductive technology is, it will not be able to cover those who have no chance to enter the clinic.

To put it bluntly, when we talk about reproductive health, we never just focus on one person’s body. From discussing with your partner whether to take birth control pills, to the community notifying you to get free folic acid, to the adjustment of the egg freezing policy discussed in the news, these big and small things are actually all within the scope of reproductive health.