Top 10 Barriers to Reproductive Health Care in Developing World

Have you ever crossed your fingers, hoping not to get pregnant?

Every day in the world’s poorest countries, women cross their fingers. They cross their fingers that when they reach the clinic—5 miles away—it will be open. They cross their fingers, hoping that the clinic will be staffed by a health care provider who can answer their questions about family planning truthfully and without bias. They cross their fingers that they won’t get an STD.

Will their finger-crossing work? Will the clinic have their preferred method of contraception? Will their partners be supportive? Will they be allowed to space their next pregnancy so that they can provide their other children with good food and keep them in school—or perhaps go back to school themselves?

Too often, women face extreme barriers to sexual and reproductive health care. They shouldn’t have to.

After four years working for Pathfinder International, a global reproductive health nonprofit, here are the top ten barriers I’ve seen. Want to break these down? Join me in supporting Pathfinder’s breaking barriers campaign. Every $1 donated before midnight on September 30th is matched by $2 by a generous anonymous donor. Let’s break these barriers together!

1. Gender inequality: Women often can’t access reproductive health care because of systemic gender inequality. For instance, a woman in desperate need of emergency obstetric care, may have to have her husband’s permission to go to a clinic.

2. Stock outs: For many reasons, including supply chain issues, poor planning, or lack of funding, clinics often run out of contraceptives.

3. Lack of skilled service providers: In many areas, the number of service providers like doctors, nurses, and midwives is limited, and those that exist are often  under-trained.

4. Distance to health service point: In rural communities, health centers, clinics, and hospitals can be far away or too difficult to reach.

5. Misinformation in communities: Whether it’s about side effects of contraceptives (like they accumulate in your stomach) or the transmission of HIV, myths and misinformation about reproductive health can take many forms.

6. Opportunity costs: For some women, the time needed to go to a clinic, or travel to a hospital means losing out on other valuable time working in the field, traveling to market, or preparing food for their children.

7. Service provider bias: Just because a nurse is trained in providing a service, does not mean he/she provides it without bias. This can take the form of refusing to discuss contraceptive use with adolescents, for instance, or turning away a woman who is seeking abortion counseling.

8. Legislative and legal barriers: Restrictive laws and policies can have a real—and sometimes devastating—impact on the people Pathfinder serves. This is particularly challenging in relation to safe abortion services.

9. Cultural norms and traditions: In some cultures women can only seek services from another women; yet, female providers are limited. In others, religious leaders resist the idea of sexual and reproductive health services, such as contraception.

10. Lack of funding: Global reproductive health is significantly underfunded. More than 200 million women want, but lack access to contraceptives. As government budgets become tighter, international funding is even more at risk.

    Breaking Down Barriers


    Christine Stewart

    I love Pathfinder! I only learned about the group this past year, but try to give (modest) donations regularly. For people who complain that they won't donate to starving people in Africa because they don't use contraception, this article should be an eye-opener. How can you use contraception if it's not available! Or your husband won't allow it, or you can't afford it...

    Gina H.
    Gina H6 years ago


    If MEN didn't RAPE women there wouldn't be such an issue with needing abortions. If MEN kept it in their pants or got a vasectomy or even wore a NEW condom, then 50% of the needs for abortion would also go down. What part of that don't YOU get? I agree with Fred K that one of the biggest barriers to reproductive health services is ORGANISED RELIGION. I'm beginning to think what they really mean about the word "organised/organized" is that these religions are totally obsessed with supposed control of the organs used for sex. The second largest part of the equation rests on the male population that chooses to rape and have unprotected sex with as many female targets as possible.

    Dawid Blyth
    David B6 years ago

    When the ANC regime took over South Africa, the hospitals worked.
    They closed most of the nursing colleges and are now surprised to find a shortage of nurses!
    16 years later, it is often fatal to be admitted to a government hospital.
    There is more concern about offering abortions than caring and nurturing life!
    Health care costs have skyrocketed!
    I believe SA is heading the way of the the rest of Africa

    Jim Gayden
    Jim Gayden6 years ago

    Marianne C.
    I really appreciate your thoughtful, hamanitarian, and well researched comments here.

    Marianne C.
    Marianne C6 years ago

    You're in luck, Steve: Federal funds pay only for abortions for victims of rape and/or incest, and for women whose pregnancies either endanger their own lives or will produce a child with conditions which, if born, will be incompatible with life.

    The rest of Federal family planning funding goes to pregnancy prevention and general health care such as mammograms, pap smears, tests for STDS for both males and females, prostate tests, and fertility tests.

    Marie W.
    Marie W6 years ago

    Sounds like the US the GOP wants.

    Marianne C.
    Marianne C6 years ago

    Part 2

    Taking away family planning dollars is what sentenced all those women and children to death, all in A SINGLE YEAR. If you support the destruction of family planning funds, you support the loss of those lives. Period. No excuses.

    What will it take to awaken Americans to that reality?

    Marianne C.
    Marianne C6 years ago

    Actually, you forgot one very significant reason: Republicans in the US Congress.

    When Republicans first took over Congress in 1998, one of the first things they did was cut funding for family planning out of foreign aid.

    The original cuts affected only 17 million people. However, but the end of the first year, the cuts had resulted in:

    * an additional 4 million unwanted pregnancies;
    * an increase in the abortion rate of 1.6 million;
    * the unnecessary deaths of an additional 8 thousand women;
    * the unnecessary deaths of an additional 123 thousand infants;
    * the unnecessary loss of a mother by 8 thousand families;
    * the unnecessary additional hunger, deprivation, and want among countless millions of older children whose families simply could not afford a new baby;
    * overburdening of health care systems already over-extended and under-funded.

    17 million people is like taking the populations of New York and LA and adding them together. If these two cities were to have an increase in abortions of 1.6 million, and a death rate of 8 thousand mothers, plus the deaths of 123 thousand children because of some stupid "cut" passed by our own Congress, we'd all be demanding Congressional heads on platters. We'd be calling them murderers.

    Why are the lives and health of women and children in other countries so easy to dismiss as insignificant and inconsequential? Taking away family planning dollars is what sentenced all those women and children to death, all in the

    Steve R.
    Steve R6 years ago

    I will help break barriers to reproductive health care as long as abortion is not classified as reproductive health care unless performed after a rape or incest, or if carrying the fetus to full term would endanger the mother's life.

    Brian M.
    Past Member 6 years ago

    When women are safe from violence, and given access to education, employment, and health care; they almost always choose to have fewer children than the previous generation. We must impose these values around the world if women are ever going to be free from the tyranny that so many of them live and die under today.