Building a supportive, enabling environment

Finally, it is important to keep in mind that the components of an enabling environment that need to be addressed across the individual, relationship, community and societal levels to support SRHR for WUD should always include the following:

• Psychosocial support.
• Healthy sexuality throughout the lifetime.
• Economic empowerment and resource access.
• Integration of SRHR and HIV services.
• Protection from violence and creating safety.
• Social inclusion and acceptance.
• Community empowerment.
• Supportive laws and policies and access to justice.
• Interventions at the relationship level to ensure that health workers at health-care facilities respect and support WUD instead of judging or stigmatizing them. This helps WUD to have easier access to contraceptive or fertility support services.
• Interventions at the community level to shift social norms relating to violence and stigma. It helps WUD to more easily have a healthy sexual life if they experience less violence and feel that all their sexual identities are accepted.
• Interventions at the societal level to enact law and policy reforms. WUD will more likely exercise their agency if they can benefit from health system policies providing them a wide range of contraceptive options or fertility support services.

The health system should intervene in matters that influence health outcomes across the levels of the social ecological framework and consider how they may interact to support women to achieve healthy sexuality.