Scottish Government high level action plan in response to the Committee on Economic, Social and Cultural Rights

18: Sexual and reproductive health

Thematic Tags

Right to health sexual and reproductive healthcare; Access to healthcare; Maternal healthcare; Rurality; Migrants; Racialised minorities

Concluding Observation 53a

The Committee recommends that the State Party, along with the devolved governments […] Increase efforts to ensure equal access to maternal health services for migrant women and women from ethnic minority groups with a view to reducing maternal and infant mortality rates and to adequately equip facilities for antenatal, perinatal and postnatal care, particularly in rural areas.

Context

We are committed to delivering care which meets the Best Start vision – that all mothers and babies are offered a family-centred, safe and compassionate approach to their care, recognising their own unique circumstances and preferences. We are committed to reducing maternal and infant mortality and advancing health equity by increasing efforts to ensure equal access to maternal health services for all women, and in particular those with additional complex needs by strengthening antenatal, perinatal, and postnatal care in alignment with our National Outcomes on health, human rights, and reducing inequalities.

A Remote, Rural and Islands Task and Finish Group has been established to evaluate ways of delivering safe, quality health care services to populations including maternal health services for migrant women and women from ethnic minority groups in these areas. As part of its work, the group aims to define ‘core services’ that should be provided locally, taking into account the requirement for specialised care that may need to be accessed outside the local area when clinically necessary.

We continue to take forward work nationally to address the challenges faced by maternity services in rural health boards. Initiatives such as the introduction of model of continuity of care, development of community hubs, and the increased use of Near Me all improve the delivery of rural maternity services.

Key Actions

We will publish a Rural Delivery Plan and a new National Islands Plan by the end of this Scottish Parliament, setting out how we are delivering for our rural and island communities respectively. We are working with islanders, local authorities and partner organisations to ensure the refreshed Plans drive progress towards our shared vision of thriving, sustainable and successful island and rural communities.

In May 2025, we published a report on our progress to implement Best Start. This confirmed the delivery of three quarters of the government’s recommendations from 2017-24. Work to implement the remaining recommendations, including continuity of care and the new model of neonatal intensive care, continues.

We published the Tackling Racialised Health Inequalities in Maternity Care Action Plan and interpretation toolkits on 6 February 2025. These are designed to support NHS Boards to continue to improve outcomes and experiences for women and families from minoritised communities, including those who require access to an interpreter. The action plan sets out 14 actions to be taken forward over the immediate, shorter, medium and longer-term. It sets the expectation of NHS Boards, Scottish Perinatal Network and other national partners to ensure that local clinical guidelines and pathways meet the needs of all service users, with a particular focus on the needs of women and babies with Black and Brown skin.

We continue to engage on the perinatal care priority for NHS Boards’ anti-racism planning guidance to ensure that tackling racialised inequalities is built into wider work on safety and standards from the outset.

Concluding Observations

53b: The Committee reco mmends that the State Party, along with the devolved governments […] Strengthen measures to ensure the accessibility and availability of appropriate, good-quality sexual and reproductive healthcare services and information, such as access to safe abortion services, including abortion medication, contraception and emergency contraception, for all women and adolescent girls in the State Party, particularly those living in rural or remote areas.

53c: The Committee recommends that the State Party, along with the devolved governments: Be guided by the Committee’s general comment No. 22 (2016) on the right to sexual and reproductive health and the Abortion Care Guideline (2022) of the World Health Organization (WHO) and take into account the recommendations made by the Committee on the Elimination of Discrimination against Women in its inquiry.

Context

Women’s health remains a principal focus for us, and we became the first government in the UK to introduce a Women’s Health Plan in August 2021. The plan outlined 66 actions designed to improve health outcomes for women and girls, concentrating on: menopause; menstrual health including, endometriosis; abortion and contraception; post-natal contraception; and heart health. A final report on the first plan was published in November 2024.

The Abortion Services (Safe Access Zones) (Scotland) Act 2024 was enacted in September 2024. Safe access zones (sometimes also called ‘buffer zones’) protect and ensure women and girls can access abortion services without fear or intimidation. It also protects staff working to provide abortion services by preventing activities, which could influence or alarm them, within a 200 metre radius of hospitals and clinics.

Access to free period products for anyone who needs them is protected in law by the Period Products (Free Provision) (Scotland) Act 2021. We are proud to have taken world leading action through investing over £47 million since 2018 to fund access to free period products across a range of settings including schools, colleges and universities, plus wider public spaces.

Key Actions

We aim to publish the next phase of our Women’s Health Plan in January 2026. We gathered the views of women and girls, key stakeholders, clinical experts, academics, and those working in women’s health.

We established an Abortion Law Expert Group to provide an independent assessment of the current law on abortion and, if appropriate, make recommendations for reform. The Expert Group’s report was published in November 2025. This report forms only one part of the review and we will now begin our own programme of stakeholder engagement on these recommendations with a wide range of individuals and organisations interested in this subject before determining the need for legislative proposals. Any future consideration of legislative proposals would be subject to a full public consultation.

As part of our Sexual Health and Blood Borne Virus Action Plan we have allocated £800,000 to several projects aimed at increasing accessibility to sexual and reproductive health services, including testing, contraception, and post-abortion care.

We continue to support Early Medical Abortion at Home where it is clinically appropriate in line with the findings of the 2023 independent evaluation.

We established a Task and Finish Group to agree a recommended service model to support women to have later stage abortions in Scotland. The group has developed a model, and work will begin with health boards to move towards implementation of this as soon as possible.