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Invisibility problem: why current economic evaluations understate the value of sexual and reproductive health and rights, and three strategic shifts to address it

Year: 2026

Type: editorial

Abstract: The value of sexual and reproductive health and rights (SRHR) has been imprecisely calculated. Despite extensive evidence demonstrating wide-ranging social, economic, environmental, peace and security benefits of SRHR interventions, 1 2 most economic evaluations include only health-sector benefits such as disability-adjusted life-years averted or the quality-adjusted life-years gained.3 For example, based on modelling of WASH data collected between 2000 and 2019, an estimated 500 million women and girls who menstruate lack access to basic menstrual materials; safe, private and clean sanitation facilities; and/or quality menstrual health services.4 Poor menstrual health can deter girls from attending school and may limit women’s workforce participation, leading to long-term economic disadvantages for individuals and society.5 While some economic evaluations of menstrual health include productivity losses, many short-term and long-term outcomes across health, education, labour and social protection systems are not considered.6 Overly narrow evaluations miss impact and cost-savings in sectors other than health and across the life course. This may result in the under-prioritisation of high-impact SRHR interventions and suboptimal investment decisions.7–9

Source: BMJ Global Health

DOI: 10.1136/bmjgh-2026-024850