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Closing the Gaps in Sexual and Reproductive Health and Rights for Women and Adolescent Girls

The Closing the Gaps in Sexual and Reproductive Health and Rights by Strengthening Health Systems for Women and Adolescent Girls (C-Gaps) Project is a six-country initiative led by the Pan American Health Organization (PAHO) with support from the Government of Canada. Running from 2025 to 2030 and with a CAD$15 million investment, the Project strengthens health systems and expands equitable access to sexual and reproductive health services for women and adolescent girls in Bolivia, Colombia, Ecuador, Guyana, Honduras, and Peru.

Building on lessons from the IHWAG Project and aligned with Canada’s Feminist International Assistance Policy and PAHO’s Strategic Plan (2026-2031), it tackles persistent inequalities by improving health service delivery, advancing women’s and girls’ leadership and agency, and promoting rights-based advocacy—particularly for those facing intersecting forms of vulnerability, including Indigenous, Afro-descendant, and migrant, populations.

“Investing in the health and rights of women and adolescents is not just a moral imperative, but also a fundamental pillar of sustainable development. When women and girls thrive, entire communities flourish” 

- PAHO Assistant Director, Dr. Rhonda Sealey-Thomas

Health-Thematic Focus Areas

  • Sexual, Reproductive, Maternal, Neonatal, and Adolescent Health
  • Reduction of Maternal and Neonatal Mortality
  • Adolescent Pregnancy Prevention
  • Access to Contraception
  • Prevention and Response to Gender-Based Violence
  • Cervical Cancer Blood Safety and Transfusion Services
  • Elimination of Mother-to-Child Transmission of HIV and Syphilis
  • Women and Youth Leadership, Participation, and Empowerment
  • Health equity, gender equality and cultural diversity
  • Health Information Systems
  • Health Research and Data Analysis
Map of participating countries highlithed

Key Facts

Barriers to access sexual and reproductive health services persist and are greater in populations living in situations of vulnerability, which leads to certain groups having systematically worse outcomes.
Maternal mortality remains a major challenge in the Region, reflecting deep inequities in access to quality care. Pregnant women facing obstetric complications often encounter financial, geographic, sociocultural, and health system barriers that delay life-saving services.
Despite progress in recent decades, Latin America and the Caribbean continue to have one of the highest adolescent pregnancy rates in the world—51.4 births per 1,000 women aged 15–19 years, which is markedly higher than the global average of 39 births per 1,000.
Persistent inequalities in access to contraceptive methods—especially long-acting methods—in Latin America and the Caribbean (LAC) result in significantly lower usage among women living in situations of vulnerability.
Evidence shows that, within countries, significant disparities persist in the burden of early pregnancy among different population groups. Indigenous and Afro-descendant adolescents, those living in rural areas, with lower levels of education, and from economically vulnerable households are up to four times more likely to begin childbearing compared with their non-Indigenous, urban, more educated, and wealthier peers.
Gender norms that assign women a primary role in reproduction and caregiving often limit their participation in education, employment, and leadership, perpetuating dependence and reducing agency. This exclusion not only affects access to contraception and comprehensive SRH services but also contributes to higher rates of adolescent pregnancy and maternal mortality.
Strengthening women’s participation and leadership in policy dialogue, community health governance, and advocacy is essential to ensure that SRH programs are equitable, culturally appropriate, and rights-based.
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