Colombia is a country marked by contrasts. On the one hand, it has achieved important legal advances in the field of sexual and reproductive health and rights (SRHR), including the decriminalization of abortion up to the 24th week of pregnancy and the prohibition of child marriage through recent laws On the other hand, it faces deep structural challenges that limit real and equitable access to these rights, especially for populations most affected by armed conflict, inequality, and conservative ideologies.

One of the main obstacles identified by those working in the field is the gap between legal recognition of rights and their effective implementation. Alba Lucía Reyes Arenas, director of the Fundación Sergio Urrego, an organization that works to prevent discrimination and suicide among young people, especially in educational settings, warns that “there is still a lack of effective implementation of various Constitutional Court rulings”, which prevents children and youth, particularly those who are LGBTIQ+, migrants, or living in territories historically excluded from public infrastructure and investment, from accessing SRHR services and information freely and without prejudice. The foundation uses art, education, and culture as tools to heal, resist, and transform.

From Profamilia, the country’s largest private organization specializing in sexual and reproductive health, executive director Marta Royo points out that “child and adolescent pregnancy has been steadily increasing since the pandemic.” This is compounded by legislative setbacks pushed by anti-rights sectors who are currently trying to block key initiatives like the Comprehensive Trans Law or the ban on so-called “conversion therapies.” For Marta, strengthening data collection and evidence-based approaches, as well as diversifying funding sources —including hybrid models like social enterprises— are key to ensuring sustainability and broad coverage.

The need for an intersectional approach is a recurring theme. Miguel Ángel Barriga Talero, executive director of the Fundación Red Somos, a community-based organization working on HIV and sexual diversity with a rights-based approach, stresses that universal access to services, both in cities and rural areas, remains out of reach, especially when the system fails to formally recognize community health providers. He proposes demanding national public funding, building collaborative networks, and acknowledging the role of communities as central actors in primary care.

Fernando Ávila, gynecologist-endocrinologist at the Fundación Valle del Lili, a high-complexity medical institution that also serves as a teaching hospital and research center, highlights that geographic accessibility remains a key barrier, particularly in rural zones: “When it comes to family planning, the lack of universality in the methods [...] means that not all women can access all of them equally.” He also emphasizes the importance of continuing to strengthen professional training on modern contraceptive methods, demystifying their use, and ensuring that insurance systems do not become yet another obstacle.

Cultural barriers deeply shape daily practice as well. Miguel Ángel López López, journalist and co-founder of the Corporación MásQueTresLetras, an organization that uses pedagogy and digital communication to reduce stigma and connect people living with HIV to health services, puts it plainly: “although many rights have been secured on paper and services should be provided, they’re not, because people —including many healthcare professionals— don’t want to, due to their beliefs.” For Miguel, the key lies in investing in education from early stages: “if we manage to educate Colombians from a younger age in innovative ways, we will see change in the medium and long term, with generational impact.”

Despite the barriers, those advancing SRHR in Colombia do so with conviction and creativity, building from the ground up through partnerships, community strength, and evidence. They agree that moving forward requires both confronting conservative mindsets and building broad consensus to ensure dignity, diversity, and rights are respected. As Marta puts it: “Colombia is a country of contrasts: it faces enormous challenges, but it also stands out as an example of democratic progress and legal innovation in a socially conservative, yet deeply transformative, context.”