United Nations

E/CN.9/1995/3


Economic and Social Council

 Distr. GENERAL
20 January 1995
ORIGINAL: ENGLISH


Population Commission
Twenty-eighth session
21 February-2 March 1995
Item 3 (c) of the provisional agenda*

        REVIEW OF POPULATION TRENDS, POLICIES AND PROGRAMMES:
          MONITORING OF MULTILATERAL POPULATION ASSISTANCE

          Monitoring of multilateral population assistance

                 Report of the Secretary-General


                            SUMMARY

     The present report has been prepared in response to
recommendation 88 of the International Conference on Population
held at Mexico City in 1984, as well as to Economic and Social
Council resolutions 1986/7 and 1987/72, in which the
Secretary-General was requested to prepare, on a regular basis,
reports on monitoring of multilateral population assistance.  Since
less than a year has elapsed since the Population Commission's
twenty-seventh session, when a full report on the monitoring of
multilateral population assistance was presented, the Commission
will have before it only an update of that report.

     The present report describes trends in multilateral population
assistance, highlights the substantive areas where such assistance
was used and reviews operational aspects within the United Nations
system for channelling assistance to developing countries.  The
report notes that as a result of the adoption of the Programme of
Action by the International Conference on Population and
Development, held at Cairo in 1994, multilateral assistance will
undergo both substantial changes in the quantity of resources made
available and a reorientation towards the major themes of the
Conference, including reproductive health/family planning and the
empowerment of women.


                           CONTENTS

                                                                  
                                                   Paragraphs  Page
 
INTRODUCTION ........................................1 - 8       4

  I.  TRENDS IN MULTILATERAL POPULATION ASSISTANCE ..9 - 34      5

      A.  Background ................................9 - 12      5

      B.  Expenditure by geographical region .......13 - 18      6

      C.  Expenditure by work-plan category ........19 - 20      7

      D.  Expenditure by work-plan category and 
          region ................................   21 - 25      8

      E.  Expenditure by executing agency ..........26 - 29      8

      F.  Multi-bilateral financing ................30 - 32      9

      G.  Loans and credits from the World Bank 
          and regional development banks............33 - 34     10

 II.  SUBSTANTIVE ISSUES ...........................35 - 92     10

      A.  Basic data collection and analysis .......37 - 42     10

      B.  Population dynamics ......................43 - 49     11

      C.  Formulation and evaluation of
          population policy .....................   50 - 54     13

      D.  Maternal and child health/family 
          planning and reproductive health service  55 - 64     13

      E.  Population information, education and 
          communication  .........................  65 - 76     15

      F.  Women, population and development ........77 - 92     18

III.  OPERATIONAL ISSUES ...........................93 - 130    20

      A.  Programming approach .....................94 - 97     21

      B.  Programme and project formulation and 
          implementation  ......................... 98 - 107    21

      C.  Monitoring and evaluation ...............108 - 112    23

      D.  Resource mobilization for the 
          Programme of Action of the International 
          Conference on Population and Development 113 - 130    24

 IV.  CONCLUSIONS ...............................  131 - 135    28

                              CONTENTS (continued)


                                                             Page

                            Tables


1.  Distribution of UNFPA expenditures, 
    by work-plan category, 1990-1993   .....................  30

2.  Distribution of expenditures for population assistance, 
    by region and channel, 1989 and 1990.   ..............    30

3.  UNFPA expenditures, by work-plan category and region,
    1990-1993 ............................................    31

4.  Distribution of UNFPA expenditures, by region, 
    1990-1993 ............................................    32


                        INTRODUCTION


1.   The present report has been prepared in response to
recommendation 88 of the International Conference on Population,
held at Mexico City in 1984, 1/ in which the Secretary-General was
requested to undertake the monitoring of multilateral population
programmes of the United Nations system aimed at the further
implementation of the World Population Plan of Action, 2/ and to
Economic and Social Council resolutions 1985/4, 1986/7 and 1987/72
and General Assembly resolution 39/228.

2.   The first report on multilateral population assistance
(E/1989/12) covered the period 1974-1988, following the World
Population Conference held at Bucharest in 1974.  Building upon the
first report, the second report (E/CN.9/1991/8) highlighted
developments that occurred during 1989 and 1990.  The third report
(E/CN.9/1994/6), covering the period 1991-1992 and part of 1993,
was prepared for the twenty-seventh session of the Population
Commission, held in March 1994.  Given the short interval between
that session and the twenty-eighth session, the present report
merely updates the 1994 report.  A further reason for preparing an
abbreviated report was that decisions concerning the follow-up to
the International Conference on Population and Development, held at
Cairo in September 1994, were expected to result in major changes
in monitoring and reporting on progress made towards achieving the
goals contained in the Programme of Action adopted by the
Conference. 3/

3.   As the General Assembly made clear in its resolution 49/128,
the Population Commission will be "revitalized", with the new
functions of monitoring, reviewing and assessing the implementation
of the Programme of Action; the name of the Commission will be
changed to the Commission on Population and Development.  In the
same resolution, the Assembly requested the Population Commission,
at its twenty-eighth session, to review the Programme of Action and
its implications.

4.   The importance of responding forcefully and promptly to the
plan set out at Cairo for concrete actions in the field of
population and development is therefore apparent.  Several actions
in the months since the Conference have already been taken to
energize the world towards fulfilling the promise of the
Conference.  It is important to update the Commission about recent
actions undertaken by multilateral agencies.

5.   Among the most significant developments are those concerning
the follow-up to the Conference.  In paragraph 16.29 of the
Programme of Action, all specialized agencies and related
organizations of the United Nations system are invited to
strengthen and adjust their activities, programmes and medium-term
strategies, as appropriate, to take into account the follow-up to
the Conference.

6.   The Executive Director of the United Nations Population Fund
(UNFPA) has been requested by the Administrator of the United
Nations Development Programme (UNDP), on behalf of the
Secretary-General, to develop a coordinated approach for the
implementation of the Programme of Action.  In order to enhance
complementarity, maximize comparative advantage and increase
coordination among the different United Nations organizations, an
Inter-Agency Task Force is being established that will include
high-level officials of the United Nations system, including the
World Bank, to devise a common and integrated strategy for the
follow-up to the Conference.  The Executive Director of UNFPA has
been requested to coordinate the Task Force and UNFPA headquarters
will serve as the secretariat for meetings of the Task Force.

7.   The Inter-Agency Task Force will meet regularly to discuss the
progress made in implementing the recommendations of the Programme
of Action.  The Task Force will focus on three aspects:  policy
development, coordination and the monitoring of progress made in
the implementation of the Programme of Action.  The principal
actions at the country level will be coordinated by the United
Nations resident coordinator.

8.   Mobilization of both domestic resources and international
assistance is given great emphasis in the Programme of Action.  The
Conference was the first United Nations international conference to
agree to a schedule of resource mobilization in order to achieve a
specific set of development objectives.  Monitoring resource
mobilization on a regular basis will in fact be an added major
responsibility for UNFPA on behalf of the Secretary-General.  It is
important to realize the fundamentally operational character of the
Programme of Action and then to put in place adequate follow-up
mechanisms to achieve the desired operational results.  At the
Conference, many major donors indicated their commitment to
substantially increase assistance for population, in line with the
estimates set out in the Programme of Action.  This will have
important implications for the level of financial resources
channelled through multilateral agencies.  Section III.D of the
present report describes in detail the requirements for resource
mobilization for the implementation of the Programme of Action.


     I.  TRENDS IN MULTILATERAL POPULATION ASSISTANCE 4/

            A.  Background

9.   Multilateral population assistance is provided by United
Nations organizations that carry out population-related programmes.

For many of these organizations, funds committed to population
activities come primarily from UNFPA and, to a lesser extent, from
their own regular budgets and other funding sources.  UNFPA is the
most important source of multilateral population assistance, both
because it is the major source of population funding for other
multilateral organizations within the United Nations system and
because of the large quantity of assistance it supports directly
through national population programmes.  The World Bank and
increasingly the regional development banks are other major
multilateral sources of population assistance through their
disbursement of loans and credits. 

10.  The overall trends in multilateral population assistance for
the United Nations system for 1990-1992, in millions of United
States dollars are summarized below (data for 1993 are not yet
available):

                                      1990       1991       1992

     Total assistance                  972      1 306      1 033
     UNFPA                             232        240        204
     Other United Nations 
      organizations                     86        102         54
     Private sources                    48         76        106
     World Bank loans a/               169        354        107

     ________________________

          a/   World Bank figures represent funds committed in a
given year and should not be confused with expenditures.  In the
case of UNFPA, committed funds are allocated for the same year; in
the case of the World Bank, committed funds are typically disbursed
as loans over several years.

In 1990, total international assistance for population programmes
amounted to US$ 972 million, including World Bank loans and
credits.  Of this amount, $669 million came from donor countries
while the rest of the United Nations system provided $86 million
and private sources, $48 million.  World Bank loans in 1990
amounted to $169 million.

11.  By 1992, international population assistance in the form of
grants and loans had barely increased over the 1990 figure, after
experiencing a large increase in 1991.  Private sources of
international assistance have continued to increase substantially,
but this was offset by a large drop in multilateral sources from
the United Nations system (excluding UNFPA).  Data for 1993 are
incomplete, but provisionally UNFPA expenditures amounted to $213
million, while World Bank loans for its fiscal year totalled close
to $200 million.

12.  Within the United Nations system (excluding the World Bank),
UNFPA has provided the largest proportion of funds to population
assistance.  In 1989, expenditures to population assistance through
the UNFPA channel amounted to 81 per cent of all funds routed
through the United Nations system.  In 1992, the proportion
remained unchanged at 81 per cent.


          B.  Expenditure by geographical region 5/

13.  Most population assistance is channelled to developing
countries under three modalities:  bilateral agencies, multilateral
agencies and non-governmental organizations.  Of total expenditures
of population-related assistance in 1992, about 33 per cent
involved direct transfers through bilateral channels, 26 per cent
through multilateral agencies and 41 per cent through
non-governmental organizations.  Over the past decade, these
proportions have fluctuated from year to year, but no apparent
trend can be observed. 

14.  The distribution of international assistance by channel
differed from region to region.  In Africa, project execution using
direct bilateral assistance accounted for 39 per cent of the funds,
multilateral means, 27 per cent and non-governmental organizations,
34 per cent.  In Asia and the Pacific, direct bilateral assistance
made up 49 per cent of funding in 1992, with 23 per cent supplied
through the United Nations system and 28 per cent through
non-governmental organizations.

15.  Between 1989 and 1992, regional variations in channels of
population assistance were slight.  In Western Asia, greater
involvement of non-governmental organizations over the period may
indicate a trend or may simply be the result of random yearly
variations.  

16.  Considering expenditures for population programmes from
multilateral sources alone, Africa and Asia and the Pacific have
received the largest share of population assistance.  This is
explained mainly by the growing priority given to those regions by
both bilateral and multilateral agencies.  In 1992, about 36 per
cent of total multilateral funds went to each region, while Latin
America and the Caribbean received 16 per cent and Western Asia, 9
per cent.  Europe accounted for under 3 per cent of the total
expenditure.  A broadly similar pattern of regional allocations is
found in the distribution of UNFPA funds for 1992 and 1993.

17.  The pattern of multilateral funding shows that Asia and the
Pacific has received a declining share of population resources.  In
1986, the region received 52 per cent of funds, which declined to
37 per cent in 1992.  In contrast, assistance to Africa has
increased, from 26 per cent in 1986 to 36 per cent in 1992.  The
share of Latin America and the Caribbean increased from 10 per cent
in 1986 to 16 per cent in 1992.  Western Asia has consistently
received about 10 per cent of the total multilateral funding.

18.  Regarding geographical trends in UNFPA funding, Africa has
increasingly received more funds, from 22 per cent in 1986 to 33
per cent in 1993.  The shares for other regions have remained
roughly stable over the same period.  Latin America and the
Caribbean has received from 12 to 13 per cent of UNFPA funds and
Western Asia, about 9 to 10 per cent during the period under
consideration. 6/


            C.  Expenditure by work-plan category

19.  Reporting of UNFPA expenditures still follows the work-plan
categories agreed upon by the Administrative Committee on
Coordination (ACC), although modifications are planned in order to
categorize activities according to the main themes identified at
the Cairo Conference.  The bulk of funds for programmes on maternal
and child health and family planning (MCH/FP) accounted for 52 per
cent of total available funding in both 1992 and 1993. 
Information, education and communication (IEC) programmes received
about 15 per cent over the same period.  Population dynamics
received 9 per cent in 1992 and 7 per cent in 1993.  About 9 per
cent of funds went to formulation and evaluation of population
policies and integration of population into development planning,
from 4 to 6 per cent went to special-sector programmes and about 3
to 4 per cent for multisectoral activities during the same period.

20.  The increase in resources allocated to MCH/FP programmes after
1991 may be attributed both to the decrease in expenditures for
data collection and analysis following the peak in the 1990 round
of censuses and to increasing demand for MCH/FP services.


      D.  Expenditure by work-plan category and region

21.  An examination of regional trends within substantive sectors
reveals that, in MCH/FP, there has been an increase in the share of
regional funding for activities in Western Asia.  In this region,
UNFPA expenditures rose from 28 per cent of the total in 1990 to 59
per cent in 1993.  The proportions of total expenditures for MCH/FP
also rose in other regions in 1993 (except in Asia and the
Pacific), but this may reflect normal fluctuations from year to
year rather than a trend.

22.  There have been year-to-year fluctuations in the proportions
of funding for the IEC sector in all regions during the period
1990-1993.  The proportion of expenditures for IEC in Africa
averaged about one fifth of the total spending over the period, the
highest of any developing region.  In Latin America and the
Caribbean and Western Asia no clear trend is evident, but both
regions had considerably lower IEC expenditures in 1993.

23.  As far as basic data collection for population is concerned,
there has been a decline in the proportion of funds in sub-Saharan
Africa and in Asia and the Pacific for this category since 1990. 
In the case of Africa, population funds for censuses, surveys and
vital statistics and civil registration systems declined from 23
per cent in 1990 to 14 per cent in 1993.  Even at this lower
percentage, however, Africa outpaced all other regions in
expenditures for data collection.  The proportion of expenditures
for basic data collection in Asia and the Pacific has also fallen,
standing at 4 per cent in 1993.  In the other two regions,
expenditures in this area remained roughly unchanged.

24.  The proportion of support for activities in
population-dynamics research has declined in all developing
regions, although in Asia and the Pacific this proportion has
historically been rather low. 

25.  Expenditures for formulation and evaluation of policies and
programmes continue to be important in Africa, where the proportion
of funds for that sector increased from 11 to 13 per cent in 1993. 
In many African countries, Governments have set up special
population units in planning and other ministries.  UNFPA has
assisted those units as well as projects specifically aimed at the
formulation of population policies.  In Western Asia, Asia and the
Pacific, and Latin America and the Caribbean, only between 3 and 6
per cent of available funds were devoted to the formulation and
evaluation of polices and programmes in 1993.


             E.  Expenditure by executing agency

26.  Population projects funded by multilateral sources are
executed by Governments, United Nations organizations or
non-governmental organizations. 7/  In 1989, approximately 20 per
cent of UNFPA-funded projects were executed by UNFPA itself, 54 per
cent by other United Nations organizations, 14 per cent by
Governments and 12 per cent by non-governmental organizations.

27.  By 1992, UNFPA execution accounted for 25 per cent and other
United Nation organizations for 44 per cent of funds originating
from UNFPA.  The increase in UNFPA execution is mainly attributable
to the increased responsibility given to UNFPA for contraceptive
procurement.  Government execution in 1992 accounted for 18 per
cent and the share executed by non-governmental organizations
remained at 13 per cent.

28.  The increase in funds for projects executed by UNFPA and those
directly executed by Governments reflects new arrangements for
national execution of projects pursuant to the policy of the
UNDP/UNFPA Governing Council that makes national project execution
the preferred modality, in conformity with General Assembly
resolution 47/199.

29.  Execution of population projects by other United Nations
organizations has generally declined since 1989, both in absolute
amounts and in their share in total project execution.  The
exception to this trend is the United Nations Children's Fund
(UNICEF).  This is in response to explicit efforts by UNFPA and
UNICEF towards greater collaboration and is in line with decisions
of the governing bodies of both organizations.


                F.  Multi-bilateral financing

30.  In addition to resources regularly contributed by donors to
UNFPA, the Fund receives funding for earmarked projects that are
managed by the Fund as multi-bilateral resources.  Five per cent of
total UNFPA expenditures in 1993 came from multi-bilateral funding
($10.3 million), about the same level as 1992.  Multi-bilateral
financing, however, has continued to rise over a longer time
period:  income from multi-bilateral sources increased from $7.3
million in 1989 to $15.6 million in 1993.  Major multi-bilateral
donors to UNFPA include Australia, Austria, Belgium, Canada,
Finland, France, Italy, Luxembourg, the Netherlands, Norway,
Sweden, Switzerland and the United Kingdom of Great Britain and
Northern Ireland.

31.  When multi-bilateral funding is analysed by work-plan
categories, it is clear that family planning programmes have
received the bulk of multi-bilateral resources, about 52 per cent
in 1993.  IEC projects received only about 8 per cent.  The other
important area supported by multi-bilateral funds in 1993 was basic
data collection, whose share of the total was 19 per cent.

32.  In 1993 the bulk of multi-bilateral financing went to
sub-Saharan Africa (44 per cent) and Asia and the Pacific (29 per
cent).  Interregional activities accounted for about 17 per cent of
multi-bilateral expenditures in 1993.


          G.  Loans and credits from the World Bank
              and regional development banks   

33.  The World Bank differs from other United Nations organizations
in that it normally provides loans rather than grants for
population activities.  The World Bank financial figures are also
expressed in terms of multi-year funding commitments rather than
annual expenditures and are therefore difficult to compare with
other donor financial statements.  Over the years, the amount of
World Bank loans in the field of population, health and nutrition
(PHN) has increased.  Loan commitments for the population component
of PHN have fluctuated in the recent past:  funds devoted to
population alone amounted to $86 million in 1988, $169 million in
1990 and $107 million in 1992. 8/

34.  Regional development banks are also giving increased priority
to loans for population activities.  Most notably, the Asian
Development Bank has prioritized population assistance in its
Medium-term Strategic Planning Framework (1993-1996).  Cumulative
Asian Development Bank support in integrated health and population
projects totalled $669 million as of mid-1993.  Of this amount, $50
million went to the population component.  The African Development
Bank has also placed population squarely in the centre of its
priority concerns for development assistance.


       II.  SUBSTANTIVE ISSUES

35.  In monitoring multilateral population assistance, the
UNDP/UNFPA Governing Council requested the Secretary-General to
review substantive and technical issues of special priority to
population concerns.  Pursuant to that request, the present report
focuses on (a) basic data collection and analysis; (b) population
dynamics; (c) formulation and evaluation of population policy; (d)
family planning as integrated in MCH and primary health-care
approaches; (e) population information, education and
communication; and (f) special programmes.  None the less, it
should be borne in mind that a new reporting mechanism for
following up the Programme of Action will soon be adopted, implying
the monitoring of a set of programme priorities and categories
(different from the six categories mentioned above) that better
capture the new priorities agreed upon in Cairo.

36.  The UNDP/UNFPA Executive Board has also recommended that
population assistance support activities integrating gender
considerations into population and development.  In the present
report, therefore, gender is reflected in all substantive areas of
population assistance.  At the same time, population assistance
primarily focused on women and development issues is covered
separately in section F below.


           A.  Basic data collection and analysis

37.  Population planning and programme implementation require
accurate data on numbers and characteristics of a country's
inhabitants, migration patterns, spatial distribution of
population, incidence of births and deaths, rate of population
increase, fertility and mortality, the formation and dissolution of
families and households and the like.  The principal sources of
such data are censuses, surveys and vital statistics systems based
on civil registration of births, deaths, marriages and divorces.

38.  During the 1990 census decade, which covered the period
1985-1994, 193 countries or territories have taken or plan to take
a population and housing census and certain others have taken a
census of population or a census of housing separately.  Of the 56
countries in Africa, a census has been taken in 45 countries or
areas; in 35 countries (37 censuses) the census was taken during
the period 1985-1992 and in 10 other countries censuses were
planned for 1993 or 1994.

39.  During the past two census decades, there has been a marked
increase in the number of censuses taken in Africa.  This is due to
the promotion of the 1980 and 1990 African Population and Housing
Census Programmes as well as to the technical and financial support
provided by the United Nations system.  With a few exceptions, all
countries in Africa received financial assistance from UNFPA for
their censuses.

40.  Efforts continued to develop cost-effective sampling
techniques and analytical procedures to address problems with an
adequate statistical base and to improve civil registration and
vital statistics systems.  It is clear, however, that in those
developing countries where coverage remains low, more innovative
approaches are called for.

41.  An important collaborative endeavour in the area of
population, data collection and analysis is the Pan-Arab Project
for Child Development (PAPCHILD) survey programme covering the Gulf
States and six other countries in Western Asia, jointly launched by
UNFPA and the Arab Gulf Fund (AGFUND).  Together with another
similar initiative in the same region, the Gulf Health Survey, the
information gathered was used to develop and improve MCH/FP
policies and programmes throughout the region.

42.  The World Fertility Survey (WFS) programme carried out in the
1970s and early 1980s has been augmented by the Demographic and
Health Surveys (DHS) programme, which has completed two phases of
surveys, DHS-I and DHS-II.  As of April 1993, 56 surveys had been
completed, 18 of which were undertaken in 1991 and 1992.


                   B.  Population dynamics

43.  Research in population dynamics over the past few years has
been increasingly influenced by two trends.  As fertility reduction
has proceeded in the 1980s it has become more apparent that certain
regions and groups have been left out of this secular trend.  One
line of research is therefore concentrating on socio-cultural
determinants of fertility behaviour.  An umbrella project on this
topic is being carried out by the United Nations Educational,
Scientific and Cultural Organization with funding from UNFPA.  The
African Social Research Programme will also have as its primary
focus socio-cultural determinants of demographic behaviour.

44.  A second trend in research on population dynamics stresses an
interdisciplinary approach and analyses how population issues are
to be integrated into socio-economic development planning.  The six
expert group meetings organized as part of the preparatory
activities for the International Conference on Population and
Development are noteworthy in this regard.  A series of round
tables, also part of the preparatory phase of the Conference, were
held to review research in a policy-oriented format on population
and human immunodeficiency virus (HIV) and acquired
immunodeficiency syndrome (AIDS), population and food, population
and development strategies, population and ethics, and population
and gender issues.

45.  Of growing importance is research linking population and the
environment.  In aggregate terms the linkages between population,
resources and the environment are clear:  increasing population
will have many important impacts on resources and the environment. 
Population growth will increase the demand for food, energy, water,
health care, sanitation and housing.  In specific cases, however,
the links between population, resources and the environment are
often blurred.  UNFPA is actively seeking to define a research
programme that would increase knowledge of interactions between
population pressure, poverty and environmental degradation.

46.  The link between population and international migration is
another area of growing concern and research.  Multilateral
assistance provided support to several multi-year studies on
migration that are still in progress.  One, executed by the
International Organization for Migration at Geneva, is analysing
emigration flows from developing to developed countries as well as
between developing countries.  A network of research institutions
in developing regions will form the base of this research effort. 
Another, executed by the Economic Commission for Europe, is
collecting data and developing a database on migration in Europe. 
Given the importance placed on migration and development issues at
the Cairo Conference, a more concerted effort to deal with
migration concerns through multilateral assistance may be expected
in the future.

47.  UNFPA continued to support activities related to
institution-building, training and research.  Most of these
activities were aimed at institutionalizing the capacity of
countries to analyse demographic data and population-development
interactions and to apply the results to development planning.

48.  The training of personnel in demographic analysis and in
integrating population factors into development planning was an
important target of multilateral assistance during the reporting
period.  The Global Programme of Training in Population and
Development provided specialized training to some 85 middle-level
professionals from 59 developing countries in 1993 alone.

49.  Multilateral assistance was also provided to develop computer
software packages in support of population activities.  One
package, POPMAP, facilitates the display in map and database form
of social, economic and demographic indicators, and shows the
location of service facilities and other institutions.  In 1993, an
important application of POPMAP to management information systems
of family planning programmes was developed.  This is a potentially
very useful tool for linking population and related information to
regional and local-level programming.


     C.  Formulation and evaluation of population policy

50.  In 1993, UNFPA continued to fund operations to support
population policy and development planning in most developing
countries.  The bulk of these operations were carried out in
Africa, where population policy is still relatively underdeveloped.

Most of the activities noted above concentrated on
institution-building efforts. 

51.  Other organizations of the United Nations system also continue
to support analysis of population policy formulation and execution.

Regular monitoring of national population policies was continued by
the Population Division of the Department for Economic and Social
Information and Policy Analysis of the United Nations Secretariat. 
The periodic United Nations Population Inquiry among Governments
was canvassed again in 1992-1993 to gather information on how
countries integrate their population policies and strategies into
their wider development policies.  Preliminary results will be
available soon.

52.  The recent period has witnessed a growing consensus that new
responses are needed to address the changing context of development
planning.  The socio-political changes of the past decade have
overtaken the world so fast that it has been hard to make the
necessary changes, to throw out old habits.  Many of the ways in
which population was linked to planning in the past presupposed an
approach to planning which has lost its force and has been
superseded by some very different thinking about how best to
achieve development.  This was the subject of a round-table meeting
convened jointly by UNFPA and the Economic and Social Commission
for Asia and the Pacific in November 1993.  As well as theoretical
issues, operational and institutional means of integrating
population into development came under scrutiny.

53.  The operational and institutional means of integrating
population into development has also come under scrutiny.  Several
new, innovative ways to better operationalize the integration of
population into development strategies for the 1990s and beyond
were suggested in the policy dialogue leading up to the Cairo
Conference in 1994.

54.  Efforts to put in place policies and programmes that are more
participatory, involve local communities and ensure the empowerment
of women are being emphasized.  Decentralized planning and a shift
towards policy-making at subnational and local levels are also
being increasingly featured in multilateral assistance for
institutionalizing the integration of population into development
strategies, following priorities set at the Conference.


        D.  Maternal and child health/family planning
            and reproductive health services     

55.  As the largest source of multilateral assistance in this
field, UNFPA has continued to increase its support to MCH/FP
activities in the developing world.  During the past decade
countries have made dramatic progress in expanding the availability
of family planning services, increasing the use of contraception
and decreasing the rates of reproductive mortality and morbidity by
spacing births, avoiding high-risk pregnancies and creating the
conditions for more responsible and healthy family formation. 

56.  The Programme of Action adopted by the International
Conference on Population and Development 3/ recognizes the need to
integrate family planning activities into the wider context of
reproductive health rights and reproductive services.  This view of
reproductive health goes beyond traditional integrated primary
health care/family planning programmes.  Reproductive health
addresses the overall health and well-being of people, particularly
of women and girls, but also emphasizes the need to provide
services to adolescents and to men.  Within the Programme of
Action, the content of reproductive health programmes is defined
quite broadly so that activities will meet local needs.  Beginning
with Principle 8, which calls on Governments to take measures to
ensure universal access to health-care services, the Programme of
Action goes on to define reproductive health care, including family
planning, and lists core components of services and other
activities.

57.  The recommendations of the Cairo Conference have implications
for policies and procedures in the area of reproductive health and
family planning.  For UNFPA, it has meant a commitment to reviewing
and modifying policy guidelines in all areas of assistance.  It has
already led to an important organizational change within UNFPA: 
its MCH/FP Branch has been replaced by the Reproductive
Health/Family Planning Branch.  Simultaneously, guidelines are
being updated, through an extensive consultative process involving
regional, non-governmental and expert inputs.  Concurrently,
international efforts, involving multilateral agencies, donors and
non-governmental organizations, are under way to define the
programmatic parameters and monitoring indicators for an expanded
reproductive health/family planning framework.

58.  The issue of human rights was given priority at the
Conference.  Consequently, reproductive rights and reproductive
freedom, in particular the right of individuals to decide freely
and responsibly their reproductive choices, have also been
thoroughly discussed.  The issues of providing wider access to
quality family planning services, more comprehensive reproductive
health services, including family planning, and the further
empowerment of women have been fundamental elements that will guide
multilateral assistance in this sector in the future.

59.  A shift to a more comprehensive approach to reproductive
health in the context of primary health care is under way. 
Reproductive-health services are aimed at ensuring that people have
the ability to reproduce, to regulate their fertility and to have
healthy and responsible sexual relationships.  This approach
implies that women can go safely through pregnancy and childbirth,
that fertility regulation can be achieved without hazard and that
people are safe while engaging in sexual activity.  Reproductive
health, probably more than any other field, has  a potential impact
that extends beyond the individual and family.  This impact
involves crucial areas of global concern, such as health,
population, the status of women and the environment.

60.  The quality of family planning services, besides being an end
in itself, by increasing informed choice for women and by
protecting them from unnecessary risk, has been increasingly
recognized as one of the most important determinants of
contraceptive acceptance and continuation of use.  Developing
programmatic guidelines and monitoring mechanisms received priority
attention from multilateral agencies during the reporting period,
following the importance given to that issue in the Programme of
Action.

61.  MCH/FP services can be one of the main sources of preventive
actions against sexually transmitted diseases and HIV/AIDS.  The
inclusion of this new preventive component will be pursued as the
recommendations of the Conference are implemented.

62.  In addition to raising additional funds for family planning,
programmes also need to be more efficient in the use of existing
resources.  In addition, new strategies for financing family
planning services, including cost-recovery mechanisms through
users' fees, are important areas for further investigation.  UNFPA
held an international Consultation on Family Planning Programme
Sustainability in March 1994, to further discuss these issues and
provide guidance to those Governments interested in implementing
cost-recovery mechanisms in their family planning programmes, as
well as in efficiently incorporating services provided by
non-governmental organizations.

63.  Work on the UNFPA Global Initiative on Contraceptive
Requirements and Logistic Management Needs in Developing Countries
continued in 1993-1994.  Working closely with selected developing
countries, other United Nations organizations, bilateral agencies
and non-governmental organizations, UNFPA completed a series of
in-depth studies to estimate contraceptive requirements and
logistic-management needs.  At present 10 country studies have been
completed in Bangladesh, Brazil, Egypt, India, Nepal, Pakistan, the
Philippines, Turkey, Viet Nam and Zimbabwe.  Additional studies are
scheduled for the coming years.

64.  A recent UNFPA study of global contraceptive requirements
estimates the cost of contraceptive commodities alone at
approximately US$ 528 million in 1994 and more than US$ 750 million
in 2005.  The total amount for the 12-year period 1994-2005 is
estimated to be more than US$ 7.5 billion.


      E.  Population information, education and communication

65.  In UNFPA and other United Nations organizations working in
population, IEC for population aims at achieving measurable
behaviour and attitude changes of specific audiences, based on
studies of their needs and perceptions.  The starting-point and
goal of IEC is to contribute to solving a population "problem", or
to support a population issue within a programme, which planners
have assumed could be tackled by changes in attitudes and/or
behaviour of designated audiences. 

66.  In 1994, UNFPA provided assistance to 72 countries to
implement 118 ongoing and new population education projects,
ranging from the initial stages of creating awareness and eliciting
support among government officials and community leaders and
training a core technical staff, to the stage of teaching
population education in schools.

67.  It has taken many years for population education to be
accepted by Governments.  The broad base of support for population
education became evident in 1993 at the first International
Congress on Population Education and Development, when 92
Governments strongly endorsed population education.  In 1994, the
focus shifted from advocacy to improving the quality and coverage
of population education activities:  more effective
teaching/learning materials, more time for high-quality training,
use of educational television, where feasible, and expanding
training activities to reach teachers who have not yet been trained
for lack of funds.

68.  A recent study undertaken by UNFPA in a number of countries
revealed several weaknesses, both operational and conceptual, in
current population education programmes.  Priorities have to be
assigned, using the Programme of Action as a guide, among potential
topics - for example, certain aspects of human sexuality, sexually
transmitted diseases and AIDS, preparation for family life,
promoting the status of women, developing among girls a positive
and future-oriented self-image, the dynamics and implications of
rapid urbanization, male responsibility and so forth.

69.  In addition to promoting population education activities in
schools, UNFPA also used such other channels as adult literacy,
workers' education and agricultural extension to reach a variety of
audiences.  As a follow-up to UNFPA involvement in the Education
for All Summit, held at New Delhi in December 1993, UNFPA has begun
to emphasize adult literacy activities that give priority to
literacy skills for girls and women, while teaching family planning
and key vocational skills.  The International Labour Organization
issued a publication on qualitative research techniques, based on
its experience with audiences of workers.  The Food and Agriculture
Organization of the United Nations produced a paper on approaches
to introducing concepts of gender, environment and population
through agricultural extension programmes.  In 1994, for the first
time, significant levels of acceptance of population topics in
agricultural extension programmes were to be seen in a number of
developing countries. 

70.  The Programme of Action emphasizes the importance of providing
adolescents with reproductive health information and services. 
While not all adolescents will need services, they all need
age-appropriate and culture-specific information.  UNFPA has
supported successful peer-counselling activities for adolescents
and young women who married at a very early age.  Youth clubs have
provided community-based education and reproductive health services
to young people in several countries. 

71.  UNFPA also provided technical assistance in the preparation of
two youth non-governmental organization forums on population and
sustainable development, at Accra and Cairo.  The Cairo forum,
attended by more than 100 young people, adopted a Cairo Youth
Declaration on Population and Development, which urged the United
Nations, including UNFPA, to demonstrate its commitment to young
people by providing resources. 

72.  A first step towards providing more effective assistance to
youth is recognition of the fact that youth spans a wide age-range
and is a very heterogeneous group with widely different needs. 
Many young people are married, others are in school and have not
yet initiated sexual activity, some are at risk of losing
educational opportunities because of unplanned pregnancies, for
example.  Early pregnancy carries health risks, regardless of
marital status, and the need to identify more clearly the target
audiences that can have an impact on this problem is evident.  This
was highlighted in a series of regional meetings convened by UNFPA
as a follow-up to the Cairo Conference.

73.  The need for clearer linkages and better coordination between
IEC and reproductive-health services, from the planning phase
onwards, became even more obvious in 1994.  This need for
coordination was reinforced by findings from a 1994 UNFPA study on
IEC in the context of the programme approach.  The year 1994 has
seen a great effort to better integrate IEC in reproductive health
services.

74.  In 1994, UNFPA began to direct attention to the issue of male
involvement in reproductive health.  Initial findings from a review
of the field indicate that most organizations for whom this is an
issue focus on male contraceptive methods and their use.  Little
attention is being given to the male's role in support of his
partner in contraceptive decision-making.  This particular problem
requires much greater attention, in view of the fact that most
resources for family planning are still allocated to services for
women.

75.  The Population Information Network (POPIN) was established in
1979 through UNFPA support as a decentralized network for the
coordination of multilateral, regional, national and
non-governmental population information activities.  Currently,
POPIN operates as a decentralized network reaching out to virtually
all population information centres, libraries, clearing-houses,
documentation centres, universities and research institutes.  In
1993, a POPIN Coordinator post was re-established within the
Population Division of the Department for Economic and Social
Information and Policy Analysis of the United Nations Secretariat,
with UNFPA support, to meet the many opportunities and challenges
posed by rapidly advancing communication technology.

76.  A recent important development for the POPIN project has been
the establishment of the POPIN Gopher which now provides a
world-wide population information service.  The Gopher is housed in
the UNDP computer system and benefits from active UNDP cooperation.

This service operates on both E-mail and the Internet, providing
population specialists around the world with a growing resource
base of population statistics, demographic and bibliographic
databases, documentation of the Cairo Conference, journals, press
releases and regional connections for most developing regions.  The
Latin American Population Documentation System (DOCPAL)
bibliographic database is incorporated in the Gopher, while plans
have been finalized to include similar databases for sub-Saharan
Africa and Asia and the Pacific.  POPIN operated the Gopher service
during the Conference in Cairo, registering more than 28,000 users
during the Conference itself.


            F.  Women, population and development

77.  In June 1991, at its thirty-eighth session, the UNDP/UNFPA
Governing Council endorsed the Implementation Strategy to
Strengthen the Capacity of the Fund to Deal with Issues Concerning
Women, Population and Development for the period 1991-1994.  The
report of the Executive Director of UNFPA prepared for that session
(DP/1991/32) examined the implementation of the Strategy, which the
Governing Council had endorsed for 1987-1990.  Based on the
priorities recommended by the Governing Council, UNFPA has
continued to pursue the Strategy up to the present, giving special
emphasis to selected components.

78.  Thus, it has worked closely with non-governmental
organizations on women to strengthen its links with them.  For
example, its assistance enabled the participation of
non-governmental organizations on women in international events
during that period, including the United Nations Conference on
Environment and Development and in the preparations for the Cairo
Conference and the Fourth World Conference on Women.

79.  Training of staff on women, population and development is
another priority under the Strategy.  UNFPA staff were provided
training through workshops conducted at Headquarters in January
1992.  Field, national and project staff received training at the
Royal Tropical Institute in 1991.  In addition, the issue of women,
population and development was mainstreamed in all training
provided to UNFPA staff.

80.  In order to develop a comprehensive reporting mechanism to
ensure more effective monitoring of the implementation of the
Strategy, a gender-reporting form has been designed which must
accompany all project submissions.  It contains information on how
women's concerns are incorporated in the project and how women are
involved as beneficiaries and participants at all stages of project
formulation, implementation and evaluation.

81.  In addition to regular technical work and programming
responsibilities in the area of women, population and development,
UNFPA actively supported two major activities:  preparations for
and participation in the International Conference on Population and
Development (Cairo, 1994) and the Fourth World Conference on Women
(Beijing, 1995).

82.  UNFPA participated in many gender-related preparatory
activities for the Cairo Conference, including a round table on
women's health organized by the Commonwealth Medical Association at
Bellagio, Italy; a non-governmental organization conference on
environment, population and women organized by the Network and
People's Forum 2001 at Tokyo; a round-table discussion on
reproductive health and human rights convened by the Centre for
Reproductive Law and Policy and the Center for Women's Leadership
at Rutgers University in New Jersey; non-governmental organization
events, such as briefings and workshops at the third session of the
Preparatory Committee for the International Conference on
Population and Development, held in April 1994; and discussions on
chapters of the draft Programme of Action of the Conference.

83.  After the Cairo Conference, UNFPA prepared a paper entitled
"From Cairo to Beijing", which maps the Programme of Action to the
Platform for Action of the Fourth World Conference on Women.  This
is being used extensively in preparations for the Fourth World
Conference on Women, with the objective of ensuring that the
recommendations of the Cairo Conference are reflected adequately in
the Platform for Action.

84.  A high-level internal task force has been established to
coordinate UNFPA's role in the Fourth World Conference on Women. 
It comprises representatives of various UNFPA divisions, including
all geographical divisions, with the Women, Population and
Development Branch serving as the secretariat.  The Task Force
works closely with the UNFPA field offices.  The first meeting of
the Task Force was convened by the Executive Director of UNFPA, who
stressed the importance of the Fourth World Conference on Women and
UNFPA's involvement in the preparatory process at both field and
headquarters levels.

85.  UNFPA has formulated a strategy for UNFPA support for the
Fourth World Conference on Women.  The main elements of the
strategy are as follows: 

     (a)  Support for the secretariat of the Conference.  UNFPA
approved funds for the salary of a senior adviser to the
Secretary-General of the Conference and for administrative support;

     (b)  Inter-agency collaboration.  UNFPA is a member of the
inter-agency advisory group to the Secretary-General of the
Conference.  UNFPA also participated in the eighteenth Ad Hoc
Inter-Agency Meeting on Women, which preceded the thirty-eighth
session of the Commission on the Status of Women, in March 1994;
the Commission served as the preparatory committee for the
Conference.  UNFPA worked on drafting a joint inter-agency
statement on the Platform for Action.  UNFPA also participated in
meetings organized by the Division for the Advancement of Women of
the Department for Policy Coordination and Sustainable Development
of the United Nations Secretariat for youth involvement in the
preparatory process.  Funds were approved for an Expert Group
Meeting on Women in Development for the least developed countries,
organized by the United Nations Conference on Trade and Development
(UNCTAD);

     (c)  Participation in regional and subregional preparatory
conferences.  UNFPA participated in all five conferences held in
1994, in Argentina, Austria, Indonesia, Jordan and Senegal, and in
the 1994 Nordic Forum, held in Finland.  It also participated in
technical expert and ministerial-level meetings;

     (d)  Support for non-governmental organizations on women. 
UNFPA funds have been approved at interregional and country levels
to enable non-governmental organizations on women to participate in
preparatory activities for the Fourth World Conference on Women,
both in the meetings of the Preparatory Committee for the
Conference and in the regional preparatory conferences.  Workshops,
such as those organized by the Commonwealth Medical Association in
the regions of the Economic Commission for Europe and the Economic
Commission for Africa, enabled non-governmental organizations to
receive briefing on such subjects as women's reproductive health
and rights.  Funds were also made available for informational
activities in support of the Conference, such as the Women's
Feature Service, and for training and materials for the Centre for
Development and Population Activities to produce a training manual
on advocacy strategies for leaders in population and development.

86.  Progress was made in the implementation of several UNFPA
projects in the area of women, population and development.

87.  A major project that has been concluded was on the family and
population policy:  towards the realization of full reproductive
choice, executed by the Population Council.  This was a
policy-oriented research project on the relationship between gender
equity, family structure and dynamics, and the achievement of
reproductive choice.  The objective is to help Governments and
international agencies in designing and implementing policies that
are affirmative of women, sensitive to the family's central role in
resource allocation and distribution, and effective in achieving
broad-based population and development goals.

88.  Women's perspectives on population policy and programmes are
the focus of another project under which the Institute of Social
Studies Trust, an Indian non-governmental organization, is
receiving assistance.  Under the project on evolving a
women-sensitive population policy and programmes, a series of
consultations with seven grass-roots organizations representing
rural women in various regions of the country have been held.

89.  A project called "Support to activities of the Global
Commission on Women's Health at the Regional Level" is being
executed by the World Health Organization (WHO).  The project's
objective is to improve women's health status and reduce gender
inequalities in health.

90.  As part of the support for information, education and
awareness-creation of women's issues, an important project is
"Support to the International Council on Women for its
Awareness-creation Activities regarding Violence against Women and
Children".  The project will provide information materials through
the production of a series of six video films on violence and
exploitation through world trafficking of women and children in
Africa, Asia and Europe.

91.  UNFPA also prepared a paper entitled "Enhancing UNFPA-NGO
collaboration in WPD".  The paper stresses the UNFPA mandate in the
area of women, population and development and the roles of
non-governmental organizations in fulfilling that mandate.  It
makes recommendations for partnerships with the non-governmental
sector.

92.  Good progress has been reported on an ongoing project being
implemented by the United Nations Research Institute for Social
Development.  Under the project, research has been undertaken on
the impact of environmental changes on women and population and how
their decisions, including those related to their fertility, are
affected by the environment.


                  III.  OPERATIONAL ISSUES

93.  Among the important operational changes taking place within
multilateral agencies are a greater emphasis on a programme
approach, decentralization of approval authority to field units, an
integrated exercise aimed at a coherent population strategy,
simplification of procedures, improved coordination among United
Nations organizations and development of technical and procedural
guidelines to improve operations.


                  A.  Programming approach

94.  It is increasingly recognized by multilateral assistance
programmes that in technical cooperation, channelling of external
assistance through projects has not been effective, nor has its
impact been sustainable.  In resolution 44/211 concerning
operational activities for development, the General Assembly called
for "more integrated and coordinated programming of United Nations
system cooperation, in which programming processes would be based
on an overall national programme framework for operational
activities for development to be prepared by the recipient
Government" (para. 17).  In 1992, the General Assembly, in
resolution 47/199, took as its basis resolution 44/211 and further
defined the programme strategy.  In particular, the Assembly
outlined a framework for cooperation and coordination among United
Nation organizations providing multilateral assistance in
development in countries through the mechanism of the country
strategy note.

95.  UNFPA introduced a programming approach for population
activities in 1989, called the Programme Review and Strategy
Development (PRSD) exercise.  Through PRSDs, the goals of a country
are set in accordance with population projections and targets over
a medium-term perspective and the inputs needed to achieve those
targets are specified.  The strategy documents emanating from PRSDs
provide countries with an analytical approach that takes into
account the totality of developmental needs as they touch upon the
population sector.

96.  In 1991, UNFPA undertook PRSD missions to 28 countries and, in
1992, 12 additional PRSD missions were carried out.  A total of 184
missions, including 68 PRSD missions, were conducted from 1977
through 1992.

97.  From 1993 through mid-1994, a further 15 PRSD exercises were
conducted:  six in sub-Saharan Africa (Benin, Chad, Comoros,
Mauritius, Mozambique and Zambia), five in Asia and the Pacific
(China, Indonesia, Iran (Islamic Republic of), Maldives and
Philippines), three in Latin America and the Caribbean (Costa Rica,
Mexico and Uruguay) and one in West Asia (Turkey).


       B.  Programme and project formulation and implementation

98.  There has been a clear shift towards a programme approach in
multilateral assistance to developing countries following
directives from United Nations governing bodies.  UNFPA assistance
to countries is now entirely based on prior development of country
programmes which, based on PRSD findings, analytically deal with
all population concerns in countries and provide a systematic way
of prioritizing resources.

99.  Programme and project formulation and implementation is the
primary responsibility of Governments.  In practice, however, many
population projects are formulated by international experts who are
either staff members or consultants of multilateral agencies.  Many
organizations of the United Nations system have stressed the
primary role of Governments in programme and project formulation. 
In pursuance of that preferred modality, training and
institution-building efforts have been supported by multilateral
agencies to strengthen national capacities to manage and execute
international population programmes.

100. An important development in programme and project formulation
and approval has been the significant decentralization of authority
for those functions to field officers.  In the case of UNFPA,
country directors were given the authority to appraise and approve
projects up to $500,000 in 1990, and $750,000 starting in late
1993.  Moreover, full decentralization of approval authority for
country projects is being tried out on a pilot basis in 11
countries and the South Pacific.

101. Another important issue in project implementation in recent
years is that of timely procurement and efficient utilization of
equipment and supplies.  Increasingly, United Nations agencies have
encouraged local procurement as a means not only of helping
developing countries but of responding to urgent project needs as
well.

102. In 1993, total UNFPA procurement amounted to $47.3 million, a
20 per cent decrease over the 1992 figure, but still a 52 per cent
increase over 1991.  The considerable increase over the recent
period in the volume of supplies procured enabled the Fund to
secure highly preferential prices and, in turn, to make the most
cost-effective use of donor funds.

103. During the 1980s and until recently, technical support for
UNFPA-funded population projects was provided to countries largely
through a network of regional advisers, regional offices,
interregional advisers and technical officers based at headquarters
of United Nations organizations, regional offices or project sites.

This arrangement helped UNFPA to respond flexibly and innovatively
to the requests for assistance from all regions and countries.  Yet
there was plenty of scope for improving the coordination and
systematic collection, analysis, dissemination and use of
information on population policies and programmes at the field
level and related technical assistance activities.

104. The UNDP/UNFPA Governing Council, in considering the matter of
technical support services, at its thirty-eighth session decided on
successor arrangements for UNFPA (decision 91/37). 9/  The result
of this process was the establishment of the technical support
system (TSS), administered by UNFPA and comprising the expertise of
much of the United Nations system of organizations and relevant
non-governmental organizations.  TSS became fully functional in
1992.  Under the system, national technical assistance requirements
are met at three levels: 

     (a)  At the national level, through greater reliance on local
expertise and institutions;

     (b)  At the regional and subregional levels, through the use
of technical personnel in technical support teams composed of
experts from various population disciplines (from UNFPA, the United
Nations system and non-governmental organizations);

     (c)  At the headquarters and regional office levels of the
United Nations and its specialized agencies, through support for
technical personnel.

105. The backbone of the TSS arrangement is the eight country
support teams based strategically throughout the major developing
regions.  With more than 160 experts specializing in every aspect
of the population field, the primary mission of the country support
teams is to provide relevant and swift technical assistance to
countries, when needed.

106. An independent evaluation of the system was also requested by
the UNDP/ UNFPA Governing Council in its decision 91/37.  In 1994,
the evaluation team visited 28 countries covered by the eight
country support teams as well as the offices of the participating
United Nations organizations, including the regional commissions
and the WHO regional offices.

107. The general conclusion of the evaluation team, whose draft
report was submitted in late 1994, was that the technical support
system, specifically the country support team system of advisers,
represented a major improvement over the previous system of
regional advisers.  The country support teams have been most
effective in providing backstopping support for UNFPA-funded
projects and, particularly, in building a multidisciplinary
approach to country programming.  At the same time, the evaluation
team found some shortcomings in the operationalization of the
overall technical support system to date, particularly with respect
to the role of the TSS specialists at the headquarters level and
the linkages between the country support team specialists and TSS
specialists.  The evaluation team also called for a strengthening
of UNFPA field offices to better utilize the technical resources
offered by the country support teams.


                C.  Monitoring and evaluation

108. During the period under review, the United Nations system
continued to monitor and evaluate population assistance, both to
conform to accountability requirements and to acquire data for
improving managerial performance.  Revised UNFPA guidelines on
monitoring and evaluation were released in August 1990, updating
those formulated in 1986.  Serious efforts have been made to
coordinate the monitoring and evaluation processes and procedures
between United Nations organizations in order to learn from each
other and lighten the burden on cooperating Governments.  A
coordinating mechanism, under the Joint Consultative Group on
Policy, has been established among UNDP, UNICEF, UNFPA, the World
Food Programme and the International Fund for Agricultural
Development. 

109. Over the past few years, the responsibility for country
programme and individual project evaluations has shifted to
decentralized entities within and outside UNFPA, including its
field offices, as well as to project management and executing
agencies.  The shift first came as part of an effort to place
increased emphasis on monitoring and evaluation as an integral
component of its programming process.

110. As a result of these developments, the number of evaluations
carried out by UNFPA has increased considerably over the past few
years.  Such evaluations range in scope from self-evaluations
conducted by project management to large- scale evaluations carried
out by a team of independent experts; they also range in the depth
and intensity of analysis, depending on the circumstances of each
case.

111. Major thematic evaluations completed in 1993 by UNFPA included
projects linking population to income-generating schemes for women,
IEC strategies in support of family planning programmes and the
quality of family planning services.  In 1994, a thematic
evaluation, carried out on the local production of contraceptives
and another on programmes supporting traditional birth attendants,
were in an advanced stage of execution.  In addition, the desk
review and evaluation design have been completed for a planned
evaluation of information and service programmes for adolescents. 
Field work on this exercise is expected to commence in the first
quarter of 1995.

112. Other major evaluation activities completed or initiated
during the reporting period dealt with the implications of family
planning technologies for services, training and information; the
principal operational issues and status of implementation of
AIDS-related components in UNFPA-supported programmes; the use of
community-participation approaches in country programmes; a reader
survey among recipients of the Directory of MCH/FP Training
Programmes, a publication issued annually by UNFPA.


     D.  Resource mobilization for the Programme of Action of the 
         International Conference on Population and Development

113. During the preparations for the Cairo Conference, an updated
and refined estimate of resources required over the next decade was
requested, improving on those originally prepared as background to
the Amsterdam Declaration on a Better Life for Future Generations. 
Estimates of annual resource requirements to 2015 for population
and reproductive health programmes contained in the Programme of
Action adopted by the Conference were the result of an intense
effort by multilateral agencies and others during the period under
review.

114. A process of consultation with experts from multilateral,
bilateral, academic and non-governmental organizations who had
experience in studies estimating resource requirements for
population programmes was undertaken to ensure a sound technical
review of the Conference estimates.  The panel included
representatives of UNFPA, the World Bank, the Population Division
of the Department for Economic and Social Information and Policy
Analysis of the United Nations Secretariat, the United States
Agency for International Development, the International Planned
Parenthood Federation and several independent foundations and
non-governmental organizations.

115. As stipulated in the Programme of Action, basic reproductive
health and family planning services, including support for
training, supplies, infrastructure and management systems,
especially at the primary-health-care level, comprise the following
major components, which should be integrated into basic national
programmes for population and reproductive health:

     (a)  The family planning services component.  Contraceptive
commodities and service delivery; capacity-building for
information, education and communication regarding family planning
and population and development issues; national capacity-building
through support for training; infrastructure development and
upgrading of facilities; policy development and programme
evaluation; management information systems; basic service
statistics; and focused efforts to ensure good quality care;

     (b)  The basic reproductive health services component. 
Information and routine services for prenatal, normal and safe
delivery and post-natal care; safe abortion (as permitted by the
laws of individual countries); information, education and
communication about reproductive health, including sexually
transmitted diseases, human sexuality and responsible parenthood,
and against harmful practices; adequate counselling; diagnosis and
treatment of sexually transmitted diseases and other reproductive
tract infections, as feasible; prevention of infertility and
appropriate treatment, where feasible; and referrals, education and
counselling services for sexually transmitted diseases, including
HIV/AIDS, and for pregnancy and delivery complications;

     (c)  The sexually transmitted disease/HIV/AIDS prevention
programme component.  Mass media and in-school education
programmes, promotion of voluntary abstinence and responsible
sexual behaviour, and expanded condom distribution;

     (d)  The basic research, data and population and development
policy analysis component.  National capacity-building through
support for demographic as well as programme-relevant data
collection and analysis, research, policy development and training.

116. The resulting projections of resource requirements have
provided information for the annual costs of the family planning
programme component in subregions every fifth year over the period
2000-2015.  Similarly, estimates are also provided for the resource
requirements for the three additional interrelated components.

117. In their entirety, the resource requirements projected for
national population and reproductive health programmes, including
family planning, total (in 1993 United States dollars) $17.0
billion in 2000, $18.5 billion in 2005, $20.5 billion in 2010 and
$21.7 billion in 2015.  Of this overall total, about 65 per cent
represent inputs to the service-delivery system for reproductive
health and family planning services.

118. For the family planning component, the total estimated annual
costs (in 1993 United States dollars) are $10.2 billion in 2000,
$11.5 billion in 2005, $12.6 billion in 2010 and $13.8 billion in
2015.  Roughly 75 per cent represents inputs to the
service-delivery system. 

119. An additional component of the integrated programme designed
to further improve the quality of care and provide family planning
as part of a broader package of reproductive health services and
referrals is estimated to cost an additional $1.03 per capita per
annum.  This would amount to (in 1993 United States dollars):  $5.0
billion in 2000, $5.4 billion in 2005, $5.7 billion in 2010 and
$6.1 billion in 2015.  Roughly 65 per cent represents additional
inputs to basic service-delivery systems; the remaining 35 per cent
represents specialized inputs specific to reproductive health
programmes. 

120. A second additional component of the programme aimed at
preventing sexually transmitted diseases, including HIV infection,
is estimated to cost an additional $0.26 per capita per annum
(based on estimates of the WHO Global Programme on AIDS).  This
would amount to (in 1993 United States dollars) $1.3 billion in
2000, $1.4 billion in 2005, $1.5 billion in 2010 and $1.5 billion
in 2015.

121. A third additional component to meet the expanded needs for
population data collection, analysis and dissemination, and policy
formulation, would add between $260 million and $670 million per
annum (depending on where the year is in the decennial census
cycle).

122. In 1990 the proportion of resources for population programmes
in developing countries that came from domestic sources
(Governments, non-governmental organizations and the private
sector) varied enormously, ranging from as little as 20-33 per cent
to nearly 100 per cent, depending on the country.  Overall,
domestic sources accounted for an estimated 75 per cent of all
resources expended to finance population programmes in developing
countries.  Many developing countries are increasingly constrained,
however, in their ability to increase domestic resources at a pace
that keeps up with expanded requirements for population programmes.

In particular, the great increases in demand (as a proportion of
the population and in total numbers) that will be seen in the
countries of sub-Saharan Africa, all or nearly all of which will
require international help, and the increase in total numbers in
parts of Southern Asia will place heavy burdens on national and
international capacities to finance population programmes.

123. These factors lead to greatly increased resource needs from
external sources, particularly in regions with significant
infrastructure development needs.  Conservatively, if requirements
for external resources increase from 25 to 33 per cent of total
resource requirements, the projections suggest that external
resource needs will amount to (in 1993 United States dollars) $5.7
billion per annum in 2000, $6.2 billion in 2005, $6.8 billion in
2010 and $7.2 billion in 2015.  This compares with the estimates of
about $1 billion each to current family planning and other
reproductive health programmes.  The strategic use of these
resources will be critical to establishing the capacity for
sustainable development in the future.

124. Collectively and separately, working out the modalities for
mobilizing these resources is a post-Cairo priority.  The detailed
work of assessing national needs and capacities has already begun. 
In collaboration with Governments, PRSD exercises, basic needs
assessments, situation analyses and other analytical enterprises
undertaken by UNFPA and other donors have detailed the inputs and
strategies needed to expand programmes and to improve their
quality.  UNFPA is keen to continue playing a key role in
mobilizing resources for programme formulation, implementation and
monitoring.

125. The formulation of national plans for the full implementation
of the Programme of Action will be an important part of the
follow-up to the Conference.  In this context, the
Secretary-General has assigned to the Executive Director of UNFPA
the task of coordinating consultations with various bodies of the
United Nations system, with international financial institutions
and various bilateral aid organizations and agencies for three
purposes:  first, to promote an exchange of information on the
requirements for international assistance; secondly, to review on
a regular basis the specific needs of countries in the field of
population (including emergency and temporary needs); and thirdly,
to maximize the availability of resources and their effective
utilization. 

126. There is an urgent need to coordinate efforts in population
assistance.  Such coordination will be necessary to avoid
duplication of efforts, to rapidly disseminate the lessons learned
from programmes and to ensure the optimal use of the available
funds both for expanding population and reproductive health
programmes and for the other social and economic transformations
envisioned in the Programme of Action.

127. The strategic application of technical assistance will also
require an increase in the use of mechanisms at the national level
to improve coordination of resource inputs.  Developing countries
will need to continue strengthening the capacity of their national
institutions both to formulate integrated population and
development strategies, plans, policies and programmes and to
implement them, in partnership with non-governmental organizations
and the private sector.  Coordination of donor strategies in
countries will require closer consultations among donor
representatives and national counterparts (both within and outside
the Government) and, possibly, the increased use of coordinated
programming strategies and arrangements directed towards providing
assistance for targeted problems, such as HIV/AIDS, urbanization
stresses and environmental degradation.

128. A new process will also be needed to coordinate efforts for
monitoring progress towards achieving the goals of the Programme of
Action.  Reporting systems will need to be simplified to reduce the
burden on national statistical offices and other monitoring
mechanisms.  Attention will need to be given and resources
committed to strengthening monitoring mechanisms at the subnational
level.  It is only in this way that information about the equity of
the distribution of programme benefits can be obtained.  External
inputs, including those of multilateral agencies, can be important
to strengthen the national institutions and maintain compatible
databases.  External inputs to facilitate the implementation of
programmes on a fully national scale will also be required. 

129. National systems to follow up, hold accountable and monitor
national programmes should be established in partnership with
non-governmental organizations, community groups and
representatives of the media and academic communities, as well as
with the support of parliamentarians.  These types of partnerships,
facilitated by the international community as advocates and, where
necessary, as donors, can help ensure that programmes are
responsive and participatory.

130. Such efforts to foster the strategic use of resources,
collaboration among development partners, careful monitoring of
programme processes and programme outcomes, and mobilization of
local participation as part of larger systems of accountability
will improve the effectiveness of UNFPA assistance.  This will
require open and transparent procedures, systematic attention and
an atmosphere of constructive criticism and self-evaluation.


           IV.  CONCLUSIONS

131. The United Nations system has continued to strengthen the
substantive content of its programmes and to increase the volume of
financial assistance to developing countries.  For the United
Nations system as a whole, assistance for population programmes
increased from $220 million in 1988 to $305 million in 1992.  The
bulk of these resources (about 82 per cent) came from UNFPA.

132. In terms of substantive emphasis, family planning, integrated
with reproductive health and carried out through a primary
health-care system, continues to receive the bulk of multilateral
resources for population.  IEC efforts in support of family
planning have also received considerable assistance.  In the past
two years, there has been a decrease in allocations for basic data
collection and analysis and population-dynamics research. 

133. There has been increased emphasis on support for programmes
and projects designed to improve the status and living conditions
of women.  Women's concerns are increasingly being mainstreamed
into all substantive areas of population assistance, especially in
reproductive health and family planning, basic data collection,
population dynamics and the formulation and implementation of
policies.  At the same time, projects to improve the status of
women, such as education for girls, leadership training, literacy
programmes and projects designed to increase the income of women
and their families, are being supported by multilateral agencies.

134. The past two years have seen continued support for population
programmes in Africa, where reproductive health and family planning
needs are a priority concern and population growth rates are the
highest in the world at present.  Trends in multilateral assistance
in Africa have shown that earlier emphasis on basic data collection
and policy formulation is giving way to operational
population-programme activities, particularly in MCH/FP and,
currently, reproductive health and family planning.

135. Looking to the future, the importance of resource mobilization
to implement a Programme of Action with its operationally oriented
approach will have to be fully grasped.  An action-oriented
mechanism will have to be put in place to coordinate the work of
the multilateral agencies and others.  The Inter-Agency Task Force
mentioned above is a step in that direction. 

                 Notes

     1/   Report of the International Conference on Population,
1984, Mexico City, 6-14 August 1984 (United Nations publication,
Sales No. E.84.XIII.8), chap. I.B.

     2/   Report of the United Nations World Population Conference,
1974, Bucharest, 19-30 August 1974 (United Nations publication,
Sales No. E.75.XIII.3), chap. I.

     3/   Report of the International Conference on Population and
Development, Cairo, 5-13 September 1994 (A/CONF.171/13 and Add.1),
chap. I, resolution 1, annex. 

     4/   Section I relies heavily on various issues of the UNFPA
Global Population Assistance Report and on unpublished data.

     5/   In section I.B and subsequent sections, annual
expenditures are used in the analyses, not commitments.

     6/   Interregional programmes in UNFPA have received from 14
to 16 per cent of all funds, although 1992 witnessed a decline in
funding for this area.  In contrast to UNFPA, other multilateral
agencies have devoted more of their regular budgets and other
sources of funds to interregional and global programmes.  When
funds received from UNFPA are excluded, in 1989 interregional
programmes received between 44 and 80 per cent of all regular
budget allocations of United Nations specialized agencies going to
population.

     7/   See table 1 contained in the report of the
Secretary-General on the monitoring of population assistance
(E/CN.9/1994/6), submitted to the Commission at its twenty-seventh
session (March 1994); at the time of preparation of the present
report, data for 1993 from the annual survey of population
organizations were still being collected. 

     8/   In 1992, the definition of the population component
changed somewhat, further complicating comparisons with previous
years.  The World Bank's fiscal year runs from July to June.

     9/   Official Records of the Economic and Social Council,
1991, Supplement No. 13 (E/1991/34), annex I.


     Table 1.  Distribution of UNFPA expenditures, by work-plan
               category, 1990-1993

                        (Percentage)

Work-plan category         1990       1991        1992       1993

Basic data collection       12         10           7          7

Population dynamics         10         11           9          7

Formulation/evaluation of
 policies and programmes     9          9           9          9

Implementation of policies   0          0           0          0

Family planning programmes   5         43          52         52

Information, education and
 communication              16         16          14        15

Special programmes           4          5           4         5

Multisectoral activities     2          3           4         4

    Total                  100        100         100       100

Total expenditures
 (millions of United 
  States dollars)        $179.2     $182.4      $138.0    $143.6


    Table 2.  Distribution of expenditures for population
              assistance, by region and channel, 1989 and 1990


                         (Percentage)


                                Latin
Channel      Sub-     Asia and  America
of funding  Saharan   the       and the    Western         Inter-
            Africa    Pacific   Caribbean  Asia    Europe  regional

                      Expenditures in 1989

Direct 
bilateral    38       50         36         51       49       2

United 
Nations 
system       29       27         20         30        42     37

Non-
governmental
organiza-
tions        33       23         44         19         9     61

Total       100      100        100        100       100    100


                   Expenditures in 1992

Direct
 bilateral   39         49         37         36        7     2

United 
Nations 
system       27         23         21         27       54    33

Non-
governmental
organizations34         28         42         37       39    65

Total       100        100        100        100      100   100


Table 3.  UNFPA expenditures, by work-plan category and region,
          1990-1993

                  Expenditures (millions US$)   % distribution
                     1990  1991  1992  1993   1990  1991  1992 1993

                      100 - Basic data collection

Sub-Saharan Africa   12.7  11.3   5.9  5.5     23    19    14   14

Western Asia          1.7   1.1   1.0  1.5     11    9   12   13
Asia and the Pacific  4.2   3.9   1.6  1.9      7    7    3    4

Latin America and the
Caribbean             2.1   2.0   2.0  1.6     10   11   12   10

Interregional         1.0   1.2   0.2  0.5      4    4    1    2


                      200 - Population dynamics

Sub-Saharan Africa    5.7   5.3   4.1  3.0     10   10    7    7

Western Asia          3.0   2.6   0.9  1.1   19   22    9    9

Asia and the Pacific  3.2   4.7   3.1  3.1    6    8    6    6

Latin America and the
Caribbean             3.3   3.5   1.6  1.0   16   17    6    6

Interregional         3.0   3.6   1.4  1.3   12   13    6    6

   300, 400 - Formulation and implementation of population policies

Sub-Saharan Africa    6.4   7.7   5.1  5.2   11   13    13   13

Western Asia          0.9   0.6   0.0  0.6    6    5     0    5

Asia and the Pacific  1.5   1.1   1.6  1.6    3    2    3     3

Latin America and the
Caribbean             1.5   1.3   1.7  0.9    7    7    10    6

Interregional         5.2   5.8   3.6  4.4   20   20    20   20

            500 - Maternal and child health/family planning

Sub-Saharan Africa   16.9  18.3  13.9 16.8   30   30    34   41

Western Asia          4.2   4.1   4.0  6.8   28   34    49   59

Asia and the Pacific 38.5  36.0  36.5 33.6   66   61    71   65

Latin America and 
the Caribbean        10.1   8.8   7.8  8.3   49   47    47   53

Interregional        10.2  10.4   8.2  7.6   40   37    46   35

            600 - Information, education and communication

Sub-Saharan Africa   11.2  13.8   8.5  7.8   20   23    21   19

Western Asia          4.0   2.3   1.4  1.0   25   20    17    9

Asia and the Pacific  7.5   7.5   5.1  6.0   13   13    10   12

Latin America and the
Caribbean             2.6   1.8   2.0  2.4   10   10    12    4

Interregional         4.4   4.8   2.6  4.8   17   17    14   22

            700 - Special programmes

Sub-Saharan Africa    1.9   1.7   1.6  0.9    2    3      4   2

Western Asia          1.6   0.8   0.4  0.2   10    7      5   2

Asia and the Pacific  2.0   5.1   2.0  4.5    3    9      3   9

Latin America and the
Caribbean             0.8   0.6   0.7  0.6    4    3      4   4

Interregional         1.3   2.1   0.8  1.0    5    7      4   5

            800 - Multisector

Sub-Saharan Africa    1.5   2.5   1.7  1.6    3    4      4   4

Western Asia          0.4   0.6   0.4  0.5    3    5      5   4

Asia and the Pacific  1.4   1.1   1.3  1.1    2    2      3   2

Latin America and the
Caribbean             0.4   0.8   0.9  0.8    2    4      5   5

Interregional         0.5   0.4   1.1  1.9    2    1      6   9


 Table 4.  Distribution of UNFPA expenditures, by region, 1990-1993

                                   (Percentage)

Region                       1990      1991       1992         1993
Sub-Saharan Africa            31        33         30           28

Asia and the Pacific          32        33         37           36

Latin America and 
 the Caribbean                12        10         12           11

Western Asia                   9         7          6            8

Europe                         2         2          2            2

Interregional                 14        16         13           15

Total                      100.0     100.0       100.0        100.0

Total expenditures (millions
of United States dollars)  179.2     182.4       138.0        143.6                         

This document has been posted online by the United Nations Department of Economic and Social Affairs (DESA). Reproduction and dissemination of the document - in electronic and/or printed format - is encouraged, provided acknowledgement is made of the role of the United Nations in making it available.

Date last updated: 23 March 2001 by mailto:esa@un.org?subject=DESA Docs comments to web master
Copyright 2001 United Nations