United Nations

E/CN.9/1995/4


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

        Activities of the United Nations Population Fund

            Report of the Executive Director of the 
                 United Nations Population Fund


                       SUMMARY

       The present report has been prepared in response to Economic
and Social Council resolution 1987/72, in which the Council
requested the Executive Director of the United Nations Population
Fund, inter alia, to continue to submit to the Population
Commission, on a regular basis, reports on the activities of the
Fund.  It examines the Fund's efforts to further strengthen
programme effectiveness in 1993 and 1994, reviews various topics of
special interest, highlights UNFPA financial and administrative
matters, notes the implications of the International Conference on
Population and Development, held at Cairo in September 1994, for
the UNFPA programme of work and reviews the steps the Fund has
taken in preparation for the Fourth World Conference on Women, to
be held at Beijing in September 1995.


                           CONTENTS

                                                                  
                                                   Paragraphs  Page

INTRODUCTION ..................................      1 - 4       3

  I.  STRENGTHENING PROGRAMME EFFECTIVENESS IN 
      1993 AND 1994 ..........................       5 - 55      3

      A.  Reproductive health and family planning    6 - 28      4

      B.  Information, education and communication  29 - 34      9

      C.  Data collection and analysis, and 
          population and development .............   35 - 43     10

      D.  Strategic programming and technical 
          assistance .............................   44 - 55     12

 II.  TOPICS OF SPECIAL INTEREST .................   56 - 90     15

      A.  Update of the UNFPA review and 
          assessment exercise .....................  56 - 63     15

      B.  Update on global contraceptive 
          requirements for 1994-2005 .............   64 - 73     16

      C.  HIV/AIDS prevention activiti............   74 - 80     18

      D.  Status of UNFPA implementation 
          of General Assembly resolution 47/199      81 - 90     20

III.  FINANCIAL AND ADMINISTRATIVE MATTERS .......   91 - 98     22

      A.  Financial highlights ...................   91 - 96     22

      B.  Administration and personnel ............  97 - 98     23

 IV.  IMPLICATIONS OF THE INTERNATIONAL 
      CONFERENCE ON POPULATION AND DEVELOPMENT
      FOR THE UNFPA PROGRAMME OF WORK ............   99 - 109    23

  V.  FROM CAIRO TO BEIJING ......................  110 - 118    26



                         INTRODUCTION


1.   The present report has been prepared in response to Economic
and Social Council resolution 1987/72, in which the Council
requested the Executive Director of the United Nations Population
Fund (UNFPA) to continue to submit to the Population Commission, on
a regular basis, reports on the activities of the Fund.

2.   This is the fifth report of the Executive Director on the
activities of the Fund.  The first report (E/CN.9/1987/5) provided
a brief summary of the mandate and principles of UNFPA and the
approaches the Fund uses to implement its programmes.  The second
report (E/CN.9/1989/6) highlighted the important developments that
had taken place in the UNFPA programme in the two years since the
first report.  The third report (E/CN.9/1991/9) examined the
activities of UNFPA in 1989 and 1990, in particular as they related
to the Fund's efforts to improve the quality, effectiveness and
outreach of its programme.  The fourth report (E/CN.9/1994/8)
supplemented the information provided in the third report,
highlighting the Fund's efforts during the period 1991-1993 to
strengthen the effectiveness of its programme.

3.   The present report examines the Fund's efforts to further
strengthen programme effectiveness in 1993 and 1994, in particular
its efforts to build upon existing family planning programmes and
to provide family planning services within the broader framework of
sound reproductive health-care services.  The report also examines
recent activities in the areas of information, education and
communication (IEC), data collection and analysis, and population
and development; reviews various topics of special interest;
highlights UNFPA financial and administrative matters; notes the
implications of the International Conference on Population and
Development for the UNFPA programme of work; and reviews the steps
the Fund has taken in preparation for the upcoming Fourth World
Conference on Women to be held at Beijing, in September 1995.

4.   The present report reflects UNFPA's efforts to make extensive
use of monitoring and evaluation exercises, both as a means of
ensuring that UNFPA-supported activities produce intended results
and as an indispensable tool in sharpening the strategic focus of
the Fund's assistance.


     I.  STRENGTHENING PROGRAMME EFFECTIVENESS IN 1993 AND 1994

5.   The effort to broaden the scope of the UNFPA programme to
encompass a more comprehensive reproductive health-care approach
was one of the most notable features of the Fund's work during 1993
and 1994.  This was accompanied by efforts to satisfy unmet needs
and to contribute to the empowerment of women, notably by
activities aimed at enhancing women's economic status and exploring
the linkages between women's economic activities and reproductive
behaviour.  The importance of such an approach was emphasized in
the Programme of Action adopted by the International Conference on
Population and Development. 1/  UNFPA also sought to strengthen and
refine its programme process, focusing on strategic programming and
its requisite policy and technical assistance.  

     A.  Reproductive health and family planning

6.   Three fundamental elements guided UNFPA assistance in this
area:  first, improving the quality of family planning programmes;
second, adopting a more comprehensive approach to reproductive
health care where family planning services are provided within the
framework of reproductive health services; and third, empowering
women in terms of reproductive rights and reproductive freedom. 
The Fund also formulated a policy paper to guide UNFPA humanitarian
assistance aimed at meeting the reproductive health needs of women
and adolescents during emergencies and other difficult situations.


     1.  Improving the quality of family planning services

7.   The quality of family planning services has increasingly been
recognized as one of the most important determinants of whether or
not people accept and continue to use contraceptives.  UNFPA's
Guidelines for UNFPA Support to Family Planning Programmes
encourage activities to improve the quality of family planning
services, emphasizing the need to expand the availability of such
services and to enhance their social acceptability and
effectiveness. 

8.   In 1993, UNFPA organized a thematic evaluation of family
planning services in eight countries to assess the quality of such
services along six dimensions:  choice of methods; technical
competence of service providers; level of information and
counselling available to clients; nature of interpersonal relations
between service providers and clients; the presence of mechanisms
within the programme to promote continued contraceptive use; and
the appropriateness and acceptability of services.

9.   The evaluation found that UNFPA's support had contributed
significantly to improving women's access to family planning
services in the eight countries visited.  Family planning services
were being delivered in facilities located within a reasonable
distance of clients; a variety of contraceptive methods were
available; service providers had had some kind of training and
generally had a positive attitude towards their work and their
clients; and basic medical equipment was in place.  In addition,
elementary management systems had been implemented with relative
success, enabling most of the facilities to operate smoothly.

10.  However, the findings also highlighted several important
limitations related to the quality of family planning services. 
For example, the evaluation found that while all eight countries
provided at least four methods of contraception (oral pills,
intra-uterine devices (IUDs), tubal ligation and condoms), the
choice of methods available to clients was limited by various
factors, including the tendency among Governments and providers to
encourage certain methods at the expense of others and the fact
that contraceptive services were almost exclusively oriented
towards female clients.  The evaluation also found that the
technical competence of service providers varied greatly, that
countries often lacked the basic infrastructure and equipment
needed for effective service delivery and that family planning
services were sometimes neglected in favour of other health-care
services.  It further noted that the lack of follow-up mechanisms
and inadequate record-keeping had limited the capacity of service
providers to ensure client satisfaction and effective, continuous
contraceptive use.

11.  Although most service providers interviewed had had some
training in family planning, that training was often insufficient
for the services provided.  Moreover, service providers seldom
screened clients for contraceptive contra-indications or paid
adequate attention to clients' complaints about side-effects.  Such
shortcomings were compounded by inadequate supervision, which was
found at times to be too weak, infrequent and insufficient to
ensure effective service delivery.

12.  The evaluation further found that while nearly all
UNFPA-supported maternal and child health and family planning
(MCH/FP) projects explicitly identified improving the quality of
services as one of their objectives, project strategies and
activities did not always focus adequately on quality issues or
specify key indicators that could help in determining whether
project inputs were having the desired effect.  This contributed to
the related problem of placing too great an emphasis on quantity
over quality, since programme performance tended to be measured in
quantitative terms, such as the number of clients served and the
amount and types of contraceptives provided. 

13.  The evaluation yielded a number of recommendations, including
the following:  (a) the mix of contraceptive methods should be
sufficiently diverse to meet the needs of all users; (b) the choice
of method should rest with the user not with the service providers;
(c) more emphasis should be placed on promoting male contraception;
(d) particular attention should be given to providing clients with
complete, accurate and understandable information on available
contraceptive methods; (e) service providers should be trained on
the job in clinical skills and in interpersonal communications and
counselling; and (f) mechanisms to ensure adequate follow-up of
family planning acceptors should be developed or strengthened and
practical and simple record-keeping systems should be developed and
institutionalized; and (g) supervisors should be trained to monitor
the quality of the services delivered (rather than just the
outcomes as indicated by service statistics) and to give technical
advice in a supportive way.


     2.  Integrating family planning into reproductive health care

14.  UNFPA regards family planning as a central component of
reproductive health care:  it allows couples and individuals to
meet their reproductive goals; is essential in reducing maternal
mortality and morbidity; is indispensable in reducing the incidence
of abortion; and contributes to efforts to prevent the transmission
of reproductive tract infections, including sexually transmitted
diseases, including human immunodeficiency virus (HIV) and acquired
immunodeficiency syndrome (AIDS).  The Fund recognizes that family
planning programmes work best when they are linked to broader
reproductive health programmes and when women are fully involved in
the design, delivery, management and evaluation of services.  UNFPA
therefore promotes an integrated programme approach that seeks to
make family planning services available to all who need and want
them and to help couples and individuals satisfy their reproductive
needs and goals.

15.  The challenges in the area of reproductive health care/family
planning range from understanding people's fertility behaviour and
satisfying their family planning needs, to preventing unsafe
abortion and to aggressively combating the spread of sexually
transmitted diseases and HIV/AIDS.  Meeting those challenges
requires designing and implementing effective ways of delivering
integrated services to all those who desire them, but especially to
hard-to-reach populations and those at increased risk of sexually
transmitted diseases and HIV infection.  Such services must be
adapted to specific socio-cultural contexts; be extended to poor
women, minorities, unmarried women and adolescents; promote healthy
and responsible reproductive behaviour; pay special attention to
young adults and men; and promote the use of condoms and other
barrier methods of contraception.

16.  UNFPA support is predicated on a number of basic principles,
all of which are in consonance with the principles of the Programme
of Action adopted by the Cairo Conference.  First and foremost is
the fundamental principle that all couples and individuals have the
basic right to decide freely and responsibly the number and spacing
of their children and to have the information, education and means
to do so.  The Fund thus rejects any form of coercion and any form
of incentives for either acceptors or service providers that might
compromise informed and voluntary choice. 

17.  UNFPA promotes programmes that (a) are designed on the basis
of meeting the needs of couples and individuals, not on the basis
of meeting targets on quotas; (b) seek to assure the highest level
of quality of care; (c) involve non-governmental, private,
professional and other voluntary organizations, especially women's
organizations, in the planning, implementation and monitoring of
reproductive health services; (d) provide a constellation of
integrated services to meet the reproductive health needs of women
and men; (e) match services provided with the demand created by IEC
programmes; and (f) provide greater and, to the extent possible,
more flexible support for local costs, particularly at the primary
health-care level in those countries that still require assistance
to strengthen basic infrastructure.

18.  UNFPA support for reproductive health programmes is likely to
include (a) the full spectrum of family planning information and
services, including counselling and follow-up services, aimed at
all couples and individuals; (b) prenatal, delivery and postnatal
care of mothers at the primary health-care level, with appropriate
referral for the management of obstetric complications; (c)
prevention of abortion, management of the consequences of abortion,
and post-abortion counselling and family planning; (d) prevention
of reproductive tract infections through preventive counselling and
condom distribution; (e) prevention of infertility and
sub-fecundity; and (f) routine reproductive health check-ups for
women.

19.  UNFPA recognizes that it will be difficult to satisfy women's
family planning and reproductive health needs without the support
of men, not only as husbands and partners but also as policy and
decision makers and community and religious leaders.  Efforts to
involve men as responsible partners in helping to satisfy such
needs take on a special urgency given the rapid spread of HIV/AIDS
and the potential improvement in reproductive health that would
follow if programmes promoted male participation as well as male
methods as part of the contraceptive choices available to couples. 
The Fund further recognizes that integrated programmes must address
the family planning and reproductive health concerns of
adolescents, who urgently need information and services that can
help protect them from unwanted pregnancies, unsafe abortion and
sexually transmitted diseases.   

      3.  Strengthening IEC in support of family planning

20.  In order to assess the strengths and weaknesses of IEC
activities in support of family planning programmes, UNFPA
organized a thematic evaluation of seven IEC projects in five
countries:  Comoros, Rwanda and Zambia in Africa; and India and the
Philippines in Asia.  The projects fell into two categories: 
MCH/FP projects with an integrated IEC component; and IEC projects
specially designed to support MCH/FP activities.  The evaluators
also drew upon evaluation and programme review reports on nine
additional projects to obtain supplementary information.

21.  The evaluation found that both types of projects had
contributed to improving the level of knowledge and practice of
family planning.  In general, however, the projects were found to
be overly ambitious, with too many objectives and an unrealistic
time-frame within which to achieve them, a not uncommon problem
with projects in other sectors as well.  Moreover, indicators of
success tended to be quantitatively rather than qualitatively
oriented.  In the projects with IEC components, it was not always
clear how the IEC component would be integrated into the MCH/FP
activities.  The support IEC projects, on the other hand, did not
usually ensure that the demand created would be matched by the
services provided.  In fact, the evaluation found that coordination
in general tended to be weak, not only between service delivery and
IEC activities in MCH/FP projects with integrated IEC components,
but also between MCH/FP and IEC project personnel more generally. 

22.  In recognition of the importance of strengthening the link
between MCH/FP and IEC activities, UNFPA prepared a technical note
on the relationship between IEC and family planning service
delivery.  The note identifies six prerequisites for success.  The
first is collaborative planning.  Service providers and IEC
personnel must work closely together to identify the behavioural
and attitudinal changes desired and the different population groups
to be addressed.  The second is strong and effective intrasectoral
and intersectoral coordination.  The third is complementary
mass-media and interpersonal approaches:  the use of mass media
helps to legitimize and disseminate IEC messages; the use of
interpersonal communications personalizes them.  The fourth is a
sound service delivery system capable of meeting the demand
generated by IEC activities.  The fifth is the effective
integration and coordination of IEC and family planning activities.

The sixth is the incorporation of monitoring and evaluation
mechanisms in project design.   

23.  The Fund also issued a technical paper on developing IEC
strategies for population programmes.  The paper contained a
12-step approach to designing an effective strategy, which if
applied in the project formulation, appraisal and monitoring stages
would specifically address most of the shortcomings identified in
the thematic evaluation.  It also identified lessons learned from
the Fund's experience in population IEC, including those
specifically oriented towards users of family planning and
reproductive health services.  Not surprisingly, good interpersonal
communication and counselling skills were found to be a
prerequisite for effective and continued use of MCH/FP services,
increased contraceptive prevalence and the acceptance of safer
sexual practices.


     4.  Linking women's economic activities and
         reproductive behaviour

24.  Economic independence for women has long been recognized as a
key to limiting fertility.  The ability to earn income helps to
create alternatives to early marriage and early and frequent
child-bearing.  It also increases the opportunity costs of women's
time and the "cost" of children, enhances women's status and
self-esteem, and increases a woman's ability to make her own
decisions, including those concerning child-bearing and
contraception.

25.  One of the ways in which UNFPA seeks to link family planning
activities with efforts to enhance women's ability to earn income
is through experimental projects that help women set up
micro-enterprises.  The projects typically help women secure
credit; provide technical assistance and training in managing small
businesses; and promote the use of family planning. 
(Micro-enterprises are unincorporated business activities that are
undertaken by individuals, households or groups and require a
limited number of employees.  They are generally part of the
informal sector and include, for example, off-farm employment,
manufacturing and commerce.)

26.  In early 1993, UNFPA published a comprehensive assessment of
the Fund's experience with micro-enterprise projects for women. 
The report culminated a year-long thematic evaluation that began
with the development of an evaluation methodology, involved a desk
review of all available documentation on 19 such projects, and
ended with four evaluation missions to project sites in six
countries:  Egypt, Ghana, India, Kenya, Paraguay and the
Philippines.  The missions reviewed all primary and secondary
project documentation, including loan records and project
monitoring data; conducted focus-group interviews; visited client
enterprises; and interviewed representatives of government agencies
and non-governmental organizations.

27.  The evaluation did not find precise data to affirm a direct
link between increased income and reduced fertility.  However, it
did show that when project inputs reached women and when women had
access to family planning services, the projects appeared to
contribute to increases in income and changes in reproductive
behaviour.  It also found that increases in income can accelerate
demand for family planning and maternal and child health services. 
At the same time, however, the evaluation showed that specialized
technical expertise was required to design population projects with
micro-enterprise and income- generation components and a strong
institutional capacity was required to implement them, both of
which made the selection of implementing and executing agencies
critical to the success of the activity.

28.  The evaluation recommended that UNFPA continue to support
micro-enterprise projects for women, giving preference to
micro-enterprise activities that clearly helped to achieve
population objectives and that linked population components to
strategies that had proved effective in increasing women's income. 
The evaluation further recommended that UNFPA-supported projects
have explicit linkages to the Fund's country-level population
programmes, especially to activities that seek to enhance women's
reproductive rights, and ensure that there are family planning
services available to meet the demand generated by the projects. 
The evaluation stressed that, as a primary strategy, UNFPA should
introduce MCH/FP, as well as IEC and other population components,
into existing micro-enterprise programmes and projects rather than
design separate micro-enterprise/population projects on its own. 
The Fund should identify executing agencies that have the requisite
technical capacity to ensure that projects are well designed,
monitored and implemented, and select implementing agencies that
have a proved track record in micro-enterprise activities.


     B.  Information, education and communication

29.  In 1994, UNFPA provided assistance to developing countries to
implement 118 ongoing and new population education activities.  The
activities supported ranged from creating awareness and eliciting
support among government officials and community leaders, to
training a core technical staff and to teaching population
education in schools. 

30.  A broad base of support for population education became
evident in 1993 at the first International Congress on Population
Education and Development, held at Istanbul, Turkey, at which 92
Governments strongly endorsed population education.  As a result,
the focus of activities in 1994 shifted away from advocacy and
towards efforts to improve the quality and coverage of population
education.  This involved, inter alia, producing more effective
teaching and learning materials; devoting more time and assistance
to high-quality training; making greater use of educational
television where feasible; and expanding training activities to
reach teachers who had not yet been trained because of lack of
funds.

31.  A recent study conducted by UNFPA in a number of countries
revealed two main shortcomings in current population education
programmes:  the lack of clear priorities in the topics covered;
and the lack of clear objectives and desired outcomes.  In response
to these and related issues, UNFPA issued a technical paper
reconceptualizing population education.  The paper proposed
specific approaches to topics perceived as sensitive or
controversial; called for new ways to select key concepts and set
priorities; and stressed the importance of ensuring that course
content was clear and appropriate to both the socio-cultural
context of the country and the age level of the students.

32.  In addition to promoting population education activities in
schools, UNFPA used other channels, such as adult literacy classes,
workers education courses and agricultural extension programmes, to
reach a variety of audiences.  As a follow-up to the Fund's
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 improving the literacy of girls
and women, while promoting family planning and teaching key
vocational skills.  The Fund has also used parent-education
programmes as a vehicle to help parents communicate better with
their children on such sensitive issues as human sexuality and
contraception and to encourage parents to send their daughters to
school. 

33.  UNFPA also provided support to peer-counselling activities
directed towards adolescents and young women who had married at an
early age.  The peer approach proved to be an effective channel of
communication, particularly in youth clubs, which were successful
in several countries in conveying messages on family planning and
responsible parenthood and in providing reproductive health-care
counselling and services.

34.  In 1994, UNFPA directed greater attention to the issue of male
involvement in reproductive health care, including family planning.

Initial findings from a review of the activities of organizations
that work in this area indicate that such organizations tend to
focus on male contraceptive methods and their use, but give little
attention to the role of men as partners in reproductive health
care.  UNFPA will therefore continue to emphasize the importance of
male involvement in reproductive health, particularly in view of
the fact that most resources for family planning are still
allocated to services for women.


       C.  Data collection and analysis, and population
           and development

35.  During 1993 and 1994, UNFPA continued to assist developing
countries in enhancing their capabilities to generate and analyse
population data in support of national population and development
activities.  The Fund's capability to provide technical assistance
has been further strengthened by the appointment of specialists in
data collection, processing and analysis to the Fund's country
support teams.  As a result of the broadening of the scope of
population and development activities called for in the Programme
of Action, UNFPA has accordingly begun to revise the modalities and
scope of its support to cover such areas as basic data collection;
social, economic and cultural research and analysis; monitoring;
and the interrelationship of population, development and the
environment.

36.  To ensure that developing countries will be able to obtain the
maximum benefit from developments in methodologies and from
technological innovations, UNFPA maintains and promotes an ongoing
dialogue with specialists from both developed and developing
countries.  The technical support teams of the Department for
Economic and Social Information and Policy Analysis of the United
Nations Secretariat are playing a crucial role in preparing
summaries of state-of-the-art developments in census taking,
household survey execution, and civil registration and vital
statistics.

37.  UNFPA continued to provide assistance to developing countries
to develop appropriate technologies to analyse, present and
disseminate data.  It is envisaged that new, user-friendly,
technologically appropriate techniques of presenting data will be
further developed, in particular in view of the international
consensus on the need for more sophisticated population and
development databases.  

38.  In 1993 and 1994, UNFPA continued to fund activities in
support of population policy formulation and development planning
in most developing countries.  The bulk of these activities
concentrated on institution-building and were carried out in
sub-Saharan Africa, a region where population policy formulation is
still evolving.  These efforts benefited from the information
provided from the monitoring of national population policies
regularly carried out by the Population Division of the Department
for Economic and Social Information and Policy Analysis of the
United Nations Secretariat.

39.  The operational and institutional means of integrating
population factors into the development process came under
increasing scrutiny, first at a round-table discussion convened
jointly by the Economic and Social Commission for Asia and the
Pacific and UNFPA in November 1993, and subsequently in the policy
dialogue leading to the Cairo Conference.  As a result, greater
emphasis is being placed on policies and programmes that encourage
grass-roots participation, involve local communities and facilitate
efforts to empower women.  Decentralized planning and a shift
towards policy-making at subnational and local levels are also
being increasingly featured in multilateral assistance, whose aim
is to institutionalize the integration of population factors into
development planning. 

40.  A series of UNFPA-supported studies being undertaken by the
Population Division continued through their third year of
implementation.  As part of a study on excess mortality of the
female child, the Division prepared an extensive bibliography of
materials dealing with this topic and will publish a study on sex
differentials in infant and child mortality and its determinants. 
For a study of the family-building process in 15 countries, the
Division undertook an analysis of the literature, designed computer
programs to analyse data, and tested the study's methodology in
Colombia and Kenya.  For a study on international migration, the
Division conducted an extensive review of the literature and
completed the framework for the survey report.  The Population
Division also continued to disseminate population information and
data through its Population Information Network (POPIN) Gopher,
including relevant documentation generated during the International
Conference on Population and Development. 

41.  The Statistical Division of the Department for Economic and
Social Information and Policy Analysis of the United Nations
Secretariat continued to develop, distribute, service and provide
training for a number of population- related computer software
packages.  The aim has been to provide software packages where
commercial software is not readily available.  The Statistical
Division has been particularly successful in developing the POPMAP
software package, especially when used as part of a management
information system (MIS) for family planning services and census
operations.  The use of such software packages has been enhanced
through regional training workshops in Chile and Senegal.  The
Statistical Division has also been evaluating the geographical
information systems (GIS) software, testing different applications
in the areas of population research, census activities and MIS
activities.

42.  The Statistical Division conducted research on developing
statistics on women and development.  The database, known as the
United Nations Women's Indicators and Statistics Database for
microcomputers (WISTAT), provides access to a wide range of data on
social and economic issues relating to women and is the main source
of statistics for reports prepared by the Commission on the Status
of Women and the Committee on the Elimination of Discrimination
against Women.  The Division has begun preparations to upgrade the
database in the light of the Fourth World Conference on Women
(Beijing, September 1995).  The Statistical Division has also been
working in close collaboration with the World Health Organization
(WHO), the International Institute for Vital Registration and
Statistics, and UNFPA in implementing an international programme
for accelerating and improving vital statistics and civil
registration systems.  The activities seek to strengthen the
technical and managerial capabilities of developing countries to
organize, maintain and operate comprehensive vital statistics and
vital registration systems.

43.  During 1993 and 1994, the UNFPA Global Training Programme on
Population and Development continued to provide training in the
field of population and development.  In 1993, 85 participants (41
of them women) from 54 countries completed a one-year training
session at the Programme's four long-term training centres.  In
1994, 100 participants (43 of them women) from 59 countries took
part in the training.  In 1993, the Global Programme expanded to
include a fifth training centre, which was established at the Cairo
Demographic Centre in cooperation with the Egyptian Government. 
The first training session started in October 1993 with 20
participants from 15 developing countries.  In October 1994, the
training centres in Belgium and the Netherlands were transferred,
respectively, to the Institut national de statistique et d'‚conomie
appliqu‚e at Rabat, Morocco, and to the University of Botswana at
Gaborone.  At present, preparations are under way to establish
training programmes at the two new sites. 

      D.  Strategic programming and technical assistance

44.  The review and assessment of programme strategies and the
evaluation of programme performance are part of a continuum to
enhance the impact and effectiveness of programmes.  They are also
at the core of the Fund's programme review and strategy development
(PRSD) exercise.  Programme performance and effectiveness, in turn,
are enhanced by high-quality technical assistance.  The Fund's
principal mechanism for providing such technical assistance at the
country level is the UNFPA country support team (CST), of which
there are currently eight in operation.  The work of the teams is
complemented by specialists and coordinators located in the United
Nations and its regional commissions, at the headquarters of United
Nations specialized agencies and at WHO regional offices.  

45.  UNFPA's report to the Population Commission at its
twenty-seventh session (E/CN.9/1994/8) provided a detailed
description of the PRSD exercise and the evolution of the UNFPA
country support teams.  The present report provides a brief summary
of the Fund's experience to date with these two important
programming tools.



         1.  Programme review and strategy development

46.  In 1993, UNFPA reviewed its experience with the PRSD exercise.

The objective was to identify ways to further strengthen the
effectiveness of the exercise and to make optimal use of the
findings and recommendations in the formulation of corresponding
country programmes.

47.  The review found that the PRSD exercises had yielded a wealth
of data, enhanced the understanding of the population dynamics in
the countries reviewed, and facilitated the planning, design and
implementation of national population programmes.  It further found
that the objectives and strategies of the corresponding UNFPA
country programmes were clearly based on the PRSD recommendations. 
However, the review suggested ways to improve the usefulness of the
recommendations, both by making them more explicit and by
establishing clear priorities.  Although the recommendations
generally were found to be specific to the needs of the country
reviewed, it was recommended that the strategies developed should
be more comprehensive and take greater account of analyses of
national capacities in various sectors, of constraints to
population programme implementation, and of the overall national
development context.  

48.  In general, the review found that much energy and attention
had been focused on activities specific to organizing and
conducting the PRSD mission, but not enough on critical preparatory
and follow-up activities.  None the less, the missions more
effectively achieved their purpose when the Government had been
actively involved in the process and when the missions had worked
in close collaboration with the UNFPA field office.  

49.  The review reaffirmed the PRSD exercise as an essential
element in population programming.  The lessons learned from the
review are being used to help strengthen the Fund's programme
development process.  UNFPA is thus taking care to generate and
maintain population programme data on a country-by-country basis;
clearly define the roles and responsibilities of those involved in
the process; clearly delineate the various phases in the
programming process; and refine and improve the tools used in
programme monitoring and evaluation.  

     2.  Technical support services

50.  As requested by the Governing Council of the United Nations
Development Programme (UNDP) and UNFPA, in its decision 91/37, 2/
the Executive Director arranged for an independent evaluation of
the Fund's successor support-cost arrangements, which had been
approved by the Governing Council in that decision.  The objectives
of the evaluation were (a) to assess whether the role and
objectives of the Fund's technical support services (TSS) system
were being fulfilled; (b) to determine if the TSS system was
working as intended; (c) to assess whether the system was meeting
the demands for technical support services; and (d) to examine
organizational issues such as regional needs, composition and size
of UNFPA country support teams and possible options for the future
configuration of the teams.   

51.  The objectives of the Fund's TSS system are fourfold:

     (a)  To improve the availability of technical knowledge,
analysis and research for use in population policies and
programmes;

     (b)  To contribute to an integrated and coordinated
multidisciplinary
approach to population;

     (c)  To accelerate the achievement of national self-reliance
through the use of national and regional expertise;

     (d)  To ensure close interaction of research and analytical
work with institutional activities.

52.  The evaluation team conducted field missions to each of the
Fund's eight country support teams as well as to 28 countries
covered by the teams.  Team members consulted government officials
and national programme staff, UNFPA country directors, CST team
leaders and members, as well as a wide range of country-level
personnel from agencies and organizations active in population
activities in the countries visited.  They also conducted
interviews with TSS specialists and coordinators at participating
United Nations agency headquarters and regional offices, whose
major function is to provide country support teams with information
and research in support of team efforts at the country level. 

53.  The evaluation team found that the concept of the CST system
had been welcomed by all those concerned.  The CST system of
advisers was a major improvement over the previous system of
regional advisers, providing more effective and timely backstopping
of UNFPA projects.  The teams had been most effective in providing
technical support for project formulation and monitoring but less
successful in building national capacity - primarily because of the
heavy workload of CST advisers.

54.  The evaluation team made numerous recommendations for
improving the TSS system at the country, regional and headquarters
levels.  For example, it recommended that UNFPA field offices
should be strengthened in both programme management and
administration, and that Governments' capacity to manage programmes
should be strengthened by using programme funds to place project
and programme managers in key operational and coordinating
ministries.  At the regional level, the team recommended that UNFPA
review the composition of all country support teams and TSS
headquarters units, together with all personnel funded under the
TSS system, and make greater use of TSS specialists.  The team
recommended at the headquarters level that the Fund clarify the
role of the country support team in agency-executed projects and
review TSS guidelines to ensure that top priority was given to
national capacity-building and that national competence was fully
utilized before using CST advisers.

55.  UNFPA will report to the Executive Board in 1995 on its
experience with the TSS arrangements, including the findings and
recommendations of the independent evaluation.



      II.  TOPICS OF SPECIAL INTEREST

      A.  Update of the UNFPA review and assessment exercise

56.  In response to Governing Council decision 93/27 A, 3/ UNFPA
updated its original review and assessment exercise, which had
examined what had or had not worked in the population field over
the 20-year period from 1969 to 1989, and identified the factors
responsible for success or failure of national population
programmes in three key areas of the UNFPA work programme:  (a)
population data, policy development and planning; (b) maternal and
child health and family planning (MCH/FP); and (c) information,
education and communication (IEC).

57.  The 1993-1994 update reaffirmed the continuing relevance of
the policy implications of the findings and recommendations of the
original review and assessment, which had stressed, inter alia,
that countries had to obtain needed political support, introduce
strategic planning and programming, diversify the agents for
demographic change (e.g., by including non-governmental
organizations, community and religious organizations and women's
groups) and strengthen resource mobilization.  The update further
reaffirmed that the review and assessment had anticipated a main
thrust of General Assembly resolutions 44/211 and 47/199, stressing
the importance of developing a national plan to serve as a
framework for coordinating all population activities within a
country and emphasizing the need to rapidly strengthen national
capacity to manage such a plan.

58.  The update identified a number of issues that still required
further elaboration and coordinated and concerted action.  These
included the need (a) to improve the quality of family planning
programmes and to provide family planning services within the
framework of reproductive health-care services; (b) to strengthen
policies and procedures for matching resources to evolving needs at
the country level, including the need to redefine the roles of
countries with successful programmes; (c) to improve strategic
planning and programme implementation; and (d) to mobilize
additional resources to help countries meet the basic needs of
their population programmes.  The update also identified several
other important issues, including the need to obtain accurate
estimates of contraceptive requirements and to devise ways to meet
those requirements, to address special problems associated with the
ageing of populations, and to formulate policies and provide
assistance and services responsive to the needs of refugees and
recent migrants.

59.  The update noted that the integrated reproductive health
care/family planning perspective went beyond the absence of disease
or disorders of the reproductive process and implied that
reproduction should be carried to a successful conclusion.  It
included the reproductive health needs of men and of adolescents
and involved extending services to all women of reproductive age as
well as to those beyond reproductive age who might require care for
the after-effects of illnesses associated with their child-bearing
years.

60.  The update further suggested that reproductive health care
should be the linchpin of integrated programmes around which
related services and activities should be structured and
coordinated.  For example, IEC activities should seek to involve
men more fully in family planning and reproductive health-care
activities and should be designed to assist both adults and
adolescents in making free and informed decisions concerning their
sexual and reproductive lives.  The update also recommended that
population IEC programmes should develop strategies to enable
couples, families and youth to discuss population and reproductive
health issues openly and honestly.


61.  Two of the other findings of the update also hold particular
significance for the work of UNFPA:  the need to strengthen
policies and procedures for matching resources with evolving needs
at the country level; and the need to improve strategic planning
and programme implementation.  The importance of the first was
reaffirmed by the General Assembly in its resolution 47/199, which
noted the need for priority allocation of scarce grant resources to
programmes and projects in low-income countries, particularly the
least developed countries (para. 4).  Such priority allocation of
resources has long been a concern of UNFPA, as reflected in the
Fund's extensive experience in implementing its priority country
system.  That system has enabled UNFPA to be flexible in responding
to changing economic and demographic situations and to concentrate
its resources in countries with the most critical needs.

62.  The success of population programmes in many countries is also
an important factor in matching resources with evolving needs.  A
number of developing countries have either met or surpassed the
goals set forth in the Programme of Action, and an even larger
number will attain similar levels of success within the next few
years.  Taken together, these successful programmes not only
demonstrate individual achievements, but also add greatly to the
pool of human and technical resources that can be mobilized to help
countries address their population issues.  These successful
countries, however, may no longer require external assistance for
comprehensive population programmes, as they have been able to
commit high levels of internal resources to meeting the needs of
their people. 
63.  The update identified the Fund's PRSD exercise and TSS
arrangements as integral components of efforts to improve strategic
planning and programme implementation.  Both heighten UNFPA's
comparative advantage and maximize the impact of the assistance it
provides, as well as that provided by other agencies and
organizations.  Both also seek to improve the Fund's effectiveness
and efficiency in delivering assistance, strengthen its capacity to
provide policy guidance and technical assistance and advice, and
help countries build up their capacity to execute programmes and
projects.  The PRSD exercise and the UNFPA country support teams
also serve important monitoring functions.


      B.  Update on global contraceptive requirements for 1994-2005

64.  In response to Governing Council decision 91/35 A, 2/ UNFPA
updated the global estimates of contraceptive requirements in
developing countries, building upon the estimates contained in the
report of the Executive Director of the Fund on contraceptive
requirements and demand for contraceptive commodities in developing
countries in the 1990s (DP/1991/34), submitted by the Governing
Council at its thirty-eighth session.  The update incorporated the
latest data from the United Nations, the Demographic Health
Surveys, the in-depth studies conducted under the UNFPA Global
Initiative on Contraceptive Requirements and Logistics Management
Needs in Developing Countries in the 1990s and other sources, and
included estimates of condom requirements for HIV/AIDS prevention
prepared by the World Health Organization Global Programme on AIDS.

The global estimates provided below are based on 1992 United
Nations population projections and must therefore be adjusted
periodically to reflect subsequent projections. 

65.  UNFPA presented a summary of the findings of the update to the
UNDP/UNFPA Executive Board at its annual session, in June 1994
(DP/1994/47).  The summary examined seven key factors: 
contraceptive use by married women; method use; contraceptive use
among all women; contraceptive commodity requirements; cost of
contraceptive commodities; sources of supply; and projections of
condom requirements for the prevention of sexually transmitted
diseases and AIDS.

66.  The update estimated that the number of married women of
reproductive age in developing countries would increase by about 14
million a year, for a total increase of 169 million, or 21.5 per
cent, in the period 1994-2005.  Thus, if contraceptive use among
married women were to remain at the 1994 level of 56.8 per cent,
the number of married women using contraceptives would increase by
96 million between 1994 and 2005, from 446 million to 542 million. 

67.  In order for population growth to remain in line with the 1992
United Nations medium projection, which forecasts an addition of
950 million persons by the year 2005, a modest increase in
contraceptive prevalence would have to take place in developing
countries, from 56.8 per cent to 63 per cent.  This increase of
about one half of 1 per cent a year in contraceptive prevalence,
combined with the increase in married women of reproductive age,
yields an increase of 157 million contraceptive users, bringing to
603 million the total number of married women using contraception
by the year 2005.  

68.  In order to attain the 1992 United Nations low-population
projection, the number of contraceptive users would have to reach
622 million in the year 2005, 176 million more than in 1994.  The
very ambitious goal of attaining replacement fertility for each
country in the world would require 269 million additional users in
2005, 60 per cent more than the number in 1994.

69.  It is estimated that of the 446 million current users in
developing countries, 200 million (45 per cent of all users) are
protected by sterilization.  IUDs are the second most used
contraceptive method, by 112 million women (25 per cent of all
users).  The pill is used by more than 51 million women (12 per
cent of all users), the condom by almost 25 million couples (6 per
cent), and injectables by 10 million women (2.2 per cent), although
such use is probably increasing relatively rapidly (the remaining
47 million contraceptive users use traditional methods).

70.  Method mix differs markedly by region.  For example, in Asia,
sterilization and IUDs account for 76 per cent of users; in Latin
America, 38 per cent use sterilization and 28 per cent use the
pill.  In both sub-Saharan Africa and the Arab States and Europe,
the pill is the most used method (26 per cent and 31 per cent,
respectively).  The largest proportionate use of injectables is in
sub-Saharan Africa, accounting for some 13 per cent of all users.

71.  Estimates of contraceptive commodity requirements for the
period 1994-2005 are 196 million sterilization procedures; 436
million IUDs; 898 million doses of injectables; 12.3 billion cycles
of pills; and 55.7 billion condoms.  The estimated annual cost of
such contraceptive commodities for family planning would increase
from $528 million in 1994 to $752 million in the year 2005.  The
total for the 12-year period 1994-2005 is estimated to be $7.7
billion and averages just over $640 million a year.  This compares
to $5.1 billion for the 10-year period 1991-2000 presented in the
original estimate of global requirements in 1991, averaging $510
million a year.

72.  An additional 14.6 billion condoms for the prevention of AIDS
and other sexually transmitted diseases are estimated to be
required for the period 1993-2005, at a cost of $406.5 million. 
Thus, the total cost of commodities, including condoms for HIV/AIDS
prevention, is estimated at $8.1 billion for the period.  The
breakdown by method, calculated in current average costs for
purchases on the international market and assuming no escalation in
cost, is as follows:  pills, $2.5 billion; sterilization
procedures, $2 billion; condoms, $1.95 billion ($1.55 billion for
family planning and $0.4 billion for the prevention of sexually
transmitted diseases and AIDS); injectables, $907 million; and
IUDs, $733 million.

73.  Governments supply about 86 per cent of all modern methods
used in developing countries:  95 per cent of clinical methods
(sterilization and IUDs), 57 per cent of pills and 47 per cent of
condoms.  In Asia, Governments furnish the supplies for more than
90 per cent of sterilization and IUDs, almost 80 per cent of users
of pills, more than two thirds of users of injectables and about
half of condoms.  Sixty-five per cent of contraceptive users in
sub-Saharan Africa receive supplies from Governments, primarily
injectables, pills and IUDs; the private sector accounts for 47 per
cent of sterilizations and 64 per cent of condoms.  In Latin
America, 62 per cent of users of modern methods (including more
than 80 per cent of users of the pill, injectables and condoms)
receive their supplies from the private sector.  Similarly, in the
Arab States and Europe, 58 per cent of users receive their supplies
from the private sector (including more than three fourths of all
condom users and two thirds of all pill users).


      C.  HIV/AIDS prevention activities

74.  The prevention and treatment of sexually transmitted diseases,
including HIV/AIDS, is an integral component of reproductive health
care.  It is also an important concern of the UNFPA programme and
a focus of considerable inter-agency collaboration.

75.  UNFPA helped organize a round table to discuss the impact of
HIV/AIDS on population policies and programmes, which was held at
Berlin in September/ October 1993 under the auspices of the Policy
Development Forum of the German Foundation for International
Development.  The Fund prepared the main background document for
the round table, which was organized as part of the preparatory
process for the International Conference on Population and
Development.  The round table recommended, among other things, that
Governments and the international community should commit
themselves to fighting against HIV/AIDS as an essential part of
sound population and related family planning policies.  It took
issue with the view held by some that AIDS will take care of the
population problem, calling it completely erroneous.  The round
table called for a firm political commitment to women's
empowerment, and stressed the need to enhance women's ability to
take control over their own reproductive and sexual lives.    

76.  During 1994, the Fund prepared and distributed the 1993 AIDS
Update, an annual publication highlighting UNFPA's support for
HIV/AIDS prevention activities around the globe.  The Update
provided information on UNFPA assistance in four areas:  supply of
condoms; training for MCH/FP service providers; HIV/AIDS
information and education as part of in- and out-of-school
population education programmes; and public information and
education activities.  The Update was sent to representatives of
Governments, non-governmental organizations and academic
institutions and was distributed at the annual session of the
UNDP/UNFPA Executive Board, held at Geneva in June; the annual
Consultative Group Meeting on Contraceptive Requirements and
Logistics Management Needs in Developing Countries in the 1990s;
the Tenth International Conference on AIDS, held at Yokohama,
Japan, in August; and the World AIDS Day ceremony at United Nations
Headquarters.

77.  UNFPA participated actively in the working group meetings to
discuss the establishment of a joint and co-sponsored United
Nations programme on AIDS.  The meetings culminated in the
submission of a report to the WHO Executive Board in January 1994. 
In July, the Economic and Social Council, in resolution 1994/24,
endorsed the establishment of the programme and urged the six
co-sponsors to initiate programme activities at the country level
as soon as possible.  UNFPA, in conjunction with the other
co-sponsors, has been engaged in the transition process leading to
the full implementation of the programme, scheduled for January
1996.  This has included the assignment of a senior technical
officer to the Geneva-based transition team to assist in the
preparation of a comprehensive proposal, to be submitted to the
Council in January 1995 (see Council resolution 1994/24, para. 9). 

78.  UNFPA also participated in meetings of the Inter-Agency
Advisory Group on AIDS and the Management Committee of the WHO
Global Programme on AIDS in order to promote and enhance
coordination of HIV/AIDS prevention activities.  The Fund also
provided financial support to the WHO Task Force on HIV/AIDS
Coordination for the publication of the biennial report on HIV/AIDS
activities. 

79.  UNFPA worked closely with the WHO Global Programme on AIDS in
preparing estimates for condom requirements for HIV/AIDS prevention
as part of in-depth studies in Bangladesh, Brazil, Egypt, the
Philippines, Turkey and Viet Nam, undertaken within the framework
of the Fund's Global Initiative on Contraceptive Requirements and
Logistics Management Needs in Developing Countries in the 1990s. 
UNFPA also published and disseminated a technical report entitled
Contraceptive Use and Commodity Costs in Developing Countries,
1994-2005, prepared in collaboration with the Population Council. 
The report includes estimates of condom requirements for the
prevention of sexually transmitted diseases and AIDS, prepared by
the WHO Global Programme on AIDS.  A summary of the findings of the
update of global estimates of contraceptive requirements in
developing countries was provided in document DP/1994/47, submitted
to the Executive Board at its annual session in June 1994 (see
sect. II.B above).

80.  In December, UNFPA organized an Expert Consultation on
Reproductive Health and Family Planning:  Directions for UNFPA
Assistance.  Inputs from this meeting, together with the
recommendations of the Cairo Conference, will help UNFPA to further
develop and enhance its support for HIV/AIDS prevention activities
within the context of reproductive health.


      D.  Status of UNFPA implementation of General Assembly
          resolution 47/199

81.  During 1994, UNFPA built upon the progress made in previous
years.  For example, the Fund continued to address relevant
concerns of resolution 47/199 in all policy planning, programming
and training exercises, including, most notably, those dealing with
the country strategy note, harmonization of programming cycles, the
programme approach, national execution and national
capacity-building, decentralization, programming guidelines and
training.

82.  UNFPA also continued to work closely with United Nations
partner agencies and organizations through its involvement in the
Joint Consultative Group on Policy (JCGP), the Consultative
Committee on Programme and Operational Questions (CCPOQ) and the
Consultative Committee on Administrative Questions (CCAQ) of the
Administrative Committee on Coordination (ACC), and relevant
inter-organizational training exercises at both the country level
and the global level - notably the International Training Centre of
the International Labour Organization (ILO) at Turin.

83.  In line with the preparations for the Cairo Conference, UNFPA
served as lead agency in conducting inter-agency training in
management coordination for senior United Nations field
representatives in May 1994 at the ILO International Training
Centre.  The Executive Director gave the keynote address to the
workshop that highlighted population and development issues.

84.  Country strategy note.  UNFPA participated in JCGP and CCPOQ
working groups to draft guidelines covering United Nations
contributions to the country strategy note.  In October 1993,
selected UNFPA field staff participated in a workshop held at the
ILO International Training Centre as part of the process of
drafting system-wide guidelines.  UNFPA continues to be a key
partner in the national country strategy note exercises in numerous
developing countries, including Brazil, Costa Rica, El Salvador,
Ghana, Honduras, Jamaica, Morocco, Nicaragua, Panama, the Sudan,
the Syrian Arab Republic and Tunisia.  In addition, UNFPA, UNDP and
the United Nations Children's Fund (UNICEF) agreed to fund an
umbrella project on a United Nations system integrated approach to
technical assistance activities in support of the country strategy
note process.  The Fund, as lead agency at the International
Training Centre's Twelfth Management Coordination Workshop, in May
1994, ensured that population issues were integrated into country
strategy note training exercises. 

85.  Harmonization of programming cycles.  As follow-up to the
joint letter sent by the executive heads of UNICEF, UNDP and UNFPA
to their respective field offices, UNFPA convened working groups on
harmonization of programming cycles for Latin America and the
Caribbean, Western Asia and Northern Africa.  The working groups
continue to monitor the work plans and deadlines agreed to by all
participating inter-agency parties. 

86.  Programme approach.  UNFPA continued to participate in JCGP
and CCPOQ efforts to elaborate a framework to help United Nations
organizations reach an agreement on a system-wide interpretation of
the programme approach.  In Egypt, UNICEF, UNDP and UNFPA signed an
agreement on an integrated development package with the Governorate
of Assiut.  In Bangladesh, UNICEF and UNFPA are working on an
integrated planning model, which will include modules on literacy,
nutrition, health and the status of women.  In 1994, UNFPA
participated in study missions organized by the United Nations to
review the experiences of selected countries in order to find ways
of accelerating progress in the area of the programme approach. 
UNFPA has also shared the lessons learned in developing programme
strategies.

87.  National execution and national capacity-building.  The UNFPA
country support teams continued to make use of national expertise
and national institutions as a source of technical assistance in
implementing population activities.  The teams prepared rosters of
national experts to be used as consultants and trained national
counterparts - both formally, through workshops, and informally, as
participants/observers on collaborative technical assistance
missions.  National execution of projects is also stressed in the
UNFPA country programmes submitted to the Executive Board.  UNFPA
will continue to provide support to expand the capacity of
countries to undertake national execution.

88.  Decentralization.  UNFPA revised its guidelines on
decentralization, considerably expanding programme approval
authority at the field level.  As a result, in the first 10 months
of 1994, some 64 per cent of the total country project approvals
were accounted for by the UNFPA country directors.  Overall, during
the same period, decentralized approvals of such projects at
headquarters and in the field accounted for close to 79 per cent of
total project approvals, compared with 43 per cent in the first 10
months of the previous year.  Moreover, the Fund extended total
programme approval authority, on a trial basis, to 12 countries or
areas (Algeria, Bangladesh, Burkina Faso, Ethiopia, Honduras,
Malawi, Pakistan, Peru, Philippines, Senegal, South Pacific
subregion and Syrian Arab Republic).  UNFPA will extend such
approval authority to other countries as appropriate.  The Fund
also recently decentralized two important functions to the field: 
the handling of travel arrangements for UNFPA consultants hired in
the field; and the hiring of national project staff.   

89.  Training.  UNFPA supports and will continue to participate in
relevant inter-organizational training exercises at the country
level and at the ILO International Training Centre at Turin.  The
Fund contributes funding, training advice and expertise to help
strengthen the Centre's work on collaborative training for the
United Nations system.  UNFPA participated in the Workshop on the
Programme Approach, held at the Centre, and acted as lead agency in
the Centre's Twelfth Management Coordination Workshop, which
highlighted population issues.  In Bangladesh, the JCGP partner
organizations have agreed to pursue an integrated approach to
training United Nations staff.  In several countries, field
committees under the leadership of the resident coordinator are
exploring joint training exercises on such issues as national
execution, national capacity-building, HIV/AIDS prevention, safe
motherhood within the context of reproductive health, and women in
development.

90.  Evaluation and management audit.  UNFPA participates in the
Inter-Agency Working Group on Evaluation, which is currently
developing guidelines for collaboration in the area of evaluation. 
UNFPA also participates in the JCGP Working Group on Management
Audit Systems.  The Working Group submitted a report to JCGP,
highlighting common elements and standard auditing practices among
the JCGP partner organizations.  The Working Group also adopted a
common definition of management auditing.  The report was accepted
as the basis for reporting to the Economic and Social Council on
management audit systems within the context of General Assembly
resolution 47/199.  UNFPA, along with UNICEF, the World Food
Programme and UNDP, commissioned a study on financial and programme
accountability.


          III.  FINANCIAL AND ADMINISTRATIVE MATTERS

                   A.  Financial highlights

91.  Total income in 1993 decreased by $18.6 million, or 7.8 per
cent below the 1992 income of $238.2 million.  Total contributions
pledged by 101 Governments in 1993 reached $216.6 million, a
decrease of $17.2 million in dollar terms, or 7.4 per cent below
the $233.8 million pledged in 1992.  Interest income amounted to
$3.9 million, or 1.8 per cent of total income.  Funds channelled
through cost-sharing arrangements totalled $0.3 million, while
other miscellaneous income and adjustments, including revaluation
of currencies and gains/losses on currency exchange, totalled minus
$1.2 million.

92.  Total expenditures in 1993 were $203.5 million, an increase of
$9.9 million, or 5.1 per cent, compared with 1992 expenditures. 
Programme expenditures in 1993, which amounted to $158.4 million,
constituted 77.8 per cent of total expenditures, compared with $151
million, or 78 per cent, in 1992.  Technical support services and
administrative and operational services (AOS) costs, including
UNFPA support services expenditures, totalled $24.1 million in
1993, or 11.8 per cent of total expenditure, compared with $22.8
million, or 11.8 per cent of total expenditure in 1992.

93.  Prior to 1992, UNFPA reimbursed United Nations executing
agencies for support costs at a rate of 13 per cent of the total
project expenditure executed by the agency.  Moreover, some of the
costs of technical advisers covered under the Fund's new TSS
arrangements, which took effect in January 1992, were financed from
intercountry projects.  In 1993, as in 1992 and 1991, total AOS
costs were composed of three elements:  reimbursements to United
Nations executing agencies for support costs; payment of overhead
charges to non-governmental organizations executing UNFPA-financed
projects; and reimbursements to UNFPA for support and procurement
services provided to government-executed projects. 

94.  In 1993, the United Nations executing agencies, including the
regional commissions, executed projects amounting to $43.5 million,
compared with $50.1 million in 1992.  Governments, with the
assistance of UNFPA field offices, executed $21.2 million in 1993,
compared with $27.5 million in 1992.  Expenditures for
government-executed projects in 1993 did not include $16.6 million
of advances to Governments, which at year-end were held by
Governments and not reported as expenditure.  UNFPA-executed
projects totalled $49.9 million in 1993, compared with $31.2
million in 1992.  Project expenditures for projects executed by
non-governmental organizations, including intergovernmental
institutions and other agencies, were $19.7 million in 1993,
compared with $19.4 million in 1992.  Expenditures for projects
executed by non-governmental organizations in 1993 did not include
$6.1 million of outstanding advances to non-governmental
organizations, which at year-end were held by those institutions.

95.  Projects executed by the United Nations and its specialized
agencies and regional commissions amounted to $43.5 million, or
32.4 per cent of total project expenditures of $134.3 million in
1993.  Governments executed $21.2 million, or 15.8 per cent of
project expenditures in 1993.  Non-governmental organizations,
including intergovernmental institutions and other agencies,
executed $19.7 million, or 14.7 per cent of project expenditure in
1993.

96.  The total administrative and programme support services
expenditure, comprising headquarters administrative and programme
support costs and total field office costs, amounted to $45.1
million, or 22.2 per cent of total expenditures, compared with
$42.6 million, or 22 per cent of total expenditures in 1992.  The
field office expenditure on administrative and programme support
services in 1993 totalled $20.5 million, compared with all field
office costs of $18.8 million in 1992.


               B.  Administration and personnel

97.  As of January 1994, in accordance with Governing Council
decisions 85/20, 86/35, 87/31, 88/36, 89/49, 90/36, 91/36, and
93/28, 4/ the total number of authorized budget posts was 837,
comprising 304 Professional staff (including 124 national programme
officers) and 533 General Service staff.  These include 105
Professional and 135 General Service posts at headquarters, 2
Professional and 2 General Service posts at Geneva and 197
Professional posts (including the 124 national programme officers)
and 396 local General Service posts in the field. 

98.  The percentage of women on UNFPA's Professional staff at
headquarters and in the field reached 44 per cent in 1993, one of
the highest percentages among United Nations agencies and
organizations.  


    IV.  IMPLICATIONS OF THE INTERNATIONAL CONFERENCE ON POPULATION
         AND DEVELOPMENT FOR THE UNFPA PROGRAMME OF WORK

99.  The Programme of Action adopted by the International
Conference on Population and Development 1/ has important policy
and programme implications for UNFPA, in particular as they relate
to the policy orientations, programme focus and programming
strategies of the Fund.

100. The Programme of Action has specific implications for UNFPA's
policy orientations.  Perhaps first and foremost is the need to
base population programmes on individuals' needs and desires rather
than on demographic targets and to place paramount importance on
ensuring quality of care.  This requires, among other things,
improving the quality of training in reproductive health and
related areas; expanding the range and quality of services; and
promoting the greater involvement of national and subnational
non-governmental organizations and women's groups in the design,
implementation and monitoring of programmes, as well as the
increased use of socio-cultural research to develop training and
IEC programmes.

101. Another important policy concern is to consolidate and deepen
development partnerships at both the national and international
levels.  The aim is twofold:  to maximize the impact of development
cooperation by taking advantage of an effective division of labour
and of the specific areas of competence of the various partners
(governmental, non-governmental, private sector, multilateral,
bilateral); and to ensure a greater level of national and local
participation in and ownership of population and development
programmes.  This will also greatly facilitate UNFPA's efforts to
address two related policy concerns:  (a) to ensure that the
broad-based support and sense of ownership for population and
development programmes generated by the Cairo Conference is
maintained, nurtured and expanded; and (b) to help create an
environment conducive to formulating and implementing integrated
population and development programmes.  

102. Based on the content and direction of the Programme of Action
and in view of the recommendations of internal and external
assessments of UNFPA's programme, the Fund plans to adopt a
thematic, rather than sectoral, approach, focusing primarily on
three major themes:  (a) reproductive health and family planning;
(b) gender, population and development; and (c) population and
sustainable development.

103. The aim would be to develop a holistic approach in addressing
the specific population and development situation in each country. 
This implies, inter alia, that where well-established family
planning programmes exist, such programmes can serve as the basis
for a primary health-care system that includes expanded
reproductive health care.  The activities in the area of
reproductive health would concentrate on improving upon traditional
maternal and child health services by adopting a more comprehensive
reproductive health-care approach that included family planning. 
The longer-term goal would be to provide a comprehensive set of
quality reproductive health-care services covering all stages of
people's lives, from adolescence through adulthood.  

104. The Programme of Action gives UNFPA broader scope in terms of
women, population and development activities, especially as
concerns advocacy in all areas relating to improving the status of
women.  The Fund will thus actively advocate a holistic approach to
empowering women, integrating efforts to improve women's health,
literacy and education, both formal and vocational, with wider
efforts to reduce social, legal, cultural and economic disparities
based on gender.  Such an approach will focus on providing
reproductive health services for poor and disadvantaged women,
while seeking to improve their ability to earn income and obtain
credit.  Other priority areas for UNFPA will include IEC efforts to
eliminate all forms of discrimination against the girl child,
eliminate traditional harmful practices against girls and women,
and increase male responsibility for reproductive health and family
planning.

105. The scope of activities in the area of population and
sustainable development policy should be broadened and linked with
efforts in the areas of health, education, family planning, the
condition of women, poverty alleviation and the environment - the
aim being to make population policy truly an integral part of all
other efforts towards sustainable development.  This will require
support for data collection and analysis, relevant socio-cultural
and operations research, the creation and maintenance of relevant
databases and support for policy formulation.

106. These activities will be supplemented and complemented by
pertinent IEC activities, data collection and analysis, and
socio-cultural and operations research.  In all of these
activities, special attention will be given to gender issues.  For
example, in the population education activities it supports, UNFPA
will focus on changing gender-based stereotypes; in data-collection
and analysis activities, the Fund will emphasize the use of
gender-sensitive indicators. 

107. In order to respond adequately to the challenges contained in
the Programme of Action, the Fund proposes to take a number of
measures to further strengthen its programming strategies.  These
measures fall into four broad but closely related areas:

     (a)  Accelerating the implementation of General Assembly
resolution 47/199 and related programming measures, with an
emphasis on building up national capacity to undertake national
execution of programmes and projects;

     (b)  Expanding collaboration with and promoting coordination
among UNFPA's development partners both within and outside the
United Nations system, in particular with Governments and
non-governmental organizations; 

     (c)  Sharpening the strategic focus of UNFPA's assistance in
line with the goals of the Cairo Conference;

     (d)  Upgrading the Fund's capacity to deliver its programme
and to provide quality services and technical assistance.

108. In order to sharpen the strategic focus of its limited
programme funds, the Fund plans to use pertinent goals of the
Conference for the year 2015 as a basis for determining the nature
of its programme support.  For example, in countries that are
already close to achieving the goals set forth in the Programme of
Action, or have even surpassed them, UNFPA will strategically
concentrate its assistance for such countries either on selected
issues requiring further attention or on selected geographical
areas that lag significantly behind the national average with
respect to achieving the goals of the Conference.  On the other
hand, in countries that show the widest gaps between their present
levels and the goals of the Conference, UNFPA will continue to
provide assistance for more comprehensive country programmes.  

109. Such an approach will allow UNFPA to focus its assistance on
the specific needs of a given country, as has been recommended by
various reviews of UNFPA's programme.  It will also enable the Fund
to target its financial support to components directly related to
the population package as defined in the Programme of Action of the
Conference.  


                   V.  FROM CAIRO TO BEIJING

110. The Cairo Conference emphasized the centrality of women.  It
recognized clearly that the empowerment of women was an important
end in and of itself and that the goal of sustainable human
development would be reached only with the full and equal
participation of women in all aspects of the development process. 
The Conference resoundingly endorsed the full participation and
partnership of women and men in sharing family and household
responsibilities.

111. At Cairo, women were visible and their voices were heard.  The
Programme of Action mainstreams women throughout its 16 chapters
and devotes one entire chapter to gender equity and the empowerment
of women; principle 4, contained in chapter 2, states:

          "Advancing gender equality and equity and the empowerment
of women, and the elimination of all kinds of violence against
women, and ensuring women's ability to control their own fertility,
are cornerstones of population and development-related programmes. 
The human rights of women and the girl child are an inalienable,
integral and indivisible part of universal human rights.  The full
and equal participation of women in civil, cultural, economic,
political, and social life, at the national, regional and
international levels, and the eradication of all forms of
discrimination on grounds of sex, are priority objectives of the
international community."

112. As one of its principal preparatory activities for the Fourth
World Conference on Women, to be held at Beijing in September 1995,
UNFPA is fully committed to ensuring that the relevant portions of
the Programme of Action of the International Conference on
Population and Development are integrated into the Platform for
Action of the Fourth World Conference on Women.  UNFPA, in its
advocacy and action programmes, will thus focus particular
attention on achieving the quantitative goals of the Programme of
Action of the International Conference on Population and
Development, many of which directly pertain to the aims of the
Beijing Conference, namely, the reduction of maternal, infant and
child mortality; the provision of universal access to education,
particularly for girls; and the provision of universal access to a
broad range of quality reproductive health care and family planning
services. 
113. As part of its preparations for the Beijing Conference, UNFPA
has been active at the interregional, regional and country levels. 
The Fund has participated in the various expert group meetings and,
in particular, has provided funding to the United Nations
Conference on Trade and Development to organize an Expert Group
Meeting on Women in Development in the Least Developed Countries. 
UNFPA has also supported the Women's Feature Services, a news
network, to enable it to undertake special initiatives focusing on
the Beijing Conference.

114. At the regional level, UNFPA has been represented by senior
staff from headquarters and field offices at all the regional
preparatory meetings.  In recognition of the importance of the
participation of non-governmental organizations, UNFPA has provided
assistance to members of women's non-governmental organizations to
enable them to take part in those regional meetings.  In connection
with the regional meetings of the Economic Commission for Europe
and the Economic Commission for Africa, UNFPA extended funding to
the Commonwealth Medical Association to conduct a round table on
women's reproductive health.

115. At the country level, UNFPA country directors have been
working with national committees and local women's groups, making
information materials available and providing funding to enhance
their capacity to take part in the Beijing process.

116. During the coming months, UNFPA will intensify its activities
in support of the Beijing Conference.  As part of its
awareness-creation activities, the Fund's 1995 State of World
Population report will focus on the empowerment of women.  The
initial section of this report will consider in some detail the
path from Cairo to Beijing.  UNFPA will continue providing
technical and financial support to the Statistical Division of the
United Nations Secretariat for the updated edition of The World's
Women, 1970-1990:  Trends and Statistics, which is one of the
official documents of the Beijing Conference.

117. The Executive Director has taken a number of steps to
facilitate the process for the Fourth World Conference on Women. 
For example, she has seconded a senior staff member to the
secretariat of the Conference and has arranged a number of
briefings between that secretariat and the secretariat of the Cairo
Conference.

118. UNFPA is fully committed to promoting gender equality, equity
and the empowerment of women.  The Cairo Conference made remarkable
progress in this direction.  UNFPA is confident that the Fourth
World Conference on Women will build upon and amplify this
progress.

                         Notes

     1/   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.

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

     3/   Ibid., 1993, Supplement No. 15 (E/1993/35), annex I.

     4/   Ibid., 1985, Supplement No. 11 (E/1985/32), annex I;
ibid., 1986,
Supplement No. 9 (E/1986/29), annex I; ibid., 1987, Supplement No.
12 (E/1987/25), annex I; ibid., 1988, Supplement No. 9 (E/1988/19),
annex I; ibid., 1990, Supplement No. 9 (E/1990/29), annex I; and
ibid., 1993, Supplement No. 15 (E/1993/35), annex I.                        

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