United Nations

E/CN.9/1996/5


Economic and Social Council

 Distr. GENERAL
19 January 1996
ORIGINAL: ENGLISH


COMMISSION ON POPULATION AND DEVELOPMENT
Twenty-ninth session
26 February-1 March 1996
Item 4 of the provisional agenda*


     FOLLOW-UP ACTIONS TO THE RECOMMENDATIONS OF THE INTERNATIONAL
    CONFERENCE ON POPULATION AND DEVELOPMENT:  REPRODUCTIVE RIGHTS
                        AND REPRODUCTIVE HEALTH

         Activities of intergovernmental and non-governmental
         organizations in the area of reproductive rights and
                          reproductive health

                    Report of the Secretary-General




                                SUMMARY

     The present report has been prepared in accordance with the
new terms of reference of the Commission on Population and
Development and its topic-oriented, multi-year work programme,
which were endorsed by the Economic and Social Council in its
resolution 1995/55.  The report summarizes information gathered
through a questionnaire sent to international, regional and
national non-governmental organizations to assess their progress
towards achieving the goals and objectives of the Programme of
Action of the International Conference on Population and
Development.  The national and international non-governmental
organizations responding to the questionnaire are rapidly
developing into strong supporters of the Programme of Action and
are demonstrating a high level of commitment to its principles.
Progress achieved in the implementation of the Programme of Action
is evidenced primarily by the activities being undertaken by
national and international non-governmental organizations on
integrating family planning into the broader framework of
reproductive health.


     *E/CN.9/1996/1.
=====================================================================

                               CONTENTS

                                                     Paragraphs
Page

INTRODUCTION. . . . . . . . . . . . . . . . . . . . . . .  1- 2

  I.  THE INCREASING ROLE OF NON-GOVERNMENTAL
      ORGANIZATIONS . . . . . . . . . . . . . . . . . . .  3- 7

 II.  PROGRAMME OF ACTION OF THE INTERNATIONAL
      CONFERENCE ON POPULATION AND DEVELOPMENT AND
      NON-GOVERNMENTAL ORGANIZATIONS. . . . . . . . . . .  8- 9

III.  METHODOLOGY . . . . . . . . . . . . . . . . . . . .  10-13

 IV.  ACTIVITIES DEVELOPED BY INTERGOVERNMENTAL AND
      NON-GOVERNMENTAL ORGANIZATIONS AFTER THE
      CONFERENCE IN THE AREA OF REPRODUCTIVE RIGHTS
      AND REPRODUCTIVE HEALTH . . . . . . . . . . . . . .  14-56

      A.  Involvement of intergovernmental organizations
          in reproductive rights and reproductive health.  15-18
      B.  Main areas of involvement of non-governmental
          organizations in reproductive rights and repro-
          ductive health. . . . . . . . . . . . . . . . .  19-23
      C.  Enhancing quality of care in reproductive health
          programmes  . . . . . . . . . . . . . . . . . .  33-35
      D.  Adolescent health . . . . . . . . . . . . . . .  36-42
      E.  Participation of women in designing and
          implementing reproductive health programmes . .  43-46
      F.  Participation of men in reproductive health
          programmes  . . . . . . . . . . . . . . . . . .  47-50
      G.  Activities developed by non-governmental
          organizations in the area of information,
          education and communication . . . . . . . . . .  51-53
      H.  Collaboration between national Governments
          and non-governmental organizations. . . . . . .  54-57

  V.  INVOLVEMENT OF NON-GOVERNMENTAL ORGANIZATIONS IN
      THE IMPLEMENTATION OF THE PROGRAMME OF ACTION . . .    58

 VI.  CONTINUED COLLABORATION OF NON-GOVERNMENTAL
      ORGANIZATIONS IN THE IMPLEMENTATION OF THE
      PROGRAMME OF ACTION                                   59-62

Annex.  LIST OF INTERNATIONAL AND NATIONAL NON-GOVERNMENTAL
        ORGANIZATIONS AND INTERGOVERNMENTAL ORGANIZATIONS
        WORKING IN THE AREA OF REPRODUCTIVE HEALTH THAT
        RESPONDED TO THE UNFPA QUESTIONNAIRE

=========================================================================

                             INTRODUCTION


1. In recent years, collaboration between the United Nations
Population Fund (UNFPA) and non- governmental organizations has
been rapidly increasing.  This culminated at the International
Conference on Population and Development, held in Cairo in
September 1994, where the active participation of those
organizations, particularly women's non-governmental organizations,
had a significant impact in advancing the agenda of reproductive
rights and reproductive health and in finalizing the Programme of
Action of the Conference.

  2. The present report summarizes the information gathered through
a questionnaire sent to international, regional and national
non-governmental organizations to assess progress made towards
achieving the goals and objectives of the Programme of Action, as
called for in the new terms of reference of the Commission on
Population and Development and its topic-oriented, multi-year work
programme, which were endorsed by the Economic and Social Council
in its resolution 1995/55.  The topic for 1996 is reproductive
rights and reproductive health, including population information,
education and communication.  Impressions included in this report
build upon the responses to the questionnaire that were received
from 34 intergovernmental organizations and international, regional
and national non- governmental organizations, as well as reviews of
written reports and materials shared by responding organizations.
In addition, the present report discusses lessons learned one year
after the Conference from the involvement of non-governmental
organizations in the implementation of the Programme of Action.


    I.  THE INCREASING ROLE OF NON-GOVERNMENTAL ORGANIZATIONS

3. Non-governmental organizations are civil institutions that
operate between the private and public sectors.  In fact, they are
being called the "third sector", and they tend to represent
specific interests of the population (reproductive rights and
family planning), as well as different groups within civil society
(women and youth).  Their mode of operation tends to be bottom-up,
particularly at the local level.

4. Non-governmental organizations have different levels of action.
Those acting at the international level have long been recognized
for their contributing role in advocating for reproductive rights
and reproductive health and for providing assistance to national
Governments and national non-governmental organizations in
technical aspects of population, family planning and reproductive
health programmes.  They are financially supported by international
donors that sustain national non-governmental organizations as
well.

5. National non-governmental organizations are often branches of
international or regional organizations.  At a time in which the
social services provided by Governments are decreasing in many
parts of the world, the role of non-governmental organizations is
clearly growing, helping the state and the private sector balance
and complement one another.  In fact, not only do they play a key
role in advocacy activities, but they also provide a variety of
services to marginalized groups and a means of testing innovative
approaches.

6. At the local level, non-governmental organizations or
grass-roots organizations are characterized by membership
enrolment, voluntary involvement, self-help practices and
participatory approaches.  Grass-roots organizations tend to be
financially supported by their members.

7. Owing to their growing institutionalization and capacity to act
in an autonomous way, non- governmental organizations involved in
reproductive health activities have an important role to play in
implementing the goals of the International Conference on
Population and Development.  The Programme of Action of the
Conference calls for establishing partnerships among Governments,
health-care providers, women and reproductive health
non-governmental organizations.  Together they can create a major
impetus for accelerating the implementation of the Programme of
Action.

 II.  PROGRAMME OF ACTION OF THE INTERNATIONAL CONFERENCE ON
POPULATION AND DEVELOPMENT AND NON-GOVERNMENTAL ORGANIZATIONS

 8. The Programme of Action recognizes the need for establishing
partnerships with non-governmental organizations for its
implementation.  For instance, in chapter XV (Partnership with the
non-governmental sector), para. 15.6, it is specified that:

   "In recognition of the importance of effective partnership,
non-governmental organizations are    invited to foster
coordination, cooperation and communication at the local, national,
regional and    international levels and with local and national
governments, to reinforce their effectiveness as key
participants in the implementation of population and development
programmes and policies.  The    involvement of non-governmental
organizations should be seen as complementary to the
responsibility of Governments to provide full, safe and accessible
reproductive health services,    including family planning and
sexual health services."


9. The Programme of Action also emphasizes the need to ensure that
non-governmental organizations and their networks are able to
maintain their autonomy and strengthen their capacity through
regular dialogue and consultations, as well as through training.


                     III.  METHODOLOGY

10.  In order to ascertain the activities being undertaken by
intergovernmental and non-governmental organizations, a follow-up
questionnaire was sent in October 1995 to approximately 95
organizations around the world, including 22 intergovernmental and
73 non-governmental organizations.  The organizations invited to
respond to the questionnaire consisted of international, regional
and national non- governmental organizations, mainly those
concerned with family planning and reproductive health and women's
organizations.  They were selected on the basis of their mandates
and their participation in the Conference.

 11. The questionnaire was organized by topics covering the most
significant aspects of reproductive
health, as delineated in the Programme of Action.

12. A total of 38 organizations responded to the questionnaire,
representing about 40 per cent of the total number of
intergovernmental and non-governmental organizations contacted for
this monitoring exercise, distributed as shown in the table (a list
of the organizations responding is contained in the annex to the
present document).

13. Of the 73 non-governmental organizations to which the
questionnaire was sent, 15 were women's organizations (of which 6,
or 40 per cent, responded) and 41 were family planning/reproductive
health non-governmental organizations (of which 25, or 60 per cent,
responded).  The rest were research institutions, foundations and
professional organizations.  The regional and national
organizations selected for the monitoring study covered all
geographical regions.

-----------------------------------------------------------------------

      Number of organizations that responded to the questionnaire



                      No. invited to Number
                      respond to the  that       Percentage
                      questionnaireresponded     of response


International non-
governmental
organizations                46            20          43.4

Regional non-
governmental
organizations                 5             2          40.0

National non-
governmental
organizations                22            12          54.5

Intergovernmental
organizations                22             4          18.0

   Total                     95            38          40.0

------------------------------------------------------------------


  IV.  ACTIVITIES DEVELOPED BY INTERGOVERNMENTAL AND
  NON-GOVERNMENTAL ORGANIZATIONS AFTER THE CONFERENCE
IN THE AREA OF REPRODUCTIVE RIGHTS AND REPRODUCTIVE HEALTH


14.  Presented below are detailed summaries of the major points
that emerged from examining the responses to the questionnaire,
according to topic area in regard to the implementation of the
Programme of Action.  The seven topic areas selected for analysis
were:  (a) areas of involvement in reproductive rights and
reproductive health; (b) integration of family planning into
reproductive health; (c) quality of care in reproductive health
programmes; (d) adolescent health; (e) participation of women in
the design and implementation of reproductive health programmes;
(f) inclusion of men in reproductive health programmes; and (g)
information, education and communication activities in reproductive
health.

         A.  Involvement of intergovernmental organizations in
              reproductive rights and reproductive health

 15.  Only two of the four intergovernmental organizations that
responded to the questionnaire are conducting activities related to
the implementation of the Programme of Action:  the South Pacific
Commission and the Organization of African Unity (OAU).

16.  The South Pacific Commission is an organization serving the
Pacific Islands.  It is a non-political technical assistance agency
with an advisory and consultative role, providing technical
assistance to member States.  The South Pacific Commission has been
active in reproductive health for a number of years through the
implementation of a project on education on and prevention of
acquired immunodeficiency syndrome (AIDS) and sexually transmitted
diseases.  Activities range from the publication of information
materials that address the needs of particular groups living in the
region, to the provision of technical assistance to Governments,
community groups, non-governmental organizations and to the
organization of regional, subregional and national training
workshops on the prevention of AIDS and sexually transmitted
diseases.

17.  OAU is the regional organization of the African countries
whose main goal is to promote cooperation among African States in
the economic, social, educational, cultural and scientific fields.
At its thirty-first ordinary session, held in June 1995, OAU
approved a Plan of Action concerning the situation of women in
Africa in the context of family health.  The Plan of Action
recognizes the need to empower women as a key to development in
Africa.  It calls for member States to address the reproductive
health needs of women throughout their life-span, including
adolescent health, safe motherhood, family planning and
AIDS/sexually transmitted diseases, in accordance with the
Programme of Action.

18.  As evidenced by the low number of intergovernmental
organizations that responded to the questionnaire (4 out of 22, of
which only two are involved in activities related to the
Conference), it is clear that it is the non-governmental
organizations, rather than the intergovernmental organizations,
that have played a more significant role in the area of
reproductive rights and reproductive health.

      B.  Main areas of involvement of non-governmental
           organizations in reproductive rights and
                     reproductive health

19.  According to the majority of the non-governmental
organizations that responded to the questionnaire, the Conference
appears to have helped most international and national
non-governmental organizations in reordering their institutional
priorities so that the Programme of Action can be implemented.
Although most non-governmental organizations were developing family
planning activities before the Conference, many were already in the
process of implementing new reproductive health components as well.

The most frequently mentioned new programmatic component was the
provision of information and health services to prevent and treat
reproductive tract infections (RTIs) and sexually transmitted
diseases.  In fact, approximately 60 per cent of the
non-governmental organizations that responded to the questionnaire
and that had previously been involved in family planning activities
(mainly information, education and communication, and the provision
of family planning services) had begun to include RTIs and sexually
transmitted diseases as a second major component of their overall
programmes.  This is very important because it indicates that the
Programme of Action has allowed for the incorporation of a clear
reproductive health need that many family planning programmes could
only now address as a result of the impetus that the Programme of
Action has been able to provide.

20.  Other programmatic components included in the Programme of
Action were also incorporated into the agendas of many
non-governmental organizations, namely:  (a) education in human
sexuality, reproductive health and responsible parenthood (60 per
cent of the non-governmental organizations); (b) prenatal, delivery
and postnatal care, including breast-feeding (37 per cent); (c)
prevention of abortion and the consequences of abortion (29 per
cent); and (d) infertility (15 per cent).

21.  While many non-governmental organizations have incorporated
new reproductive health components as a consequence of the
Programme of Action, others stated that they had adopted the
comprehensive approach to reproductive health many years prior to
the Conference.  Those non-governmental organizations recognized
that the Conference had been instrumental in legitimizing their own
reproductive health work programme and in gaining a new momentum in
strengthening its focus on reproductive health.  Undoubtedly, the
Conference has reinforced their commitment to the reproductive
health idea.  However, the involvement of non-governmental
organizations in reproductive health issues prior to the Conference
also highlights the critical role that they played at the
Conference, particularly in advancing the agenda of the Programme
of Action.

  22.  The majority of the national non-governmental organizations
indicated that they tended to provide the selected services to
marginalized populations because of the unavailability of state
services in the areas where those people live.  The balancing role
of non-governmental organizations in the provision of services is
particularly stressed by those in Latin America.  In fact, the
retrenchment of States from social welfare policies has caused most
of the urban poor and rural populations to be cut off from access
to services, and non-governmental organizations have responded to
that demand.

23.  The majority of the activities developed by international
non-governmental organizations include the provision of technical
assistance to Governments and national non-governmental
organizations in the areas of needs assessment, programme
development, evaluation, and training and research.  In addition,
many international non-governmental organizations are involved in
conducting advocacy activities in the areas of reproductive rights
and reproductive health.  With respect to national non-governmental
organizations, major efforts include the provision of family
planning services, training and advocacy activities.

            1.  From family planning to reproductive health


24.  Nearly all the non-governmental organizations consulted are in
the process of articulating more clearly the concept of
reproductive health and dealing with how to translate into practice
those concepts agreed to at the Conference.  Because no models
exist, the central issue in the implementation of the Programme of
Action remains the transformation of existing family planning
programmes into reproductive health programmes.  For this reason,
a number of international non-governmental organizations have
established a working group on reproductive health and family
planning that serves as a forum for discussion of the
responsibility of international agencies for integrating the
concept of reproductive health into the thinking, programming and
services of the agency.

25.  Among non-governmental organizations, there are many
innovative approaches to integration that range from management
issues and development of new technologies that can help integrate
family planning into reproductive health, to cost estimations and
training.  For instance, among international non-governmental
organizations:

   (a)  The Program for Appropriate Technology in Health (PATH) is
developing a series of reproductive health assessment tools that
programme managers can use to integrate new reproductive
health interventions into existing family planning programmes;

   (b)  The Population Council is studying the feasibility of
developing a single package to provide family planning care with
sexually transmitted diseases services, abortion care and health
services for post-partum mothers and babies;

   (c)  Management Sciences for Health (MSH) is developing a model
to determine the costs of integrating reproductive health services
into ongoing family planning programmes;

   (d)  Family Health International (FHI) is testing contraceptives
that may also provide protection against sexually transmitted
diseases;

   (e)  The Johns Hopkins Program for International Education in
Gynecology and Obstetrics Corporation (JHPIEGO) is integrating
family planning with maternal health training;

   (f)  The International Planned Parenthood Federation (IPPF) is
working on integrating sexual and human rights into reproductive
health services in order to protect women's right to health;

   (g)  The International Program Assistance Service (IPAS) is
developing new approaches to
integrating post-abortion services into family planning services.

26.  Among national non-governmental organizations:

   (a)  Parivar Seva Sanstha in India is working on a comprehensive
prevention health-care package for women called "Medicheck" that
provides regular screening and diagnostic testing for the detection

of breast and cervical cancer and timely treatment.  It plans to
incorporate other aspects of reproductive health, including sex
education, treatment of RTIs/sexually transmitted diseases and
infertility into its activities;

   (b)  Non-governmental organizations in Senegal promote the
provision of a minimum package of
services composed of prenatal and delivery care, breast-feeding,
family planning and sexually transmitted
diseases;

   (c)  The Centre for Population Studies and Responsible
Parenthood (CEPAR) in Ecuador is exploring the option of
integrating reproductive health into primary health care
programmes;

   (d)  Several non-governmental organizations are working on ways
to integrate services for the prevention and treatment of
RTIs/sexually transmitted diseases into existing family planning
programmes.


27.  Although most of the non-governmental organizations that
responded to the questionnaire are clearly working on integrating
existing family planning programmes into reproductive health, it
appears that a number of traditional family planning organizations
are still struggling with the concept of reproductive health.  For
example, reproductive health is confused with the provision of
family planning and maternal and child health services only or,
rather, the provision of family planning and child health services
exclusively.  For these organizations, as has occurred regularly in
the past, the focus is still on the child rather than on the woman.

This gives the impression that for some, the concept of
reproductive health is still at a very early stage.

28.  Despite the clear need to work towards integrating men into
reproductive health programmes, there are very few initiatives that
deal with this issue.  As expected, the integration of RTIs and
sexually transmitted diseases into family planning is the most
common undertaking, probably because of the urgent need to deal
with the widespread incidence of RTIs and sexually
transmitted diseases.


         2.  From family planning to reproductive health:  the
                           positive outcomes

 29.  A general consensus appears to exist among international and
national non-governmental organizations that there are already many
positive aspects to the activities carried out so far to integrate
family planning into reproductive health.  The following are some
of the positive trends mentioned by non-governmental organizations:

   (a)  There is a growing sense that the integration of family
planning into reproductive health has increased awareness of the
vast unmet need among the poorest and most marginalized populations
in developing countries, particularly poor women.  In addition,
Governments are slowly but steadily giving more priority to
reproductive health, and everyone working in the field of
population is shifting from demographic concerns to concerns about
meeting the needs of individuals for reproductive health
information and services;

   (b)  The change in attitudes towards women, the inclusion of
their perspectives in the development of programmes and the whole
process of strengthening and providing prominence to the women's
health movement was noted consistently in the completed
questionnaires as a condition necessary for the success of
reproductive health programmes.  Additionally, the involvement of
women themselves in information and dissemination activities helps
ensure that scientific findings have a practical application;

   (c)  There is widespread recognition of the importance of
integration at the grass-roots level, which has been shown by the
enthusiasm of clients, providers and community organizations that
are being involved to an increasing degree;

   (d)  There is a sense that it is possible to work with
adolescents and that adults have recognized the importance of
working with them.

           3.  From family planning to reproductive health:
                          the main obstacles

30.  All respondents expressed clear ideas on the constraints that
many of them face in the integration of family planning into
reproductive health.  The following is a summary of the major
findings regarding the most important obstacles encountered by
non-governmental organizations:

   (a) There is a lack of clarity concerning the encompassment of
reproductive health, as well as lack of study results that document
successful (and unsuccessful) efforts to integrate family planning
into reproductive health.  Moreover, since the integration of
reproductive health is a new issue, there are serious limitations
with technical capacity and programme assistance, particularly for
national non- governmental organizations;

   (b) The shortage of findings to implement the variety of new
activities proposed after the Conference seems to be a very common
obstacle for many national non-governmental organizations.  In
addition, the economic crisis and structural adjustment policies
clearly increase funding problems;

   (c) The costs of integration are poorly estimated, leaving many
new programmes without a clear notion of how to develop realistic
budgets;

   (d) Many non-governmental organizations perceive that there is
a reluctance among leaders and managers of governmental programmes
to give up some of the control and independence to which they have
become accustomed.  Therefore, they resist the integration of
family planning into reproductive health.  In many cases, they
continue to have as their main goal the reduction of population
growth.  As a result, they do not wish to "dilute" resources by
including any emphasis other than the provision of contraceptives.
Certainly, the extent of this resistance varies by country and
programme and within programmes themselves;

   (e) A number of non-governmental organizations perceive that
priorities determined by funding agencies may discourage a truly
integrated approach to reproductive health;

   (f) More than one non-governmental organization expressed the
view that many international non- governmental organizations are
often driven by the geographical preferences of their founders,
resulting in overlapping efforts among them.


         4.  Evaluation of the integration of family planning
                       into reproductive health

 31.  Many non-governmental organizations reported that it has been
difficult to develop evaluation indicators that measure the
progress achieved in integrating family planning into reproductive
health.  A number of non-governmental organizations felt that it
was too early for them to make this evaluation.  This may reflect,
in part, the fact that programme evaluation is not developed in
conjunction with the design of the project from its inception.
This is a problem seen in other programmes as well.


           5.  From family planning to reproductive health:
                           future directions

 32.  Based on the above-mentioned facts, the following suggestions
may be useful in helping non- governmental organizations to
increase their effectiveness in implementing the Programme of
Action:

   (a) Given the lack of worldwide experience concerning the
integration of family planning into reproductive health, a special
effort to disseminate successful "integration" experiences could
help in accelerating this process.  It appears that many
non-governmental organizations, particularly international
non-governmental organizations, are well advanced in articulating
the translation of the reproductive health concept into practice.
Broad dissemination of documents concerning the integration of
family planning into reproductive health, particularly at the
national and local levels, could improve the understanding of the
issue;

   (b) Funding seems to be a major barrier for non-governmental
organizations in the implementation of the Programme of Action.  As
a result, long-term sustainability is, perhaps, an issue that
should be carefully considered.  Some national non-governmental
organizations manifested interest in improving their fund-raising
skills and their overall technical capacity to become as
financially independent as possible.  In this sense, negotiations
between Governments that are privatizing services and non-
governmental organizations will become an increasingly important
factor in furthering the goal of greater financial
self-sufficiency;

   (c) Training of managers and leaders of family planning
programmes in the new concept of reproductive health could improve
their understanding of the reproductive health approach.


             C.  Enhancing quality of care in reproductive
                           health programmes

33.  There is general agreement among the majority of
non-governmental organizations that the quality of reproductive
health services should be a top priority for programmes.  Although
most of the efforts in this area have focused on delineating the
elements of quality and promoting the concept of quality of care
among other international organizations, these initiatives have
been developed mainly in the area of family planning.  However,
most of the non-governmental organizations consulted have plans to
include this issue as part of their activities for integrating
family planning into reproductive health.  The following are some
of the most innovative initiatives developed by international and
national non-governmental organizations:

   (a) JHPIEGO has developed a major initiative to improve the
quality of care in conjunction with access to services.
"Maximizing access and quality" (MAQ) is delivered in the form of
workshops to health providers.  This includes providing
contraceptive technology updates and fostering discussions to
develop action plans by country in order to improve both access and
quality of care;

   (b) The Population Council is working towards changing the
criteria by which family planning programmes are evaluated.  They
are in the process of developing quality-of-care indicators and
other means of assessing and measuring quality;

   (c) Family Care International (FCI) is training providers in
improving their interpersonal relations, communication skills and
counselling techniques.  In fact, most of the non-governmental
organizations that reported on the issue have implemented
counselling techniques in family planning programmes as a way of
ensuring that clients have access to accurate information before
they adopt a contraceptive method;

   (d) The International Council on the Management of Population
Programmes (ICOMP) has addressed the improvement of quality of care
through action-research activities.  This has facilitated the
involvement of providers in determining their own quality-of-care
indicators;

   (e) The Programme in Reproductive Health of the Colegio de
M‚xico is trying to ensure that the dimension of reproductive
rights is included in reproductive health services and that they
have a gender- sensitive approach to health care.  A number of
other non-governmental organizations reported that they were
developing indicators of quality of care for gender awareness and
women's empowerment.

34. There is a general consensus among non-governmental
organizations that the emphasis given to quality of care in the
Programme of Action has helped many organizations renew their
efforts towards improving their own standards of care.  Several
non-governmental organizations have noted that clients appreciate
improvements in this area.  The most frequently mentioned obstacles
to improving the quality of care in programmes are:

   (a) Lack of funding to improve quality-of-care standards
represents a real problem for understaffed services and overworked
providers.  Because health providers are poorly compensated, their
motivation is generally low and investments for raising standards
of quality are very scarce.  As a consequence, changing staff
attitudes is perceived to be very slow;

   (b) The infrastructure, equipment and supplies of services tend
to be inadequate.  However, non- governmental organizations that
are involved in providing services have better quality-of-care
standards than those services provided by the public sector.
Because the size of some non-governmental organizations is
generally small, it appears relatively easy for them to implement
effective quality-of-care standards;

   (c) Lack of appropriate infection prevention practices is a
generalized obstacle to high quality of services.  The
standardization of training and service delivery practices is
considered to be a critical step in overcoming this problem;

   (d) National non-governmental organizations feel that they are
not generally asked by Governments to assist them in improving
standards of quality in the public sector, in spite of seeing
themselves as positive models for Governments to replicate;

   (e) Interpersonal relations and communication skills are rarely
taught in pre-service training.  This is seen as a real obstacle to
the achievement of quality-of-care standards;

   (f) Indicators of care for reproductive health programmes have
not yet been developed.  In addition, for the few that are
developing indicators of quality of care, there seems to be too
little emphasis on the client perspective and on the gender
perspective.

35.  As the importance of quality becomes more accepted, new
evaluation criteria will be available to assess the progress made
in reproductive health initiatives, and this will certainly ensure
the dissemination of information on successful efforts.

                         D.  Adolescent health

36.  The recognition in the Programme of Action of adolescent
pregnancy as a significant social and health problem has been
welcomed by the majority of the non-governmental organizations that
reported on the issue.  Because of political and religious
sensitivities in some countries, work with adolescents is at an
early stage of development.  Indeed, many of them only initiated
activities in this area since the Conference.

37.  For most national non-governmental organizations working with
adolescents, it seems that the best solution in addressing the
sexual and reproductive health needs of this critical group of the
population is to provide young people with information through sex
education classes, so that they could make sound decisions about
their sexuality and, if they are sexually active, to give them
access to contraceptive services.  There are many non-governmental
organizations that are developing educational materials and
teaching family life education to adolescents.  The aim of family
life education programmes is to provide adolescents with
decision-making skills and to improve their
self-esteem.

38.  Owing to the current understanding of the issue and increasing
social pressures, it is known that these types of interventions are
necessary but not sufficient.  Many disadvantaged girls may become
mothers because they realize that they have limited access to
social and economic opportunities, often thus following a pattern
similar to their mother's behaviour.  Only a small proportion of
young people take active and consistent measures to avoid
pregnancy.  When pregnancy occurs, the most disadvantaged
adolescents, that is, those living in poor urban areas, are likely
to obtain unsafe abortions or to remain single mothers.  A further
problem is that many of these early pregnancies may be the result
of sexual abuse.  Thus, although many non-governmental
organizations have begun to work on the problem of adolescent
health, it is an issue that needs much greater attention in general
and from a gender perspective in particular.

39.  The levels of discrimination against adolescent girls
(education, nutrition, lack of self-esteem to negotiate
contraceptive use when they engage in voluntary sex) and the
limited life opportunities they have, as compared to boys of the
same social class, seem to be the major factors leading to early
pregnancy.

40.  Innovative experiences in the area of adolescent health
include:

   (a) The IPPF initiative to establish a Youth Task Force and a
Youth Comittee.  The main objective of the initiative is to include
youth in the development of sexual and reproductive health
programmes.  It is believed that their involvement in the
development of programmes could enrich discussions about how best
to satisfy youth needs for services and to ensure that messages on
avoiding pregnancy are delivered in an understandable way;

   (b) The strategy of IPAS to target adolescents for abortion
prevention and post-abortion family planning services.  It has been
documented that in some parts of the world adolescent girls are
very likely to resort to abortion when they become pregnant;

   (c) The MSH programme in the Russian Federation, which has been
developed in collaboration with a local non-governmental
organization.  It provides sex education, counselling and some
reproductive health services with community support;

   (d) The Advocates for Youth initiative to address the
reproductive health needs of adolescent girls through their
participation in the design of programmes and in peer education
activities;

   (e) An initiative of a non-governmental organization in India
that has established a telephone hot line for adolescents in New
Delhi that is very successful in disseminating information on
reproductive health issues;

    (f) An initiative of the Kenyan Association for the Promotion
of Adolescent Health, which is an umbrella organization of 25
non-governmental organizations and government agencies working in
advocacy activities for adolescent reproductive health, that has
helped influence the Government of Kenya to reverse its policy of
expelling pregnant girls from school;

   (g) The 14 youth centres of the Asociaci˘n Colombiana pro
Biennestar de la Familia (PROFAMILIA) in Colombia, where
adolescents receive sexuality information and contraceptive
services.

41. With some exceptions, many of the activities developed by
national non-governmental organizations are directed towards the
school population.  In many parts of the world, however, a
significant number of girls are out of school, and it is difficult
to reach out-of-school youth.  Nevertheless, there are some
non-governmental organizations that are working towards enabling
girls to expand their life options.  Others are working on
understanding the meaning of reproductive health issues for
adolescent girls in their own social context and on how to keep
adolescent girls in school.

42.  Nearly all the non-govermental organizations that responded to
the questionnaire reported an increase in activities concerning
adolescent health.


       E.  Participation of women in designing and implementing
                    reproductive health programmes


43.  The recommendation in the Programme of Action concerning the
participation of women in the design and monitoring of reproductive
health programmes has created enormous interest among non-
governmental organizations.  However, many non-governmental
organizations have reported that the issue is just starting to be
considered by Governments and reproductive health-oriented
organizations.

44.  The issue has raised opposing views among national
non-governmental organizations.  While some agree that women are
participating in the design of reproductive health programmes at
the policy level, others maintain that the potential for women's
participation is greater at the grass-roots level because it could
be easier to develop effective mechanisms to integrate them into
programmes.  Moreover, the possibility of including women in
positions of power is seen by some as less likely to occur soon
because of the strong resistance on the part of policy makers and
managers of traditional family planning programmes to support that
policy.  Indeed, many policy makers and programme managers fear
that this could increase the competition for the positions that
they currently hold.  However, one reproductive health
non-governmental organization stated that even women in positions
at the mid-management level do not necessarily see women's
participation as an important issue.

45.  Obviously, the participation of women in the design of
programmes appears to be more challenging for traditional family
planning programmes than for women's non-governmental
organizations.  With respect to those organizations, it has been
recognized that the Conference has helped promote a real dialogue
and partnership among women's health groups, thereby increasing
their visibility in the international scene.  Those groups are
developing activities in the area of advocacy and some provide
model health services.  Their role is seen as being very critical
to monitoring the implementation of the Programme of Action.

46.  There is wide consensus about the fact that the involvement of
women in the design and monitoring of programmes is not yet
adequate.  While some organizations are incorporating women's
perspectives in the design of programmes, such as those
non-governmental organizations conducting operational research
studies or conducting contraceptive research guided by women's
inputs, the key issue of actually including them in the design,
implementation, monitoring and evaluation of programmes is still in
its early stages.  There is, for example, no demonstrated working
methodology that involves community groups of women in monitoring
and evaluating programmes.  In spite of those obstacles, the trend
seems to be towards women's participation in the design and
monitoring of programmes.

      F.  Participation of men in reproductive health programmes

47.  The involvement of men in reproductive health, including
contraception, has been largely ignored by service programmes that
have traditionally addressed women.  The Programme of Action
emphasizes the need to include men in reproductive health
programmes.

48.  But what exactly does "men's involvement" in reproductive
health programmes entail?  Since this is a new area of work for
many organizations, several of them, particularly non-governmental
organizations, are in the process of articulating the precise
meaning of the concept and considering its
application.  For some, this includes increasing male
responsibility in decisions and behaviour concerning sexual
practices, including greater participation in family planning.
They see this as a key to improving reproductive health generally
and for curtailing the spread of sexually transmitted diseases,
including HIV/AIDS.  In addition, other non-governmental
organizations consider it important to include the issue of
increasing male involvement in responsible parenthood.  The
conclusion of one non-governmental organization is that programme
approaches towards men should focus on men having their own set of
reproductive health-related needs while acting as partners with
women, and not simply as an interdependent factor in women's
health-care programmes.

49.As a result of the new nature of this effort, several
non-governmental organizations are conducting research studies to
assess the reproductive health-care needs of men.  For instance,
among international non-governmental organizations:

   (a) The Population Council is looking at the issue of male
participation in post-partum health care for mothers and babies.
It is also trying to learn more about the male role in family
decision-making in order to find links between men's role in the
sexual, marital and parenthood spheres;

   (b) PATH is working on the development of an information,
education and communication strategy to reach male clients of sex
workers with information about the prevention of sexually
transmitted diseases and their own health as well as that of their
wives and children;

   (c) FHI is conducting a study on male perspectives on family
planning in Bolivia and Zimbabwe as part of its women's study
project;

   (d) ICOMP of Malaysia is involved in a process of identifying
the managerial requirements for the provision of services to men;

   (e) The Family Planning Association of India is developing
initiatives to identify the major cultural and political
constraints to male participation and support in reproductive
health programmes;

   (f) The Family Planning Association of Mauritius periodically
organizes sensitization sessions on male involvement in sexual and
reproductive health.


50.Among the main obstacles mentioned in developing activities for
male involvement in reproductive health were:

   (a) Lack of conviction among policy makers, programme managers
and some women's groups that involving men in health programmes
will be beneficial to women or to the programme itself;

   (b) Allocation of resources to men's needs when basic outreach
and services for women are still inadequate;

   (c) Lack of documentation on the impact of successful programme
approaches that would be helpful in convincing policy makers of the
need for investment in this area;

   (d) Lack of prototype information and training materials
specifically related to men's involvement.  These would serve as a
useful base for programmes for those who wish to adapt materials
for local use.

      G.  Activities developed by non-governmental organizations
        in the area of information, education and communication

51.Non-governmental organizations have actively participated in
advertising the results of the Conference either on their own, in
coordination with Governments, or through a network of
collaborating non-governmental organizations.  The experiences are
prolific and varied.  In some cases, non- governmental
organizations have developed specific brochures highlighting the
most critical aspects of the Programme of Action.  Others have
included special sections of the Programme of Action in the
materials that they regularly publish.  The following are some of
the activities developed by non- governmental organizations to
disseminate the Programme of Action.

   (a) A network of women's non-governmental organizations around
the world has developed a major initiative to disseminate the
Programme of Action.  The group, coordinated by Women Watch ICPD
and the Women's Environment and Development Organization (WEDO),
was created during the Conference to monitor the implementation of
the Programme of Action around the world.  WEDO is, in addition,
monitoring international agencies to ensure that they are working
on the implementation of the Programme of Action;

   (b) IPPF/Western Hemisphere organized a contest called ICPD
Dissemination Awards that was set up to promote the implementation
of the Programme of Action as well as the IPPF Strategic Plan
Vision 2000.  A total of 14 family planning associations in Latin
America and the Caribbean presented proposals, and nine winners
were selected.  Each organization received a cash award of about
$5,000 for the development of the activities described in their
proposals;

   (c) FCI has issued several publications, including Action for
the 21st Century:  Reproductive Health and Rights for All, which
summarizes recommended actions in this area.  This report was
published in English, French and Spanish, and has been distributed
in 117 countries.  Other publications of FCI include a fact sheet
developed for UNFPA that addresses the most important topics
covered in the Programme of Action and a paper entitled Commitments
to Reproductive Health and Rights for All:  A Framework for Action
for policy makers and programme planners.

   (d) IPAS has prepared a special brochure in English, Portuguese
and Spanish reproducing paragraph 8.25 of the Programme of Action,
which addresses the public health problem of abortion;

   (e) IPPF has developed a document comparing and contrasting its
Vision 2000 Strategic Plan with the Programme of Action of the
Conference.  The document has helped in the organization of public
forums to discuss the content of the document and to stimulate
national debates on the issue;

   (f) UNFPA, together with the Mexican National Council on
Population, the Ministry of Public Health and several reproductive
health and women's non-governmental organizations in Mexico,
organized a special public event in Mexico City to disseminate the
results of the Conference among policy makers.  In addition, MEXFAM
published a special book on the Conference and has organized
presentations and discussion meetings across the main cities of
Mexico.

52.The new reproductive health agenda contained in the Programme of
Action requires a renovated strategy to promote a positive attitude
from policy makers, health providers, women, men, youth and the
public in general, towards reproductive health.  Non-governmental
organizations have been working towards this end by disseminating
the Programme of Action in the countries in which they are
currently working and by developing numerous activities in the area
of information, education and communication.  Most of the
activities carried out in this area build upon the experience
gained by non-governmental organizations in their past work on
family planning.  The challenge at present is how to go beyond
family planning and adopt the holistic approach to reproductive
health.  Some of the activities reported by non- governmental
organizations in targeting policy makers as follows:

   (a)  ICOMP of Malaysia has organized international seminars to
sensitize top-level managers on reproductive health issues;

   (b) The World Population Foundation of the Netherlands has
carried out many educational, advocacy and information activities
directed to parliamentarians and government officials to ensure
that they continue to provide funding for reproductive health in
developing countries;

   (c) Advocates for Youth is currently working to organize a
national coalition of non-governmental organizations that serve
youth in order to advocate on behalf of youth to government
officials, policy makers and donors;

   (d) The Centro de Adolescentes y Jovenes Si Mujer of Nicaragua
participates in several organizations in coordination with other
non-governmental organizations.  These include the National
Commission against Maternal Mortality, the Women's Health Network
"Maria Cavallery", the Federation for Adolescents' Health and
Sexuality and the National Commission against AIDS;

   (e) The Family Planning Association of Mauritius is developing
several strategies to strengthen the political will and government
support for reproductive health policies.

  53.  In addition, many non-governmental organizations are working
on creating awareness of reproductive health issues through a
variety of communication channels, including printed materials,
conferences, workshops and the mass media.  Messages are directed
towards the public in general or targeted to specific audiences,
such as women, youth and men.


              H.  Collaboration between national Governments
            and non-governmental organizations

   54.  The responses to the questionnaire show that the particular
situation of non-governmental organizations in relation to
Governments varies enormously from country to country.
Collaboration between Governments and non-governmental
organizations seems to be a key factor in determining how the
reproductive health strategy is being implemented in a given
country.  In this sense, non-governmental organizations appear to
have a prominent role when they are able to establish reliable
collaborative links with the Government through a formal
consultative body; advocate with Governments on reproductive health
issues; provide technical assistance to each other; and pool some
resources.  In addition, the existence of a network of
non-governmental organizations, not merely a single
non-governmental organization, is of enormous help in strengthening
collaboration between Governments and non- governmental
organizations.


55. The pattern of collaboration between Governments and
non-governmental organizations ranges over:

     (a) Those non-governmental organizations that were able to
work together with Governments before and during the Conference and
are currently making enormous progress in renewing collaborative
links with them by developing committees to follow up the
Conference.  Collaborative activities may include the replication
of demonstration projects of non-governmental organizations in
state services with technical assistance provided by
non-governmental organizations (Mexico is an example);

     (b) Non-governmental organizations that collaborate with
Governments because they are part of consultative bodies, such as
national population councils, that were created even before the
Conference to endorse population policies.  In this case,
non-governmental organizations may collaborate with the Government
in a consultative capacity (India is an example);

     (c) Transfer of key activities from the public to the
non-governmental sector due to the privatization of several social
services (as in Colombia and Thailand).  

56.  Responses to the questionnaire also reveal the existence of some 
obstacles concerning collaboration between the Government and
non-governmental organizations.  These include:  initial suspicion
of each other's agenda; lack of experience in collaborative working
relations; competition for funds; changes in policy-making and of
policy makers; difficulty in overcoming the established views of
government officials and the medical establishment; the bureaucracy
of government contracts; reluctance of many Governments to work
with non-governmental organizations directly (they sometimes feel
more comfortable working with networks of non-governmental
organizations); and scepticism on the part of Governments about the
proliferation of non-governmental organizations and doubts about
their professionalism.

  57.While these are perceived as real problems, they do not seem
to represent conditions and situations that cannot be changed.
Rather, they furnish direction for ways of improving existing
collaborative activities between Governments and non-governmental
organizations and to create collaborative linkages in those
countries where collaboration is still new.


  V.  INVOLVEMENT OF NON-GOVERNMENTAL ORGANIZATIONS IN THE
          IMPLEMENTATION OF THE PROGRAMME OF ACTION

  58.The present report indicates that the 34 non-governmental
organizations that responded to the questionnaire are developing a
wide range of activities for the implementation of the Programme of
Action.  In developing a holistic approach to reproductive health,
non-governmental organizations have demonstrated an encouraging
learning curve.  They are learning not only how to translate the
Programe of Action into practice but how to improve their advocacy
activities and their existing services and initiatives in order to
serve their clients better.  Through their efforts,
non-governmental organizations have demonstrated their viability as
a major means of meeting the reproductive health needs of women and
men.  The following is a summary of some of the important lessons
learned:

    (a) The majority of the non-governmental organizations that
responded to the questionnaire are involved in conducting
activities for the integration of family planning into reproductive
health services.  However, several non-governmental organizations
are working on integration with a gradual approach.  Owing to the
increasing demand for diagnostic and treatment services for
reproductive tract infections and sexually transmitted diseases,
and because of the limited resources available to most of them,
many non-governmental organizations have selected this area as
their priority for integrating family planning into reproductive
health;

    (b) Non-governmental organizations, particularly those at the
international level, serve as real laboratories for the integration
of services.  Indeed, they are developing models of integration for
national non-governmental organizations and the government sector;

   (c) International and national non-governmental organizations
have been pioneers in applying the concept of reproductive health
to their programmes, even before the Conference.  Women's non-
governmental organizations have demonstrated that they can employ
effective strategies in advocating on behalf of women and girls, at
both the international and national levels.  The creation of
coalitions among them has strengthened their role as guarantors for
the promises of the Conference, and they will continue to have an
important role in challenging Governments to implement the
Programme of Action;

     (d) National non-governmental organizations appear to fulfil
an important function in ensuring access to reproductive health
services to marginalized sectors of the population, such as the
rural and urban poor, as well as to groups with special needs, such
as adolescents or battered women.  This role is becoming more
critical as Governments reduce the amount of resources they provide
for social services;

     (e) International non-governmental organizations are actively
working in the area of quality of care by developing indicators of
quality and clinical protocals for the control of infectious
diseases and by providing technical assistance in implementing
standards of quality.  Several national non-governmental
organizations serve as models of quality care for government
services.  However, lack of adequate resources could jeopardize
their work in this area;

     (f) Current understanding of adolescent health problems is the
result of the experience gained by the involvement of national and
international non-governmental organizations in this area, even
before the Conference.  If properly disseminated, the experience of
working with adolescents could be of enormous help to Governments
that are just initiating programmes for adolescents.  Given the
limited capacity of non-governmental organizations to serve large
segments of the youth population, their role could be considerably
enhanced if those efforts are made in collaboration with
Governments;

    (g) National and international non-governmental organizations
have only just begun to address the role of men in reproductive
health programmes.  This is probably true for most institutions.
Because of the lack of experience in this area, dissemination of
documented successful experiences could accelerate the difficult
task of including men in reproductive health programmes;

     (h) Collaboration between Governments and national
non-governmental organizations varies from country to country.  In
the majority of cases, the links established between Governments
and national non-governmental organizations are incipient and,
therefore, still very weak.  It seems that in those cases in which
non-governmental organizations are clearly able to complement the
role of Governments in providing services, the results are
promising and plans for further collaborative activities are under
way.  In the majority of cases, collaborative relationships are
forged after a long history of informal and formal contacts between
both institutions.  Experience also demonstrates that the existence
of a network of non-governmental organizations tends to facilitate
their collaborative activities with Governments.  Collaborative
activities are highly important in a number of ways, including
co-developing strategies to implement the Programme of Action,
increasing mutual technical assistance in new areas of programme
development, co-evaluating the progress of the implementation of
the Programme of Action, and working together in creating awareness
of reproductive health;

     (i) The long-term existence of non-governmental organization
programmes is dependent upon their ability of those organizations
to achieve greater self-sufficiency.  Some non-governmental
organizations face this limitation by providing services to those
sectors of the population that can afford to pay a fee.  This
enables them to provide services to the poorest segments of the
population with what are, in effect, subsidies from the middle
class.  In any case, self-sufficiency appears to be an issue for
both national and international non-governmental organizations,
although international non-governmental organizations have easier
access to financial support;

     (j) Although both international and national non-governmental
organizations have acquired extensive experience during the past
few years, the lessons learned by them are very different.
Although both are clearly moving from a narrow focus on family
planning to the broader concept of reproductive health,
international non-governmental organizations serve as real
laboratories for Governments and international agencies.  National
non-governmental organizations are becoming more institutionalized
organizations with increasing capacity to fill the gaps left by
Governments in providing services.


       VI.  CONTINUED COLLABORATION OF NON-GOVERNMENTAL
ORGANIZATIONS IN THE IMPLEMENTATION OF THE PROGRAMME OF ACTION

   59.  The national and international non-governmental
organizations responding to the questionnaire are rapidly
developing into strong supporters of the Programme of Action and
have demonstrated a high level of commitment to its principles.
Progress towards its implementation is evidenced primarily by the
activities being undertaken by national and international
non-governmental organizations on integrating family planning into
the broader framework of reproductive health.

  60. Within the framework of the Programme of Action, each
non-governmental organization has its own specific programme goals
based on the needs of its particular audience, the backgrounds and
specific skills of its staff, the amount and type of funding
available and the resources of the country or countries in which it
develops its activities.  From the responses to the questionnaire,
it appears that all the organizations are going through a period of
transition whose starting point was marked by the Conference.

61.  Non-governmental organizations have particular strengths and
weaknesses and, as mentioned earlier, they vary from country to
country.  Overall, the main strength of non-governmental
organizations lies in their capacity to create innovative programme
models that could be replicated at a larger scale by Governments.
Their main weaknesses are related to their long-term sustainability
and lack of self- sufficiency.

62.  Because national and international non-governmental
organizations have been instrumental in promoting and implementing
the Programme of Action, they continue to have a role in:

     (a) Developing advocacy initiatives to monitor the
implementation of the follow-up activities to the Conference at the
national level, particularly in coalition with other
non-governmental organizations;

     (b) Developing programme models to be replicated on a larger
scale by national Governments;

     (c) Complementing the role of States in serving marginalized
populations and groups with special needs, such as adolescents;


     (d) Providing reproductive health services in partnership with
Governments;

    (e) Providing technical assistance to Governments and other
national non-governmental organizations, and as a means of creating
innovative interventions.

                                    Note

   1/  Report of the International Conference on Population and
Development, Cairo, 5-13 September 1994 (United Nations
publication, Sales No. E.95.XIII.18), chap. I, resolution 1, annex.

===========================================================================

                                 Annex

      LIST OF INTERNATIONAL AND NATIONAL NON-GOVERNMENTAL
      ORGANIZATIONS  AND INTERGOVERNMENTAL ORGANIZATIONS 
         WORKING IN THE AREA OF  REPRODUCTIVE HEALTH 
          THAT RESPONDED TO THE UNFPA QUESTIONNAIRE

                    A.  Non-governmental organizations

                           International

  1.  Advocates for Youth (formerly Center for Population Options),
      United States of America
  2.  Catholics for a Free Choice, United States of America
  3.  Center for Development and Population Activities (CEDPA),
      United States of America
  4.  Center for Population Planning, School of Public Health,
      University of Michigan, United States of America
  5.  Center for Reproductive Health, University of California,
      United States of America
  6.  Family Care International (FCI), United States of America
  7.  Family Health International (FHI), United States of America
  8.  Ford Foundation, United States of America
  9.  International Planned Parenthood Federation (IPPF), United
      Kingdom of Great Britain and Northern Ireland
 10.  International Program Assistance Service (IPAS), United States
      of America
 11.  Johns Hopkins Program for International Education in
      Gynecology and Obstetrics Corporation, United States of America
 12.  Management Sciences for Health (MSH), United States of
      America
 13.  Margaret Sanger Center (Planned Parenthood of New York City)
 14.  Pacific Institute for Women's Health, United States of America
 15.  Pathfinder International, United States of America
 16.  Program for Appropriate Technology in Health (PATH), United
      States of America
 17.  The Population Council, United States of America
 18.  Women's Environment and Development Organization (WEDO)
 19.  Women's Health Action Foundation, Netherlands
 20.  World Population Foundation, Netherlands

                            Regional

 21.  International Council on the Management of Population
      Programmes (ICOMP), Malaysia
 22.  International Planned Parenthood Federation, Western
      Hemisphere Region, Inc., United States of America

               National

  Africa

 23.  Egyptian Family Planning Association
 24.  Family Planning Association of Mauritius  Asia
 25.  Family Planning Association of India
 26.  Parivar Seva Sanstha (India)
 27.  Population Foundation of India
 28.  Self-employed Women's Association (India)

 Latin America

 29.  Asociaci˘n Colombiana pro Biennestar de la Familia (PROFAMILIA)
 30.  Centro de Adolescentes y Jovenes:  Si Mujer (Nicaragua)
 31.  Centro de Estudios de Poblaci˘n y Paternidad Responsable
      (Centre for Population Studies and Responsible Parenthood)
      (Ecuador)
 32.  El Colegio de M‚xico
 33.  MEXFAM (Mexico)
 34.  South to South (Brazil)
 

                  B.  Intergovernmental organizations

35.   Organization of African Unity 
36.   South Pacific Commission
                   

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