United Nations

A/52/208


General Assembly

Distr. GENERAL  

24 June 1997

ORIGINAL:
ENGLISH


                                                    A/52/208

                                                    Original: English

General Assembly
Fifty-second session
Item 99 (c) of the preliminary list */

*/ A/52/50.


        Sustainable development and international economic cooperation:
        population and development

        Implementation of the Programme of Action of the International
        Conference on Population and Development

        Report of the Secretary-General


Contents

                                                           Paragraphs  Page

      I.   Introduction . . . . . . . . . . . . . . . . . . .      1     2

     II.       Administrative Committee on Coordination Task
               Force on Basic Social Services for All . . . . . . 2-5    2

    III.       United Nations system follow-up. . . . . . . . . . 6-20   3

     IV.       Progress at the country level. . . . . . . . . . .21-28   8

      V.       South-South cooperation. . . . . . . . . . . . . .29-30   9

     VI.       Financial resource flows . . . . . . . . . . . . .31-38  10

    VII.       Commission on Population and Development . . . . .39-43  12

   VIII.       Implementation by the governing body of the
               United Nations Population Fund . . . . . . . . . .44-46  13


        I.      Introduction

1.      The present report has been prepared in response to General Assembly
resolution 51/176 of 16 December 1996, in which the Assembly requested the
Secretary-General to report to it at its fifty-second session on the
implementation of the resolution. The report examines the themes addressed
in resolution 51/176. Section II focuses on the work of the Administrative
Committee on Coordination Task Force on Basic Social Services for All.
Section III highlights United Nations system follow-up in implementing  the
Programme of Action of the International Conference on Population and
Development. Section IV provides a brief overview of progress made at the
country level in implementing the Programme of Action. Section V focuses on
some important recent developments in the area of South-South cooperation.
Section VI examines the flow of resources for population assistance from
primary sources to recipient countries. Section VII examines the outcomes
of the work of the Commission on Population and Development. Finally,
section VIII briefly reviews actions taken by the governing body of the
United Nations Population Fund (UNFPA) to facilitate the implementation of
the Programme of Action.

        II.   Administrative Committee on Coordination Task Force on Basic
              Social Services for All

2.      In accordance with paragraph 11 of General Assembly resolution
51/176, the Administrative Committee on Coordination Task Force on Basic
Social Services for All, chaired by UNFPA, reported on its work to the
Commission on Population and Development at its thirtieth session, in
February 1997. 1/ The collaboration and cooperation among the member
organizations of the Task Force has been noteworthy, and the Task Force is
producing various outputs that will enhance the ability of the United
Nations system to assist countries to increase their capacity to deliver
basic social services effectively in the context of their poverty
eradication efforts. These end products include a wall chart on basic
social services; guidelines on key areas of the Programme of Action; a
report on lessons learned/best practices in donor collaboration in
assistance to the social sector; an information card on advocacy for basic
social services; and a compendium of international commitments relevant to
poverty and social integration. The end products are anchored in a human
rights framework and can be used as advocacy tools for promoting the 20/20
concept. They can also serve as valuable inputs to the work of the regional
commissions and in the common country assessment process. The Task Force is
focusing on country-level follow-up, and at its most recent meeting, the
Chairperson emphasized that special attention should be focused on
developing partnerships with non-governmental organizations, the private
sector and civil society in assisting countries in achieving the goals
agreed to at the recent United Nations global conferences. The regional
commissions have a key role to play in promoting the use of the Task Force
end products. The Task Force's Working Group on International Migration
will organize an international technical symposium on international
migration in 1998.

              The need for indicators

3.      In paragraph 12 of its resolution 51/176, the General Assembly
emphasized the importance of the ongoing efforts of the Task Force to
develop, on an urgent basis, appropriate indicators as reliable means for
monitoring the progress of the implementation of the Programme of Action.
The Task Force has been actively focusing on the development and selection
of indicators to assist countries in monitoring their progress in achieving
the goals agreed to at the International Conference on Population and
Development and other recent United Nations global conferences. In the
first instance, the Task Force has developed and disseminated widely a wall
chart on basic social services for all, which can also be accessed via the
Internet at http://www.undp.org/popin/ wdtrends/bss/bss.htm, and all member
organizations of the Task Force have been asked to link their Web sites to
the wall chart Web site. To show where countries are at the present time
and where they should aim to be in the future in the light of the goals
agreed upon at the International Conference on Population and Development
and other United Nations conferences, the wall chart provides country data
in six key areas: population; primary health care; nutrition; basic
education; drinking water and sanitation; and shelter. The indicators
pertaining to these areas will serve as a guide to assist countries in
monitoring their progress in achieving the goals agreed to at the
International Conference on Population and Development and other recent
United Nations conferences. It should be noted that eight of the indicators
on the wall chart are the same as eight of the 15 indicators in the Minimum
National Social Data Set endorsed by the Statistical Commission at its
twenty-ninth session, in February 1997. Additionally, six of the seven
Conference goal indicators selected by UNFPA for its revised approach to
resource allocation to countries are the same as those on the wall chart.
These indicators are related to access to reproductive health services;
mortality reduction; and education, especially of women and girls. 2/ 

4.      In April 1997, the World Health Organization (WHO), the lead agency
of the Task Forcežs Working Group on Reproductive Health, organized a
technical meeting on reproductive health indicators for global monitoring.
The meeting, which brought together participants from developing countries
and technical experts, as well as representatives of United Nations
agencies, focused on reaching consensus on a short list of reproductive
health indicators for national and global monitoring. These indicators meet
certain essential criteria; they are considered to be ethical, useful,
scientifically robust, representative and accessible. The short list of 15
indicators provides an overview of the reproductive health situation in
different settings. It is not envisaged that these indicators can provide
all the information needed for national or global monitoring or for the
evaluation of programme impact. For the latter, WHO advises that countries
focus on strengthening national capacities for data generation, analysis
and interpretation. To support countries in these endeavours, WHO has
developed a guideline targeted at district health planners and managers
that describes a process for the identification and selection of
reproductive health indicators that meet essential criteria.

5.      During 1996, UNFPA developed a list of quantitative and qualitative
indicators that address the principal dimensions of reproductive health.
The list includes indicators that are primarily related to outcome (events)
and process (delivery of services and management). The suggested list of
indicators could be used for a variety of purposes, including monitoring
the goals and targets set at the International Conference on Population and
Development; assessing performance in delivery of reproductive health
services; advocating for and developing policies in reproductive health;
and programming and evaluating different components of reproductive health
programmes. While the list of indicators is not intended to be exhaustive
of all the possible data needs of policy makers and managers, those
included have been selected so as to be manageable in most countries,
though some indicators may require complex collection instruments and
procedures. A subset of indicators can be determined at the country level
according to priority needs. The set of indicators is presented in the
document entitled  "Indicators for assessing the performance of reproductive
health programmes: a discussion paper". 3/ Representatives from various
bilateral agencies, United Nations agencies, non-governmental organizations
and the UNFPA Country Support Teams have been involved in the process
leading to the development of this set of indicators. In addition, UNFPA
has also developed a framework of selected indicators to assess the impact
of information-education-communication (IEC)/advocacy activities in support
of population and reproductive health programmes; and indicators for
population and development. These indicators, which will be published by
UNFPA in one document, will assist countries in monitoring their progress
in achieving the goals of the International Conference on Population and
Development.

        III.        United Nations system follow-up

6.      The organs and organizations of the United Nations system continued
an array of activities to implement the Programme of Action of the 
International Conference on Population and Development. Through inter-
agency task forces, theme groups and other mechanisms of the United Nations
system, agencies and organizations focused on increasing their
collaboration and cooperation. In keeping with the Programme of Action, all
United Nations system organizations are also emphasizing partnerships with
non-governmental organizations, the private sector and civil society. The
present section highlights, selectively, owing to limitations of space,
some of the activities being undertaken.

7.      During 1996, the Economic Commission for Europe (ECE), with support
from UNFPA, focused its work in the area of population on follow-up to the
International Conference on Population and Development in the countries
with economies in transition, including the provision of assistance for
data collection and processing, analysis and research, and dissemination of
policy-relevant information and knowledge in support of the implementation
of the Programme of Action in the key areas of fertility and reproductive
health, population ageing and international migration. ECE is also
collaborating with Department for Economic and Social Information and
Policy Analysis of the United Nations Secretariat, the Statistical Office
of the European Union (EUROSTAT), the Council of Europe and the
Organisation for Economic Cooperation and Development (OECD) to streamline
the collection and dissemination of population statistics in the region.
Early in 1997, with financial assistance from and in collaboration with
UNFPA, a project on the follow-up to the International Conference on
Population and Development in transition countries was initiated, which,
inter alia, will assist these countries in developing population
information sites on the World Wide Web in the context of the United
Nations Population Information Network (POPIN). The national information
systems will be part of a subregional information system for monitoring the
implementation of the Programme of Action.

8.      In its follow-up to the Programme of Action, the Economic and Social
Commission for Asia and the Pacific (ESCAP) implements its mandate through
advocacy, intercountry research, technical assistance and training to
strengthen national capacity and information dissemination. In the area of
reproductive health and family planning, the Population Division of ESCAP
has initiated a regional project to strengthen monitoring and information
systems to provide accurate and timely indicators and has been assisting
Governments in developing and strengthening policies for involving the
elderly in social and economic development. In 1996, the following volumes
on ageing were published: Population Ageing in Asia and the Pacific; Added
Years of Life in Asia: Current Situation and Future Challenges; and
Annotated Bibliography on Productive Ageing in Asia and the Pacific.   To
improve the availability and quality of statistical data disaggregated by
sex, and to promote the use of those data in the region, the Statistics
Division of ESCAP is implementing two projects on gender statistics, under
which regional publications, several statistical profiles on women and
national statistical booklets on the situation of women and men have been
published. ESCAP will continue to give priority to several specific gender
issues in which direct measurement remains difficult or where the
information collected is still not reliable, such as gender equity,
violence against women and maternal mortality. In keeping with the
Programme of Actionžs call for enhancing partnerships with non-governmental
organizations, ESCAP, with support from the Government of the Netherlands,
organized a Regional Seminar on Government-Non-Governmental Organization
Cooperation for Strengthening Population Policies and Programmes, which was
held at Bangkok in February 1997. ESCAP also serves as the secretariat for
Asia-Pacific POPIN, a regional information network comprising information
centres and libraries in 25 countries dedicated to the exchange of
population, family planning and reproductive health data and information.
Asia-Pacific POPIN makes its information services and products widely
available through the Internet at http://www.un.org/depts/
escap/pop/welcome.htm.

9.      In April 1996, the Ad Hoc Committee on Population and Development of
the Economic Commission for Latin America and the Caribbean (ECLAC) met in
Costa Rica during the Commission's twenty-sixth session, to review
achievements and examine obstacles encountered in implementing the Regional
Plan of Action. The member countries have requested the secretariat to
prepare a document on reproductive health and poverty for their
deliberations at the twenty-seventh session, to be held in Aruba in 1998.
In assisting countries, the Latin American Demographic Centre (CELADE) has
offered several national and regional training activities, delivered
information services in the field of population and provided technical
assistance in a wide range of population-relevant fields, such as the
integration of socio-demographic information into development policies and
programmes, particularly in social sectors and at the decentralized level.

10.     In early 1996, the Economic and Social Commission for Western Asia
(ESCWA) started executing a UNFPA-supported project on population policies
in the Arab countries of the ESCWA and North African regions, which, in the
light of the Programme of Action, includes a series of training activities
related to the formulation, implementation and monitoring of population
policies for the technical staff of the national population committees. The
project also provides for the establishment and maintenance of an ESCWA
population policies integrated information system in the Arab countries,
which will facilitate the monitoring of the implementation of the
recommendations of the Arab Conference on Population and Development, held
at Amman in 1993, as well as the Programme of Action of the International
Conference on Population and Development. With UNFPA support, ESCWA will
conduct two training workshops during 1997, on food and environment and on
reproductive health, gender and human rights. An expert group meeting on
population dynamics, urbanization and environment is scheduled to be held
in late 1997, in conjunction with the Second Meeting of Heads of National
Population Councils and Committees in the Arab World. ESCWA also
participated in the preparatory meetings and in the organization of the
Arab Regional Population Conference, held at Cairo in December 1996, in
which one of the panel sessions was specifically devoted to follow-up of
the Programme of Action of the International Conference on Population and
Development.

11.     The Economic Commission for Africa (ECA) is organizing the Second
Meeting of the Follow-up Committee for the Implementation of the Dakar/Ngor
Declaration and the Programme of Action of the International Conference on
Population and Development and the Second General Assembly of the African
Commission, from 12 to 19 June 1997. To report on national experiences of
both development frameworks and to draw on lessons learned, a questionnaire
was sent to all ECA member States and an analysis of the responses would be
discussed at the June meetings.

12.     The Office of the United Nations High Commissioner for Refugees
(UNHCR) is comprehensively addressing the issue of the reproductive health
of refugees, including through the appointment of a Senior Technical
Adviser on Reproductive Health. Refugee camps are characterized by high
birth rates. General and reproductive health education campaigns are run in
all refugee settings and target both men and women. The incidence of sexual
violence against refugees is one of the main areas of such programming.
Three manuals for programming, namely, Sexual Violence against Refugees:
Guidelines for Prevention and Response; an inter-agency manual on
reproductive health for refugees; and Guidelines for HIV Intervention in
Emergency Settings, have set the background for interventions to implement
the Programme of Action. Under a Special Initiative for Women in Rwanda, a
significant part of the programme seeks to address the reproductive health
of these women, irrespective of ethnic origin. Furthermore, under the
special General Initiative Fund for Refugee Women, project support is being
provided for the training of 100 traditional birth attendants in seven
districts of Afghanistan; for improving the reproductive health of refugee
women in Malawi, which includes family planning advisory services,
education on sexually transmitted diseases and HIV/AIDS prevention and the
addressing of cultural constraints and male attitudes to reproductive
health care; and for an educational video on female genital mutilation in
Eritrea and related reproductive health care. In Pakistan, UNHCR, together
with a non-governmental organization, the United States of America Save the
Children Fund, is working with local doctors to develop and pilot test a
rapid appraisal assessment of the reproductive health needs of Afghan
refugee women. The method being developed is culturally sensitive and is
designed to take into account the local customs of the beneficiaries.

13.     As mandated by its Executive Board, the United Nations Childrenžs
Fund (UNICEF) follow-up to the International Conference on Population and
Development is guided by the reaffirmed rights perspective, and includes
programmes for girls' education, womenžs empowerment, primary health care
and child survival, reproductive health, with a focus on maternal mortality
reduction, and measuring progress in child and maternal mortality.
Prevention of maternal mortality and morbidity is the primary focus of the
UNICEF programmes relating to follow-up to the Conference. At the country
level, safe motherhood programmes have been strengthened, under the
technical guidance of WHO and in partnership with all donors and experts in
that field. Guidelines on process indicators to measure progress on
acceptability and use of obstetric services were finalized and are to be
published jointly by WHO, UNICEF and UNFPA. UNICEF and UNFPA are both
members of the Inter-Agency Group on Safe Motherhood. UNICEF is also
engaged in integrated programmes in regions where maternal mortality rates
decreased over the past years but where there is a high prevalence of other
reproductive health problems such as sexually transmitted diseases,
unwanted adolescent pregnancies, cervical cancers and gender violence.
UNICEF supported seminars in several countries in order to build consensus
on reproductive health profiles and to strengthen the process of
integration of the various components. In emergency situations a coalition
of United Nations agencies and non-governmental organizations works
together to improve reproductive health programmes. The contribution of
UNICEF includes the provision of delivery kits and the improvement of
security conditions for girls and women in camps and other settlements.
UNICEF has developed a systematic approach to eradicate the practice of
female genital mutilation in 12 countries in Africa. Increased attention is
given to violence against women and girls in all country programmes, and
regional initiatives are focusing on assessing the magnitude of the
problem, analysing contributive factors and designing strategies that
involve adolescent boys and men. As a co-sponsor of the Joint United
Nations Programme on HIV/AIDS (UNAIDS), UNICEF collaborates in specific
interventions like school-based programmes, injection safety and health
communications.

14.     The United Nations Development Programme (UNDP) continued to make an
important contribution to the overall coordination of follow-up efforts to
the Conference  in 1996 and 1997 at the country, regional and international
levels, primarily through advocacy and support of poverty eradication and
the mainstreaming of gender into development programmes and policies. In
addition, UNDP had direct involvement in certain key themes of the
Conference, as outlined below. High priority is given to identifying
opportunities for integrating HIV/AIDS prevention activities in key
programming areas, including governance, gender and poverty. Training
workshops have been organized in country offices to strengthen programming
skills of national focal points. UNDP has contributed actively to the work
of numerous inter-agency planning and programming efforts, within the
framework of UNAIDS, at country and regional levels, and participated in
collaborative programme review, development and training activities with
bilateral agencies and non-governmental organizations. UNDP supports
initiatives in the education and health sectors, often in collaboration
with UNFPA. UNDP priorities and activities for youth and adolescents
primarily stress youth education, training and employment issues. Within
basic education, a large number of activities focus on or give special
attention to female basic education, which was prioritized at the
International Conference on Population and Development and defined as
important to reproductive health. UNDP participates actively with WHO,
UNICEF, UNFPA and the World Bank on the Safe Motherhood Initiative and is
an active supporter of several non-governmental organizations and non-
governmental organization networks that focus on or include education of
females, population education and reproductive health in their activities.

15.     WHO continues to implement the Programme of Action of the Conference
through its various programmes at the global, regional and country level.
This includes participation and technical input to various international
meetings such as the Global Commission on Women, which met during 1996. The
Office of the Executive Director for Family and Reproductive Health
coordinates the normative and technical inputs that have immediate impact
on reproductive health development. During the period under review, the
programme of adolescent health had as one of it highlights of the
implementation of the Programme of Action, the final drafting of the
WHO/UNFPA/UNICEF statement on action for adolescent health. The document
also contains a framework for country programming in adolescent health. A
further contribution was a joint WHO/UNICEF publication on the status of
adolescent health in developing countries. At the field level, three
African countries were supported in strategy development for adolescent
health services. Existing methodologies for adolescent reproductive health,
for example, the grid approach and the narrative research method, continued
to be applied. 
 
16.     In the area of womenžs health and development, specific contributions
were made to address the issues of violence against women and the role of
the health sector in prevention and management of its consequences, the
identification and the integration of gender perspectives into health
policy and programme formulation. A training course syllabus has been
developed for health planners, managers and activists to address gender and
reproductive health. Training materials have been tested and a first course
will take place in South Africa during 1997. Another focus was developed on
female genital mutilation. Tools were developed to assess the magnitude of
the problem. Further activities concentrated on training materials, risk
factor identification, and management of consequences of female genital
mutilation, and indicator development to assess programme performance. The
nutrition programme addressed the following issues: protection, promotion
and international support of breastfeeding. The baby-friendly hospitals
initiative saw an almost 50 per cent increase in certification, from 4,282
hospitals in 1995 to 8,000 in 1996. Infant-feeding practices have been the
subject of consultation during 1996 and the programme is finalizing the
preparation of guidelines on complementary feeding of infants and, in 1997,
will publish Guiding Principles for Feeding Infants and Young Children
during Emergencies. 

17.     The Special Programme on Research, Development and Research Training
in Human Reproduction has developed and tested a new strategy to strengthen
country capacity to broaden contraceptive choice. Furthermore, the
Programme played a critical role in the identification of levonorgestrel as
a novel method of emergency contraception, which is being implemented in
model programmes in a number of countries. Ongoing activities include
improving access to once-a-month injectable contraceptives and assessing
the quality of contraceptives. In its activities on information and
advocacy, the Division of Reproductive Health (Technical Support) provided,
inter alia, support on database development on selected reproductive health
indicators and violence against women. Furthermore, and in close
collaboration with other WHO programmes and UNFPA and other United Nations
system agencies, a core set of reproductive health indicators and
methodologies for generating and analysing reproductive health information
were developed. Inter-agency cooperation with United Nations system
agencies has led to joint policy statements on female genital mutilation,
revised estimates on maternal mortality, guidelines on indicators for
measuring progress in reducing maternal mortality, an information package
on the female condom, and a joint statement on HIV and infant feeding. A
wide range of technical guidelines on family planning was issued during
1996. This includes a much demanded application defining medical
eligibility criteria for contraceptive use. A videotape was produced for
health-care providers to improve safe motherhood. WHO support to
reproductive health development has been summed up in the publication,
Achieving Reproductive Health for All: The Role of WHO.

18.     UNFPA has continued to strengthen its administrative, technical and
field structure to be better able to take a lead role in meeting the
increased post-Conference demands for population and reproductive health
programmes in the developing world. National execution of projects and
decentralized approval authority to UNFPA field offices have become major
features of national programmes. To assure adequate monitoring, auditing
and oversight of a decentralizing structure, UNFPA is introducing
modifications of the organizational structure at UNFPA headquarters. UNFPA
has also recently completed country profiles for all countries of the
developing world. These profiles include descriptions of national status on
key social, health and demographic indicators, preliminary estimates of
resource requirements for the national population and development
programmes and a summary of relevant national population policies. UNFPA is
supporting HIV/AIDS prevention activities in 124 countries and, in
providing support to national AIDS prevention and control programmes, has
collaborated with 115 non-governmental organizations. UNFPA is a co-sponsor
of UNAIDS and continues to work closely with it. UNFPA is addressing the
issue of female genital mutilation and, in 1996, sponsored a technical
consultation in Ethiopia, with representatives from 25 countries, to
discuss, inter alia, the types of training, research and services needed to
eradicate female genital mutilation. The Fund is focusing increasing
attention on the key area of adolescent reproductive health, including
through collaboration with non-governmental organizations, for example, the
International Planned Parenthood Federation. Recently, in collaboration
with another non-governmental organization, the Centre for Development and
Population Activities, UNFPA organized the African Youth Forum on
Adolescent Reproductive Health, which was held at Addis Ababa. UNFPA also
sponsored an international youth essay contest on promoting responsible
reproductive health behaviour. In November 1996, UNFPA signed an agreement
with the International Federation of Red Cross and Red Crescent Societies
and UNHCR to address the reproductive health needs of refugees in the Great
Lakes region of Central Africa. This collaborative effort marks the first
time that reproductive health-care services for refugees have been planned
at the beginning of an emergency operation.

19.     In paragraph 9 of its resolution 51/176, the General Assembly
requested the Economic and Social Council to continue to give guidance on
matters concerning harmonization, cooperation and coordination within the
United Nations system regarding the implementation of the Programme of
Action. In 1995, the Council had agreed to promote a coordinated follow-up
to major international conferences in the economic, social and related
fields. This effort entailed, inter alia, a strengthened role for the
Council, streamlining the work and strengthening the role of functional
commissions, and enhanced country-level and inter-agency coordination. As
part of its strengthened role for coordinated follow-up, in 1996, the
Council examined poverty eradication as a cross-cutting theme of
international conferences. It made recommendations for improving the
coordination of United Nations system activities at field and headquarters
levels, as well as for harmonizing and integrating the work of functional
commissions. 4/ These have a bearing on the follow-up to the International
Conference on Population and Development. In particular, the Council
advised that the Commission on Population and Development address issues
relating to poverty and population in the context of the outcome of the
Conference. This focus should be borne in mind when, in 1999, the
Commission examines the broad theme of -Population growth, structure and
distribution, with special emphasis on sustained economic growth and
sustainable development". It should also be noted that, at its recent
session, the Commission on Sustainable Development addressed provisions of
the Programme of Action in this area. 5/ Also, the Council indicated how
its functional commissions should share the work on the issue of basic
social services for all. 6/ The Council, inter alia, considered that the
Commission on Population and Development would not need to conduct a
separate discussion of education but should continue to examine education
and awareness programmes targeted at population objectives 7/. In its
resolution 1996/36 of 26 July 1996, the Council also decided to continue to
ensure, on a regular basis, the harmonization and coordination of the
multi-year work programmes of relevant functional commissions. Indeed, the
Programme of Action of the International Conference on Population and
Development touches upon a number of other cross-cutting themes of major
international conferences, such as issues of social integration (youth,
family, disabled persons, refugees and migrants). The Council's guidance
may be required for ensuring a better sharing of tasks among functional
commissions in these areas. 

20.     In accordance with paragraph 15 of General Assembly resolution
51/176, UNFPA has endeavoured to ensure that the special session of the
General Assembly would give due attention to the issue of population in the
context of sustainable development. UNFPA would participate in the events
planned for the occasion and has organized a panel discussion on the topic
-Population, environment and gender". The main objectives are twofold:
first, to create a wider understanding and awareness of the critical
synergies between women, population pressures, poverty, environmental
degradation and sustainable development, and secondly, to discuss practical
ways for forging partnerships at the national, regional and international
levels for the implementation of effective policies and programmes that can
address these issues in a holistic manner. The panel would have
representatives from the major groups of Member States. The intention was
that the UNFPA-sponsored panel would focus both on key concepts and on
practical measures. In keeping with the statement made on behalf of the
Secretary-General at the opening session of the Commission on Sustainable
Development stressing stronger commitment to the empowerment of women as a
fundamental prerequisite for containing poverty and achieving sustainable
development, the UNFPA panel would concentrate on measures to increase the
rights, health and welfare of women. Given women's pivotal role in natural
resource management, income-generation, childbearing and childcare, such
measures should result in benefits to sustainable development. The panel
would also aim at addressing some of the key questions and concerns that
the Commission on Sustainable Development has raised during its meetings,
including the overarching need to improve women's conditions as a
precondition for combating poverty.

        IV.   Progress at the country level

21.     In its resolution 51/176, the General Assembly reiterated that
Governments should continue to commit themselves at the highest political
level to achieving the goals and objectives of the Programme of Action of
the International Conference on Population and Development and to take a
lead in coordinating the implementation, monitoring and evaluation of
follow-up actions at the national level. The present section provides a
brief overview of national progress in the implementation of the Programme
of Action. A number of inquiries have been conducted to ascertain the level
of progress in the implementation, including the recent one undertaken by
UNFPA in preparing the report of the Secretary-General on the monitoring of
population programmes, 8/ which was submitted to the Commission on
Population and Development at its thirtieth session.

22.     In response to the Programme of Action, many countries are updating
their population and development policies in line with the goals of the
Conference; strengthening and reorganizing health services to reduce
maternal mortality and to integrate family planning with other reproductive
health concerns; instituting legal and constitutional reforms to protect
womenžs rights and promote gender equality; and formulating legislation and
measures that address migration concerns of sending and receiving
countries. A number of Governments that had no formal population policy
have since formulated, or are in the process of formulating, comprehensive
policies that reflect the agreements reached at Cairo.

23.     Reproductive health and family planning issues have received
considerable attention since the International Conference on Population and
Development. Even countries that had formerly considered such issues too
sensitive to discuss publicly are now including reproductive health and
family planning concerns as part of the political and development
discourse. The Programme of Action has been quoted in a recent election
campaign, which included, for the first time, a population policy in the
platforms of the two major political parties. Workshops and seminars for
planners and health workers have been organized in many countries to
address the reproductive health approach and to discuss its implementation.
A number of countries have strengthened and reoriented their policies and
programmes in health care and family planning and in so doing have set up
special task forces, separate departments or national commissions on
reproductive health.

24.     Many Governments have begun to broaden family planning services to
include other reproductive health components in their programmes. Many of
them are moving away from narrowly defined demographic targets and focusing
on meeting individual needs for reproductive health information and
services. This process has increased public awareness of the unmet needs of
women, especially those who find themselves in the poorest areas of the
country and in the most marginalized groups. Efforts to integrate family
planning with other reproductive health services, including sexually
transmitted diseases and HIV/AIDS control, early detection of cancers of
the reproductive organs, and counselling on sexuality, have been initiated
in an effort to avoid duplication of services, expand accessibility to
services, and increase cost-effectiveness. Gender concerns are increasingly
being taken into account in programme design and implementation, although
the level of activity varies from country to country. There is increased
attention to the right to reproductive and sexual health, gender equality
and freedom from violence.

25.     The quality of care in reproductive health and family planning
programmes is also increasingly being addressed, and there is evidence of
efforts to improve both the quality of care provided to clients and health-
care facilities themselves. Among the activities undertaken are developing
human resources, improving infrastructure, developing medical protocols for
reproductive health/family planning services, and increasing the
availability of reproductive health services. Improving the quality of
family planning services is a major goal in most countries. A number of
countries, especially those with economies in transition, have made the
expansion of family planning services a special priority. Many countries
have undertaken such activities as establishing new training centres for
rural midwives, training health-care providers in interpersonal
communications and counselling, and expanding their network of volunteers
to provide reproductive health and family planning services. Others have
strengthened their activities by expanding services and broadening the
choice of contraceptive methods available to clients.

26.     Issues that had not always been adequately addressed prior to the
International Conference on Population and Development, such as adolescent
reproductive health and the role of men in family planning, are receiving
increased attention as a direct result of the Conference. Many countries
are promoting education about reproductive health and family planning,
using the mass media to encourage healthy and responsible sexual behaviour,
and providing counselling and services in an effort to reduce teenage
pregnancies and sexually transmitted diseases, including HIV/AIDS, among
adolescents. Seminars have been organized for both men and women on the
joint responsibility in the area of family planning, parenting and family
life. Some countries are conducting studies to assess menžs reproductive
health needs, their role in sexual, marital, parenting and family decision-
making, and cultural constraints to their participation in reproductive
health programmes.

27.     There are also encouraging signs of commitment and dedication to the
implementation and strengthening of programmes and activities in the area
of international migration. 9/ Governments are willing to exchange
information, participate in negotiations and enter into bilateral and
multilateral agreements with neighbouring countries on issues of special
concern. They are also willing to participate at the international and
regional levels in discussions of such major problems as undocumented
migration, asylum abuse, integration of documented migrants, protection of
migrants against discrimination and trafficking in migrants. Several
countries formulated migration policies, passed migration legislation or
modified existing policies and laws governing migration since the
International Conference on Population and Development. Several others are
currently in the process of reviewing immigration legislation. Governments
have also addressed the plight of refugees, initiating or strengthening a
number of resettlement and rehabilitation programmes for refugees and
returnees since the Conference. A number of countries that sought to reduce
the number of undocumented migrants within their territory addressed their
concerns by holding negotiations with other Governments. Others adopted
specific measures to alleviate the problem, including formulating new
policies such as enforcing border patrols and increasing penalties for
undocumented migrant workers and employers who hired them. A number of
countries reported discussing or signing readmission agreements to protect
the basic human rights of undocumented migrants and persons whose asylum
claims have been rejected. Several countries reported activities to prevent
trafficking in migrants.

28.     While there are encouraging signs of commitment to the implementation
of the Programme of Action, in many countries a shortage of funds and
trained personnel has impeded efforts to achieve the goals and objectives
agreed to at Cairo. To overcome these obstacles, countries require
assistance from the international community in the form of both human and
financial resources. Governments, locally elected bodies, communities, the
private sector and non-governmental organizations should work to increase
public awareness of population and development issues. It is important to
sustain political commitment at all levels of society for the successful
implementation of policies and programmes that address the Conferencežs
concerns. At the same time, international cooperation and collaboration are
vital to the achievement of the goals and objectives of the Programme of
Action of the Conference.

        V.    South-South cooperation

29.     In paragraphs 6 and 7 of resolution 51/176, the General Assembly
reiterated the importance of South-South cooperation and invited all
Governments, relevant organizations of the United Nations system, as well
as the private sector and non-governmental organizations, to continue to
support South-South cooperation activities being undertaken by the
developing countries. The intergovernmental initiative Partners in
Population and Development, launched at the International Conference on
Population and Development by 10 developing countries (Bangladesh,
Colombia, Egypt, Indonesia, Kenya, Mexico, Morocco, Thailand, Tunisia and
Zimbabwe), commenced field activities in 1996. The Partners' work plan
includes strengthening the capacity of developing countries for South-South
cooperation, the promotion of -twinning; modalities and the development of
regional training institutions. In March 1997, the Partners' Executive
Committee met in Bangkok, to discuss, inter alia, a strategic framework and
a communication strategy. In September 1996, the Partners' secretariat
began operations in Dhaka and serves as a central point for networking
among the Partners and for identifying opportunities for South-South
exchanges and funding sources. For example, the secretariat has promoted
the formulation of South-South initiatives in East Africa, Mexico, Colombia
and Indonesia and sought support for those initiatives from the European
Union and the Governments of the United Kingdom of Great Britain and
Northern Ireland and the Netherlands.

30.     UNFPA has further developed its policy and activities regarding
South-South cooperation in the areas of population and reproductive health,
including sexual health, inter alia, through two intercountry initiatives:
the Centres of Excellence and Partners in Population and Development.
Additionally, in September 1996, an advisory group was established at UNFPA
headquarters to support South-South cooperation at the policy, programme
and operational levels. In order to consolidate the strategy, policies and
procedures under the Conference perspective, UNFPA will shortly circulate a
new guidance note for South-South cooperation. During the past year, UNFPA
funded projects in each of the Centres of Excellence and provided support
for courses and study tours on such topics as adolescents and mass media in
Mexico, community participation and programme management in Indonesia,
population and development policies in Thailand, and gender perspectives
and programme management in Tunisia. In April 1997, representatives of the
four Centres met at UNFPA headquarters to discuss and share experiences of
their reproductive health training programmes and agreed, inter alia, that
the Centres would use selected common materials on reproductive health that
reflect the Conference approach, improve the participant selection process
and employ a common evaluation strategy. They also discussed the
institutional and financial sustainability of the Centres. Through its
country programmes, UNFPA is encouraging countries to make use of South-
South activities both as recipients and/or providers and to draw on the
technical resources of public institutions, non-governmental organizations,
private organizations and individuals from developing countries. UNFPA
representatives are required to specifically consider this modality during
programme review exercises, as well as in the formulation of country
programmes and projects. As a result, UNFPA is supporting South-South
exchange activities under several country programmes, including those in
the Dominican Republic, Honduras, Indonesia, Kenya, Malawi, Thailand,
Tunisia, Uganda and the United Republic of Tanzania.

        VI.   Financial resources flows

31.     In paragraph 4 of resolution 51/176, the General Assembly urged all
countries to consider, among other things, their current spending
priorities, with a view to making additional contributions in line with
national priorities for the implementation of the Programme of Action,
taking into account the provisions of chapters XIII and XIV thereof and the
economic constraints faced by developing countries, in particular the least
developed among them. In paragraph 5, the Assembly emphasized that
international cooperation in the field of population and development was
essential for the implementation of the recommendations adopted at the
Conference and, in that context, called upon the international community to
continue to provide, both bilaterally and multilaterally, adequate and
substantial support and assistance for population and development
activities, including through UNFPA, other organs and organizations of the
United Nations system and the specialized agencies that would be involved
in the implementation of the Programme of Action. In paragraph 8, the
Assembly emphasized the importance of the identification and allocation of
financial resources by all members of the international community,
including regional financial institutions, to enable them to fulfil their
commitments with regard to the implementation of the Programme of Action.

32.     The International Conference on Population and Development was the
first United Nations conference to spell out a schedule of resource
mobilization to achieve a specific set of development objectives. The
estimated cost of these measures is $17 billion a year by 2000, increasing
to $21.7 billion in 2015 (in constant 1994 dollars). The Programme of
Action recommended that, globally, approximately two thirds of the needed
resources in developing countries would have to come from domestic sources
in the future. Therefore, one third of the projected resource requirements
would have to come from external sources: $5.7 billion in the year 2000,
increasing to $7.2 billion by 2015. The Programme of Action explicitly
acknowledged that the two-thirds/one-third formula would apply globally,
not to each country individually. In situations where the constraints on
domestic resources are most severe owing to weak economic performance,
inadequate infrastructure and the shortage of trained personnel, it is
expected that most of the needed resources will be supplied through
external population assistance. On the other hand, a substantial proportion
of the resources for many national programmes in other developing regions
is expected to be mobilized from within the countries themselves.

33.     Grants from donor countries make up the largest part of total
international population assistance. In 1990, $669 million of such aid was
given for population, increasing to about $977 million in 1994. The 1994
total represented a substantial increase of about 26 per cent over the 1993
figure, reflecting the importance that the international community has
given to the challenges set out by the Conference. The 1995 overall flow of
financial assistance from donor countries has increased over the 1994 total
by more than 20 per cent and has reached more than $1.3 billion. Private
sources of population assistance, such as benevolent foundations and some
international non-governmental organizations, have steadily increased in
the 1990s as important providers of international population assistance. In
1990 such institutions provided $48 million, about 5 per cent of total
assistance. By 1994, the amount contributed by private sources had
increased considerably to $117 million (10 per cent of the total).
Preliminary estimations for 1995, however, indicate that private
international flows did not increase over the 1994 amount, and may have
even decreased marginally.

34.     Over the period 1990-1995, the annual income of UNFPA increased from
$212 million to $313 million but decreased in 1996 to $308.8 million. This
was chiefly attributable to a decreased contribution from one major donor
country and to lower rates of exchange as compared to the previous year. In
1990, the United Nations system -  excluding UNFPA - provided $86 million,
or 9 per cent of the total amount of assistance for population. In 1994,
multilateral funds from the United Nations system, excluding UNFPA,
amounted to $107 million, contributing less than 7 per cent of total
external population resources. 10/ Apart from UNFPA, the organs and
organizations reporting support for population activities include the
International Labour Organization, the Department for Economic and Social
Information and Policy Analysis of the United Nations Secretariat, UNICEF
and WHO, as well as the regional commissions, in particular ECLAC (CELADE).
The World Bank is another major multilateral source of population
assistance through its loan agreements with developing countries. World
Bank loans have increased dramatically since 1990 when they amounted to
$169 million, or 17 per cent of total population assistance. The World Bank
made available $448 million for population and reproductive health
assistance in 1995 and $599 million in 1996. 

35.     Looking to the future, the mobilization of resources to implement the
Programme of Action should be more fully monitored than at present. UNFPA
currently monitors, on an annual basis, the amount of international
assistance for programmes dealing with population and development, and
publishes the Global Population Assistance Report. UNFPA also collects each
year descriptive information on population projects throughout the
developing world, compiling them in the comprehensive report Inventory of
Population Projects in Developing Countries around the World. The data-
collection efforts to track global resource flows for population is being
developed further through a collaborative project between UNFPA and the
Netherlands Interdisciplinary Institute under an initial two-year contract.
The projectžs objectives are to systematically collect and record data on
the flows of financial resources for population and development programmes,
both internationally and domestically, in order to create and maintain a
dynamic database, and to perform basic analyses of the data and disseminate
such findings.

36.     The rising trend in resource flows documented for the period
1994-1995 is encouraging. A great deal has been accomplished with
relatively modest investments and must count as one of the real successes
in global development efforts. But the successful implementation of the
Programme of Action is still dependent upon higher levels of resource
mobilization as well as increasing efficiency in resource utilization.
Additional resources are urgently required to better identify and satisfy
unmet needs in areas related to population and development. Sub-Saharan
Africa and parts of Asia, and least developed countries everywhere, will
need a much larger share of resources from the international community, but
all countries should redouble efforts to increase their own resources for
population and reproductive health. Although several donor countries have
shown early and laudable commitments through announcements of increased
funds for population activities, overall official development assistance
has declined in recent years. Most donors still need to review their
development assistance policies and increase resources for global
population activities accordingly.

37.     Reducing the level of resource mobilization below that envisaged by
the Programme of Action would have dramatic consequences, even by the year
2000. A recent conference room paper, entitled -Meeting the goals of the
ICPD: consequences of resource shortfalls up to the year 2000ž, 11/
submitted to the Executive Board of UNDP/UNFPA at its annual session in May
1997, highlighted in quantitative terms some of the serious consequences by
the year 2000 if the Conference programme were to be under-funded.
Depending on the resource assumptions (the paper presented three
scenarios), in the year 2000, 96-175 million fewer couples would use modern
family planning services and, of these, 43-78 million couples would not be
using any contraceptive method at all; from 1995 to 2000, 43-88 million
abortions would be added to the projected 225 million already expected;
between 1995 and 2000, a total of 57-104 million extra unintended births
would occur; an additional 65,000 to 117,000 women would die from maternal
mortality causes; the number of additional infants and young children that
would die during the period 1995-2000 would be between 5.2 and 9.3 million.
These preliminary estimates will be refined in a definitive version of this
analysis to be submitted as a formal report to the Executive Board at its
September 1997 session.

38.     To realize the concrete and achievable goals set out by the
International Conference on Population and Development, the mobilization of
resources, both domestic and external, must be placed high on the global
development agenda and the implications of increasing financial resources
to the level of $17 billion by the year 2000, as called for in the
Programme of Action, must be faced squarely. At the Conference, it was
agreed that donor assistance needed to reach $5.7 billion by the year 2000,
whereas in 1995 this totalled only $2 billion. All countries should take
into account the resources for population that will be required over the
next 20 years and devise policies and strategies for resource mobilization
that will allow the Conference programme to succeed.

        VII.        Commission on Population and Development

39.     In paragraph 10 of resolution 51/176, the General Assembly reiterated
that the Commission on Population and Development has the primary
responsibility for monitoring, reviewing and assessing the implementation
of the Programme of Action. The Commission operates under a topic-oriented,
multi-year work programme as established by the Economic and Social Council
in its resolution 1995/55 of 28 July 1995. In addition, in 1999, the
Commission will consider the quinquennial review and appraisal of the
implementation of the Programme of Action of the International Conference
on Population and Development. The substantive servicing of the Commission
lies with the Population Division of the United Nations Secretariat. The
Population Division maintains close collaboration and cooperation with
other relevant United Nations bodies.

40.     The thirtieth session of the Commission on Population and Development
was held at United Nations Headquarters from 24 to 28 February 1997. Its
central theme was chapter X of the Programme of Action, covering
international migration, in particular, international migration and
development, documented migrants, undocumented migrants and refugees,
asylum-seekers and displaced persons. The major substantive report before
the Commission was the report of the Secretary-General on world population
monitoring, 8/8 the preparation of which was coordinated by the Population
Division. The report provided a comprehensive and up-to-date description
and analysis of international migration issues with respect to the numbers
and characteristics of migrants, national policies and their evolution over
time and the relationship between international migration and development.
In its review of the report, the Commission stressed the need for more
reliable data on migration, particularly on the direction of migrant flows
and the characteristics of migrants. Other reports before the Commission
covered the monitoring of population programmes, the activities of the
Administrative Committee on Coordination Task Force on Basic Social
Services for All, activities of intergovernmental and non-governmental
organizations, and flows of financial resources, as well as a report
responding to agreed conclusions 1996/1, adopted by the Economic and Social
Council, on coordinating activities for poverty eradication, and reports on
the progress of work and proposed future programme of work of the
Population Division. In addition, revised recommendations on international
migration statistics adopted by the Statistical Commission at its 1997
session, were presented to the Commission on Population and Development.

41.     The Commission considered follow-up actions to the recommendations of
the International Conference on Population and Development. Recognizing the
need for further analysis of international migration trends and the
linkages among the social, economic, political and cultural factors related
to international migration and development, the Commission adopted
resolution 1997/1, in which it noted with interest that the Administrative
Committee on Coordination Task Force on Basic Social Services for All would
be holding a technical symposium on international migration in 1998 and
requested the Chairperson of the Task Force to make every effort to raise
the necessary extrabudgetary resources to prepare and hold the symposium.
The Commission further recalled General Assembly resolution 50/123 of 20
December 1995, in which the Assembly decided to include international
migration and development, including the convening of a United Nations
conference on international migration and development, in the provisional
agenda of its fifty-second session.

42.     In the light of General Assembly resolutions 50/206 of 23 December
1995 and 51/211 of 18 December 1996, the Commission considered its
reporting requirements. In resolution 1997/2, the Commission decided to
streamline reporting and requested the Secretariat to report to it at its
thirty-first session on a new document structure and periodicity and
revised reporting methodologies for ensuring coverage of currently required
reporting. The Commission, inter alia, also decided that activities of
intergovernmental and non-governmental organizations should be integrated
into other Commission documents. The Commission reviewed the work programme
of the Population Division of the United Nations Secretariat and adopted
resolution 1997/3 on the work programme in the field of population. Noting
the ongoing reform of the United Nations system and the restructuring and
revitalization of the intergovernmental process, the resolution, among
other things, stressed the importance of continuing the basic work of the
Population Division, emphasized the importance of the Population Divisionžs
role as secretariat to the Commission on Population and Development and
requested the Population Division to continue to give such servicing high
priority in undertaking its activities. The resolution also emphasized the
importance of preparations being made by the Population Division for the
review and appraisal of the implementation of the Programme of Action, and
underlined the need to further enhance the efficiency, effectiveness and
capacity of the Division in order to successfully implement the above-
mentioned preparations.

43.     In preparation for the thirty-first session of the Commission, the
Population Division is currently preparing the monitoring report on the
state of knowledge in the area of health and mortality, with special
emphasis on the linkages between health and development, and on gender and
age. The report will focus on substantive issues presented in chapter VIII
of the Programme of Action (health, morbidity and mortality). UNFPA is
preparing the following reports on the theme of the thirty-first session:
report of the Secretary-General on the monitoring of population programmes;
report of the Administrative Committee on Coordination Task Force on Basic
Social Services for All; and report of the Secretary-General on the flow of
financial resources. Other documents are also being prepared.

        VIII.       Implementation by the governing body of the United Nations
                    Population Fund

44.     At the annual session of the Executive Board of UNDP/UNFPA, in May
1997, the Executive Director of the United Nations Population Fund, which
is designated as the lead agency for follow-up to the International
Conference on Population and Development, proposed, in consultation with
the Department for Policy Coordination and Sustainable Development of the
United Nations Secretariat, that a comprehensive review of the
implementation of the Programme of Action be undertaken in the context of
the fifth anniversary of the Conference, in 1999, and that the General
Assembly, at its fifty-second session, be requested to define and establish
this review process. As part of the broader review process, the Executive
Director proposed that UNFPA undertake an exercise within its own mandate
for compiling and analysing the operational experience in implementing the
Programme of Action. In response, the Executive Board adopted decision
97/14, in which it requested the Executive Director to undertake
preparatory activities for the review and appraisal within the mandate of
the Fund. At the same time, it invited the President of the Executive Board
to submit to the General Assembly at its fifty-second session, through the
Economic and Social Council at its substantive session of 1997, the
proposal for an overall review and appraisal of the implementation of the
Programme of Action of the International Conference on Population and
Development for the consideration of the General Assembly and subsequent
decision on the process and modalities.

45.     The Executive Board also discussed a conference room paper entitled -
Meeting the goals of the International Conference on Population and
Development: consequences of resource shortfalls up to the year 2000ž, 11/11
which underscores in quantitative terms some compelling consequences by the
year 2000 if the Conference programme were to be under-funded. Noting the
preliminary nature of the paperžs analysis, as well as the seriousness of
the negative consequences outlined in the paper, the Executive Board
decided to continue its discussion on the matter of resource requirements
for implementing the Programme of Action. It requested UNFPA to develop the
paper further for formal submission at its September 1997 session, taking
into account comments and observations made by Board members.

46.     The Executive Board has been instrumental in the past two years in
guiding the evolution of the UNFPA programme in the post-Conference era. In
June 1995, the Board supported the broad outline of the Fundžs future
programme of assistance and endorsed the core programme areas of UNFPA
(decision 95/15). The following year, in March, the Board endorsed the
Fundžs new programme resource allocation approach and approved the relative
shares of resources to the different categories of countries (decision
96/15). Together, these two decisions provided the Fund with the framework
it needed to combine substantive programming with resource allocation
priorities in line with the principles and directions set forth by the
Programme of Action. During 1996-1997, UNFPA formulated 47 country
programmes based on these new programming and resource allocation
priorities. These country programmes are designed to assist countries in
implementing the Programme of Action, particularly in the areas of
reproductive health, including family planning and sexual health;
population and development strategies; and advocacy.


                               Notes

1/      E/CN.9/1997/4.

2/      See also report of the Executive Director on a revised approach for
the allocation of UNFPA resources to country programmes (DP/FPA/1996/15).

3/      UNFPA, April 1997.

4/      See Report of the Economic and Social Council for the Year 1996
(A/51/3 (Part I)), chap. III, agreed conclusions 1996/1; to be issued as
Official Records of the General Assembly, Fifty-first Session, Supplement
No. 3 (A/51/3/Rev.1).

5/      The report of the Secretary-General (E/CN.17/1997/2/Add.4) addressed
both chapter 5 of Agenda 21, on demographic dynamics and sustainability,
and chapter III of the Programme of Action of the International Conference
on Population and Development, on interrelationships between population,
sustained economic growth and sustainable development.

6/      Agreed conclusions 1996/1, paras. 53-55.

7/      Ibid., para. 53.

8/      E/CN.9/1997/3 and Corr.1.

9/      See also E/CN.9/1997/3 and Corr.1.

10/     The total of $107 million includes $72 million reported by UNICEF.
Because its operational activities are highly decentralized, UNICEF
reported that it was not possible to extract the information required from
its database. The Fundžs broader definition of population assistance
includes support for basic education and literacy, especially for women, as
well as enhancing the status of women.  In the Global Population Assistance
Report 1993, $6.3 million of the Fund's reported total of $63 million was
included as population assistance according to pre-Conference categories of
assistance.

11/     DP/FPA/1997/CRP.1.

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Date last posted: 10 January 2000 10:05:30
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