United Nations

A/RES/S-21/2


General Assembly

Distr. GENERAL  

2 July 1999

ORIGINAL:
ENGLISH



                                                   A/RES/S-21/2
                                                   9th plenary meeting
                                                   2 July 1999
 
 
      S-21/2.  Key actions for the further implementation of the Programme of
               Action of the International Conference on Population and
               Development
 
   The General Assembly
 
   Adopts the key actions for the further implementation of the Programme of
Action of the International Conference on Population and Development annexed
to the present resolution.
 
 
                              ANNEX
 
Key actions for the further implementation of the Programme of Action of the
International Conference on Population and Development
 
                           I.  Preamble
 
1. The Programme of Action of the International Conference on Population and
Development, approved by consensus on 13 September 1994, as contained in the
report of the Conference and as endorsed by the General Assembly in its
resolution 49/128 of 19 December 1994, marked the beginning of a new era in
population and development. The objective of the landmark agreement reached at
the Conference was to raise the quality of life and the well-being of human
beings and to promote human development by recognizing the interrelationships
between population and development policies and programmes aiming to achieve
poverty eradication, sustained economic growth in the context of sustainable
development, education, especially for girls, gender equity and equality,
infant, child and maternal mortality reduction, the provision of universal
access to reproductive health services, including family planning and sexual
health, sustainable patterns of consumption and production, food security,
human resources development and the guarantee of all human rights, including
the right to development as a universal and inalienable right and an integral
part of fundamental human rights.
 
2. The Programme of Action acknowledges that the goal of the empowerment and
autonomy of women and the improvement of their political, social, economic and
health status is a highly important end in itself and is essential for the
achievement of sustainable development. Greater investments in health and
education services for all people, in particular women, to enable the full and
equal participation of women in civil, cultural, economic, political and
social life are essential to achieving the objectives of the Programme of
Action.
 
3. The Programme of Action emphasizes that everyone has the right to
education, which shall be directed to the full development of human resources,
and human dignity and potential, with particular attention to women and the
girl child, and therefore everyone should be provided with the education
necessary to meet basic human needs and to exercise human rights. It calls for
the elimination of all practices that discriminate against women, and affirms
that advancing gender equality and equity and the empowerment of women, the
elimination of all kinds of violence against women and ensuring women's
ability to control their own fertility are cornerstones of population and
development-related programmes. It affirms that the human rights of women and
the girl child are an inalienable, integral and indivisible part of universal
human rights. It further affirms that reproductive rights embrace certain
human rights that are already recognized in national laws, international human
rights documents, and other consensus documents. These rights rest on the
recognition of the basic right of all couples and individuals to decide freely
and responsibly the number, spacing and timing of their children and to have
the information and means to do so, and the right to attain the highest
standard of sexual and reproductive health.  It also includes their right to
make decisions concerning reproduction free of discrimination, coercion and
violence, as expressed in human rights documents. In the exercise of this
right, they should take into account the needs of their living and future
children and their responsibilities towards the community. The promotion of
the responsible exercise of those rights for all people should be the
fundamental basis for government- and community-supported policies and
programmes in the area of reproductive health, including family planning.
 
4. The International Conference on Population and Development and its
implementation must be seen as being closely related to the outcome of and
coordinated follow-up to the other major United Nations conferences held in
the 1990s. Progress in the implementation of the Programme of Action should be
supportive of and consistent with the integrated follow-up to all major United
Nations conferences and summits.
 
5. The implementation of the recommendations contained in the Programme of
Action and those contained in the present document is the sovereign right of
each country, consistent with national laws and development priorities, with
full respect for the various religious and ethical values and cultural
backgrounds of its people, and in conformity with universally recognized
international human rights.
 
6. The Programme of Action recommended a set of interdependent quantitative
goals and objectives. These included universal access to primary education,
with special attention to closing the gender gap in primary and secondary
school education, wherever it exists; universal access to primary health care;
universal access to a full range of comprehensive reproductive health-care
services, including family planning, as set out in paragraph 7.6 of the
Programme of Action; reductions in infant, child and maternal morbidity and
mortality; and increased life expectancy. The Programme of Action also
proposed a set of qualitative goals that are mutually supportive and of
critical importance to achieving the quantitative goals and objectives.
 
7. The Programme of Action articulates a comprehensive approach to issues of
population and development, identifying a range of demographic and social
goals to be achieved over a 20-year period. While the Programme of Action does
not quantify goals for population growth, structure and distribution, it
reflects the view that an early stabilization of world population would make a
crucial contribution to realizing the overarching objective of sustainable
development.
 
8. According to the United Nations estimates and projections, the world's
population will exceed 6 billion for the first time in 1999, of which nearly
80 per cent will be living in developing countries. Depending on the quality
and the magnitude of the actions taken over the next five to ten years in the
areas of population policy and reproductive health, including the provision of
family planning services, world population will total somewhere between 6.9
billion and 7.4 billion in 2015. The majority of the world's countries are
converging in a pattern of low birth and death rates, but since these
countries are proceeding at different speeds, the emerging picture is that of
a world facing increasingly diverse demographic situations. The world's
reproductive age population continues to grow at a slightly higher rate than
the world's population as a whole, reflecting the large number of young people
entering their childbearing years. The Programme of Action rightly emphasizes
the need to integrate population concerns fully into development strategies
and planning, taking into account the interrelationship of population issues
with the goals of poverty eradication, food security, adequate shelter,
employment and basic social services for all, with the objective of improving
the quality of life of present and future generations through appropriate
population and development policies and programmes.
 
9. The five-year review of progress shows that the implementation of the
recommendations of the Programme of Action has shown positive results. Many
countries have taken steps to integrate population concerns into their
development strategies. Mortality in most countries has continued to fall in
the five years since the adoption of the Programme of Action. The Conference's
broad-based definition of reproductive health is being accepted by an
increasing number of countries and steps are being taken to provide
comprehensive services in many countries, with increasing emphasis being given
to quality of care. The rising use of family planning methods indicates that
there is greater accessibility to family planning and that more and more
couples and individuals are able to choose the number and spacing of their
children. Many countries, both countries of origin and countries of
destination, have taken important steps, including, inter alia, at the
regional level, aimed at better managing international migration flows through
bilateral and multinational agreements. In addition, many civil society
organizations are contributing to the formulation and implementation of
policies, programmes and projects on their own or in partnerships with
governmental and intergovernmental organizations as well as the private
sector.
 
10.   However, for some countries and regions, progress has been limited and,
in some cases, setbacks have occurred. Women and the girl child continue to
face discrimination. The human immunodeficiency virus/acquired
immunodeficiency syndrome (HIV/AIDS) pandemic has led to rises in mortality in
many countries, in particular in sub-Saharan Africa. Mortality and morbidity
among adults and children from infectious, parasitic and water-borne diseases,
such as tuberculosis, malaria and schistosomiasis, continue to take their
toll. Maternal mortality and morbidity remain unacceptably high. Adolescents
remain particularly vulnerable to reproductive and sexual risks. Millions of
couples and individuals still lack access to reproductive health information
and services. An increase in adult mortality, especially among men, is a
matter of special concern for countries with economies in transition and some
developing countries. The impact of the financial crises in countries of Asia
and elsewhere, as well as the long-term and large-scale environmental problems
in Central Asia and other regions, is affecting the health and well-being of
individuals and limiting progress in implementing the Programme of Action.
Despite the goal of the Programme of Action of reducing pressures leading to
refugee movements and displaced persons, the plight of refugees and displaced
persons remains unacceptable.
 
11.   Achieving the goals and objectives of the Programme of Action will
require sufficient domestic and external resources, committed government
action and effective, transparent partnerships. In order to implement further
the Programme of Action, a number of financial, institutional and
human-resource constraints must be overcome.  Implementing the key actions of
the present document and addressing the full range of recommendations of the
Programme of Action will require greater political commitment, development of
national capacity, increased international assistance and increased domestic
resources. Effective priority-setting, within each national context, is an
equally critical factor for the successful implementation of the Programme of
Action.
 
12.   In implementing and taking forward the Programme of Action, an
integrated approach should be adopted towards policy design, development
planning, service delivery, research and monitoring to utilize scarce
resources for greater added value and to promote intersectoral coordination.
 
13.   The present document draws on the results and findings of
intergovernmental reviews under the auspices of the United Nations, including
the annual and quinquennial review and appraisal by the Commission on
Population and Development and meetings and reports of the United Nations
regional commissions regarding progress made and constraints faced in the
implementation of the Programme of Action.
 
14.   In recommending the key actions contained in the present document,
Governments affirm their renewed and sustained commitment to the principles,
goals and objectives of the Programme of Action. Governments and civil society
at the national level, in partnership with the international community, should
join in efforts to ensure that the goals and objectives of the International
Conference on Population and Development are accomplished as soon as possible,
with special attention to those that should be met within the twenty-year
time-frame of the Programme of Action.
 
               II.  Population and development concerns
 
       A.  Population, economic development and the environment
 
15.   Governments should:
 
   (a)   Intensify efforts to equip planners and decision makers with a better
understanding of the relationships among population, poverty, gender inequity
and inequality, health, education, the environment, financial and human
resources, and development; and re-examine recent research concerning the
relationships among reductions in fertility and economic growth and its
equitable distribution;
 
   (b)   Draw attention to and promote linkages among macroeconomic,
environmental and social policies through increased dialogue among finance
ministries and other relevant ministries;
 
   (c)   Intensify efforts to implement legislative and administrative
measures as well as to promote public education, with special attention to
youth, about the need for sustainable production and consumption patterns;
foster sustainable natural resource use; and work concertedly to prevent
environmental degradation within their countries;
 
   (d)   Increase investments in the social sector, especially health and
education, as an effective strategy for development;
 
   (e)   Develop and expand integrated community-based approaches to
   sustainable development.
 
16.   Governments, in cooperation with the international community, should
reaffirm their commitment to promoting an enabling environment to achieve
sustained economic growth in the context of sustainable development and to
eradicating poverty, with a special emphasis on gender, including by promoting
an open, equitable, secure, non-discriminatory and predictable trading system;
stimulating direct investment; reducing the debt burden; and ensuring that
structural adjustment programmes are responsive to social, economic and
environmental concerns. Population-related goals and policies outlined in the
Programme of Action need to be reflected, as appropriate, in international
agreements in such areas as environment and trade.
 
17.   Governments of developing countries and countries with economies in
transition, with the assistance of the international community, especially
donors, including through bilateral and multilateral financial support, should
ensure that social safety nets are implemented, especially in those countries
most affected by the recent global financial crisis, and ensure that they are
adequately funded.
 
18.   Governments of developing countries and countries with economies in
transition, with the assistance of the international community, especially
donors, should:
 
   (a)   Continue to support declines in infant and child mortality rates by
strengthening infant and child health programmes that emphasize improved
prenatal care and nutrition, including breastfeeding, unless it is medically
contraindicated, universal immunization, oral rehydration therapies, clean
water sources, infectious disease prevention, reduction of exposure to toxic
substances, and improvements in household sanitation; and by strengthening
maternal health services, quality family-planning services to help couples to
time and space births, and efforts to prevent transmission of HIV/AIDS and
other sexually transmitted diseases;
 
   (b)   Strengthen health-care systems to respond to priority demands on
them, taking into account the financial realities of countries and the need to
ensure that resources are focused on the health needs of people in poverty;
 
   (c)   Determine the causes of the stagnation or increase in mortality
levels among adult populations and develop special policies and programmes on
health promotion where such stagnation or increase is observed, especially
among women in reproductive age groups and males in productive age groups;
 
   (d)   Ensure that poverty eradication programmes are targeted particularly
at females and that priority is given to female-headed households;
 
   (e)   Develop innovative ways to provide more effective assistance to
strengthen families in extreme poverty, such as providing micro-credit for
poor families and individuals;
 
   (f)   Undertake policies and programmes that seek to ensure a level of
consumption that meets the basic needs of the poor and disadvantaged.
 
19.   Measures should be taken to strengthen food, nutrition and agricultural
policies and programmes, and fair trade relations, with special attention to
the creation and strengthening of food security at all levels.
 
20.   Governments should promote and protect the rights of indigenous people
with particular regard to their cultures, resources, belief systems, land
rights and languages.
 
 
        B.  Changing age structure and ageing of the population
 
21.   Governments should:
 
   (a)   Continue to examine the economic and social implications of
demographic change and how they relate to development planning concerns and
the needs of individuals;
 
   (b)   Meet the needs of youth, especially young women, with the active
support, guidance and participation, as appropriate, of parents, families,
communities, non-governmental organizations and the private sector, by
investing in the development and implementation of national, regional and
local plans. In this context, priority should be given to programmes such as
education, income-generating opportunities, vocational training, and health
services, including those related to sexual and reproductive health. Youth
should be fully involved in the design, implementation and evaluation of such
programmes and plans. These policies, plans and programmes should be
implemented in line with the commitments made at the International Conference
on Population and Development and in conformity with the relevant
international conventions and agreements. Emphasis should be placed on
fostering intergenerational dialogue through better communication and mutual
support; 
 
   (c)   Support research and develop comprehensive strategies at the
national, regional and local levels to meet, where appropriate, the challenges
of population ageing. Invest more resources in gender-sensitive research as
well as in training and capacity-building in social policies and health care
of older persons, especially the elderly poor, paying special attention to the
economic and social security of older persons, in particular older women;
affordable, accessible and appropriate health-care services; the human rights
and dignity of older persons and the productive and useful roles that they can
play in society; support systems to enhance the ability of families and
communities to care for older family members; the ability of the elderly to
care for family members and community victims of HIV/AIDS; and generational
solidarity with the goal of maintaining and improving social cohesion.
 
22.   Governments and civil society, including non-governmental organizations
and the private sector, should create opportunities and remove barriers that
hinder elderly women and men from continuing to contribute their skills to
their families, to the workforce and to their communities, in order to help to
foster intergenerational solidarity and enhance the well-being of society.
This will require life-long education and opportunities for retraining.
 
23.   The United Nations system should, provided that additional resources are
made available, document the positive experience of policies and programmes in
the area of ageing of men and women and disseminate information and
recommendations about those practices. Countries should be enabled, through
adequate training and capacity-building, to evolve their own policies
appropriate to their cultures, traditions and socio-economic circumstances.
 
 
                      C.  International migration
 
24.   Governments in both countries of origin and countries of destination,
including through international cooperation, are urged:
 
   (a)   To intensify efforts to protect the human rights and dignity of
migrants irrespective of their legal status; provide effective protection for
migrants; provide basic health and social services, including sexual and
reproductive health and family-planning services; facilitate family
reunification of documented migrants; monitor violations of the human rights
of migrants; effectively enforce the laws applicable to the protection of
human rights; and ensure the social and economic integration of documented
migrants, especially of those who have acquired the right to long-term
residence in the country of destination, and their equal treatment before the
law.  Non-governmental organizations should play a valuable role in meeting
the needs of migrants;
 
   (b)   To prevent trafficking in migrants, in particular women and children
subjected to forced labour or sexual or commercial exploitation; to develop
clear penalties for such trafficking and migrant smuggling, backed by
effective administrative procedures and laws, ensuring punishment of those who
commit such crimes; and to finalize as soon as possible the trafficking and
smuggling protocols which are currently being negotiated by the Commission on
Crime Prevention and Criminal Justice;
 
   (c)   To support and ensure effective follow-up to bilateral and
multilateral initiatives, including regional and subregional consultation
processes, where appropriate, to develop national policies and cooperative
strategies to maximize the benefits and manage the challenges posed by
international migration;
 
   (d)   To conduct public information campaigns on migration in both
countries of origin and countries of destination so that racist and xenophobic
attitudes in countries of destination are combated and so that potential
migrants fully understand the implications of the decisions to move;
 
   (e)   To consider ratifying or acceding to the International Convention on
the Protection of the Rights of All Migrant Workers and Members of Their
Families, if they have not already done so.
 
25.   The international community should extend assistance and support to
programmes in developing countries that host the majority of refugees and
displaced persons. Assistance should also be extended to programmes in
countries lacking the capacity to manage large flows of migrants and displaced
persons. 
 
26.   All States are encouraged to become parties to the 1951 Convention and
the 1967 Protocol relating to the Status of Refugees and put in place
effective asylum procedures.
 
27.   Governments, with the assistance of the international community, should
intensify their efforts to improve data collection and analysis, including
gender-based analysis, in the areas of international migration and, in this
context, promote the implementation of the United Nations recommendations on
statistics of international migration; encourage studies designed to assess
the causes of international migration and displacement and the positive
contribution that migration makes to both countries of origin and countries of
destination; and improve understanding of the links between relevant factors
that have an impact on international migration.
 
28.   The international community should channel adequate support to effective
programmes to address the causes of movement of refugees and displaced
persons. 
 
29.   In planning and implementing refugee assistance activities, special
attention should be given to the specific needs of refugee women and children
and elderly refugees. Adequate and sufficient international support should be
extended to meet the basic needs of refugee populations, including the
provision of access to adequate accommodation, education, protection from
violence, health services, including reproductive health and family planning,
and other basic social services, including clean water, sanitation, and
nutrition. Refugees should respect the laws and regulations of their countries
of asylum. Governments are urged to abide by international law concerning
refugees, inter alia, by respecting the principle of non-refoulement. In
acknowledging refugees' rights to repatriation, their return and integration
should be facilitated in cooperation with relevant international
organizations.
 
D.  Internal migration, population distribution and urban agglomerations
 
30.   Governments should carry out research to strengthen the understanding of
the factors, trends and characteristics of internal migration and geographical
distribution of the population in order to provide grounds for the formulation
of effective population distribution policy.
 
31.   Governments should improve the management and delivery of services for
the growing urban agglomerations and put in place enabling legislative and
administrative instruments and adequate financial resources to meet the needs
of all citizens, especially the urban poor, internal migrants, older persons
and the disabled.
 
32.   Governments should strongly reaffirm the call in the Programme of Action
that population distribution policies should be consistent with such
international instruments as the Geneva Convention relative to the Protection
of Civilian Persons in Time of War, of 12 August 1949, including article 49
thereof. 
 
33.   Governments should strongly reaffirm the call in the Programme of Action
that countries should address the causes of internal displacement, including
environmental degradation, natural disasters, armed conflict and forced
resettlement, and establish the necessary mechanisms to protect and assist
displaced persons, including, where possible, compensation for damages,
especially for those who are not able to return to their normal place of
residence in the short term and, where appropriate, facilitate their return
and reintegration, with special attention to the needs of women and children.
 
 
               E.  Population, development and education
 
34.   Governments and civil society, with the assistance of the international
community, should, as quickly as possible, and in any case before 2015, meet
the goal of the International Conference on Population and Development of
achieving universal access to primary education, eliminate the gender gap in
primary and secondary education by 2005 and strive to ensure that by 2010 the
net primary school enrolment ratio for children of both sexes will be at least
90 per cent, compared with an estimated 85 per cent in 2000. Special efforts
should be made to increase the retention rates of girls in primary and
secondary school. Parents should be sensitized to the value of education of
children, particularly of girls, so that the girls do achieve their full
potential.
 
35.   Governments, in particular of developing countries, with the assistance
of the international community, should:
 
   (a)   Expand youth and adult education and lifelong culture- and
gender-sensitive learning polices and programmes, with particular attention to
migrants, indigenous people and people with disabilities;
 
   (b)   Include at all levels, as appropriate, of formal and non-formal
schooling, education about population and health issues, including sexual and
reproductive health issues, in order to implement further the Programme of
Action in terms of promoting the well-being of adolescents, enhancing gender
equality and equity as well as responsible sexual behaviour, and protecting
them from early and unwanted pregnancy, sexually transmitted diseases,
including HIV/AIDS, and sexual abuse, incest and violence; and ensure the
active involvement and participation of parents, youth, community leaders and
organizations for the sustainability, increased coverage and effectiveness of
such programmes;
 
   (c)   Reduce the rate of illiteracy of women and men, at least halving it
for women and girls by 2005, compared with the rate in 1990;
 
   (d)   Promote the achievement of functional literacy for adults as well as
children, where schooling remains unavailable;
 
   (e)   Continue to give high priority to investments in education and
training in development budgets;
 
   (f)   Provide adequately equipped facilities by rehabilitating existing
schools and building new ones.
 
36.   The Programme of Action recognized that greater public knowledge,
understanding and commitment at all levels, from the individual to the
international, are vital to the achievement of its goals and objectives. To
this end, ensuring access to and use of modern communication technology,
including satellite transmission and other communication mechanisms, should be
studied and appropriate action taken as a means to address the barriers to
education in developing countries, in particular, the least developed
countries, with assistance from the international community.
 
 
                F.  Data systems, including indicators
 
37.   Governments, in collaboration with research institutions and
non-governmental organizations, as well as with the assistance of the
international community, including donors, should strengthen national
information systems to produce reliable statistics on a broad range of
population, environment and development indicators in a timely manner. The
indicators should include, inter alia, poverty rates at the community level;
women's access to social and economic resources; enrolment and retention of
girls and boys in schools; access to sexual and reproductive health services
disaggregated by population sub-groups, including indigenous people; and
gender sensitivity in sexual and reproductive health services, including
family planning. In addition, in consultation with indigenous people,
Governments should establish and strengthen national statistics and data
collection concerning the health of indigenous people, including sexual and
reproductive health and their determinants. All data systems should ensure
availability of age- and sex-disaggregated data, which are crucial for
translating policy into strategies that address age and gender concerns and
for developing appropriate age- and gender-impact indicators for monitoring
progress. Governments should also collect and disseminate the quantitative and
qualitative data needed to assess the status of male and female reproductive
health, including in urban areas, and to design, implement, monitor and
evaluate action programmes. Special attention should be given to maternal
mortality and morbidity, as this database remains inadequate. Health and
reproductive health data should be disaggregated by income and poverty status
to identify the specific health profile and needs of people living in poverty
and as a basis for focusing resources and subsidies on those who need them
most.
 
38.   The United Nations system and donors should be specifically urged to
strengthen the capacity of developing countries, particularly the least
developed countries, and those with economies in transition, to undertake
censuses and surveys on a regular basis so as to improve vital registration
systems, and to develop innovative and cost-effective solutions for meeting
data requirements, especially for regular monitoring of the implementation of
the goals of the International Conference on Population and Development,
including improved estimates of maternal mortality.
 
 
        III.  Gender equality, equity and empowerment of women
 
         A.  Promotion and protection of women's human rights
 
39.   Governments should ensure that the human rights of women and girls are
respected, protected and promoted through the development, implementation and
effective enforcement of gender-sensitive policies and legislation.  All
Governments are encouraged to sign, ratify and implement the Convention on the
Elimination of All Forms of Discrimination against Women and are also
encouraged to promote consideration by the Economic and Social Council and the
General Assembly of the Optional Protocol thereto, and interested States
parties are encouraged to work towards removing all existing reservations that
are incompatible with the objective and purpose of the Convention. In the
implementation of the goals of the Programme of Action and those of other
United Nations conferences, measures aimed at promoting and achieving gender
equality and equity in a systematic and comprehensive manner should be
coordinated and harmonized.
 
40.   The implementation of population and development policies by Governments
should continue to incorporate reproductive rights in accordance with
paragraphs 1.15, 7.3 and 8.25 of the Programme of Action.  Governments should
take strong measures to promote the human rights of women. Governments are
encouraged to strengthen, as appropriate, the reproductive and sexual health
as well as the reproductive rights focus on population and development
policies and programmes. The work of relevant United Nations bodies on
indicators for the promotion and protection of the human rights of women
should incorporate issues related to sexual and reproductive health.
Governments should ensure the protection and promotion of the rights of
adolescents, including married adolescent girls, to reproductive health
education, information and care. Countries should establish mechanisms for
consultation with all relevant groups, including women's organizations. In
this context, Governments are urged to incorporate human rights into both
formal and informal education processes.
 
41.   Governments, civil society and the United Nations system should advocate
for the human rights of women and the girl child. Governments, in reporting to
the human rights treaty bodies, are encouraged to consult, as appropriate,
with civil society on and promote civil society awareness of the reporting
process, to ensure the broadest representation in the area of human rights,
including reproductive rights.
 
42.   Governments should promote and protect the human rights of the girl
child and young women, which include economic and social rights as well as
freedom from coercion, discrimination and violence, including harmful
practices and sexual exploitation. Governments should review all legislation
and amend and revoke that which discriminates against the girl child and young
women.
 
 
                     B.  The empowerment of women
 
43.   Governments should establish mechanisms to accelerate women's equal
participation and equitable representation at all levels of the political
process and public life in each community and society and enable women to
articulate their concerns and needs and ensure the full and equal
participation of women in decision-making processes in all spheres of life.
Governments and civil society should take actions to eliminate attitudes and
practices that discriminate against and subordinate girls and women and that
reinforce gender inequality.
 
44.   Governments should take measures to promote the fulfilment of girls' and
women's potential through education, skills development and the eradication of
illiteracy for all girls and women without discrimination of any kind, giving
paramount importance to the elimination of poverty and ill health.
Governments, in collaboration with civil society, should take the necessary
measures to ensure universal access, on the basis of equality between women
and men, to appropriate, affordable and quality health care for women
throughout their life cycle.
 
45.   Governments should take every possible action to remove all gender gaps
and inequalities pertaining to women's livelihoods and participation in the
labour market through the creation of employment with secure incomes, which
has been shown to advance women's empowerment and enhance their reproductive
health.  Legislation ensuring equal pay for equal work or for work of equal
value should be instituted and enforced.
 
 
           C.  Gender perspective in programmes and policies
 
46.   A gender perspective should be adopted in all processes of policy
formulation and implementation and in the delivery of services, especially in
sexual and reproductive health, including family planning. In this regard, the
institutional capacity and expertise of staff in Government, civil society,
including non-governmental organizations, and the United Nations system should
be strengthened in order to promote gender mainstreaming.  This should be done
by sharing tools, methodologies and lessons learned in order to develop and
strengthen their capacity and institutionalize effective strategies for
gender-based analysis and gender mainstreaming. This includes the development
and availability of gender-disaggregated data and appropriate indicators for
monitoring progress at the national level.
 
47.   The differential impact on women and men of globalization of the economy
and the privatization of basic social services, particularly reproductive
health services, should be monitored closely. Special programmes and
institutional mechanisms should be put in place to promote and protect the
health and well-being of young girls, older women and other vulnerable groups.
The provision of services to meet men's reproductive and sexual health needs
should not prejudice reproductive and sexual health services for women.
 
48.   Governments should give priority to developing programmes and policies
that foster norms and attitudes of zero tolerance for harmful and
discriminatory attitudes, including son preference, which can result in
harmful and unethical practices such as prenatal sex selection, discrimination
and violence against the girl child and all forms of violence against women,
including female genital mutilation, rape, incest, trafficking, sexual
violence and exploitation. This entails developing an integrated approach that
addresses the need for widespread social, cultural and economic change, in
addition to legal reforms. The girl child's access to health, nutrition,
education and life opportunities should be protected and promoted. The role of
family members, especially parents and other legal guardians, in strengthening
the self-image, self-esteem and status and in protecting the health and
well-being of girls should be enhanced and supported.
 
              D.  Advocacy for gender equality and equity
 
49.   Governments, parliamentarians, community and religious leaders, family
members, media representatives, educators and other relevant groups should
actively promote gender equality and equity. These groups should develop and
strengthen their strategies to change negative and discriminatory attitudes
and practices towards women and the girl child. All leaders at the highest
levels of policy- and decision-making should speak out in support of gender
equality and equity, including empowerment of women and protection of the girl
child and young women.
 
50.   All leaders at all levels, as well as parents and educators, should
promote positive male role models that make  it easier for boys to become
gender-sensitive adults and enable men to support, promote and respect women's
sexual and reproductive health and reproductive rights, recognizing the
inherent dignity of all human beings. Men should take responsibility for their
own reproductive and sexual behaviour and health. Research should be
undertaken on men's sexuality, their masculinity and their reproductive
behaviour.
 
51.   Governments, donors and the United Nations system should encourage and
support expansion and strengthening of women's grass-roots, community-based
and advocacy groups.
 
 
            IV. Reproductive rights and reproductive health
 
   The present section is especially guided by the principles of the Programme
   of Action.
 
 A.  Reproductive health, including family planning and sexual health
 
52.   Governments, in collaboration with civil society, including
non-governmental organizations, donors and the United Nations system, should:
 
   (a)   Give high priority to reproductive and sexual health in the broader
context of health-sector reform, including strengthening basic health systems,
from which people living in poverty in particular can benefit;
 
   (b)   Ensure that policies, strategic plans and all aspects of the
implementation of reproductive and sexual health services respect all human
rights, including the right to development, and that such services meet health
needs over the life cycle, including the needs of adolescents, address
inequities and inequalities due to poverty, gender and other factors and
ensure equity of access to information and services;
 
   (c)   Engage all relevant sectors, including non-governmental
organizations, especially women's and youth organizations and professional
associations, through ongoing participatory processes in the design,
implementation, quality assurance, monitoring and evaluation of policies and
programmes, in ensuring that sexual and reproductive health information and
services meet people's needs and respect their human rights, including their
right to access to good-quality services;
 
   (d)   Develop comprehensive and accessible health services and programmes,
including sexual and reproductive health, for indigenous communities, with
their full participation, that respond to the needs and reflect the rights of
indigenous people;
 
   (e)   Increase investments designed to improve the quality and availability
of sexual and reproductive health services, including establishing and
monitoring clear standards of care; ensuring the competence, particularly the
technical and communication skills, of service providers; ensuring free,
voluntary and informed choices, respect, privacy, confidentiality and client
comfort; establishing fully functioning logistical systems, including
efficient procurement of necessary commodities; and ensuring effective
referral mechanisms across services and levels of care, taking care that
services are offered in conformity with human rights and with ethical and
professional standards;
 
   (f)   Ensure that sexual and reproductive health programmes, free of any
coercion, provide pre-service and in-service training and supervision for all
levels of health-care providers to ensure that they maintain high technical
standards, including for hygiene; respect the human rights of the people they
serve; are knowledgeable and trained to serve clients who have been subjected
to harmful practices, such as female genital mutilation and sexual violence;
and are able to provide accurate information about the prevention and symptoms
of reproductive tract diseases, as well as about personal hygiene and other
factors in reproductive tract infections, in order to minimize adverse
physical consequences such as pelvic inflammatory disease, infertility and
ectopic pregnancy, as well as psychological consequences;
 
   (g)   Promote men's understanding of their roles and responsibilities with
regard to respecting the human rights of women; protecting women's health,
including supporting their partners' access to sexual and reproductive health
services; preventing unwanted pregnancy; reducing maternal mortality and
morbidity; reducing transmission of sexually transmitted diseases, including
HIV/AIDS; sharing household and child-rearing responsibilities; and promoting
the elimination of harmful practices, such as female genital mutilation, and
sexual and other gender-based violence, ensuring that girls and women are free
from coercion and violence;
 
   (h)   Strengthen community-based services, social marketing and new
partnerships with the private sector while working to ensure that safety,
ethical and other relevant standards are met; and provide subsidies from
public resources and donor funds, as appropriate, to ensure availability and
access for those otherwise unable to access services.
 
53.   Governments, with assistance from the international community, should
develop and use indicators that measure access to and choice of
family-planning and contraceptive methods and indicators that measure trends
in maternal mortality and morbidity and HIV/AIDS and use them to monitor
progress towards the goal of the International Conference on Population and
Development of universal access to reproductive health care.  Governments
should strive to ensure that by 2015 all primary health-care and family
planning facilities are able to provide, directly or through referral, the
widest achievable range of safe and effective family planning and
contraceptive methods; essential obstetric care; prevention and management of
reproductive tract infections, including sexually transmitted diseases; and
barrier methods, such as male and female condoms and microbicides if
available, to prevent infection. By 2005, 60 per cent of such facilities
should be able to offer this range of services, and by 2010, 80 per cent of
them should be able to offer such services.
 
54.   The United Nations system and donors should support Governments in the
building of national capacity to plan, manage, implement, monitor and evaluate
reproductive and sexual health services, including ensuring that all refugees
and all other persons in emergency humanitarian situations, particularly women
and adolescents, receive appropriate health care, including sexual and
reproductive health care and information, and greater protection from sexual
and gender-based violence. They should also ensure that all health workers in
relief and emergency situations are given basic training in sexual and
reproductive health-care information and services.
 
55.   Increased efforts are needed by the United Nations system, with support
from the international community, to develop and agree upon common key
indicators on reproductive health programmes, including, inter alia, family
planning, maternal health, sexual health, sexually transmitted diseases,
HIV/AIDS, and information, education and communication for appropriate
consideration in the relevant intergovernmental process. Bearing in mind the
efforts made by national Governments, the World Health Organization is invited
to take the lead role in this area, in coordination with the United Nations
Children's Fund, the United Nations Population Fund, the United Nations
Development Programme, the Joint and Co-sponsored United Nations Programme on
Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome, the
Department of Economic and Social Affairs of the Secretariat and other
relevant United Nations entities, drawing on other expertise and knowledge as
appropriate. Indicators on maternal and neonatal mortality, maternal morbidity
and maternal health programmes should be given a prominent place, in order to
monitor progress effectively and ensure that priority is given to reproductive
health care in the provision of general health services. The international
community is encouraged to provide financial and technical assistance to
developing countries to improve their capacity-building in terms of
indicators, data collection, monitoring, and evaluation in this field.
 
 
        B.  Ensuring voluntary quality family-planning services
 
56.   Governments, in accordance with the Programme of Action, should take
effective action to ensure the basic right of all couples and individuals to
decide freely and responsibly the number, spacing and timing of their children
and to have the information, education and means to do so.
 
57.   The United Nations system and donors should, upon request, support
Governments in:
 
   (a)   Mobilizing and providing sufficient resources to meet the growing
demand for access to information, counselling, services and follow-up on the
widest possible range of safe, effective, affordable and acceptable family
planning and contraceptive methods, including new options and underutilized
methods; 
 
   (b)   Providing quality counselling services and ensuring ethical,
professional and technical standards of care, as well as voluntary, free and
informed choices in an atmosphere of privacy, confidentiality and respect;
 
   (c)   Strengthening programme management capacity, including logistical
systems, to make services safer, more affordable and more convenient and
accessible to clients and to ensure the availability and continuous supply of
safe and effective contraceptives and other sexual and reproductive health
supplies and, as appropriate, the raw material for them;
 
   (d)   Adequately strengthening social safety nets using resources and funds
and, in the context of primary health care, ensuring the availability of and
access to reproductive health services, including family planning,
particularly for people most affected by poverty, the adverse impact of
structural adjustment policies and financial crises, or otherwise unable to
access services.
 
58.   Where there is a gap between contraceptive use and the proportion of
individuals expressing a desire to space or limit their families, countries
should attempt to close this gap by at least 50 per cent by 2005, 75 per cent
by 2010 and 100 per cent by 2050. In attempting to reach this benchmark,
demographic goals, while legitimately the subject of government development
strategies, should not be imposed on family planning providers in the form of
targets or quotas for the recruitment of clients.
 
59.   Governments, with the increased participation of the United Nations
system, civil society, donors and the private sector, are urged to pursue the
research and development of new, safe, low-cost and effective family-planning
and contraceptive methods, for both men and women, including female-controlled
methods that both protect against sexually transmitted diseases, including
HIV/AIDS, and prevent unwanted pregnancy. All actors must abide by
internationally accepted ethical, technical and safety standards in all
research and development as well as, where appropriate, by applicable
standards in manufacturing practices, quality control and product design,
production and distribution.
 
60.   The international community and the private sector should also take the
necessary measures, particularly in the transfer of technology, as
appropriate, to enable countries, in particular developing countries, to
produce, store and distribute safe and effective contraceptives and other
supplies essential for reproductive health services in order to strengthen the
self-reliance of those countries.
 
61.   The United Nations Population Fund is urged to continue to strengthen
its leadership role within the United Nations system in assisting countries to
take the strategic action necessary to ensure availability of reproductive
health services and choice of reproductive health products, including
contraceptives.
 
 
             C.  Reducing maternal mortality and morbidity
 
62.   Governments, with the increased participation of the United Nations
system, civil society, including non-governmental organizations, donors and
the international community, should:
 
   (a)   Recognize the linkages between high levels of maternal mortality and
poverty and promote the reduction of maternal mortality and morbidity as a
public health priority and reproductive rights concern;
 
   (b)   Ensure that the reduction of maternal morbidity and mortality is a
health sector priority and that women have ready access to essential obstetric
care, well-equipped and adequately staffed maternal health-care services,
skilled attendance at delivery, emergency obstetric care, effective referral
and transport to higher levels of care when necessary, post-partum care and
family planning. In health sector reform, the reduction of maternal mortality
and morbidity should be prominent and used as an indicator for the success of
such reform;
 
   (c)   Support public health education to create awareness of the risks of
pregnancy, labour and delivery and to increase the understanding of the
respective roles and responsibilities of family members, including men, as
well as of civil society and Governments, in promoting and protecting maternal
health;
 
   (d)   Develop appropriate interventions, beginning at birth, to improve the
nutritional, health and educational status of girls and young women, so that
they are better able to make informed choices at maturity about childbearing
and obtain access to health information and services;
 
   (e)   Implement programmes to address the negative impact of environmental
degradation, in some regions, on the high levels of maternal mortality and
morbidity.
 
63.   (i)   In no case should abortion be promoted as a method of family
            planning. All Governments and relevant intergovernmental and
            non-governmental organizations are urged to strengthen their
            commitment to women's health, to deal with the health impact of
            unsafe abortion as a major public-health concern and to reduce the
            recourse to abortion through expanded and improved family planning
            services.  Prevention of unwanted pregnancies must always be given
            the highest priority and every attempt should be made to eliminate
            the need for abortion. Women who have unwanted pregnancies should
            have ready access to reliable information and compassionate
            counselling. Any measures or changes related to abortion within
            the health system can be determined only at the national or local
            level according to the national legislative process. In
            circumstances where abortion is not against the law, such abortion
            should be safe. In all cases, women should have access to quality
            services for the management of complications arising from
            abortion. Post-abortion counselling, education and family planning
            services should be offered promptly, which will also help to avoid
            repeat abortions;
 
   (ii)  Governments should take appropriate steps to help women to avoid
         abortion, which in no case should be promoted as a method of family
         planning, and in all cases provide for the humane treatment and
         counselling of women who have had recourse to abortion;
 
   (iii) In recognizing and implementing the above, and in circumstances where
         abortion is not against the law, health systems should train and
         equip health-service providers and should take other measures to
         ensure that such abortion is safe and accessible. Additional measures
         should be taken to safeguard women's health.
 
64.   In order to monitor progress towards the achievement of the goals of the
International Conference on Population and Development for maternal mortality,
countries should use the proportion of births assisted by skilled attendants
as a benchmark indicator. By 2005, where the maternal mortality rate is very
high, at least 40 per cent of all births should be assisted by skilled
attendants; by 2010 this figure should be at least 50 per cent and by 2015, at
least 60 per cent. All countries should continue their efforts so that
globally, by 2005, 80 per cent of all births should be assisted by skilled
attendants, by 2010, 85 per cent, and by 2015, 90 per cent.
 
65.   In order to have a basis for cost-benefit analysis for interventions
aimed at reducing maternal mortality, the societal costs of maternal deaths
should be calculated. This should be done in cooperation with Governments,
United Nations agencies and development banks, and the research community.
 
66.   The World Health Organization, in cooperation with other relevant United
Nations bodies, is urged to fulfil its leadership role within the United
Nations system in assisting countries, in particular developing countries, to
put in place standards for the care and treatment for women and girls that
incorporate gender-sensitive approaches and promote gender equality and equity
in health-care delivery and to advise on functions that health facilities
should perform to help guide the development of health systems to reduce the
risks associated with pregnancy, taking into consideration the level of
development and the economic and social conditions of countries. At the same
time, United Nations agencies, including the United Nations Population Fund
and the United Nations Children's Fund, and multilateral development banks,
such as the World Bank, should intensify their role in promoting, supporting,
advocating for and investing in action to improve maternal health.
 
D.  Prevention and treatment of sexually transmitted disease, including human
               immunodeficiency virus/acquired immunodeficiency syndrome
 
67.   Governments, from the highest political levels, should take urgent
action to provide education and services to prevent the transmission of all
forms of sexually transmitted diseases and HIV and, with the assistance, where
appropriate, of the Joint and Co-sponsored United Nations Programme on Human
Immunodeficiency Virus/Acquired Immunodeficiency Syndrome, develop and
implement national HIV/AIDS policies and action plans, ensure and promote
respect for the human rights and dignity of persons living with HIV/AIDS,
improve care and support for people living with HIV/AIDS, including support
services for home-based care, and take steps to mitigate the impact of the
AIDS epidemic by mobilizing all sectors and segments of society to address the
social and economic factors contributing to HIV risk and vulnerability.
Governments should enact legislation and adopt measures to ensure
non-discrimination against people living with HIV/AIDS and vulnerable
populations, including women and young people, so that they are not denied the
information needed to prevent further transmission and are able to access
treatment and care services without fear of stigmatization, discrimination or
violence.
 
68.   Governments should ensure that prevention of and services for sexually
transmitted diseases and HIV/AIDS are an integral component of reproductive
and sexual health programmes at the primary health-care level.  Gender,
age-based and other differences in vulnerability to HIV infection should be
addressed in prevention and education programmes and services. Governments
should develop guidelines for HIV treatment and care, emphasizing equitable
access, and for wide provision of and access to voluntary HIV testing and
counselling services, and should ensure wide provision of and access to female
and male condoms, including through social marketing. Advocacy and
information, education and communication campaigns developed with communities
and supported from the highest levels of Government should promote informed,
responsible and safer sexual behaviour and practices, mutual respect and
gender equity in sexual relationships. Special attention needs to be given to
preventing sexual exploitation of young women and children. Given the enhanced
susceptibility to HIV/AIDS of individuals infected by conventional and
treatable sexually transmitted diseases and the high prevalence of such
diseases among young people, priority must be given to the prevention,
detection, diagnosis and treatment of such infections. Governments should
immediately develop, in full partnership with youth, parents, families,
educators and health-care providers, youth-specific HIV education and
treatment projects, with special emphasis on developing peer-education
programmes.
 
69.   While one of the most important interventions to reduce HIV infections
in infants is primary prevention of infection, Governments should also scale
up, where appropriate, education and treatment projects aimed at preventing
mother-to-child transmission of HIV. Anti-retroviral drugs, where feasible,
should be made available to women living with HIV/AIDS during and after
pregnancy as part of their ongoing treatment of HIV/AIDS and provide
infant-feeding counselling for mothers living with HIV/AIDS so that they can
make free and informed decisions.
 
70.   Governments, with assistance from the Joint and Co-sponsored United
Nations Programme on Human Immunodeficiency Virus/Acquired Immunodeficiency
Syndrome and donors, should, by 2005, ensure that at least 90 per cent, and by
2010 at least 95 per cent, of young men and women aged 15 to 24 have access to
the information, education and services necessary to develop the life skills
required to reduce their vulnerability to HIV infection. Services should
include access to preventive methods such as female and male condoms,
voluntary testing, counselling and follow-up. Governments should use, as a
benchmark indicator, HIV infection rates in persons 15 to 24 years of age,
with the goal of ensuring that by 2005 prevalence in this age group is reduced
globally, and by 25 per cent in the most affected countries, and that by 2010
prevalence in this age group is reduced globally by 25 per cent.
 
71.   The private and public sectors should increase investments in research
on the development of microbicides and other female-controlled methods,
simpler and less expensive diagnostic tests, single-dose treatments for
sexually transmitted diseases and vaccines. Governments, in particular of
developing countries, with the support of the international community, should
strengthen measures to improve generally the quality, availability and
affordability of care of people living with HIV/AIDS.
 
72.   In accordance with its mandate, the Joint and Co-sponsored United
Nations Programme on Human Immunodeficiency Virus/Acquired Immunodeficiency
Syndrome should be provided with financial resources in order to do the utmost
to ensure a well-coordinated response from the United Nations system to the
HIV/AIDS pandemic and to provide support to national programmes, particularly
in developing countries.
 
                            E.  Adolescents
 
73.   Governments, with the full involvement of young people and with the
support of the international community, should, as a priority, make every
effort to implement the Programme of Action in regard to adolescent sexual and
reproductive health, in accordance with paragraphs 7.45 and 7.46 of the
Programme of Action, and should:
 
   (a)   In order to protect and promote the right of adolescents to the
enjoyment of the highest attainable standards of health, provide appropriate,
specific, user-friendly and accessible services to address effectively their
reproductive and sexual health needs, including reproductive health education,
information, counselling and health promotion strategies. These services
should safeguard the rights of adolescents to privacy, confidentiality and
informed consent, respecting their cultural values and religious beliefs and
in conformity with relevant existing international agreements and conventions;
 
   (b)   Continue to advocate for the protection and promotion of and support
for programmes for adolescent health, including sexual and reproductive
health; identify effective and appropriate strategies to achieve this goal;
and develop gender- and age-based indicators and data systems to monitor
progress;
 
   (c)   Develop at national and other levels, as appropriate, action plans
for adolescents and youth, based on gender equity and equality, that cover
education, professional and vocational training and income-generating
opportunities. Such programmes should include support mechanisms for the
education and counselling of adolescents in the areas of gender relations and
equality, violence against adolescents, responsible sexual behaviour,
responsible family planning practices, family life, reproductive health,
sexually transmitted diseases, HIV infection and AIDS prevention, in
accordance with paragraph 7.47 of the Programme of Action.  Adolescents and
youth themselves should be fully involved in the design and implementation of
such information and services, with proper regard for parental guidance and
responsibilities. Special attention should be devoted to vulnerable and
disadvantaged youth;
 
   (d)   Acknowledge and promote the central role of families, parents and
other legal guardians in educating their children and shaping their attitudes
and ensure that parents and persons with legal responsibilities are educated
about and involved in providing sexual and reproductive health information, in
a manner consistent with the evolving capacities of adolescents, so that they
can fulfil their rights and responsibilities towards adolescents;
 
   (e)   With due respect for the rights, duties and responsibilities of
parents and in a manner consistent with the evolving capacities of the
adolescent and their right to reproductive health education, information and
care, and respecting their cultural values and religious beliefs, ensure that
adolescents, both in and out of school, receive the necessary information,
including information on prevention, education, counselling and health
services to enable them to make responsible and informed choices and decisions
regarding their sexual and reproductive health needs, in order, inter alia, to
reduce the number of adolescent pregnancies. Sexually active adolescents will
require special family planning information, counselling and health services,
as well as sexually transmitted diseases and HIV/AIDS prevention and
treatment. Those adolescents who become pregnant are at particular risk and
will require special support from their families, health-care providers and
the community during pregnancy, delivery and early childcare. This support
should enable these adolescents to continue their education. Programmes should
involve and train all who are in a position to provide guidance to adolescents
concerning responsible sexual and reproductive behaviour, particularly parents
and families, and also communities, religious institutions, schools, the mass
media and peer groups. These policies and programmes must be implemented on
the basis of commitments made at the International Conference on Population
and Development and in conformity with relevant existing international
agreements and conventions;
 
   (f)   Countries should ensure that programmes and attitudes of health-care
providers do not restrict the access of adolescents to appropriate services
and the information they need, including for the prevention and treatment of
sexually transmitted diseases, HIV/AIDS and sexual violence and abuse.
Countries should, in this context, and in the context of paragraph 73 (e) of
the present document, where appropriate, remove legal, regulatory and social
barriers to reproductive health information and care for adolescents.
 
74.   Recognizing the growing and special needs of youth and adolescents,
including reproductive and sexual health issues, and taking into account the
special situations they face, the United Nations system and donors should
complement Governments' efforts to mobilize and provide adequate resources to
respond to those needs.
 
75.   Governments, in consultation with national non-governmental
organizations, including youth organizations where applicable, and with the
required assistance of United Nations agencies, international non-governmental
organizations and the donor community, should evaluate programmes and document
experiences and develop data-collection systems to monitor progress, and
widely disseminate information about the design and functioning of programmes
and their impact on young people's sexual and reproductive health. United
Nations agencies and donor countries should support regional and international
mechanisms for sharing those experiences among all countries, especially among
developing countries.
 
 
                  V.  Partnerships and collaborations
 
76.   Governments are encouraged, in dialogue with non-governmental
organizations and local community groups, and in full respect for their
autonomy, to facilitate, as appropriate, the involvement of civil society at
the national level in policy discussions and in the formulation,
implementation, monitoring and evaluation of strategies and programmes to
achieve Programme of Action objectives. Partnerships between Governments and
multilateral and donor agencies and civil society need to be based, as
appropriate, on delivering agreed outcomes that bring benefits to poor
people's health, including reproductive and sexual health.
 
77.   Governments, where appropriate, should include representatives of
non-governmental organizations and local community groups in country
delegations to regional and international forums where issues related to
population and development are discussed.
 
78.   Governments, civil society at the national level and the United Nations
system should work towards enhancing and strengthening their collaboration and
cooperation, with a view to fostering an enabling environment for partnerships
for the implementation of the Programme of Action. Governments and civil
society organizations should develop systems for greater transparency and
information-sharing, so as to improve their accountability.
 
79.   Governments are encouraged to recognize and support the important and
complementary role that civil society at the national level can play towards
changing attitudes and actions for further implementation of the Programme of
Action.
 
80.   Governments are also encouraged to recognize and support the important
and complementary role that civil society at the national level can play in
helping communities to articulate and meet their needs for health care,
including reproductive health care.
 
81.   Governments and international organizations should create and support
mechanisms to build and sustain partnerships with community-based
organizations and non-governmental organizations committed to assisting women
to establish and realize their rights, including those that relate to
reproductive and sexual health, as well as other relevant organizations, the
research community and professional organizations. Governments, civil society
at the national level and the international community should together focus on
human resources development and on building and strengthening national
capacity to implement sustainable population and reproductive health
programmes.
 
82.   Governments and civil society organizations, where appropriate, are
encouraged to design innovative approaches and build partnerships with, among
others, the media, the commercial sector, religious leaders, local community
groups and leaders, as well as youth, which can serve as effective advocates
for the achievement of the goals and objectives of the Programme of Action.
 
83.   With reference to paragraph 15.10 of the Programme of Action,
Governments, international organizations and donors are encouraged to provide,
in accordance with national laws and regulations and national development
priorities, adequate financial and technical resources and information to
build the human resources, institutional capacity and sustainability of civil
society organizations, particularly women's and youth groups, in a manner not
compromising their full autonomy, to facilitate their active involvement in
the research, design, implementation, monitoring and evaluation of national
population and development policies, programmes and activities. Like
Governments, civil society organizations should also put in place transparency
and accountability mechanisms to ensure that programme implementation is
directly targeted to, and funds are used effectively for, national population
and development programmes, as well as activities, services and evaluation
procedures.
 
84.   Governments, international organizations and civil society organizations
at the national level, including non-governmental organizations, should
encourage partnerships with the private and, where appropriate, the informal
sector to strengthen their engagement and collaboration in the implementation
of the Programme of Action. The private sector may assist the efforts of
Governments, but it cannot substitute for the Government's responsibility to
ensure and provide quality, full, safe, accessible, affordable and convenient
health services, including reproductive health, family planning and sexual
health services. Governments are encouraged to review relevant national laws,
standards and regulations, as appropriate, to facilitate private-sector
involvement and to seek to ensure that all health-care products and services,
including reproductive health products and services, meet internationally
accepted standards.
 
85.   Implementation of key elements of the Programme of Action must be tied
closely to a broader strengthening of health systems. The public sector plays
an important role in this regard and should be encouraged to define its role
and to work more closely with the private and informal sectors to monitor and
improve standards and to ensure that services are available and that their
delivery is of good quality and affordable.
 
86.   Recognizing its increasing role in providing reproductive health
information, education, services and commodities, the private sector should
ensure that its services and commodities are of high quality and meet
internationally accepted standards; that its activities are conducted in a
socially responsible, culturally sensitive, acceptable and cost-effective
manner; that it fully respects various religions, ethical values and cultural
backgrounds of each country's people; and that it adheres to basic rights
recognized by the international community and recalled in the Programme of
Action.
 
87.   Parliamentarians and members of national legislatures are invited to
ensure the legislative reform and expanded awareness-raising necessary for
implementing the Programme of Action. They are encouraged to be advocates for
the implementation of the Programme of Action, including through the
allocation, as appropriate, of financial resources. There should be regular
exchanges of experiences among parliamentarians at the subregional, regional,
interregional and international levels, where appropriate.
 
88.   External funding and support, from donor countries as well as the
private sector, should be provided to promote and sustain the full potential
of South-South cooperation, including the South-South initiative "Partners in
Population and Development", in order to bolster the sharing of relevant
experiences, and the mobilization of technical expertise and other resources
among developing countries. Updated information on institutions and expertise
available within developing countries in the area of population and
development, including reproductive health, should be compiled and
disseminated.
 
89.   All relevant bodies and entities of the United Nations system should
continue to clarify, within existing mechanisms, their specific leadership
roles and responsibilities and continue to strengthen their efforts to promote
system-wide coordination and collaboration, especially at the country level.
The intergovernmental work of the Commission on Population and Development
should be reinforced, as should also the inter-agency coordination role of the
United Nations Population Fund, in the field of population and reproductive
health.
 
90.   Governments, civil society organizations at the national level and the
United Nations system are urged to consult youth organizations in the design,
implementation and evaluation of policies and programmes for youth.
 
 
                       VI.  Mobilizing resources
 
91.   Increased political will from all Governments and reaffirmation of the
commitment for mobilization of international assistance, as was agreed at
Cairo, are urgently needed to accelerate the implementation of the Programme
of Action which, in turn, will contribute to the advancement of the broad
population and development agenda.
 
92.   All developed countries are urged to strengthen their commitment to the
goals and objectives of the Programme of Action, in particular its cost
estimates, and to make every effort to mobilize the agreed estimated financial
resources required for its implementation; in so doing, the needs of least
developed countries should receive priority.
 
93.   All developing countries and countries with economies in transition are
urged to strengthen their commitment to the goals and objectives of the
Programme of Action, in particular its cost estimates, and to continue to make
efforts to mobilize domestic resources. Developing and developed countries and
countries with economies in transition are urged to promote international
cooperation and to increase technical cooperation and transfer of technology
through South-South cooperation, in order to implement fully the Programme of
Action.
 
94.   Donor countries and international funding agencies are urged to support
the inclusion of South-South components in development cooperation programmes
and projects so as to promote cost-effectiveness and sustainability.
 
95.   Translation of commitment to the goals of the International Conference
on Population and Development into commensurate levels of donor funding has
not been forthcoming, and there is an urgent need for donor countries to renew
and intensify efforts to meet the need for complementary external resources
required to implement the costed elements of the Programme of Action, namely,
in 1993 United States dollars, $5.7 billion in 2000, $6.1 billion in 2005,
$6.8 billion in 2010 and $7.2 billion in 2015. Donor countries are also urged
to increase significantly official development assistance funding for other
elements of the Programme of Action as contained in chapter XIII thereof, in
particular, improvement in the status and empowerment of women, basic health
care and education, emerging and continued health challenges, such as malaria
and other diseases identified by the World Health Organization as having a
major impact on health, including those having the highest mortality and
morbidity rates; and to intensify efforts to help countries to eradicate
poverty. Donor countries are therefore urged to take the necessary action to
reverse the current decline in overall official development assistance and
should strive to fulfil the agreed target of 0.7 per cent of gross national
product for overall official development assistance as soon as possible.
 
96.   With full regard to their respective jurisdiction and mandates,
legislators and other decision makers are encouraged to undertake measures to
increase support for achieving the goals and objectives of the Programme of
Action through legislation, advocacy and expanded awareness-raising and
resource mobilization. Advocacy efforts should be increased at all levels,
both national and international, to ensure that the resource goals are met.
 
97.   Since the HIV/AIDS pandemic is having a more severe impact than was
originally projected, special attention should be given to providing promptly
the necessary resources, as has been called for in the Programme of Action,
for the prevention of sexually transmitted diseases and HIV. Particular
attention should be given to vulnerable populations, especially children and
young people. All countries affected by the pandemic must continue to make
efforts to mobilize domestic resources from all sources in order to combat it.
The international community is called upon to assist developing countries and
countries with economies in transition in their efforts. Additionally,
Governments and the donor community should intensify efforts to provide
resources for care and support to those affected by HIV/AIDS and for
specialized prevention needs.
 
98.   The international community should provide the necessary financial and
technical assistance to support developing countries and countries with
economies in transition committed to implementing the goals and objectives of
the Programme of Action. Special attention should be paid to the needs of
Africa and the least developed countries, countries facing or suffering from
emergency humanitarian situations and financial and economic crises, and those
developing countries suffering from low commodity prices, as well as countries
facing long-term and large-scale environmental problems.
 
99.   Donor countries and international funding agencies, including the World
Bank and the regional development banks, are urged to complement, at the
request of countries, the domestic efforts made to meet the growing and urgent
basic health and reproductive health needs, including reproductive health
commodities, of the developing and the least developed countries, countries
facing increasing demands for such commodities and a diminishing share of
international assistance and countries with economies in transition.
 
100.  Governments and the international community should encourage and promote
additional ways and mechanisms to increase funding for population and
development programmes, including sexual and reproductive health programmes,
in order to ensure their sustainability. These could include, as appropriate:
(a) advocacy for increased funding from international financial institutions
and regional development banks; (b) selective use of user fees, social
marketing, cost-sharing and other forms of cost recovery; and (c) increased
involvement of the private sector. These modalities should facilitate access
to services and should be accompanied by adequate social safety net measures
to promote access to services by those living in poverty and other members of
vulnerable groups. Consideration should also be given to more efficient and
coordinated mechanisms to address the debt problem, including the reduction of
the burden of external debt through various measures such as debt cancellation
and debt swaps for population, health and other social sector investment to
promote sustainable development.
 
101.  Governments of recipient countries are encouraged to ensure that public
resources, subsidies and assistance received from international donors for the
implementation of the goals and objectives of the Programme of Action are
invested to maximize benefits to the poor and other vulnerable population
groups, including those who suffer disproportionately from reproductive ill
health.
 
102.  Utilizing existing coordinated mechanisms at the national level, as
appropriate, donor countries, international agencies and recipient countries
should continue to strengthen their efforts and their collaboration, so as to
avoid duplication, identify funding gaps and ensure that resources are used as
effectively and efficiently as possible.
 
103.  Governments, in cooperation with the United Nations Population Fund as
appropriate, should seek to ensure full and regular monitoring of resource
flows, paying particular attention to transparency and accountability for the
costed population and reproductive health package included in the Programme of
Action.  Non-governmental organizations may provide the necessary information,
as appropriate, in this regard.
 
104.  Countries, especially developed countries, are urged to increase
substantially their voluntary contribution to the United Nations Population
Fund, as well as to other relevant United Nations programmes and specialized
agencies, so that they will be in a better position to assist countries to
implement further the goals and objectives of the Programme of Action,
including reproductive health programmes.
 
105.  Governments of developed and developing countries are encouraged to give
thorough consideration to the implementation of the 20/20 initiative, a
voluntary compact between interested donor and recipient countries, which can
provide increased resources for broader poverty eradication objectives,
including population and social sector objectives.
 
106.  Governments should implement policies that facilitate increased access
to basic health services, including high-quality and affordable reproductive
health and family planning services; promote effective interventions and
support services, including private sector services, as appropriate; set
standards for service delivery; and review legal, regulatory and import
policies to identify and eliminate those policies that unnecessarily restrict
or prevent the greater involvement of the private sector. Public sector
resources and subsidies should have as a priority people living in poverty,
under-served populations and low-income sectors of the population.