UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)
|
| UN Population Division, Department of Economic and Social Affairs, with support from the UN Population Fund (UNFPA) |
|
Dispatches: News from UNFPA
Number 9, September 1996
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This document is published and made available in electronic
format by the Information and External Relations Division, United
Nations Population Fund (UNFPA), 220 East 42nd Street, New York,
NY 10017, USA. (212) 297-5020. For further information, contact:
Jessica Jiji, jiji@unfpa.org, or Hugh O'Haire, ohaire@unfpa.org.
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SADIK MARKS SECOND ANNIVERSARY OF ICPD
Dr. Nafis Sadik delivered the following message on 5 September --
two years after the historic International Conference on
Population and Development (ICPD) opened in Cairo:
"It is now exactly two years since the International Conference
on Population and Development opened in Cairo. The ten days of
the Conference saw the most intense and exciting international
debate ever held on the question of population and development.
It was the culmination of three years of preparation which
involved consultation with governments at all levels, but also
with a very broad spectrum of non-governmental organizations,
especially women's groups; parliamentarians and other important
policy makers at all levels; and many thousands of concerned
individuals. This inclusive and exhaustive process made possible
the Programme of Action adopted at the Cairo Conference, and
opened the way for agreement on these issues at the Social Summit
and the Fourth World Conference on Women in 1995.
"Today all countries accept that integration of population
questions in development is an intrinsic element of national
policy, and that it will be essential for our common aim of
sustained and sustainable development. The global community
recognizes that prospects for a viable future depend on how well
we attend to the rights and needs of individuals.
"Policies and programmes today are based on agreement on the need
for individual empowerment, and in particular empowering and
educating women, safeguarding their reproductive and sexual
health, and enabling couples and individuals to make free and
informed choices about childbearing. Both women and men have the
right to reproductive health: for women reproductive rights are
the basis of empowerment. Free and informed choice will certainly
result in smaller families, and thus will help eventually to
stabilize population growth and secure sustainable development.
In this area, global and national needs coincide with personal
rights and interests.
"This consensus should drive all development work, and hence all
political and economic decision-making, in the years ahead. It
recognizes that culture and society help to determine fertility
behaviour. In the past, women were valued only for their
reproductive role, family decisions were typically made by men,
and fertility was often used as a means to control women. Lack of
support in pregnancy and childbirth was an indicator of the low
value placed on women's lives.
"This is still true in too many places. But today, many countries
have learned by experience that the most effective approach to
personal empowerment and national development alike is to provide
an enabling environment in which both women and men can make
informed and free decisions for themselves. They are challenging
attitudes and norms that favour boys over girls, even before
birth. They are extending and expanding education and health
care. They are paying special attention to reproductive health
care, including family planning and sexual health services and
information, for both women and men. They are striving to get
more girls into school and enable them to stay there, and to
increase literacy among adult women. They are expanding economic
opportunities so that women can take advantage of their new
freedom. They aim to give women greater access to productive
resources, and to remove legal and cultural barriers to their
full and equal participation in society. And they are encouraging
men to support women's advancement and to take greater
responsibility for their own reproductive behaviour.
"UNFPA has made ICPD implementation the central focus of its
work. A key aspect of this is encouraging countries to commit
sufficient of their own resources to support reproductive health,
including family planning and sexual health.
"To implement the ICPD Programme of Action, $17 billion will be
needed annually by the year 2000. Developing countries themselves
will provide two thirds of this total: but the industrial
countries have also agreed to do their part. The ICPD Programme
of Action calls on donors to provide one third of the resources
necessary for implementation. This represents an increase from
their previous one-fifth share, and a sizeable expansion in
absolute terms. The $5.7 billion needed by 2000 in the form of
international assistance is an ambitious goal, but it is a
realistic one. It is an indispensable investment in the future.
"While a number of industrial countries have made good their
pledge in Cairo and have significantly increased their support of
reproductive health and population programmes since the ICPD,
others have not yet done so. The whole world took part in shaping
the Cairo consensus: now the whole world must take part in
implementing it.
"The conferences in Cairo and Beijing showed us what we must do
to provide women and men alike with the means to gain control of
their own lives. The enthusiasm with which governments and
non-governmental organizations alike are adopting the ICPD
approach gives us every reason to believe we will succeed."
* ** *
UNFPA/DPI LAUNCH RADIO SERIES ON POPULATION AND DEVELOPMENT
"Our boys and girls do not know about themselves. They don't know
about their reproductive systems...They sometimes tell each other
that if you have sexual intercourse while you are standing, or in
a river... or if after having sexual intercourse you take a
number of capsules or aspirins you won't be pregnant."
This is the voice of youth organizer Annie Nkumba of Malawi,
describing misconceptions which know no geographic, racial,
cultural or class boundaries. But she has found a solution to
enlighten young people: having women teach young women about the
male reproductive system while males teach young men about the
female reproductive system. Her story, and many others, are
featured in "Population and Development", a 108-part series of
15-minute radio programmes recently launched by UNFPA in
cooperation with the United Nations Department of Public
Information (DPI).
Ayman El-Amir, Chief of DPI's Radio Division, explained that the
radio series was produced based on the understanding that the
Cairo Programme of Action must be implemented at the grass-roots
level if it is to succeed, since people, not governments, are its
agents and its beneficiaries. In light of that, Mr. El-Amir
instructed producers to speak not only to policy-makers, but also
to people on the ground about their population and development
needs.
This approach allowed producers to tackle a range of subjects,
such as family planning, maternal and child health care,
immigration patterns and sexually transmitted diseases, from the
perspective of their impact on the lives of citizens, community
leaders, doctors, teenaged mothers, and even children. "We hope
that by producing these programmes, their experiences will become
shared experiences. Sometimes people in a given culture feel that
their problems are unique, but through listening to the radio
series, they can benefit from the experience of others facing
those same problems," said Mr. El-Amir.
The programmes, which are produced in Arabic, English, French,
Spanish, Swahili and Hindi, are currently being received by 690
broadcasters in 132 countries around the world. All programmes
are available free of charge. For more information, please write
to UN Radio Special Series on Population and Development, Radio
Section, Room S-850C, United Nations Secretariat, New York, N.Y.
10017, or call (212) 963-6957. The fax number is (212) 963-1307.
* ** *
ECOSOC: NEED FOR ACCELERATED RESPONSE TO ICPD
At its annual summer session, the Economic and Social Council
emphasized the need to mobilize additional financial resources
for reproductive rights and reproductive health programmes as
called for in the Cairo Programme of Action. In her address to
the Council, UNFPA Executive Director Dr. Nafis Sadik said that
while there had been a positive response to the call for funding
the ICPD and other conferences, the resources currently available
were not enough. Recalling that the Programme of Action called on
donors to contribute $5.7 billion by the year 2000, she said, "We
still have three more years to go -- I hope that that figure will
be reached."
The need to secure adequate and predictable resources for
operational activities for development was a pervasive theme
throughout the Council's session. Speaking during the annual
high-level policy dialogue, Rubens Ricupero, the
Secretary-General of the United Nations Conference on Trade and
Development (UNCTAD) told the Council that official development
assistance (ODA) had reached its lowest level in 20 years.
Echoing the concerns expressed by many about budget cuts in
development assistance, Mr. Ricupero quoted the Managing Director
of the International Monetary Fund, Michel Camdessus, who said,
"I am happy that President Clinton... acknowledged that cuts in
ODA were not necessary in order to balance the U.S. budget. This
is a remark that is everywhere true and must be heard."
Numerous speakers joined in calling for adequate resources to
implement the Programme of Action. Among them was Cecilia B.
Rebong of the Philippines, who made a direct plea for reaching
the goals set in Cairo: "I would like again to remind all the
members of the international community, especially the developed
countries, to remember the commitments they undertook at the ICPD
conference... We call on the developed countries to complement
the national financial efforts of developing countries in
population and development, and to intensify their efforts to
transfer new and additional resources to the developing
countries." Dr. Sadik concurred, adding that "we need to mobilize
resources at the domestic level and at the international level."
* ** *
ECOSOC ACTION ON NGOS LONG SUPPORTED BY UNFPA
The Economic and Social Council adopted a resolution on
arrangements for consultation with non-governmental organizations
(NGOs) and recommended that the General Assembly give
consideration to the participation of those organizations in all
areas of the work of the United Nations.
The revised arrangements provide definitions of the various
levels of status accorded to NGOs: general consultative status,
special consultative status and roster status. NGOs in
consultative status will have access to UN libraries as well as
accommodation for conferences or smaller meetings, seating
arrangements, and facilities for obtaining documents.
A working group began drafting the resolution in 1993. UNFPA,
which has a long history of advocating for expanded cooperation
with NGOs, participated actively in the working group's meetings
since the first session, when the Fund's representative pointed
out that NGOs have competence not only at the global but also at
the regional, national and local levels.
The UNFPA was particularly concerned, in the drafting of the
revised arrangements, with the section covering NGO accreditation
to UN conferences. The ICPD marked a watershed for NGOs because
of their active involvement in the Conference as representatives
on government delegations. This was prompted by the urging of
UNFPA Executive Director Dr. Sadik, who stressed the important
role played by NGOs in implementing national population and
development strategies, and called on governments to include NGOs
on their official delegations to the Cairo Conference.
The UNFPA spends, on average, more than 10 per cent of its
annual project budget for NGO-executed activities. In 1993, 13.4
percent of the budget, amounting to $21.3 million, was executed
by NGOs.
* ** *
GROUP OF 7 SUMMIT IN LYON CALLS FOR NEW GLOBAL PARTNERSHIP
Meeting in Lyon from 27 to 29 June, leaders of the Group of
Seven most industrialized countries called for a new global
partnership for development for the 21st century. They said that
the multilateral development institutions play an important role
in promoting development and encouraging the developing countries
to reduce poverty, implement sound economic policies and improve
capacity. The multilateral development institutions "must be
provided with sufficient and appropriate financial resources for
this purpose."
The G-7 communique calls for more explicit priority for
sustainable development and the alleviation of poverty,
specifying that "this should mean adequate ODA funding of all
essential sectors such as health and education..." In order to
enhance the effectiveness of multilateral development
institutions, the Group of Seven leaders recommend, among others,
that the timetable for approval of UNDP, UNFPA and UNICEF country
programmes should be harmonized. Their communique further states
that regular meetings of donors in each country should be
organized to facilitate the exchange of information and the
shaping of programmes according to the comparative advantages of
each institution.
* ** *
UNFPA PARTICIPATES IN VANCOUVER GLOBAL CONFERENCE ON AIDS
Remarkable progress has been made in reducing the spread of HIV
in some developing countries and certain populations in
industrialized countries, concluded a UNFPA-cosponsored symposium
at the XI International Conference on AIDS, held in Vancouver in
July. The symposium, which dealt with "The Status and Trends of
the Global HIV/AIDS Pandemic", was convened from 5 to 6 July.
The symposium was to review epidemiological and behavioural
patterns; identify the specific data needs for monitoring and
forecasting; and produce a consensus report on the matter. Ten
regional teams composed of 55 leading epidemiologists as well as
public health and development specialists from around the world
collected and analysed data and information in their region prior
to the symposium. Regional working group sessions were held by
each team. A plenary discussion was then held on each region and
conclusions were drawn for the final report.
The symposium found that HIV incidence has declined in young men
in Thailand. Impressive declines have been reported in homosexual
men in the United States, Australia, Canada and Western Europe. A
decline in prevalence has also been observed in young women in
Uganda. The fact that HIV prevalence has remained low in
injecting drug users in a number of countries was attributed to
education and prevention programmes.
Despite such welcome developments, participants found that the
HIV epidemic continues to expand in most developing countries, as
well as those European countries undergoing political stress and
upheaval. The spread in developing countries is especially
dramatic among young adults, adolescents and children. In a
number of industrialized countries, the spread of HIV is
increasing rapidly in minority populations. In many countries,
the proportion of infected women is now roughly equal to that of
men. Globally, heterosexual transmission continues to rise.
Extensive commercial sex industry, high prevalence of sexually
transmitted diseases and injecting drug use provide the potential
for explosive epidemics in several States, including Indonesia,
China and several countries in West Africa and Eastern Europe. In
India, Cambodia and Myanmar, the explosion has already occurred.
Different strains of the virus, differences in modes of
transmission and differences in affected populations have made
the HIV pandemic a series of multiple epidemics. Care and support
for people living with HIV/AIDS continues to be grossly
inadequate, especially in developing countries and among
disenfranchised populations in developed countries.
The symposium's final report calls for improvements in the
collection and analysis of surveillance data, including
epidemiological, behavioural and socio-economic data. Prevention
efforts should focus on women, young adults and adolescents, and
marginalized communities. Special attention must be given to
explosive epidemics in India, Cambodia and South Africa as well
as countries and regions with the potential for explosive
epidemics.
The report also recommends that close linkages be forged at the
local, national and global levels among epidemiologists,
behavioural scientists, public health specialists, HIV/AIDS
workers and non-governmental and private voluntary organizations
in order to improve prevention and care efforts and to monitor
trends. "The observed epidemic trends require continuous
improvement of policy commitment and an increase in mobilization
of financial resources for prevention and care efforts at the
local, national and international levels," the report concludes.
"AIDS affects all of us. We have to care for people living with
HIV/AIDS, comfort the bereaved, work for prevention and seek a
cure." This was one of several messages vividly transmitted
through an "AIDS clock" set up by UNFPA at the Vancouver
Conference. Visitors and delegates to the Conference were drawn
to the clock, where they viewed a compelling display combining a
clock ticking up infections (at 5 per minute) with a collage of
glimpses of life in the age of HIV/AIDS. "We Can Stop the Clock"
was the exhibit's central theme. The clock, produced by UNFPA for
UNAIDS (the Joint and Cosponsored UN Programme on AIDS) will be
on display in London, Geneva and New York later in the year.
* ** *
NEW STUDIES ON CERVICAL CANCER UNDERLINE NEED FOR REPRODUCTIVE
HEALTH SERVICES
Scientific studies on the role of the HPV virus in cervical
cancer are giving greater urgency to UNFPA's work in the area of
providing basic reproductive health services for all. Chronic
infection with certain types of human papillomavirus (HPV) has
been identified as the major cause of cervical cancer, of which
an estimated 500,000 new cases being diagnosed each year
worldwide, according to the World Health Organization (WHO).
Results from two studies published on 7 July in the Journal of
the National Cancer Institute support the hypothesis that male
carriers of HPV may play an important role in the development of
cervical cancer in their wives. The studies, carried out by Drs.
Nubia Munoz and F. Xavier Bosch at the International Agency for
Research on Cancer, were conducted with colleagues in Spain,
Colombia and the United States.
These results, according to the WHO, carry important
implications for the prevention of cervical cancer, which is the
second most common cancer in women worldwide, and by far the most
common in developing countries, where cervical cancer screening
programmes cannot be organized for lack of funds and qualified
personnel.
The HPV virus is sexually transmitted, causing warts in its
active state. Often, those warts go undetected in asymptomatic
women, who cannot observe the subtle changes on their cervix or
vaginal wall which are caused by the virus.
The Programme of Action adopted at the ICPD recommends
intensified efforts to prevent, detect and treat sexually
transmitted diseases. The annual cervical smear test is a
powerful tool in meeting this challenge, as it serves to reveal
cell dysplasia and alert doctors to the possibility of HPV
infection. In light of new evidence on the link between HPV and
cervical cancer, women exposed to HPV should have twice-yearly
cervical smear tests so that if cancer should occur, it will be
detected in its early stage when prospects for full recovery are
optimal.
As the Cairo Programme of Action notes, "For women, the symptoms
of infection from sexually transmitted diseases are often hidden,
making them more difficult to diagnose than in men, and the
health consequences are often greater, including increased risk
of infertility and ectopic pregnancy."
* ** *
WORLD POPULATION DAY COMMEMORATED ON 11 JULY
World Population Day was observed on 11 July this year with
special events on the theme of combatting the spread of HIV/AIDS
through reproductive health care and community and individual
responsibility. The Day was marked by more than 100 countries, as
well as institutions, non-governmental and private organizations.
Many national television systems and local stations broadcast
"Changing Places", a 19-minute video produced and distributed by
the UNFPA. Based on the 1996 State of World Population Report, it
illustrates the effects of global urbanization as seen through
the lives of women in Bangkok, Mexico City and Vancouver. In
addition, the UNFPA has produced and distributed brochures on the
Day, briefing kits on population issues, and population posters.
In Ghana, Dr. Sadik's message was read out on her behalf by the
country's UNFPA representative, Teferi Seyoum. The Minister of
Health, Dr. Eunice Brookman-Amissah, responded on behalf of her
Government. Several hundred participants also held a march clad
in specially designed World Population Day T-shirts carrying
placards with various messages on HIV/AIDS.
In Belarus, celebrations of World Population Day were organized
by the country's national population committee, which is headed
by Deputy Prime Minister Leonid Sinitsyn. Demographic changes in
Belarus give greater urgency to the committee's work: the country
is experiencing sharply falling birth rates, an ageing
population, and depopulation. The members of the national
population committee include prominent scientists and State
leaders.
Palau marked World Population Day with a Presidential
Proclamation declaring 10 to 12 July to as "Population Education
Forum Week". In the Proclamation, President Kuniwo Nakamura
stresses the importance of improving education on reproductive
health in order to prevent the spread of HIV/AIDS. "Population
growth is an important issue even to a small island nation such
as Palau," he states.
Nicaragua held numerous activities commemorating the Day which
aimed to raise awareness among the population about HIV/AIDS
prevention. A two-day seminar on sexually transmitted diseases
was held at the Teenage Care and Recreation Centre of Sutiaba. A
forum entitled "HIV/AIDS: Human Rights and Prevention" was held
at Central American University in Managua with the participation
of some 200 persons, including government officials as well as
members of the diplomatic corps, United Nations personnel and the
media. The National University of Nicaragua hosted a panel
discussion on "Community Responsibility: Reproductive Health"
which was attended by 50 medical students.
* ** *
1996 POPULATION AWARD TO PHILIPPINE SENATOR LETICIA RAMOS
SHAHANI AND PATHFINDER INTERNATIONAL
On 17 July, the 1996 United Nations Population Award was
presented to Senator Leticia Ramos Shahani, of the Philippines --
a leading advocate for population policies and programmes in her
country and internationally, and Pathfinder International -- a
United States-based non-governmental organization that helps
start and manage population programmes worldwide.
At the awards ceremony, Secretary-General Boutros Boutros-Ghali
stressed the importance of addressing population and development
issues. "This is not always an easy task," he said. "It may not
always be possible to translate positive words into positive
deeds. But today's event demonstrates clearly that real and
lasting progress is possible. Real and lasting progress can be
achieved."
In a speech which focused on the motivations driving United
States policy in the area of population, the President of
Pathfinder International, Daniel E. Pellegrom, decried cuts in
funding. "Slashing support for reproductive health care is
shortsighted and is counter to what Americans offer each other or
have offered the world until now." Speaking personally, he said,
"As a family planner, I am proud of my profession and as and
American, I am proud of a variety of past American
accomplishments in this field, but I am ashamed of what a few
members of the U.S. Congress have recently done to hurt women, to
hurt families, and to hurt the cause of reproductive health."
He criticized politicians who have broken faith with Cairo
pledges. "Remove family planning services and women will rely on
abortion, often illegal and unsafe and often at the risk of their
very lives." Calling on the United States Congress to restore
funding for family planning services, he warned that, "Withdrawal
is ineffective as a method of family planning, and it is
downright reprehensible as a method of American foreign policy."
In her acceptance speech, Senator Ramos-Shahani stressed the need
to address concerns about population in the context of
sustainable development. She identified the most crucial elements
of a strategic human development intervention as education and
health with full attention to the gender dimension. "Slowing down
population growth and initiating improvements in the relationship
between human population and the natural environment will
inevitably have to consider women's development and freedom," she
emphasized.
A member of the Philippine Senate, Leticia Ramos-Shahani was
chosen for her more than 30 years of leadership in the field of
population. In 1988, at a time when virtually no one in the
Philippine Congress was talking publicly about population, she
spearheaded the establishment of the Philippine Legislators
Committee on Population and Development. She sponsored
legislation aimed at strengthening the country's new population
policy and the Commission on Population of the Philippines, and
has been widely credited with helping shape the positive
population policies of her Government. Ms. Shahani is also active
internationally, serving, among others, as Secretary-General of
the World Conference to Review and Appraise the United Nations
Decade for Women, held in Nairobi, Kenya in 1985.
Pathfinder International was selected for its 38 years of
sustained effort in developing and improving family planning
programmes and creating awareness of population issues. Founded
in 1957, Pathfinder was hard at work in the field providing
funds, contraceptive supplies, and technical assistance long
before the United States Government began supporting population
programmes. To date, 29 family planning associations have been
launched with grants from Pathfinder, which has also supported
more than 2,000 programmes in over 30 countries in such areas as
training, adolescents, service delivery, integrated family
planning and HIV/AIDS/sexually transmitted disease prevention. In
several instances, Pathfinder, through privately raised funds,
has sustained national programmes when foreign assistance funds
were unavailable.
The United Nations Population Award, established by the General
Assembly in 1981, has been presented annually to individuals and
institutions that have made outstanding contributions to the
awareness of population issues and solutions. The laureates are
selected by a committee composed of 10 representatives of United
Nations Member States. Each winner received a diploma, a gold
medal and a monetary prize of $12,500.
* ** *
NEW STUDY RAISES ESTIMATES OF MATERNAL MORTALITY
A recent WHO/UNICEF study on maternal mortality places the number
of women dying in pregnancy or childbirth each year at 585,000 --
significantly higher than the previous estimate of 500,000. The
report also concludes that about 17.5 million women suffer
injuries, infections or disabilities related to pregnancy and
childbirth each year.
According to the study, the first and most obvious step towards
reducing maternal mortality is making high-quality family
planning services available to all who need them. Better health
care during and after pregnancy is also needed.
Maternal deaths are most common in regions of Africa and Asia:
one in 13 women dies during pregnancy in sub-Saharan Africa and
one in 35 in south central Asia dies, compared with one death
among 3,300 women in the United States, the report states.
* ** *
HABITAT II ENDORSES LANGUAGE OF CAIRO AND BEIJING
The Second United Nations Conference on Human Settlements
(HABITAT II), held in Istanbul from 3 to 14 June, concluded with
the adoption of an Agenda and Global Plan of Action which address
the two main themes "adequate shelter for all" and "human
settlements development in an urbanizing world".
The issue of reproductive rights was a key point of contention
during negotiations on the Conference documents. Delegates
grappled with the matter until the final hours of HABITAT II.
The Holy See challenged several references to sexual health and
reproductive rights which the United States had proposed adding
to the others already present in the text. In response to
criticism by the Vatican, United States representative Melinda
Kimble stated that the references were fully consistent with the
language adopted at previous conferences, such as the Cairo
Programme of Action. The Conference Secretary-General agreed that
the references to reproductive rights were important, stating "we
cannot afford to roll back the gains of earlier conferences."
Those seeking to retain the reference stressed that women's
access to reproductive health is inextricably linked to the
health of human settlements. The final version of the Habitat
Agenda retains Beijing's stronger references to human rights and
the duty and responsibility of States to protect them. Among
other measures, it recommends that governments develop and
implement programmes to ensure universal access for women
throughout their life-span to a full range of affordable health
care services, including those related to reproductive health
care, which includes family planning and sexual health.
* ** *
EGYPT BANS FEMALE CIRCUMCISION
Egypt's Minister of Health, Ismail Sallam, used the occasion of
World Population Day to announce that his country had decided to
completely prohibit female genital circumcision and that firm
legal procedures would be taken against practitioners of the
harmful practice, which was neither Islamic nor Pharonic but was
African. This is a welcome development in the country which
hosted the ICPD. As the Cairo Programme of Action states, "In a
number of countries, harmful practices meant to control women's
sexuality have led to great suffering. Among them is the practice
of female genital mutilation, which is a violation of basic
rights and a major lifelong risk to women's health."
* ** *
ISLAM AND POPULATION DISCUSSED AT UNFPA SEMINARS IN GHANA
Gender equality in Islam, Islamic marriage and its purposes, as
well as family planning from the Muslim perspective were among
the topics discussed at a UNFPA-sponsored seminar held in Accra,
Ghana. Representatives of Muslim youth and women's organizations
as well as Muslim Chiefs gathered on 21 May at the seminar, which
was organized by the Muslim Family Counselling Services to
enlighten participants on the various methods of family planning
and to raise awareness about population pressures.
Some 200 Muslim leaders and youth groups participated in a
seminar in Accra on "Islam and family planning, adolescent
reproductive health and HIV/AIDS" which was also sponsored by
UNFPA. The event, held on 30 May, highlighted the problems
associated with reproductive health and AIDS.
* ** *
ZAMBIANS CALL FOR GREATER MALE PARTICIPATION IN FAMILY PLANNING
"We think we know how to incorporate men in family planning, but
we don't -- men have no access to information, and if they have
no access to information, they feel embarrassed to talk about it
with their wives," said Zambia's former Project Chief of Family
Planning Services, Winthrop Morgan, in an interview in the April
issue of "Z Magazine", which was devoted to UNFPA's work in that
country.
Morgan said there was a need to include men as equal partners in
the family planning process. Sex is a difficult subject to talk
about and not all women have the courage to bring their husbands
into serious discussions about family planning, he noted.
"Men do not care about family planning because they are not
directly involved in the risk their wives go through," said
University Teaching Hospital Nurse Edna Imenda. Another nurse at
that Hospital, Matildah Jere, stressed that men should be
educated on the collective responsibility involved in having a
family.
According to the article, records at the University Teaching
Hospital show that only four men have undergone vasectomy in the
last two years, while more than 10,000 women in Lusaka were using
several methods of contraception offered at the Hospital.
* ** *
BANGLADESH: FAMILY PLANNING FLOURISHES DESPITE DIFFICULT ECONOMIC
CIRCUMSTANCES
The latest Sectoral Review of Reproductive Health in Bangladesh,
published by UNFPA, describes a successful family planning
programme flourishing in conditions of extreme economic
deprivation. This trend has lead some analysts to speculate that
poverty is responsible for the increased demand for family
planning services. "The theory is that couples are driven to
accept family planning as a means of survival in an increasingly
bleak economic picture." Others point out that the attitudes
among the poorest members of society towards fertility are no
different from those who are less poor.
Putting aside debates on theory, the report focuses on practical
matters. "Whether it is more appropriate to base family planning
success on changes in economic or social factors or simply on the
increased accessibility of a choice of methods is actually not
the issue. It is important to recognize that as Bangladesh
changes, women's demands for family planning will increase, as
will their concern for quality services."
The report finds dramatic changes on all measures of direct
family planning success. For example, the total fertility rate
has decreased from seven births per women in 1975 to 3.4 today.
Age at first birth has increased from 16.8 in 1975 to 18.3 in
1994. Women in Bangladesh are also getting married later.
"While this is a significant improvement, there is no room for
complacency," cautions the report. It notes that the women are
still married at an early age, and more than half have their
first child while still teenagers, with one in four having a
second child by age 20. The Government estimates that 19 percent
of married women have unmet contraceptive demands and are in need
of services.
The main question to be addressed in the coming years is how to
respond to the needs of the millions of young women in Bangladesh
who have already used most of the modern methods without finding
one which satisfies them. "The quality of both the delivery of
information about methods and the delivery of the services must
be improved if the needs of women are to be met," the report
concludes.
* ** *
INVESTING IN WOMEN: KEY TO GLOBAL FOOD SECURITY
Unless women are placed at the centre of efforts both to increase
food production, and to stabilize global population growth, vital
opportunities to meet the world's present and future food needs
will be missed, says a new report entitled Food for the Future:
Women, Population and Food Security produced by UNFPA.
"Women have a pivotal role in enhancing food production and
ensuring adequate diets for their families. Their free and
informed decisions are also the key to solving the problem of
rapid population growth. The challenge of the 21st century is to
feed a world of between 9 and 10 billion people. Only the full
involvement of women as equal partners can guarantee success,"
said UNFPA Executive Director Dr. Nafis Sadik in the report.
According to the report, many of today's small-scale food
producers and a disproportionate number of the world's poor are
women. Providing them with access to credit, markets and
technical advice, as well as education and health care, could
both improve the food supply of the world's poorest people and
help them to escape from poverty. Empowering women could
substantially reduce the current number of the world's
malnourished; giving them adequate health care, including
reproductive health care, could help to lower population growth.
"Women provide much of the food grown for home consumption in the
developing world. Since the bulk of their production is in the
"informal sector", it is not included in food production
statistics. Much of this food comes from shrinking and fragmented
farmsteads, backyard gardens, even abandoned lots in the middle
of cities.
"Most countries do little to encourage women farmers:
agricultural investment and technical assistance policies assume
that recipients are men, and landholding and inheritance
practices are biased in their favour. At the same time, women are
frequently offered little support even in their recognized role
of child-bearing and rearing. Support for women's reproductive
rights and reproductive health will have a decisive impact on the
growth and eventual size of world population", according to the
UNFPA Report.
While the world has an adequate supply of food for its present
population of 5.8 billion, food is neither produced nor consumed
equitably and most of the world's hungriest are women and
children. Moreover, the three-decade cycle of food production out
pacing population growth may be coming to an end and while more
people are being fed adequately today than every before, the
numbers of the poor and the malnourished, estimated at 41
million, have risen the report says.
The report doesn't choose sides with the usual positions taken in
discussions of the maximum "carrying capacity " of the earth, but
rather argues that the solution to food security and slowing
population growth may lie with focusing attention on the needs of
individual men and women, especially women. Carrying capacity
discussions generally tend to focus on predictions of future food
shortages caused by environmental degradation and population
growth and arguments that human ingenuity and technology will
find ways to support larger and larger world populations,
The UNFPA report, part of a series of advocacy booklets being
published by the Population Fund, cites several policy areas
which will effect food security including: insuring that women
can have ownership or to title to the land they work; the right
of women and girl children to inherit land and property; women's
access to credit; the delivery of training and extension services
to rural women; integrated population and reproductive health
strategies; male support for women's fertility decisions and as
food producers; and the inclusion of women in the policy making
process.
The report calls for a series of actions based on the
recommendations of UN conferences which called on governments to:
* Strengthen food, nutrition and agricultural policies and
programmes, and fair trade relations, with special attention to
the creation and strengthening of food security in all levels.
* Eliminate existing inequities and barriers to women in the
workforce and enhance women's participation in all policy-making
and implementation, as well as increasing their share of
productive resources, including the ownership of land, the right
to inherit property and access to credit.
* Generate jobs for women in the industrial, agricultural and
service sectors.
The study also cites the ICPD Programme of Action which calls for
universal access to reproductive health care including family
planning and sexual health by 2015; universal access to primary
education by 2015; urges countries to close the gender gap in
primary and secondary education by 2005; and reduce infant and
maternal mortality.
"The Programme of Action places women and men, and their
families, at the top of the international development agenda. It
is a population action programme that puts people first," said
Dr. Sadik. Among other results, she added, the Programme of
Action will: "bring women at last into the mainstream of
development. It will protect their health, promote their
education and encourage their economic contributions; promote
education for all and close the gender gap in education; ensure
that every pregnancy is intended and every child is a wanted
child; and protect and promote the integrity of the family."
Copies of the Report may be obtained from UNFPA, 220 East 42nd
St., New York 10017.
* ** *
NEW REPORT ON FOOD NEEDS RELATIVE TO POPULATION GROWTH
Africa will have to increase its food supplies by 200 per cent in
order to satisfy its population demands by the year 2050,
according to a new study published by UNFPA and the Food and
Agriculture Organization (FAO). The report is part of a series of
technical papers being prepared for the World Food Summit to be
convened in Rome from 13 to 17 November.
The UNFPA/FAO report notes that fairer distribution of food
supplies would probably eliminate most causes of
undernourishment, which affected 841 million people worldwide
from 1988 to 1990, according to the latest available statistics.
The report points out that the root of the food problem is
poverty. It predicts that distribution problems will remain in
2050, by that hopefully by then populations will be coming to
grips with these serious inequalities in order to reduce them
further. "The health of a large proportion of the world's
population and its ability to take its future into its own hands
depends on this," says the report.
Worldwide, the effects of population changes will mean a 75
percent increase in food supply needs by 2050, according to the
report. The report finds important regional variations, with
noteworthy food production increases in Asia and Latin America,
while many African countries experienced declining levels over
the same period.
But not only African countries face serious food shortages at the
national level; such Asian countries as Afghanistan, Nepal and
Mongolia also have shortages, and Bangladesh, Myanmar and
Cambodia face chronic undernourishment. India and China suffer
chronic food deficits at regional levels. Overall, East Asia and
South Asia continue to be by far the two regions most seriously
affected by malnutrition worldwide.
The Asian Forum of Parliamentarians on Population and
Development, meeting on 2 May in Kuala Lumpur, adopted a
statement on food security and population reaffirming their
commitment to the goals of the ICPD and stating that the vision
described at Cairo calls for substantial increases in resources
for primary health care, family planning and reproductive health
services. "This is especially true for women and girls, and for
those living in rural areas, who are often left behind in
development efforts. We believe it is important for
parliamentarians to encourage the international community and
their own governments to increase resources for these
activities."
* ** *
PERU TAKING ACTION ON REPRODUCTIVE HEALTH
Visiting Peru in July, Dr. Sadik was welcomed by a high-level
delegation strongly supportive of the country's broad
reproductive health programmes. The Prime Minister of Peru,
Alberto Pandolfi, stressed his government's determination to
expand information and services on reproductive health and family
planning, with particular focus on couples with low levels of
education and those living in the rural areas. "Our concern is
not only with numbers, but with quality of services, to ensure
informed consent."
Peru has recently launched a national programme for sex education
which aims to train public school teachers to provide information
and guidance to young Peruvians in order to avoid unintended
pregnancies. Broader programmes designed to raise the status of
women are also in place.
* ** *
VIDEO ON POPULATION AND DEVELOPMENT RELEASED BY ILO/UNFPA
Even if all Nigerian women suddenly had only two children, the
population would continue increasing from 108 million in 1990 to
stabilize at 140 million in about 45 years, while if women
continue to have an average of six children, in 50 years the
population will be more than 500 million.
These and other population and development trends are explored in
a new video, entitled "Who decides?", produced by the
International Labour Organisation (ILO) with financial support
from the UNFPA. The main theme of the video is that reducing
population growth rates will not itself solve the many problems
being faced in developing countries, but lower fertility will
contribute to finding solutions to future problems such as
crowded cities, poverty, unemployment, schooling for children,
child labour, and maternal and infant mortality. It concludes
that various levels of decision-makers have particular
responsibility, as do individual women and men.
The video is designed to support discussion on the relations
between population factors and development. It is appropriate for
a range of audiences, including managers, civil servants, trade
union leaders and leaders of women's organizations.
The video "Who decides" and its accompanying brochure are
available in English, French and Spanish on request to the
Development Policies Department, ILO, 4 route des Morillons, 1211
Geneva 22, Switzerland.
* ** *
ORAL CONTRACEPTIVES/"MORNING AFTER" PILL
The United States Food and Drug Administration (FDA) Advisory
Committee for Reproductive Health Drugs found mifepristone to be
safe and effective in inducing abortions early in pregnancy and
recommended that the drug be approved for marketing in the United
States. While the FDA is not required to follow the panel's
advice, it is highly uncommon for it to do otherwise.
Meanwhile, researchers have determined that certain types of oral
contraceptives can be used after unprotected sex to prevent
pregnancy. Combined oral contraceptives must be taken in higher
doses (multiple pills) within 72 hours after unprotected
intercourse, and repeated 12 hours later. For "progestin-only"
pills, which do not contain estrogen, the initial dose should be
taken within 48 hours of exposure and repeated in 12 hours.
This method may be of service to women who have been sexually
assaulted. It can also be used as a back-up by couples whose
birth control has failed, as when a condom breaks, or by couples
who have forgotten to use birth control.
* ** *
CONFERENCE FOR YOUNG WOMEN FOLLOWS-UP ON CAIRO AND BEIJING
"Youth Acting on Beijing and Cairo" was the theme of a conference
held in Washington, D.C., and Easton, Maryland from 19 to 23
August. Sponsored by UNFPA and the Centre for Development and
Population Activities, the conference aimed to promote the
participation of young women in formulating and acting upon
recommendations of the 1994 International Conference on
Population and Development and the 1995 Fourth World Conference
on Women. Workshop participants included young women ages 21 to
25 from some 30 countries in Africa, Asia, Latin America and
Eastern Europe, as well as from the United States.
* ** *
SPECIAL PROGRAMME ON HUMAN REPRODUCTION PUBLISHES REPORT
The UNDP/UNFPA/WHO/World Bank Special Programme of Research,
Development and Research Training in Human Reproduction has just
issued its 1994-1995 biennial report. Unlike previous reports,
which had chapters on such topics as "epidemiological research"
and "social science research", the new edition organizes its
chapters based on what the Programme does and seeks to achieve.
Chapter titles include surveying reproductive health; assessing
and improving reproductive health services; understanding
people's reproductive health needs and perspectives; expanding
family planning options; and building reproductive health
research capacity in developing countries. Each chapter opens
with a short, easy-to-read "highlights" section.
"We hope this approach will enable readers, especially
policy-makers and non-scientists, to have a better understanding
of the Programme's work", say Director Giuseppe Benagiano and
Associate Director Paul F.A. Van Look in the report's
introduction.
* ** *
NEW WHO REPORT ON CONTRACEPTIVE USE
Improving Access to Quality Care in Family Planning is the title
of a new publication by WHO which focuses on medical eligibility
criteria for contraceptive use. It contains recommendations for
revising family planning policies and prescribing practices in
line with updated medical eligibility criteria which are
supported by the latest scientific evidence.
"Revising medical guidelines for the provision of contraceptives
is an important first step in ensuring the availability of high
quality family planning information services," says Dr. Tomris
Turmen, Executive Director Family and Reproductive Health for the
WHO. He urges countries to use the document as a reference and to
adapt its recommendations to suit the diverse situations in which
contraceptives are provided.
Material was gathered for the report over the course of two
scientific expert group meetings convened by the WHO in March
1994 and May 1995 which brought together health advocates and
scientific experts from all regions of the world, as well as
representatives of major organizations and agencies active in the
area of family planning research and programme development.
* ** *
UNFPA AND IPPF SIGN MEMORANDUM OF UNDERSTANDING
Recognizing that coordination and cooperation between the UNFPA
and the International Planned Parenthood Federation (IPPF) is
mutually reinforcing and will serve to help both reach their
common goals, a memorandum of understanding was concluded in July
between the two organizations. Among its provisions, the
memorandum calls for the convening of joint meetings between
UNFPA and IPPF from time to time; collaborating more at the field
level through annual meetings; and exploring the possibility of
developing collaborative regional, interregional and global
activities.
In a letter issued jointly on the memorandum by UNFPA's Executive
Director and the IPPF Secretary-General, they state that the two
organizations have long collaborated at the national and
international levels. "This cooperation is now particularly
crucial since the objectives of our two organizations in the area
of reproductive health, including family planning and sexual
health, are converging now more than ever before," they add.
The new memorandum supersedes an earlier one which was concluded
in October 1988.
* ** *