Boost Funding for Integrated Sexual, Reproductive Health Services, Population Fund Chief Urges as Commission on Population and Development Opens Session
Boost Funding for Integrated Sexual, Reproductive Health Services, Population Fund Chief Urges as Commission on Population and Development Opens Session
|Department of Public Information • News and Media Division • New York|
Commission on Population and Development
2nd & 3rd Meetings* (AM & PM)
Boost Funding for Integrated Sexual, Reproductive Health Services, Population Fund
Chief Urges as Commission on Population and Development Opens Session
Cuts in Funding ‘Short-Sighted’, Under-Secretary-General
Cautions as Keynote Speaker Gives ‘Mixed Scorecard’ on Fertility Rates
Expressing concern about the $24 billion shortfall in the amount of financing needed to implement the Programme of Action from the International Conference on Population and Development, the new head of the United Nations Population Fund (UNFPA) called on Member States today to bolster funding for integrated sexual and reproductive health services.
“Investing in the health and rights of women and young people is not an expenditure; it is an investment in our future,” UNFPA Executive Director Babatunde Osotimehin told the Commission on Population and Development as it began its forty-fourth session under the special theme “Fertility, reproductive health and development”.
Mr. Osotimehin, who assumed his new post on 1 January, said such rights were not only essential to women’s empowerment and gender equality, they also quickened the pace of economic growth and improved prospects for sustainable development. Since the 1994 International Conference, reproductive health services had already saved millions of lives, but the poor state of sexual and reproductive health services — particularly in the developing world, where 215 million women lacked access to modern contraception — had caused millions of unintended pregnancies and unsafe abortions, in addition to 358,000 deaths, including 47,000 from unsafe abortions.
Too many women faced discrimination, coercion and violence in making decisions about reproduction, a reality the world could no longer ignore, he emphasized. Moving forward, the focus must be on human rights and equity, he said, adding that under his leadership, UNFPA would advocate greater investment in sexual education, reproductive health, employment and social participation. It would also support national family planning services.
Echoing those concerns, Sha Zukang, Under-Secretary-General for Economic and Social Affairs, said the decline in donor funding — which had shrunk by half over the past decade, despite the marked increase in the number of women of reproductive age, particularly in low-income countries — was short-sighted. “Family planning is a cost-effective investment. For every dollar spent on modern contraceptives, $1.30 is saved in maternal and newborn care,” he said.
He recalled that during the Millennium Development Goals Summit last September, world leaders had urged universal access to reproductive health by 2015, including by integrating family planning and health-care services into national strategies and programmes. Also in 2010, United Nations Secretary-General Ban Ki‑moon had launched the Global Strategy on Women’s and Children’s Health to speed up the realization of the fourth and fifth Millennium Development Goals, on reducing child mortality and improving maternal health, respectively. To achieve those aims, everyone must enjoy basic reproductive rights, he emphasized, urging the Commission to take the lead in guiding national actions to ensure the Goals were met by the 2015 deadline year.
Hania Zlotnik, Director of the Population Division in the United Nations Department of Economic and Social Affairs, similarly called on Governments urgently to erase the barriers to reproductive health that poor women faced, such as the lack of resources and poor information. Reduced fertility had multiple socio-economic benefits, and while rates had dropped in developing countries, from 5.8 children per woman in the early 1960s to 2.5 children today, they remained behind those in developed countries, where fertility averaged just 1.6 children per woman.
John Bongaarts, Vice-President of the Population Council, said in a keynote address that the development scorecard on fertility rates was mixed. Countries with high rates experienced an increase in the number of young people competing for jobs, which often led to lower wages. They also grappled with depleted natural resources and greater pollution, higher maternal and child mortality, reduced Government investment in education, health services and infrastructure, in addition to extremism and civil strife. For them, family planning programmes and investment in human capital, particularly girls’ education, were desirable.
On the other hand, he continued, countries with low fertility rates experienced slower economic growth and increases in living standards due to the declining percentage of the population actually working, slower growth in worker productivity, unsustainable health and pension costs, rising Government budget deficits and the growing voter power of the elderly. For such countries, changes in pension policies and pushing back retirement ages were desired policy options, as were programmes to encourage immigration and child-bearing, including through Government-assisted fertility treatments and related health policies.
Brian Bowler ( Malawi), Commission Chairperson, introduced the report on the first three intersessional meetings of the Bureau.
The following United Nations officials presented reports of the Secretary-General for the Commission’s consideration: Ann Biddlecom, Section Chief in the Population Division; Werner Haug, Director of UNFPA’s Technical Support Division; and Jose Miguel Guzman, Chief of that Division’s Population and Development Branch.
Also today, the Commission elected Attila Zimonyi (Hungary) as Vice-Chair for the session and Easton Williams (Jamaica) as Rapporteur. It also adopted its agenda and organization of work.
Others speaking today were representatives of Nepal (on behalf of the Group of Least Developed Countries), Russian Federation, Hungary (on behalf of the European Union), China, Cuba, Malta, Australia, Estonia, Iran, Malaysia, United States, Switzerland, Indonesia, Japan, Poland, Spain, Finland, Croatia, Malawi, Brazil, Ireland, Jordan and Kenya.
Representatives from the Gambia, Norway, United States and Honduras took part in the discussion that followed the keynote address by Mr. Bongaarts, as did a representative of the Latin American and Caribbean Women’s Health Network.
The Commission will meet again at 10 a.m., on Tuesday, 12 April, to continue its general debate.
The Commission on Population and Development began its forty-fourth session today under the special theme “Fertility, reproductive health and development”. Before it was the report on the meetings of the Bureau of the Commission on Population and Development (document E/CN.9/2011/2), which summarizes its deliberations ahead of the session. The Bureau takes note of the need to establish a multi-year programme of work for the Commission, among other things, and discusses various themes that might be considered in 2013 and beyond. It also recommends the special theme “Population and sustainable development” for 2013.
With regard to the current session, the report says, the Bureau recommends that the general debate on further implementation of the Programme of Action of the International Conference on Population and Development in light of its twentieth anniversary (item five of the Commission’s provisional agenda) focus on ways to buttress the achievements of the Conference, and to ensure the integration of the population and development agenda into key global processes related to development, especially the 2012 United Nations Conference on Sustainable Development, to be held in Rio de Janeiro, Brazil. The Bureau also recommends the establishment of a working group at the start of the resumed forty-fourth session to discuss issues that might result in resolutions or decisions. The working group should begin its work on the first day of the resumed session.
A functional commission of the Economic and Social Council, the Commission monitors, reviews and assesses implementation of the International Conference’s Programme of Action at the national, regional and international levels and advises the Council accordingly. For more information on the session, please see Press Release POP/990 of 11 April.
SHA ZUKANG, Under-Secretary-General for Economic and Social Affairs and Secretary-General of the 2012 United Nations Conference on Sustainable Development, recalled that during the Millennium Development Goals Summit last September, world leaders had called for universal access to reproductive health by 2015, including the integration of family planning and health-care services into national strategies and programmes. That appeal reflected history’s lessons, he said, noting that lower fertility levels were associated with higher family incomes, increased well-being for women and children, and fewer maternal deaths. Fertility and reproductive health were at the core of development, he stressed.
Since 1960, fertility had fallen worldwide, from nearly 5 children per woman in the 1960s to 2.6 children per woman today, he continued, adding that reduced fertility had led to a “demographic dividend” — as the number of children had declined, the share of the working-age population had increased, boosting the momentum for economic growth. That dividend had helped develop the world’s fastest growing economies over the past three decades, he said, cautioning, however, that challenges remained. Although the decline in fertility had been nearly universal, its speed had varied among populations, while fertility levels had varied among countries.
He went on to emphasize that high fertility perpetuated poverty, adding that in high-fertility countries, where women lacked access to family planning, maternal and child mortality rates remained high, stalling development. The preparatory process for the United Nations Conference on Sustainable Development recognized that link and called for addressing population dynamics as a new, emerging challenge. Meeting key health-related Millennium Development Goals hinged on ensuring universal access to reproductive health, including by improving access to family planning through strengthened health-care systems, he said.
However, support for family planning had weakened over the past decade and donor funding for it had dropped by almost half, he said, despite an increase in the number of women of reproductive age over the same period, particularly in low-income countries. “This decline in funding is short-sighted. Family planning is a cost-effective investment. For every dollar spent on modern contraceptives, one dollar and 30 cents is saved in maternal and newborn care.” In 2010 the Secretary-General had launched the Global Strategy on Women’s and Children’s Health to expedite the realization of the fourth and fifth Millennium Development Goals, on reducing child mortality and improving maternal health, including by ensuring that financial commitments to reach those targets were kept.
The Commission had noted the estimated funding needed to meet reproductive health goals and objectives of the Programme of Action, he noted. Now it must act more decisively and urge Governments to work cooperatively to meet the required funding levels. “Meeting the goals in maternal and child mortality rests on ensuring that couples and individuals enjoy basic reproductive rights.” By actively promoting those rights, Governments improved the lives of children, their mothers and families, he said, adding that children became healthier, maternal mortality dropped, and women were better able to combine childbearing with working life.
It was a matter of equity to ensure that people were not deprived of their rights just because they were poor, he emphasized. “The successes some societies have achieved in advancing reproductive rights should inspire us to work even more earnestly for those that are lagging behind,” he said, urging the Commission to take the lead in guiding national action and international cooperation to meet that challenge. Last December, when the General Assembly had recognized that the goals and objectives of the Programme of Action had not been met, it had decided to extend it beyond 2014, but had set no specific deadline, he recalled, stressing that the Commission must ensure that the goals were met by the 2015 deadline.
BABATUNDE OSOTIMEHIN, Executive Director, United Nations Population Fund (UNFPA), said that as the global population approached 7 billion, everyone should be able to enjoy human rights and dignity, and to realize his or her full potential. The right to sexual and reproductive health was essential to women’s empowerment, gender equality and sustainable development. Since the 1994 International Conference, countries had made substantial gains in advancing those rights and saving millions of lives through reproductive health services, notably in high- and middle-income countries.
However, high rates of mortality, fertility and population growth still threatened development in least developed countries, he pointed out. Investing in reproductive health would enable them to meet the needs of women and couples lacking access to family planning and to reduce poverty at the same time. Achieving universal access to reproductive health and rights was an urgent challenge. “As I speak, too many people continue to face discrimination, coercion and violence in making decisions about reproduction. Too many women and couples cannot exercise their right to determine freely and responsibly the number and spacing of their children,” he said, pointing out that some 215 million women in developing countries lacked access to modern contraception.
He went on to note that each year, neglect of sexual and reproductive health caused an estimated 80 million unintended pregnancies, 22 million unsafe abortions and 358,000 deaths from maternal causes, including 47,000 deaths from unsafe abortions. “We can no longer afford to shy away from these realities,” he said, adding that no woman or girl should die from pregnancy, childbirth or unsafe abortion. The best way to reduce recourse to abortion was to provide comprehensive sexuality education and family planning. “Family planning as part of comprehensive reproductive health services saves lives, slows population growth, enhances women’s life options and reduces poverty,” he emphasized.
But progress in reducing adolescent birth rates and meeting unmet family planning needs had stalled in most parts of the world over the past decade, he said, pointing out that most of those left behind were poor, uneducated women and girls, particularly from rural areas. Moving forward, there was an urgent need to focus on human rights and equity, and to reach the most vulnerable, particularly youth, who comprised one quarter of the world’s population. He said that under his leadership, UNFPA would give youth the attention they deserved, and advocate greater investment in education, including age-appropriate sexuality education, and in reproductive health, employment and social participation.
The agency would also provide support for countries’ reproductive health efforts, including family planning services, as part of national primary health-care systems, he continued. “Investing in young people, reproductive health and gender equality can speed up countries’ economic growth and improve their prospects for sustainable development,” he said. Increased funding was needed for the full implementation of the Programme of Action, he said, pointing to the $24 billion funding shortfall and calling for increased political will, renewed commitment and urgent action, to advance the agenda of the International Conference. “Investing in the health and rights of women and young people is not an expenditure; it is an investment in our future,” he stressed, calling upon Member States to commit themselves to sustained, predictable financing for integrated sexual and reproductive health services.
HANIA ZLOTNIK, Director, Population Division, Department of Economic and Social Affairs, said that following the fastest global population growth ever in the 1960s, the annual rate had slowed to 1.2 per cent, 40 per cent lower than at its peak. Declining fertility was responsible for that slowdown, she said. Nonetheless, the various projections of demographers indicated the possibility that sustained increases in the world’s population over the current century were still well within the realm of possibility.
Those scenarios had particular significance for the theme of the current session, she said, citing evidence that reduced fertility — achieved through improvements in reproductive health, child health, education and the empowerment of women — had accelerated economic growth and reduced poverty. It was a matter of urgency to ensure the disappearance of barriers that reduced the options of those of lower socio-economic status, such as the lack of resources and limited access to information, including with regard to the exercise of their reproductive rights. In that vein, Governments wishing to accelerate development had much to gain by investing in reproductive health, she said.
She said that such investments would not only help improve the lives of millions, they were also likely to result in beneficial demographic trends that would permit greater investment in human capital by moderating population growth, especially the number of children. If ensuring the well-being of future generations was a major goal of sustainable development, continuing the reduction of population growth was essential. Therefore, enabling all people to decide freely and responsibly the number and spacing of their children, and providing them with the information and means to do so was the “task to pursue”, she concluded.
Introduction of Reports
BRIAN BOWLER (Malawi), Chairperson of the Commission, then introduced the report on the first three intersessional meetings of the Bureau (document E/CN.9/2011/2), saying it had taken note of the need to establish a multi-year work programme for the Commission, and discussed themes to be considered in 2013 and beyond.
ANN BIDDLECOM, Section Chief, Population Division, Department of Economic and Social Affairs, then presented the report of the Secretary-General titled “Fertility, reproductive health and development” (document EC/CN.9/2011/3), saying it documented trends in fertility and proximate determinants, as well as the main challenges in ensuring universal access to reproductive health and ways to accelerate realization of the relevant goals and objectives of the Programme of Action.
The report found that high-fertility countries tended to score poorly on most outcomes relating to reproductive health and determinants of fertility. Additionally, high-fertility developing countries tended to have lower per capita incomes, high levels of poverty, lower educational attainment and higher mortality than other developing countries with lower fertility levels. The report also found that women in high-fertility countries usually married earlier than their counterparts in other countries and had higher adolescent birth rates, she said.
Because women who bore children at a very young age had a higher risk of complications from pregnancy and childbirth, delaying marriage until age 18 or later would be beneficial, she continued. Improving the educational attainment of girls and women was another important policy that could help to reduce the number of early marriages, as well as adolescent fertility, she said, adding that the use of contraception — particularly effective, modern methods — was critical to enabling couples and individuals to determine the timing and number of children they would have. In low-fertility countries, long delays in childbearing were common, as was the postponement of marriage, she said, noting that high proportions of women aged 25-29 remained single and that the use of contraceptives was high among women who were married or had stable partners. There was considerable room for increasing the range of safe and effective contraception methods available to those wishing to use it.
With regard to mortality, she cited the report’s finding that there was an urgent need to increase support for improving care during pregnancy and delivery, and to ensure that all men and women had access to sexual and reproductive health care. The overall number of maternal deaths was estimated to have declined from 545,000 in 1990 to 358,000 in 2008, a drop made possible by both reduced fertility and improvements in maternal health care. However 65 per cent of all maternal deaths still occurred in high-fertility countries, and most were preventable, she emphasized, noting that those countries were likely to miss the relevant Millennium target. Addressing existing inequities required both national commitment and commensurate funding for reproductive health on the part of donors and national Governments, she emphasized, pointing out that, to date, funding had not kept pace with demand.
WERNER HAUG, Director, Technical Division, UNFPA, presented the report of the Secretary-General titled “Monitoring of population programmes, focusing on fertility, reproductive health and development” (document E/CN.9/2011/4), saying it provided an overview of the related work that UNFPA had been undertaking at the global, regional and country levels. The report noted that as the world population reached 7 billion, it was more diversified than ever, he said, pointing out, however, that inequitable access to reproductive health was an often deepening reality.
A recent UNFPA study showed that in sub-Saharan Africa, the prevalence of contraceptive use among women of the wealthiest 20 per cent of households was close to four times that of their counterparts in the poorest 20 per cent. The high level of diversity in fertility called for different programmatic approaches, adapting to specific realities and changes in the framework of national policies and plans. Inequities must be addressed within countries, as well, to ensure that basic health services, including health and family planning, reached the poor and excluded.
He cited the report as noting that sustainable delivery of quality sexual and reproductive health services required functioning health-care systems, while the services must in turn be part of efforts to strengthen health-care systems. Additionally, socio-cultural norms surrounding gender equity, sexuality, reproduction and harmful practices must be challenged in order to address the roots of poor sexual and reproductive health, and to reach people at the community level. A multisectoral approach — integrating gender equity, women’s and girls’ rights while expanding sexual education — was necessary in that respect, and the most marginalized and vulnerable must be factored into the design, planning and implementation of related programmes.
Political commitment and the quality of governance at the national and local levels were crucial, he emphasized, adding that credibility and capability were also vital in devising and implementing sound policies for strengthening health systems and creating and enabling an equitable environment that would make universal access possible. Moreover, progress on universal access to sexual and reproductive health called for “courageous and creative programming”, as well as the involvement of diverse actors, including development banks, civil society, faith-based and private-sector partners, Governments and international organizations.
JOSÉ MIGUEL GUZMAN, Chief, Population and Development Branch, Technical Support Division, UNFPA, presented the report of the Secretary-General titled “Flow of financial resources for assisting in the implementation of the Programme of Action of the International Conference on Population and Development” (document E/CN.9/2011/5), saying it covered funding for family planning services; basic reproductive health services; sexually transmitted diseases and HIV//AIDS activities; and basic research, data and population and development policy analysis. The latest available data showed that donor aid had stabilized at about $10 billion and developing countries had mobilized about $30 billion for population activities.
He recalled that two years ago, when UNFPA had revised the original cost estimates of the International Conference, in line with current needs, it had determined that $65 billion would be required by 2010 to fund necessary services in full. However, donor aid would likely remain at the current level, creating a $24 billion shortfall in funding for population programmes in developing countries, he noted. Greater donor aid and national investment in those countries was needed, he said, warning that out-of-pocket consumer spending by the poor, which financed most population goods and services in such countries, could drive them further into poverty and impede spending on other essentials like food and education.
“The price may be high, but the cost of not mobilizing adequate financial resources is definitely higher,” he emphasized, pointing to the resulting increase in infant and child mortality, maternal mortality, and HIV/AIDS-related deaths. It was particularly important to meet the needs of the poorest populations, he said, pointing out that some countries lacked adequate funds for the proper conduct of censuses, and for the analysis and dissemination of data essential for defining vulnerable populations and providing the evidence bases needed for policy formulation, programme planning and monitoring of the Millennium Development Goals.
The Commission then began its consideration of actions in follow-up to the recommendations of the International Conference on Population and Development.
CHANDRA ACHARYA ( Nepal), speaking on behalf of the Group of Least Developed Countries, said the current session was important in the context of the upcoming United Nations Conference on the Least Developed Countries, to be held in Istanbul, Turkey, next month. Those countries faced a number of problems and challenges relating to the rising aspirations of their growing populations, as well as their development prospects. Their inner structural constraints, vulnerabilities and lack of capacity, in addition to external shocks, had severely affected their efforts to realize the goals and objectives of the Programme of Action, he said.
More than a billion people of the world’s people still lived in “miserable conditions”, many of them in least developed countries, he said, noting that they endured the highest rates of maternal and child mortality, and had some of the highest fertility rates . It was therefore necessary to “break the nexus” of high fertility, lack of services and poverty afflicting least developed countries, he said, adding that he was deeply concerned about the challenges they faced from HIV/AIDS, tuberculosis and malaria, the lack of women’s empowerment and problems in providing health facilities and workers.
With regard to the implementation of the Programme of Action, he said there were gaps in terms of attention, action and global efforts to eradicate poverty and achieve sustainable development. The mobilization of resources, particularly through official development assistance (ODA), fairer terms of trade, technology transfer and capacity-building, among other things, should further enable least developed countries to make greater progress in meeting the goals and targets of the International Conference. Among other things
GRIGORI USTINOV ( Russian Federation) said the Secretary-General’s report failed to take fully into account all aspects of national demographic transitions, particularly population ageing. The Russian Federation had expected it to provide a more multifaceted, nuanced picture. According to the report, reducing birth rates was the only way to achieve socio-economic development and well-being, he said, criticizing that “one-size-fits-all” approach for failing to take into account the many factors influencing a nation’s development.
Emphasizing that his country’s priority was to increase fertility rather than reduce it, he said low birth rates were a cause of great concern in the Russian Federation and other countries that accounted for one fifth of the global population. However, the Secretary-General’s report lacked a description and analysis of the problem of low birth rates in some countries where ageing populations were increasing the number of people dependent on social welfare, thus raising welfare spending. With few exceptions, developed countries were the ones with birth rates below population replacement rates, he pointed out.
Similar problems occurred in the global South, he continued, pointing out that population ageing was a worldwide problem that was taking place at a faster pace in the developing world. The proportion of elderly people was set to triple in developing countries, but they lacked an established system to care for them. It was difficult to predict the economic pay-off of structural change in developing countries, he said, cautioning that their smaller labour forces would hinder their economic potential and the global economy as a whole.
JOHN BONGAARTS, Vice-President of the Population Council, the keynote speaker, said that while the addition of 4 million people to the world’s population was the most obvious example of recent global fertility trends, fertility had nonetheless fallen overall and more people were living longer and healthier lives. Reviewing fertility trends in the world’s regions — particularly as expressed in the number of surviving daughters per woman — he said there was a strong correlation between total fertility rates and population growth, and the world was extremely diverse in that respect.
In high fertility growth countries, there was rapid population growth and a large, rapidly growing percentage of the population was under the age of 25, he said. The development-related consequences of a high fertility rate included a large influx of young people competing for jobs, which often led to lower wages; the depletion of natural resources and more pollution; higher maternal and child mortality; lagging Government investment in education, health services and infrastructure; and more extremism and civil strife.
By contrast, he continued, in countries with intermediate and declining fertility rates, the population was decreasing, leading to fewer young people and more workers. That, in turn, led to rising wages, but also often to higher levels of inequality. It also led to the increasing engagement of women in the workforce, as they had a less urgent need to stay at home; declining maternal and child mortality; massive investments in education, health services and infrastructure; and political inequality and disaffected voters.
In countries with low fertilities, including many developed countries, there was near-zero or negative population growth rates and rapidly ageing populations, he continued. Development indicators related to low fertility rates included slower economic growth; slower increases in living standards due to the declining percentage of the population actually working; slower growth in worker productivity; unsustainable health and pension costs; rising Government budget deficits; and the growing voter power of the elderly.
The policy options that various countries could pursue to achieve their population aims varied widely between countries seeking to increase the ageing population and those that sought to decrease their large, young populations. In high-fertility countries, for example, family planning programmes and investment in human capital — particularly the education of girls — were desirable. Family planning programmes improved maternal and child health, reduced poverty and inequality, helped to achieve gender equality and countered HIV/AIDS.
Policy options in ageing societies, by contrast, included changes in pension policies and pushing back retirement ages, he said. Such countries could allow more immigration while working to encourage child-bearing, including through Government-assisted fertility treatments and related health policies. Additionally, they could strive to reverse the “tempo effect” of women having children later in life, particularly by encouraging an earlier start to child-bearing and smaller intervals between births.
During the ensuing discussion, speakers asked how African countries could strike a balance between population growth and population control in trying to avoid the excessively low birth rates seen in some European countries. One speaker pointed out that the value that poor women in developing countries placed on large families often hindered family planning efforts. They asked why fertility decline had stalled in many countries and what potential impact it could have on wages for youth and senior citizens. They asked Mr. Bongaarts to elaborate on European programmes to curb fertility rates.
Mr. BONGAARTS, responding, strongly advised African Governments to invest in family planning while cautioning that the prospects for population decline on the continent were very low. While the HIV/AIDS pandemic had led to wide-scale deaths during the 1990s, they had not been enough to offset population growth in Africa. In fact, the population in Niger was expected to triple, causing a reliance on outside aid for food and other basic needs. However, there were some exceptions, he said, citing lower fertility rates in Kenya and Ghana, and more recently in Rwanda, which had invested largely in contraceptive use. But typically, African families desired four to five children each, double the size desired in many other regions.
While agreeing that there were social obstacles to family planning in poor countries, particularly among uneducated women — including false rumours about the dangers of contraception and husbands pressuring wives to have several children — he pointed out that fertility rates in Indonesia and Thailand, where family planning programmes had been introduced in rural areas, were the same among both educated and uneducated women. Regarding wages, he said older workers tended to be more productive than their younger counterparts, but their wages were also higher, making it more cost-effective, in many cases, to hire younger people. He cited successful family planning programmes in France and the Scandinavian countries.
He went on to emphasize that having a child was a large commitment and that over the course of a lifetime, raising one would cost almost $1 million in direct investment and opportunity costs. Giving parents small “birth bonuses”, therefore, would not be enough and more substantial policies were needed to influence decision-making. Raising the birth rate to 1.7 per cent or 1.8 per cent, which was doable in most countries, would be sufficient to create population stability in countries where rates were too low, he said.
The representative of Honduras, noting that many countries experienced a “clash of forces” with regard to reproductive health, said the “weight of culture” was greater than that of political decisions, and asked how such societies could effectively overcome that discrepancy.
A representative of the non-governmental organization Latin American and Caribbean Women’s Health Network (Red de Salud de las Mujeres Latinoamericanas y del Caribe)describededucation as the best form of contraception for women. Looking at the debate on regulating fertility in terms of national development, therefore, placed a “precarious” emphasis on development before human rights, she said.
Mr. BONGAARTS responded by saying that any policy that he recommended would “not try to change culture”, but only to help individuals reach their own reproductive goals, adding that women around the world had welcomed such policies. With regard to education, he stressed the importance of policies that would make it possible for all women to have access to knowledge and choices.
The Commission then resumed its consideration of actions in follow-up to the recommendations of the International Conference on Population and Development.
CSABA KÖRÖSI (Hungary), speaking on behalf of the European Union, reaffirmed its strong support for and commitment to the full implementation of the Cairo Programme of Action, as well as for key actions for its further implementation, agreed at the five-year review of the International Conference, and for the Copenhagen Declaration and Programme of Action. The European Union emphasized that gender equity could not be achieved without guaranteeing women’s sexual and reproductive health and rights. It had been at the Cairo Conference that delegates had confirmed reproductive rights and first proclaimed the right to the highest standard of sexual and reproductive health, which “cut to the core of human existence, progress and survival”. While progress had been made in that respect, those rights remained unfulfilled for far too many women, men and young people, with “devastating and far-reaching” consequences, he said.
As for Millennium Development Goal 5, improving maternal health, he said every woman needed three critical reproductive health services — family planning, skilled attendants at birth, and emergency obstetric care if complications arose. Governments must show significant political and financial commitment to saving women’s lives, which would also improve maternal and child health while reducing the incidence of HIV/AIDS and other sexually transmitted infections, he said. The lack of access to information about reproductive health and services must also be urgently addressed. “Poor sexual and reproductive health threatens human development, economic growth and social coherence,” he said, adding that progress in education would help reduce fertility and morbidity.
While fertility rates had declined in virtually all countries, the timing and speed of that decline varied greatly, he continued. The challenge for Europe, besides the ageing population, was that fewer women were giving birth at an increasingly later age. Advances in gender equity had not been sufficiently balanced by “family-friendly” policies, but Member States today were increasingly paying more attention to developing such policies, which had an important influence on fertility trends. In the countdown to 2015, the European Union would accelerate action to guarantee universal access to reproductive health and ensure the security of reproductive health commodities. It would also do its utmost to increase access to family planning. Finally, he noted the need for sufficient domestic and international resources to achieve full implementation of the Cairo Programme of Action, and to work towards the implementation of the wider Millennium Development Goals.
WANG PEI’AN, Vice-Minister, National Population and Family Planning Commission of China, strongly endorsed the recommendations in the Secretary-General’s report for reducing fertility and promoting reproductive health. He stressed the importance of focusing on the influence of cultures and traditional customs on changes in fertility, each country’s specific fertility situation and needs, the responsibility of Governments and non-governmental organizations in reducing fertility and promoting reproductive health, and cooperation among countries and regions in that regard.
Greater attention must be paid to the role of family planning in socio-economic development, he said, noting that despite remarkable progress, family planning and reproductive health still failed to attract due attention, and that it required more funding. He called for enhanced capacity for family planning and reproductive health services; safe, effective and appropriate contraceptives; and better monitoring of and research into family planning services and regulations. Greater efforts were needed to ensure gender equality in education and for reproductive-health advocacy through public dissemination campaigns. Governments should work hard to incorporate reproductive health into national development plans and poverty-reduction strategies, he said, calling also for greater South-South and triangular cooperation.
JAIRO RODRÍGUEZ HERNÁNDEZ ( Cuba) said his country had a very low rate of HIV/AIDS infection, as well as low rates of maternal and child mortality, while Cuban women enjoyed significant gender empowerment. He said little progress had been made since 2009 in reviewing the flow of funds from donors to the reproductive health programmes of developing countries. Those funds were not enough in comparison to the growing needs of developing countries, and in that vein, Cuba advocated greater commitment by donor countries to generate the political will needed to support reproductive health in developing countries.
SAVIOUR BORG ( Malta) emphasized that that any position taken, or recommendations and reports on sexual and reproductive health rights and services, should not in any way obligate any party to consider abortion as a legitimate form of such rights or services. Such positions were to be considered in accordance with the outcome of the International Conference and its Programme of Action, including reservations registered during the Conference and at subsequent international meetings or with the Commission.
He said his country’s development assistance supported action to promote and improve sexual and reproductive health care, particularly action aimed at safe motherhood. Men’s health was also an important component of family health care, which, if neglected, could result in fertility problems and the spread of sexually transmitted diseases. Universal access to education and information on the relevant aspects of sexual and reproductive health were essential, he said. Malta also supported gender equality and promoted the advancement of women, as well as the elimination of violence against them, as demonstrated by the great advances Maltese women had made in education, employment and socio-economic well-being over the past four decades.
Emphasizing the importance of early education in efforts to eliminate gender stereotyping and encourage gender equality, he said that in countries with low fertility rates, such as his own, that could be enhanced by helping workers reconcile family and work life. Flexible working arrangements, as well as provisions for special leave and child care, helped parents create a healthy balance in that regard. He expressed support for a women’s right to control her own fertility and for couples to control the size of their families through effective contraceptive methods.
ANDREW GOLEDZINOWSKI ( Australia) said his country was concerned about the high fertility rates of many countries, including some in its own region. In Papua New Guinea, for example, only an estimated 39 per cent of births had been attended by a skilled birth attendant, and maternal mortality rates were high. As previously announced, Australia had committed $1.6 billion to support maternal- and child-health programmes over the next five years, he said. Among other actions, it was working with its neighbours in the Asia-Pacific region to strengthen health services — by training birth attendants and midwives in particular — and was investing in family planning.
However, the focus going forward should not just be on spending more, he stressed, noting the need for political will and effective interventions. Partners should avoid fragmentation and work to identify bottlenecks in health services. Alongside the United States, the United Kingdom and the Bill and Melinda Gates Foundation, Australia had joined the International Alliance for Reproductive, Maternal, and Newborn Health, he said. Finally, he noted that countries like Bangladesh were achieving “impressive results” in their pursuit of universal access to reproductive health. With innovative and integrated programming and full support at all levels, universal access was indeed achievable, he said.
KARIN KAUP ( Estonia) said her country strongly supported full implementation of the Programme of Action and the decision to extend it beyond 2014, emphasizing that firm national commitments were needed to achieve its objectives in full. Population dynamics were directly linked to global sustainable development, she said. Sexual and reproductive health rights were a crucial part of population policy, calling for universal access to reproductive health care services, in line with the International Conference. All couples and individuals should have the right to decide freely and responsibly the number, spacing and timing of their children. It was critical to educate youth and to provide them with access to sexual and reproductive heath information and services, she said, expressing her country’s strong support for full implementation of the Beijing Platform for Action. Women’s empowerment was crucial for development everywhere, she added.
ESHAGH AL-HABIB ( Iran) said the world’s population was undergoing an “historic” change from high to low levels of fertility, but not all countries were experiencing that change at the same rate. Such a diverse situation warranted a tiered approach, and similarly, the Commission’s work should account for the distinct needs of different countries and avoid a “straitjacket” approach. In addition, Commission members should recognize that the issue at hand did not affect developing countries exclusively. A culturally sensitive approach to sexual and reproductive health was the most effective strategy in many countries, including Iran, he said, emphasizing the importance of taking the many different issues relating to reproductive and sexual matters into account.
The Commission then began its general debate on national experiences in population matters: fertility, reproductive health and development.
NOORUL AINUR MOHD NUR, Secretary-General, Ministry of Women, Family and Community Development of Malaysia, said fertility in her country was declining faster than expected due to the rise in the average marriage age from 24.7 in 1991 to 25.3 in 2004. Malaysia’s fertility rate was expected to reach the replacement level by 2015, she said, adding that the Government hoped to sustain the current fertility rate of 2.3 children. That major challenge must be monitored to prevent a contraction of the labour force, rapid ageing of the population or other social implications, she said.
She recalled that since the 1990s, her country had implemented strategies to ensure that fertility remained at the current level, with an emphasis on family development. The national family policy introduced in December 2010 incorporated a family perspective on socio-economic development planning, law, policies and services. To ensure realization of Millennium Development Goal 5, Malaysia had scaled up efforts to reduce maternal mortality, which had resulted in an impressive decline from 140 per 100,000 live births in 1970 to 30 per 100,000 in 2008. That number would be reduced to 11 per 100,000 by 2015, she added.
The Government had introduced programmes to fulfil unmet family planning needs, she said, pointing to the national policy on reproductive health and social education, approved in November 2009, which had paved the way for more accessible reproductive health-care information and services for youth. The Ministry of Health had introduced sex education in primary schools, and since 2006, the Government had been providing free treatment for all HIV/AIDS patients in its hospitals and clinics.
Ms. STRAKHOVA ( Russian Federation) said fertility and reproductive health were very important topics for her country, which had a low birth rate of just 1.9 children per woman. That number was under the replacement rate, she said, adding that President Dmitry Medvedev had said that increasing fertility rates was a key priority. The main aims of the national population strategy included raising the birth rate, improving the health of women and children, halving mortality rates, providing assistance and health care to women during pregnancy, training midwives and birth attendants, improving the quality of health care and reducing the risks associated with labour.
She said her country had been carrying out measures to improve the quality of family life since 2007, in particular by increasing Government assistance in the form of lump-sum cash payments to families with children. With respect to reducing child and maternal mortality, it had been carrying out several programmes and helping clinics to acquire more medical equipment. Also under way was the creation of a network of maternal health centres staffed by highly qualified personnel. The Russian Federation had also launched a central perinatal centre and 14 local ones, and was providing treatment for HIV-infected mothers. While women should be able to make their own decisions about motherhood, the Russian Federation was trying to reduce the number of abortions, she said. Thanks to the many measures implemented, the national birth rate had risen by more than 21 per cent since 2005, while maternal and child mortality had fallen.
MARGARET POLLACK ( United States) said the session must address the real-life circumstances of youth, and pursue progress in providing them with the tools to shape their future, including comprehensive information, sexuality education and health services. She welcomed the Secretary-General’s Global Strategy on Women’s and Children’s Health, which encouraged investment in women and girls to meet the health-related Millennium Development Goals. The Strategy had already won significant financial support, she said, noting that nearly 30 countries with the highest burden of maternal mortality had made commitments to prioritize the necessary investment, especially in the integration of reproductive health services.
She went on to state that the aim of her country’s Global Health Initiative was to provide integrated health services based on strong health systems that emphasized country ownership. It focused on women, girls and gender equality, and on the fight against disease and efforts to promote good health worldwide. President Barack Obama’s Emergency Plan for AIDS Relief was working to improve women’s reproductive health as part of wider efforts to foster comprehensive responses to HIV, particularly in prevention, which would more effectively meet the needs of women and girls. The Administration was strongly committed to achieving reproductive health and promoting human rights, both domestically and internationally, she stressed.
Ms. HILBER (Switzerland) said that despite universal recognition that all couples and individuals should have the right freely and responsibly to decide the number and spacing of their children, and have the information, means and education to do so, there remained a considerable unmet need for family planning. Reaching the most vulnerable, poor and disadvantaged members of society required concerted efforts, as well as a proactive, human rights-based approach on multiple levels and in various sectors. For renewed commitments to be effective, sexual and reproductive health care services should be integrated into primary health-care packages, she said, adding that there was also a need for targeted investments in health systems and for the removal of barriers such as excessive user fees that limited access to essential services.
In Switzerland, as in most other European countries, fertility was low, women delayed childbearing until their early 30s on average, and the population was ageing, she noted. Though access to family planning and health care were guaranteed by law, social and financial barriers still impeded the use of some services by the country’s most vulnerable populations. The poor and disenfranchised were the most in need, but also the least likely to gain access to the services they needed, she said. That resulted in increased morbidity, unplanned pregnancies and high rates of abortion, particularly among young migrant women and undocumented women workers.
Similar challenges could be seen in developing countries in which the Swiss Development Corporation was active, she continued. Additionally, there were patterns of discrimination and under-utilization with regard to reproductive health-care services, as well as constraints in human resources, infrastructure and health commodities including essential drugs, logistics and financing, which required sustained support through long-term efforts. Employing “system thinking” to expand access, particularly at the primary care level, was therefore a priority for Switzerland, she said, adding that the low status of women in many countries contributed to high fertility and poor sexual health and reproductive outcomes.
Vice-Minister WANG, National Population and Family Planning Commission China, said that, as a large, populous developing country, China had made impressive gains in family planning since the 1970s. Its fertility rate had dropped from 5.8 per cent to 1.8 per cent, while the percentage of the Chinese population around the world had dropped from 22 per cent to less than 19 per cent. The country had also made good progress in promoting universal access to reproductive health by 2015, with maternal and infant mortality rates having dropped. To reduce fertility and promote reproductive health by seeking a unique, comprehensive solution to population matters and promoting long-term balanced population development, the Government had incorporated population matters into socio-economic development policy.
In recent years, the Government had vigorously advocated family planning, better child-rearing practices and gender equality, he said. At present, contraceptive use exceeded 85 per cent while 70 per cent of people in the rural areas, as well as 85 per cent in urban areas, had access to basic reproductive health care. Frequent education and training for Government officials had enhanced awareness of the national population situation, security and the basic state of family planning. The Government had steadily increased public funding on family planning services in rural and urban areas, and in 2009, it had promulgated family planning regulations to protect the legitimate rights of migrant workers. China had participated actively in the development of international population forecast rules and standards, he added.
SUGIRI SYARIF ( Indonesia) underscored the vital need to enhance financing, strengthen policy and improve service delivery in addressing challenges related to sexual and reproductive health. Legislation had recently been passed to address the country’s high fertility rate and the low health status of its population, he said. That commitment had resulted in the decline of Indonesia’s total fertility rate from 5.6 in 1970 to around 2.3 today. Additionally, the infant mortality rate had declined from 142 deaths per 1,000 live births in 1971 to the current 34 deaths per 1,000. Such achievements were already evident, as Indonesia had been ranked eighteenth in the world economy in terms of gross domestic product, he said.
However, Indonesia still faced a number of challenges pertaining to maternal mortality and HIV/AIDS, he noted. Its maternal mortality rate remained high, but was gradually falling, while the rate of HIV infection was low but undergoing a relatively high rate of increase. Continuing efforts in those areas would entail raising the quantity and quality of health-care services and enhancing community participation, he said, recalling that in January, the Government had approved a policy to fully finance ante-natal care, properly skilled birth attendants, post-natal and newborn care, as well as family planning services provided by 23,500 family planning clinics serving poor families and those in remote areas. Indonesia had also agreed to bilateral cooperation with several countries in the field of reproductive health.
SHIGESATO TAKAHASHI (Japan) thanked the international community for their condolences and assistance in response to the “Great East Japan” earthquake and tsunami.
He said his country was faced with a low fertility rate that was far below the needed population replacement level. As a result, Japan’s population was ageing rapidly. To address that, the Government had created “the vision on children and child care”, which set concrete targets based on the “children first” concept of child rearing. Increasing fertility would help slow the ageing of Japan’s population, reduce the national social security burden and boost economic vitality. Japan was working to ensure safe contraception and childbirth, enhance the ability of communities to raise children, and increase men’s involvement in child rearing.
To address high rates of infant mortality and abortion, the country had strengthened its national supervision of public health and medical systems, he continued. Japan’s health policy was based on the concept of human security, and in 2010, the country had donated more than $26 million to UNFPA and over $10 million to the International Planned Parenthood Federation. In the same year, it had supported implementation of Afghanistan’s census, and provided instruments and other supplies needed for emergency obstetric treatment provided by UNFPA projects in Pakistan, Ethiopia, Zimbabwe and the Democratic Republic of the Congo. This year, Japan had proposed the “ensure mothers and babies get access to care” aid model of community-based preventive and clinical care as part of its new global health policy, he said.
ADAM FRONCZAK, Deputy Under-Secretary of State in the Ministry of Health of Poland, associated himself with the European Union and noted that any references to family planning did not constitute his country’s endorsement of abortion. Poland’s infant mortality rate had been falling, and the country had made significant accomplishments against maternal mortality, he said. The protection of women during the pregnancy, labour and post-partum periods was assured by national legislation and by the Constitution itself, he stressed. Given the need to provide them with the best possible services, Poland had passed a regulation, in line with World Health Organization (WHO) and other international standards, which protected patients’ rights, optimized the costs of care and ensured sufficient funds for care, among other things.
He said his country’s fight against the HIV/AIDS epidemic was led by a multisectoral approach based on the principles of the inviolability of dignity and respect for human rights. The Government ensured the provision of easily accessible, free antiretroviral therapies. With regard to maternal mortality, he said data gathered over the last 15 years had shown a significant decrease in the rate, and the national infant mortality rate had also fallen. The primary objectives of the country’s population policy were to improve the quality of life, support families and provide services related to the sustainability of socio-economic development. In addition, a vast variety of social benefits and social welfare programmes provided help for those in need.
JUAN PABLO DE LA IGLESIA ( Spain) said gender equality could not be achieved without guaranteeing the sexual and reproductive rights of women. Spain had recently updated its legal framework on those rights, and in 2006, had adopted a law on assisted human reproductive techniques. Recently, the country had adopted sexual and reproductive health legislation and, in 2010, a national strategy for reproductive and sexual health, including the right to decide on reproductive commitments, pre- and postnatal treatment and the right to decide freely on those issues. Those strategies made it possible for pregnant women and breastfeeding mothers to know their labour rights and reconcile family and work life, he said, adding that they also gave men the right to paternity leave. One million fathers had taken advantage of that since its introduction in 2007.
Describing his country as one of the top-10 donors to UNFPA, he said it supported maternal health as well as sexual health-care services in Africa. At the end of 2010, the Government of Spain had signed a strategic agreement with UNFPA, which included multi-year commitments and a new communications strategy linked to accountability, among other things. The Spain United Nations Development Programme (UNDP) Fund for the Millennium Development Goals contained a window devoted to infancy, food security and nutrition, for which the country had contributed $130 million, he said. It was important that donors and international organizations coordinate their contributions and channel aid to national health-care systems, he emphasized.
JANNE TAALAS (Finland) said sexual health had been taught in Finish schools since the 1970s, but in the 1990s, cuts had been made to education curriculums and sexual education was no longer mandatory. As a result, adolescent abortions had increased by 50 per cent, he said, adding that the rate had fallen again after the education programmes had been re-established in 2006. That experience demonstrated that reliable and sufficient sexuality education did not promote promiscuity or encourage young people into early sexual encounters. Health education not only had preventative effects, such as reducing teen pregnancies, it also changed attitudes and created open discussion on issues concerning sexual and reproductive health and rights, he continued, noting that about 1.8 billion young people would be entering their sexual and reproductive lives in 2011. The young could not be ignored, he stressed, adding in that respect that his country looked forward to the Commission’s 2012 theme on youth and adolescents.
It had been estimated that an additional year of schooling could reduce female fertility by 5 to 10 per cent, he said. An educated woman was more likely to educate her children, and in turn, to have positive effects on the social and economic development of a community and on poverty alleviation. However, that positive cycle was not possible without access to information about sexual and reproductive health and rights. The adequate provision of contraceptives was also essential, he said, adding that it had been estimated that each dollar spent on family planning saved $31 in other sectors. All individuals, including unmarried and young people, had the right freely and responsibly to decide on all matters related to their sexuality and reproduction, free of coercion, discrimination and violence, he emphasized.
MARIJA TASLER (Croatia) said measures to ensure good reproductive health, safe motherhood and family planning were among her country’s top priorities. Croatia’s fertility rate stood at 1.5 births per woman, and would continue to decline due to the global economic crisis, which was impeding the national development agenda due to younger women and men postponing marriage. The Government had established measures to help women and men balance family and work life, he said. Women had the right to six months of maternity leave and to breastfeed at work, she said, adding that, while there had been 16 groups promoting breastfeeding in 2006, today there were 105.
She went on to say that her country’s “baby-friendly maternal hospitals” national programme gave women the right to choose how they wished to give birth. Half of Croatia’s 30 maternity hospitals participated in the programme, which gave women the right to in-room care and provided the opportunity for breastfeeding in the first 24 hours after birth. Since the inception of Croatia’s national programme for early breast cancer detection four years ago, the number of women voluntarily undergoing testing for the disease had gradually increased, she said. Thanks to such screenings, 1,400 cases of breast cancer had been detected and successfully cured.
Mr. DAMBULA (Malawi) said his country’s population was very young, with a median age of 17. The fertility rate was declining, but at a slower rate than the global trend. Currently at 5.7, it had declined from 6.3 in 2003. The population growth rate stood at 2.8 per cent and was expected to double by 2023, he said, adding that Malawi’s population policy, introduced in 1994, was currently under review. In a bid to reduce the population growth rate, Malawi was focusing on enhancing sexual and reproductive health services, improving quality and access to family planning services, girl-child education, early-childhood development and ensuring that everyone’s rights to reproductive health were met.
While acknowledging the need for and benefits of lower fertility levels, he said Malawi felt strongly that it could not adopt a prescription of 2.5 as the number of children each woman could have, since that would have implications on the country’s productivity and development. However, Malawi would instead continue to advocate smaller family sizes through information, education and communication, and by ensuring that people made informed decisions on the number of children they wished to have. The national laws categorized abortion as illegal, he said, adding that the average Malawian woman was more concerned with having a healthy pregnancy, healthy children and adequate nutritious food for her family.
EDUARDO RIOS-NETO, President of the National Commission on Population and Development of Brazil, said his country’s fertility rate had steadily declined in recent decades, from 4.4 children per woman in 1980 to 1.9 children per woman in 2009. Today, the rate was below replacement levels, which could result in lost opportunities, due to the lack of proper State social policies and macroeconomic stabilization adjustment measures. Brazil had fully embraced the spirit of the International Conference and its Action Programme. In Brazil, access to health care was a constitutional right. Brazil’s health system was one of the largest public health systems in the world providing universal coverage. It included strategic initiatives to improve access to reproductive health and provide family planning. Access to contraceptive measures was guaranteed for all men and women of reproductive age, regardless of their marital status. Improving family planning had been an important part of a strategy to reduce maternal mortality and unsafe abortions.
In Brazil, 1.2 billion condoms were distributed free of charge, he said. In addition, 34 million reproductive-age women received a variety of contraceptive supplies. The public health system provided in-vitro fertilization, as well as infertility and sexual dysfunction treatment for men. Also, Brazil was a well-known pioneer in treating HIV/AIDS, and thanks to its promotion of universal access to antiretroviral treatment, the incidence of HIV/AIDS was declining. This year, Brazil had started a plan to strengthen the national programme to control breast and cervical cancer through prevention, early detection and treatment. The Brazilian Ministry of Health had strategies to reduce maternal and neonatal mortality, and as a result, the former had dropped by 56 per cent from 1990 to 2007.
ANNE ANDERSON (Ireland) said that the lack of access to reproductive health care remained one of the principal barriers to achieving real gender equality and ensuring that women were empowered to fully participate in the political, economic and social life of their communities and societies. In that respect, Ireland welcomed the unanimous decision of the General Assembly to extend the Programme of Action beyond 2014, and believed that a related special session of the Assembly, to be held in 2014, would be a “milestone in the international debate on reproductive health and development”. It was unacceptable that 200 million women across the world lacked access to safe, effective and affordable forms of contraception, and that up to half a million women died during pregnancy and childbirth each year — 99 per cent of them in developing countries.
With regard to abortion, the Programme of Action underlined two important principles, namely that abortion should never be used as a form of family planning, and that the availability, or otherwise, of abortion was a matter for individual Member States to decide. Ireland was fully committed to upholding those principles. Moreover, as States were free to define sexual and reproductive health services under national law, it wished to put on record that it persistently objected to any interpretation of those services as including abortion. At the national level in Ireland, the Irish Constitution acknowledged the right to life of the unborn and, with due regard to the right to life of the mother, committed the State to respect and defend that right. Ireland did not believe that the right to sexual and reproductive health services included an intrinsic right to have access to abortion services. Meanwhile, Ireland did not seek to influence the decisions taken by other national Governments, in that respect.
DIANA AL-HADID (Jordan) said her country was giving due attention to new developments in human resources, particularly concerning changing demographic patterns that presented windows of socioeconomic opportunity. Planning for and monitoring of those changes could create useful opportunities, as fertility rates declined. Her Government had devised national plans to take advantage of such opportunities, based on three scenarios. The first plan imagined a continuation of the country’s current demographic situation. The second was based on national objectives to achieve a fertility rate of 2.5 births per woman by 2017, and that rate would continue to fall until it reached the replacement rate of 2.1 births per woman in 2030. The third aimed at reaching the fertility replacement rate by 2040.
The plans aimed to increase the effectiveness and efficiency of reproductive health and family planning programmes, raising awareness about healthy sexual behaviour among youth, while taking into account religious customs and traditions, she said. They aimed to advance educational methods, research and development, as well as improve women’s socioeconomic situation by strengthening their participation in the labour market.
SAMUEL K. SINEI, Chair, National Coordinating Agency for Population and Development of Kenya, said that fertility levels in his country had declined over the past two decades. By 1998, the rate had reached an average of 4.7 children per woman; after a slight increase, that rate had fallen further to 4.6. Fertility rates varied widely with a mother’s education and economic status. Women who had secondary and higher education had an average of 3.1 children, while women without education had more than twice as many. Wealthy women had fewer children than those who were poor. Additionally, a large percentage of Kenya’s population was youthful, and adolescent fertility rates had unfortunately reached “worrisome” levels, with about 18 per cent of girls aged 15 to 19 already having started childbearing.
Real evidence showed that the knowledge of family planning methods in Kenya was nearly universal, as 95 per cent of all women aged 15 to 49 knew at least one modern method of family planning, he said. Although Kenya was working towards improving access to family planning, a lack of stocks hindered access to those services for critical segments of the population. The Government had instituted several policies and legislative measures to enforce reproductive health and rights since the 1994 International Conference. It continued with the development and implementation of policies, guidelines and training curricula on task shifting among health-care providers, as spelled out in the Second National Health Sector Strategic Plan 2005-2010. While facing some challenges to the accessibility of reproductive health services — including weaknesses in the health sector, low demand for and utilization of reproductive health services and social and cultural barriers — Kenya hoped to restructure and strengthen its health-care system in line with its new Constitution. Moreover, the “Kenya Vision 2030” plan hoped to transform the country into a modern, globally competitive, middle-income country and to reduce the number of people living below the poverty line by 2030.
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* The 1st Meeting was covered in Press Release POP/984 of 16 April 2010.