UN Population Division, Department of Economic and Social Affairs,
with support from the UN Population Fund (UNFPA)

Women, empowerment and health


Cairo, Egypt

5-13 September 1994



The empowerment and autonomy of women, and improvements in their

political, social, economic and health status, are recognized by

the International Conference on Population and Development (ICPD)

as highly important ends in themselves. In addition, they are seen

as essential for the achievement of sustainable development.

     The central role women play in regard to population and

development has been strongly emphasized in all preparations for

ICPD. Empowerment of women was discussed during five regional

population meetings, three sessions of the ICPD Preparatory

Committee, and a number of expert group meetings and round tables.

     The need for gender equality, equity and empowerment of women

is emphasized throughout the draft Programme of Action of the

Conference, adopted at the third and last session of the ICPD

Preparatory Committee (PrepCom III) in April 1994. (Wording within

square brackets was proposed but not agreed to at PrepCom III, and

is subject to further negotiation in Cairo.)

     Chapter IV of the draft Programme, entitled, Gender Equality,

Equity and the Empowerment of Women, includes subchapters on: the

empowerment and status of women; the girl child; and male

responsibilities and participation. The draft chapter calls upon

countries to act to empower women and to take steps to eliminate

inequalities between men and women as soon as possible.

     Recognizing that discrimination on the basis of gender starts

at the earliest stages in life, the document asserts that greater

equality for girls in regard to health, nutrition and education is

the first step in ensuring that women realize their full potential

and become equal partners in development. The draft Programme

encourages leaders to speak out forcefully against gender

discrimination, and undertake efforts to promote equitable

treatment of girls and boys with respect to nutrition, health care,

inheritance rights, education, and social, economic and political


     The draft Programme of Action underscores the need to promote

gender equality in the family and in the community, noting in

particular that men should take responsibility for their fertility

and parental duties. It calls for special efforts to involve men in

safe and responsible parenthood and family planning.

     Education is one of the most important means of empowering

women with the knowledge, skills and self-confidence necessary to

participate fully in the development process. One of the goals

specified in the draft Programme of Action is for all countries to

ensure that all girls and boys have access to primary school or

equivalent level of education, as quickly as possible and in any

case before 2015.

     Countries that achieve universal primary education sooner are

urged to extend access to and facilitate completion of secondary

and higher levels of education and training. In seeking to attain

these goals, the draft Programme states that particular attention

should be given to eliminating disparities in educational access

and support that are detrimental to girls.



To realize their full potential, women must be guaranteed the

exercise of their reproductive rights and must be able to manage

their reproductive roles, the ICPD draft Programme states. Chapter

VII, Reproductive Rights, [Sexual and Reproductive Health] and

Family Planning focuses in five subchapters on: reproductive rights

and reproductive health; family planning; sexually transmitted

diseases and prevention of human immunodeficiency virus (HIV)

infection; human sexuality and gender relations; and adolescents.

     The draft Programme defines reproductive health as: "a state

of complete physical, mental and social well-being and not merely

the absence of disease or infirmity, in all matters relating to the

reproductive system and to its functions and processes."

     Reproductive health implies that people are able to have a

satisfying and safe sex life and that they will have the capability

to reproduce and the freedom to decide if, when and how often to do

so. Women and men must be provided with the necessary information

and services to exercise this right, according to the draft


     Sexual health is defined in the draft Programme as: "the

integration of somatic, emotional, intellectual and social aspects

of sexual being, in ways that are positively enriching and that

enhance personality, communication and love."

     According to the document, the cornerstone of [sexual and

reproductive health] is recognition of the basic right of all

couples and individuals to decide freely and responsibly the

number, spacing and timing of their children, and to have the

information and means to do so. It also includes respect for

[security of the person and] physical integrity of the human body.

     Promotion of the responsible exercise of these rights by all

people should be the basis of government policies and programmes in

the area of [sexual and reproductive health], including family

planning, the draft Programme asserts. It urges all countries to

strive to make accessible through the primary health-care system

[reproductive health] care to all individuals [of all ages] as soon

as possible [and no later than 2015].

     Reproductive health care, the document states, should include:

information and services for family planning, prenatal care,

delivery and post-natal care; prevention of abortion and management

of complications of abortions; health care for women and infants;

and prevention and treatment of infertility and sexually

transmitted diseases; among others.

     The draft Programme stresses that women should be involved in

all levels of health care programmes, and involved in the planning,

implementation and evaluation of [sexual and reproductive] health

care programmes. The document emphasizes that the principle of

informed free choice is essential to the long-term success of

family planning programmes; no form of coercion has any part to


     Currently about 55 per cent of couples in developing countries

use some method of family planning. This figure represents a

tenfold increase in absolute terms (to 460 million couples) and a

fivefold increase in percentage terms since the 1960s. Family

planning programmes have contributed considerably to the decline in

fertility rates in developing countries from about six to seven

children per family in the 1960s to three to four children at


     However, the number of couples of reproductive age will grow

by at least 18 million each year during the rest of this decade.

The full range of modern family planning methods presently remains

unavailable to at least 350 million couples world-wide, many of

whom say they want to space or prevent another pregnancy. Survey

data suggest that approximately 120 million additional women

world-wide would currently be using a modern family planning method

if more accurate information and services were accessible to them.

     These figures would be even higher if sexually active

unmarried individuals were also included. The [reproductive health]

needs of adolescents have been largely ignored by existing

services. The draft Programme calls upon Governments to remove

legal, regulatory and social barriers to sexual and reproductive

health information and services for adolescents.

     Another crucial issue addressed in Chapter VII is human

sexuality and gender relations, two closely related issues which

together affect the ability of men and women to achieve and

maintain sexual health and manage their reproductive lives.

Violence against women is widespread, and rising numbers of women

are at risk from acquired immune deficiency syndrome (AIDS) and

other sexually transmitted diseases as a result of the high-risk

sexual behaviour of their partners. In a number of countries,

harmful practices like female genital mutilation pose a major

lifelong risk to women's health.

     The world-wide incidence of sexually transmitted diseases is

high and increasing. The situation has worsened considerably with

the emergence of the HIV pandemic. The draft Programme calls for

prevention and reduction of the incidence of sexually transmitted

diseases, including HIV/AIDS. At the same time, it states,

treatment should be provided for the complications of sexually

transmitted diseases such as infertility, with special attention to

girls and women.


Chapter VIII of the draft Programme of Action, "Health, Morbidity

and Mortality", deals with: primary health care and the health-care

sector; child survival and health; women's health and [safe

motherhood]; and HIV infection and AIDS.

     In the past half century, life expectancy in the world as a

whole has increased by about 20 years, and the risk of dying in the

first year of life has been reduced by nearly two thirds.

Nevertheless, the draft Programme points out, considerable

improvements are still needed; the document calls upon countries to

ensure that health care services and facilities are accessible,

available, acceptable and affordable to all people.

     The draft Programme presents a comprehensive set of

mortality-reduction goals, calling particular attention to the need

to reduce infant and child mortality and maternal mortality. It

states that one of the aims of Governments should be to eliminate

excess mortality of girls, wherever such a pattern exists. It

underscores the need to achieve a rapid and substantial reduction

of maternal morbidity and mortality. The realization of these goals

will have different implications for countries with different

levels of mortality. However, all countries are called upon to

reduce maternal morbidity and mortality levels to where they no

longer constitute a public health problem.

     The age at which women begin or stop child-bearing, the

intervals between births, the total number of pregnancies and the

sociocultural and economic circumstances in which women live all

influence maternal morbidity and mortality.

     Addressing the threat to women's health due to self- induced

or otherwise unsafe abortion is another feature of Chapter VIII.

There was considerable debate on this issue during PrepCom III.

This debate will continue at the Conference. The draft text

contains two alternative paragraphs on abortion under section 8.25.

Both are bracketed and will be the subject of further negotiation

in the Main Committee of the Conference. They are:

     "8.25. [All Governments, intergovernmental organizations and

relevant non-governmental organizations are urged to deal openly

and forthrightly with [unsafe abortion] as a major public health

concern. Particular efforts should be made to obtain objective and

reliable information on the policies on, incidence of and

consequences of abortion in every country. Unwanted pregnancies

should be prevented through sexual health education and through

expanded and improved family-planning services, including proper

counselling to reduce the rate of abortion. Governments are urged

to assess the health and social impact of induced abortion, to

address the situations that cause women to have recourse to

abortion and to provide adequate medical care and counselling.

[Governments are urged to evaluate and review laws and policies on

abortion so that they take into account the commitment to women's

health and well-being in accordance with local situations, rather

than relying on criminal codes or punitive measures. Although the

main objective of public policy is to prevent unwanted pregnancies

and reduce the rate of abortion, women should have ready access to

quality health-care services that include reliable information,

counselling and medical care to enable them to terminate

pregnancies in those cases where it is allowed by law, if they so

decide, and that provide for the management of complications and

sequelae of unsafe abortion. Post-abortion counselling, education

and family-planning services should be offered promptly so as to

prevent repeat abortions].

     "[ALTERNATIVE 8.25. All Governments and intergovernmental and

non-governmental organizations are urged to deal openly and

forthrightly with unsafe abortion as a major public health concern.

Governments are urged to assess the health impact of unsafe

abortion and to reduce the need for abortion through expanded and

improved family-planning services. Prevention of unwanted

pregnancies must always be given the highest priority and all

attempts should be made to eliminate the need for abortion. In no

case should abortion be promoted as a method of family planning. In

circumstances where abortion is legal, women who wish to terminate

their pregnancies should have ready access to reliable information

and compassionate counselling and such abortion should be safe. In

all cases, women should have access to services for the management

of complications arising from unsafe abortions. Any measures to

provide for safe and legal abortion within the health system can

only be determined at the national level through policy changes and

legislative processes which reflect the diversity of views on the

issue of abortion.]"

     AIDS is another major threat to health, in both developed and

developing countries. The World Health Organization estimates that

the cumulative number of AIDS cases in the world by mid-1993

amounted to 2.5 million persons, and that over 14 million people

had been infected with HIV since the pandemic began. The draft

Programme calls upon Governments to assess the demographic and

development impact of HIV/AIDS and to address the pandemic through

policies in a range of social sectors.


ICPD Secretariat

220 E. 42nd St., 22nd floor

New York, NY 10017, U.S.A.

Tel: (212) 297-5244/5245

Fax: (212) 297-5250

Media Contacts: (212) 297-5023/5030 or 5279

August 1994


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