COMMISSION ON POPULATION AND DEVELOPMENT TO MEET AT HEADQUARTERS 26 FEBRUARY - 1 MARCH
Press Release
POP/607
COMMISSION ON POPULATION AND DEVELOPMENT TO MEET AT HEADQUARTERS 26 FEBRUARY - 1 MARCH
19960223 Background ReleaseReproductive rights and health, including such issues as family planning, maternal and child health, abortion and information on sexuality, will be the central theme of the second session of the Commission on Population and Development, to be held at Headquarters from 26 February to 1 March.
The Commission, which was founded in 1946, is marking its fiftieth anniversary this year. Its work was given new impetus by the International Conference on Population and Development, held in Cairo in 1994. The Conference adopted a Programme of Action, which the General Assembly subsequently charged the Commission with monitoring (General Assembly resolution 49/128). The Assembly later endorsed the decision of the Economic and Social Council to enlarge the Commission's membership from 27 to 47 members (resolution 50/124), and elections were held in January for that purpose. The expanded Commission is thus meeting for the first time.
The topic for this session, "reproductive rights and reproductive health, including population education, information and communication", involves long-standing matters of concern, as well as new issues that have only recently begun to attract international attention. Among them are the reproductive health and rights of adolescents, including their right to information concerning sexuality, as well as the role of men in fertility regulation. Reports before the Commission shed light on initiatives taken by States, intergovernmental organizations and non-governmental organizations in those areas, and identify future challenges in promoting reproductive rights and enhancing reproductive health.
As in previous years, the Commission will hold a general debate on national experience in population matters. It is then scheduled to examine the follow-up to the Conference's recommendations concerning reproductive rights and reproductive health, as well as world population monitoring in those areas. In that context, the activities of the Inter-Agency Task Force for the implementation of the Programme of Action, as well as those of intergovernmental and non-governmental organizations, will be reviewed.
in addressing the delicate issues of reproductive health and rights -- which can be particularly controversial topics -- delegates will benefit from the definitions laid out in the Programme of Action adopted by the International Conference on Population and Development. According to the Programme of Action, reproductive health is 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.
As described in the Secretary-General's concise report on world population monitoring, 1995, before the Commission, "reproductive health implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so". The definition of reproductive rights recognizes the basic right of 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, as well as the right to make decisions concerning reproduction, free of discrimination, coercion and violence.
Discussions of challenges in the field of reproductive rights and health will be informed by reports before the Commission which analyse trends in the field. Among those is the global shift towards later marriage, which has been accompanied by indications of a fertility decline in many countries. While most births continue to occur within marriage, premarital births are increasing in a number of countries around the world. Noting that marriage is not the only context within which child-bearing takes place, the Secretary- General's concise report states that, in many developed countries, the rapid increase in child-bearing outside marriage, closely linked to the rise in cohabitation, constitutes one of the most significant recent transformations in family-building patterns.
"The prevailing gap between women's ideal family size and actual child- bearing suggests that women's reproductive aspirations are seldom fulfilled", according to the concise report on world population monitoring. The inadequate control women have over their reproduction is also evident from the high prevalence of unplanned child-bearing. Control over fertility has important health implications, but socio-economic conditions, education, nutrition and health care are often more important determinants of women's survival.
In the area of contraception, the growing use of female sterilization is cited in the concise report on world population monitoring as the most important trend in both developed and developing countries. Regarding other methods, it is stated that, in many cases, a substantial proportion of women who are at risk of an unwanted pregnancy reports that health concerns are their main reason for not using contraception. At the same time, the recent rise in the level of contraceptive use is due almost entirely to increased use
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of modern methods. "The evidence suggests that, although modern methods have worked well for many couples, their use still presents difficult choices for many others", the report states.
More than 70,000 women are estimated to die annually as a result of complications arising from unsafe abortion. Addressing that issue, the Secretary-General's concise report states that, of the estimated 45 million abortions that were performed worldwide in 1990, some 20 million were unsafe.
Every year, there are 5 million neonatal deaths, of which 3.5 million occur within the first week of life and are largely a consequence of the lack of proper care during pregnancy, delivery or the first critical hours after birth. And for every newborn death, another infant is stillborn. "The paucity of information about maternal ill-health has resulted in long neglect of the problem, neglect that the international community has only recently started to address", according to the concise report.
Adolescent abortion is a growing area of concern, several of the reports indicate. Because adolescents are sometimes unwilling or unable to seek appropriate health care, or because they wait longer in the gestation period to obtain help, induced abortion generally presents a greater risk to their health and life. In the industrialized countries, there are indications of an increase in the overall proportion of young people who are sexually active. Furthermore, the prevalence of sexually transmitted diseases among unmarried adolescents suggests that premarital sexual activity is not uncommon and may be increasing.
Several of the reports before the Commission reveal that adolescent reproductive behaviour has become an emerging world-wide concern. Most countries do not have coherent policies for the protection and maintenance of reproductive health in adolescents, partly because of the sensitivity of the subject. Because of the critical stage of their personal development, young people, particularly adolescents, have a special need for information on sexual and reproductive health. The provision of information about sexuality, pregnancy and sexually transmitted diseases, combined with information about local services and counselling availability, is an effective way of assisting young people.
A picture of the international response to concerns about adolescents and other pertinent issues emerges from two of the reports before the Commission, which present the results of questionnaires filled out by representatives of the United Nations Population Fund (UNFPA) and by members of other intergovernmental and non-governmental organizations.
The Conference triggered a process aimed at giving far-greater attention than ever before to the needs and problems of adolescents in the field of
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sexual and reproductive health, according to those reports. Nearly two thirds of the countries responding to the questionnaire reported having undertaken initiatives to address adolescents' reproductive rights and reproductive health and to put their needs on the political agenda. Often, governments and non-governmental organizations were working hand in hand to address adolescent reproductive health issues.
Nearly all the non-governmental organizations that responded to the questionnaire reported an increase in activities concerning adolescent health. For most of those organizations, the best solution in addressing the sexual and reproductive health needs of adolescents would be to provide them with information through sex education classes, so that they could make sound decisions about their sexuality and, if they are sexually active, to give them access to contraceptive services. Many non-governmental organizations are developing educational materials and teaching family life education to adolescents with the aim of providing adolescents with decision-making skills and improving their self-esteem.
Concerning the prevention and control of sexually transmitted diseases, reports before the Commission indicate that until recently it has been a low priority for most countries and development agencies. To date, most programmes for the prevention of sexually transmitted diseases have focused on prevention of complications, or what is referred to as secondary prevention. The prevention of transmission of infection -- primary prevention -- is at present receiving increased attention because of the global HIV/AIDS epidemic.
The HIV epidemic continues to grow with thousands of new infections occurring every day. An estimated cumulative total of 18.5 million adults and 1.5 million children have been infected with HIV, according to the concise report. During the current decade, the World Health Organization (WHO) forecasts that by the year 2000, 30 to 40 million HIV infections will have occurred, 90 per cent of which will be in developing countries. The epidemic is having devastating effects on individuals, families and entire communities. Young people are particularly affected by HIV and AIDS; it is estimated that 50 per cent of HIV infections occur in people from the 15 to 24 years of age.
Most of the 333 million cases of sexually transmitted diseases which are curable occur in developing countries, the concise report continues. "Sexually transmitted diseases have been a neglected area in public health in most of the developing countries despite the overwhelming facts of their impact on health, particularly for women and newborns." For several decades, sexually transmitted diseases have ranked among the top five conditions for which adults in many developing countries seek health-care services. In most industrialized countries, on the other hand, there has been a spectacular decline in the incidence of sexually transmitted diseases, particularly gonorrhoea and syphilis.
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Many countries now recognize the role of men as being important for an effective implementation of reproductive health programmes. Some countries reported using innovative interventions to involve them in issues related to reproductive and sexual health, family planning and their responsibility in these areas. Male opposition, often in combination with religious objections, was frequently given as a reason for the reluctance of governments to plan interventions. "Formal opposition or outright resistance from the religious hierarchy or establishment was a powerful factor in a number of countries", states the report of the Secretary-General on the monitoring of population programmes.
Despite the clear need to work towards integrating men into reproductive health programmes, there are very few initiatives that deal with that issue, according to the survey of intergovernmental and non-governmental organizations. Since this is a new area of work for many organizations, several of them are conducting research studies to assess the reproductive health-care needs of men. That might involve increasing male responsibility with respect to sexual practices, including greater participation in family planning -- viewed as a key to improving reproductive health and curtailing the spread of sexually transmitted diseases -- as well as increasing male involvement in responsible parenthood.
As evidenced in most Commission reports, funding seems to be a major barrier for non-governmental organizations in the implementation of the Programme of Action. "Additional resources are urgently required in order better to identify and satisfy unmet needs in issues related to population and development, such as reproductive health care, including family planning and sexual health information and services, and to keep pace with growing demands and improve the scope and quality of programmes", states the report of the Secretary-General on the flow of financial resources in international assistance for population.
Funding for UNFPA field-level and other activities has increased, as indicated in one report which states that, over the period 1990 to 1995, the annual income of the UNFPA increased from $212 million to $306 million. (According to Press Release POP/600 of 7 November 1995, the UNFPA estimates that its contributions for 1996 will reach a record of $325 million.)
Despite the positive trend with respect to the work of the Fund, the overall financial crisis faced by the United Nations is hampering the analytical work of its departments in the population field. According to one report, on the progress of population-related work of the United Nations Department for Economic and Social Information and Policy Analysis, "some delays in the implementation of programmed outputs occurred as a consequence of the extraordinary measures taken by the Secretary-General in response to the financial situation of the Organization". For example, a meeting of an expert group mandated to examine issues related to the quality of family-
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planning services, which was to have been held last October, was canceled owing to financial constraints.
While there are encouraging signs of commitment and dedication to reproductive health programmes, the socio-economic and cultural environment is not always conducive to change, the Commission reports state. On a national level, widespread poverty severely hampers the abilities of governments to fully implement such programmes, limiting people's access to reproductive health care. Many obstacles still need to be overcome, and countries need assistance from the international community to deal with those constraints.
Documentation
The following documents, used to prepare this background press release, will each be summarized in detail when they are taken up by the Commission: report of the Secretary-General on world population monitoring, focusing on reproductive rights and reproductive health, including population information, education and communication (document E/CN.9/1996/2); report of the Secretary- General on the monitoring of population programmes (document E/CN.9/1996/3); report of the Inter-Agency Task Force for the implementation of the Programme of Action of the International Conference on Population and Development (document E/CN.9/1996/4); report of the Secretary-General on the activities of intergovernmental and non-governmental organizations for the implementation of the Programme of Action (document E/CN.9/1996/5); report of the Secretary- General on the flow of financial resources for assisting in the implementation of the Programme of Action (document E/CN.9/1996/6); and report of the Secretary-General on progress of work in the field of population, 1995 (document E/CN.9/1996/7).
Membership
The 42 members of the Commission on Population and Development are: Bangladesh, Belgium, Brazil, Bulgaria, Cameroon, Canada, China, Colombia, Cuba, Egypt, El Salvador, Finland, France, Germany, Hungary, India, Indonesia, Iran, Italy, Jamaica, Japan, Kenya, Malta, Mexico, Nepal, Netherlands, Nicaragua, Nigeria, Pakistan, Peru, Philippines, Republic of Korea, Russian Federation, Sudan, Syria, The former Yugoslav Republic of Macedonia, Tunisia, Ukraine, United Kingdom, United Republic of Tanzania, United States and Venezuela.
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