UN Human Rights Treaties

UNITED NATIONS
A
General Assembly
Distr.
GENERAL
A/48/430/Add.1
14 October 1993
ORIGINAL: ENGLISH
GENERAL ASSEMBLY
Forty-eighth session
Agenda item 96
INTERNATIONAL CONFERENCE ON POPULATION AND DEVELOPMENT
Progress report on the preparations for the Conference
Addendum
Annotated outline of the final document of the Conference
Note by the Secretary-General
The Secretary-General has the honour to transmit to the General Assembly,
as an annex to the present note, an annotated outline of the final document of
the International Conference on Population and Development. The annotated
outline has been prepared, in close collaboration with the Secretary-General of
the Conference, in response to Economic and Social Council resolution 1993/76
requesting that the annotated outline be included in the progress report
referred to in paragraph 20 of General Assembly resolution 47/176. The first
draft of the final document based on the present annotated outline will be
discussed by the Preparatory Committee for the Conference at its third session
from 4 to 22 April 1994.
93-51718 (E) 201093 /...
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Annex
ANNOTATED OUTLINE OF THE FINAL DOCUMENT OF THE INTERNATIONAL
CONFERENCE ON POPULATION AND DEVELOPMENT
CONTENTS
Chapter Paragraphs Page
Part One. Preamble and principles
I. PREAMBLE ............................................ 1 6
II. PRINCIPLES .......................................... 2 6
Part Two. Choices and responsibilities
III. THE INTERRELATIONSHIPS BETWEEN POPULATION, SUSTAINED
ECONOMIC GROWTH AND SUSTAINABLE DEVELOPMENT ......... 3 - 12 10
A. Population, sustained economic growth and
sustainable development ......................... 4 - 6 10
B. Population, socio-economic development and poverty
alleviation ..................................... 7 - 9 11
C. Population and the environment .................. 10 - 12 11
IV. GENDER EQUALITY AND EMPOWERMENT OF WOMEN ............ 13 - 22 12
A. Empowerment and the status of women ............. 14 - 16 13
B. Male responsibilities and participation ......... 17 - 19 13
C. The girl child .................................. 20 - 22 14
V. THE FAMILY, ITS ROLES, COMPOSITION AND STRUCTURE .... 23 - 29 14
A. Diversity of family structures and composition .. 24 - 26 14
B. Socio-economic support to the family ............ 27 - 29 15
VI. POPULATION GROWTH AND STRUCTURE ..................... 30 - 45 16
A. Diversity of fertility, mortality and population
growth rates .................................... 31 - 33 16
B. Children and youth .............................. 34 - 36 16
C. Ageing populations .............................. 37 - 39 17
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CONTENTS (continued)
Chapter Paragraphs Page
D. Disabled persons ................................ 40 - 42 17
E. Indigenous people ............................... 43 - 45 18
VII. REPRODUCTIVE RIGHTS, REPRODUCTIVE HEALTH AND
FAMILY PLANNING ..................................... 46 - 58 18
A. Reproductive health ............................. 47 - 49 19
B. Family planning ................................. 50 - 52 20
C. Human sexuality and gender relations ............ 53 - 55 20
D. Adolescents ..................................... 56 - 58 21
VIII. HEALTH AND MORTALITY ................................ 59 - 71 22
A. Maternal morbidity and mortality ................ 60 - 62 22
B. Infant and child mortality ...................... 63 - 65 23
C. Sexually transmitted diseases and acquired
immune eficiency syndrome ....................... 66 - 68 23
D. Primary health care and the health-care sector .. 69 - 71 24
IX. POPULATION DISTRIBUTION, URBANIZATION AND INTERNAL
MIGRATION ........................................... 72 - 84 25
A. Population distribution, natural resources and
the environment ................................. 73 - 75 25
B. Population distribution policies and sustainable
development strategies .......................... 76 - 78 26
C. Population growth in large urban agglomerations . 79 - 81 26
D. Displaced persons ............................... 82 - 84 27
X. INTERNATIONAL MIGRATION ............................. 85 - 97 27
A. International migration and development ......... 86 - 88 28
B. Documented migrants ............................. 89 - 91 28
C. Undocumented migrants ........................... 92 - 94 29
D. Refugees ........................................ 95 - 97 29
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CONTENTS (continued)
Chapter Paragraphs Page
Part Three. Means of implementation
XI. POPULATION INFORMATION, EDUCATION AND COMMUNICATION . 98 - 104 32
A. Public awareness ................................ 99 - 101 32
B. Information, education and communication ........ 102 - 104 32
XII. CAPACITY-BUILDING ................................... 105 - 114 33
A. Management of programmes ........................ 106 - 108 33
B. Education and training of policy makers, managers
and other personnel ............................. 109 - 111 34
C. Institutional development ....................... 112 - 114 34
XIII. TECHNOLOGY, RESEARCH AND DEVELOPMENT ................ 115 - 124 35
A. Basic data collection and analysis .............. 116 - 118 35
B. Biomedical research and development ............. 119 - 121 36
C. Social and economic research and development .... 122 - 124 36
XIV. NATIONAL ACTION ..................................... 125 - 131 37
A. National policies and plans of action ........... 126 - 128 37
B. Resource allocation ............................. 129 - 131 38
XV. INTERNATIONAL COOPERATION ........................... 132 - 138 39
A. Modalities ...................................... 133 - 135 39
B. Resource mobilization: bilateral and
multilateral development assistance ............. 136 - 138 40
XVI. PARTNERSHIPS WITH NON-GOVERNMENTAL GROUPS, INCLUDING
NON-GOVERNMENTAL ORGANIZATIONS, THE PRIVATE SECTOR
AND LOCAL COMMUNITY GROUPS .......................... 139 - 144 40
XVII. FOLLOW-UP ........................................... 145 - 151 42
A. Implementation .................................. 146 - 148 42
B. Monitoring and review ........................... 149 - 151 43
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Part One
PREAMBLE AND PRINCIPLES
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Chapter I
PREAMBLE
1. The preamble will convey the vision and purpose of the International
Conference on Population and Development and define the context of the proposed
action programme. The preamble will cover the following elements:
(a) Brief survey of present population dynamics and their interrelations
with current social, economic and political trends, bringing out the interaction
between population, sustained economic growth and sustainable development.
(b) Overview of the experience gained in the field of population policies
and programmes during the past 20 years. This assessment, based on the findings
of the progress made in achieving the goals and objectives of the World
Population Plan of Action adopted in 1974, will provide the critical foundation
for the development of goals and strategies for the future.
(c) Brief presentation of the objectives and general goals contained in
the proposed action programme.
(d) General introduction to the set of actions necessary to achieve the
proposed population objectives that are consistent with sustained economic
growth and sustainable development. Particular emphasis will be given to human
rights, as well as to the socio-economic situation of the developing countries,
particularly the least developed countries.
(e) Indication of the resources and efforts required for the
implementation of the proposed action programme.
(f) Reference to the most relevant intergovernmental instruments relating
to population, economic and social development and sustainability.
Chapter II
PRINCIPLES
2. This section of the proposed action programme will provide the guiding
philosophy in the area of population and development well into the twenty-first
century. The principles will build as much as possible on agreed international
instruments, including the World Population Plan of Action, 1/ the
recommendations of the International Conference on Population, held at Mexico
City, in 1984, 2/ the Amsterdam Declaration on a Better Life for Future
Generations, 3/ the Rio Declaration on Environment and Development 4/ and
Agenda 21 5/ adopted by the United Nations Conference on Environment and
Development, held at Rio de Janeiro from 3 to 14 June 1992. They will also
reflect the Nairobi Forward-looking Strategies for the Advancement of Women 6/
and the applicable provisions of human rights instruments such as the Universal
Declaration on Human Rights, 7/ the International Covenant on Economic, Social
and Cultural Rights, 8/ the International Convention on the Elimination of All
Forms of Racial Discrimination, 9/ the Convention on the Elimination of All
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Forms of Discrimination against Women 10/ and the Convention on the Rights of
the Child. 11/ The guiding principles will be organized around the following
major topics:
(a) Human rights and population: recognizing obligations and
responsibilities. Protection of rights of individuals; elimination of all forms
of discrimination; rights, obligations and responsibilities of couples and
individuals in relation to their sexual and reproductive life; protection of
vulnerable groups; and opposition to all forms of coercion to have or not to
have children.
(b) The responsibility of society for human development, reproductive
health and family planning: ensuring choices and responsibilities.
(c) Sustainable development and population. Linkages between population,
resource use, consumption, environmental impact and repercussions on the quality
of life for present and future generations.
(d) Partnership in population: moving from commitment to action. Mutual
responsibility and interdependence among individuals, social groups and nations.
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Part Two
CHOICES AND RESPONSIBILITIES
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Chapter III
THE INTERRELATIONSHIPS BETWEEN POPULATION, SUSTAINED
ECONOMIC GROWTH AND SUSTAINABLE DEVELOPMENT
3. This chapter will address the inextricable interdependence between
population, resources, the environment and development. In addition to
reaffirming the relevance of key intergovernmental instruments such as the
Declaration on International Economic Cooperation, in particular the
Revitalization of Economic Growth and Development of the Developing Countries,
the International Development Strategy for the Fourth United Nations Development
Decade and Agenda 21, the Conference is expected to provide guidance for the
formulation of population policies and programmes that seek to simultaneously
achieve sustained economic growth and sustainable development, taking into
account the interlinkages of population with poverty; production and consumption
patterns; environmental quality; natural resources; and economic, social and
gender inequality.
A. Population, sustained economic growth and
sustainable development
Basis for action
4. All countries, and especially the developing countries, where almost all of
the future growth of the world population will occur, face increasing
difficulties to improve the quality of life of their people in a sustainable
manner. Many of those countries experience major development obstacles, among
which are those related to the persistence of trade imbalances, the slow down in
the world economy, the increasing burden of debt servicing and growing
"aid-fatigue" of the international donor community. Lack of development or
unbalanced development and poverty are often associated with inappropriate
spatial distribution of the population and undesirable environmental conditions.
The critical challenge in all countries, whether developed, developing or in
transition, is to improve the quality of life for present generations without
compromising the ability of future generations to meet their own needs. It
cannot be addressed without recognizing the strong linkages between population,
resources, the environment and development.
Objectives
5. To create an international environment favourable to the realization of the
right to development and to establish consistent policy frameworks that promote
balanced and sustainable development, recognizing population factors as an
integral part of any environmentally sustainable policy and programme.
Selected topics for recommendations
6. Need to foster sustained economic growth in developing countries, by all
appropriate means, including reduction of trade barriers, debt relief,
investment in sustainable job-creating projects and promotion of relevant
technologies. Formulation of long-term policies and programmes that
simultaneously address population growth, alleviate poverty and reduce social
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inequality in both rural and urban settings. Ensuring that policies and
programmes are responsive to the needs of the poor in all countries,
particularly in health, education, training, and family planning and maternal
and child health programmes.
B. Population, socio-economic development and
poverty alleviation
Basis for action
7. Widespread poverty is a major challenge to development efforts as poverty
is often accompanied by ignorance, illiteracy, low status of women and limited
access to health and family-planning services, all these factors tending to
result in high levels of fertility, morbidity and mortality. Women are often
among the poorest of the poor. Alleviating the conditions of abject poverty
under which close to 1 billion people live today is an integral part of the
agenda for sustainable development. It is also necessary to prepare for meeting
the basic needs of the population that will inevitably be added in the near
future. The goals and objectives of the International Development Strategy for
the Fourth United Nations Development Decade aim at responding to such concerns.
Objectives
8. To break the poverty-population growth cycle through integrated population
and development policies and programmes that recognize the key role of human
resources in national development and give strong emphasis in national planning
and policy-making to the development of human resources. To make equity in the
allocation of resources and access to services an important element of national
policy, designing policies and strategies to ensure that the benefits of
development are widely shared.
Selected topics for recommendations
9. Making the alleviation of poverty, the achievement of equitable social and
economic relations, and the provision of basic infrastructure and social welfare
services key components of socio-economic development and central factors for
harmonizing demographic trends with sustainable development. Need to give high
priority to investments and expenditures to facilitate access to education,
training and credit to all deprived sectors of society, as well as to economic
policies that increase their opportunity to participate in the formal labour
force; particular attention should be given to the situation of poor women.
C. Population and the environment
Basis for action
10. Current patterns of population growth and spatial distribution, associated
with present levels and patterns of production and consumption exert increasing
pressures on the carrying capacity of the planet, which is understood as the
number of people that the planet can support at an acceptable level of quality
of life, without irreversibly reducing its capacity to support people in the
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future. This carrying capacity is being exceeded in many parts of the world.
Some areas are characterized by deep and widespread poverty, while others are
affluent. Associated issues are the loss of agricultural land, due either to
soil degradation and erosion or conversion to urban land; the destruction of
forests; water problems such as scarcity, depletion and pollution; loss of
biological diversity; and climatic change.
Objectives
11. To recognize the critical nature of environmental degradation and the role
of demographic variables. To adopt environmentally sustainable development
strategies giving due priority to social programmes and policies, including
those on population and education. To address the underlying causes of
environmental degradation such as poverty and unsustainable production and
consumption patterns.
Selected topics for recommendations
12. Formulation of enforceable measures to promote greater harmony between
population, resources, environment and development, so as to achieve improved
quality of life on a sustainable basis. Identification of critically endangered
areas subject to acute population pressures and formulation of actions needed to
alleviate pressures on the environment. Finding durable solutions to problems
related to environmentally displaced persons.
Chapter IV
GENDER EQUALITY AND EMPOWERMENT OF WOMEN
13. Gender equality is recognized as a human rights issue by the numerous
international agreements and declarations since the Universal Declaration on
Human Rights, including the World Population Plan of Action (1974) and the
recommendations for its further implementation adopted at the International
Conference on Population (Mexico City, 1984), the Nairobi Forward-looking
Strategies for the Advancement of Women (1985), the Amsterdam Declaration on a
Better Life for Future Generations (1989), the United Nations Conference on
Environment and Development (1992) and the World Conference on Human Rights
(1993). Nevertheless, discrimination continues against women and girls. Hence,
the need to empower women and to improve their status is acknowledged by most
Governments. In addition, improvement in the status of women is a key
development issue because of women’s vital and multiple roles. It is widely
accepted that improvements in women’s advancement, health, education and
employment, are mutually reinforcing and should be pursued simultaneously in a
holistic manner. Changes in men’s and women’s attitudes and behaviour are
necessary conditions for achieving full gender equality.
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A. Empowerment and the status of women
Basis for action
14. The improvement of the status of women, particularly with respect to
education, health and economic autonomy, is a highly important end in itself.
In addition, it affects and is in turn affected by demographic variables such as
fertility and maternal, infant and child mortality. Experience shows that
population and development programmes are most effective when measures have been
taken to improve the status of women.
Objectives
15. To achieve full gender equality. To fully integrate women into population
and development programmes, both as beneficiaries and as active participants.
Selected topics for recommendations
16. Encouragement of women to participate in the political process,
particularly at the grass-roots level and promotion of women’s economic
security, right to inherit or own land and access to credit. Achieving balanced
representation of both sexes in population and development programmes,
especially at management and policy-making levels, both in the Government and
private sectors. Combating violence against women and girls, including sexual
violence.
B. Male responsibilities and participation
Basis for action
17. In general, men exercise preponderant power in nearly every sphere of life,
including personal decisions regarding family planning and the policy and
programme decisions taken at all levels of Government. It is essential to
improve communication between men and women, and the understanding of their
respective and joint responsibilities, so that women and men are seen as equal
partners in public and private life.
Objectives
18. To promote gender equity by ensuring that men understand and accept full
and equal responsibility in both family and community life, with regard to all
issues of mutual concern to men and women.
Selected topics for recommendations
19. Full and active participation of men in all areas of family and community
responsibilities, so that these responsibilities may be equally shared by women
and men.
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C. The girl child
Basis for action
20. Since discrimination on the basis of sex starts at the earliest stages of
life, full equality for the girl child is a necessary condition for women to
fulfil their potential and to contribute effectively to society. Investments
made in the girl child’s health and education are steps towards raising the age
at marriage and reducing early child-bearing, while also increasing her options
later in life.
Objectives
21. To increase public awareness of the value of the girl child and eliminate
the root causes for son preference. To strengthen the girl child’s self-image
and self-esteem and improve the status of the girl child, especially in health,
nutrition and education.
Selected topics for recommendations
22. Access by girls and women to education and improvement of the quality and
relevance of their education, including the elimination of gender stereotyping
in school curricula and in the media. Enforcement of minimum legal age at
marriage, paying attention to the provision of alternatives to early marriage
such as educational and employment opportunities.
Chapter V
THE FAMILY, ITS ROLES, COMPOSITION AND STRUCTURE
23. The family, in its many forms, is a basic unit of society and it is the
social institution within which most child-bearing and child-rearing occur.
These two universal roles are complemented by other important functions such as
the mutual support of its members and, in many countries, the care of the
disabled and the elderly. The large diversity of family forms and structures
reflects how these functions are accomplished, how societies value and protect
their families, and which patterns of family formation are prevalent in a
particular social context. Families are important agents of sustainable
development at all levels of society and their contribution to that process is
crucial. The family also plays an important role in the intergenerational
transmission of social values as a primary agent of socialization and is
therefore a potential agent of social change.
A. Diversity of family structures and composition
Basis for action
24. There are numerous concepts of the family around the world; this diversity
corresponds to the wide variety of social, political and cultural systems. As
part of the process of rapid demographic and socio-economic change in both
developed and developing countries, patterns of family formation are undergoing
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considerable change so that the composition and structure of families are being
altered. In many societies, a traditional gender-based division of productive
and reproductive functions within the family coexists with new arrangements.
The recognition of the diversity of family forms is important because in many
cases policies and programmes relative to the family still refer only to
specific sizes and forms of the family that may no longer be predominant; this
issue is particularly important in reference to gender equality and the rights
of children.
Objectives
25. To adopt policies and laws recognizing and supporting the plurality of
family forms, including due attention to the large number of households headed
by women.
Selected topics for recommendations
26. Provision of means (i.e., social services, kindergartens, part-time jobs,
flexible schedules etc.) to facilitate compatibility between professional and
parental roles. Elimination of all forms of coercion and discrimination in
policies and practices related to marriage and to child-bearing.
B. Socio-economic support to the family
Basis for action
27. As a basic unit of society, the family is entitled to receive protection by
society and the State. In many parts of the world the rapid process of
development intensifies the strains on family life. There is an increasing
number of vulnerable families, including single-parent families headed by poor
women, poor families with disabled members, families separated by the working
conditions of their members, refugee and displaced families, families affected
by human immunodeficiency virus (HIV) infection and acquired immune deficiency
syndrome (AIDS) or by family disintegration, domestic violence and child abuse
or neglect.
Objectives
28. To formulate "family-sensitive" policies aimed at providing support
particularly to vulnerable families. To introduce the concept of "family
impact" into the process of preparation of plans, policies and programmes of
social and economic development.
Selected topics for recommendations
29. Assistance to families which manifest specific problems (i.e., domestic
violence, drug and alcohol dependency, sexual and child abuse, neglect etc.),
have special responsibilities (i.e., handicapped members, care of the dependent
elderly etc.), or are in a particular vulnerable position (i.e., circumstances
of war, drought, famine, racial and ethnic violence, economic deprivation etc.).
Establishing guidelines for monitoring the implementation of family policies and
programmes.
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Chapter VI
POPULATION GROWTH AND STRUCTURE
30. Growth of the world population, in absolute numbers, is likely to persist
at levels near the present all-time high in the coming decades. There are also
remarkable differences between regions and countries in terms of population
growth and its fertility and mortality components. These levels and
differentials have implications for the ultimate size and regional distribution
of the world population and for population structure characteristics, in
particular population ageing. Action is required to take more fully into
account the variety of trends in population growth and structure in the context
of sustained economic growth and sustainable development.
A. Diversity of fertility, mortality and population growth rates
Basis for action
31. Within the context of the ongoing transition from high to low levels of
fertility and mortality, important variations exist both at the regional level
and within regions and countries, reflecting the present position of countries
in their passage through the different stages of their demographic transition.
The majority of countries are converging to low rates of population growth but
at different speeds of decline, thus yielding rates of growth that are
increasingly diverse. In addition, a substantial minority of populations are
still at a pre-transitional stage or at the very beginning of their transition.
Objectives
32. To reduce the disparities in regional fertility and mortality levels and
achieve early stabilization of the world population.
Selected topics for recommendations
33. Action required to accelerate the demographic transition in those countries
that desire such an acceleration.
B. Children and youth
Basis for action
34. Owing to declining mortality levels and the persistence of high fertility
levels, a large number of developing countries continue to have substantial
proportions of children and young people in their populations. The ongoing and
future demands created by their large young populations, particularly in terms
of health, education and employment, represent a major challenge.
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Objectives
35. To promote to the fullest extent the well-being of all children and youth
in line with the commitments made in this respect at the World Summit for
Children.
Selected topics for recommendations
36. Giving priority and higher levels of attention to all dimensions of human
development for children and youth.
C. Ageing populations
Basis for action
37. There have been notable increases in the proportion and number of persons
at older ages in the population of most countries, a trend resulting from the
decline in fertility levels, reinforced by continued declines in mortality
levels among the elderly. The situation of developing countries that have
experienced very rapid declines in their levels of fertility deserves particular
attention. In most societies the elderly population is composed of considerably
more women than men and in many societies, elderly poor women are especially
vulnerable. The steady increase of older age groups in national populations has
significant implications for both the developed and the developing countries.
The economic and social impact of this "ageing of populations" is both an
opportunity and a challenge to all societies.
Objectives
38. To create conditions that allow the elderly to work and live independently
in their own communities for as long as possible and as desired.
Selected topics for recommendations
39. Need to ensure that long-term socio-economic planning takes into account
the needs of increasingly large proportions of elderly persons in the
population. Strengthening formal and informal safety nets for the elderly in
all countries.
D. Disabled persons
Basis for action
40. The implementation of the World Programme of Action concerning Disabled
Persons during the United Nations Decade of Disabled Persons (1983-1992)
contributed towards increased awareness and expanded knowledge of disability
issues, increased the role played by persons with disabilities and by concerned
organizations, and the improvement and expansion of disability legislation.
However, there remains a pressing need for continued action to promote effective
measures for the prevention of disability, for rehabilitation and for the
realization of the goals of full participation and equality for persons with
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disabilities. By resolution 47/88 of 16 December 1992, the United Nations
General Assembly encouraged the consideration by the International Conference on
Population and Development of disability issues relevant to the subject-matter
of the Conference.
Objectives
41. To ensure the participation of disabled people in all aspects of social,
economic and cultural life to the fullest extent of their abilities.
Selected topics for recommendations
42. Recognition of the needs of disabled persons concerning, inter alia, sexual
and reproductive health, including family-planning services and elimination of
the specific forms of discrimination that disabled people may face with regard
to international migration, reproductive rights and household and family
formation.
E. Indigenous people
Basis for action
43. In many regions of the world, indigenous people are experiencing steady
and, in some places, rapid population growth resulting from improved access,
often belated, to health and welfare services. At national, regional and
international levels, the perspectives of indigenous people are gaining
increasing recognition, most recently at the United Nations Conference on
Environment and Development and the marking of the United Nations Year of
Indigenous People. This section will give recognition to the specific
perspective of indigenous people on the interrelations between population, the
environment and development.
Objectives
44. To ensure that the various perspectives of indigenous people on population
and development are brought before the national and international communities,
taking into account the commitments made during the United Nations Year of
Indigenous People and the ongoing activities of the proposed International
Decade of the World’s Indigenous People.
Selected topics for recommendations
45. Recognizing the distinct perspective of indigenous people on aspects of
population and development and addressing their specific needs.
Chapter VII
REPRODUCTIVE RIGHTS, REPRODUCTIVE HEALTH AND FAMILY PLANNING
46. The cornerstone of reproductive rights is the recognition of the basic
right of all couples and individuals to decide freely and responsibly the number
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and spacing of their children. Although reproductive and sexual health are
central to people’s lives, many persons fail to achieve it because the relevant
information and means, including those related to family planning, may not be
available to them. The disparities are especially marked between those in the
developed and the developing countries. The result is unnecessarily high levels
of reproductive mortality and morbidity in many developing countries, a problem
that must be addressed by promoting reproductive and sexual health for all
people as the fundamental basis for publicly supported reproductive health and
family-planning programmes.
A. Reproductive health
Basis for action
47. Reproductive health is not merely absence of disease or disorders of the
reproductive process. It implies that people have the ability and choice to
reproduce, to regulate their fertility and to practise and enjoy sexual
relationships. Family planning and safe motherhood are essential components of
reproductive health. The attainment of optimal reproductive health eludes many
persons owing to inadequate knowledge about human sexuality, inappropriate
sexual behaviour, gender bias and inappropriate, inadequate information and
services or owing to involuntary sterility. Unsafe abortion is one of the most
neglected underlying causes of reproductive ill health, and constitutes a major
public health issue. Genital mutilation is also an obstacle to reproductive
health. Concerning all factors of reproductive ill health, women, adolescents
and disadvantaged population groups are particularly vulnerable. Finally,
reproductive health cannot be achieved without the full involvement of both
women and men.
Objectives
48. To ensure the provision of appropriate information and services that are
free of coercion, voluntary, accessible, affordable, acceptable and promoting
informed choice. To provide services that respond to the changing reproductive
and sexual health needs of individuals and couples over the life cycle and
reflect the social, cultural, economic and demographic diversity of the
communities they serve.
Selected topics for recommendations
49. Ensuring that reproductive health services for men and women of all ages
have a client-centred approach, are cost-effective, follow high standards of
quality and include maternity care, family planning, prevention and treatment of
infertility, prevention, diagnosis, treatment and referral of sexually
transmitted diseases, including HIV infection and AIDS, and education and
information on sexuality and responsible parenthood. Full involvement of women
in the formulation and implementation of reproductive health programmes. Review
of the legal and regulatory barriers to reproductive health such as early or
enforced marriages, illegality of abortion, maternity leave regulations and
access to reproductive health services.
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B. Family planning
Basis for action
50. Over the past three decades, the emergence of acceptable, safer methods of
modern contraception has permitted greater individual freedom and control of
reproduction. However, these family-planning methods remain unavailable to many
persons who need them, both women and men. Proper widespread use of
family-planning services saves the lives and health of millions of women and
children. Such services are also a cost-effective intervention, because of
their many direct and indirect benefits for individuals, couples and
communities. The experience of the past decades points at the importance of
promoting informed choice and availability of a wide range of safe and effective
contraceptive methods and ensuring that women play a central role in the design
and implementation of family-planning services. Many family-planning programmes
have benefited from partnerships between public, non-governmental and private
sectors.
Objectives
51. To help couples and individuals to achieve the desired number and spacing
of their children, thereby reducing the incidence and risk of unwanted
pregnancies. To reduce the incidence of high-risk pregnancies. To extend
coverage and improve access to family-planning services to all who need them.
To improve the quality of family-planning services for women and men. A
quantitative goal concerning the size of the unmet need for family-planning
information and services and the resources required to meet that need will be
proposed for adoption by the Conference.
Selected topics for recommendations
52. Ensuring easily accessible and available high-quality family-planning
counselling and services responsive to individual needs, in particular through
improved human resource planning, selection and training of staff and community
involvement in the delivery of family-planning services. Removal of unnecessary
and inappropriate legal, medical and regulatory barriers to access to family
planning while continuing to ensure safety. Making information, services and
supplies available to unreached populations. Ensuring sufficient and continuous
supply of contraceptive commodities and strengthening of logistics systems.
C. Human sexuality and gender relations
Basis for action
53. Human sexuality and gender relations are closely interrelated and together
affect the ability of men and women to achieve and maintain sexual health and
control their fertility. Responsible sexuality and sensitivity in gender
relations, particularly when instilled during the formative years, enhance and
promote respectful and harmonious relationships.
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Objectives
54. To ensure that men and women have access to information, education and
services to exercise their reproductive and sexual rights. To foster mutually
respectful gender relations as an important requisite of sexual and reproductive
health.
Selected topics for recommendations
55. Fostering acceptance among men and women of the importance of equal rights
in sexual relationships through sex education and counselling for boys and girls
in and beyond the formal school system. Promotion of responsible and safe
sexuality and parenthood.
D. Adolescents
Basis for action
56. Motherhood at a young age entails a risk of maternal death much greater
than the average, and the children of young mothers also fare less well. In
many countries, sexually active adolescents of both sexes are increasingly at
high risk of contracting and transmitting sexually transmitted diseases,
including HIV infection, and they are often poorly informed about how to protect
themselves. In many societies, adolescents are facing increasing pressures to
engage prematurely in sexual activity. Young women, particularly poor teenage
girls, are especially vulnerable because of their subordinate social position.
Millions of teenage girls world wide seek abortions every year, which attests to
the critical importance of the issue of unwanted pregnancy. Overall, for young
women, early marriage and early motherhood severely curtail educational and
employment opportunities. Programmes addressing these issues have shown to be
more effective when they secure the full involvement of adolescents in
identifying and searching for solutions to their reproductive and sexual health
needs, including support to those who wish to abstain from sexual activity.
Objectives
57. To address adolescent reproductive health issues, including HIV infection
and AIDS, through the promotion of responsible and healthy reproductive and
sexual behaviour. To protect the human rights and well-being of adolescents and
to promote their active involvement in the process of socio-economic
development.
Selected topics for recommendations
58. Recognition of the special needs of adolescents and the programmes required
to meet those needs, including education programmes in the areas of family
planning, family life, reproductive and sexual health, sexually transmitted
diseases, HIV infection and AIDS and reproductive health services, including
family-planning services specially designed to meet the needs of adolescents.
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Chapter VIII
HEALTH AND MORTALITY
59. Although mortality has continued to decline at the world level, there are
sizeable population groups within countries and entire national populations that
still experience high morbidity and mortality rates. Child survival has
increased, but high infant and child mortality rates still prevail in some
population groups and regions. Women in the developing world continue to
experience high maternal mortality. Another cause of great concern is the
increasing incidence of HIV infection and AIDS among children of HIV-infected
mothers. The health of the adult population in the working ages is being
negatively affected by the spread of HIV infection and certain forms of
behaviour, such as the consumption of tobacco, alcohol or drugs, pointing to the
need for changes in lifestyles. The growing number of older people is
associated with an increase in the incidence of non-communicable diseases.
Adequate access to health care is still not available to a large portion of the
world population.
A. Maternal morbidity and mortality
Basis for action
60. Maternal mortality is one of the leading causes of death among women of
child-bearing age in the developing world. At the global level, about half a
million women continue to die each year from pregnancy-related causes;
99 per cent of them in developing countries. Maternal mortality rates vary
widely. In a majority of developed countries, maternal mortality rates are
below 10 deaths per 100,000 live births. In contrast, for the less developed
regions, the estimated rate is 420 deaths per 100,000 live births, with Africa
having an estimated rate of 630 maternal deaths per 100,000 births. In
developing countries, mortality resulting from complications of poorly performed
abortions accounts for a significant percentage of maternal deaths. There is a
particular need to monitor the progress made in reducing maternal mortality so
as to enhance the effectiveness of ongoing and future programmes.
Objectives
61. To achieve a rapid and substantial reduction of maternal morbidity and
mortality in accordance with quantitative goals to be adopted by the Conference
for the period up to 2015.
Selected topics for recommendations
62. Need to increase the provision of maternity services in the context of
primary health care and improve those services by including safe-motherhood
education, nutrition programmes, family planning, prenatal and postnatal care
and delivery assistance by adequately trained birth attendants. Need to address
the problem of maternal deaths and complications resulting from unsafe abortion.
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B. Infant and child mortality
Basis for action
63. Important progress has been made in reducing infant and child mortality
rates everywhere, although improvements have been slower in sub-Saharan Africa.
It is estimated that during the period 1990-1995, over 100 out of every
1,000 children born alive will die before age 1 in a number of African and Asian
countries, compared with only 12 per 1,000 in more developed countries as a
whole. The mortality of children under age 5 exhibits a similar pattern.
Poverty, malnutrition, ignorance of proper sanitation, inadequacy of health
facilities, social unrest and wars are factors associated with high infant and
child mortality. Early, late, frequent and multiple pregnancies intensify the
risks of infant and child mortality.
Objectives
64. To improve the health status of infants and children, to reduce the
incidence of low birth weight and to lower infant and child mortality in line
with the commitment of Governments made at the World Summit for Children. The
document will include quantitative goals for infant mortality reduction for the
period up to 2015.
Selected topics for recommendations
65. Promotion of comprehensive mother-and-child health services, including
prenatal care, child-spacing, breast-feeding, infant and child health-care
services, greater immunization coverage, prevention and management of childhood
diseases and proper nutrition counselling.
C. Sexually transmitted diseases and acquired
immune deficiency syndrome
Basis for action
66. The incidence of sexually transmitted diseases continues to be high, with
an estimated annual number of cases surpassing 250 million. In the developed
world the incidence of many sexually transmitted diseases caused by bacteria
have stabilized but in the developing world that incidence appears to be
increasing. In addition, over 1 million people a year are becoming newly
infected with HIV, the virus causing AIDS. The AIDS pandemic has emerged in
both developed and developing countries as a major public health issue,
threatening to undermine major gains in the reduction of morbidity and
mortality. The World Health Organization estimates that as of mid-1993 over
2.5 million cumulative AIDS cases have occurred but more than 14 million people
world wide have been infected since the epidemic began, including more than
1 million children infected with HIV through their mothers. The estimated
distribution of cumulative HIV infections in adults as of mid-1993 shows that
approximately four fifths of all cases occurred in the developing countries,
where the infection is increasingly being transmitted through heterosexual
intercourse.
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Objectives
67. To strengthen the contribution that family-planning programmes can make to
the prevention and treatment of sexually transmitted diseases, with special
attention to HIV infection.
Selected topics for recommendations
68. Strengthening programmes that minimize sexually transmitted diseases and
HIV infection through the promotion of safe and responsible sex and the
provision of sexual health education and of preventive, diagnostic and curative
treatment to inhibit the transmission of sexually transmitted diseases.
D. Primary health care and the health-care sector
Basis for action
69. There have been important advances in improving access to the essential
elements of primary health care and making available basic curative health
services, as reflected in the sustained increases in life expectancy at birth in
most parts of the world. Notable achievements include the vaccination of about
80 per cent of the children in the world and the wide use of low-cost child
survival techniques such as oral rehydration therapy. Despite such progress,
large segments of the population (mainly the poor) lack access to public
services, such as clean water and sanitation facilities, and are thus at greater
risk of infectious disease. In many countries and regions, the health effects
of environmental degradation (including workplace environmental conditions) are
increasingly a cause for grave concern. Various forms of substance abuse
(tobacco, alcohol and drugs), inappropriate diets and lack of exercise have been
found to hamper progress in mortality and morbidity conditions, particularly
among the poor and those unreached by health education. There is also concern
about the reduction of social investment in health that has taken place in many
countries as a result of structural adjustment programmes.
Objectives
70. To attain further and more widely shared progress in general morbidity and
mortality reduction, in accordance with intergovernmental commitments to provide
health for all. Revised quantitative goals for increased expectation of life
will be proposed for adoption by the Conference.
Selected topics for recommendations
71. Securing improved access to primary health-care services, with increased
attention to the prevention of ill-health caused by environmental degradation,
and to the promotion of changes in lifestyle patterns that are conducive to
better health.
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Chapter IX
POPULATION DISTRIBUTION, URBANIZATION AND INTERNAL MIGRATION
72. Migration and urbanization are intrinsic parts of the development process.
Although rural-rural and urban-urban migration are the dominant forms of spatial
mobility in many countries, attention has mostly been focused on rural-urban
flows because of their contribution to urban population growth. The latest
United Nations estimates indicate that the majority of the world population will
live in urban areas by 2005. There are, however, marked differences in the
levels and rates of urbanization among regions and countries. The less
developed regions are undergoing rapid urbanization, a process that is projected
to continue for decades to come. In contrast, the rate of urbanization in the
more developed regions is slow and is expected to remain so. However, whereas
the rural population of the more developed regions is declining, that of the
less developed regions continues to increase despite rural-urban migration.
A. Population distribution, natural resources and the environment
Basis for action
73. The mode of development affects both migration and the resulting patterns
of population distribution. In rural areas, land degradation often leads to
migration both to urban and to other rural areas. In urban areas, environmental
strains are also prompting people to move. Yet, to the extent that industry,
financial services and communication facilities remain spatially concentrated in
urban areas, they will continue to encourage an unbalanced population
distribution. The pursuit of sustainable development is likely to foster more
manageable population distribution patterns and eliminate migration prompted by
environmental push factors. Since the poor are often most vulnerable to the
impact of natural resource depletion and environmental degradation, promoting a
more rational use of natural resources is also consistent with the goal of
poverty alleviation.
Objectives
74. To foster a more balanced population distribution by promoting
simultaneously the sustainable development of rural and urban areas, with
particular emphasis on the promotion of social equity. To reduce the role of
push factors in migration flows.
Selected topics for recommendations
75. Promotion of strategies that simultaneously encourage the growth of small
or medium-sized urban centres and the sustainable development of rural areas.
Reducing the risks of environmental degradation by developing appropriate
strategies to address the problems emanating from the expansion of human
settlements on areas with fragile ecosystems.
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B. Population distribution policies and sustainable
development strategies
Basis for action
76. Population distribution policies should be part of general development
strategies. In the early 1990s, approximately half of the Governments in the
world, most of them in developing countries, considered their patterns of
population distribution to be unsatisfactory and wished to change them. To be
effective, population distribution policies should be consistent with other
government policies, especially those fostering economic development and the
allocation of resources.
Objectives
77. To formulate effective population distribution policies whose objectives
and goals do not conflict with other government policies. To foster
administrative efficiency and improve services.
Selected topics for recommendations
78. Paying explicit attention to the spatial impact of macroeconomic and other
policies that have implications for population distribution, in order to bring
them into harmony with relevant national, regional and local development goals.
C. Population growth in large urban agglomerations
Basis for action
79. In many countries, the urban system is characterized by the overwhelming
preponderance of a single major city or agglomeration. The tendency towards
population concentration, fostered by the concentration of public and private
resources in some cities, has contributed to the rising number and size of
mega-cities. In 1992, there were 13 cities with at least 10 million inhabitants
and their number is expected to double by the year 2010. In that year, most
mega-cities will be located in the developing countries. The continued
concentration of population in primate cities in general and in mega-cities in
particular poses important economic, social and environmental challenges for
Governments, particularly in view of the unbalanced and unsustainable patterns
of production and consumption and the high degree of social inequality that
generally prevails in such environments.
Objectives
80. To enhance the management of urban agglomerations, reduce the urban bias
that contributes to the further concentration of population in large cities, and
improve the quality of life of the urban poor.
Selected topics for recommendations
81. Securing the revenue necessary for local authorities to improve urban
infrastructure, safeguard the environment and provide urban services through
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measures such as decentralization of expenditure and tax-raising rights, and
adoption of equitable cost-recovery schemes.
D. Displaced persons
Basis for action
82. During the past decade, awareness about the situation of migrants who are
forced to leave their places of usual residence for a variety of reasons has
been rising. Because there is no single definition of internally displaced
persons, estimates of their number vary as do the causes for their migration.
However, it is generally accepted that those causes range from natural disasters
that destroy human settlements to internal conflicts that force people to flee
from one area of the country to another. Given the forced nature of their
movement, internally displaced persons often find themselves in particularly
vulnerable situations.
Objectives
83. To offer adequate protection and assistance to persons displaced within
their country.
Selected topics for recommendations
84. Measures that can be taken by the international community to assure
adequate protection and assistance to internally displaced persons, especially
to those who are not able to return to their normal place of residence in the
short term.
Chapter X
INTERNATIONAL MIGRATION
85. Voluntary international migration is a rational response of individuals to
the real or perceived economic, social and political differences between
countries. Most international migration flows are of a regional nature, with
people moving between neighbouring countries or between countries in the same
region. However, interregional migration, particularly that directed to
developed countries, has been growing. During the 1980s, the population gains
of developed countries attributable to net international migration passed from
being relatively low during the early years of the decade to being relatively
high towards the end. The relaxation of exit regulations in Eastern European
countries contributed to that trend, as did the growing, although still
moderate, outflow of migrants from developing countries. In Asia, the temporary
migration of workers to the oil-producing countries of Western Asia remained
significant and countries such as Japan and some of the newly industrializing
economies of south-eastern Asia emerged as receivers of migrant labour.
However, the trend towards increased international population mobility has not
generally been matched by the willingness of countries of destination to admit
more documented migrants. Given that the pressures for migration are growing in
a number of developing countries, especially as their labour force continues to
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increase, undocumented or irregular migration is expected to rise. Such
developments, coupled with the steady growth of refugee numbers, imply that
vulnerable migrant groups will increasingly need the aid of the international
community.
A. International migration and development
Basis for action
86. International migration both affects and is affected by the development
process. When that migration is regular, it can be beneficial for both
countries of origin and destination. A number of measures can be taken by
countries of origin and destination that, by addressing the causes of migration,
can contribute to promote its benefits.
Objectives
87. To maximize the benefits of migration to those concerned and increase the
likelihood that migration has positive consequences for the development of both
sending and receiving communities.
Selected topics for recommendations
88. Assessing the effects of the economic, trade and development cooperation
policies of countries of origin and destination on international migration.
Realizing the full potential of return migration, both permanent and temporary,
as a channel for the transfer of technology and know-how to the migrants’
countries of origin.
B. Documented migrants
Basis for action
89. Documented migrants are those who satisfy all the legal requirements to
enter, stay and, if applicable, to hold employment in the country of
destination. Many documented migrants have acquired over time the right of
long-term residence in the countries of destination. Their integration into the
host society is generally desirable. Their being granted all of the rights
established by the International Convention on the Protection of the Rights of
All Migrant Workers and Members of Their Families (1990) would contribute to
achieve that aim.
Objectives
90. To promote the social and economic integration of documented migrants,
especially those who have acquired the right to long-term residence in the
country of destination. To combat discriminatory practices against documented
migrants, especially female migrants. To ensure protection against racism and
xenophobia. To promote the welfare of documented migrant workers and members of
their families.
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Selected topics for recommendations
91. Ensuring equality of opportunity for documented migrants in line with the
rights established in the International Convention on the Protection of the
Rights of All Migrant Workers and Members of Their Families, paying attention to
the formulation of appropriate strategies to combat racism and xenophobia.
Facilitating the naturalization of documented migrants who already have the
right of long-term residence and of their children, and extend civil and
political rights to long-term foreign residents.
C. Undocumented migrants
Basis for action
92. It is the sovereign right of every nation State to decide who can enter and
stay in its territory and under what conditions. Undocumented or irregular
migrants who do not fulfil the requirements established by the country of
destination to enter, stay or exercise an economic activity are a source of
concern. The control of undocumented migration is necessary to safeguard the
rights of migrants in general and prevent the exploitation of those in an
irregular situation.
Objectives
93. To control undocumented migration, prevent the exploitation of undocumented
migrants and ensure that their basic human rights are protected.
Selected topics for recommendations
94. Adoption of effective sanctions against those who organize undocumented
migration and those who exploit undocumented migrants, in particular vulnerable
groups such as women and children.
D. Refugees
Basis for action
95. Two thirds of all countries in the world have ratified the 1951 Convention
relating to the Status of Refugees and the 1967 Protocol, which guarantee the
right to seek asylum. However, the growing numbers of refugees and
asylum-seekers are straining the asylum system. The number of refugees, which
was 8.5 million worldwide in 1985, rose to nearly 19 million early in 1993 and
further increases are expected. In addition, the number of persons filing
applications for asylum in developed countries has grown substantially, to
average well over half a million annually during the first years of the 1990s.
There is a need to combat the root causes of refugee movements, with explicit
condemnation of the practice of "ethnic cleansing", and to support the
international protection and assistance of refugees, particularly of refugee
women and children.
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Objectives
96. To reduce refugee flows by combating their root causes, to find durable
solutions for the plight of refugees, to ensure the adequate protection and
assistance of refugee populations and to prevent the erosion of the right to
seek asylum.
Selected topics for recommendations
97. Need to combat the root causes of refugee movements by fostering conflict
resolution, the promotion of peace, the respect of human rights, the alleviation
of poverty, democratization, good governance and the prevention of environmental
degradation. Need to ensure the adequate protection and assistance of refugees
in first countries of asylum, keeping in mind the burden-sharing responsibility
among the international community. Support for the voluntary repatriation of
refugees and provision of reintegration assistance in conjunction with
development programmes.
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Part Three
MEANS OF IMPLEMENTATION
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Chapter XI
POPULATION INFORMATION, EDUCATION AND COMMUNICATION
98. The creation and maintenance of awareness about the importance of
population issues is of crucial importance at both the national and the local
levels to promote the aims and activities of population programmes and at the
global level to build world-wide support for population activities. Population
information, education and communication (IEC) activities usually have a broad
mandate and complex functions, involving many different audiences, messages and
channels of communication. These activities will require, inter alia,
appropriate use of the most modern media available, accompanied by
state-of-the-art monitoring techniques, for maximum effectiveness. Therefore, a
coordinated strategic approach is necessary.
A. Public awareness
Basis for action
99. Public awareness is vital for groups and individuals to act constructively
on population issues. Awareness is needed at several levels (professional,
political, general public and individual), in both industrialized and developing
countries, taking into account the differences in their situations.
Objectives
100. To create and strengthen population awareness among the various audiences
in need of information, through strategies that provide for responses to
specific needs.
Selected topics for recommendations
101. Creating and maintaining awareness of population issues in a large variety
of groups, including opinion leaders and policy makers.
B. Information, education and communication
Basis for action
102. Attitudes that form the basis for behaviour and views on population issues
are often formed early; for this reason, an approach beginning long before
adulthood is required and population education in the school system is one such
approach. Population education may take place in schools and elsewhere. It may
begin with the home and the school system and continue with counselling for
newlywed couples, followed by parent education to help them educate their own
children, and continue the cycle with the education of children, young adults
and even grandparents (who may tend to exert pressure on couples to have
children early etc.).
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Objectives
103. To take action simultaneously and in a coordinated manner on several fronts
to achieve programme goals, through better strategic IEC planning. To enable
activities to be more client-responsive and effective through more appropriate
research and its application. To contribute to increased understanding and to
the formation of responsible population attitudes and behaviour through
population education, beginning at an early age.
Selected topics for recommendations
104. Adoption of comprehensive planning strategies for IEC activities, including
the development of innovative ways of promoting IEC, in particular through the
use of new technologies. Making high-quality population education available to
all schoolchildren in the context of Education for All, paying explicit
attention to human rights, population and environment, gender relationships,
responsible reproductive behaviour, reproductive health and sexuality, and the
consequential choices and responsibilities.
Chapter XII
CAPACITY-BUILDING
105. The fundamental purpose of mechanisms for the attainment of population
goals is the generation of the capacity for countries through their Governments,
non-governmental organizations and private and personal initiatives to undertake
programmes of action to further their own national development, advancing the
quality of life and range of choice of their people. The development of
integrated programmes addressing population issues, particularly family
planning, within the context of sustainable economic activity, requires the
participation of appropriately trained personnel working within effective
institutional arrangements. In order to assure the development and widespread
availability of such a capacity, it will be necessary to facilitate the transfer
of technologies and the development of training and programme-implementation
institutions and the dissemination of information and managerial and
administrative skills. The building of national capacities and strengthening of
local and regional institutions to meet the challenges of demographic change
must be a priority activity.
A. Management of programmes
Basis for action
106. National capacity-building in the areas of management skills and strategic
planning is crucial to ensure the appropriate selection and deployment of
trained individuals to maximize institutional effectiveness. In times of
budgetary constraints for governmental and non-governmental institutions there
is an increased need to ensure that trained personnel are retained and function
effectively in the areas of their expertise. The existence of sufficient cadres
of trained staff in population and development will also facilitate the
establishment of institutional linkages within and between countries to allow
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the dissemination of information and transfer of operational experience in the
areas of programme development, analysis and evaluation.
Objectives
107. To improve the cost-effectiveness and impact of national population
programmes, by training and retaining staff in key areas of expertise. To
facilitate the flow of information between actors in national population
programmes to enhance the formulation of policy and monitoring of performance.
To increase accountability for performance in the implementation of national
population programmes.
Selected topics for recommendations
108. Strengthening strategic management approaches in public and private
population and development programmes, including the development of management
information systems.
B. Education and training of policy makers,
managers and other personnel
Basis for action
109. The recent trend towards decentralization of authority in many national
population and development programmes, particularly in government programmes,
significantly increases the requirement for training staff to meet new
responsibilities at all administrative levels. This increased demand for
trained personnel is added to the requirement for continued strengthening of
national institutions. The decentralization trend modifies the skill-mix
required in central institutions more towards policy analysis, evaluation and
strategic planning in collaboration with a diverse variety of institutions. New
modalities for programme implementation and development require the assessment
of the adequacy of past human resource development and institution-building
strategies and their modification to changing circumstances.
Objectives
110. To ensure the availability of an appropriately trained supply of personnel
for the formulation, implementation and monitoring of population programmes.
Selected topics for recommendations
111. Promoting coordinated educational and training activities and advisory
services related to population programmes.
C. Institutional development
Basis for action
112. In many countries and in some regions, the formulation of population and
development policies, programmes and plans of action, and their implementation
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and monitoring remains constrained by insufficient local capacity. The quality
of technical inputs to programme formulation is, in some cases, another
important bottleneck. Widespread dissemination of the lessons learned in
programme implementation will be required to make the development and transfer
of tested procedures and approaches more efficient.
Objectives
113. To increase national capacities for population and development programme
and project formulation. To reduce attrition of trained staff. To facilitate
the timely dissemination and use of information and policy analyses produced at
national institutions.
Selected topics for recommendations
114. Ensuring sustained commitment by both donor and national authorities to all
aspects of institution-building and maintenance, thereby increasing the share of
technical activities in population being directly undertaken by national
personnel.
Chapter XIII
TECHNOLOGY, RESEARCH AND DEVELOPMENT
115. The need to base population and development policies and programmes on
sound knowledge is increasingly recognized. The research needs involve a broad
spectrum of disciplines, to measure and analyse population trends, to develop
safer and more effective programme inputs and to improve the delivery of
services in accordance with the conditions prevailing in various socio-economic
and cultural settings.
A. Basic data collection and analysis
Basis for action
116. Important improvements have been made over the past 20 years in the
collection and analysis of demographic data, as well as in population policy
databases, which have become more comprehensive and systematic. Nevertheless,
much crucially important work remains to be done. Indeed, in many developing
countries, basic demographic data and analyses based on current direct
observation are still lacking. Data on migration are generally felt to be
scarce and incomplete. In all cases, there is need to continuously update,
consolidate and improve data collection and analysis to keep pace with rapid and
often unprecedented population trends currently taking place in many regions and
in numerous newly independent countries. There is also need for greater insight
into those areas and subpopulations that have been neglected in the past or
where change is lagging, to help in devising appropriate action to speed the
process of demographic transition.
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Objectives
117. To enhance the balance, coverage and relevance of programmes of data
collection and analysis, to improve the basis for analysis, interpretation and
presentation of population and relevant phenomena.
Selected topics for recommendations
118. Improving the quality of basic data on vital processes and national
subpopulations, taking gender into account, and making those data accessible and
available on a timely basis.
B. Biomedical research and development
Basis for action
119. As a result of continuing biomedical and related research, more and more
people at present have access to modern methods of fertility regulation. In
many parts of the world, this has led to improved reproductive health and
reduced fertility. However, a substantial degree of effort across a wide range
of activities will be required to ensure that all people have the opportunity to
achieve and maintain sound reproductive health and to exercise their basic right
to safe and voluntary fertility regulation. Higher levels of biomedical
research and development are essential elements in achieving these goals.
Objectives
120. To expand reproductive choice by developing new and improved methods of
fertility regulation which are safe, effective and respond to the needs and
concerns of users. To continue to ensure the long-term safety of existing and
new methods of fertility regulation.
Selected topics for recommendations
121. Promoting research on all methods of fertility regulation, including
women-controlled barrier methods and male methods, according to internationally
accepted ethical principles and technical standards and incorporating women’s
perspectives into all stages of the research process and seeking the involvement
of private industry and drug-regulatory agencies as partners in biomedical
research. Promoting research on unsafe abortion and other aspects of
reproductive health, including those related to the needs of adolescents.
C. Social and economic research and development
Basis for action
122. Greater understanding of social and behavioural processes is essential in
order to achieve many of the goals of population and development programmes;
such programmes should be based on accurate and culturally relevant knowledge of
the people whom they seek to serve. There is need to promote research essential
to the design and monitoring of population policies and programmes, in order to
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ensure, inter alia, that they respond to the needs of the society at large, as
well as to the needs of women and of vulnerable, marginalized and underserved
people. Such research should address issues such as quality of care, cost and
accessibility of services.
Objectives
123. To advance the understanding of demographic processes and their
interrelations with the environment and social and economic development. To
establish balanced programmes of research that are policy-relevant and
action-oriented. To foster the dissemination and use of research results,
particularly to policy makers and programme officers.
Selected topics for recommendations
124. Promotion of research on the broad field of interrelations between
population, environment and development. Ensuring that the population programme
and policy research agenda has a balance of theoretical, operational and
methodological work.
Chapter XIV
NATIONAL ACTION
125. National action undertaken by countries to address their own population
problems, in a broadened context of balanced social and economic development,
encompasses the coordinated work of national Governments, regional or local
authorities, organizations, institutions, associations, unions or communities.
National action requires sound policies to ensure that the benefits of
development are shared by the entire population. National, state and local
community-level resource mobilization in each country according to their
capacities is another priority area for action if countries are to meet the
current and future demand of their people for family-planning services and other
population programme needs.
A. National policies and plans of action
Basis for action
126. National Governments are primarily responsible for designing, implementing
and evaluating national population policies and programmes. In many countries,
clarifying the mode of interaction between the entity of the central government
responsible for coordinating population policies and programmes, the sectoral
ministries and other concerned parties is still a problem to be overcome.
However, over-reliance on the government sector can become a bottleneck. The
experience of the past decades suggests that the mobilization of sustained
political commitment, not only at the highest level but also down to local
leaders of the public, private and non-governmental sectors at the grass-roots
level, has been an important factor behind the success of strong national
population programmes. There has also been growing recognition of the fact that
population policies stand a lesser chance of success in the long run if their
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beneficiaries are not fully involved in their design and subsequent
implementation.
Objectives
127. To address population problems through effective and concerted action
within the framework of a national population policy and to achieve grass-roots
involvement in formulating and implementing plans of action in the field of
population.
Selected topics for recommendations
128. Increasing the political commitment of Governments to formulate, implement
and evaluate their national population programmes and strengthening their
capacity to enlist the cooperation of the private sector, non-governmental
organizations, academia, the mass media and other influential groups and to
foster the grass-roots participation of programme beneficiaries.
B. Resource allocation
Basis for action
129. The allocation of resources at the national level generally falls into
several broad categories: population data collection and analysis;
policy-relevant research; awareness-creation and advocacy; capacity-building
activities; policy formulation and implementation; family-planning services; IEC
activities and special programmes for youth and women; and population and
development. National resource mobilization is a priority area for action, in
the light of the substantial increase in demand for reproductive health and
family-planning services that will take place in the coming decades. Efforts to
generate domestic resources to support service-delivery programmes and
associated information, education and communication activities will need to be
intensified, although many of the countries where the demand will be growing
most rapidly are currently witnessing recessionary trends in their domestic
economies.
Objectives
130. To achieve an adequate level of national resource allocation devoted to
programmes aimed at resolving population problems, based on a clear
understanding of the costs involved in meeting the unsatisfied demand for
family-planning services and for other social-sector services, such as primary
education and primary health care, which also affect population dynamics.
Selected topics for recommendations
131. Intensifying efforts to generate domestic resources to support all
categories of population programme activities, with increased attention to
selective use of user fees, social marketing, cost-sharing and other forms of
cost-recovery.
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Chapter XV
INTERNATIONAL COOPERATION
132. International cooperation in the area of population comprises, in addition
to technical and financial assistance by bilateral and multilateral agencies to
population activities in developing countries, other forms of cooperation
regarding issues such as international migration and the AIDS pandemic.
Attention needs to be directed as well to the comparative advantages (and
disadvantages) of various modalities for the provision of international
assistance. International technical and financial assistance has played an
important role in facilitating the efforts of national Governments to devise and
implement population policies and programmes but has not kept pace with growing
resource requirements as more and more developing countries have formulated and
begun to implement national population policies and programmes. National
population and development programmes need to receive stable, consistent and
appropriate levels of international support, taking into account the balance and
relationship between international assistance directed to population-related
activities and international cooperation connected to broader areas of
socio-economic development.
A. Modalities
Basis for action
133. The coordination of international inputs to population and development is
primarily the responsibility of Governments. However, reducing duplication of
efforts, identifying and expanding successful programmes and ensuring maximal
effectiveness is also a task that profits considerably from the cooperation of
all donors and active participants, including the specialized agencies and
organizations and bodies of the United Nations system.
Objectives
134. To assure the effective and coordinated use of various mechanisms of
assistance for the formulation, implementation and monitoring of national
population programmes. To ensure the full mobilization of national
(governmental and non-governmental organizations and the private sector)
participants in the national population programme for effective action in their
areas of particular competence, expertise and comparative advantage. To monitor
performance of the various components of the national population programme to
assure that appropriate technical and material contributions are made by
organizations according to their capacities.
Selected topics for recommendations
135. Coordination of international organizations and donor nations to encourage
use of multilateral and multi-bilateral mechanisms, including technical
back-stopping, to guarantee consistency and continuity of support to programmes,
based on the analysis of the impact and cost-effectiveness of such mechanisms
and in line with comprehensive national development strategies.
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B. Resource mobilization: Bilateral and multilateral
development assistance
Basis for action
136. Little progress has been made over the past 5-10 years towards reaching the
earlier goals articulated in the donor community for support for population
activities as proportions of their overseas development assistance or as
proportions of their gross national product. The current average is
1.3 per cent, compared to 2 per cent in the early 1970s. Nevertheless, there
remains a strong consensus on the need to mobilize significant additional
financial resources both from the international community and within countries
for the implementation of national population programmes in support of
sustainable development policies. Additional resources are required,
inter alia, to satisfy the existing unmet need for family-planning services,
respond to future increases in demand, keep pace with the increased population
sizes that must be served, and improve the quality of care of programmes.
Although intensified additional efforts to mobilize domestic resources are
needed and projected, additional financial resources from the international
community will be required especially to assist the least developed countries
and countries implementing structural adjustment programmes, including so-called
countries in transition.
Objectives
137. To satisfy the growing resource requirements of population programmes.
Selected topics for recommendations
138. Mechanisms for the international community to establish guidelines/
recommendations for assistance levels as proportions of gross domestic product
and overseas development assistance, on the basis of updated estimates for
resource requirements consistent with the scale of efforts needed to achieve the
quantitative goals adopted by the Conference and taking into consideration the
constraints created by economic reform and structural adjustment programmes.
Chapter XVI
PARTNERSHIPS WITH NON-GOVERNMENTAL GROUPS, INCLUDING
NON-GOVERNMENTAL ORGANIZATIONS, THE PRIVATE SECTOR
AND LOCAL COMMUNITY GROUPS
139. There is an increasing recognition of the need for a partnership on
population and development issues between Governments and non-governmental
groups, which are composed of non-governmental organizations, the private sector
and local community organizations. In some areas of population and development
activities, non-governmental groups may have comparative advantages in relation
to governmental agencies, either because their experience of advocacy and
programme implementation (especially at the local level) predate that of
Governments, or because they represent and interact with constituencies that are
poorly served and hard to reach through governmental channels. Non-governmental
groups operate locally, nationally and, in some cases, internationally, often
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having networks and affiliates facilitating cooperation at all levels and
enhancing partnership among themselves and with Governments. Where they are
working on population and development activities as partners with Governments,
the quality of services has often improved markedly.
Basis for action
140. Non-governmental organizations have been actively involved in the provision
of services for population and development programmes and projects and support
activities such as data collection and analysis. They have been working as
partners with Governments in delivering services and helping implement
population and development programmes; in many cases this partnership has been
instrumental in ensuring that national policy goals were achieved. They also
have acted as catalysts for change, often serving as a voice for previously
unrecognized concerns, reaching underserved populations, setting quality
standards responsive to the beneficiaries’ needs and developing innovative
approaches.
141. In many countries, the private sector has the financial capacity and the
technology to produce and deliver commodities and services in the population
field, and Governments usually rely to some extent on the private sector for the
procurement of such programme inputs. This has produced a valuable partnership,
which the private sector is keen to expand. By acknowledging the valuable
contribution of the private sector, and by seeking more areas for cost-effective
and mutually beneficial cooperation, Governments may expect to enhance the
efficiency of population and development activities.
142. Local community organizations vary from country to country. In some
countries, Governments helped establish them and in others they have been
created by the communities themselves. They range from the family and kinship
to political, social, economical, religious and educational institutions and
organizations. They are generally well-established and continue from one
generation to the next, providing a social framework for their communities.
They are generally seen as meeting the needs of families and individuals and
their role as providers of services is widely and favourably acknowledged.
Numerous development processes can be encouraged by fostering the partnership
between Governments and local community organizations. Some who already provide
a number of social services could readily be encouraged to also participate in
population activities.
Objectives
143. To enhance the partnership between Governments, non-governmental
organizations, the private sector and local communities in order to attain a
more effective working relationship and to identify new areas for cooperative
activity, including, as appropriate, the efficient production of population
programme commodities and the fair-cost delivery of services.
Selected topics for recommendations
144. Creating suitable mechanisms and frameworks to enhance the role of
non-governmental organizations in the field of population. Promoting the
effective use of the experience and resources of the private sector to achieve
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population and development goals. Ensuring the participation of local
communities in the formulation and implementation of population policies and
programmes.
Chapter XVII
FOLLOW-UP
145. In order to ensure that commitments made at the Conference are implemented
with tangible results, it will be necessary to make arrangements appropriate for
the effective implementation of the recommendations of the Conference. At the
level of the United Nations system, this should involve increased integration of
population concerns into social and economic development efforts, including
policy development. Arrangements will need to be outlined to ensure ongoing
monitoring, review and appraisal of the outcome of the Conference. Attention
will also need to be given to effective follow-up at the operational level,
particularly in regard to funding, technical assistance and coordination.
A. Implementation
Basis for action
146. The World Population Plan of Action, adopted in 1974, contained a number of
recommendations related to institutional arrangements for its proper
implementation, further elaborated by the recommendations of the International
Conference on Population, held at Mexico City in 1984. Similarly, there will be
a need for the Cairo Conference to consider how best to organize the involvement
of the international community of Governments, non-governmental organizations,
the United Nations system and regional intergovernmental bodies to assist
Governments in the implementation of the new action programme adopted by the
Conference, also in view of the outcomes of other major United Nations
conferences of the decade, particularly the United Nations Conference on
Environment and Development, the World Conference on Human Rights, the World
Social Summit and the Fourth World Conference on Women.
Objectives
147. To ensure the effective implementation of the new action programme.
Selected topics for recommendations
148. Ensuring the integration of population concerns in governmental,
non-governmental and international development efforts through appropriate
arrangements.
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B. Monitoring and review
Basis for action
149. The World Population Plan of Action called for continuous monitoring and
periodic review and appraisal of its implementation. Accordingly, three
quinquennial review and appraisal exercises have been carried out to assess the
progress in the implementation of the Plan and a fourth one will take place at
the Cairo Conference. The Conference may find it necessary to establish
appropriate mechanisms for the monitoring and review of its action programme.
Objectives
150. To assess the progress in the implementation of the action programme
adopted by the International Conference on Population and Development and take
necessary measures to guide further action.
Selected topics for recommendations
151. Establishing accurate and timely mechanisms for assessing the progress made
in achieving the goals and objectives of the action programme adopted by the
International Conference on Population and Development.
Notes
1/ Report of the United Nations World Population Conference, Bucharest,
19-30 August 1974 (United Nations publication, Sales No. E.75.XIII.3), chap. I.
2/ Report of the International Conference on Population, Mexico City,
6-14 August 1984 (United Nations publication, Sales No. E.84.XIII.8 and
corrigenda), chap. I, sect. B.
3/ Report of the International Forum on Population in the Twenty-first
Century, Amsterdam, the Netherlands, 6-9 November 1989 (New York, United Nations
Population Fund, 1990), annex.
4/ Report of the United Nations Conference on Environment and
Development, Rio de Janeiro, 3-14 June 1992, vol. I, Resolutions Adopted by the
Conference (United Nations publication, Sales No. E.93.I.8), resolution 1,
annex I.
5/ Ibid., resolution 1, annex II.
6/ Report of the World Conference to Review and Appraise the Achievements
of the United Nations Decade for Women: Equality, Development and Peace,
Nairobi, 15-26 July 1985 (United Nations publication, Sales No. E.85.IV.10),
chap. I, sect. A.
7/ General Assembly resolution 217 A (III).
8/ General Assembly resolution 2200 A (XXI), annex.
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9/ General Assembly resolution 2106 A (XX).
10/ General Assembly resolution 34/180, annex.
11/ General Assembly resolution 44/25, annex.
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