ICPD

Summary of the ICPD Programme of Action

ICPD: Providing Youth Friendly Adolescent Health Services

The Problem

“The reproductive health needs of adolescents as a group have been largely ignored to date by existing reproductive health services…Poor educational and economic opportunities and sexual exploitation are important factors in the high levels of adolescent child-bearing. In both developed and developing countries, adolescents faced with few apparent life choices have little incentive to avoid pregnancy and child-bearing…In many societies, adolescents face pressures to engage in sexual activity. Young women, particularly low-income adolescents, are especially vulnerable. Sexually active adolescents of both sexes are increasingly at high risk of contracting and transmitting sexually transmitted diseases, including HIV/AIDS, and they are typically poorly informed about how to protect themselves.” ICPD POA, Paragraphs 7.41, 7.42 and 7.43.

The Promise

By 2015, the response of societies to the reproductive health needs of adolescents should be based on information that helps them attain a level of maturity required to make responsible decisions. In particular, information and services should be made available to adolescents to help them understand their sexuality and protect them from unwanted pregnancies, sexually transmitted infections, including HIV/AIDS and the risk of infertility. This should be combined with the education of young men to respect women's self-determination and to share responsibility with women in matters of sexuality and reproduction. This effort is uniquely important for the health of young women and their children and, in many countries, for efforts aimed at reducing the momentum of population growth. ICPD POA, Para. 7.41

Therefore, it is crucial that governments work towards providing an array of services aimed at promoting responsible and healthy reproductive and sexual behavior, including voluntary abstinence and the provision of appropriate services and counseling suitable for adolescents and young people in the age group 10-24. ICPD POA, Para. 7.44.

UNFPA's Strategic Approach

Through UNFPA's Country and Regional Programmes, the Fund is encouraging governments to implement comprehensive policies and services designed to enhance the sexual and reproductive health of young people. This broad-based initiative consists of the following key components:

• Advocacy with national and state governments on the need for comprehensive adolescent sexual and reproductive health services, including counseling, as an important strategy in reducing adolescent pregnancies and preventing STIs and HIV/AIDS.
• Removal of discriminatory laws, regulations and social barriers preventing adolescents and young people from accessing culturally appropriate RSH information and services.
• Working with governments, NGOs and community groups to meet the special needs of adolescents by establishing youth programmes. Such programmes should include support mechanisms for the education and counseling of adolescents in the areas of gender relations and equality, violence against adolescents (especially girls), responsible sexual behavior, family planning, family life education, reproductive health, STIs, and HIV infection and AIDS prevention.
• Introduction of family life and sexuality education into school curricula.
• Promotion of national youth policies, including the involvement of youth in the planning, implementation and evaluation of policies and programmes aimed at providing for their RSH needs.
• Training programmes aimed at those who can influence adolescent sexual behavior, especially parents, peers, community and religious leaders, teachers, and the mass media. Such programmes are important in influencing and changing adolescent behavior patterns. Part of this approach involves Behavior Change Communication programmes (BCC) aimed at improving the knowledge, skills and attitudes of young people.

How are we doing?

Nearly half of all people in the world are under the age of 25; 1.2 billion are between the ages of 10 and 19, the largest generation of adolescents in history. The options and opportunities they have to regulate their fertility, avoid unwanted pregnancies and plan families, will determine to a large extent the future demographic profile of the planet.

Despite promises to address the needs of adolescents, most countries are only beginning to come to terms with adolescent RSH issues. Still, since the ICPD, there has been an upsurge in efforts to provide appropriate sexual and reproductive health services to young people. Despite setbacks, some notable progress has been made. Take Uganda as an example. Thanks to a national programme involving more than 700 NGOs, government agencies and donors, such as UNFPA, the HIV infection rate among young people fell dramatically from 15% of all infections in 1991 to just 5% by 2001. One of the centerpieces of the anti-AIDS programme was an emphasis on education and the application of the ABC approach – Abstinence, be Faithful in a relationship and/or use Condoms. As a result of BCC programmes in schools and communities, Ugandan youth have significantly altered their sexual behavior: in 1994 more than 60% of students aged 13-16 years of age reported that they were sexually active, but by 2001 that figure had dropped to 5%.

Many countries have also introduced national youth policies or changed discriminatory laws and regulations. Gabon, Panama, China, Mongolia and Honduras have all enacted policies promoting sexuality education and life skills in schools.

UNFPA is a primary partner in the United Nations Foundation supported programme operating in 13 countries, to better address the development and participation rights of adolescents, including access to better designed ARSH information and services. To date over half a million adolescents have benefited from this comprehensive programme.

As part of service delivery packages, peer education programmes have taken off in many countries over the past decade. One notable achievement has been UNFPA's regional peer education programme in Central and Eastern Europe and the former Soviet Union. Called the Y-PEER Network, this ambitious initiative involves 185 youth groups in 27 countries and is designed to reduce the incidence of HIV/AIDS and STIs, promote healthy, responsible sexual behavior and reduce drug and alcohol addiction, among other things. As of 2004, 241 youth had been trained as peer educator trainers; these in turn have reached over 70,000 young people in the entire region.

Much remains to be done, but a number of developing countries, assisted by UNFPA, are showing the way ahead.

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