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Action Priorities
In adopting the ICPD Programme of Action in 1994,
the world’s governments recognized that investing in
people, broadening their opportunities and enabling
them to realize their potential as human beings is the
key to sustained economic growth and sustainable
development.
Successful action to implement the Cairo agenda
and combat poverty depends on adequate funding and
effective partnerships.
This chapter discusses the role of partnership in
promoting better reproductive health and efforts to
achieve the goals of ICPD and the MDGs, and the
resources required; this is followed by a summary
of priorities for action.
Non-governmental organizations, the backbone of
many programmes around the world, played a crucial
role in shaping the ICPD consensus, and their level of
participation in the intergovernmental process was
unprecedented. The Programme of Action was farreaching
in its recommendations for promoting
partnerships with NGOs, other civil society institutions
and the private sector.
In many countries today, NGOs are active in providing
reproductive health services and promoting the Cairo
agenda in numerous other ways, including advocacy.
Before 1994, partnerships between governments
and NGOs mostly involved family planning associations,
which had been major providers of family
planning services in many developing countries. These
collaborations continued over the past decade, with
NGOs frequently receiving substantial external funding
to provide services independent of governments.
Since the ICPD and its 1999 review, partnerships
have developed between governments and a broader
range of civil society organizations, including professional
associations, community groups and others.
In the UNFPA 2003 global survey, 90 per cent of
governments in all regions reported active partnerships
on population and reproductive health. Both
sides have accepted that NGOs often can reach some
groups more easily and carry out certain programmes
more effectively than can governments.
NGOS AND REPRODUCTIVE HEALTH SERVICES. Some
governments do not provide certain components of
reproductive health due to financial constraints or a
lack of capacity. In some settings requiring flexibility
and quicker outreach, NGOs are better-placed than
governments to promote gender equality, address
gender-based violence, encourage male responsibility,
provide reproductive health information and services to
adolescents, undertake youth development programmes,
and reach groups at higher risk of HIV infection.
In Mexico, the Government recognizes the role of
NGOs in providing medical services including cervical
smear tests, gynaecological consultations, antenatal
care and care of newborns.
With the introduction over the past decade of
health sector reform, Poverty Reduction Strategy
Papers (PRSPs) and sector-wide approaches, many
donors are now providing funding directly to governments.
As a result, developing country governments are
now often in a better position to partner with NGOs,
other civil society actors and the private sector in ways
that complement programmes they are implementing.
In Bangladesh, where NGOs and the private sector
provide most health care, the Government has included
NGOs and community-based organizations in a
National Advisory Committee for Stakeholder
Participation in the Health, Nutrition, and
Population Sector, to ensure client-focused services,
quality care, social and gender equity, and decentralization.
The intent is to involve partners in planning
as well as implementing policies and programmes.
On the other hand, some countries have included
NGOs and others in the development of poverty reduction
and health sector reform strategies, but have
excluded them from the implementation phase.
NGOs and other civil society actors, including
professional associations, are taking up actions traditionally
considered the sole province of governments,
including setting standards and ensuring
accountability, either as a complement to or to fill
gaps in government efforts. NGOs can also monitor
government compliance with human rights treaties
and commitments made to implement the
Programme of Action.
Professional associations of doctors, nurses,
midwives and other health care staff have key roles to
play in standard setting, including ethical standards,
and in providing continuing medical education and
skills training to their members related to reproductive
and sexual health and rights and the elements of
quality care. International NGOs like the Commonwealth
Medical Trust have carried out activities for
this purpose.
PRIVATE SECTOR. Another new development in the
past decade has been partnership between NGOs
and the private sector in promoting reproductive
health, as each side has come to recognize the other’s
comparative advantages. Private companies provide
opportunities for social marketing of condoms and
other reproductive health commodities through
supermarkets, shops and pharmacies. Some private
employers now recognize the benefits of promoting
sexual and reproductive health among their employees
and in the communities where they operate.
PARLIAMENTARIANS. Elected representatives play
important roles in setting priorities, allocating
resources and defining institutional responsibilities
with regard to sexual and reproductive health services
and reproductive rights. Parliamentarians’ groups
in a number of countries have worked to promote
implementation of and adequate funding for the
ICPD agenda.
The first such group, the Japan Parliamentarians
Federation for Population, has been a leader in the
global parliamentarians movement for three decades. The United Kingdom’s
All Party Parliamentary Group
on Population, Development and Reproductive Health
has inspired national parliamentary groups in other
European countries. Groups in developing countries
include India’s Association of Parliamentarians on
Population and Development, and committees on
population and development in both houses of the
Nigerian Parliament.
Regional and global networks of parliamentarians
are also active in advocacy efforts. The Asian Forum
of Parliamentarians on Population and Development,
the Forum of African and Arab Parliamentarians on
Population and Development, and the Inter-American
Parliamentary Group on Population and Development
all scheduled events in 2004 to commemorate the 10th
anniversary of the ICPD.
From 18-19 October 2004, the second International
Parliamentarians’ Conference on the Implementation
of the ICPD Programme of Action (IPCI/ICPD) will be
held in Strasbourg, France. The conference is jointly
organized by the Inter-European Parliamentarian
Forum on Population and Development and UNFPA in
collaboration with the Council of Europe.
At the first IPCI/ICPD in 2002 in Ottawa, Canada,
103 elected officials from 72 countries signed a
Statement of Commitment1 outlining specific actions
they will take to safeguard women’s reproductive
rights, improve access to reproductive health services
including family planning, reduce maternal mortality
and prevent the spread of HIV/AIDS, and pledged to
strive to allocate up to 10 per cent of their nations’
development budgets for population and reproductive
health programmes.
UNIVERSITIES. Governments frequently turn to universities
to collect and analyse data, and for research,
on sexual and reproductive health issues. In India, for
example, 18 Population Research Centres attached to
universities are responsible for researching population
trends and dynamics, knowledge and attitudes of
clients, operational issues and other aspects of the
population and development nexus. The Institute of
Social, Statistics and Economic Research in the
University of Ghana provides training in reproductive
health, gender, poverty and population-development
interrelationships.
SOUTH/SOUTH COOPERATION. Facilitating the
exchange of know-how and experiences between
developing countries is another important aspect of
the ICPD’s emphasis on partnership. Partners in
Population and Development, established in 1994 with
the support of UNFPA, the Rockefeller Foundation
and other donors, is now an alliance of 20 developing
countries (Bangladesh, Benin, China, Colombia, Egypt,
the Gambia, India, Indonesia, Jordan, Kenya, Mali,
Mexico, Morocco, Nigeria, Pakistan, Thailand,
Tunisia, Uganda, Yemen and Zimbabwe) working to
expand and improve South-South collaboration on
family planning and reproductive health.(2)
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