the right to decide freely and responsibly the number and spacing of their children
and to have the information, education and means to do so was first recognized as a human
right in 1968. The right to reproductive health has been endorsed and strengthened in
successive international forums, particularly at the 1994 International Conference on
Population and Development (ICPD) in Cairo as well as at the Fourth World Conference on
Women (Beijing, 1995), the World Summit for Social Development (Copenhagen, 1995) and the
World Conference on Human Settlements (Istanbul, 1996). The right to reproductive health
now includes the concept that individuals have the right to attain the highest standard of
sexual and reproductive health and to make reproductive choices free from coercion.
The right to plan the size and spacing of the family was
originally agreed at the International Conference on Human Rights in Teheran in 1968.
At the World Population Conference held in Bucharest in 1974, the right was formulated
All couples and individuals have the basic right
to decide freely and responsibly the number and spacing of their children and to have the
information, education and means to do so; the responsibility of couples and individuals
in the exercise of this right takes into account the needs of their living and future
children, and their responsibilities towards the community. (Principle 14f, World
Population Plan of Action).
The Programme of Action of the International Conference
on Population and Development 1994 states:
Everyone has the right to the enjoyment of the
highest attainable standard of physical and mental health. States should take all
appropriate measures to ensure, on a basis of equality of men and women, universal access
to health-care services, including those related to reproductive health care, which
includes family planning and sexual health. Reproductive health-care programmes should
provide the widest range of services without any form of coercion. All couples and
individuals have the basic right to decide freely and responsibly the number and spacing
of their children and to have the information, education and means to do so. (Principle
The Programme of Action adds:
The aim of family planning programmes must be to
enable couples and individuals to decide freely and responsibly the number and spacing of
their children and to have the information and means to do so and to ensure informed
choices and make available a full range of safe and effective methods. The success of
population education and family planning programmes in a variety of settings demonstrates
that informed individuals everywhere can and will act responsibly in the light of their
own needs and those of their families and communities. The principle of informed free
choice is essential to the long-term success of family planning programmes. Any form of
coercion has no part to play. (Para 7.12).
Reproductive health is a state of complete physical, mental and social well-being
not merely the absence of disease or infirmity in all matters relating to
the reproductive system and to its functions and processes, according to the ICPD
Programme of Action. Reproductive health implies that people are able to have a satisfying
and safe sex life, that they are able to reproduce and that they have the freedom to
decide if, when and how often to do so.
Exercising that freedom requires having access to both family planning and related
health care services. These services include family planning, pre- and post-natal medical
care and the prevention of sexually transmitted diseases (STDs), including HIV/AIDS.
Many people are unable to attain optimal reproductive health because of incomplete
knowledge about health and human sexuality; gender bias; high-risk sexual behaviour; and
the unavailability or poor quality of reproductive health care services. Violence against
women such as domestic abuse and rape leads to STDs and unwanted pregnancies, as well as
to physical injury and mental illness, The growing incidence of STDs including HIV/AIDS
also negatively affects reproductive health as does the continuation of harmful practices
such as female genital mutilation. Adolescents who lack of information and services are
particularly at risk. In most parts of the world, the majority of new HIV infections are
in young people between the ages of 15 and 24, sometimes younger.
Older women and men also have distinct reproductive and sexual health needs that
are often inadequately addressed.
Each year an estimated 585,000 women die as a result of pregnancy and childbirth
(maternal mortality) and perhaps 15 times as many suffer injury or infection (maternal
morbidity). Most of these deaths and disabilities happen to women in developing countries,
where pregnancy and giving birth are among the leading causes of death for women of
childbearing age, and where the risk of death is 50 to 100 times greater than in developed
Abortion performed under unsafe conditions is a serious threat to reproductive
health. The World Health Organization estimates that about 70,000 women die each year as a
result of unsafe abortion, almost all of them in developing countries.
Up to a third of maternal mortality and morbidity could be avoided if all women had
access to a range of modern, safe and effective family planning services which would
enable them to avoid unwanted pregnancy.
|Abortion and the International
Conference on Population and Development
1994 International Conference on Population and Development agreed that abortion should
not be promoted as a method of family planning. The Conference described unsafe abortion
as a "major public health concern." It was agreed that expanding and improving
family planning services was key to reducing recourse to abortion and that, in countries
where abortion is not against the law, abortion should be safe.
United Nations agencies and programmes, including UNFPA, do not support or promote
abortion in any country in the world, in any circumstances or under any conditions.
Family planning services are an essential part of reproductive health care and have
saved the lives and protected the health of millions of men, women and children. Over the
past 30 years, the development of modern contraceptive methods has given people greater
individual freedom and enhanced their ability to plan their families. Contraceptive use
has increased from less than 10 per cent of couples 30 years ago to some 60 per cent of
couples today, and family size has fallen from an average of six children in the 1960s to
less than three. However, today at least 350 million couples do not have access to the
full range of safe and effective modern methods of family planning. Surveys from more than
60 developing countries indicate that more than 100 million women who are not currently
using a contraceptive method want to delay the birth of their next child or to stop
childbearing altogether. Each year during this decade, the number of couples in their
reproductive years will increase by about 18 million, according to the ICPD Programme of
Action. Reproductive health programmes will have to expand their reach and improve their
quality, to provide a full range of services to these men and women.
By the year 2000, there will be almost 1.1 billion young people in the world (900
million in less developed regions), of whom more than half are likely to be either married
or sexually active. Currently, an estimated 1 in 20 teenagers worldwide acquires an STD
each year, while childbearing among young women, despite a greater risk of complications
and death, is not uncommon. Developing and providing appropriate information and services
to young people is not easy, given the need to balance rights to confidentiality with the
concerns of families and communities. While the support of community leaders and parents
is critical to the success of programmes for youth, young people should be involved in
designing the programmes that will serve them, since they may understand best the needs of
Both the ICPD in Cairo in 1994 and the Fourth World Conference on Women in Beijing
a year later, acknowledged the reproductive health needs of refugees, internally displaced
persons and others in conflict and emergency situations.
The UN system and the international community believe that reproductive health care
including family planning, safe maternity, and protection from the transmission of STDs
including HIV/AIDS as well as from violence and sexual abuse should be available in all
situations and circumstances based on the needs and expressed demands of refugees, with
priority given to the needs of women and adolescent girls. Provision of such care should
take into account full respect for the various religious and ethical values and cultural
backgrounds of the refugees, in conformity with universally recognized human rights. The
first ever reproductive health care package to be incorporated from the outset into an
emergency assistance response framework was funded by UNFPA in a project executed by the
International Federation of Red Cross and Red Crescent Societies working with UNHCR and
NGOs in the Great Lakes Region of Central Africa in late 1996. In April 1999, UNFPA,
working with UNHCR and other UN agencies, sent emergency reproductive health kits to
Albania to help some 350,000 Kosovo refugees. The kits were designed to respond to a range
of needs associated with emergency situations: family planning, including emergency
contraception; assisted childbirth; complications connected with unsafe abortions; and
STDs, including HIV/AIDS. Emergency contraception, also known as the "morning after
pill", is an elevated dose of birth control pills which prevent pregnancy when taken
within 72 hours of intercourse. It is intended for use in cases of sexual violence,
including rape. In line with the ICPD Programme of Action, the package does not include
support for abortion services.
"UNFPA recognizes that all refugees and persons in emergency situations have
the same vital human rights, including the right to reproductive health, as people in any
community," said Dr. Nafis Sadik, the Funds Executive Director. There is still
a long way to go, however, to ensure that all persons in conflict and emergency situations
have the benefit of quality reproductive health counselling and related services.