Reproductive Health and Safe Motherhood

Kouboura Moutari of Niger married when she was only 15 years old. Soon after, she gave birth to her first child, who was stillborn. During her second pregnancy, she laboured for two days before her family brought her by horse-drawn cart to the hospital for an emergency Caesarean section. Unfortunately, it was too late, and she not only lost the baby, but also suffered obstetric fistula. With the help of UNFPA, however, she was able to obtain treatment and today works with a UNFPA-supported non-governmental organization (NGO) to inform village women of the importance of prenatal care and timely obstetric intervention.

Promoting reproductive health and rights is central to the UNFPA mission. The Fund strives to contribute to the Millennium Development Goals (MDGs) by focusing on maternal mortality, adolescents, gender equality, HIV prevalence (particularly among women), under-5 child mortality and unmet family planning needs.

In many developing countries, maternal mortality remains unacceptably high—a stinging indictment of inadequate national priorities that fail to address a global tragedy that is as easily preventable as it is seemingly intransigent. According to the 2006 MDG progress report, advancement on maternal health has stagnated and, in some instances, has even deteriorated.

Although many countries have established reproductive health programmes, millions of pregnancies are still unwanted or mistimed. Furthermore, modern family planning methods remain out of reach for the world’s poorest and, in particular, for unmarried young people.

In 2006, UNFPA strengthened efforts to guarantee the right to sexual and reproductive health, to help girls at risk of acquiring HIV and to support young people, who hold the key to a healthy future.

Saving Mothers’ Lives

Saving lives—reducing maternal death and protecting women from serious health complications associated with pregnancy and childbirth—is not only a leading international development priority, but is also a human rights imperative. UNFPA helps families and individuals to gain access to reliable family planning, and developing countries to build capacity so they can provide women with skilled attendance at birth and emergency obstetric care in case of complications. In 2006:

Family Planning: So that Every Pregnancy is Wanted

Improving access to voluntary family planning services lies at the heart of the UNFPA mandate. Despite the lack of up-to-date data on global or regional contraceptive prevalence rates, improvement is evident: An increasing number of countries report that service delivery points now stock at least three modern methods of contraception. Nevertheless, millions of people still lack access to contraceptives. Today, an estimated 201 million women worldwide are unable to acquire safe and effective contraceptive services. in 2006:

UNFPA Executive Director Thoraya Ahmed Obaid
with a 16-year-old patient at the Fistula Repair Centre at Dhaka Medical College Hospital in Bangladesh. The centre was established with UNFPA support.

Coming through with Commodities

Every minute, 190 women are forced to confront the possibility of an unplanned or unwanted pregnancy— one that could have been easily prevented if only they had access to contraceptives. Every minute, 650 people contract an STI and nearly 10 are newly infected with HIV because they could not obtain condoms. Government allocation of funds for contraceptives is key to the sustainability of reproductive health services.

To improve access to reproductive health services, UNFPA Country Offices have focused on: (a) undertaking advocacy to increase national investments in family planning services; (b) promoting reproductive health commodity security; (c) expanding the choice of methods; (d) improving the quality of services; (e) increasing the number of service delivery points; (f) increasing capacity in areas such as protocol development, logistics, forecasting, costing, monitoring and evaluation; and (g) undertaking advocacy and capacity-building to expand services to adolescents.

With UNFPA support, some governments are fundraising for their five-year condom strategies. Others are allocating funds from other sources, such as the Global Fund to Fight AIDS, Tuberculosis and Malaria, to support commodities and programme costs. Moreover, female condoms are now being integrated into the National Essential Drug List for HIV and for reproductive health in some countries. In 2006:

Restoring Hope and Dignity to Women and Girls

Galvanizing support for maternal health is the goal of the UNFPA-led Campaign to End Fistula, which in 2006 worked in 40 countries in sub-Saharan Africa, South Asia and the Arab States. The aim is to prevent and treat a terrible childbirth injury called fistula—a rupture in the birth canal that occurs during prolonged, obstructed labour and leaves women incontinent, isolated and ashamed. Most victims are poor, young and malnourished. Nine out of ten fistulas can be successfully repaired.

Three mothers and their babies at the UNFPAsupported Al-Rimal clinic in Gaza, in the Occupied Palestinian Territory.

Only three years after launching the campaign in 2003, UNFPA has assisted 30 countries to complete needs assessments. More than 20 countries have moved from assessment and planning to implementation. Eleven governments, as well as private-sector supporters such as Johnson & Johnson, One by One, the 34 Million Friends of UNFPA and Virgin Unite, donated to the campaign in 2006.

The year saw several “firsts�. In 2006:

Investing in Youth,Investing in the Future

With the support of UNFPA, young people in every region took action in 2006 to protect their health, education and future opportunities. The Fund championed young people’s rights and promoted youth issues as a priority for human development and social and economic growth. Among the major achievements in 2006:

Intensifying HIV Prevention

Prevention offers the best hope of reversing the HIV epidemic. Sustained political commitment through intensive programmes in diverse settings has reduced HIV incidence. Advances in treatment are reinforcing prevention efforts by encouraging voluntary testing and reducing the stigma associated with AIDS. Nevertheless, the pandemic is outstripping efforts to contain it and is gaining ground globally. The overarching strategy of UNFPA is to link HIV/ AIDS and sexual and reproductive health to optimize prevention, care, treatment and support.

The majority of HIV infections are sexually transmitted or associated with pregnancy, childbirth and breastfeeding. Both HIV/AIDS and poor sexual and reproductive health are driven by common root causes—poverty, gender inequality and social marginalization. Responses to both health issues need to be closely linked and mutually reinforcing.

As one of 10 co-sponsors of UNAIDS, UNFPA works to intensify and scale up HIV prevention efforts by using rights- and evidence-based strategies. Within UNAIDS, the Fund focuses on condom programming and HIV prevention. In 2006:

The AIDS clock, created by UNFPA in 1997 to record the rising human toll of the epidemic, was re-launched in 2006 using new epidemiological data from the Joint United Nations Programme on HIV/AIDS (UNAIDS). The Web-based clock was unveiled during the High-level Meeting on AIDS, held at United Nations headquarters from 31 May-2 June. In addition to showing estimates of the number of people living with HIV, the clock offers links to regional figures, fact sheets, and major campaigns targeting the disease. The clock is accessible at www.unfpa.org/aids_clock.
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Reproductive Health and Safe Motherhood