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Africa

Arab States

Central and Eastern Europe

Asia and the Pacific

Interregional Programmes

Efforts to operationalize reproductive health programmes have been pursued vigorously through the region’s country programmes as well as through multi-country, regional activities. To this end, in October, a meeting was held in Peru to build consensus on regional strategies. Efforts are under way with the Pan American Health Organization (PAHO) of WHO to clarify and promote the concept of reproductive health, study the institutional arrangements for its implementation, seek improvements in quality, and find appropriate programme designs to make services accessible to adolescents. To improve the quality of reproductive health services and to expand the options that are available, the Fund initiated support for a research project to learn more about the reasons for the extensive use of surgical sterilization of women in the region. One of the focuses of that research will be to verify whether coercion is involved and to what extent women are making informed choices.

The need to build capacity for management of social programmes is being addressed throughout the region. The UNFPA CST based in Santiago, Chile, includes expertise in this area, which is being made available to countries in the region. This has been further supported by specific efforts with WHO/PAHO in the field of management of reproductive health services. The training of CST advisers in contraceptive logistics management is expected to be replicated by cascade training within the team and, most importantly, throughout the region.

The regional strategy explicitly favours NGOs and grass-roots groups, notably those of women and youth. Most country and regional projects supported in the region have NGOs as important partners in design and implementation. While the efficiency of NGOs in delivering quality reproductive health services is widely established, they do face certain challenges concerning sustainability and scope of coverage. A regional meeting with NGOs, held in Quito, Ecuador, showed that there is still much to be accomplished to ensure that NGOs find their place in national agendas. As a follow-up to the meeting, national workshops based on an inter-agency, collaborative approach have been held or are planned in some 15 countries of the region. An innovative project was started in 1997, designed to eventually reach a quarter of a million unionized workers through their regular education programmes. The project will introduce components dealing with reproductive health and reproductive rights with a gender perspective into those programmes.

Successful initiatives with NGOs in the region abound. In Paraguay, for example, UNFPA collaborated with the national NGO PROFAMILIA, the national obstetric and gynaecological association and the Ministry of Health to organize the First Paraguayan Congress on Reproductive Health and Family, held in October. The congress was attended by over 200 professionals and was declared an event of national interest by the country’s Parliament. It received extensive coverage in the media and had a great impact on the country’s NGOs, scientific and medical community, professional institutions and public opinion.

Adolescent reproductive health is a significant concern throughout Latin America and the Caribbean region. A major regional meeting on the topic was organized by UNFPA in Costa Rica in December. The meeting concluded that while access to information and services is crucial, countries must take an integrated, multisectoral and interinstitutional approach in order to provide youth with educational and economic opportunities that offer them alternatives to early childbearing and exposure to STD/HIV. The meeting also underscored the importance of ensuring the involvement of young people in designing programmes that address their needs.

All of the Fund’s country programmes in the region have components dealing with adolescent reproductive health concerns. Nicaragua has the highest rate of teenage pregnancy in Central America, with one out of every four pregnancies occurring among adolescents. The Fund has, therefore, developed a sub-programme focusing solely on adolescent reproductive health and designed to improve the access of young people in Nicaragua to quality reproductive health education and services in ten priority departments, both rural and urban. At the institutional level the subprogramme is supporting vigorous advocacy efforts to promote the formulation of norms, policies and programmes for adolescents.

In Guatemala, UNFPA supported a study on youth gangs called "maras", whose members are subject to both high reproductive health and social risks. The information obtained in the study showed the need for various initiatives in addressing the problems; UNFPA will provide support for those that fall within its mandate. In the Caribbean, the new subregional programme, which started in 1997, emphasizes adolescent reproductive health and rights, while moving away from the past focus on "women in union". Guyana, Jamaica and Suriname were identified as countries of special concern for these initiatives.

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| Regional Overviews | Mobilizing Resources |
| Appendices  | Tables & Graphs |
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