Introduction

Africa (Sub-Saharan)

Arab States

Europe

Asia and the Pacific

Latin America and the Caribbean

Interregional Programmes

In Africa, as many parts of the world, girls do not always enjoy
the same educational opportunities as boys.

In 1998, UNFPA collaborated with the Economic Commission for Africa (ECA) on a review of the achievements made and the constraints encountered in the Africa region since ICPD in 1994. The review showed progress in most countries in the areas of reproductive health (including adolescent reproductive health), women's empowerment and partnerships with civil society. It also found that many countries had adopted or revised their population policies in the light of ICPD.

However, African countries still faced constraints related to economic difficulties, insufficient private-sector involvement, shortages of trained personnel, and ineffective advocacy strategies. In addition, countries faced difficulties in changing gender-related attitudes and behaviour. In most countries, educational opportunities for males and females remained unequal. Moreover, reproductive health services were often compartmentalized, male involvement was minimal, and referral systems left much to be desired.

In 1998, UNFPA worked on creating an enabling environment for the implementation of the Programme of Action at the country level. The Fund also worked to ensure that population is given attention in all United Nations initiatives. To that end, UNFPA negotiated and secured the inclusion of the population sector as the fifth priority area of the United Nations Special Initiative for Africa.

UNFPA also prepared a paper that identified the region's priority population-related issues, which could be effectively addressed by coordinated efforts within the United Nations system and with other partners. Such collaborative efforts would add value to the efforts of individual agencies. UNFPA also strengthened its collaboration with the World Bank, agreeing on priority areas and countries for closer collaboration. In addition, the Fund participated in UNDAF exercises in 11 pilot countries.

Continuing its advocacy efforts on behalf of ICPD implementation efforts, the Fund organized a July conference for African women ministers and parliamentarians from 38 countries. The participants committed themselves to work for the elimination of violence against women and the eradication of harmful traditional practices, and they agreed to support initiatives aimed at ensuring the reproductive health of adolescents. Moreover, the women vowed to encourage open discussion of these issues by national leaders.

Recognizing the strong influence that religious leaders have on their constituents, UNFPA has supported efforts to sensitize them to population and reproductive health issues. Many of these religious authorities have a good understanding of the problems faced by their communities and of the concept of reproductive health in a religious context. The Fund sees them as important partners in working towards ICPD goals.

In November of 1988, the Fund organized a conference in Niamey, Niger, for over 80 Muslim leaders and scholars. The meeting, which drew participants from 19 sub-Saharan African countries as well as eight other countries, considered such topics as Islam and reproductive health; Islam and the status of women; and Islam, population and development.

Religious leaders were also increasingly involved in country-level activities. In Ghana, for example, eight religious organizations are currently preparing manuals to incorporate population and family life education into religious activities and to encourage parents to discuss sexuality with their children. The mid-term review of the UNFPA country programme in Uganda in November was attended by religious leaders and other members of civil society. The Muslim leaders in Uganda have developed a set of reproductive health guidelines for the country's imams.

One constraint is the sustainability of these activities. This obstacle might be overcome by creating national and regional networks to facilitate the sharing of information and experiences between religious groups and associations at the country and regional levels. Providing training in the use of information, education and communication techniques would also help make these activities sustainable.

In an effort to offer women and men more contraceptive choice, the Fund, in collaboration with Margaret Sanger International, organized a conference on strengthening reproductive health through emergency contraception. The meeting, held in Malawi from 15-18 November, aimed to identify where and how such contraception might be incorporated into reproductive health services within the countries of the Southern Africa Development Community (SADC). The meeting also provided a forum for sharing experiences related to needs, public opinion and the delivery of emergency contraception services. The conference activities were designed to maximize opportunities for South-South exchange of knowledge and experiences through a combination of focused plenary and small group activities. There were 19 presenters from the SADC, East Africa, the United Kingdom and the United States, and action plans for each country were developed by conference participants. 

The HIV/AIDS epidemic and the reproductive health needs of youth and adolescents continue to be priority issues in sub-Saharan Africa. In Rwanda, UNFPA provided a "one day HIV/STD prevention and family planning strategy" for couples in Kigali; follow-up activities showed a clear increase in condom use. In Ghana, UNFPA developed playing cards with messages on HIV/AIDS prevention. The cards, which proved to be very popular, have been widely disseminated. In a number of countries, including Eritrea, Namibia, Senegal and Uganda, reproductive health information and services are offered through youth-friendly multi-purpose centres. Among the services offered are ones targeting HIV/AIDS. HIV/AIDS-prevention modules have already been incorporated into the UNFPA-supported clinical skills training programmes offered at the Mauritius Institute of Health, as well as into the population IEC programmes offered in Nairobi, Kenya, and Abidjan, Côte d'Ivoire.

The Fund participated in and supported the participation of delegates from 28 African countries in the Pan-African Conference on Women and HIV/AIDS. The conference, organized by the Society of African Women against AIDS, was held in December in Dakar, Senegal. 

UNFPA also supported an international conference on HIV/AIDS in African prisons. The gathering, held in Dakar in February 1998, attracted participants from 35 African countries. 

As with young people throughout the world, adolescents and youth in Africa are confronted by the consequences of early sexual intercourse, marriages and childbirths. Teenage pregnancies often lead to curtailed educations and/or to unsafe abortions. Early sexual intercourse also makes young people more prone to sexually transmitted diseases, including HIV/AIDS. It is clear that preventable reproductive health problems not only threaten the health of youth and adolescents in Africa, but also negatively affect their educational, occupational and social opportunities. The Fund therefore continued to help African governments address adolescent reproductive health needs. UNFPA-supported interventions include promoting advocacy efforts, sharing lessons learned and best practices, supporting research, assisting in the provision of information and quality reproductive health counselling and services, creating youth-friendly community environments, building skills for adolescents, and providing population and family life education in and out of schools. 

In Africa, as in other parts of the world, there is often resistance to the idea of providing reproductive health information and services to youth and adolescents. Such resistance may come from parents, health care providers and community members. Another common constraint of youth programmes is the limited coverage of the programmes that are developed.

UNFPA-assisted programmes are working to overcome resistance by supporting community sensitization, mobilization and involvement in youth programmes. Youth-friendly services are often provided at multi-purpose youth centres jointly constructed or renovated by communities and governments with assistance from UNFPA. While government ministries of youth and development usually coordinate the activities at the youth centres, the young people serve as peer mobilizers both at the centres and within the communities. Rather than pay peer mobilizers — a practice that would not be sustainable on a long-term basis — UNFPA supports efforts to offer them skills development training and income-generating activities. In this context, the idea of supporting micro-credit income-generating activities is being explored with other donors.  

UNFPA-supported initiatives addressed the reproductive health needs of young people in many African countries. For example, youth-friendly reproductive information and services were provided in Botswana, Côte d'Ivoire, Eritrea, Namibia, Senegal and Uganda. In Senegal, reproductive health services and counselling on contraceptives, the prevention of unwanted pregnancies and sexual violence were provided by midwives and psychologists at five youth centres. A compact disc entitled "I Need to Know" was launched in Kenya on World Population Day to create awareness about reproductive health and rights and responsible sexual behaviour. The CD has encouraged open discussions on adolescent reproductive health issues.

At an April conference celebrating the 40th anniversary of ECA, UNFPA joined UNICEF and ECA in organizing a discussion on "Africa's New Generation". The Fund supported the participation of youth and adolescents from 22 African countries. The young people stressed the importance of involving them in the provision of reproductive health information and services, and they underlined the need for governments to offer them employment and education opportunities.

The Fund continued to emphasize national capacity-building. Activities were designed to provide national counterparts with both the technical and managerial skills required to develop, implement and monitor population programmes. In this context, advisers from UNFPA Country Support Teams organized and conducted on-the-job training in a number of countries on the logical framework (logframe) methodology and on subprogramme development. As a result, many country programmes that had experienced implementation delays made important strides in 1998. This was the case, for example, in Ghana, Mauritania, Nigeria and Senegal. However, experience during the year showed that, given the novelty of the logframe approach and the high turnover of personnel in government offices, more training is required.

In some other countries, including Burkina Faso, Chad, Madagascar and Malawi, on-the-job training was carried out by country offices on the Fund's financial procedures. In some cases, this included the participation of auditors familiar with the Fund's procedures and with the most commonly observed weaknesses in audit reports. While weaknesses persist in financial reporting in some countries, consistently good reporting was noted in many others.

Substantively, national capacity-building was pursued in several areas, including operational and sociocultural research, reproductive health and gender. For example, the CST in Harare, Zimbabwe, conducted a one-week training course on operational research in reproductive health for six countries in the SADC subregion — Botswana, Lesotho, Malawi, Mozambique, Zambia and Zimbabwe. The training helped countries identify reproductive health issues requiring further research and assisted them in preparing protocols for such research.

The Fund also collaborated with UNESCO to sponsor research in a number of countries, including Malawi and Mozambique. The research focused on sociocultural factors affecting demographic behaviour and their implications for the formulation and execution of population programmes. The findings were disseminated in Malawi during a workshop attended by managers of the national population programme.  

During the year, UNFPA worked on reorienting regional training in population and development strategies. The Fund's purpose was to align the training with ICPD recommendations, in particular as they relate to the integration of population into overall development planning. With a view towards ensuring a readily available critical mass of local experts in this area, the Fund initiated a search of African development institutes that could be strengthened to undertake training in population and development strategies.

During the year, UNFPA organized a consultative meeting on UNFPA assistance in emergency situations in Africa. The meeting included UNFPA Representatives and representatives of NGOs. The meeting's recommendations were used as inputs in the ICPD+5 technical meeting on reproductive health services in crisis situations held in November in Rennes, France. The consultation found that one major constraint in implementing activities in emergency situations was the difficulty in accessing funds.

UNFPA participated in joint assessments of the needs of refugees and displaced persons in a number of African countries during 1998. Assistance for emergency reproductive health services was provided in Angola, Comoros, Eritrea, Ethiopia, Guinea-Bissau and Lesotho.

Despite the conflict taking place in the Democratic Republic of the Congo, UNFPA continued to collaborate with the International Federation of Red Cross and Red Crescent Societies to meet the urgent reproductive health needs of Congolese women. Through this undertaking, three centres designed for the care of pregnant women have been established. They are expected to contribute to the improvement of reproductive health services, the reduction of maternal mortality and the prevention of HIV/AIDS. In another UNFPA-assisted project, three teams of psychotherapists were trained by the International Rescue Committee to help victims of sexual violence; the therapists are currently offering counselling at three hospitals.

UNFPA is also providing reproductive health services in refugee camps in the United Republic of Tanzania, in collaboration with one international and two national NGOs. Evaluations conducted since 1996 indicate a dramatic improvement in the quality of services and a reduction of maternal deaths in the refugee camps.