Country Profiles for Population and Reproductive Health
"Country Profiles for Population and Reproductive Health: Policy Development and Indicators 2005" covers the areas of socioeconomic health, adolescent reproductive health, gender equality and reproductive health commodity security. Indicators for ICPD Goals as well as MDGs are identified by special symbols. Information is also given on differences within countries between urban and rural areas, best performing and worst performing administrative regions, by education, and different income groups, where available.
In 1994, the International Conference on Population
and Development (ICPD) approved a 20-year Programme of Action,
later endorsed by the United Nations General Assembly, that reflects
the international consensus on a comprehensive set of targets,
goals and recommendations aimed at fostering sustainable development,
poverty reduction and women's empowerment, improving health (including
reproductive health) and the quality of life of the world's people,
and creating a better balance between population dynamics and
social and economic development.
Encouragingly, 2004 and 2005 have seen ringing
endorsements and recommitments by the United Nations, regional
organizations, national governments, parliamentarians and civil
society organizations around the world to strive to continue to
implement the Programme of Action and to guarantee sexual and
reproductive health rights of all women as agreed to by consensus
at ICPD and again in the Platform for Action adopted in 1995 at
the Fourth World Conference on Women in Beijing.
In 2000 representatives of 189 nations, including 147 heads of
state or government gathered at the United Nations for a historic
Millennium Summit. They adopted an ambitious set of Millennium
Goals (MDGs). Achieving them by the target date of 2015 would
transform the lives of billions of the world's people. Their achievement
would reduce by half the number of people living in extreme poverty,
promote gender equality, improve maternal health and combat
HIV/AIDS. The consensus of 179 nations at the ICPD not only helped
lay the foundation for the Millennium Development Goals, but also
meshes seamlessly with them. Indeed as the United Nations
Secretary-General, Kofi Annan has said "The Millennium Development
Goals, particularly the eradication of extreme poverty and hunger,
cannot be achieved if questions of population and reproductive health
are not squarely addressed. And that means stronger efforts to
promote women's rights, greater investment in education and health,
including reproductive health and family planning."
In 2003 UNFPA and the Population Reference Bureau
(PRB) published "Country Profiles for Population and Reproductive
Health: Policy Developments and Indicators" along with a companion
CDROM containing the complete contents of the printed report as
well as search and comparison capabilities. All of the information
and country statistics and indicators in the report were also
placed on the web sites of UNFPA (www.unfpa.org/profile)
and PRB (www.prb.org).
The current publication is an updated, expanded
version of the 2003 volume. The report's indicators cover the
areas of socioeconomic health, adolescent reproductive health,
gender equality and reproductive health commodity security. Indicators
for ICPD Goals as well as MDGs are identified by special symbols.
Information is also given on differences within countries between
urban and rural areas, best performing and worst performing administrative
regions, by education, and different income groups, where available.
In the web version indicators can be compared for up to five countries.
Attention is also given to the "public
expenditures on health and education" for each country.
Country Profiles for Population and Reproductive
Health will be published every two years with updated policy descriptions
and indicators.
UNFPA and PRB hope you will find these materials
of value in your policy-making, advocacy and resource mobilization
efforts.
This section outlines the objectives of the country's formal population
policy (if any), or of population-related components of its general
development policies. Particular attention is placed on the poverty,
inequality, gender, HIV/AIDS, and ICPD Programme of Action and
MDG-related activities and progress. Actions and other measures
currently taken to implement these policies are also highlighted to
illustrate the government's political will and priorities. These
descriptions are based on various sources, including the biennial
Population Policy Inquiries of the United Nations Population Division
and the annual reports on country programme progress submitted to
UNFPA. Each of the major subregions is introduced with an overview
of common key issues.
Population Reference Bureau staff and consultants,
with input from UNFPA, researched and drafted population policy
and regional overviews.
A draft of each country policy overview was
sent to the respective UNFPA Representatives and Country Directors
for comments and information. The insights and information provided
by the UNFPA Representatives, Country Directors and Geographic
Divisions helped to improve the content of the profiles. 1
These tables summarize the major indicators of the country's
demographic and social situation based on the most recent
information available. Data from the 1990s are also presented to
facilitate trend analysis and monitoring of development goals. They are
presented in blocks of indicators related to population, socio-economic
and health conditions, adolescent reproductive health, gender equality,
reproductive health commodity security needs and internal disparities.
Indicators used for MDG and ICPD Programme of Action monitoring
are highlighted.
A graph of key indicators related to the MDGs
and the ICPD Programme of Action goals are presented for each
country.
The database is collated and maintained by the
Population Reference Bureau staff.
The ICPD Programme of Action contained global
estimates of resource requirements for the implementation of national
population and reproductive health programmes through the year
2015. These estimates are described in paragraphs 13.15, 13.16
and 14.11 as follows:
It has been estimated that, in developing
countries and countries with economies in transition, the implementation
of programmes in the area of reproductive health, including
those related to family planning, maternal health and the prevention
of sexually transmitted diseases, as well as other basic actions
for collecting and analysing population data, will cost $17.0
billion in 2000, $18.5 billion in 2005, $20.5 billion in 2010
and $21.7 billion in 2015.
It is tentatively estimated that up to two
thirds of the costs will continue to be met by the countries
themselves and about one third from external sources. However,
the least developed countries and other low-income developing
countries will require a greater share of external resources
on a concessional and grant basis. Thus, there will be considerable
variation in needs for external resources for population programmes
between and within regions.
Given the magnitude of the financial resource
needs for national population and development programmes, and
assuming that recipient countries will be able to generate sufficient
increases in domestically generated resources, the need for
complementary resource flows from donor countries would be in
the order of (in 1993 US dollars) $5.7 billion in 2000, $6.1
billion in 2005, $6.8 billion in 2010 and $7.2 billion in 2015.
The financial targets of the ICPD Programme of Action were fixed
over 10 years ago, with cost estimates based on experiences as of
1993. It provided resource estimates for a delimited package of
interventions largely to be delivered through primary health care
outlets. At the same time the ICPD recognized that there were
additional programmes needed (for example, for a broader range of
HIV/AIDS prevention and additional treatment and care interventions,
for referral systems and general health system strengthening and for
tertiary level services for safe motherhood) that would require
significant added investments.
Since that time, the population and health situation in the world
has changed dramatically. The HIV/AIDS crisis is far worse than
anticipated, maternal mortality and morbidity remains unacceptably
high in many parts of the world. In addition, since that time, health
costs have skyrocketed and health systems have deteriorated.
Furthermore, the value of the dollar in 2005 is far lower than it was in
1993.
Although the financial targets of the ICPD Programme of Action for
2000 were not met, it is encouraging to note that both international
donor assistance and domestic expenditures for population activities
have increased since then. Thus donor assistance for population,
which stood at $2.6 billion in 2000, was estimated at $4.2 billion in
2003, up from $3.2 billion in 2002. Domestic expenditures, which
hovered between $7 and $9 billion during 2000-2002, were
estimated at almost $11 billion in 2003. But this progress has been
made against escalating needs.
To reach the 2005 target of $18.5 billion, all parties would have to
mobilize additional resources. Estimates for 2004 and 2005 are
encouraging. Donor assistance is estimated to have increased to $4.5
billion in 2004 and projected to increase to almost $6.4 billion in
2005 with resources mobilized by developing countries totaling $12.5
billion in 2004 and $12.7 billion in 2005.
The largest share of funding is currently going to HIV/AIDS-related
activities (up from 9 per cent of population assistance in 1995 to over
one half in 2005). However, the increased resources are still not
adequately addressing the growing AIDS pandemic. In particular,
comprehensive prevention strategies need added support.
Interventions in prevention, treatment and care are supported
selectively by various donors and in national efforts and coordination
is weak. Vertical programming and funding poses a threat to needed
improvements in integrated health system capacity. In addition,
funding for family planning and reproductive health services - at a
time of great unmet need for such services and unacceptably high
levels of maternal mortality - has been lagging far behind and must
be increased substantially to meet the pressing needs in these areas.
As noted by UNFPA in its latest flow of financial resources report
to the Commission on Population and Development, " the substantial
increase in funding for AIDS clearly demonstrates that further
resources can still be mustered and that, given the political will to do
so, they can be made available for the other critical components of the
costed population package of the International Conference of
Population and Development, especially family planning and
reproductive health." Mobilizing the financial, personal and
institutional investments for the costed package as part of an
integrated approach to universal access to basic health care remains a
critical challenge for development and poverty reduction.
A glossary has been
provided that explains common abbreviations used to refer to programmatic
efforts in population and reproductive health.
Technical notes provide information regarding
the data sources for key indicators. These notes also provide
guidance to the interpretation of the statistics. In general,
United Nations sourced data have been used, supplemented, as necessary,
by additional standard data sources. Information on social and
political contexts and policy priorities have been obtained from
UNFPA country offices and standard United Nations reports. Information
on disparities within countries is derived from reports of Demographic
and Health Surveys, special tabulations of the World Bank and
related sources. Details are provided in the Technical
Notes section.
Maps of eight MDG-related
monitoring indicators have been added to this volume. Indicators
include: per cent of population living on less than $1 per day,
ratio of girls' to boys' primary education, per cent of seats
in parliament held by women, under-five mortality rate, maternal
mortality ratio, HIV prevalence among those 15-24, per cent of
population with access to improved water supply, and country debt
levels as a per cent of gross domestic product. Only data for
countries included in the Country Profiles are displayed in the
maps. Maps are created on the 1:15,000,000 scale.
1 Most of the policy overviews were produced and cleared during late 2004-early 2005. Some recent developments may not be reflected in the policy descriptions.
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