269. The ICPD marked a turning point in international policy-making. It has become synonymous with the spirit of inclusion, cooperation and consensus for a new generation of reproductive health and population-related policies based on human rights, gender equality and equity, and partnership. The Programme of Action is an intergovernmental instrument, adopted by 179 Governments; it is also a reflection of unofficial discussions between government delegates and NGO representatives at the ICPD. It recognizes that to implement the conceptual shift to an approach highlighting human-centred development and the life-cycle concept of sexual and reproductive health within the fuller framework of sustainable human development, a broad-based and interactive collaboration among Governments, the international community and civil society42, especially NGOs and the private sector, would be required. Thus, the Programme of Action calls for the promotion of an effective partnership between all levels of Government and the full range of NGOs and local community groups in the design, implementation, coordination, monitoring and evaluation of population policies and programmes. It also calls for strengthening the partnership among Governments, international organizations and the private sector to identify new areas of cooperation; and for the promotion of the role of the private sector in service delivery and in the production and distribution of high-quality reproductive health and family planning commodities and contraceptives, which are accessible and affordable to low-income sectors of the population.
270. Four years after Cairo, changing development paradigms have shifted the roles of Government, civil society and the international community. Partnership has emerged as a basic element to support and advance the Programme of Action implementation process, both vertically and horizontally. Since the ICPD, important changes have taken place in many parts of the world, which have both strained the existing patterns of, and provided new opportunities for, the political, economic and social construct. The changes have contributed to creating a public setting that undergirds the idea of a civil society. Emerging patterns are creating different institutional arrangements which have given a major thrust to the rationale for the increased inclusion of civil society in an holistic development process.
271. It has become increasingly apparent that Governments alone cannot manage to provide the development services to meet the basic human and social needs and aspirations of their citizens. The involvement of civil society in initiating and sustaining social and economic transformation has become essential in the context of economic globalization, privatization, limited resources and the downsizing and decentralization of the government apparatus. At the same time, new information technologies are dramatically transforming the global context of information exchange and the sharing of ideas and experiences from cities to communities. The full participation of civil-society organizations and leaders will become increasingly critical, particularly with respect to the provision of reproductive health information and services as well as the promotion of advocacy and social mobilization efforts, in order to carry forward the goals of the Programme of Action.
272. A review of progress over the last few years on the scope of collaborative efforts with civil society provides a basis for optimism. Major strides have been taken in procedural areas, such as positive changes in the concept of participation and the processes for consultation; recognition of the changing roles of civil society; increasing acceptance of innovative and varied development approaches, including decentralized and community-based modalities; and improved partnership among United Nations organizations and bodies. Similarly, the context for substantive discourse and action by all parties has also changed, with increasing awareness of the societal dimensions of development and economic issues; growing recognition of the necessity for a human rights-based approach; expanding acceptance of reproductive and sexual health concepts and programmes; and deepening awareness and acknowledgment of gender inequities and the need for gender equality and the empowerment of women.
273. After the ICPD, most, if not all, Governments accepted the increasing involvement of a broad range of civil society representation in all aspects of national development, including the promotion of reproductive health and rights. Although NGOs, in particular, have long been active in the population and reproductive health areas, their roles and responsibilities dramatically expanded after the ICPD due to, inter alia, economic globalization, reduction in government human and financial resources, the increased demand for reproductive health services, and the need for realization of human rights, including gender equality and equity. As of mid-1998, at least 106 Governments recognized -- and, of these, 48 Governments supported -- NGO/civil-society involvement in the implementation of the Programme of Action; 59 Governments included NGOs in all phases of the formulation, implementation, monitoring and/or assessment of population policies, plans and programmes, while 28 Governments included NGOs only in the formulation and implementation of programmes and projects. Many Governments have adopted significant measures since 1994 to promote the involvement of NGOs at various stages of policy and/or programme implementation in areas such as reproductive health and gender equality. The most general new measure adopted was to include representatives of NGOs or other civil society members on the national bodies responsible for formulating policies. In some other countries, Governments made efforts to involve NGOs in policy formulation through policy dialogue or consultation. Regarding programme implementation, numerous Governments established an office to coordinate programmes with NGOs; in other cases, NGOs implemented government-funded programmes. Little or no cooperation between Governments and NGOs seemed to exist in only a few countries, primarily due to mutual mistrust, civil unrest or political instability. Even in many of these situations, however, the international community played a constructive role by ensuring the inclusion of all appropriate parties in the implementation of the Programme of Action.
274. Notwithstanding the new policies, legislation or other measures that have been adopted by many Governments to enable NGOs to play a larger role in population programme implementation, the enabling environment for NGO participation needs to be further strengthened in most countries.
275. For the civil society to become an even more effective partner in advancing the Programme of Action agenda, it is crucial that the human resource and institutional capacities of civil-society organizations be significantly strengthened. Since 1994, only limited progress has been made in this respect. In some countries, Governments took strong measures to strengthen the institutional capacity of civil society, including, inter alia, the provision of funding and the removal of cumbersome legal restrictions. Government provision of technical and financial support to NGOs, however, was hampered for various reasons, including the limitations of government resources and the difficulty of selecting recipients from among the large number of local NGOs.
276. Almost all Governments allowed NGOs to receive funding, directly or indirectly, from external donors. In at least 57 countries, Governments permitted direct funding of NGOs from all external donors (e.g., international NGOs, bilateral and multilateral donors), with no restrictions; due to the relatively recent difficult economic situation and the reduction or withdrawal of external bilateral assistance in some cases, governmental restrictions on external funding of NGOs seems to have eased. In at least 27 countries, direct funding, with some restrictions (e.g., Government to be informed; limitations on amount of funding), was permitted. In at least 21 countries, indirect funding, through government channels or with their approval, was allowed. External funding, however, also poses several dilemmas: increased competition among NGOs for such funding; lack of strategic planning regarding institutional and programmatic objectives and sustainability by NGOs due to their predominant reliance on external donors, which may have their own agendas; and crises of institutional and programme viability when external funding is withdrawn from NGOs.
277. The contribution of civil society to the advancement of population issues has been enormous. In particular, most of the achievements in reproductive health and rights, especially in the area of family planning, are due to efforts of courageous women leaders, the energy of volunteer workers and the commitment of NGOs. NGOs, at international, regional and country levels, continue to play a vital role in the wide gamut of population and reproductive health activities. The importance of their participation in public policy and decision-making, research, advocacy, education and training, service provision, and monitoring and evaluation cannot be overestimated or overstated. Nevertheless, it is clear that although civil society, and NGOs in particular, have been instrumental in the progress achieved to date, the vast potential of civil society in the population field has only begun to be tapped.
278. For civil-society institutions to play their full role, their organizational capacities and management capabilities must be significantly increased and enhanced. In many countries, the civil society has taken initiatives to strengthen their institutional sustainability, build coalitions and mobilize resources. Overall, however, in most countries, NGOs have achieved only limited progress towards strengthening their institutional and financial sustainability, enhancing networking with other organizations, improving their transparency, accountability and responsiveness to constituencies or in mobilizing additional public and financial support for population activities. The limited achievements in this respect hamper the potential contributions to be made by NGOs. For example, NGOs are appropriately recognized for the innovative approaches that they undertake. The replicability and broad adoption of their innovative approaches, however, have often been stymied by weak or non-existent networking and coordination among NGOs themselves, particularly at the country level. For example, in only about 21 countries have NGOs established a national coordinating group on advocacy and/or for implementation of the Programme of Action. In several countries where such a coordinating mechanism has been initiated, issues of sustainability have arisen. Similarly, in only an estimated 25 countries, have NGOs tried to coordinate their activities on a thematic basis (e.g., gender equality, HIV/AIDS and advocacy) whereas in about 12 others, NGOs have instituted a forum for networking and information exchange. In contrast, in at least 53 countries, no mechanism for NGO coordination or networking has been established.
279. The commercial private sector provides reproductive health-care services in nearly all developing countries. In most of these, the private sector had already been active before the ICPD; for example, in some countries, the private sector had been operating clinics, informing and educating the public or offering affordable commodities. The private sector is most involved in social marketing programmes in which Government-subsidized, low-priced contraceptives are distributed through commercial channels. Multilateral organizations and international NGOs have strengthened country-level activities in the social marketing of contraceptives. Innovative initiatives are now being undertaken by international organizations such as UNFPA to work with Governments and the private sector to minimize barriers and to facilitate cost reductions so that reproductive health services, including contraceptive commodities, may be made more accessible -- both more affordable and more available -- to the majority of the population, while at the same time, better enabling those who can afford to pay to do so. Activities with the private sector to provide reproductive health information, education, counseling or services for employees or for local communities have been additionally undertaken or initiated, for example, by the TATA Foundation in India. While progress has been made, important opportunities for cooperation with the private sector remain to be explored. Proactive initiatives are required to sensitize and more fully involve the private sector, especially corporate leaders, business associations and trade unions, in all appropriate aspects of implementation of the Programme of Action.
280. Parliamentarians play a unique role in the partnership between Governments and civil society. They are, in essence, the bridges between the civil society and the government apparatus. Significant progress at the advocacy level has sensitized parliamentarians to the Programme of Action issues. As a result, intra-parliamentary lobbying activities have increased, relevant legislation has been promulgated and regional and international parliamentarian networks are thriving B for example, the Asian Forum of Parliamentarians on Population and Development, the Forum of African and Arab Parliamentarians on Population and Development, the Inter-American Parliamentary Group, and the Global Committee of Parliamentarians on Population and Development. All-party parliamentary committees and groups, however, need to be established, where they do not exist, and strengthened to ensure that Governments meet their commitments to the ICPD. Parliamentary advocacy has enabled the level of funding to be maintained and sustained in some countries where such funding was to be decreased or eliminated. A number of donor countries, however, have not met their commitment to the process of meeting the ICPD target, and resources have not significantly increased, which may result in an overall shortfall if current trends continue. In some developing countries, Governments have increased the proportion of their allocations to the social sector, while in countries with economies in transition, health-sector allocations have decreased as a proportion of overall national investment.
281. In 1994, the General Assembly adopted a resolution on the international follow-up of the ICPD that requested United Nations agencies and organizations to review and adjust their programmes in the context of the Programme of Action objectives and report to the Economic and Social Council (ECOSOC) on the respective policy implications. It urged the organizations and bodies of the United Nations system and the Regional Commissions to actively implement the Programme of Action through the United Nations Resident Coordinator system at the field level. This section highlights partnerships and collaborative efforts among the United Nations specialized agencies and funds, inter-agency units, regional commissions and intergovernmental organizations to achieve the goals of the Programme of Action.
Partnerships and Collaborations among United Nations Agencies and Organizations
282. As a follow-up to the ICPD, various United Nations agencies have collaborated on a range of initiatives relating to key areas of the Programme of Action. UNFPA has often served as a catalyst to promote enhanced coordination as well as joint activities among sister United Nations organizations and other donor community partners in the implementation of the Programme of Action. The examples summarized below are only an indication of the broad spectrum of such collaborative efforts.
283. United Nations agencies have been working closely in tracking progress in reducing child and maternal mortality, particularly in helping countries build a statistical base for monitoring and reporting on such progress. Efforts have been made to bring together both users and producers of data to ensure that policy and decision makers have access to understandable and current information that will help them take informed decisions on the formulation and implementation of policies and programmes. In collaboration with WHO and UNFPA, UNICEF has issued Guidelines for Monitoring the Availability and Use of Obstetric Services, which details measurement issues, proposes a set of process indicators and provides options for collecting needed data. In addition, a core set of reproductive health indicators and methodologies for generating and analysing reproductive health information has been developed through a joint undertaking of UNFPA, WHO and other United Nations system agencies and organizations.
284. WHO, UNICEF and UNFPA recently established a Coordinating Committee on Health (CCH) to enhance partnership and concerted action in achieving health and related social goals as well as in promoting the more efficient use of resources. The CCH is a transformation of the UNICEF/WHO Joint Committee on Health Policy, which was established 50 years ago. The first CCH meeting took place in Geneva in July 1998.
285. WHO, UNICEF, UNFPA, the World Bank and two NGOs - IPPF and the Population Council - have co-sponsored the Safe Motherhood Initiative, which focuses on five key areas of action: advocacy; epidemiological, social and operational research; information dissemination; human resource development; and health-service improvement measures (e.g., renovation of facilities, provision of equipment and supplies and support for training for essential obstetrical care) in numerous countries. In October 1997, a technical consultation on Safe Motherhood was held in Sri Lanka to review progress on this aspect of reproductive health.
286. Regarding adolescent reproductive health, UNFPA, UNICEF and WHO have developed a common agenda for action and support through the WHO Adolescents Health and Development (AHD) Programme. The AHD Programme aims at using and expanding the available knowledge base to achieve effective and sustainable programmes; facilitating action in countries; expanding human, institutional and material resources to promote adolescent health and development; and providing technical cooperation to countries and key partners.
287. Harmful traditional practices concern both the health and the rights of women and children. UNFPA, UNICEF and WHO are undertaking concerted action to support policies and programmes that can bring an end to the harmful traditional practice of FGM. Within this collaboration, WHO focuses on increasing knowledge through a research and development programme and promoting technically sound policies and approaches. UNICEF emphasizes the elimination of FGM through the work of its field offices and country programmes. UNFPA continues to advocate for the elimination of FGM and supports the review and revision of national policies, laws, regulations and traditional practices which serve to perpetuate the practice. UNFPA sponsored a technical consultation in Ethiopia in 1996, with representatives from 25 countries, to discuss, inter alia, the types of training, research and services needed to eradicate the practice. The potential impact of such advocacy is highlighted by the tremendous success of the UNFPA-funded Reproductive Education and Community Health (REACH) Programme in Kapchorwa district, Uganda, where community-based agents involved community leaders and other persons from all sectors of society in sensitization seminars about the harmful aspects of FGM. The REACH Programme resulted in a 39 per cent drop in FGM in less than one year.
288. Six co-sponsors -- UNDP, UNESCO, UNFPA, UNICEF, WHO and The World Bank -- have pooled and focused their efforts through UNAIDS to strengthen the capacity of the United Nations system to, inter alia, assist Governments and civil society to effectively respond to the HIV/AIDS epidemic; and to improve the content of, access to and use of the body of knowledge needed to accelerate prevention and control of HIV/AIDS. UNAIDS also gives a high priority to developing, advocating and implementing best practices in combating the epidemic. At the country level, United Nations Theme Groups on HIV/AIDS have been established to support an expanded multisectoral response to the HIV/AIDS epidemic and have become a key mechanism for coordinated and joint United Nations action in data collection and analysis; advocacy and awareness campaigns and prevention programmes; and provision of financial and technical support.
289. Recognizing that the provision of reproductive health services is as important as providing other services in refugee and emergency situations, UNHCR and UNFPA have given a new impetus to meeting reproductive health concerns in refugee and emergency situations. The two agencies have signed a memorandum of understanding establishing a framework for collaboration for the benefit of persons in refugee situations. UNHCR and UNFPA are jointly developing strategies and programmes to provide reproductive health information and services for women, men, youth and adolescents and to combat sexual violence; and organizing joint assessment, monitoring and evaluation missions relating to reproductive health information and services.
290. The BSSA Task Force, established in 1995, expanded the terms of reference of the earlier Inter-Agency Task Force on the Implementation of the Programme of Action of the International Conference on Population and Development. Eighteen United Nations organizations and agencies, including the Bretton Woods institutions, participated in the BSSA Task Force. The mandate of the Task Force encompassed the following key concerns: population, with a special emphasis on reproductive health and family planning services; basic education; primary health care; drinking water and sanitation; shelter; and social services in post-crisis situations. The BSSA Task Force mandate also encompassed the main parameters of the 20/20 Initiative. (The 20/20 Initiative is a mutual commitment between interested developed and developing country partners to strive to allocate on average 20 per cent of their ODA and 20 per cent of their national budgets, respectively, to basic social services.) The Task Force factored into its work the following cross-cutting dimensions: selection and use of indicators; gender perspectives; resource mobilization; policy frameworks; the targeting of specific groups, including those in post-crisis situations; and the involvement of civil society.
291. The Task Force adopted a pragmatic and time-bound programme of work that would clearly respond to key issues and priorities at the country level, using the modality of working groups with lead agencies. These included the Working Group on Primary Health Care (led by WHO and UNICEF); Working Group on Reproductive Health (led by WHO); Working Group on Basic Education (led by UNESCO); Working Group on International Migration (led by ILO); and Working Group on National Capacity-Building in Tracking Child and Maternal Mortality (led by UNICEF). UNFPA served as the Chair of the BSSA Task Force.
292. The Task Force maintained a strategic focus on its primary objective: to provide coordinated support to the United Nations Resident Coordinator system in assisting developing countries to implement policies and programmes for achieving the goals adopted at recent United Nations global conferences. Member organizations of the BSSA Task Force also focused on strengthening and expanding their collaboration with civil-society organizations and the private sector to maintain strategic partnerships among all development partners. One of the principal outputs of the Task Force was a set of Guidelines to enable the Resident Coordinator system to bridge the normative and operational dimensions of social-sector activities. The Task Force also developed indicators to enable countries to better monitor their progress in achieving the goals agreed to at the United Nations global conferences. Other end-products included a wall chart on basic social services; guidelines on key areas of the Programme of Action; a report on lessons learned/best practices in donor collaboration for assistance to the social sector; an information card on advocacy for basic social services; and a compendium of international commitments relevant to poverty and social integration.
United Nations Regional Commissions
293. Recommendation 16.16 of the Programme of Action calls on regional commissions, organizations of the United Nations system functioning at the regional level, and other relevant subregional and regional organizations to play an active role within their respective mandates to implement the Programme of Action through subregional and regional initiatives on population and development and to coordinate their activities in order to ensure efficient and effective action in addressing population and development issues relevant to their regions.
294. Since the ICPD, the ECA has established a committee of Member States, with the Bureau of the third African Population Conference as core members, to review progress on the implementation of the Dakar/Ngor Declaration and the ICPD Programme of Action. Some of the programmed research studies have focused on the following areas: management of family planning programmes; urban environment and health; infant, child and maternal mortality; population and conflict; impact of environmental policies and programmes relating to population and human settlements, and the convening of a Regional Working Group on the Recommendations for the 2000 Round of Population and Housing Censuses. ECA has held seminars and workshops on the integration of population factors in development planning; patterns, causes and consequences of female migration; and adolescent fertility in Africa. Special emphasis is being given to population policies in the context of their relation to food, environment and sustainable development. Arrangements are under way to create better collaborative relations between ECA and its development partners in assisting Member States.
295. In 1996, ECE, with support from UNFPA, focused its population efforts on the countries with economies in transition. Assistance was provided for data collection and analysis, research and the dissemination of policy-relevant information in the key areas of fertility and reproductive health, population ageing and international migration. The ECE project on population ageing and elderly persons is based on censuses conducted circa 1990 in about 15 mostly central and eastern European countries. Comparative research and country-specific analyses are based on national data sets, including information on living arrangements, work and retirement patterns and housing conditions. ECE is collaborating with the United Nations Department of Economic and Social Affairs, the Statistical Office of the European Union (EUROSTAT), the Council of Europe and the Organization for Economic Cooperation and Development (OECD), to streamline the collection and dissemination of population statistics in the region.
296. ECLAC and the Latin American Demographic Centre (CELADE) conducted joint activities with national statistical offices and other institutions to produce new population estimates and projections at the country level. CELADE is implementing a project on international migration in Latin America (IMILA), which comprises a database with information from each national census on persons born abroad. A project funded by the Inter-American Development Bank (IDB) was designed to integrate population variables into specific IDB investment programmes and projects launched by CELADE. IDB/CELADE produced a book on the impact of demographic trends on social sectors and prepared several technical reports on methodological issues connected with the integration of population factors into social sector policies and programmes. CELADE, which developed a specialized computer software package to analyse geographically disaggregated data, down to the city-block level, has offered several workshops on the utilization of an updated version. This software is now in use for social programming at the municipal and ministerial levels in various countries of the region. In close cooperation with POPIN, information has been put on the Internet by the Bibliographic Information System for Latin America and the Caribbean.
297. ESCAP has focused its efforts on addressing population, environmental, poverty and quality-of-life issues; using population data for local area development planning; strengthening monitoring and evaluation systems for measuring progress in reproductive health/family planning programmes; strengthening policy analysis and research on female migration, employment, family formation and poverty; and studying implications of ageing for Asian families and the elderly and assisting Governments in developing and strengthening policies for involving the elderly in social and economic development.
298. ESCWA organized an Expert Group Meeting in 1995 in Cairo on Demographic Estimates and Projections for the Arab Countries. Its Population Section has developed regular contacts with organizations specializing in applied system analysis, with a view to designing and implementing a population projections project, integrating, for the first time, demographic and related socio-economic variables. The Population Section has undertaken two studies as part of the activities of the ESCWA Task Force on Poverty Alleviation in Western Asia, one on population dynamics and poverty in the region and the other on Palestine. Also in 1995, ESCWA embarked on an UNFPA-supported three-year project on Population Policies in the Arab Countries. The project provides for: training on population policy formulation, implementation and monitoring for the technical staff of national population committees; coordination meetings for the heads of the committees; and the establishment of an ESCWA population policies integrated information system, which will facilitate monitoring the implementation of the recommendations of the Arab Conference on Population and Development, held at Amman, Jordan, in 1993 and of the ICPD Programme of Action.
Partnerships among Inter-governmental Organizations
299. The World Bank has substantially increased loan allocations in the area of health, including reproductive health, gender, education and other social development areas. As a co-sponsor of UNAIDS, the World Bank is one of the leaders in the funding of HIV/AIDS programmes and links its efforts to broader initiatives in reproductive health. Through active partnership with several United Nations specialized agencies, donor countries and NGOs, the World Bank is supporting health-sector reform and capacity-building in the developing countries.
300. The OAU adopted a resolution in 1995 requesting Member States to make policy, institutional and financial arrangements for the implementation of the ICPD Programme of Action. Since then, OAU has organized several seminars, workshops and conferences for different target groups, such as the diplomatic community in Addis Ababa. Study tours to promote population issues will soon be implemented under this programme. The objectives include seeking areas of collaboration and information exchange between Governments and NGOs on population issues.
301. An intergovernmental initiative, Partners in Population and Development (PPD), launched at the ICPD by 10 developing countries -- Bangladesh, Colombia, Egypt, Indonesia, Kenya, Mexico, Morocco, Thailand, Tunisia and Zimbabwe -- commenced programme activities in 1996 with support from the Rockefeller Foundation, UNFPA and the World Bank. China and Pakistan joined the PPD in 1997, and India and Uganda in 1998. The PPD work plan includes strengthening the capacity of developing countries for South-South cooperation, the promotion of "twinning" modalities and the development of training institutions. PPD has focused on four priority areas to facilitate and coordinate South-South collaboration in research, training and information: I) integration of family planning and reproductive health services and the establishment of reproductive health structures; ii) promotion and integration of STD and HIV/AIDS prevention and care within the reproductive health structure; iii) provision of family planning/reproductive health services aimed at the special needs of both male and female adolescents; and, iv) reduction of maternal mortality and morbidity.
302. Through its country programmes, UNFPA is encouraging countries to make use of South-South activities, both as recipients and/or providers, and to draw upon the technical resources of public institutions, NGOs, private organizations and individuals from developing countries. UNFPA Representatives are required specifically to consider this modality during programme review exercises as well as in the formulation of country programmes and projects. Consequently, UNFPA is supporting South-South exchange activities under several country programmes, including those in the Dominican Republic, Honduras, Indonesia, Kenya, Malawi, Thailand, Tunisia, Uganda and the United Republic of Tanzania.
303. Following the ICPD, the International Organization for Migration (IOM) incorporated into its strategic planning and operational programmes the objectives concerning international migration and development set forth in Chapter X of the Programme of Action. IOM has also become involved in supporting government efforts to improve international dialogue on migration issues at the regional level, especially with respect to the CIS and relevant neighbouring countries, all of the countries of Central and North America and countries in East and South-East Asia. For example, IOM, along with UNHCR, was active in planning the 1996 CIS conference on the problems of refugees and displaced persons and in implementing the Conference's Plan of Action. In Central and North America, IOM has given substantive and logistical support to ongoing regional consultations among the participating States, known as the "Puebla Process." In Asia, IOM continues to assist the "Manila Process," which brings together 17 countries for regular exchanges of information on irregular migration and trafficking as well as a second regional process, the Asia-Pacific Consultations, which meets periodically to discuss a broad range of topics on population movements. Among the other components of IOM's programmes are national migration policy workshops, technical assistance on migration legislation and training workshops for migration officials, including a major new International Migration Policy and Law course, launched in November 1998 in Budapest, as a joint endeavour of the United Nations Institute for Training and Research (UNITAR), UNFPA and IOM.
304. Numerous constraints frustrate collaboration and constitute obstacles to the achievement of the partnership envisioned by the Programme of Action. Governments have increasingly included NGOs in the population programme process. However, such inclusion has been primarily of NGOs as part of the government-directed programme. Little coordination exists among the reproductive health programmes directed by the Government, NGOs and the private sector; these programmes operate separately and in parallel. Thus, one major constraint to partnership faced by both Governments and NGOs is the lack of a coordination mechanism; another major constraint is that of insufficient financial resources. Other constraints may include in varying degrees, depending on the respective country: insufficient NGO and Government institutional capacity, human resources and trained staff; insufficient NGO coordination; a hostile or confrontational Government-NGO relationship; a lack of awareness or understanding of the issues by the civil society; and a lack of awareness or understanding of the importance of partnership and weak political commitment.
305. Other bottlenecks include: divergent agendas and priorities among partner groups; volatile political climates; lack of a clear legal framework, regulations and guidelines for the partnership; unresolved stereotypes, including biases, about potential partners; lack of trust among partner agents and agencies; weak commitment to the partnership, often evidenced by rhetoric which is not backed by action; lack of communication among partners; protection of vested interests; cultural, language, class and race as well as religious biases and barriers; hesitancy in collaboration based on historical legacies or former experiences; fear of perceived dominance of the partnership by some players; geographical preferences (the urban-centric bias); lack of human resource capacity, especially given the increased staffing needs due to the decentralization of the government apparatus; insufficient or poorly described information about the Programme of Action; and loss of momentum since the ICPD.
306. Regression has also occurred in some areas. Advocacy with trade unions and employers' associations for implementation of the Programme of Action has subsided. Reduced commitment of bilateral donors, both in financial support and in their partnerships with civil society, and decreased funding from official development assistance (ODA) for reproductive health has affected several countries.
307. Further efforts are required for the building of strong dynamic partnerships at the national level. It is critical for Governments to take a lead role in establishing a positive, supportive enabling environment for partnership -- through the promulgation of appropriate policies and legislation; the institution of modalities for interactive discussion and the development of a consensus on common objectives and strategies to integrate the Programme of Action into all economic and social activities; and agreement on respective roles, responsibilities and comparative institutional advantages for programme implementation. For the institutions of civil society to play an effective role as development partners, financial and technical assistance for capacity-building is essential. Human, institutional and managerial strengthening is vital for improved and enhanced accountability, transparency, sustainability, coalition-building and responsiveness to constituencies. For the broad range of private-sector companies, their role may encompass, inter alia, the provision of a work environment safe for reproductive health; the provision of reproductive health information, counselling and services for their employees, on-site or as part of their insurance benefits package; and the promotion of employment practices which promote gender equality and equity. Private-sector companies engaged in commodity production, insurance coverage or service provision have a special role in ensuring full access to a wide range of affordable, high-quality reproductive health services.
308. Government and civil society institutions have another critical role to play in extending the partnership to all individuals -- at every level, in every city, town and village. Leaders, including those in the political, civic, business, media and religious spheres, have a special obligation to translate the Programme of Action for their constituencies and to assist them in adopting the Programme's provisions as their own personal agendas for action. The Programme of Action is meant to be a People's Agenda -- only in that way will its vision be transformed into action to open the future for the hopes, dreams, opportunities and choices of women, men and youth everywhere.
Establish an Enabling Environment for Effective Partnership
309. In order to establish an enabling environment for effective partnership, Governments, working closely with civil society, should:
institute common forums for dialogue for building partnerships;
adopt policy measures to facilitate the involvement of civil society, particularly of NGOs, in the formulation, implementation and monitoring of strategies and programmes to achieve the Programme of Action objectives;
formulate a common framework for working together and establish the underlying principles governing their collaboration and partnership so that roles will be clear, expectations will be realistic, and programme accountability can be promoted;
identify key common legislative, policy and programme issues as the basis for further collaboration;
identify key players and institutions to involve in addressing population and social issues and encourage the adoption of various approaches to enhance civil society participation, such as the facilitation of community-based initiatives; and,
develop transparent systems to become accountable to their respective constituencies.
Strengthen the Human Resources and Institutional Capacities of Civil Society
310. Governments should adopt innovative financial and technical assistance approaches, including direct funding to NGOs to foster effective partnerships.
311. In order to enhance the institutional viability and programme sustainability of civil society, donors should broaden the scope of their financial and technical assistance to include components to build and strengthen the human resource and institutional capacity and sustainability of civil society institutions, especially NGOs. Governments should consider earmarking core grants to support civil society involvement.
312. Civil society should establish mechanisms to promote and strengthen its human resources and institutional capacities. Such mechanisms might include, for example, the establishment of training and research centres to build the managerial skills and organizational capacities of NGOs and the creation of an independent body to accredit NGOs and to set standards for NGO operations.
313. Civil-society institutions, especially NGOs, should give increased attention to coalition-building and networking at the national and regional levels in order to promote programme replicability, complementarity and synergy, in addition to facilitating information exchanges and concerted action for policy and legislative inputs.
Strengthen and Intensify Social Mobilization Efforts
314. Governments, working closely with civil society, should strengthen and intensify their social mobilization efforts. They should formulate IEC and advocacy strategies which are bolder and more innovative than those used in the past, and which are designed, on the basis of socio-cultural and economic research, to reach specific audiences within a broader spectrum of civil society. For the Programme of Action to be adopted by all segments of the population, it is crucial that the Programme of Action message be translated into the vernacular of the selected audience, explaining it in terms which will have meaning within their realm of experience and hopes. In addition, more time and money should be devoted for the effective use of the media.
315. Governments, assisted by civil society, should open up for public discourse controversial topics and cultural taboos, in a manner which is culturally sensitive and which promotes justice and health.
Promote Access to High-Quality Reproductive Health and Family Planning Services
316. Governments together with NGOs, the private sector and international organizations, should significantly increase their efforts to identify areas, as well as promote innovative modalities, for concerted action to achieve programme complementarity and synergy, particularly with respect to reproductive health.
317. NGOs and professional organizations should take the leadership role in assisting the Governments in determining appropriate standards for quality reproductive health service and in disseminating these standards to providers and clients.
Encourage the International Community to Meet its Commitments
318. The international community needs to be encouraged to increase its technical and financial assistance for the implementation of population and development programmes in developing countries, in fulfilment of the commitment established in the Programme of Action of the ICPD.
319. United Nations agencies and organizations should promote and strengthen inter-agency coordination and collaboration at all levels on selected population and development themes; they should provide their field staff, in particular, with technical and operational guidance on selected themes in order to enhance coordination and collaboration at the country level.
320. The United Nations Resident Coordinator system needs to liaise with and utilize the existing country-level inter-ministry theme groups, a counterpart of the United Nations inter-agency theme groups, to strengthen and expand linkages with NGOs, the private sector and civil society, and to draw upon their comparative advantages to build and strengthen national capacity.