Hague Forum background paper - Chapter 6

Mobilization of Required Resources for Implementing the ICPD Programme of Action

321. Full implementation of the ICPD Programme of Action envisages mobilization of resources for a variety of development sectors. The Programme of Action, while providing specific estimates in the areas of reproductive health and other population activities, emphasizes the need to mobilize additional resources for other social-sector goals and objectives, such as universal basic education and continued infant, child and maternal mortality declines, improvement of the status of women and poverty eradication. While a large portion of the additional funds required will need to come from domestic resources, the Programme of Action calls for a substantial increase in complementary resource flows from donor countries, development banks, international NGOs and foundations. The costed-out portion of the Programme of Action estimates that, in developing countries and countries with economies in transition, $17 billion will be needed in 2000, including $5.7 billion from donor sources, including development banks. These figures increase slightly over the period 2000-2015, reaching $18.5 billion a year in 2005 and $21.7 billion by 2015. They reflect the level of resources required to finance activities in basic reproductive health, including those related to family planning, maternal health and the prevention of sexually transmitted disease (STDs) and HIV/AIDS, as well as the collection and analysis of basic population data.

322. UNFPA regularly collects data on flows of international financial assistance for population activities and annually publishes the Global Population Assistance Report, based on the collected data.43 That report describes the levels, trends and characteristics of international financial flows for population assistance. Since January 1997, UNFPA has worked closely with the Netherlands Interdisciplinary Demographic Institute (NIDI) to collect annual data on both international and domestic financial resource flows for population activities. This chapter draws heavily on data collected through that project.

The Costed ICPD Reproductive Health and Population Package: Donor Response

323. The term "external population assistance" is often used to indicate financial grants from donors (Governments or private foundations) and from multilateral organizations such as UNFPA as well as concessionary and "regular" loans from the World Bank and other development banks.44 Over the period 1990-1996, total external assistance to developing countries and countries with economies in transition increased substantially, from $972 million in 1990 to $2,044 million in 1996. The increases in 1994 and 1995, around the time of the ICPD, were especially steep, rising 55 per cent over the two years. Incomplete data for 1997 and 1998 indicate that increases have not continued and that there have instead been small decreases in external population assistance to developing countries (Table 6.1).

Table 6.1 Trends in Total External Population Assistance, 1990-1997* (in millions of $US)










Total External Population Assistance









Source: UNFPA, Global Population Assistance Report, various years (New York, UNFPA).

324. While the increases in assistance during 1993-1995 should be interpreted as reflecting support for the Cairo agenda, the increases are also partly the result of definitional changes in what was meant by "population assistance". As a result of the broader population and reproductive health paradigm agreed to at Cairo, the definition of what constitutes population assistance has been expanded. Additional components of reproductive health have been incorporated into the definition of population programmes, and into the accounting of resource flows.

325. One reason for the slowdown in the growth of external aid for population after 1996 is the fall in the levels of Official Development Assistance (ODA).45 As Table 6.2 indicates, ODA peaked in 1992, at almost $61 billion and has since declined, reaching $47.6 billion in 1997.46 Seen in the light of this sizeable downward trend, population assistance has fared reasonably well. Preliminary estimates suggest that the share of ODA devoted to population assistance increased in 1997 to 2.8 per cent, due to the faster erosion of overall assistance than of population assistance. As discussed below, new forms and sources of assistance have emerged in the past few years that needs also to be taken into account in assessing resource trends.

Table 6.2 Official development assistance (ODA) of donor countries, 1990-1997 (in millions of $US)










Total ODA









Total ODA for population









Population assistance as % of ODA









Source: UNFPA, Global Population Assistance Report, various years (New York, UNFPA).

326. The United States has historically been the largest provider of population assistance, and, until 1996, was increasing its aid in this area as fast as or faster than other countries. Denmark, the Netherlands, the United Kingdom and Australia also notably increased their support for population activities in the 1990-1997 period.

327. The United States is also well ahead of any other country in the share of ODA allocated for population activities. In 1995, approximately 9 per cent of its ODA went for population activities; in 1996, 7 per cent of its ODA was spent for population. These percentages are unprecedented in the history of population assistance and are far above the notional ODA target of 4 per cent for population assistance used in the early 1990s, when the definition of population assistance was narrower. However, the level of ODA as a percentage of the gross national product (GNP) in the United States was, in recent years, under 0.3 per cent, less than half of the long-standing agreed target of 0.7 per cent reaffirmed at the Social Summit in 1995. The shift in the definition of comprehensive reproductive health care to include safe motherhood and HIV/AIDS prevention programmes had a significant impact in increasing the funds counted as ODA in the population sector.

328. It is noteworthy and encouraging that a number of donor countries with exemplary overall ODA performance records in the 1990s led by the Danish, Norwegian and Swedish Governments traditionally allocated a relatively large share of their ODA for population and, in recent years, the Netherlands, the United Kingdom and Australia have begun to devote a relatively large share of ODA for population. The adoption following Cairo of an expanded definition of population and reproductive health programmes, however, also suggests that the prior notional share of development assistance earmarked for population needs to be reassessed upwards, perhaps to 4.5 to 5 per cent.

329. The political will of a country to provide ODA at or near the agreed target level of 0.7 per cent is a complex result of many factors, including the level of available wealth, technical capacity, moral sentiments, commitment to international development and beliefs about the efficacy of different strategies for assisting developing countries. In relation to their relative national wealth, the Nordic countries and the Netherlands have been strong supporters of ODA, including for population and reproductive health concerns.

The Costed ICPD Reproductive Health and Population Package: Developing Countries

330. Total amounts expended by Governments and NGOs for the financing of the costed-out components of the population package vary greatly from region to region and from country to country.47 Estimates of global, regional and domestic resource flows have been generated based on information for 61 countries reporting in 1996.48 Globally, it is estimated that in 1996 Governments and national NGOs spent almost $7 billion on population programmes from resources mobilized in developing countries. It is further estimated that private channels in these countries were responsible for another $1 billion.

331. The data show that countries in Asia and the Pacific mobilized the most domestic resources for population and reproductive health programmes ($5.21 billion), followed by Latin America and the Caribbean ($1.02 billion). Smaller amounts were mobilized in Western Asia and North Africa ($260 million) and sub-Saharan Africa ($192 million). Additionally, an estimated $103 million was mobilized in countries in economic transition.

332. Further development of the methodologies for monitoring national resource allocations will be required, particularly in private resource mobilization, where further increases will be particularly important. While some progress has been made, monitoring the allocation of resources to the different functional components of the population and reproductive health package remains problematic.49 Data making such distinctions can only be indicative, and related conclusions tentative.

333. Some of the regional findings are skewed and must be qualified insofar as a small number of large countries accounted for a sizeable proportion of regional totals. For instance, the combined expenditures of China, India, Indonesia, the Islamic Republic of Iran and Mexico amounted to $5.5 billion, approximately 80 per cent of the entire estimate of $6.8 billion mobilized from domestic resources in 1996. On a per capita basis, the remaining 56 countries for which data was available expended only $0.35 per capita, compared with the 61-country spending of $2.20 per capita. Therefore, although a few large developing countries with high levels of commitment and well-articulated policies were mobilizing large amounts of resources domestically, most other developing countries had limited capacity and/or constrained financial resources to utilize for population and reproductive health programmes as well as underdeveloped systems for monitoring flows. The per capita income levels and the available public resources in the majority of these countries, and particularly the 51 least developed countries (LDCs), were clearly inadequate to meet their populations' needs for reproductive health and family planning services.

334. For example, on average, only 26 per cent of resources were mobilized domestically in sub-Saharan Africa, and some countries in the region were only able to mobilize a smaller proportion of these resources. In contrast, the regions of Asia and the Pacific (at 89 per cent) and Latin America and the Caribbean (at 76 per cent) contributed far more to ICPD implementation from domestic sources. Significant variations existed within all regions, particularly between large countries with established population programmes and countries with less developed programmes largely dependent on external support. Within external assistance, grants accounted for the largest share of inputs (75 per cent in the aggregate, although less than two thirds in Asia and the Pacific and in Latin America) except in the countries in economic transition, where loan support predominated. Overall in 1996 approximately 20 per cent of all population resources expended in developing countries and countries in transition, or about $2 billion out of a total of $10 billion came from the international community. These findings indicate that although overall expenditures increased, the expected overall increase in the proportion of external support for population and reproductive health did not materialize.

335. Along with the other functional components of resource requirements, renewed attention needs to be given to mobilizing the $1.3 billion for STD/HIV/AIDS-prevention programmes in the year 2000 as proposed in the ICPD Programme of Action. The latest United Nations Population Division population estimates and projections, based on UNAIDS data, suggest more dramatic potential impacts of the pandemic on life expectancy and national growth (demographic and economic) than had been anticipated in 1994. The number of people infected with HIV/AIDS rose from 14 million in 1994 to 33.4 million in November 1998, and the number of women and children with HIV infection skyrocketed in the same period. More than 43 per cent of infected people over 15 years of age are female, and half of all new infections are occurring among young people aged 15-24. There is no indication yet that these trends will reverse. Thus, prevention efforts, including those targeted at adolescents, require full funding. Successful models for prevention efforts have been found to be effective where commitment and resources have been appropriately mobilized. A recent United Nations report50 indicates that young people were more likely to practice abstinence or safer sex than adults when they had the information enabling them to do so.

336. The prospects for changes in the balance of national and international support are difficult to assess. Initial information suggests that the economic crisis in South-East Asia threatens the ability of affected countries to maintain the high proportions of domestic financial support for their population programmes they had reached in the early and mid-1990s. Impoverished populations and the young are particularly vulnerable to the negative economic conditions and to potential programme erosion. The escalating demand and size of populations requiring services, will continue to challenge both domestic and international support.

The Role of the Private Sector

337. In addition to Government and NGO expenditures, the private sector is an important component of resource flows in developing countries and countries with economies in transition. An increasing amount of attention is being given to expanding the potential of private-sector efforts in both multilateral and bilateral assistance programmes. Methodologies to monitor private-sector inputs require further development. The UNFPA/NIDI resource survey has not yet attempted to measure the role of the private sector, but some information is available through individual country studies. These and other research efforts show that diverse mixtures of public and private financing and provision of services are possible. These include the funding of private clinics by private foundations, private investment in family planning education, the provision or sponsoring of family planning services at for-profit institutions, and public or private insurance schemes covering reproductive health services.

338. Many countries are encouraging the private provision of services, particularly for those with the ability to pay, and assessing fees to recover portions of the cost of public-service provision. Health-sector reform programmes are using these means to increase the efficiency and cost-effectiveness of health-service delivery. Household expenditure surveys consistently indicate that many people make out-of-pocket payments to health service providers (public, private and traditional), including payments for reproductive health care. Regular assessments of the willingness and capacity of different groups in the population to pay fees for quality reproductive health services could improve programme planning.

339. The extension of national health accounts and the inclusion in surveys of information on costs and willingness to pay are positive developments that will facilitate the monitoring of trends in private resources. Interesting national developments include the inclusion of reproductive health services in national insurance schemes (as in Bolivia and Mexico). Notwithstanding the many technical and managerial challenges that remain, especially for ensuring equitable access to services among the poor and other marginalized populations, the prospects for an increased private-sector role in channelling programme resources are positive. UNFPA has co-sponsored meetings to further develop a Private Sector Initiative programme. A November 1998 meeting recommended the expansion of the Initiative at the national level and support for technical studies to provide information to further encourage private-sector interest and partnership.

The Role of Non-Governmental Organizations and Private Foundations

340. Non-governmental organizations have become increasingly important as full partners of Governments and key recipients of both domestic and international resource flows for programme development and the implementation of comprehensive reproductive health activities. As recommended in the Programme of Action, these efforts must continue and must build on past successes particularly in HIV/AIDS-prevention and control, adolescent programmes and the testing of innovative programme approaches. For their part, private foundations contributed a total of $141 million in 1996 to help finance population programmes in developing countries, an increase of 66 per cent over the 1995 total.

341. Many international foundations and donor agencies support research and programme activities in advocacy, IEC and HIV/AIDS prevention, among other issues emphasized at the ICPD. The funds are frequently channeled through domestic NGOs, furthering the development of the large NGO sector as a cost-effective alternative provider at the grass roots level of reproductive health information and services and of advocacy on population issues.

342. In 1996, the top foundation donors were the Ford Foundation, the Rockefeller Foundation, the MacArthur Foundation, the Hewlett Foundation and the Mellon Foundation51, all contributing between $10 and $30 million for population activities. In a highly encouraging recent development, the Packard Foundation announced in November 1998 that it will be allocating more than $300 million to international population and reproductive health programmes over the next five years (1999-2003).

343. More recently, foundations such as the newly created United Nations Foundation, a subsidiary of the Turner Foundation, gave specifically targeted grants focusing on population and women, with special emphasis on adolescents. In its first round of grants in May 1998, the Foundation provided UNFPA with $8 million for six population projects. In its second round of grants, the Foundation will give UNFPA $4.3 million over a two-year period for the advancement of adolescent reproductive and sexual health. In addition, the William H. Gates Foundation contributed $1.7 million to the United Nations, for specific use by UNFPA to support collaboration among developing countries. These grants exemplify the targeted private resource flows that will have an impact on the ICPD+5 review, supporting a special youth forum as well as funding advocacy, education and training programmes for adolescent reproductive health in Latin America and the Caribbean.

Sector Investment Programmes and Sector-Wide Approaches

344. New modalities to improve the impact and sustainability of development cooperation are especially relevant to resource flows and programme management. Sector Investment Programmes (SIPs) and Sector-Wide Approaches (SWAps) are two such modalities. Both address constraints or weaknesses in the traditional mechanisms of donor support for projects and programmes, including the fragmentation of resource management, perpetuation of budgetary imbalances due to reliance on long-standing projects without sufficient monitoring and evaluation mechanisms, and differing commitment levels to projects viewed as externally driven.

345. SIPs and SWAps, although not new concepts, are now being implemented in a number of countries targeting a particular sector. SWAps differ from SIPs primarily in that they include all types of resources involved in a sectoral programme, not only investment, as in the case of SIPs. Both include clearly stated sectoral goals and objectives, pooled or parallel resource flows and a coherent and well-developed policy and investment framework. A key element is the recipient country's increased responsibility for developing and articulating the approach, and its resultant ownership. Although only preliminary information is available on the efficacy and efficiency of SIPs and SWAps, they do provide alternative development assistance modalities that engender more communication and collaboration between developing countries and donors with regard to programme objectives and resource allocation. The SWAp mechanism is being increasingly used as an element of overall health-sector reform initiatives.

346. National experiments in broad participatory approaches to the delivery of essential service packages for health systems are under way in a variety of countries (including Nepal and Bangladesh). At the same time, the decentralized management of health-sector reforms provides opportunities for the further generation and more efficient use of local resources. Ensuring adequate representation of all stakeholders, including those endorsing reproductive health programmes, remains a key issue.

Resources for the Broader ICPD Goals

347. The ICPD Programme of Action viewed population issues as a fundamental part of a broader approach required for sustainable development, which, in addition to integrated reproductive health programmes, includes efforts to provide other basic social services, improve the status of women and other development initiatives. Although the ICPD focused on and estimated resource requirements for the major reproductive health and population components of a concerted action agenda, the Programme of Action also made it clear that other important parallel actions had to be undertaken. The resource targets, including the $17 billion needed annually by the year 2000 for integrated population programmes, would have to be supplemented by resources aimed at meeting the other goals and objectives set forth in the action plan, such as the reduction of infant, child and maternal mortality, basic education for all (and especially girls) and the empowerment of women.

348. It has been estimated that developing countries and countries with economies in transition devote approximately 0.2 per cent of their combined GNP to population activities that are part of the "costed package." Data available for all efforts in the health and education sectors reveal that far larger sums are expended in these sectors generally. Overall, and in approximate terms, these countries spend about 2 per cent of GNP in the health sector and 4 per cent in the education sector. If health and education are taken together as the two main areas of social spending, expenditures for the ICPD costed package amount to only 3 per cent or less of social spending. Only about 10 per cent of total health outlays go to reproductive health and family planning activities, despite the contribution of reproductive health to the overall burden of disease in developing countries and the cost-effectiveness of many relevant interventions.52

Recent Advances in Development Partnerships

349. The 20/20 Initiative which was endorsed at the Social Summit in 1995 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 five components of basic social services, in a definition agreed on at a 20/20 meeting in Oslo in 1996, are basic health; basic education; reproductive health, including family planning and sexual health; nutrition; and, basic water and sanitation. Government expenditure accounts rarely separate basic social services from other spending, such as on tertiary health systems, e.g., hospitals, or education, including universities.

350. Since 1996, efforts to measure basic social services expenditures have led to a number of special studies in many developing countries. A follow-up meeting, attended by 29 developing countries, 19 donor countries, 11 international NGOs and 13 multilateral development organizations, held in Hanoi in October 1998 led to the 31-paragraph "Hanoi Consensus on the 20/20 Initiative: Universal Access to Basic Social Services". The meeting agreed that the current economic and financial crisis underscores the relevance of the 20/20 Initiative to protect access to basic social services for the most vulnerable people. The meeting also identified the 20/20 Initiative as addressing the input dimension of the Development Assistance Committee (DAC) partnership strategy enunciated in Shaping the 21st Century: The Contribution of Development Cooperation, noting that at the country level the shared need will vary, depending on local circumstances. The meeting urged the DAC to prepare a report on donor support for basic social services using both data reported by members and the assessment of efforts in peer aid review and to present it to the preparatory meeting for the World Summit for Social Development (WSSD)+5. The meeting agreed that the Hanoi Consensus and the objective of achieving universal access to basic social services should be presented and promoted in relevant international forums.

351. The World Bank, through its International Bank for Reconstruction and Development (IBRD) facility and International Development Assistance (IDA) lending provided funding for investments in the Social Sector totaling $8.48 billion in fiscal year 1998. This accounting includes loans earmarked for the social sector, for health, nutrition, and population, for education, and for the social protection components of other sectoral commitments. Bank lending has increasingly supported integrated reproductive health programmes that give priority to population issues, both directly and through sector-wide assistance and health reform efforts. According to the Bank's 1998 Annual Report, an average $354 million a year since fiscal 1992 supported projects containing these two components.

352. The Bank's 1998 Annual Report notes significant allocations in projects to gender components ($2.5 billion); to health, nutrition and population sectors ($2.0 billion); and to education ($3.1 billion). An additional $3.76 billion have been loaned for efforts in the area of social protection, which includes projects directed towards helping the poor cope with economic hardships and change, assisting refugees and other displaced persons in emergency situations as well as related policy development and locally generated social development initiatives.

353. It was announced in November 1998 that IDA will have $20.5 billion to disburse to 80 or more of the world's poorest countries from mid-1999 through mid-2002. The Bank indicated that it aims at providing 50 per cent of IDA's resources during that period to African countries that are committed to poverty reduction, including social-service interventions, economic reform and sustainable broad-based growth.

354. Studies undertaken for the 20/20 Initiative provide rough estimates of the developing countries' current expenditure on basic social services as well as the additional resources required. Adding the basic social services components together, a further $70-80 billion would be needed beyond what is currently being expended to achieve universal access to the complete basic social services package. The shortfall in resources includes the additional $7 billion needed to implement the costed-out portions of the ICPD Programme of Action.

355. The European Union (EU) announced in Cairo that it planned to increase its aid in the population sector by more than 10 times by the end of the century, to reach a projected yearly total of $347 million by the year 2000. Its financial support of population projects and programmes has been increasing; by 1997, the European Union allocated an estimated $140 million for population activities. With increased political commitment and the strengthening of technical capacity to allocate an monitor these funds, this modality could further supplement existing bilateral and multilateral mechanisms.

356. Technical cooperation between developing countries has been increasing through the expanded activities of the Partners in Population and Development Programme ("the South-South Initiative"), supported by the UNFPA and private foundation funding. Such efforts provide an additional cost-effective mechanism for technical assistance and an additional component of resource flows.


Donor Countries

357. Since the ICPD, some positive trends have been observed. First, the 1994-1995 period saw some growth in external assistance for population. Second, several donor countries have responded to the ICPD by reassessing their aid policies and the role that the Programme of Action should play in their overall development assistance strategy. Denmark, Germany, Japan, the Netherlands, the United Kingdom and the United States have all undertaken significant major changes so that the ICPD goals could be better addressed in their aid-giving strategies.

358. Additionally, the proportion of total ODA destined for population has increased since the ICPD and, in 1997, stood at a historic high level of 3.09 per cent (preliminary) of ODA, demonstrating the donor community's greater emphasis on population concerns than in the past. Although this trend is encouraging, total ODA has declined in recent years, and therefore that percentage actually reflects a much slower growth or even negative growth in total resources allocated to population activities.

359. Unfortunately, although funding for population has increased since the ICPD, it has not increased at a rate consistent with meeting the agreed-upon target of $17 billion by the year 2000. A major obstacle to increasing resource mobilization in line with the ICPD resource goals has been the slow downward trend in ODA. The reasons for this trend are several. Some donor countries have reduced aid as an overall drive to reduce budget deficits. There has been a loss of confidence in some countries as to the efficacy of development aid. The large increases in private-sector investment in 10 or 12 developing countries in the 1993-1996 period, as well as the growing belief in the centrality of market-driven development, may also have worked against ODA that is preponderantly tied to projects in the public sector.

360. The trends in decentralization of both external assistance and national resources, along with overall structural reform, have posed new challenges for programme management, monitoring and evaluation. These restructuring trends, which will make assistance more effective in the long term, have left countries faced with the need to more rapidly expand their technical and financial capacity to implement programmes.

361. Rigid donor aid policies inhibit the flexibility needed for increasing and efficiently using resource flows and donor management information systems that are both demanding and inappropriate for monitoring decentralized population assistance.

362. The level of commitment of some donor countries is another constraint to realizing the resource targets contained in the Programme of Action. A number of donor countries that had devoted a relatively small part of their total ODA to population before the ICPD are continuing at low levels, despite the consensus on the centrality of population to development and the need to implement the 20-year plan contained in the Programme of Action. Thus, a number of countries in Europe commit substantially less than even 1 per cent of their ODA towards the implementation of the Programme of Action.

363. From another perspective, if all donor countries not currently extending assistance at least at the level of 3.5-4 per cent of ODA were to have done so in 1996, an additional $902 million to $1.11 billion would have been available to finance international population efforts, in addition to the $2 billion actually allocated.53 If a higher level (4-5 per cent) of ODA were to be achieved, consistent with the expanded definition of population and reproductive health programmes, further resources could have reached as much as $1.71 billion.

Developing Countries

364. Besides financial constraints, Insufficient technical and human resources are among the most prevalent constraints noted in reports by developing countries regarding obstacles to implementing the ICPD Programme of Action. Other obstacles have militated against increased resource flows, such as financial crises, very low prices for export commodities, constraints necessitated by on-going structural adjustment programmes and political instability. Under such circumstances previous pronouncements do not always translate into domestic resource flows for population programmes, basic social services and programmes aimed at fostering gender equity and equality.

365. Poverty and the necessary responses to economic crises that have eroded already meager public sector resources translate into far too few resources being available for basic social programmes. The answers to questions about what priorities should guide governance and finance decisions remain critical. The estimated $8 billion raised domestically for population is still $3.3 billion short of the year-2000 target. While it will be difficult under the current circumstances to totally fill that gap, best effort attempts are called for to build on the gains and resulting progress in the 1994-1997 period.

366. One obstacle that may result in a lack of political commitment is the lack of timely and accurate policy-relevant information generated within developing countries, which would shed light on national population issues, programme progress and linkages to other development concerns, and would help garner support for further efforts. Insufficient and incomplete systematic data on resource flows and programme requirements impede efforts to assess and prioritize needs and evaluate current programmes as well as to mobilize and allocate resources.

367. While some noteworthy progress has been made since the ICPD, opposition to population programmes on traditional or cultural grounds remains an obstacle to the mobilization of resources in certain domestic contexts. Such opposition can also influence the scope of the population programmes to which the resources would be allocated. At times, misinformation campaigns regarding the real purpose of population programmes have been used to stigmatize population activities and create adverse public opinion. IEC, training and advocacy related to population issues and their relevance to development strategies can help correct such misperceptions.

Further Action Required

368. Efforts should be redoubled -- by developing countries, donors, multilateral organizations, including the regional development banks, foundations, the private sector, NGOs and other civil-society representatives -- to both advocate for and help provide the level of resources required for the full implementation of the ICPD Programme of Action.

369. Governments of developing countries should increase their investment in broader social sector and attempt to provide an increasing portion of their resource needs domestically.

370. Governments of developing countries should continue their efforts to ensure the efficient and effective use of both national and external resources by strengthening the technical and managerial capacity of reproductive health programmes, especially in light of such developments as sector-wide approaches and decentralization.

371. Governments of developing countries should strengthen mechanisms to coordinate national reproductive health programmes involving all partners -- including civil-society organizations, NGOs and the private sector. Moreover, both donor and recipient countries should work to improve the planning and implementation of population programmes and their relationship to development strategies.

372. Governments of developing countries should conduct studies to create a knowledge base that is capable of dramatizing the interrelationships among population, environment, poverty and development. Such studies need to be undertaken on an advanced level and linked to an advocacy strategy so that their messages will reach the public, the media, parliamentarians and opinion leaders.

373. Finally, the implementation of the Programme of Action must be viewed by all countries and all partners as a collaborative effort in which all parties continue to work together to do more to attain the ICPD goals and objectives. All countries, developed and developing, should participate in open, accurate and timely sharing of information on programme progress and constraints and on their resource commitments and expenditures.

374. After two years of encouraging growth in the levels of international population assistance in 1994 and 1995, the levels of ODA in 1996 and 1997 declined. International population assistance in 1996 hovered at the 1995 level; provisional figures show a slight decrease in 1997. This is a discouraging and disheartening development, especially in light of the significant negative impact on the provision of social services engendered by the economic and financial crisis of the past 18 months in South East Asia, in Russia and in Latin America and the continuing vulnerabilities in other developing countries and regions. These highly disruptive developments greatly heighten the concern of all of the parties and individuals committed to reaching the goals and objectives for improving the quality of life that are set forth in the ICPD Programme of Action. It is to be hoped that 1996-1998 will prove to be only an anomaly and that increased mobilization of international population assistance will resume in 1999 and accelerate in the year 2000 and beyond.

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