1 This report has been prepared by the United Nations Population Fund (UNFPA) as a background document for the Hague Forum, to be held in The Hague, the Netherlands, 8-12 February 1999. The Forum will examine the progress made and the constraints encountered during the first 4-5 years of the on-going implementation of the 20-year Programme of Action of the International Conference on Population and Development (ICPD) held in Cairo, Egypt, in 1994. Adopted by 179 countries, the ICPD Programme of Action underscores the integral and mutually reinforcing linkages between population and development and endorses a new rights-based strategy which focuses on meeting the needs of individual women and men rather than on achieving demographic targets. Since the ICPD, several extensive reviews have been made of the first phase of the implementation of its recommendations. This report reflects the findings of those efforts, which include a series of round-table and technical meetings organized by UNFPA during 1998; consultations organized by United Nations regional commissions; and a global inquiry conducted by UNFPA in mid-1998, in which information was collected from 114 developing countries and countries with economies in transition through UNFPA Field Offices and to which 18 donor countries also responded.
2 Considerable progress has been made in implementing key areas of the ICPD Programme of Action, through policy reformulation, programme redesign, increased partnership and collaboration, and increased resource allocation. In particular, there has been encouraging progress since 1994 in promoting reproductive rights and implementing reproductive health as defined by the Programme of Action. As of mid-1998, many countries had made policy, legislative and/or institutional changes in the area of reproductive health and/or rights since the ICPD. Several countries are testing ways to integrate various reproductive health services, and others are exploring other means to ensure rights-based approaches.
3 Sector-wide progress in policy formulation is occurring in several countries, while work on improving specific aspects of policies has begun in others. The UNFPA Field Offices reported that 41 countries had made policy/legislative changes in reproductive health after the ICPD. Critical measures undertaken by countries more advanced in the implementation of the ICPD agenda have provided the right to have free and easily accessible reproductive health services as an overall health component, throughout the life cycle, including the voluntary choice of family planning methods.
4 As one of its key principles, the ICPD Programme of Action emphasizes that advancing gender equality, equity and empowerment of women, eliminating all kinds of violence against women, and ensuring women's ability to control their own fertility are cornerstones of population and development-related programmes and are central to the notion of sustainable development. The Programme of Action sets out as an important objective to encourage and enable men to take responsibility for their sexual and reproductive behaviour and their social and family roles. These aims are important conditions for building a sustainable, just and developed society.
5 The incorporation of a gender perspective in population and development programmes has faced considerable constraints. Foremost among these has been the difficulty associated with operationalizing concepts related to gender equality, equity and empowerment of women in various social, cultural and political contexts. This constraint has slowed the integration of these concerns in a number of important planning and programming processes because of the absence of a consensus on what they mean. This problem is closely linked, in many countries, to the absence of data or research studies that would help in establishing clear operational definitions of these concepts. Most available data are based on quantitative methodologies and statistical analyses of only a few variables. Even in those countries where conceptual issues have been resolved, action plans have not always been accompanied by the necessary resource allocations, constraining the extent to which such plans can be effectively implemented.
6 The Programme of Action calls for the promotion of an effective partnership between all levels of Government and the full range of non-governmental organizations (NGOs) and local community groups in the design, implementation, coordination, monitoring and evaluation of population policies and programmes. Four years after Cairo, changing development paradigms are continuing to shift 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. 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. NGOs were genuine partners in framing the Programme of Action agreements and are now partners in its implementation. Effective and empowered women's movements and other mass movements are proving to be important in ensuring progress in policy development and implementation in many parts of the world.
7 A review of progress over the last few years on the scope of collaborative efforts with the 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 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 recognition of the need for gender equality and the empowerment of women.
8 All of the regional consultations and technical meetings held as part of the ICPD+5 process underscored, however, that if the ICPD goals are to be achieved, efforts to meet the funding levels specified in the Programme of Action will have to be intensified. Many countries have made impressive progress in realigning domestic budgets to address ICPD goals for improving the accessibility and quality of reproductive health programmes, reducing mortality and increasing attention to related social sectors. However, financial crises are affecting the ability of many countries, and especially developing countries and countries with economies in transition, to maintain the initial momentum towards achieving these goals. Donor countries are strongly encouraged to redouble their efforts to reach the $5.7 billion target for international assistance by the year 2000 as was agreed to at Cairo.