First event in the ICPD+5 review process
NEW YORK, 14 April (UNFPA) -- Many of today's adolescents are sexually active, and urgently need reproductive health information and services. But acknowledging and addressing these needs is still a very sensitive issue in most countries, and is one of the most difficult aspects of implementing the decisions of the 1994 International Conference on Population and Development (ICPD).
Speakers and participants in the round-table meeting on "Adolescent Sexual and Reproductive Health and Rights: Assessing the Impact of ICPD" stressed the need to overcome attitudes and other barriers that prevent young people from receiving support and protection. Several also emphasized that young people should help shape the programmes that aim to serve them.
The four-day meeting, sponsored by the United Nations Population Fund (UNFPA), began this morning with a statement from UNFPA Executive Director Dr. Nafis Sadik, and panel presentations on the theme of "Promoting an Enabling Environment for Adolescent Reproductive Health".
The meeting was opened by Virginia Davis Floyd, Director of the Ford Foundation. The foundation is hosting the meeting, which brings together experts and advocates on adolescent health from more than two dozen countries to review progress in implementing the Cairo Programme of Action with respect to adolescent reproductive and sexual health.
"The biggest obstacle facing adolescents exercising their right to reproductive health may lie not in resources or delivery systems; nor infrastructures, but in the minds of other people," Dr. Sadik told the group.
She pointed out that many members of the world's largest-ever generation of youth--some 1.2 billion people--are marrying later and starting sexual activity earlier, often without the knowledge or services to prevent unwanted pregnancy or sexually transmitted diseases. Adolescent women account for an estimated 4.4 million abortions each year. In some countries, girls still marry at an early age and face health risks from early pregnancy; their reproductive health needs also are not being met.
The ICPD explicitly addressed these issues for the first time, Dr. Sadik noted, and "extended the concept of the right to reproductive health to cover sexual education, information and services to adolescents." But the topic "continues to be, one of the most contentious and difficult areas in which to work," she added, and many "myths and misunderstandings were not totally dispelled."
Controversy continues regarding parental responsibilities, and whether to provide reproductive health information and services to young people. Parents are often unwilling to admit their own children may be sexually active. "Parents carry the ultimate responsibility for the well-being of their children, but the way they exercise it must be flexible and subject to change as their children grow up, and as society changes around them. Dr. Sadik said.
"The most difficult, the most intractable concerns are those which are considered private or family matters," she observed, including sexual abuse and violence, incest and female genital mutilation.
"We know from our experience and our research that adolescents want to take responsibility for their own lives, including their sexuality and their reproductive health." Adults need to learn that young people are not merely "children in need of protection," she said. Youth need to "help make and implement the policies that will shape their lives."
"Legal, religious and social barriers remain," Dr. Sadik added, "but the main battle in most countries now is to concentrate policy makers' attention on the urgency of the issue, to make resources available, and to remove the conceptual barriers still in the minds of many service providers at all levels."
Dr. Pramilla Senanayake, Assistant Secretary-General of the International Planned Parenthood Federation started the morning's panel discussion. "To perceive young people as sexual beings still seems to be one of the hardest things to accept in most societies," she pointed out. She emphasized the need to think about adolescent reproductive health in terms of human rights, and to recognize the harmful consequences of violating young people's rights. Giving adolescent services, education, support and guidance is not enough: "The real challenge is to relinquish our control over young people and to work with them to implement their rights."
Kwame Ampomah, a Director of Ghana's National Population Council, informed the meeting of the progress made in his country in the field of adolescent reproductive health. A national assessment had showed an urgent need to improve adolescent reproductive health programmes in Ghana. An Adolescent Reproductive Health Summit had led to the formation of groups working on programme strategies. A coalition had also been formed to promote adolescent reproductive health, and the Population Council was working with religious groups towards the same ends.
The issue had acquired greater momentum since 1996, with the President of Ghana's repeated calls for better programmes and the proposal of a draft policy on ARH. Mr. Ampomah also reported that UNFPA was working in support of some of the programmes for ARH in his country, and that Ghana's National Youth Council had been strengthened and placed at the centre of reproductive health issues related to young persons.
Wendy Thomas, the Chief Executive of the British group Population Concern, spoke of the need to allay adults' concerns that discussing adolescent reproductive health would lead to greater sexual activity by young people. Those fears are unfounded, she said, and are preventing meaningful discussions of the issue. Open discussion would clear the way for adequate training of young people about reproductive and sexual health. She assailed the "hypocrisy" of some large corporations that exploit young people's sexuality to sell their products, but are reluctant to contribute towards the provision of ARH information and services.
There were more panellists in the afternoon: Dr. Charlotte Gardiner of UNFPA's Technical and Policy Division gave examples of the Fund's support for adolescent reproductive health programmes. Claudio Stern, coordinator of research on adolescent sexuality and reproductive health at El Colegio de Mexico, spoke of the need to view teen pregnancy in its sociocultural context and not simply a health problem. And Seema Chouhan of the Centre for Development and Population Activities talked about her group's advocacy programme in support of adolescents' sexual and reproductive health and rights.