THE STATE OF WORLD
Lives Together, Worlds Apart
Men and Women in a Time of Change
Inequality between women and men limits
the potential of individuals, families, communities and nations. Ending gender discrimination is an urgent human rights and
development priority, says The
State of World Population 2000 report from the United Nations Population Fund (UNFPA).
Despite the tremendous changes of the 20th century, discrimination and violence against
women and girls remain firmly rooted in cultures around the world. Passed down from one
generation to the next, ideas about "real men" and "a womans
place" are instilled at an early age and are difficult to change.
These restrictions take a heavy toll. Girls and women the world over are denied access
to education and health care. Millions are subjected to abuse and violence. Womens
legal rights are not protected. Their medical concerns are given less attention than
mens are. They are denied opportunities in the workplace and receive less pay than
men for the same work.
Men, and societies, also pay a price. Yet, until recent years, gender discrimination
was considered either unimportant or non-existent, either accepted or ignored, without
even the statistics to describe it. While many countries have started taking steps to
protect womens rights and promote equality, actual progress has been slow.
Gender discrimination will not end until all eyes are open to its inherent
contradictions, and countries, communities and families act to end it.
Gender and Health
Gender inequality harms womens health and prevents many women from participating
fully in society. Unequal power relations between men and women often limit womens
control over sexual activity and their ability to protect themselves against unwanted
pregnancy and sexually transmitted diseases (STDs), including HIV/AIDS. Teenage girls are
Inadequate reproductive health care for women also results in high rates of unwanted
pregnancy, unsafe abortion and preventable death and injury as a result of pregnancy and
childbirth. Gender-based violence including rape, wife beating and female genital
mutilation hurts womens health, well-being and social participation.
Universal access to sexual and reproductive health care, including family planning
services, was a central objective of the 1994 International Conference on Population and
Development (ICPD) in Cairo. Countries agreed that empowering women and meeting
peoples needs for education and health were necessary for individual advancement and
balanced development. At the 1999 fifth-year review of the Conference (ICPD+5),
governments agreed on these new bench-marks, among others: to halve the 1990 illiteracy
rate for women and girls by 2005; to halve unmet need for family planning by 2005 and to
eliminate it altogether by 2015; to reduce HIV infection in youth by one quarter by the
year 2010, by providing information and services to reduce their risk; and to ensure that
by 2015, 90 per cent of all births are assisted by skilled attendants. They also agreed
that where abortion is legal, it should be safe and accessible.
Providing family planning to everyone who wants it is a significant challenge. Today
about one third of all pregnancies 80 million a year are believed to be
unwanted or mistimed. If women could have the number of children they wanted, the average
family size in many countries would fall by nearly one child.
Over the next 15 years assuming services can be provided the number of
contraceptive users in developing countries is expected to increase by more than 40 per
cent to 742 million due to population growth and increased demand for contraception.
Providing women with safe options for pregnancy and childbirth is another priority. Today,
some 500,000 maternal deaths occur each year in developing countries, where only 53 per
cent of all births are professionally attended. This lack of care translates into the
neglect of 52.4 million women annually. Nearly 30 per cent of women who give birth in
developing countries, some 38 million each year, receive no antenatal care.
Quality care before, during and after birth is essential to safe motherhood. The best
way to prevent maternal deaths, however, is to provide emergency obstetric care. Rapid
transport to a medical facility is crucial to saving mothers who are facing complications.
Each year, women undergo an estimated 50 million abortions, 20 million of which are
unsafe, resulting in the deaths of 78,000 women and the suffering of millions more. At
least one fourth of all unsafe abortions are to girls aged 15-19. Increased access to
family planning is clearly the best way to reduce abortion. Care for women who have
undergone abortion is also an important way to reduce maternal mortality.
At the end of 1999, 34.3 million men, women and children were living with HIV or AIDS,
and 18.8 million had already died from the disease. HIV/AIDS is now the leading cause of
death in Africa and the fourth most common cause of death worldwide. In 1999, there were
5.4 million new infections, 4.0 million of them in sub-Saharan Africa. In Africa,
HIV-positive women outnumber men by 2 million. Programmes that address gender inequality
and engage men as partners in fighting AIDS can help slow the spread of the disease.
Another health, and human rights, concern is female genital mutilation (FGM), which
affects over 100 million women and girls, mostly in Africa and Western Asia. Since it is
nearly always carried out in unsanitary conditions without anaesthetic, FGM can result in
severe infection, shock or even death, and there are lifetime health consequences
including an increased risk of experiencing a difficult delivery and dying in childbirth.
Gender-sensitive reproductive health programmes are essential to counter inequality and
protect womens health. Programmes are beginning to address the dynamics of
knowledge, power and decision-making in sexual relationships, between providers and
clients, and between community leaders and citizens. Non-governmental organizations (NGOs)
are increasingly playing important roles in providing services, for instance to address
sensitive topics such as adolescents needs.
Young men and women face different social pressures and expectations which may work
against responsible sexual behaviour. Many girls are forced into early and unsafe sexual
activity by abuse, child marriage or poverty. Both married and unmarried youth lack access
to reproductive health information and services. Training young people as peer educators
encourages responsible behaviour. Parents and other adults can learn to be sources of
information and counselling.
Men also face reproductive health problems including sexually transmitted infections,
impotence and infertility. Many men also say they want to limit or space their children,
but neither they nor their wives are using contraception. Reproductive health services for
men have concentrated on STDs. The proportion of contraceptive use attributable to men has
fallen in recent years. Good programmes can increase mens knowledge of and use of
At least one in three women has been beaten, coerced into sex, or abused in some way
most often by someone she knows. One woman in four is abused during pregnancy. At
least 60 million girls are "missing", mostly in Asia, as a result of
sex-selective abortion, infanticide or neglect.
Two million girls between ages 5 and 15 are introduced into the commercial sex market
each year. Perhaps as many as 5,000 women and girls are murdered each year in so-called
"honour" killings by members of their own families. Rape, battery and other
forms of gender-based violence are widespread worldwide.
Many cultures condone or tolerate a certain amount of violence against women. In parts
of the world, men are seen as having a right to discipline their wives as they see fit.
Even women often view physical abuse as justified under certain conditions.
Justification for violence stems from distorted views about the roles and
responsibilities of men and women in relationships. Events that may trigger violent
responses include not obeying the husband, talking back, refusing sex, not having food
ready on time, failing to care for the children or home, questioning the man about money
or girl-friends or going somewhere without his permission.
Violence can cause immense damage to womens reproductive health and well-being,
resulting in unwanted pregnancies; unsafe abortion; persistent gynaecological problems;
sexually transmitted diseases, including HIV/AIDS; and psychological and emotional
problems that can be more difficult to bear than physical pain.
NGOs are actively countering violence against women. African NGOs have led the
increasingly successful fight against FGM. In Colombia, womens groups provide
training and support for rape survivors. A Bosnian group has counselled 20,000 women and
children who have suffered from sexual violence.
Men, Reproductive Rights and Equality
Discrimination against women and girls will never stop without the support and
understanding of men, especially in the family. Mens attitudes and behaviours are
strongly influenced by stereotypical definitions of masculinity and what it means to be a
"real man". These stereotypes, however, are unrealistic and set men up for
failure, stress and difficulty in relationships. Men unable to live up to expectations
that they should be powerful and competent may retreat into passivity, escape through
drugs or alcohol, or resort to violence or exaggerated bravado and risk-taking.
Helping women and men to communicate about their family roles and responsibilities can
strengthen families, protect reproductive health, and reduce gender inequality and
gender-based violence. One study in the Philippines showed that domestic violence was
least prevalent when the husband and wife communicated and shared responsibility for
Mens behaviour can change. In India, male health workers have motivated other men
to take an interest in womens health and help with house-work. In Mali, mens
involvement in reproductive health has led to support for womens employment. And in
Nicaragua, courses on gender and power have reduced gender-based violence and increased
Counting the Cost of Inequality
Just as substantial as the human suffering caused by gender discrimination are the
social and economic costs. Inequality rewards men, and some women, blinding them to more
productive alternatives. It obstructs social and economic participation and closes off
possible partnerships. And it reduces womens effectiveness by failing to support
their responsibilities, challenges and burdens.
Womens economic activity is undercounted because it is often in the informal
sector. Better accounting could encourage investment and promote productivity. A study in
Kenya found that giving women farmers the same support as men could increase yields by
more than 20 per cent. In Latin America, eliminating gender inequality in the labour
market could increase womens wages by half and national output by a full 5 per
Girls in poor households are more likely to die than boys before age 5, even though
globally girls have a better chance of surviving childhood. Inadequate health care in poor
populations has a greater impact on women than men; in particular, poor women are more
likely than other women to die as a result of pregnancy. The costs of the death of a
mother include her lost contribution to the family and its survival, and increased
mortality for her children.
High rates of HIV/AIDS infection, due in part to gender inequality and a failure to
invest in prevention, have taken a tremendous toll in many nations. In some countries, it
is estimated that the pandemic has reduced per capita GDP growth by 0.5 per cent annually.
The impacts on the health system and on the poor are severe. In some of the most affected
countries, infected persons occupy more than half the available hospital beds.
The global costs of gender violence and abuse include the direct costs of health care,
missed work, law enforcement and protection, shelter and divorce. The World Bank estimates
that in industrial countries sexual assault and violence take away almost one in five
healthy years of life for women aged 15-44.
Denying education to girls slows social and economic development; investing in
education pays off. One study concluded that, other factors being equal, countries having
three female students or fewer for every four male students could expect 25 per cent less
GNP per capita than countries with greater parity in education. The economic advances in
some Asian countries from the 1960s through the 1980s hinged in part on smaller family
sizes and increased investment in girls education and health. Educated women with
increased income invest more in their childrens health and education.
The gender gap in schooling is closing in most of the world, but it remains large in
South Asia and sub-Saharan Africa, where fewer than 40 per cent of secondary students are
Another cost, one that will rise in coming years as the number of older persons
increases, is caring for the elderly. Everywhere, older women live longer than men do. But
despite their longer life spans, public pension systems offer women less support because
of womens lower formal labour force participation.
A series of human rights treaties, starting with the United Nations Charter and the
Universal Declaration of Human Rights, affirm the rights of girls and women. Forged over
several decades by governments and influenced by the global womens movement, these
agreements provide a legal foundation for ending gender discrimination and gender-based
rights violations, and oblige governments to take action.
The 1979 Convention on the Elimination of All Forms of Discrimination against Women has
165 states parties. An Optional Protocol to the Convention was opened for signature in
December 1999 and will enter into force with 10 ratifications. The Protocol will enable
individuals and groups of women to submit discrimination complaints to the treaty
monitoring body. It will also enable the Committee on the Elimination of Discrimination
against Women to initiate inquiries into situations of grave or systematic violations of
The Vienna Declaration and Programme of Action for human rights (1993), the Programme
of Action adopted by the ICPD, and the Platform for Action adopted by the Fourth World
Conference on Women (Beijing, 1995) also strongly support gender equality and womens
empowerment. These agreements, while not legally binding, are powerful instruments for
The agreements from the ICPD and the Beijing womens conference clearly spell out
the components of reproductive rights. These include the right to sexual and reproductive
health; voluntary choice in marriage, sexual relations and childbearing; freedom from
sexual violence and coercion; and the right to privacy. All of these rights are essential
to gender equality.
However, for womens rights to become a reality, they need to be taken seriously,
especially by men. This requires education and awareness raising. Womens rights also
need to be incorporated into national policies, laws and programmes.
In the past few years, many legal victories have been registered. Mexico and Peru, for
example, have passed laws to increase access to reproductive health services. Portugal has
amended its constitution to specify that the Government has to guarantee family planning.
Botswana, China, Colombia, the United Kingdom and Viet Nam have increased penalties for
various sexual offences. Bolivia no longer requires that a woman be found
"honest" to be considered the victim of a sexual offence. Germany has
criminalized rape by a husband against a wife. Several have outlawed female genital
mutilation. But much more remains to be done.
Working Towards a Better Future
Governments have a key role to play in creating conditions for gender equality, by
removing legal barriers and changing laws, policies and programmes. Political leaders can
advocate and promote gender equality and encourage others to do so. Womens increased
political participation is another important way to advance.
Governments have agreed that everyone should have access to reproductive health care by
2015. The key elements family planning, services for safe motherhood and protection
from sexually transmitted disease are essential to the quality of life of both men
Programmes are also needed to address mens reproductive health needs and foster
their active support for womens health. Men should be engaged in dialogues on gender
inequality and its costs to men, women and society at large.
Systematic gender analysis and monitoring can show what is needed to respond to the
needs of both women and men and promote gender equality. Womens groups need to be
involved in designing, implementing and monitoring programmes. Further improvements are
needed in the quality of sexual and reproductive health care. Service providers need
training and support to provide sensitive care to both women and men.
Needed action against gender-based violence includes advocacy, gender-sensitivity
training, legal changes, improved enforcement, safe alternatives for victims, reporting
systems, mediation and counselling services, and support for groups providing counselling
Elimination of gender inequality in hiring, wages, benefits and job security should
include ending requirements that women prove that they are using contraceptives or are not
pregnant. Human rights and health education campaigns should take into account the
different perspectives of men and women.
The long-term approach to ending gender discrimination requires efforts at all levels,
including training children to see and avoid gender bias. Media, including film, radio, TV
and the Internet, can encourage positive images and role models.
Stronger partnerships among governments, NGOs and local communities to monitor and
promote compliance with human rights standards are also needed, as are stronger efforts to
achieve universal primary education. The international development community, including UN
agencies and the World Bank, needs to continue efforts to mainstream gender analysis into
policies and programmes. Better collaboration among donors is needed to reduce duplication
and share expertise.
Of the $5.7 billion per year that countries have agreed is needed from international
sources for reproductive health and population programmes, only about $2.1 billion has
been made available. Funding for education and womens empowerment is also
inadequate. While international donors, including foundations, have strongly supported
efforts to promote gender equality, sufficient resources do not yet back this
The last several decades have seen greater attention and some progress towards the
empowerment of women. There has also been a growing recognition of how the rules governing
mens and womens opportunities, social endowments and behaviours affect
prospects for accelerated development and justice. But social change is often difficult,
particularly when the basic relations between men and women are involved.
The changes in these relationships, and the systems of power and belief that support
them, are no less sweeping than other changes already under way in urbanization,
globalization and governance. In the end, societies need their own solutions to provide a
better life for both women and men, consistent with their cultures and conditions,
grounded in a vision of justice and gender equality.
Word count: 3,002
For more information:
United Nations Population Fund
Information and External Relations Division
220 E. 42nd Street
New York, NY 10017
Tel. 212-297-5020; fax: 212-557-6416.
The full report and this summary, in English, French and Spanish may be found on the UNFPA
web site, www.unfpa.org, along with
news features, photographs and fact sheets.
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