Political leadership and adequate funding will be critical to meet both the goals of Cairo and the MDGs. Priorities for action over the next 10 years include:

POLICY COORDINATION

• Integrate ICPD priorities into development policy dialogues on poverty eradication, women’s empowerment, social policies, human rights, environmental sustainability and macroeconomic polices, and in sector-wide approaches, PRSPs and other programming processes;
• Broaden policies and programmes to meet the needs of the poorest populations and ensure that ICPD implementation efforts have a pro-poor orientation. Give priority to increasing the education and skills of the poor, and to providing services to poor rural and urban communities;
• Make civil society participation a routine aspect of national, regional and local institutional practices;
• Reform laws, policies and institutions to promote gender equality and equity. Combat gender-based violence and harmful traditional practices; expand women’s access to land and credit; increase women’s participation in decision-making; and redress inequality within families, workplaces and communities;
• Link national capacity-building efforts and systems aimed at achieving the MDGs and monitoring progress to those needed to implement the ICPD Programme of Action, to maximize synergy and programme effectiveness.

POPULATION AND DEVELOPMENT

• Include population dynamics in national planning and policy dialogues. As population size, composition and density change, planners need to anticipate and meet infrastructure and service needs;
• Respond to rapid urbanization, including in the least-developed countries. Expand primary health care—including reproductive health—and other social services in the poor communities on the margins of cities. Facilitate decentralized decision-making by training local staff in budgeting, service delivery and monitoring;
• Pay more attention to rural development to: address gaps in health care, education and employment; halt environmental degradation; slow the migration of those with skills and education; and reduce the impact of HIV/AIDS.

REPRODUCTIVE HEALTH

• Focus more attention and resources on providing comprehensive, high-quality reproductive health services;
• Give priority to reproductive health and family planning in efforts to strengthen and reform health systems, and in sectorwide approaches, PRSPs and strategies for meeting the MDGs;
• Strengthen capacity at all levels to provide reproductive health services, ensure sustainable financing and adequate staffing, improve service quality and increase use;
• Ensure the sustainability and security of supply chains of all commodities, equipment and supplies needed for comprehensive reproductive health care, including contraceptives;
• Direct capacity and resources to interventions known to be most effective including new approaches for reducing maternal mortality and ensuring adolescents’ reproductive health;
• Improve the quality of care, building on progress in the past decade;
• Establish effective monitoring and evaluation mechanisms to address constraints in programme implementation and to assess success;
• Strengthen systems for data collection, analysis, dissemination and use, through institutional support and training.

MATERNAL HEALTH

• Scale up and expand women’s access to interventions most effective in preventing maternal deaths: deliveries with skilled attendants and access to emergency obstetric care;
• Strengthen family planning services to enable women to postpone, space and limit pregnancies;
• Increase the use of safe motherhood services, particularly among poor households, by raising awareness, addressing social and economic barriers and improving infrastructure;
• Remove financial obstacles to antenatal, delivery and postpartum care, by making all such care free or covering fees through national insurance systems.

HIV/AIDS

• Link HIV/AIDS interventions more effectively to reproductive health care as part of a multisectoral response to the epidemic;
• Expand support for family planning and reproductive health programmes—important entry points for HIV prevention, treatment and care;
• Strengthen efforts to integrate HIV/AIDS prevention and treatment into comprehensive reproductive health services;
• Scale up current programmes, using a multisectoral approach;
• Address socio-economic factors facilitating HIV/AIDS infection, including gender relations, through culturally appropriate behaviour change programmes.

ADOLESCENT REPRODUCTIVE HEALTH

• Intensify efforts to reach all adolescents in need, including married adolescents and those not in school;
• Increase youth participation in programme design, implementation and monitoring, and in policy processes;
• Expand the comprehensive approach to youth programming and development;
• Scale up current efforts.

RESOURCES

• Increase donor assistance directed to ICPD implementation;
• Exchange information on what works, so that funds and administrative capacity combine for maximum impact;
• Support governments to make good decisions in an atmosphere of transparency and accountability.