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Country Profiles for Population and
Reproductive Health
"Country Profiles for Population and Reproductive
Health: Policy Development and Indicators 2005" covers the areas of
socioeconomic health, adolescent reproductive health, gender
equality and reproductive health commodity security. Indicators for
ICPD Goals as well as MDGs are identified by special symbols.
Information is also given on differences within countries between
urban and rural areas, best performing and worst performing
administrative regions, by education, and different income groups,
where available.
In 1994, the International Conference on
Population and Development (ICPD) approved a 20-year Programme of
Action, later endorsed by the United Nations General Assembly, that
reflects the international consensus on a comprehensive set of
targets, goals and recommendations aimed at fostering sustainable
development, poverty reduction and women's empowerment, improving
health (including reproductive health) and the quality of life of
the world's people, and creating a better balance between population
dynamics and social and economic development.
Encouragingly, 2004 and 2005 have seen ringing
endorsements and recommitments by the United Nations, regional
organizations, national governments, parliamentarians and civil
society organizations around the world to strive to continue to
implement the Programme of Action and to guarantee sexual and
reproductive health rights of all women as agreed to by consensus at
ICPD and again in the Platform for Action adopted in 1995 at the
Fourth World Conference on Women in Beijing.
In 2000 representatives of 189 nations, including
147 heads of state or government gathered at the United Nations for
a historic Millennium Summit. They adopted an ambitious set of
Millennium Goals (MDGs). Achieving them by the target date of 2015
would transform the lives of billions of the world's people. Their
achievement would reduce by half the number of people living in
extreme poverty, promote gender equality, improve maternal health
and combat HIV/AIDS. The consensus of 179 nations at the ICPD not
only helped lay the foundation for the Millennium Development Goals,
but also meshes seamlessly with them. Indeed as the United Nations
Secretary-General, Kofi Annan has said "The Millennium Development
Goals, particularly the eradication of extreme poverty and hunger,
cannot be achieved if questions of population and reproductive
health are not squarely addressed. And that means stronger efforts
to promote women's rights, greater investment in education and
health, including reproductive health and family planning."
In 2003 UNFPA and the Population Reference Bureau
(PRB) published "Country Profiles for Population and Reproductive
Health: Policy Developments and Indicators" along with a companion
CDROM containing the complete contents of the printed report as well
as search and comparison capabilities. All of the information and
country statistics and indicators in the report were also placed on
the web sites of UNFPA (www.unfpa.org/profile) and
PRB (www.prb.org).
The current publication is an updated, expanded
version of the 2003 volume. The report's indicators cover the areas
of socioeconomic health, adolescent reproductive health, gender
equality and reproductive health commodity security. Indicators for
ICPD Goals as well as MDGs are identified by special symbols.
Information is also given on differences within countries between
urban and rural areas, best performing and worst performing
administrative regions, by education, and different income groups,
where available. In the web version indicators can be compared for
up to five countries.
Attention is also given to the "public
expenditures on health and education" for each country.
Country Profiles for Population and Reproductive
Health will be published every two years with updated policy
descriptions and indicators.
UNFPA and PRB hope you will find these materials
of value in your policy-making, advocacy and resource mobilization
efforts.
This section outlines the objectives of the
country's formal population policy (if any), or of
population-related components of its general development policies.
Particular attention is placed on the poverty, inequality, gender,
HIV/AIDS, and ICPD Programme of Action and MDG-related activities
and progress. Actions and other measures currently taken to
implement these policies are also highlighted to illustrate the
government's political will and priorities. These descriptions are
based on various sources, including the biennial Population Policy
Inquiries of the United Nations Population Division and the annual
reports on country programme progress submitted to UNFPA. Each of
the major subregions is introduced with an overview of common key
issues.
Population Reference Bureau staff and consultants,
with input from UNFPA, researched and drafted population policy and
regional overviews.
A draft of each country policy overview was sent
to the respective UNFPA Representatives and Country Directors for
comments and information. The insights and information provided by
the UNFPA Representatives, Country Directors and Geographic
Divisions helped to improve the content of the profiles. 1
These tables summarize the major indicators of the
country's demographic and social situation based on the most recent
information available. Data from the 1990s are also presented to
facilitate trend analysis and monitoring of development goals. They
are presented in blocks of indicators related to population,
socio-economic and health conditions, adolescent reproductive
health, gender equality, reproductive health commodity security
needs and internal disparities. Indicators used for MDG and ICPD
Programme of Action monitoring are highlighted.
A graph of key indicators related to the MDGs and
the ICPD Programme of Action goals are presented for each
country.
The database is collated and maintained by the
Population Reference Bureau staff.
The ICPD Programme of Action contained global
estimates of resource requirements for the implementation of
national population and reproductive health programmes through the
year 2015. These estimates are described in paragraphs 13.15, 13.16
and 14.11 as follows:
It has been estimated that, in developing
countries and countries with economies in transition, the
implementation of programmes in the area of reproductive health,
including those related to family planning, maternal health and
the prevention of sexually transmitted diseases, as well as other
basic actions for collecting and analysing population data, will
cost $17.0 billion in 2000, $18.5 billion in 2005, $20.5 billion
in 2010 and $21.7 billion in 2015.
It is tentatively estimated that up to two
thirds of the costs will continue to be met by the countries
themselves and about one third from external sources. However, the
least developed countries and other low-income developing
countries will require a greater share of external resources on a
concessional and grant basis. Thus, there will be considerable
variation in needs for external resources for population
programmes between and within regions.
Given the magnitude of the financial resource
needs for national population and development programmes, and
assuming that recipient countries will be able to generate
sufficient increases in domestically generated resources, the need
for complementary resource flows from donor countries would be in
the order of (in 1993 US dollars) $5.7 billion in 2000, $6.1
billion in 2005, $6.8 billion in 2010 and $7.2 billion in
2015.
The financial targets of the ICPD Programme of
Action were fixed over 10 years ago, with cost estimates based on
experiences as of 1993. It provided resource estimates for a
delimited package of interventions largely to be delivered through
primary health care outlets. At the same time the ICPD recognized
that there were additional programmes needed (for example, for a
broader range of HIV/AIDS prevention and additional treatment and
care interventions, for referral systems and general health system
strengthening and for tertiary level services for safe motherhood)
that would require significant added investments.
Since that time, the population and health
situation in the world has changed dramatically. The HIV/AIDS crisis
is far worse than anticipated, maternal mortality and morbidity
remains unacceptably high in many parts of the world. In addition,
since that time, health costs have skyrocketed and health systems
have deteriorated. Furthermore, the value of the dollar in 2005 is
far lower than it was in 1993.
Although the financial targets of the ICPD
Programme of Action for 2000 were not met, it is encouraging to note
that both international donor assistance and domestic expenditures
for population activities have increased since then. Thus donor
assistance for population, which stood at $2.6 billion in 2000, was
estimated at $4.2 billion in 2003, up from $3.2 billion in 2002.
Domestic expenditures, which hovered between $7 and $9 billion
during 2000-2002, were estimated at almost $11 billion in 2003. But
this progress has been made against escalating needs.
To reach the 2005 target of $18.5 billion, all
parties would have to mobilize additional resources. Estimates for
2004 and 2005 are encouraging. Donor assistance is estimated to have
increased to $4.5 billion in 2004 and projected to increase to
almost $6.4 billion in 2005 with resources mobilized by developing
countries totaling $12.5 billion in 2004 and $12.7 billion in
2005.
The largest share of funding is currently going to
HIV/AIDS-related activities (up from 9 per cent of population
assistance in 1995 to over one half in 2005). However, the increased
resources are still not adequately addressing the growing AIDS
pandemic. In particular, comprehensive prevention strategies need
added support. Interventions in prevention, treatment and care are
supported selectively by various donors and in national efforts and
coordination is weak. Vertical programming and funding poses a
threat to needed improvements in integrated health system capacity.
In addition, funding for family planning and reproductive health
services - at a time of great unmet need for such services and
unacceptably high levels of maternal mortality - has been lagging
far behind and must be increased substantially to meet the pressing
needs in these areas.
As noted by UNFPA in its latest flow of financial
resources report to the Commission on Population and Development, "
the substantial increase in funding for AIDS clearly demonstrates
that further resources can still be mustered and that, given the
political will to do so, they can be made available for the other
critical components of the costed population package of the
International Conference of Population and Development, especially
family planning and reproductive health." Mobilizing the financial,
personal and institutional investments for the costed package as
part of an integrated approach to universal access to basic health
care remains a critical challenge for development and poverty
reduction.
A glossary has
been provided that explains common abbreviations used to refer to
programmatic efforts in population and reproductive health.
Technical notes provide information regarding the
data sources for key indicators. These notes also provide guidance
to the interpretation of the statistics. In general, United Nations
sourced data have been used, supplemented, as necessary, by
additional standard data sources. Information on social and
political contexts and policy priorities have been obtained from
UNFPA country offices and standard United Nations reports.
Information on disparities within countries is derived from reports
of Demographic and Health Surveys, special tabulations of the World
Bank and related sources. Details are provided in the Technical Notes
section.
Maps of eight
MDG-related monitoring indicators have been added to this volume.
Indicators include: per cent of population living on less than $1
per day, ratio of girls' to boys' primary education, per cent of
seats in parliament held by women, under-five mortality rate,
maternal mortality ratio, HIV prevalence among those 15-24, per cent
of population with access to improved water supply, and country debt
levels as a per cent of gross domestic product. Only data for
countries included in the Country Profiles are displayed in the
maps. Maps are created on the 1:15,000,000 scale.
1 Most of the
policy overviews were produced and cleared during late 2004-early
2005. Some recent developments may not be reflected in the policy
descriptions.
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