Population and reproductive health

Since the human race began, women have delivered for society. It is time now for the world to deliver for women.
Ann M. Starrs, executive vice president of Family Care International.

We now know that voluntary family planning has been very effective. Over the last 30 years, the percentage of couples in developing countries using family planning has increased from 10 per cent to 55 per cent. Access to family planning, coupled to economic development, has caused a marked decline in developing world fertility, from an average of six children per woman of reproductive age in 1960 to 3 today.

Mother and newly-born child, Ghana
� Nancy Durrell McKenna

• One in four pregnancies in developing countries is unwanted and many more are unplanned;
  
• Every year, 50 million women have abortions to end unwanted pregnancies;
  
• Over 10 per cent of all births worldwide are to adolescent girls.
  
• Nearly 600,000 women die in pregnancy or childbirth yearly, greatly increasing the risk that their children under five will die as well.
  
• Over 2 million girls are subjected to female genital mutilation every year.
  
• Over 300 million people contract new sexually transmitted infections every year.
  
• Over 5 million people become infected with HIV every year.
  
• About 200,000 maternal deaths each year result from the lack or failure of contraceptive services.
  

HIV/AIDS, which is almost exclusively spread by heterosexual intercourse in the developing world, is one of the biggest challenges in the field of sexual and reproductive health, especially in sub-Saharan Africa.

The Cairo Conference also tackled three areas which previous international meetings had avoided or glossed over:

• Unsafe abortion;
  
• Violence against women, and in particular female genital mutilation; and
  
• Adolescent sexual and reproductive health - sexuality education and reproductive health services.
  

Adolescent sexual and reproductive health is perhaps the most urgent task for the international community. There are now more than one billion adolescents aged 10-19 in the world -and 85 per cent of them live in developing countries. These teenagers are tomorrow's parents. Their decisions about when to have children will have dramatic implications for their own well-being and for that of the planet. The outcome also depends on the quality of reproductive health services they receive. Better services could prevent millions of deaths among mothers and children; prevent hundreds of millions of abortions; and lead to lower overall population growth.

The great achievement of the Cairo Conference was that the international community recognised for the first time what many had argued for years:

• Coercion and demographic targets have no place in family planning programmes;
  
• There is a sufficiently high level of unwanted childbearing in most developing countries that voluntary family planning programmes can readily attract contraceptive users and lead to significantly reduced fertility levels;
  
• Other reproductive health services, such as diagnosis and treatment of sexually transmitted infections STIs and infertility, should be provided alongside contraceptive services;
  
• Unsafe abortion is a major public health issue, best prevented by providing safe and effective contraception.

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