CONFERENCE ON POPULATION AND DEVELOPMENT A. African Regional Conference (APC.3)
149. The above assessment underlines clearly the current situation of African women which in comparison to that of women in other developing regions is rather low in spite of the improvements which have occurred in some aspects of their lives. African Governments have shown recognition of this situation. The "Abuja Declaration on Participatory Development: The Role of Women in Africa in the 1990s" (the outcome of the fourth Regional Conference on the Integration of Women in Development and on the Implementation of the Arusha Strategies for the Advancement of Women in Africa), reflects the emerging consensus that women in the region should participate in the mainstream of development activities and that the mobilization of women for development is not just a question of equity but one of efficiency and therefore vital to the
achievement of economic and demographic goals. This consensus was aiso echoed in the Treaty establishing
the African Economic Community which called on member States to "formulate, harmonize, coordinate and establish appropriate policies and mechanisms for the full development of the African women through the improvement of her social and cultural conditions" (p. 83).150. At the third African Regional Population Conference, held in Dakar, Senegal, in 1992, African
Governments urged that women's rights and needs, particularly in the areas of education, employment and health care should be explicitly reflected in all national development planning.
151. In the Dakar/NGOR Declaration on Population, Family and Sustainable Development which was adopted by the Conference, African Governments for the first time unanimously approved demographic
objectives for the region including reduction in maternal mortality rates by 50 per cent, a one-third reduction of under-5 mortality rates by the year 2000; and lowering the population growth rate from 3 to 2.5 per cent by the year 2000 and 2.0 per cent by 2010. The latter is to be achieved through increases in contraceptive prevalence rates from 10 to 20 per cent by the year 2000 and 40 per cent by 2010. They also agreed to, inter alia:
"(a) Adopt a national policy on improving the role, status and participation of women, taking into account mainstreaming as a means of incorporating women's programmes into all aspects of development and monitor its implementation at the highest government level in accordance with the Abuja Declaration.
Take necessary steps to eliminate discrimination against women, as well as certain traditional and cultural practices and religious extremism which inhibit their effective advancement and participation in development;
(b) Institute and strengthen programmes for reforming the educational system and vocational training with a view to providing basic education to all those at school age with particular emphasis on the education of girls;
(c) Establish programmes and
(i) pass legislation to enhance the legal status of women within the family and the com munity with a view to enabling women to contribute more directly in decision-making, and in the formulation of strategies aimed at upholding family values, pro viding support to family members and contributing to stability in society;
(ii) formulate national policies and initiate measures aimed at ensuring greater participa tion and assumption of responsibilities by men in the maintenance and nurturing of their families and enacting national legislation that will emphasize the complemen tary and equal partnership roles that men and women have to play in development;
(iii) recognize the participation of women in all production sectors particularly in agricul ture and provide for them appropriate technology to reduce their work load and maximize their efficiency and effectiveness and better access to credit facilities and farm inputs with a view to enhancing their economic independence and improving the quality of life".
(d) Ensure the provision of high quality services which will address unwanted and high risk
pregnancies and HJV-AIDS.152. The Dakar/NGOR Declaration also represents the African Governments' consensus on issues relating to the International Conference on Population and Development (ICPD) which took place in Cairo from 5
to 13 September 1994. The ICPD was expected to make a valuable contribution to the goals of the fourthWorld Conference on Women scheduled for September 1995 in Beijing. The ICPD sees the World Con ference on Women and its preparatory activities as extremely important and as a significant opportunity for building on and amplifying the messages of previous conferences including the Vienna Human Rights Con ference (1993) and the World Conference to Review and Appraise the Achievements of the United Nations Decade for Women: Equality, Development and Peace, held in Nairobi in 1985 at which the Nairobi
Forward-looking Strategies for the Advancement of Women were adopted.153. Women's issues have been given prominent attention in all the preparations for the ICPD. Examples
are the six Expert Group meetings which dealt with various substantive issues and the specific Expert Group
Meeting on Population and Women (Botswana, 1992). The latter emphasized that women's advancement,health and family planning are mutually reinforcing and should be pursued simultaneously in a holistic
manner.
154. Another Round-table on Women's Perspectives on Family Planning, Reproductive Health and Repro ductive Rights, focused on women, human rights and reproductive rights; family planning service delivery, contraceptive research, development and introduction; ant! men and family planning. A regional meeting of African women NGOs in Dakar in June 1994 enabled African women to voice their concerns and to make suggestions for the Conference. Thus, the ICPD draft Programme of Action underscores the importance of empowering women and eliminating inequalities between men and women.
B. The Programme of Action for ICPD
155. The Programme of Action for ICPD which wa adopted by consensus during the Conference in September, includes major themes relating to the critical importance of integrating population concerns into all aspects of development; the improvement of the quality of life of all persons throughout their entire life cycle and the urgency of empowering women, eliminating all forms of gender discrimination, informed choice, particularly with regard to reproductive health and family planning. Gender equity and empower ment of women are among the principles upon which the Programme of Action is based and therefore receive major emphasis throughout the Programme of Action. The Third and final Prepcom for the ICPD held in April 19,94 in New York reached universal agreement that gender bias toward women in all forms
should be eliminated.
156. A separate chapter in the Programme of Action is devoted to "gender equality, equity and empower ment of women". Three issues are discussed in this chapter which are also key issues for the World Con ference on Women. These are empowerment of women, the girl child and male responsibilities:
(a) Empowerment of women
157. The single most important theme emerging from the ICPD process is the value of empowering women both as an end in itself, and as a prerequisite for achieving sustainable development. By this chapter, Governments will be called upon to review inequalities between women and men. This is expected to be achieved by establishing mechanisms which promote women's equal participation and equitable representa tion at all levels of the political process and the fulfilment of women's potential through education, skill development and employment. Other measures would include the elimination of poverty, literacy and ill-health, all practices which discriminate against women and violence against women, as well as the adoption of measures which improve women's ability to earn income beyond traditional occupations.
(b) The status of the girl child
158. The Programme of Action calls for her value to both family and society to be expanded beyond tradi tional definitions as potential child-bearer and caretaker through, for example, access to all levels of educa tion as well as vocational and technical training. Gender discrimination in Africa is an important factor in curtailing the access of girl children to rood, education and health care. Public awareness of the value of the girl child needs to be increased and investments are critical in the girl child's health, nutrition and educa
tion from infancy.
(c) Male responsibilities and participation
159. This issue highlights the role that men should play along with women, to bring about gender
equality. Special efforts should be made to emphasize men's shared responsibility and promote their active
involvement in responsible parenthood including family planning, prenatal, maternal and child health; pre
vention of STDs, including HIV/AIDS; prevention of unwanted and high-risk pregnancies; and, shared con
trol and contribution to family income. Programmes to reach boys before they become sexually active are
urgently needed. National, community and religious leaders should promote the full involvement of men
in family life and the full integration of women in community life.
160. A major outcome of the third and final PrepCom for the ICPD was in the area of health, which, along with education and employment, is one of the sub-themes of the Nairobi Forward-looking Strategies and an important theme in the Abuja Declaration. The Programme of Action broadens the concept of family planning by including it as a part of reproductive health care. Reproductive health includes not only family planning information and services, but pre-natal and postpartum care and assisted deliveries. It also includes prevention and treatment of STDs, education and counselling about sexual health and responsible parenthood.
This approach goes well beyond family planning and is not focused merely on demographic targets but instead includes as priorities the health and educational need of individuals, especially women and girls.
161. High rates of maternal mortality and morbidity continue to cause concern in developing regions, especially in Africa. Almost all delegates agreed that in order to effect significant reductions in maternal mortality and morbidity, maternal health services should be expanded, based on informed choice, to include education on safe motherhood, pre-natal care, maternal nutrition, referral services and post-natal care.
IV. UNFPA'S WOMEN, POPULATION AND DEVELOPMENT STRATEGY
AND PROGRAMMES IN AFRICAA. Mandate and strategy
162. The United Nations Population Fund is the largest multilateral provider of population assistance, managing one third of the world's aid for population and family planning programmes in developing coun tries. UNFPA is also an important channel tor bilateral assistance through which donor countries direct additional funds to specific programmes and projects. UNFPA's mandate positions it to address women's issues through its promotion of population and reproductive health including safe motherhood/family planning. The adopted ICPD Programme of Action therefore provides an important framework for the Fund
to broaden its strategic role in the promotion and advocacy of gender concerns.
163. Over the years, UNFPA has exercised strong advocacy for women's concerns. Its support of and involvement in the women, population and development area has been a distinctive feature of the Fund since its inception. 25 years ago. UNFPA sees improving the status oi' women not only as a human rights issue but as necessary because of the reciprocal effect of women's status on demographic variables such as fertility and maternal and child mortality and vice-versa. Since 1975, therefore, the UNFPA Governing Council has endorsed measures taken by UNFPA to address women, population and development issues. The 1975 guidelines on women, population and development (the first by a United Nations organization) and the 1987 Strategy to strengthen the Fund's capacity to deal with issues concerning women, population and develop ment and the 1991 endorsement of this latter strategy, are all testimony of UNFPA's commitment to women,
population and development issues.164. The ultimate objective of UNFPA's Strategy in this area is the total integration of women's concerns into all of its programming ensuring that they participate in and benefit from all stages of policy and pro gramme development and implementation including decision making. UNFPA has adopted two approaches
to achieve this objective, that is:(a) "Mainstreaming" women's concerns in all programme activities which provides women with the opportunity to function as a resource and to work in partnership with men;
(b) Supporting special programmes for women or women-specific programmes which aim at giv ing women opportunities to acquire self-esteem, self-confidence, skills and stature in their communities and
to be involved in decision making.165. Such projects may include education,.training, skill development, or economic activities, as well as
activities aimed at increasing the awareness of policy makers, opinion leaders, media and the general public
of the importance of women's issues in population and development and the strengthening of national institu tions for the coordination of activities and the improvement of women's status. The strategy is based on five main activities:
(a) Revision of UNFPA project and programme procedures and guidelines;
(b) Training of staff at all levels;
(c) Closer coordination of activities with other United Nations agencies;
(d) Identification of experts to provide technical support;
(e) Improving the information system. Under the current strategy, special emphasis is being given to women, population and development training, clarification of current women, population and development guidelines and strengthening linkages with women's NGOs.
B. UNFPA-supported programmes in Africa
166. With the highest population growth rate in the world, persistently high fertility and maternal mortality rates, low economic performance, prevalence of poverty etc. as discussed in section II of this paper, it is not surprising that Africa is a major focus for programme assistance. Of the 58 developing coun tries designated as priority countries by UNFPA, 35 are located in Africa. These countries have, inter alia, an annual population increase of 100,000 or more, a gross reproductive rate of two or more daughters per woman, an infant mortality rate of 120 or more per 1000 live births and a female literacy rate of 40 per cent or less.
167. Since the 1970s, UNFPA has been playing an important role in assisting African governments to formulate and implement population programmes compatible with their socio-cultural and political environ ment. Today, all countries in the region have comprehensive population programmes which also address the needs of African women. The programmes are guided by the U NFPA Strategy tor Assistance to Africa adopted in 1987 and updated in 1994. The objective of the updated Strategy is to continue to assist countries to foster and institutionalize population policies and programmes within their broader development frame work, to take advantage of the upsurge of government awareness of population issues (as demonstrated at APC.3) and to translate changing attitudes into increased family planning practice and growing participation in other population programmes. This is to be achieved through, inter alia, the intensification of population information, education and communication (IEC) programmes to encourage attitudinal change and improve reproductive health services including family planning as well as to support specific activities to improve the status of women.
168. UNFPA increased its support tor population activities steadily and significantly from 1986 (the year before the adoption of the Africa Strategy) and total expenditures (UNFPA regular and multibilateral resources combined) rose from $US 22.0 million to about $56.8 million in 1990. The percentage of increase in "special programmes", the bulk of which are for projects addressing the special needs of women, was even dramatic - expanding by some nine times the amount in 1986.
169. Reproductive health/family planning: Women's reproductive health and rights are a central con cern in the area of WPD since without reproductive freedom, women cannot exercise fully their other rights such as those relating to education and employment. Women's health and status are inseparable and the key to their full participation in all aspects of reproductive life are free and informed choice and mutual respect.
Within this context, reproductive health/family planning is the largest single area supported by UNFPA absorbing half of its funding. The emphasis is on providing integrated MCH/FP services, improving their quality in order to reduce infant and early childhood mortality, maternal morbidity and mortality and the
high rates of fertility in accordance with the principles of the UNFPA Africa Strategy. To this end, UNFPA has been supporting at least one MCH/FP project in each African country. In these projects-, training is pro vided to improve the technical competence of service providers both in the formal and non-formal sectors.
170. In addition, UNFPA supports operational research to improve quality and delivery ot:services. Birth spacing, family planning counselling, ante-natal, post-natal care and prevention of high-risk pregnancies are now provided in at least some parts of the health infrastructure in almost all countries. This reflects the growing public and private recognition of the negative effects of unregulated fertility on the health and chances of survival of the mother and child. In no country in the region is the Government any longer imposing limitations on the population's access to modern contraceptives, even in the fact of unfavourable laws. UNFPA thus advocates the cafeteria approach and provides a method mix that meets the specific needs of individual users and provides them with a choice.
171. Although there has been a significant growth in the network of MCH/FP services in about 90 per cent of African countries, utilization of these services varies from a low of 10 per cent (of population with easy access) in some countries to a high of 85-90 per cent in Botswana and Zimbabwe. The low utilization in some countries may be due to lack of awareness and information and to cultural resistance. Secondly, the improvements that have occurred have not yet produced significant declines in birth rates of notable
increases in contraceptive prevalence rate in the region as a whole. MCH/FP programmes are beginning
to develop strategies in countries such as Mali, Cameroon and the Gambia to promote male involvement in view of their important role in decision making and the influence that they have on their partners' decisions on whether to use family planning. Partnership, mutual respect and responsibility are necessary for the attainment of the goals of the Dakar/Ngor Declaration.172. In the broader context of reproductive health/FP, UNFPA-assisted programmes have been addressing the issue of H1V-AIDS because of their importance as puhlic health issues and their rapid spread in the African region, especially among women. Efforts are also being made in Central African countries to pro vide education and counselling to prevent STDs and associated infertility.
173. Important activities in the effort to combat AIDS include specialized training for staff, counselling in AIDS prevention and the provision of condoms. In addition, IEC activities in many African countries have been designed with UNFPA's support, to create awareness of these issues and prevent their spread.
174. Given the fact that the lack of information and awareness remain serious barriers to changes in atti
tudes and fertility behaviour, UNFPA has been supporting over 80 IEC projects in a variety of formal and
non-formal settings, including the workplace. Most countries in Africa have begun, at least, on a pilot basis,
to include some population and family life education in their formal school curricula. The content of popula174. Given the fact that the lack of information and awareness remain serious barriers to changes in atti