Review of Progress on the Implementation of the ICPD Programme of Action @ 25 years
Table of Contents 1. Methods and approach 2. A Diverse World 3. Dignity and Human Rights 4. Sexual and Reproductive Health 5. Mobility and Displacement 6. Sustainability and Climate Change 7. The ICPD and the SDGs 2
The Global Review Methods and approach Data drawn from UNFPA ICPD Global Monitoring Framework Systematic review of trend data since 1994 across ICPD pillars Cross-referenced with the SDG indicator framework Sustainability Health Dignity & Human Rights Governance & Accountability Place & Mobility 3
Inputs to the Global Review Findings from ICPD Regional Reviews, led by Regional Economic Commissions & UNFPA, (based on 2013 Regional Outcomes) Source: UNECE, 2017 4
1. Methods and approach 2. A Diverse World 3. Dignity and Human Rights 4. Sexual and Reproductive Health 5. Mobility and Displacement 6. Sustainability and Climate Change 7. The ICPD and the SDGs
Diversity of age structure Asia Africa Europe Latin America and the Caribbean Source: United Nations Population Division, World Population Prospects: 2017 Division 6
More Adolescents in the poorest countries LIC/LMICs account for proportionately more adolescents (61%) than total world population (50%) 100 11 16 Percent 80 60 40 28 48 35 41 20 0 13 9 % of world adolescent population % of total world population LICs LMICs UMICs HICs
1. Methods and approach 2. A Diverse World 3. Dignity and Human Rights 4. Sexual and Reproductive Health 5. Mobility and Displacement 6. Sustainability and Climate Change 7. The ICPD and the SDGs
More Girls at Risk of Child Marriage = In 1994, 10 million girls got married before age 18 = In 2019, 10.3 million girls will marry before age 18 Despite the decline in percentage from 33.7% to 25.3%. Source: SDG 2017 report; UNFPA 2018
More girls will undergo FGM = In 1994, 3.6 million girls age 15-19 underwent FGM = In 2019, 3.8 million girls age 15-19 will have undergone FGM Despite a decline in percentage from 49.4% to 31.3% Source: SDG 2017 report; UNFPA 2018
Nr of countries that legally ban FGM Countries banning FGM in 1994 Countries banning FGM in 2007 Countries banning FGM today* Source: in Sudan a law has been implemented in two states: South Kordofan and Gedaref 11
Women's empowerment Mixed gains in other sectors Estimates show that still approximately one-third of women experience some form of violence in their lives, predominantly by intimate partners. There have been few gains since 1994 in women s participation in the labour market, in salary differentials for equal work, lifetime earnings, or professional leadership. Over the past 20 years, the number of women members of parliaments has increased roughly two-fold, nevertheless only reached 24% worldwide in 2018. 12
What works? Inclusion of grassroot movements, to assure success is achieved through discussion and consensus; Public declaration ceremony, Guinea. UNICEF, How to transform a social norm Implementation of school-based programs combatting stereotypes and promoting understanding of gender-roles and inequality; Reform of legislative, judicial and policy systems to enforce accountability; Shared political power to increases acceptance of women leaders and higher aspirations for girls. UNFPA/Ben Manser 13
Gross enrollment ratio in secondary school 120 Gross enrollment 100 80 60 40 20 0 1994 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 In Latin America and the Caribbean proportionately more females enroll in secondary school While in Sub- Saharan Africa proportionately more males enroll Africa (Sub-Saharan) female Latin America and the Caribbean female Oceania female Northern America and Europe female Africa (Sub-Saharan) Male Latin America and the Caribbean Male Oceania Male Northern America and Europe Male 14
Literacy among 65+ men & women 1994-2016 Regional disparities, but steady increase At global level, sex differential has not decreased since 1994 Source: UNESCO Institute for Statistics
What works? Investments in formal education, but also in lifelong opportunities for vocational training; A revolution in quality standards as emphasised in Agenda 2030; To increase participation, provision of cash transfers and access to credit for the poor, low-cost private schools, and school feeding. UNFPA / Alvaro Serrano 16
Unemployment vs. Poverty Youth unemployment 2018 Percentage of population 15-24 Working poverty among young people 2018 Percentage of population 15-24 Source: ILO, ILOSTAT, 2018 17
Working poverty 2000-2019 Source: ILO, ILOSTAT, 2018 18
Unemployment 1994-2019 Global unemployment rate, by age and sex Women 15-24 Men 15-24 Women 25+ Men 25+ Globally, no progress in youth unemployment rates Persistently higher unemployment rates among youth compared to adults Source: ILO, ILOSTAT, 2018 Persistently higher unemployment rates among women compared to men 19
Older Persons Receiving Retirement or Pension Income Latin America 83.8% MEN 75% MEN 26.4% ADULTS 65% MEN 16% ADULTS 62% WOMEN 19% WOMEN 25% WOMEN URUGUAY BRAZIL MEXICO COLOMBIA BOLIVIA 3 - UNFPA, 2017. UNA MIRADA SOBRE EL ENVEJECIMIENTO: DONDE ESTÁN VARIOS PAÍSES LATINOAMERICANOS A 15 AÑOS DEL PLAN DE ACCIÓN INTERNACIONAL DE MADRID.
What works? Young people: Where formal jobs are scarce, subsidized employment coupled with investments in skills improved long-term prospects. Women: Education across the lifecourse, financial and political inclusion of women, legal protection and gender balance in unpaid work improve women's economic empowerment. UNFPA / Alvaro Serrano 21
1. Methods and approach 2. A Diverse World 3. Dignity and Human Rights 4. Sexual and Reproductive Health 5. Mobility and Displacement 6. Sustainability and Climate Change 7. The ICPD and the SDGs
Rising Use of Family Planning
At ICPD+25, more women will need FP Despite a decline in percent of women with unmet need for FP from 13.8% to 11.5% Number of married women with unmet need (in million) 150 140 130 120 110 13.8% 132 Million 143 Million 11.5% 16 14 12 10 8 6 4 2 Unmet need for contraception, % 100 1994 2019 0 Source: UNPD 2017, UNFPA 2018
Access to multiple methods of FP Impact of adding new contraceptive methods on the number of users, selected countries, 1965-1973 Korea Hong Kong 800 40 700 35 600 30 New users, in Thousands 500 400 300 200 100 0 1965 1966 1967 1968 1969 1970 1971 1972 1973 Sterilization Condom Foam IUD Pill New users, in Thousands 25 20 15 10 5 0 1965 1966 1967 1968 1969 1970 1971 1972 1973 IUD Pill Other Thailand New users, in Thousands 500 450 400 350 300 250 200 150 100 50 0 1965 1966 1967 1968 1969 1970 1971 1972 1973 Steralization IUD Pill 25
Access to multiple methods of FP Ethiopia, 2014 India, 2015-16 Source: PMA, 2014 Source: DHS 2015-16 Female sterilization Injectable Implant Any traditional method Male Condom Pill IUD Male sterilization 26
Unintended pregnancy rates Decline in the global annual rate of abortions Increase in absolute number of women resorting to abortion from under 20 million to over 25 million 27
What works? Multiple modern methods of contraception, and quality care. For youth, integration of health care within other non-health youth interventions are more successful than stand-alone health services. UNFPA / Priscilla Mora 28
Legal barriers to SRH for Adolescents
Declining Maternal Mortality Maternal Mortality Ratio 1200 1000 955 Central and Southern Asia Deaths per 100,000 live births 800 600 400 200 462 196 555 216 Eastern and South-Eastern Asia Europe and Northern America Latin America and the Caribbean Northern Africa and Western Asia Oceania Sub-Saharan Africa World 82 0
Mortality rates for Reproductive Health Cancers (age standardized) 1994-2016 100 90 80 Breast Cancer, women Prostate Cancer 45 88.3 88.1 40 35 70 60 50 52.1 53.0 45.6 40 43.5 39.7 30 30.3 32.6 23.2 24.6 20 22.7 10 16.9 0 1994 1999 2004 2009 2014 30 25 20 15 10 40.1 36.5 33.3 31.3 28.7 28.0 25.2 21.0 17.2 16.3 14.9 11.6 11.8 7.3 7.5 7.4 5 0 1994 1997 2000 2003 2006 2009 2012 2015 5.8 6.5 6.7 Central Europe, Eastern Europe, and Central Asia High-income North Africa and Middle East Southeast Asia, East Asia, and Oceania Global Latin America and Caribbean South Asia Sub-Saharan Africa
What works? Quality care at birth averts up to 40 percent of maternal and neonatal deaths; Skilled attendance has progressed, but EmOC far less. Prevention of reproductive cancer mortality is possible in much of the rich world, but needs to be rolled out globally.. And to avoid fragmentation, it is time to redouble efforts on universal access to SRH UNFPA / Micka Perier 32
What works? comprehensive sexuality education (CSE) post-abortion care; safe abortions as allowed by law treatment for GBV Comprehensive SRH package STI screening & treatment, incl ART reproductive cancer screening & treatment infertility diagnostics and assisted reproduction Critical to advance in Universal Health Coverage 33
1. Methods and approach 2. A Diverse World 3. Dignity and Human Rights 4. Sexual and Reproductive Health 5. Mobility and Displacement 6. Sustainability and Climate Change 7. The ICPD and the SDGs
Human Mobility Migrant population vs host population - Global 12 PERCENT 10 8 6 4 Host population Migrant Population 3.3% global population Median age: 39 years 2 0 15% of international Migrant population vs host population - Africa PERCENT 16 Host population 12 8 Migrant Population 4 migrants < 20 years 34% in SSA <20 years 48% female and rising 0 UN Population Division: International Migrant Stock and World Population Prospects, 2017 35
Displacement Number of forcibly displaced persons MILLIONS 80 70 60 68.5 million 50 40 30 20 10 0 1951 1957 1963 1969 1975 1981 1987 1993 1999 2005 2011 2017 UNHCR, Global Trends Report, 2018, https://www.unhcr.org/ph/figures-at-aglance, includes IDPs, others of concern, refugees, including refugee like situations, returnees (IDPs and refuges) and stateless persons 36
What works? Prioritize documentation to provide access to services; Provide accessible, language-friendly, safe spaces within transit locations; UHC for migrants; Provide social services for mobile and native populations alike, regardless of status, to both promote integration and reduce discrimination. UNPFA/Aral Kalk 37
1. Methods and approach 2. A Diverse World 3. Dignity and Human Rights 4. Sexual and Reproductive Health 5. Mobility and Displacement 6. Sustainability and Climate Change 7. The ICPD and the SDGs
Population and Climate Change 8 Fertility and per capita emissions Total Fertility Rate, 2015-2020 7 6 5 4 3 2 1 High income High middle income Low middle income Low income 0 0 5 10 15 20 25 30 35 40 Per Capita Emissions, 2014 World Population Prospects, 2017 revision; World Bank Open Data 39
What works? Respect for reproductive rights, women s empowerment, and better health and education offer the most effective means to promote smaller families; Development also helps people develop the knowledge & skills to address climate change. Irrespective of population growth, patterns of consumption and emissions must be urgently addressed. Helen Volk (sxc.hu) 40
1. Methods and approach 2. A Diverse World 3. Dignity and Human Rights 4. Sexual and Reproductive Health 5. Mobility and Displacement 6. Sustainability and Climate Change 7. The ICPD and the SDGs
Re-proving Rights & Choice Matter 1. FP choice & service quality is a win-win for coverage [SDG 3]. 2. Addressing education/decent work and SRH together show gender dividends - and we must advance response(s) for ageing populations [SDGs 1/4/5/8]. 3. Getting to zero on FGM/Child marriage will demand increased efforts [SDG 5] 4. As essential SRH package [SDG 3] should address needs of young & old alike, and should be part of UHC in all contexts. 5. Accountability matters and state-of-the-art evidence is crucial [SDG 17].