How the ICPD Programme of Action supports the MDGs

Development is a multi-dimensional process. Changes in one area reinforce changes in other areas. Reproductive health, which affects many aspects of social and economic life, is known to be a particularly powerful lever for improving lives. Better reproductive health often results in smaller, healthier families, with ripple effects at the community, national and regional levels.

As former UN Secretary-General Kofi Annan has noted, "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, and greater investment in education and health, including reproductive health and family planning."

The work of UNFPA is directly related to five of the MDGs, and indirectly UNFPA plays a role in assisting countries to meet all eight goals. UNFPA's work is directly related to the goals dealing with poverty reduction; gender equality and the empowerment of women; child mortality; maternal health, including reproductive health; and HIV/AIDS.

There is now consensus that advancing women's rights, in general, and reproductive rights, in particular, is a necessary precondition for halving the number of people living in poverty and underpins success in achieving all the other goals. The United Nations Millennium Project, which was commissioned by the UN Secretary-General, brought together more than 250 experts from around the world to identify best practices and to plot the way forward for meeting the MDGs. Their final synthesis report, Investing in Development, and their series of specialized task force reports as well as a special report, reaffirmed the centrality of promoting universal access to reproductive health in meeting the MDGs.

Many of these linkages to the mission and mandate of UNFPA are summarized here:

MDG 1: Eradicate extreme poverty and hunger

Universal access to reproductive health is imperative to reduce poverty as it increases the possibility of higher investment in human development, sustainable livelihoods and food security. Reproductive health problems disproportionately affect women and the poor, and they can impoverish struggling families. When women have access to reproductive health, including family planning services, they typically have smaller, healthier families and are better able to maintain their own and their families' health.

Investments in the economic rights of women — equal employment opportunities and wages, access to credit and agricultural resources, inheritance and property rights — increase productivity, and family well-being. Women's control over household resources leads to higher investments in children's health, nutrition and education. Also, increased income-earning opportunities offer young women alternatives to early marriage.

Many of the poorest countries are those in or emerging from conflict. Investing in women and young people during the rebuilding of societies and economies can reduce poverty and lead to lasting peace and stability.

With half the world's population under 25 years, investments in adolescents and youth, including education and training, reproductive health and personal safety, are critical for reducing poverty. Targetted investments in this group's productive and reproductive options are crucial to promoting young people's right to a better, healthier life and to achieve the MDGs.

Full and productive employment and decent work for all, including youth and women — one of the goal's targets — coupled with appropriate socio-economic policies can enhance savings, productivity and living standards.

Universal access to family planning can have an impact on the demographic transition of poor countries. Increased educational and employment opportunities during the time of a demographic transition can help countries realize a 'demographic bonus' from large cohorts of young people relative to those who are too young or too old to work, accelerating economic development.

Rapid population growth, on the other hand, can offset economic gains, strain food and water supplies and exacerbate environmental degradation.

MDG 2: Achieve universal primary education

Allowing children to go to school is a crucial factor for poverty reduction and human development. Schooling promotes financial and social opportunities throughout adolescence and adulthood, and reduces the number of children in child labour.

However, gender biases keep many girls out of school, often to help mothers care for siblings, manage household needs or collect water and firewood. For many families, the priority is educating boys.

When mothers are educated and families are smaller, the likelihood that all children will go to school increases. Thus, a woman's education has intergenerational ripple effects. Also, families with fewer children, and children spaced further apart, can afford to invest more in each child's education. This has a special benefit for girls, whose education may have a lower priority for families than that of boys. Preventing early pregnancy can help keep adolescent girls in school who may otherwise be forced to leave.

Achieving universal primary education for all boys and girls by 2015, can be supported through the empowerment of women, training teachers to be gender sensitive, promoting the value of educating girls, making schools safe, postponing early marriage and childbearing, allowing pregnant teens to continue studying and return to school after delivery, offering scholarships or stipends, and providing universal access to reproductive health.

MDG 3: Promote gender equality and empower women

Women's empowerment is an engine of development. Equal political, economic, social and cultural rights can help unleash the productivity of women.

Women's ability to decide freely the number and timing of children is key to their empowerment and expanded opportunities for work, education and social participation.

Men play a pivotal role in achieving gender equality, poverty reduction and development goals, including improved infant and maternal health and reduced HIV transmission and gender-based violence.

Violence against women and girls results in high social and economic costs — to individuals, families and public budgets.

Eliminating child marriage, enabling adolescent girls to delay pregnancy, ending discrimination against pregnant girls, and providing support to young mothers can help ensure that girls complete their education. Educated mothers can improve prospects for the whole family, thus helping to break the cycle of intergenerational poverty.

Girls' secondary education provides high payoffs for poverty reduction, gender equality, labour force participation and reproductive health, including HIV prevention and women's and children's health and education status overall.

MDG 4: Reduce child mortality

The healthier the mother, the healthier her children are likely to be. The death of a mother increases the risk that her children will die. Therefore, a continuum of care through pregnancy and early childhood can reduce infant and under-five deaths.

Family planning prevents unintended pregnancies. Unwanted children are more prone to illness and premature death. Family planning can also promote birth spacing, which increases a child's chances of surviving the first years of life. Also, where resources are limited, children in large families may be deprived of nutrition, medical care and attention.

Screening pregnant women for HIV and other sexually transmitted infections and providing them with the appropriate medicine and treatment can prevent infant illness, disability and death.

Empowering adolescent girls to delay pregnancy can prevent many newborn deaths. Babies born to adolescents face much higher mortality rates compared to women who have reached physical maturity.

MDG 5: Improve maternal health

For women in the reproductive age (15-49 years), reproductive health problems constitute the leading cause of ill health and death. And because women are often the backbones of their families, these problems can affect the well-being of the whole family.

Universal access to family planning; access to pre- and antenatal care; skilled attendance at all births; and timely emergency obstetric care when complications arise can prevent almost all maternal mortality and greatly reduce injuries of childbearing.

Access to family planning alone can reduce unwanted pregnancies, unsafe abortion and maternal death and disability, saving women's lives and the lives of their children. Access to family planning can also allow women to better space their births, which increases the mother's chances of surviving childbirth.

Elimination of child marriage reduces the risks associated with too-early childbearing. Very young women face significant health risks associated with pregnancy and childbirth.

Maternal health care can also be an important entry point to other health services. A 'continuum of care' approach to the full range of reproductive, maternal, newborn and child health concerns can ensure better health overall and more effective integration of services.

MDG 6: Combat HIV/AIDS, malaria and other diseases

Universal access to reproductive health is critical in the fight against HIV/AIDS. Access to HIV/AIDS information and services can prevent transmission of HIV and other sexually transmitted infections.

Half of new HIV infections are among young people, who are a top priority for UNFPA. Gender discrimination fuels the AIDS epidemic, placing adolescent girls and women at risk, including within marriage.

Harmful traditional practices, such as child marriage and female genital mutilation/cutting may leave girls more vulnerable to HIV. Also, gender-based violence increases women's risk of acquiring HIV.

Preventing infection means enabling people to protect themselves from sexually transmitted diseases through access to reproductive health information, education and services and the development of life skills.

Women living with HIV should have access to family planning to prevent unwanted pregnancies. Also, they should receive appropriate information and treatment during pregnancy and birth to reduce the risk of mother-to-child transmission.

MDG 7: Ensure environmental sustainability

Investments in clean water, sanitation, time-saving technologies and skills training can improve sustainable resource management, food security, nutrition and health. It can also reduce the time spent on collecting water and firewood, releasing girls and women for educational and other productive activities.

The prevention of unwanted births through family planning can help stabilize rural areas, slow urbanization and environmental pressures, and ease demands on public services, thereby balancing natural resource use with the needs of the population. Improving access access to education and reproductive health services, including family planning, can mitigate negative effects on the environment by promoting sustainable rural population growth; increasing knowledge on sustainable development; and by stabilizing urban migration.

Urbanization affords both opportunities and challenges in the environmental arena. The sustainable improvement of the lives of slum and shanty dwellers will depend on proactive policies, informed by an analysis of population trends, that can harness the potential of cities to provide opportunities and improve lives.

MDG 8: Develop a global partnership for development

UNFPA works with many partners to promote sustainable development, reproductive health and gender equality. It also mobilizes support for the ICPD Programme of Action, which is fully aligned with the MDGs.

A global partnership is critical to securing adequate supplies of essential reproductive health drugs and commodities for poor countries — including contraceptives, equipment to promote maternal health; and testing kits and treatment for HIV and other sexually transmitted infections. A global partnership is also crucial to strengthen health systems including building capacity of doctors, nurses and midwifes; and building up management systems.

Population and reproductive health programmes have lagged in the least-developed countries, especially those with high levels of mortality and unwanted fertility. These countries will benefit most from higher international assistance and debt relief, as well as domestic resources for health and education. They need universal access to reproductive health coupled with affordable prices for essential drugs and a secure supply of contraceptives and other reproductive health commodities.

The cost of meeting the Goals is approximately half of one percent of the GNP of the industrialized nations — less, in fact, than the 0.7 percent that the wealthy nations have already promised to contribute to the world's poor.