ICPD/15 International Conference on Population and Development
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ICPD/15 International Conference on Population and Development Africa Regional Review Report ICPD and the MDGs: Working as One Fifteen-Year Review of the Implementation of the ICPD PoA in Africa – ICPD at 15 (1994 – 2009) MAIN REPORT United Nations Economic United Nations Population Fund African Union Commission Commission for Africa United Nations Economic Commission for Africa United Nations Population Fund African Union Commission Africa Regional Review Report ICPD and the MDGs: Working as One Fifteen-Year Review of the Implementation of the ICPD PoA in Africa – ICPD at 15 (1994 – 2009) MAIN REPORT ECA/ACGS/HSD/ICPD/RP/2009 ECA Addis Ababa October 2009 Table of contents Acronyms and abbreviations ..............................................................................v Foreword ..............................................................................................................vii Acknowledgements .............................................................................................ix Executive Summary ............................................................................................1 Part 1 Review Process ......................................................................................37 Part 2 Review Results .......................................................................................47 Section 1 Poverty, Population, Environment and Sustainable Development ..................49 Section 2 Gender Equality, Equity, and Empowerment of Women ...................................65 Section 3 The Family, its role, rights, composition and structure .....................................79 Section 4 Children and Youth ...................................................................................................85 Section 5 Reproductive Rights and Reproductive Health ..................................................97 Section 6 HIV/AIDS, Malaria, Tuberculosis and other Communicable Diseases ...........119 Section 7 Population Distribution, Urbanization and Internal Migration .......................131 Section 8 International Migration ............................................................................................143 Section 9 Crisis Situation and Emergency Preparedness ...................................................149 Section 10 Population and Development Data ......................................................................157 Section 11 Resource Mobilization, Partnerships and Coordination .................................165 Section 12 Monitoring and Evaluation Mechanisms .............................................................171 Section 13 Factors Affecting Implementation of the ICPD PoA and MDGs ..................177 Part 3 Recommendations and Way Forward .................................................183 References ............................................................................................................191 Annexes ................................................................................................................194 iii Acronyms and abbreviations ADB African Development Bank AIDS Acquired Immuno-Deficiency Syndrome ART Anti-retroviral Therapy ARH Adolescent Reproductive Health AU African Union CBO Community-Based Organization CEDAW Convention on the Elimination of All Forms of Discrimination Against Women CSO Civil Society Organization DHS Demographic and Health Survey DHIS District Health Information System DRC Democratic Republic of the Congo FBO Faith-Based Organization GDP Gross Domestic Product GBV Gender-Based Violence HIS Health Information System HIV Human Immuno-deficiency Virus ICPD International Conference on Population and Development IDMC Inter-departmental Disaster Management Committee IDPs Internally Displaced Persons IEC Information, Education and Communication IMR Infant Mortality Rate IOM International Organization for Migration MCH Maternal and Child Health MCP Multiple Concurrent sexual Partnerships MDG Millennium Development Goals v MMR Maternal Mortality Ratio NEP National Electrification Programme NGO Non-governmental Organization NHS National Health System NPA National Programme of Action NYC National Youth Commission NYS National Youth Service ODA Official Development Assistance PoA Programme of Action RDP Reconstruction and Development Programme SADHS South Africa Demographic and Health Survey STD Sexually-Transmitted Disease STIs Sexually-Transmitted Infections TB Tuberculosis TFR Total Fertility Rate UN United Nations UNCT United Nations Country Team UNDAF United Nations Development Assistance Framework UNDP United Nations Development Programme UNFPA United Nations Population Fund UNICEF United Nations Children Fund UNHCR United Nations High Commission for Refugees WHO World Health Organization YDN Youth Development Network vi Foreword The International Conference on Population and Development (ICPD) held in Cairo in 1994 adopt- ed a twenty-year Programme of Action (ICPD-PoA). The ICPD was preceded by the 1992 Dakar/ Ngor Declaration (DND) on Population, Family and Sustainable Development and both are mile- stones in advancing population and development in Africa. DND formed the basis of Africa’s com- mon position submitted to ICPD (1994) while ICPD-PoA provides a comprehensive framework on issues of interrelationship between population, sustained economic growth and sustainable de- velopment, and advances in education, economic status and empowerment of women. DND and ICPD-PoA have since guided the implementation of health, population, environment and related development policies in Africa. The implementation of the recommendations of ICPD-PoA is the “sovereign right of each country, in line with national laws and development priorities”. The ICPD- PoA also calls on the regional institutions, including the United Nations system, to play an active role in the implementation of the Programme of Action. In Africa, the United Nations Economic Commission for Africa (ECA) is mandated by the General Assembly of the United Nations to follow up on the implementation of the Dakar-Ngor Declaration and Programme of Action of ICPD. In collaboration with UNFPA, and in close consultation with African governments, the African Union Commission (AUC), the African Population Commission (APC) and the African Development Bank (AfDB), ECA implemented this mandate by carrying out ICPD reviews at five-year intervals in 1999 and 2004. The 1999 review identified some key priority areas for action, with emphasis on education and literacy; reproductive health care and unmet need for contraception; maternal mortality reduction; and HIV/AIDS. In this regard the 1999 Report stressed the need for addressing general health, education, income generation and employment, reducing infant and maternal mortality, and HIV/AIDS and sexually transmitted infections. Issues such as the family, refugees, the role of the aged in society, political and social instability, interre- lationship between the role of the NGOs, private sector and civil society, information, education, communication materials and advocacy strategies were those that needed adequate attention. The ICPD review in 2004 demonstrated that countries had made significant progress in adopting and implementing a reproductive health approach; strengthening efforts to improve gender equal- ity, equity and women’s empowerment; addressing adolescent reproductive health; forging new partnerships with civil society and the private sector and promoting integration of population dy- namics and trends into development planning and policymaking. However, the outcomes showed that major challenges to the full implementation of the Cairo agenda still remained. vii This year, as we mark the fifteenth anniversary of the adoption of ICPD, ECA and its partners (AU and UNFPA) undertook a fifteen-year review of the implementation of DND and ICPD-PoA in Africa in the context of the MDGs. The review work included collecting data from Member States, and analyzing it to develop this publication; ICPD and the MDGs: Working as one. The report reveals the tremendous work done thus far by the African Union, UN Agencies and Member States to formulate policies, develop appropriate legal frameworks and adopt relevant in- ternational instruments to achieve the objectives of ICPD-PoA and the MDGs. Many countries have set up new institutions, strengthened existing ones and designed national and sectoral programmes and plans to address the various dimensions of population. However, several countries are yet to give explicit consideration to population planning and design a specific action plan or programme to address policy implementation. Overall, the review notes the wide gap existing in most African countries between population-related policies and actual implementation. Barely five years to the end of the ICPD and MDG programme cycles (2014 and 2015 respectively), the prognosis for achieving the ICPD objectives and MDG targets points to the need for greater commitment and effort. While national conditions may vary, the outcome of this review suggests that significant difference could be made through renewed focus by all countries on population and development issues, based on a human rights approach. This would be in the areas of health and reproductive health, education, skills development and productive employment, human resources and institutional capacity and finance, with emphasis on domestic resource mobilization. All stake- holders in Africa and partners have a role to play in scaling