Population legislation vital for development
Publication date: Monday, 24th November, 2008
The New Vision (Uganda)
By Jotham Musinguzi
The year 2009 marks the 15th anniversary of the International Conference on Population and Development (ICPD). While very few people know the acronym, much less the goals and outcomes of this United Nations conference held in Cairo, Egypt in 1994, most people, particularly those in developing countries, have benefitted from the agreement of 179 countries (including Uganda) to the ICPD programme of action.
The ICPD programme of action has been an essential scale for countries’ population legislation and policy and has proved critical to the global improvement of sexual and reproductive health and rights and gender equality.
The population conference was groundbreaking in its introduction of a new human rights-based approach to population and development — the links between women’s status, reproductive health, environmental destruction, poverty, and social and economic development were first recognised by the global community at the ICPD. The principal goal of the ICPD — universal access to reproductive health services by 2015 — is reinforced in the Maputo Plan of Action, which agreed that poor sexual and reproductive health is a leading killer in Africa. The Maputo Plan was later ratified by African heads of state.
In Uganda, infant mortality fell from 122 deaths per 1,000 live births in 1989 to the current rate of 76 deaths per 1,000 live births. In 1995, the use of modern contraceptive methods among married women in Uganda was 7.8%, this has now increased to 17.9%. And due to the strong partnership between the Government, civil society and international organisations, more people have access to reproductive health information and services to help them fulfill their decisions on the number and spacing of their children and to protect themselves from sexually transmitted infections such as HIV/AIDS.
We should congratulate ourselves on these changes while recognising that Uganda, like most developing countries, requires much more progress on these sexual and reproductive health and rights indicators. Global progress has, in part, been hampered by underfunding and the effects of the HIV/AIDS epidemic.
Despite progress on many of the Millennium Development Goals (MDGs), less than a 10th of the distance to be covered to meet the MDG 5 of reducing maternal mortality globally has been met.
This MDG on maternal health is unlikely to be met, particularly in sub-Saharan Africa, without concerted efforts. A woman’s lifetime risk of dying from pregnancy or childbirth in sub-Saharan Africa is one in 16 while the risk in developed countries is only about one in 3,800. Maternal health is, therefore, an issue of great concern.
In Uganda alone, approximately 6,000 women die every year due to pregnancy complications. Women bleed to death, they do not have access to antibiotics to prevent simple infections; they often do not have the option of a caesarean section when it is necessary. It is a tragedy that women continue to die when maternal deaths and injuries are preventable when women have access to prenatal care, skilled attendance at births, and emergency obstetric care.
This means that Africans, must not only acknowledge our accomplishments in reproductive health, but we must take responsibility and work to address areas of greatest need. We can do this by sharing our experiences and good practices through South-South cooperation and learning from the successes of our brothers and sisters in other developing countries.
We need to look at example from countries like Malaysia, Thailand, South Africa and Sri Lanka, who have successfully lowered their rates of maternal ill-health through sustained financial and political commitment. Sri Lanka’s long-term commitment to safe motherhood services has, over four decades, decreased maternal mortality more than twenty-fold, from 486 maternal deaths per 100,000 livebirths to 24 per 100,000.
This shows that with effort and resources, large-scale improvements in public health are achievable, a lesson that we need to take seriously. South-South collaboration is a workable model for developing countries to partner and learn from each other as we all strive towards the attainment of the common ICPD goals and MDGs.
Reproductive health and rights play an essential role in the development of our countries. Yet, these critical development issues have not received the importance and priority they deserve, despite their centrality to poverty eradication.
Enhancing individual reproductive health and rights enables governments to achieve their population goals—such as preventing unplanned pregnancies and slowing population growth—and provides the necessary conditions for economic and social development. Improving the overall well-being of populations also improves the development prospects of our countries.
As representatives from 25 developing countries gather this week in Kampala at the International Forum on “ICPD @ 15: Progress and Prospects,” hosted by Partners in Population and Development, to review progress and agree to an agenda for how to move the ICPD programme of action forward.
As we come to the 15th anniversary of the conference in 2009, we must remain focused on the most vulnerable and overlooked populations and issues to ensure that a just, equitable, and sustainable development is the one we bring about. Ensuring sexual and reproductive health and rights is not only a moral imperative, it is economically sound. Economic and social development can only happen with a healthy and educated population.
We need donors and our governments to allocate sufficient resources, financial and otherwise, to support sexual and reproductive health and rights to fight poverty in our countries.
We must activate civil society to hold donors and governments accountable for the promises they have made. We must remain committed and vigilant, and demand that policies are in place and funds are allocated and expended in line with the commitments our leaders have made.
We must not relent on these efforts until women and their families in developing countries no longer fear marriage and pregnancy because of the high likelihood of death, illness and disability for themselves and their children.
We want to watch our sisters, wives and daughters experience the birth of their children as sources of joy, not as the cause of suffering and untimely death.
The writer is the Regional Director, Partners in Population and Development Africa Regional Office
This article can be found on-line at: http://www.newvision.co.ug/D/8/459/661115