Delivering on global population, development targets
The 25th anniversary of the International Conference on Population and Development (ICPD) jointly hosted by the government of Kenya, the government of Denmark and the United Nations Populations Fund (UNFPA) from November 12-14, 2019 is among the two major events on the African continent which turned the world’s eyes towards the continent, while the other is the African Investment Summit that was held in South Africa.
The one hosted by Kenya and named the Nairobi Summit gathered more than 7,000 participants from across the globe to assess what had been done within the 25 years since the maiden Summit in Cairo, identify gaps, commit to improvement, and set clear targets to meet the unmet goals.
Twenty five years ago, 11,000 representatives from governments, donors, civil society organizations and the youth gathered in Cairo, Egypt for what is now being referred to as a momentous time in the global initiative. Dubbed the International Conference on Population and Development (ICPD), the Cairo Program of Action (PoA) was adopted by 179 countries aiming to achieve 200 recommendations between the years 1995 and 2015. While the PoA planned to reduce the number of deaths to 60 out of 100,000 live birth and increase life expectancy to 75 years and for high mortality rate countries to 70 years, the central theme of the Cairo summit was to provide a comprehensive reproductive healthcare, which includes family planning, safe pregnancy and delivery services, abortion where legal, prevention and treatment of sexually transmitted diseases information and counseling on sexuality, and elimination of harmful practices against women like genital mutilations (FGM) and forced marriage.
Since 1994, the world has come a long way and achievements had been registered in the areas stipulated in the PoA. But result is not as it was expected and much needs to be done if the world is to become a place for all where people can equally enjoy life, the summit participants attested. In her opening statement in Nairobi, Natalia Kanem (MD), the Executive Director of the UNFPA, asserted that “since the Cairo ICPD, we have put women and girls at the center if global development. This has paid off time and again. That ICPD vision is still far from reality, and that journey that began 25 years ago in Cairo is far from over.” While admitting that good progress had been made since Cairo, she reminds that, “good progress is not enough. Women rights and reproductive health are not up for negotiation.”
Firmly stating that the world should not wait for another 25 years, after now zero is the only acceptable target, she asserted. “Zero unmet need for contraceptives, zero preventable maternity death, zero gender-based violence, zero female genital mutilation, and zero child marriages.”
Upholding what Natalia stated, Uhuru Kenyatta, president of the Republic of Kenya, welcomed his guests by saying “we are here to commit new ideas and finish the unfinished business.” He reinforced his commitments quoting an African proverb that goes as like “women are the backbones of a family, and bedrock of a nation.”
He added that his country is committed to eliminate child marriage and end cross boarder female genital mutilation as Kenya has signed agreements with five neighboring nations including Ethiopia.
Leaders of other African nations including Yoweri Museveni, President of Republic of Uganda, Mohamed Abdullahi Mohamed, President of Federal Republic of Somalia, Gaston Brown, Prime Minister of Antigua and Barbuda, Her Royal Highness Princess Angelika Tuku’aho of Tonga and Her Royal Highness Mary, Crown Princess of Denmark graced the opening session where various leaders, ministers and civil society were in attendance.
Representing the government of Ethiopia were the Commissioner for the National Planning and Development Commission Fitsum Assefa (PhD) and Sahrela Abdullahi, State Minister of Health attended along with representatives from civil society organizations, youth representatives and other stakeholders during which they made commitments to achieve the ICPD PoA.
Speaking to The Reporter after making a statement of the country's commitment, both Fitsum and Saharela agree that despite the huge stride that the country has made in terms of the stipulated PoA goals, there are country specific challenges that need proper attention.
“ICPD has brought a shift in the perception of reproductive health from control=based approach to rights based approach, which impacted Ethiopia in a way for the country to draw its policies in conformity with this as it is one of the signatories of the PoA,” Fitsum said, adding that, “Although there are successes we can count, we also face current challenges. Still mothers die while giving birth and despite the seven percent increase in access to contraceptives, still it is 42 percent of women that have access, which means there are women that do not have access. This means women could not decide if and when they have children.”
But she says that there is country specific contexts that need to be put into consideration while talking about ICPA PoA in Ethiopia because of practices like FGM.
Saharela also says that the ICPD PoA has contributed hugely to the health sector and the successes registered in this regard are wide ranging. She points out that “although we have worked hard to achieve maternal mortality, we still face challenges in this regard. We have expanded health centres but still access is limited. Building conducive health centres that make mothers feel at home when they go to get services requires huge attention along with expanding the reach.”
Saharela also picks other sides of the ICPD PoA which deals with family planning and prevention from sexually transmitted infections that aim at resulting in informed decisions where people get information on their lives, reminding that there are even confusions whether it is family planning or birth control.
“This has been one component of the health extension program which delivery d well in terms of informing mothers,” she says also mentioning that the government is providing access to family planning for free so that women have the right to choose rather than forceful controls.
Speaking of the zero target set in various areas, Saharela expressed her belief that setting such targets is helpful for Ethiopia and she strongly advocates that a woman should not by any means lose her life while giving birth.
“There is a strong commitment from the government’s side to achieve that and there are measures being taken towards achieving that including efforts to increase the number of ambulances to expand access. I believe that, even though we might not achieve the zero target as mothers could die because of various reasons, we can reach a closer number in a short time,” she reiterated.
This target is helpful for other relating activities like FGM which the country committed to end by 2025 as was stipulate by Deputy Prime Minister Demeke Mekonnen at the Girl Summit back in 2014 in London, Saharela says.
While both admit that there are gaps in achieving the targets including the unfulfilled maternal mortality target from the Millennium Development Goals (MDGs), they say that the nation has given serious attention to the issue. Fitsum disclosed that the 10-year-plan that the country is preparing, from which another five-year-plan will be extracted, gives due attention for the targets as one of the areas of focus is human resource development, which says is a means and an end by itself. Hence, education and health services are tools to achieve this. Apart from this, areas of contributions from various sectors have been identified in addition to integrating the plans they prepare for their respective sectors.
The ICPD PoA is also aimed at harnessing the demographic dividend of the globe. And focusing on this is important for continents like Africa that have larger portion of younger population, Eastern and Southern Africa UNFPA regional director Julitta Onabanjo (MD) said. While these young generation are “the jewel of the population”, she stands by the belief that they need to be educated and be innovative.
“They have to get enough skill sets that drive our development,” she said.
Fitsum also conquers that there is huge portion of younger generation in Africa and Ethiopia’s70 percent population falls under this category. Hence, harnessing the demographic dividend is a focus in planning.
But, equally with the benefits it brings, a huge number of youngsters pose challenges because of the youth bulge. According to the Commissioner, unless the youth are occupied by doing something, they might engage in unproductive activities, sometimes becoming destructive.
“Job creation is an important aspects of our planning,” says Fitsum, adding that the growth that Ethiopia registered over the years has been criticized for being a “jobless growth”. Although there were educated youth that were looking for job and investors looking for skilled labour but there was a skills mismatch.
Among the Ethiopian delegation that attended the Nairobi Summit are civil society representatives who were standing behind Fitsum while she read out the commitments statement from the Ethiopian side. This was appreciated and lauded by the UNFPA Ethiopia Country Representatives Bettina Maas who was also at the Cairo summit 25 years ago.
“The ICPD PoA brought a mind shift how we approach population issues, to push forward on rights bases approaches for sexual and reproductive health,” she said. Although the East African region has registered great progress, there still are challenges ahead, she says.
And for the achievement of the zero targets which she says are particularly important for the region to finish this unfinished work by bringing different stakeholders like civil societies on board and accelerating the promise.
“The ICPD25 summit here brought together governments, donors, civil society organizations and others to evaluate the level of achieving of the promises made in Cairo,” Yirga Gebregziabher, the Manager for Organization for Social Service, Health and Development, Tigray, told The Reporter also reminding that the gathering is aimed at renewing the promises to bring about the needed change.
Ethiopia has made good progress in terms of decreasing child and maternal mortality apart from criminalizing FGM, Yirga appreciates, adding that the policy and legal frameworks are already on the ground.
So, the role of the civil society in complementing these efforts and helping in the achievement was commendable, he stressed. So, in order to meet the unmet targets and achieve the goals of the PoA, Yirga says the role of the civil society is immeasurable.
The ICPD Program of Action global implementation requires 260 billion dollars to meet the zero target goals by 2030, Onabanjo said. And unlike previous times when such initiatives are externally financed, this time round the financial source shifted to domestic.
“This is investing in the future and a dollar invested in this results in a USD 2.5 return.
For financing and the whole PoA, innovative solutions are sought after and various groups are involved in developing apps to help mothers locate health centres. Public Private Partnership is also one mechanism of financing these targets.