Review of the International Conference on Population and
Development, New York 1999
Expert Round-table Meeting on Ensuring Reproductive Rights, and Implementing Sexual
and Reproductive Health Programmes, Including Womens Empowerment, Male Involvement
and Human Rights, Kampala, Uganda, 22-25 June 1998
The aims of the Kampala Round Table were to identify strategies that have emerged since
the International Conference on Population and Development (ICPD) in ensuring reproductive
rights and in making sexual and reproductive health programmes operational; to identify
successes and constraints in policy, legal, administrative, managerial, strategic and
financial aspects; and to agree on actions needed to accelerate progress towards achieving
the goals of the ICPD.
The Round Table recognized that sector-wide progress in policy formulation has occurred
in several countries, while work to improve specific aspects of policies and of
implementation has started in others. Where there is political commitment to the
principles of sexual and reproductive health and rights and gender equality and
empowerment of women, progress is occurring in collaboration between governments and civil
society. Effective and empowered womens movements, other mass movements and
non-governmental organization (NGOs) are proving vital to ensuring progress in policy
development and implementation in areas such as the establishment of greater understanding
and will for developing rights-based policies.
While various elements of reproductive health care are available in many countries, the
implementation of comprehensive integrated services has advanced slowly. Traditionally
vertical administrative structures, compartmentalized budgets and personnel prevent
intersectoral collaboration and coordination among ministries in numerous countries.
Within integrated and comprehensive reproductive health, three central issues have
emerged as global concerns that have not received universal and balanced investment:
meeting the need for family planning; ensuring maternal health (including the reduction of
unsafe abortion); and reducing infant mortality and morbidity; and preventing and treating
sexually-transmitted diseases (STDs), including HIV/AIDS. Although much remains to be done
in these areas, the central commitment is to reduce verticality of programmes and
integrate all aspects of reproductive health in the context of primary health care and
health sector reform.
Technologies are seriously inadequate in STDs, including HIV/AIDS. Few women can
protect themselves and their partners. Although the female condom exists and is beginning
to be made available, simpler diagnostic tests and single dose treatments remain
The challenge of Cairo continues to be the integration of or better collaboration
between different institutional structures, transformation of existing facilities,
improvement of logistic systems and training to ensure appropriate and effective care. The
means to meet the challenge involve the structural and strategic reorientation of health
systems and financing. Integration is not just a matter of adding services to family
planning programmes. Another challenge is to overcome social barriers to access, including
mens understanding of their roles and responsibilities of womens health.
The Round Table experts reached consensus on the following actions needed:
- In health sector reform, emphasis must be given to ensuring sexual and reproductive
health for all people at the highest achievable standard of care, and to mobilizing the
necessary resources. Equity is a necessary prerequisite to achieving the right to health.
- Continue and promote the reorientation of the health system to ensure that sexual and
reproductive health policies, strategic plans and all aspects of implementation are
rights-based, cover the life cycle and serve all. This requires that the public health
system be open to inputs from civil society in the content and delivery of services and
information. The public health system should make partnerships with civil society in the
spirit of collaboration with equals.
- Continue and promote health system structural reform involving infrastructure, human
resource development, financing, to achieve both coverage and quality. Changes in systems
will have to be incremental and phased according to resource availability. They should
also be determined by a participatory consultative process and designed on the basis of
the longer term strategic plan.
- Increased investments should be made in management of service provision including:
- Provide more resources for groups to network: build alliances, involve the media,
undertake advocacy, promote public education to create a favorable environment for the
ICPD Programme of Action policy development and implementation; develop the capacity of
groups to participate in policy development and implementation; and ensure that groups can
help in monitoring policy implementation.
- Empower people to uphold their sexual and reproductive rights and health. Information
provided should be relevant and easily understandable. Content must include common human
experience such as sexuality and power relations between men and women, including
- Create an enabling environment through participatory processes at all levels of
society for womens empowerment and male involvement in promoting sexual and
reproductive rights in a human rights framework. This requires the adoption of a gender
perspective that accounts for the different realities and constraints which women and men
face in their lives. Programmes for women are an initial and essential means through which
gender inequalities and inequities can be addressed.
Full report available at http://www.unfpa.org/icpd/round&meetings/kampala_rh/rhrtnews.htm