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International Conference on Population and Development (ICPD)

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Programme of Action of the International Conference on Population and Development

Chapter 13 : National Action

A. National policies and plans of action

B. Programme management and human resource development

C. Resource mobilization and allocation

 

A. National policies and plans of action                                              [ UP ]

Basis for action 13.1. During the past few decades, considerable experience has been gained around the world on how government policies and programmes can be designed and implemented to address population and development concerns, enhance the choices of people and contribute to broad social progress. As is the case with other social development programmes, experience has also shown, in instances where the leadership is strongly committed to economic growth, human resource development, gender equality and equity and meeting the health needs of the population, in particular the reproductive health needs, including family planning and sexual health, countries have been able to mobilize sustained commitment at all levels to make population and development programmes and projects successful.

13.2. While such success can be facilitated by developments in the overall social and economic context, and by success in other development efforts, population and development are intrinsically interrelated and progress in any component can catalyse improvement in others. The many facets of population relate to many facets of development. There is increased recognition of the need for countries to consider migration impacts, internal and international, in developing their relevant policies and programmes. There is also growing recognition that population-related policies, plans, programmes and projects, to be sustainable, need to engage their intended beneficiaries fully in their design and subsequent implementation.

13.3. The role of non-governmental organizations as partners in national policies and programmes is increasingly recognized, as is the important role of the private sector. Members of national legislatures can have a major role to play, especially in enacting appropriate domestic legislation for implementing the present Programme of Action, allocating appropriate financial resources, ensuring accountability of expenditure and raising public awareness of population issues.

Objectives

13.4. The objectives are:

(a) To incorporate population concerns in all relevant national development strategies, plans, policies and programmes;

(b) To foster active involvement of elected representatives of people, particularly parliamentarians, concerned groups, especially at the grass-roots level, and individuals, in formulating, implementing, monitoring and evaluating strategies, policies, plans and programmes in the field of population and development.

Actions

13.5. Governments, with the active involvement of parliamentarians, locally elected bodies, communities, the private sector, non-governmental organizations and women's groups, should work to increase awareness of population and development issues and formulate, implement and evaluate national strategies, policies, plans, programmes and projects that address population and development issues, including migration, as integral parts of their sectoral, intersectoral and overall development planning and implementation process. They should also promote and work to ensure adequate human resources and institutions to coordinate and carry out the planning, implementation, monitoring and evaluation of population and development activities.

13.6. Governments and parliamentarians, in collaboration with the international community and non-governmental organizations, should make the necessary plans in accordance with national concerns and priorities and take the actions required to measure, assess, monitor and evaluate progress towards meeting the goals of the present Programme of Action. In this connection, the active participation of the private sector and the research community is to be encouraged.

B. Programme management and human resource development      [ UP ]

Basis for action

13.7. Building the capacity and self-reliance of countries to undertake concerted national action to promote sustained economic growth, to further sustainable national development and to improve the quality of life for the people is a fundamental goal. This requires the retention, motivation and participation of appropriately trained personnel working within effective institutional arrangements, as well as relevant involvement by the private sector and non-governmental organizations. The lack of adequate management skills, particularly in the least developed countries, critically reduces the ability for strategic planning, weakens programme execution, lessens the quality of services and thus diminishes the usefulness of programmes to their beneficiaries. The recent trend towards decentralization of authority in national population and development programmes, particularly in government programmes, significantly increases the requirement for trained staff to meet new or expanded responsibilities at the lower administrative levels. It also modifies the "skill mix" required in central institutions, with policy analysis, evaluation and strategic planning having higher priority than previously.

Objectives

13.8. The objectives are:

(a) To improve national capacities and the cost-effectiveness, quality and impact of national population and development strategies, plans, policies and programmes, while ensuring their accountability to all persons served, in particular the most vulnerable and disadvantaged groups in society, including the rural population and adolescents;

(b) To facilitate and accelerate the collection, analysis and flow of data and information between actors in national population and development programmes in order to enhance the formulation of strategies, policies, plans and programmes and monitor and evaluate their implementation and impact;

(c) To increase the skill level and accountability of managers and others involved in the implementation, monitoring and evaluation of national population and development strategies, policies, plans and programmes;

(d) To incorporate user and gender perspectives in training programmes and ensure the availability, motivation and retention of appropriately trained personnel, including women, for the formulation, implementation, monitoring and evaluation of national population and development strategies, policies, plans and programmes.

Actions

13.9. Countries should:

(a) Formulate and implement human resource development programmes in a manner that explicitly addresses the needs of population and development strategies, policies, plans and programmes, giving special consideration to the basic education, training and employment of women at all levels, especially at decision-making and managerial levels, and to the incorporation of user and gender perspectives throughout the training programmes;

(b) Ensure the nationwide and efficient placement of trained personnel managing population and development strategies, policies, plans and programmes;

(c) Continuously upgrade the management skills of service delivery personnel to enhance the cost-effectiveness, efficiency and impact of the social services sector;

(d) Rationalize remuneration and related matters, terms and conditions of service to ensure equal pay for equal work by women and men and the retention and advancement of managerial and technical personnel involved in population and development programmes, and thereby improve national execution of these programmes;

(e) Establish innovative mechanisms to promote experience-sharing in population and development programme management within and among countries at subregional, regional, interregional and international levels in order to foster relevant national expertise;

(f) Develop and maintain databases of national experts and institutions of excellence in order to foster the use of national competence, giving special consideration to the inclusion of women and youth;

(g) Ensure effective communication with, and the involvement of, programme beneficiaries at all levels, in particular at rural levels, in order to ensure better overall programme management.

13.10. Governments should give special attention to the development and implementation of client-centred management information systems for population and development, and particularly for reproductive health, including family- planning and sexual health programmes, covering both governmental and non-governmental activities and containing regularly updated data on clientele, expenditures, infrastructure, service accessibility, output and quality of services.

C. Resource mobilization and allocation                                            [ UP ]

Basis for action

13.11. Allocation of resources for sustained human development at the national level generally falls into various sectoral categories. How countries can most beneficially allocate resources among various sectors depends largely on each country's social, economic, cultural and political realities as well as its policy and programme priorities. In general, the quality and success of programmes benefit from a balanced allocation of resources. In particular, population-related programmes play an important role in enabling, facilitating and accelerating progress in sustainable human development programmes, especially by contributing to the empowerment of women, improving the health of the people (particularly of women and children, and especially in the rural areas), slowing the growth rate of demand for social services, mobilizing community action and stressing the long-term importance of social-sector investments.

13.12. Domestic resources provide the largest portion of funds for attaining development objectives. Domestic resource mobilization is, thus, one of the highest priority areas for focused attention to ensure the timely actions required to meet the objectives of the present Programme of Action. Both the public and the private sectors can potentially contribute to the resources required. Many of the countries seeking to pursue the additional goals and objectives of the Programme of Action, especially the least developed countries and other poor countries that are undergoing painful structural adjustments, are continuing to experience recessionary trends in their economies. Their domestic resource mobilization efforts to expand and improve their population and development programmes will need to be complemented by a significantly greater provision of financial and technical resources by the international community, as indicated in chapter XIV. In the mobilization of new and additional domestic resources and resources from donors, special attention needs to be given to adequate measures to address the basic needs of the most vulnerable groups of the population, particularly in the rural areas, and to ensure their access to social services.

13.13. Based on the current large unmet demands for reproductive health services, including family planning, and the expected growth in numbers of women and men of reproductive age, demand for services will continue to grow very rapidly over the next two decades. This demand will be accelerated by growing interest in delayed child-bearing, better spacing of births and earlier completion of desired family size, and by easier access to services. Efforts to generate and make available higher levels of domestic resources, and to ensure their effective utilization, in support of service-delivery programmes and of associated information, education and communication activities, thus, need to be intensified.

13.14. Basic reproductive health, including family-planning services, involving support for necessary training, supplies, infrastructure and management systems, especially at the primary health-care level, would include the following major components, which should be integrated into basic national programmes for population and reproductive health:

(a) In the family-planning services component - contraceptive commodities and service delivery; capacity-building for information, education and communication regarding family planning and population and development issues; national capacity-building through support for training; infrastructure development and upgrading of facilities; policy development and programme evaluation; management information systems; basic service statistics; and focused efforts to ensure good quality care;

(b) In the basic reproductive health services component - information and routine services for prenatal, normal and safe delivery and post-natal care; abortion (as specified in paragraph 8.25); information, education and communication about reproductive health, including sexually transmitted diseases, human sexuality and responsible parenthood, and against harmful practices; adequate counselling; diagnosis and treatment for sexually transmitted diseases and other reproductive tract infections, as feasible; prevention of infertility and appropriate treatment, where feasible; and referrals, education and counselling services for sexually transmitted diseases, including HIV/AIDS, and for pregnancy and delivery complications;

(c) In the sexually transmitted diseases/HIV/AIDS prevention programme component - mass media and in-school education programmes, promotion of voluntary abstinence and responsible sexual behaviour and expanded distribution of condoms;

(d) In the basic research, data and population and development policy analysis component - national capacity-building through support for demographic as well as programme-related data collection and analysis, research, policy development and training.

13.15. It has been estimated that, in the developing countries and countries with economies in transition, the implementation of programmes in the area of reproductive health, including those related to family planning, maternal health and the prevention of sexually transmitted diseases, as well as other basic actions for collecting and analysing population data, will cost: $17.0 billion in 2000, $18.5 billion in 2005, $20.5 billion in 2010 and $21.7 billion in 2015; these are cost-estimates prepared by experts, based on experience to date, of the four components referred to above. These estimates should be reviewed and updated on the basis of the comprehensive approach reflected in paragraph 13.14 of the present Programme of Action, particularly with respect to the costs of implementing reproductive health service delivery. Of this, approximately 65 per cent is for the delivery system. Programme costs in the closely related components which should be integrated into basic national programmes for population and reproductive health are estimated as follows:

(a) The family-planning component is estimated to cost: $10.2 billion in 2000, $11.5 billion in 2005, $12.6 billion in 2010 and $13.8 billion in 2015. This estimate is based on census and survey data which help to project the number of couples and individuals who are likely to be using family-planning information and services. Projections of future costs allow for improvements in quality of care. While improved quality of care will increase costs per user to some degree, these increases are likely to be offset by declining costs per user as both prevalence and programme efficiency increase;

(b) The reproductive health component (not including the delivery-system costs summarized under the family-planning component) is estimated to add: $5.0 billion in 2000, $5.4 billion in 2005, $5.7 billion in 2010 and $6.1 billion in 2015. The estimate for reproductive health is a global total, based on experience with maternal health programmes in countries at different levels of development, selectively including other reproductive health services. The full maternal and child health impact of these interventions will depend on the provision of tertiary and emergency care, the costs of which should be met by overall health-sector budgets;

(c) The sexually transmitted diseases/HIV/AIDS prevention programme is estimated by the WHO Global Programme on AIDS to cost:

$1.3 billion in 2000, $1.4 billion in 2005 and approximately $1.5 billion in 2010 and $1.5 billion in 2015;

(d) The basic research, data and population and development policy analysis programme is estimated to cost: $500 million in 2000, $200 million in 2005, $700 million in 2010 and $300 million in 2015.

13.16. It is tentatively estimated that up to two thirds of the costs will continue to be met by the countries themselves and in the order of one third from external sources. However, the least developed countries and other low-income developing countries will require a greater share of external resources on a concessional and grant basis. Thus, there will be considerable variation in needs for external resources for population programmes, between and within regions. The estimated global requirements for international assistance are outlined in paragraph 14.11.

13.17. Additional resources will be needed to support programmes addressing population and development goals, particularly programmes seeking to attain the specific social- and economic-sector goals contained in the present Programme of Action.

The health sector will require additional resources to strengthen the primary health-care delivery system, child survival programmes, emergency obstetrical care and broad-based programmes for the control of sexually transmitted diseases, including HIV/AIDS, as well as the humane treatment and care of those infected with sexually transmitted diseases/HIV/AIDS, among others. The education sector will also require substantial and additional investments in order to provide universal basic education and to eliminate disparities in educational access owing to gender, geographical location, social or economic status etc.

13.18. Additional resources will be needed for action programmes directed to improving the status and empowerment of women and their full participation in the development process (beyond ensuring their basic education). The full involvement of women in the design, implementation, management and monitoring of all development programmes will be an important component of such activities.

13.19. Additional resources will be needed for action programmes to accelerate development programmes; generate employment; address environmental concerns, including unsustainable patterns of production and consumption; provide social services; achieve balanced distributions of population; and address poverty eradication through sustained economic growth in the context of sustainable development. Important relevant programmes include those addressed in Agenda 21.

13.20. The resources needed to implement the present Programme of Action require substantially increased investments in the near term. The benefits of these investments can be measured in future savings in sectoral requirements; sustainable patterns of production and consumption and sustained economic growth in the context of sustainable development; and overall improvements in the quality of life.

Objective

13.21. The objective is to achieve an adequate level of resource mobilization and allocation, at the community, national and international levels, for population programmes and for other related programmes, all of which seek to promote and accelerate social and economic development, improve the quality of life for all, foster equity and full respect for individual rights and, by so doing, contribute to sustainable development.

Actions

13.22. Governments, non-governmental organizations, the private sector and local communities, assisted upon request by the international community, should strive to mobilize and effectively utilize the resources for population and development programmes that expand and improve the quality of reproductive health care, including family-planning and sexually transmitted diseases/HIV/AIDS prevention efforts. In line with the goal of the present Programme of Action to ensure universal availability of and access to high- quality reproductive health and family-planning services, particular emphasis must be put on meeting the needs of underserved population groups, including adolescents, taking into account the rights and responsibilities of parents and the needs of adolescents and the rural and the urban poor, and on ensuring the safety of services and their responsiveness to women, men and adolescents. In mobilizing resources for these purposes, countries should examine new modalities such as increased involvement of the private sector, the selective use of user fees, social marketing, cost-sharing and other forms of cost recovery. However, these modalities must not impede access to services and should be accompanied with adequate "safety net" measures.

13.23. Governments, non-governmental organizations, the private sector and local communities, assisted upon request by the international community, should strive to mobilize the resources needed to reinforce social development goals, and in particular to satisfy the commitments Governments have undertaken previously with regard to Education for All (the Jomtien Declaration), the multisectoral goals of the World Summit for Children, Agenda 21 and other relevant international agreements, and to further mobilize the resources needed to meet the goals in the present Programme of Action. In this regard, Governments are urged to devote an increased proportion of public-sector expenditures to the social sectors, as well as an increased proportion of official development assistance, stressing, in particular, poverty eradication within the context of sustainable development.

13.24. Governments, international organizations and non-governmental organizations should collaborate on an ongoing basis in the development of precise and reliable cost estimates, where appropriate, for each category of investment.

[ UP ]

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