State of World Population 2012 - Country Page List - UNFPA

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Sexuality, sexual and gender stereotypes and limited use of vasectomy A lack of information and access to vasectomy services can compromise the rights and health of men and women who, if they were appropriately informed, might prefer this relatively safe, simple, permanent and noninvasive procedure over female sterilization. Men who choose vasectomies decide upon the long-term method after considering numerous physiological, psychological, social and cultural factors. In many places, male sterilization is not well understood and is viewed as a threat to male sexuality and sexual performance. When men and women have access to a full range of family planning information and services, more couples may choose vasectomy as their preferred method of contraception. The low uptake of vasectomies reflects limited access to appropriate information about the procedure, institutional biases against the method, and individual concerns about the effects of vasectomies on sexual performance and pleasure. Sources: Landry and Ward, 1997; Greene and Gold, n.d.; EngenderHealth, 2002. by about 7 per cent in the past decade, while births among girls with secondary plus schooling have declined by about 14 per cent (Loaiza and Blake, 2010). The widening disparities in birth rates among educated and uneducated girls over time reflect a similar increasing gap in their use of contraception. In sub-Saharan African, girls with secondary schooling were found to be more than four times more likely to use contraception than girls with no education (Lloyd, 2009). Whereas contraceptive use among educated adolescent girls has risen somewhat between the two surveys to 42 per cent overall, there was no change among uneducated girls. No more than one in 10 uneducated adolescents uses contraception, even though one in four girls in these countries, independent of wealth, education or residence, has an unmet need for family planning. These figures suggest that efforts to improve access to reproductive health services among youth by expanding youth-friendly services have not benefited young women who are poor, live in rural areas, and are poorly educated. Those most in need of these services lag the furthest behind (Loaiza and Blake, 2010). The most plausible explanations for the positive family planning outcomes associated with education are that better-educated women marry later and less often, use contraception more effectively, have greater knowledge about and access to contraception, exercise greater autonomy in reproductive decision-making, and are more aware of the socioeconomic costs of unintended child-bearing (Bongaarts, 2010). Case study CASE STUDY Youth-friendly services in Malawi The sexual and reproductive health needs of adolescents and young people were not well served in Malawi, as in many other parts of Africa. The lack of information, long distances to services and unfriendly providers contributed to high rates of unintended pregnancy and HIV. UNFPA has partnered with the Malawian Ministry of Health and the Family Planning Association of Malawi to provide integrated youth-friendly sexual and reproductive health services through multi-purpose Youth Life Centres as well as via community-based and mobile services; they have strengthened their infrastructure as part of improving quality of care for young people. Services include contraception, including emergency contraception, pregnancy testing, treatment of sexually transmitted infections, HIV counselling and testing, antiretroviral therapy, treatment of opportunistic infections, cervical cancer screening and treatment, general sexual and reproductive health counselling, post-abortion care, and prenatal and postnatal care for teen mothers. The services are promoted through newspa- 20 CHAPTER 2: ANALYSING DATA AND TRENDS TO UNDERSTAND THE needs
pers, advertisements and by word of mouth. Improvements in service infrastructure, the participation of young people in service provision, the integration of sexual and reproductive health and HIV services, and the frequent solicitation of input from young clients—all of these things have improved the quality of the sexual and reproductive health services and have significantly increased their use. The connections between schooling, family planning use and fertility are most readily evident in adolescence. But the effects of education on desired family size and contraceptive use persist into adulthood. The adjacent figure shows that women with secondary education use family planning at four times the rate of women with no schooling in sub-Saharan Africa. This effect reflects both preferences for number of children and access to family planning (UNFPA, 2010). Family planning use and place of residence Contraceptive use in sub-Saharan Africa is double in urban areas than what it is in rural areas. Many countries, especially the world’s poorest, struggle to bring services to rural areas. In addition, people in rural areas tend to have less access to schooling, another important correlate of preferences for smaller families and use of family planning. Family planning demand and use evolve through life A review of global data shows that sexual activity evolves over a person’s lifetime. Women and men have sex for different reasons and under different circumstances at various times in their lives. Individual decisions to initiate sex with a partner are The poorest, least educated and rural women have the lowest rates of contraceptive use in Sub-Saharan Africa EDUCATION WEALTH No Education Primary Secondary Poorest 20% Second Third Fourth Richest 20% LOCATION Rural Urban 10% 10% 13% 18% 17% 24% 25% 34% 42% 0 5 10 15 20 25 30 35 40 45 PERCENTAGE OF USE 38% Contraceptive prevalence by background characteristics from 24 sub-Saharan African countries at most recent survey, 1998-2008 (Percentage of women aged 1-49, married or in union, using any method of contraceptive). Source: Demographic and Health Surveys (calculated using data in Annex III). 50 THE STATE OF WORLD POPULATION 2012 21
Page 1 and 2: 14 November 2012 BY CHOICE, NOT BY
Page 3 and 4: state of world population 2012 BY C
Page 5 and 6: ut many others have to do with econ
Page 7 and 8: t Women who are able to plan their
Page 9 and 10: What are the social and economic be
Page 11 and 12: CHAPTER ONE The right to family pla
Page 13 and 14: to—the social, political and econ
Page 15 and 16: 1994 At the International Conferenc
Page 17 and 18: Rights, 2012). The charges had been
Page 19 and 20: health care, which includes family
Page 21 and 22: designing and delivering accessible
Page 23 and 24: use, and reduces unintended pregnan
Page 25 and 26: For UNFPA, the key benefits to impl
Page 27 and 28: CHAPTER TWO Analysing data and tren
Page 29: through the wealthiest 20 per cent.
Page 33 and 34: cohabitating partner (UNICEF, Offic
Page 35 and 36: methods are several times more effe
Page 37 and 38: Despite the tendency to consolidate
Page 39 and 40: CASE STUDY No-scalpel vasectomy in
Page 41 and 42: contribute to high unmet need (Sing
Page 43 and 44: abortions in the region lead to mor
Page 45 and 46: (as stated in the Convention on the
Page 47 and 48: arriers prevent individuals from ac
Page 49 and 50: CHAPTER THREE Challenges in extendi
Page 51 and 52: sources of sexual and reproductive
Page 53 and 54: messages were delivered via a numbe
Page 55 and 56: Ricardo, 2005). Moreover, young and
Page 57 and 58: information and services, including
Page 59 and 60: instances of early sexual initiatio
Page 61 and 62: ut conventional family planning mes
Page 63 and 64: Social Affairs, 2009). Data from 15
Page 65 and 66: Many institutions, providers, and c
Page 67 and 68: groups (Maya, Xinka, and Garifuna)
Page 69 and 70: who are living with HIV and are con
Page 71 and 72: Studies suggest that HIV may have a
Page 73 and 74: with a public health challenge (Wor
Page 75 and 76: State-run family planning programme
Page 77 and 78: people in mobile, temporary, and re
Page 79 and 80: systems and civic participation to
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CHAPTER FOUR The social and economi
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t Community education in Caracas, V
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Estimates of Total Fertility 2010-2
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children, and healthier women also
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empirical evidence supporting this
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y the 1990s was accompanied by incr
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gender equality is much stronger an
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substantially, created new opportun
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CHAPTER FIVE The costs and savings
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Europe; the highest is 64 per cent
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Extending access to meet the unmet
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“family planning” services ofte
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therapy as an inexpensive preventiv
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CHAPTER SIX Making the right to fam
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1 Expand the reach of family planni
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ange of rights. Meeting those oblig
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including indigenous and ethnic min
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4 Increase funding for family plann
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Monitoring Monitoring ICPD ICPD Goa
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Monitoring ICPD Goals Demographic -
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Monitoring ICPD Goals - Selected In
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Bibliography Abbasi-Shavazi, Mohamm
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Delivering a world where every preg
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