State of World Population 2012 - Country Page List - UNFPA

Studies suggest that HIV may have adverse
effects on both male and female fertility (Lyerly,
Drapkin and Anderson, 2001). Moreover,
among discordant couples—relationships in
which one person is HIV positive and the
other is not—the ways to safely pursue having
children vary. Artificial insemination can
reduce the risk of infection when the woman is
HIV-positive. When the male partner lives with
HIV, pursuing pregnancy can be more complicated,
problematic, and costly (Semprini, Fiore
and Pardi, 1997).
The poor. Although sexual and reproductive
health outcomes have improved over the
last 20 years, they vary according to income
levels (UNFPA, 2010). This widening gap
has increased the number of people who are
unable to exercise the right to family planning.
Moreover, research finds that a disproportionate
amount of public spending on health and
education is allocated towards wealthier sectors
of society, thereby exacerbating the likelihood
that present-day inequalities will continue to
widen among and within countries (Gwatkin,
Wagstaff and Yazbeck, 2005).
Demographic and Health Surveys from 24
sub-Saharan African countries find that the
poorest and least educated women have “lost
ground,” with poor adolescent girls having the
lowest levels of sustained contraceptive use and
the highest unmet need for family planning
(UNFPA, 2010). For example, only 10 per cent
of those belonging to the poorest households
use contraception, compared to 38 per cent of
women belonging to the wealthiest households.
Social exclusion makes it harder for poor
people to access family planning information
and services, compared to individuals of higher
socioeconomic status. These disparities compromise
women’s health, men’s and women’s
“Reproductive health eludes many of the world’s people because
of such factors as: inadequate levels of knowledge about
human sexuality and inappropriate or poor-quality reproductive
health information and services; the prevalence of high-risk
sexual behaviour; discriminatory social practices; negative
attitudes towards women and girls; and the limited power many
women and girls have over their sexual and reproductive lives.
Adolescents are particularly vulnerable because of their lack of
information and access to relevant services in most countries.
Older women and men have distinct reproductive and sexual
health issues which are often inadequately addressed.”
— ICPD Programme of Action, 1994, paragraph 7.3
rights, and undermine poverty reduction efforts
(Greene and Merrick, 2005). For example,
research finds that birth rates have increased
among the least educated, poor adolescent girls
who often live in rural communities (UNFPA,
2010). In contrast, more educated adolescent
girls who live in the wealthiest 60 per cent of
households in urban areas have experienced low
and declining birth rates since 2000.
Hard-to-reach persons in rural or urban
communities. In most developing countries,
national measures of poverty are highly correlated
with place of residence; urban households
tend to be weathier than rural households
(Bloom and Canning, 2003a). Hard-to-reach
communities vary across countries, but where
people live influences their ability to access
family planning.
In some settings, women and men in rural
areas are unable to routinely access quality
family planning information and services. On
average, for example, poor women in rural
sub-Saharan Africa have a contraceptive prevalence
rate of 17 per cent, compared to 34
per cent for their urban peers (United Nations
Population Fund, 2010). Relative differences
THE STATE OF WORLD POPULATION 2012
61