State of World Population 2012 - Country Page List - UNFPA

people in mobile, temporary, and resource-poor
settings manage their fertility (United Nations
High Commissioner for Refugees, 2011).
Potential beneficiaries of family planning
services may feel alienated by their providers
at moments that compromise their long-term
health. For example, in communities with high
levels of HIV, alienating experiences among
young people from select castes or ethnic groups
can dissuade them from accessing services at
critical moments in their sexual and reproductive
lives (United Nations, Economic and Social
Council, 2009a). Ethnic minorities, people from
lower castes, and sex workers who may spend
considerable portions of their lives in poor,
hard-to-reach, or other stigmatized communities
do not always benefit from the full range of
approaches to distribution (UNHCR, 2011).
These include the safe, community-based provision
of injectables and intrauterine devices that
the World Health Organization has approved for
use (World Health Organization, USAID and
Family Health International, 2009).
CASE STUDY
Tajikistan
Tajikistan has worked to overcome a lack of
information and services, particularly in rural
areas. Through the joint efforts of UNFPA and
the Ministry of Health, Tajikistan has improved
the access of vulnerable populations to family
planning. Family planning information and
services are being provided in the context of
comprehensive and quality reproductive health
services and information, a key stipulation of
the ICPD Programme of Action. Tajikistan has
accomplished this shift through building capacity,
conducting awareness-raising campaigns, providing
contraceptives and ensuring there is adequate
equipment to support quality services.
CASE STUDY
India
In keeping with its demographic goals, India’s
family planning programme had in the 1970s
established targets for a narrow range of methods
and relied on health workers to promote
these methods. Many people were pressured or
even coerced into using long-term or permanent
methods of family planning, and the approach
restricted access to the full range of methods.
Evidence existed, however, that unmet need
could be addressed without resorting to targets
by making supply respond more effectively to
local needs. In response, the Government developed
a new framework that provided family
planning in the context of broader reproductive
and child health services, and that built on planning
at the local level based on an assessment of
women’s need for services (Murthy et al., 2002).
Though shifting a massive national programme
is a slow process, increasing the range of methods,
managing health workers in a less directive
way, and making the programme more responsive
to local needs has contributed to increasing
demand for family planning.
t
Health extension
worker dispenses
family planning in an
Ethiopian village.
©UNFPA/Antonio Fiorente
THE STATE OF WORLD POPULATION 2012
67