State of World Population 2012 - UNFPA Haiti

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tCouple visiting a ruralfamily planning clinic.Mindanao, Philippines.©Panos/Chris Stowersmethods is one challenge; distributing them isanother: The majority of international fundingfor condoms is spent on the procurement ofthe commodity with relatively little spent ondelivery, distribution and administration.CASE STUDYSupplies in SwazilandAccess to supplies and their reliable provision areessential to the realization of individuals’ rightto family planning. Like many other Africancountries, Swaziland has experienced stock-outs,making it difficult for people to choose and haveconfidence in relying on specific contraceptivemethods. Reproductive health commodity securityprogramming had focused mainly on theprocurement of contraceptives by the government,with poor results.As part of its effort to address high maternalmortality and adolescent pregnancy,Swaziland has invested in reproductive healthcommodity security. The Ministry of Healthstrengthened its relationship with civil societyand UNFPA by establishing a partnershipwith the Family Life Association of Swaziland,Management Sciences for Health and UNFPAin 2011 to strengthen programme delivery.Its overall objective was to increase the healthsystem’s effectiveness in ensuring reproductivehealth commodities through three strategies:National systems were strengthened forreproductive health and commodity security;human resources capacity was strengthenedfor implementation, monitoring and reporting;and political and financial commitment toreproductive health commodity security wereenhanced. By conventional standards, successwas achieved through an increase in contraceptiveprevalence. Just as important, however, wasthe increase in the number of facilities offeringfamily planning services and the reliability ofthose services.Traditional methods of family planningremain popularTraditional methods remain widely used,especially in developing countries. Surveydata do not often shed light on why peopleuse traditional rather than modern methodsof family planning.Traditional methods include periodic abstinence,withdrawal, lactational amenorrhea(extended breast-feeding) and “folk” practices;thus their effectiveness varies very significantly.Comparative studies across diverse settingsconfirm that women who use modern methodsare much less likely to become pregnantthan women who rely on a traditional method(Trussell, 2011).26 CHAPTER 2: ANALYSING DATA AND TRENDS TO UNDERSTAND THE needs
Despite the tendency to consolidate all traditionalmethods into a singular category, notall traditional methods are the same. Severalcountries have good histories with non-modern,traditional methods. For example, withdrawalis a commonly used among educated couplesin Iran and Turkey and has been widely usedto prevent pregnancy in Sicily and Pakistan(Cottingham, Germain and Hunt, 2012; Erfani,2010). The Demographic and Health Surveyscategorize coitus interruptus as a “totally ineffectivefolk method,” even though this method isused extensively in a number of countries andis about as effective as condoms (Cottingham,Germain and Hunt, 2012).five married women. Nearly everywhere, womenare far more likely to undergo the sterilizationprocedure than men. In Colombia, for example,where 78 per cent of women are current contraceptiveusers, nearly a third of all women(31 per cent) have been sterilized, comparedwith just two per cent of men (United Nations,Department of Economic and Social Affairs,2011). Since desired fertility declines over time,couples married at young ages will stop havingchildren at earlier ages. After reaching theirdesired fertility, these younger couples may haveto avoid unintended pregnancy for up to 25years, making permanent methods attractiveto them.Female methods of family planning morewidely used than male methodsThe ICPD Programme of Action noted as a“high priority… the development of new methodsfor the regulation of fertility for men,” andcalled for the involvement of private industry.It urged countries to take special efforts toenhance male involvement and responsibilityin family planning (Paragraph 12.14.). Nearly20 years later, no new male methods have beenwidely introduced to the public. With few contraceptiveoptions for men, men’s use of familyplanning has been less than envisioned by theICPD. Today, even if all traditional methodsrequiring men’s cooperation (rhythm, withdrawaland others) are counted together withmale condoms, male methods account for about26 per cent of global contraceptive prevalence(United Nations, Department of Economic andSocial Affairs, 2011).Female sterilization rates far outnumber malerates. Although the decision to permanently endchildbearing can be difficult, sterilization is themost commonly used family planning methodin the world, relied upon by more than one in”Although the decision to permanently end childbearing canbe difficult, sterilization is the most commonly used familyplanning method in the world, relied upon by more than onein five married women.”While female sterilization rates are highest inLatin and Central America, ranging as high as47 per cent in the Dominican Republic, only 14countries in the world have at least 5 per centof men who have undergone vasectomy. Maleand female sterilization rates are most similar inAustralia and New Zealand, where about 15 percent of both men and women have been sterilized(United Nations, Department of Economicand Social Affairs, 2011). Male sterilizationexceeds female sterilization in only a handfulof countries, most notably in Canada and theUnited Kingdom, where men are about twice aslikely as women to be sterilized.One might infer from the mostly developedcountries that vasectomy rates primarily reflectwomen’s economic power and rights in thesecountries. Nepal is among the few developingcountries where vasectomy rates are aboveTHE STATE OF WORLD POPULATION 201227
Page 6 and 7: OverviewOne hundred seventy-nine go
Page 8 and 9: The report is structured to answer
Page 10 and 11: viiiCHAPTER 1: THE RIGHT TO FAMILY
Page 12 and 13: “All human beings are born free a
Page 14 and 15: Treaties, conventions and agreement
Page 16 and 17: Health: a social and economic right
Page 18: “Everyone has the right to educat
Page 21 and 22: designing and delivering accessible
Page 23 and 24: use, and reduces unintended pregnan
Page 26 and 27: 16 CHAPTER 2: ANALYSING DATA AND TR
Page 28 and 29: Change in Age-Specific Fertility Ra
Page 30 and 31: Sexuality, sexual and gender stereo
Page 32 and 33: not necessarily associated with a d
Page 34 and 35: METHOD EFFECTIVENESSMethod, rankedf
Page 38: Demand and supply over time5 per ce
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: CHAPTERTHREEChallenges in extending
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 58 and 59: per cent in Guatemala. Across all c
Page 60 and 61: tTeenager inMadagascar listens toa
Page 62 and 63: Consensual unions account for an in
Page 64 and 65: when. The proportion of never-marri
Page 66 and 67: 63 per cent to 93 per cent of young
Page 68 and 69: Family planning in humanitariansett
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
Page 81 and 82: CHAPTERFOURThe social and economici
Page 83 and 84: tCommunityeducation inCaracas, Vene
Page 85 and 86: Estimates of Total Fertility2010-20
Page 87 and 88:
children, and healthier women also
Page 89 and 90:
empirical evidence supporting this
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tRicardo and Sarain Mexico City say
Page 94 and 95:
to secure the future population’s
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86 CHAPTER 5: THE COSTS AND SAVINGS
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Unintended Pregnancies and outcomes
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tDonor Commitmentspanel at the Lond
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UNFPA supports the Health for All c
Page 104 and 105:
tDr. BabatundeOsotimehin, Executive
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96 CHAPTER 6: MAKING THE RIGHT TO F
Page 108 and 109:
When individuals are able to exerci
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Family planning programmes must ref
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Family planning programmes reinforc
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tPresident of NigeriaGoodluck Jonat
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Monitoring Monitoring ICPD ICPD Goa
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Page 121 and 122:
Page 123 and 124:
Monitoring ICPD Goals Demographic -
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Monitoring ICPD Goals - Selected In
Page 127 and 128:
BibliographyAbbasi-Shavazi, Mohamma
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Page 131 and 132:
Page 133 and 134:
Page 135 and 136:
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Page 140:
Delivering a world where every preg
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