State of World Population 2012 - UNFPA Haiti

world (United Nations Population Division,2012). In sub-Saharan Africa, adolescentsbetween the ages of 15 and 19 have, on average,120 births per 1,000 per year, ranging froma high of 199 per 1,000 girls in Niger to a lowof 43 per 1,000 girls in Rwanda. Over half ofyoung women give birth before age 20 (Godha,Hotchkiss and Gage, 2011), and adolescentfertility in most countries in sub-Saharan Africahas shown little decline since 1990 (Loaiza andBlake, 2010). In the Caucasus and Central Asia,fertility among adolescents has leveled off overthe past 10 years, perhaps because the regionhas achieved such high levels of girls’ schooling,with gender parity at the secondary level andmore girls studying at the tertiary level than boys(United Nations, 2012). The only region whereadolescent fertility increased between 2000 and2010 was Southeast Asia.The need for comprehensive dataProtecting the right to family planning firstrequires a baseline understanding of who currentlyhas access to family planning and whodoes not. Ensuring rights also requires anData-driven advocacy results inpolitical and financial support forfamily planning in EcuadorFertility rates in Ecuador vary among population groups. Women in thelowest income quintile, for example, have an average of five children,compared to women in the highest income quintile who have about two.These disparities reflect inequalities in access to sexual and reproductivehealth services. In response, UNFPA partnered with the Ministry ofHealth and other bilateral and multinational organizations to collect andanalyse data to document the disparities and to advocate for changesthat would rectify these inequalities. The data made the case in 2009 fora new strategy for family planning and for the prevention of adolescentpregnancy, and as a result, Ecuador stepped up its investments in reproductivehealth supplies, including contraceptives, by more than 700 percent between 2010 and 2012, to $57 million.understanding of how young people and adultsview sex, sexuality, and the decision to havechildren. New technologies make it possible forStates to gain a greater understanding of demographictrends and the environmental factorsthat motivate people to have sex and influencefertility rates. Digital and mobile communicationsmake it possible for people to more easilyaccess information about their rights and theirgovernments’ obligations to uphold them.An assessment of family planning trendsrequires a nuanced analysis of who is most vulnerable,whose needs have been neglected, andwhat factors contribute to peoples’ vulnerabilitiesand their inability to realize their rights to familyplanning throughout their lives (UNFPA, 2010).Good demographic measures tell a complexand evolving narrative. Stakeholders increasinglyneed to analyse these data in concert withinformation about the social, cultural, andpolitical conditions that shape health and causepatterns in health to evolve. The World HealthOrganization asserts that these social determinantsof health drive “most of the global burdenof disease and the bulk of health inequalities”(World Health Organization, 2005). At alllevels—individual, community, and national—social determinants of health establish conditionsthat influence the ability of women, men, andyoung people to access quality family planningwhen they want to prevent or delay pregnancy atdifferent stages of their lives.Policymakers must therefore use comprehensivedata across sectors on population dynamics,including age structures and the rate of urbanization,as well as other trends. Simply increasingthe availability of family planning may do littleto reduce unintended pregnancy without analysesof where unmet need is greatest, where effortsto uphold reproductive rights have been weak,or where cultural, social, economic or logistical36 CHAPTER 2: ANALYSING DATA AND TRENDS TO UNDERSTAND THE needs