State of World Population 2012 - UNFPA Haiti

when. The proportion of never-married adults issteadily increasing in all parts of the world, placingnew obligations on States to meet the familyplanning needs of older people (United Nations,Department of Economic and Social Affairs,2009). In their older years, women and menhave unmet need for “mature-friendly” services.Male fertility declines very gradually over aperiod of many years (Guttmacher Institute,2003, cited in Barker and Pawlak, 2011). Fertilelong after females, older men often lack supportfor preventing high-risk pregnancies in theirrelationships, many of which occur with youngerwomen. With greater numbers of single men andwomen having sex after marriage and marital dissolution,a complementary focus on educatingolder men about the benefits and availability ofall methods, including condoms and no-scalpelvasectomy, could empower elders with resourcesto prevent unintended, high-risk pregnancies inolder age, thereby protecting older women’sright to health.Low rates of unintended pregnancyand abortion among young peoplein the netherlandsThe Netherlands has addressed the obstacles to young people’s accessin a variety of ways (Greene, Rasekh and Amen, 2002). Among thechanges of note were: Comprehensive sex education in primary andsecondary schools that includes instruction on relationships, valuesclarification, sexual development, skills for managing healthy sexuality,and tolerance for diversity, for which teachers receive regular trainingin content and instructional approaches; the provision of qualityinformation to parents, family doctors, youth-friendly clinics and themedia; patient-doctor confidentiality, even among young adolescents;and explicit and humorous national campaigns on sexual health. Thetheme running through the policy commitment to youth sexual andreproductive health in the Netherlands is that laws should addressreality, not ideology (Ketting, 1994). In short, the government respondedto the needs and rights of young people with policies that ensure theiraccess to information and services. The Netherlands now has among thelowest rates of unintended pregnancy and abortion in the world.3 MalesMen and women in heterosexual relationshipscan be partners in discussing the timing andspacing of children. Nonetheless, the needsand participation of men and boys in familyplanning has received little attention relative totheir roles as supportive partners for women’shealth (Barker and Pawlak, 2011). Consideringthe evidence and the increased awareness aboutthe importance of engaging men and boys inhealth and gender equality, national responsesto the interlinked family planning needs of bothwomen and men remain limited in scale and inscope (Barker et al., 2010).A growing body of evidence over the last 20years has demonstrated that harmful gendernorms influence attitudes and behaviours amongboys and men, with negative consequences forwomen and girls and men and boys themselves(Barker, Ricardo and Nascimento, 2007; Barkeret al., 2011). This same programme researchacross diverse settings has noted that boys andmen can and often do adopt gender-equitableattitudes and behaviours that support improvedhealth for themselves, their partners, and theirfamilies. This insight is increasingly informingfamily planning policies and programmes.In addition, several international conventionsand agreements including the Programmeof Action of the ICPD affirm the importanceof men’s participation in family life, includingsexual and reproductive health and familyplanning. More governments now engage inpolicy dialogue around men’s roles in sexual andreproductive health, and greater numbers ofdevelopment practitioners integrate gender intoprogramme designs.The international community has acknowledgedthat male partners can exert considerableinfluence in couples’ fertility preferences(UNFPA, 1994; Bankole and Singh, 1998).54 CHAPTER 3: CHALLENGES IN EXTENDING ACCESS TO EVERYONE