State of World Population 2012 - UNFPA Haiti

63 per cent to 93 per cent of young men reportingusing contraception in parts of NorthAmerica, Europe, and Latin America and theCaribbean (United Nations, 2007). These figuresstand in stark contrast with most sub-SaharanAfrican countries, where less than 50 per centof young, sexually active men used a condom atlast sex. Globally, female sterilization remains themost commonly used method, chosen by 20 percent of married women (United Nations, 2011).The figure is much higher in some countriesdepending on fertility patterns and the rangeof reversible methods available to women.Countries, with the support of the international community,should protect and promote the rights of adolescents toreproductive health education, information and care andgreatly reduce the number of adolescent pregnancies …Governments, in collaboration with non-governmentalorganizations, are urged to meet the special needs ofadolescents and to establish appropriate programmes torespond to those needs. Such programmes should includesupport mechanisms for the education and counseling ofadolescents in the areas of gender relations and equality,violence against adolescents, responsible sexual behaviour,responsible family-planning practice, family life, reproductivehealth, sexually transmitted diseases, HIV infection andAIDS prevention.— ICPD Programme of Action, paragraphs 7.46 and 7.47.The international community has morethoroughly cultivated men’s engagement in thecontext of HIV prevention, and communitybasedprevention efforts have contributed toincreased uptake of male condoms. Yet theWorld Health Organization reports that lessthan a third (31 per cent) of young men indeveloping countries have a “thorough andaccurate” understanding of HIV, suggesting thatmore support for men’s sexual and reproductivehealth, including sexuality education and contraceptives,is needed (United Nations, 2009b).Men are increasingly expressing a desire tobe more engaged in planning their families,including reducing the number of unplannedpregnancies (Barker and Pawlak, 2011). Up to50 per cent of men in some countries—Brazil,Germany, Mexico, Spain, and the UnitedStates—would consider hormone-based contraceptionif such male methods became available(Glasier, 2010). Involving men of reproductiveage in family planning programmes from anearly age can promote more constructive communicationbetween couples about the timingand spacing of children.4 Other marginalized groupsIndigenous people and ethnic minorities.Indigenous peoples and ethnic minorities oftenlack access to family planning. Results fromqualitative interviews find that providers themselvesexpress difficulties assisting ethnic andindigenous women, often because of an inabilityto adequately communicate or understandtheir cultural practices (Silva and Batista, 2010;Cooper, 2005). Prejudice against these groupscan lead to lower levels of investment in theirsexual and reproductive health (United NationsEconomic and Social Council, 2009).The harmful consequences of governmentunder-investment are reflected in large disparitiesbetween indigenous and non-indigenous womenon key reproductive and maternal health indicators.These include maternal mortality rates,total fertility rates and unmet need for familyplanning (Silva and Batista, 2010).Significant health-related inequalities existbetween indigenous and non-indigenousgroups in several countries around the world.In Guatemala, for example, where indigenous56 CHAPTER 3: CHALLENGES IN EXTENDING ACCESS TO EVERYONE