Reproductive health

Spotlight on Development

David Rooney

Goal: Provide access for all who need reproductive health services by 2015

Reproductive health services are an area where gains have been made in recent years, but with rising numbers of people in poor countries passing through their reproductive ages, the pressure is on to sustain and build upon this progress in the decade ahead.

Increased attention is now being paid to the quality and range of services provided, including offering a wider choice of contraceptives, so as to meet the individual needs of women, men and adolescents.

Reproductive health services provide women, men and adolescents with the knowledge they need to protect their health and that of their families. The services include provision of family planning methods, prenatal and postnatal care, preventing and treating sexually transmitted diseases, including HIV/AIDS, and discouraging harmful practices against women, such as female genital mutilation. There is a growing recognition of the need to integrate such services into primary healthcare and to afford them priority when it comes to reform and decentralisation.

Take the example of the Islamic Republic of Iran, which in 1989 integrated a national family planning programme into its extensive primary healthcare system. This move not only led to increased access, but also helped to promote greater choice of contraceptive use. And in response to the 1994 Cairo International Conference on Population and Development (ICPD), the scope of the programme was widened to include other components of reproductive health. It proved to be a successful strategy. Between 1989 and 1997 the contraceptive prevalence rate per 1,000 married women aged 15-49 in Iran rose from 49% to 73%.

Measuring access to reproductive health services is anything but straightforward, since not only do questions like proximity to delivery points, the types of services available and their affordability have to be taken into account, but consideration also has to be given to the extent to which women feel free to utilise the available services.

Contraception is a case in point. Its use increased in all regions in the 1990s – but Africa lags markedly behind other regions, especially in the poorest African countries. Expanding the use of contraception clearly depends on access and information, but gender relations and power balances within couples are also important. Reproductive health depends on the extent to which men discipline their own sexual behaviour and support their partners’ rights and health. Power relationships are often embedded in culture and customs, which is why education plays such a determining role.

Adolescent problems  

Another major challenge is to increase access to reproductive health information and services for adolescents. There are currently more than 1.1 billion adolescents aged 10-19, the largest number ever in this age group. Many adolescents lack formal education, work and beneficial recreation; many live in extreme poverty; and many are not sufficiently aware of the dangers they face, ill equipped to protect themselves and willing to take potentially life-threatening risks.

Globally more than 14 million adolescent girls give birth each year. A large proportion of those pregnancies are unwanted, and an estimated 4.4 million abortions are sought by adolescent girls each year.

Many adolescents also face serious risks of contracting sexually transmitted diseases, including HIV/AIDS. At the end of 1999, 33.6 million men, women and children were living with HIV/AIDS, 95% of them in developing countries. More than half of new HIV infections occur among 15-24-year-olds. Effective national programmes, together with massive international support, can help attack the pandemic at its root, offering hope to millions.

This is the thinking behind the ICPD plus 5 goal, which aims to ensure that by 2005 at least 90% of young men and women aged 15 to 24 will have access to the information, education and services they need to reduce their vulnerability to HIV infection. The aim is to cut the HIV infection rates in persons aged 15 to 24 globally, and by 25% in the most affected countries. Reducing levels of HIV/AIDS requires not only expanded access to quality reproductive health services, but also major changes in intimate aspects of human relationships and behaviour, in values and norms, and so on. That means education, via formal and informal programmes and media campaigns. But changes in behaviour also require support from political, religious and community leaders, who have to acknowledge the seriousness of the problem. Getting them to do so will be an important part of the challenge ahead. End

* The views in this article are those of the author and do not necessarily reflect those of UNFPA.

For larger graph, please click here


• United Nations, “Population and Development, Vol.1., Programme of Action adopted at the International Conference on Population and Development”, Cairo, 5-13 September 1994, United Nations, New York, 1995.

• United Nations, “Key actions for the further implementation of the Programme of Action of the International Conference on Population and Development.” Report of the Ad Hoc Committee of the Whole of the Twenty-first Session of the General Assembly, New York, 1999.

• United Nations Population Fund (UNFPA), Report of the 1998 UNFPA Field Inquiry: Progress in the Implementation of the ICPD Programme of Action, New York 1999.

• United Nations Population Fund (UNFPA), Country Population Assessment: Islamic Republic of Iran, UNFPA, Tehran, 2000.

©OECD Observer No 223, October 2000

Economic data

GDP growth: +0.6% Q1 2019 year-on-year
Consumer price inflation: 2.3% May 2019 annual
Trade: +0.4% exp, -1.2% imp, Q1 2019
Unemployment: 5.2% July 2019
Last update: 8 July 2019


Stay up-to-date with the latest news from the OECD by signing up for our e-newsletter :

Twitter feed

Subscribe now

<b>Subscribe now!</b>

To receive your exclusive paper editions delivered to you directly

Online edition
Previous editions

Don't miss

  • MCM logo
  • The following communiqué and Chair’s statement were issued at the close of the OECD Council Meeting at Ministerial level, this year presided by the Slovak Republic.
  • Food production will suffer some of the most immediate and brutal effects of climate change, with some regions of the world suffering far more than others. Only through unhindered global trade can we ensure that high-quality, nutritious food reaches those who need it most, Angel Gurría, Secretary-General of the OECD, and José Graziano da Silva, Director-General of the United Nations Food and Agriculture Organization, write in their latest Project Syndicate article. Read the article here.
  • Globalisation will continue and get stronger, and how to harness it is the great challenge, says OECD Secretary-General Gurría on Bloomberg TV. Watch the interview here.
  • OECD Secretary-General Angel Gurría with UN Secretary-General António Guterres at the 73rd Session of the UN General Assembly, in New York City.
  • The new OECD Observer Crossword, with Myles Mellor. Try it online!
  • Listen to the "Robots are coming for our jobs" episode of The Guardian's "Chips with Everything podcast", in which The Guardian’s economics editor, Larry Elliott, and Jeremy Wyatt, a professor of robotics and artificial intelligence at the University of Birmingham, and Jordan Erica Webber, freelance journalist, discuss the findings of the new OECD report "Automation, skills use and training". Listen here.
  • Do we really know the difference between right and wrong? Alison Taylor of BSR and Susan Hawley of Corruption Watch tell us why it matters to play by the rules. Watch the recording of our Facebook live interview here.
  • Has public decision-making been hijacked by a privileged few? Watch the recording of our Facebook live interview with Stav Shaffir, MK (Zionist Union) Chair of the Knesset Committee on Transparency here.
  • Can a nudge help us make more ethical decisions? Watch the recording of our Facebook live interview with Saugatto Datta, managing director at ideas42 here.
  • The fight against tax evasion is gaining further momentum as Barbados, Côte d’Ivoire, Jamaica, Malaysia, Panama and Tunisia signed the BEPS Multilateral Convention on 24 January, bringing the total number of signatories to 78. The Convention strengthens existing tax treaties and reduces opportunities for tax avoidance by multinational enterprises.
  • Globalisation’s many benefits have been unequally shared, and public policy has struggled to keep up with a rapidly-shifting world. The OECD is working alongside governments and international organisations to help improve and harness the gains while tackling the root causes of inequality, and ensuring a level playing field globally. Please watch.
  • Checking out the job situation with the OECD scoreboard of labour market performances: do you want to know how your country compares with neighbours and competitors on income levels or employment?
  • Trade is an important point of focus in today’s international economy. This video presents facts and statistics from OECD’s most recent publications on this topic.
  • The OECD Gender Initiative examines existing barriers to gender equality in education, employment, and entrepreneurship. The gender portal monitors the progress made by governments to promote gender equality in both OECD and non-OECD countries and provides good practices based on analytical tools and reliable data.
  • Interested in a career in Paris at the OECD? The OECD is a major international organisation, with a mission to build better policies for better lives. With our hub based in one of the world's global cities and offices across continents, find out more at .
  • Visit the OECD Gender Data Portal. Selected indicators shedding light on gender inequalities in education, employment and entrepreneurship.

Most Popular Articles

OECD Insights Blog

NOTE: All signed articles in the OECD Observer express the opinions of the authors
and do not necessarily represent the official views of OECD member countries.

All rights reserved. OECD 2019