Third meeting of the Working Group for the Follow-up to the Dakar/Ngor Declaration/
International Conference on Population and Development

Dakar, Senegal
18-20 December 2002

Monitoring the Implementation of the Dakar/NGOR Diclaration and the ICPD Programme of Action

Progress with Africa ICPD+10 review

I. INTRODUCTION

1. At its second meeting, held in Dakar, Senegal, on 14-16 June 2000, the Working Group for the follow-up to the DND/ICPD reviewed the main findings and recommendations of the ICPD+5 review process and made proposals for the substantive preparations of ICPD+10 in Africa.

2. The paper will attempt to recall the main recommendations of the Second Meeting of the Working Group, summarize the main findings and recommendations of the Fourth Meeting of the Follow-up Committee and make proposals for the preparation of ICPD+10.

II. THE SECOND MEETING OF THE WORKING GROUP

3. The Second Meeting of the Working suggested that the ten-year review and evaluation process in the Africa region will focus on the following five main thematic areas: Poverty and demographic changes; HIV/AIDS; Youth; Migrations; Gender.

4. The Meeting further suggested that the following issues will be addressed in each of the five thematic areas:

(i) Poverty and demographic changes:

- Relevant indicators to measure and monitor poverty

- Focus on trends and collect data to enable comparative analysis within subregions

- Determine the qualitative aspects of poverty based upon the data collected

(ii) HIV/AIDS:

- Issue of appropriate methodologies to determine more accurate AIDS prevalence

- Socio-economic implications of HIV/AIDS

- Appropriate IEC strategies for prevention, counseling and treatment

- Budget allocation in co-financing HIV/AIDS treatment

(iii) Youth:

- Proportions and characteristics of the youth

- Education and vocational training

- Employment and insertion of young graduates in the labor market

- Strategies formulated and implemented by Governments to address these issues

- Health and adolescent sexuality

(iv) Migrations:

- Internal migrations

- International migrations

- Type and systems of migrations within sub-regions in Africa

- Integration instruments - Find out whether African sub-regional economic communities (SADEC, ECOWAS, COMESA...) have formulated strategies and put in place data collection systems on migrations

- Impact of migrations on receiving and sending countries

- Data collection and analysis on migrations

(v) Gender:

- Issues addressed in the final document of UNGASS on ICPD+5

- Operationalization of the concept

- Strategies to integrate gender perspectives into the socio-economic development process

- Women empowerment through access to land, micro-credits, education...

- Partnerships between Governments and NGOS including community-based associations

5. The meeting also recommended that both quantitative and qualitative aspects should be evaluated during the process. The quantitative evaluation will use the country questionnaire to assess progress made in country implementation of the DND/ICPD and the recommendations contained in the final document on the key actions. The qualitative evaluation will be based on the preparation of country reports.

6. Concerning the partnership arrangements, the meeting suggested that the Joint Secretariat should involve NGOS, IGOs, sub-regional economic communities in the evaluation process and make use of existing Memoradum of Understanding (MOU) between members of the Joint Secretariat and other institutions to complement different areas of intervention.

III. THE FOURTH MEETING OF THE FOLLOW-UP COMMITTEE

7. The Follow-up Committee on the implementation of the DND/ICPD held its Fourth Meeting on 28-31 January 2002 in Yaounde, Cameroon, discussed the population perspectives in the NEPAD and made relevant recommendations including proposals on the ICPD+10 review process in Africa. It is also to be noted that participating NGOS established a mechanism to co-ordinate their activities in implementing identified NEPAD priories i. e.:  NEPADACT.

8. Participating countries reported mainly on policy interventions, accomplishments, challenges/constraints and the way forward in "Reproductive Rights and Reproductive Health with special reference to HIV/AIDS" as summarized below

3.1 Country experience in population matters: Policies and interventions in "reproductive rights and reproductive health, with special reference to HIV/AIDS "

Policy interventions and accomplishments       

9. Since 1994, there has been increased awareness among policy makers on the concept of reproductive health (RH) and reproductive rights (RRs). With the increasing political commitment at the highest level, most countries have revised their existing population policies to include new emerging issues and developed RH programmes and strategies with a special focus on HIV/AIDS and STDs. New AIDS policies place more emphasis on the role of the private sector and NGOs, and are decentralized with district or community response initiatives.

10. Accordingly, the role of monitoring and coordinating the implementation of these programmes and the surveillance of the pandemic have been assigned to government institutions or Commissions specifically set up to perform these functions. In some countries (e.g., Ghana, Kenya and Niger), the National AIDS Commission was established in the office of the Head of the State.

In Rwanda, the support for the fight against HIV/AIDS has been realized at the highest political level following the initiative of the First Lady who created a Fund to combat AIDS.

11. Countries reported that they have operationalised the concept of RH on several fronts, i.e. universal access to health and reproductive health services, safe motherhood, family planning, prevention of abortion and care for its complications, fight against HIV/AIDS and STDs, fight against sexual violence and services including FGMs, reproductive health for the youth and adolescents, human resources training and development, institutional and legal framework and policies, IEC, etc...

12. As far as counseling and research are concerned, some countries (e.g. Lesotho and Côte d'Ivoire) reported that they established counseling clubs and centres to educate and provide counseling services in RH to the most vulnerable segments of the population, especially to the youth. In South Africa, the Human Science Research Council was commissioned to conduct a situational analysis in key development sectors on the impact of HIV infection and AIDS mortality on the population. As a result, thirteen cases studies have been prepared, indicators to measure impact are being developed, and concerns have been raised on the high mortality rate among teachers as a result of HIV/AIDS.

13. IEC campaigns have been promoted at the national and regional levels to sensitize population, especially the most vulnerable groups, on the RH and HIV/AIDS issues. In Gabon, for example, more than 95 per cent of the population is aware of the pandemic and ways of its spread. In Nigeria, knowledge and use of contraceptives were promoted respectively from 9 per cent to 30 per cent and from 3 to 12 per cent during the period 1990-1999. In Tanzania, family life education has been incorporated in primary and secondary schools. In South Africa, a primary HIV/AIDS capacity development programme for Government planners was launched in July 2001 with a two-pronged approach to raise awareness and to develop basic skills for government planners. To date 1000 Government planners have been trained within this programme to be able to analyze and interpret population data projections, and therefore mainstream population dynamics in development planning.

14. Countries have also striven to train a lot of professionals and workers in the RH field. Lesotho reported that the country conducted several activities including the following: Trained family planning service providers in contraceptive logistics management, Trained nurses and officers in RH programmes in three pilot health service areas, and organised refresher training for CBD (Community Based Distribution) agents in the mountain districts to improve accessibility of family planning services at the community level. An obstetric record book has been developed and finalized and a Parent Education Programme (PEP) manual has been developed, pre-tested, produced and translated into the local language.

Challenges/Constraints

15. Countries reported that despite all these efforts made at the regional, sub-regional and national levels to improve RH and eradicate HIV/AIDS, Africa is still facing increasing challenges of ever-spreading of the pandemic, conflict, poverty, food insecurity, debts, etc. All these issues are inter-related and make it difficult to achieve a long-term goal of reducing population growth rates and ensuring sustainable human development in the continent.

16. Other challenges and constraints as identified in the national reports are the following: Urbanization as a factor of poverty and food insecurity; Environmental degradation; Unemployment; Conflicts resulting into a massive flow of refugees and displaced persons; Weak infrastructure of IEC; Lack of high quality personnel in the area of population and development; Sustainability of government commitment towards population programmes especially with respect of HIV/AIDS; Preventing reversals of the gains already achieved by the reproductive health programmes and sopping spread of HIV; Cultural norms and practices that compromise RH; Financial constraints; Inadequate systems of national information and lack and poor quality of data.

3.2 Main recommendations of the Committee

17. Given the achievements, best practices and constraints identified by the meeting, the Committee adopted the following recommendations for the way forward on population and development in Africa including proposals for ICPD+10.

Enabling political environment for the implementation of DND/ICPD

(i) Priority should be given to conflict prevention and resolution, peace, resettlement of displaced people, democracy and good governance. Poverty alleviation plans should aim at achieving social justice and improving the quality of life of the most vulnerable segment of the population. Improvement of African socio-economic welfare should take into account environment protection, sustainable development and attainment of food security.

(ii) African countries and the international community are called upon to strengthen their commitment to implementation of the DND/ICPD. Additional resources should be mobilized at the national and international levels to support the implementation of population and reproductive health programmes.

Health Policies and RH Programmes

(i) Priority should be given to the primary health care package addressing immunization, safe motherhood, HIV/AIDS, tuberculosis, malaria and other endemic illnesses.

(ii) The reproductive health policies currently in place should be translated into more effective interventions. Sub-regional and regional programmes taking into account country specificities should be implemented and monitored.

(iii) Reproductive health programmes including family planning that target selected sub-groups, notably youth, adolescents and rural populations are needed. In conformity with the ICPD, crucial areas for policy consideration should include:

- Women status, male involvement and gender relations.

- Reproductive rights and reproductive health

HIV/AIDS

(i) HIV/AIDS pandemic should be aggressively addressed regardless of the prevalence level of individual countries. In this regard, African countries and their development partners should be committed to implement declarations adopted at various fora including the African Summit on HIV/AIDS, Tuberculosis and Other Infectious Diseases (Abuja, Nigeria, April 2001) and UN General Assembly Special Session (UNGASS) on HIV/AIDS (New York, June 2001), in particular, the recommendation at the Abuja Summit to direct 15% of budgetary allocation to the health sector.

(ii) Strategies to decentralize fight against HIV/AIDS should be put in place and involve traditional and community leaders at all levels including religious leaders. Information on best practices in effective prevention campaigns should be disseminated

(iii) National capacities in HIV/AIDS testing and counseling should be strengthened. Women and men should be sensitized on the modes of transmission including mother-to-child transmission. Advocacy interventions directed to leaders and parliamentarians and IEC campaign targeting young people, especially girls, should be promoted.

(iv) Methods of HIV/AIDS data collection and analysis should be improved. Research on demographic and socio-economic impacts of HIV/AIDS and surveys on sexual behavior should be encouraged.

(v) Programmes of social support should be put in place in order to assist those infected or affected by HIV/AIDS, especially the elderly people and AIDS orphans.

Capacity building, Data, Monitoring and evaluation mechanisms

(ii) Capacity building in support of the implementation of both DND and ICPD-PA should be strengthened. Particular attention should be given to:

- Promoting South to South cooperation,

- Strengthening partnerships among governmental institutions and NGOs,

- Supporting national institutions which deal with population and development policies and programmes as well as regional research and training institutions

(iii) Collection, analysis and dissemination among countries including development of country information systems and databases should be supported and harmonized. Data collection should include among others information on HIV/AIDS.

(iv) National and regional evaluation and monitoring of the implementation of DND and ICPD-PA should be strengthened.

ICPD+10

(i) The ten-year review process in the Africa region should focus on the following seven

thematic areas: (i) Reproductive health; (ii) Youth; (iii) Gender; (iv) Migration and urbanization; (v) Poverty, population, environment and sustainable development, (vi) HIV/AIDS; (vii) Resource mobilization

Population perspective of NEPAD

(i) Population concerns, including priority sectors identified by the meeting, should be considered within the implementation framework of NEPAD. The following priority areas are identified: (i) Poverty reduction and sustainable development; (ii) HIV/AIDS; (iii) Population dynamics and distribution; (iv) Data, information and communications; (v) Reproductive health and; (vi) Human resources development/employment.

IV. PROPOSALS FOR FOLLOW UP ACTIVITIES IN PREPARATION FOR AFRICA ICPD+10 REVIEW: 2002-2004

18. In spite of the growing number of national population policies and programmes adopted in Africa, there are still some constraints in planning their implementation. However, the prospects today seem brighter for the implementation of the DND/ICPD given the considerable efforts made by Governments, international and regional organizations, donors and NGOs in undertaking timely and periodic reviews of population and development strategies as implied by the IDPD recommendations. Indeed, the identification and examination of achievements and best practices, as was done in the context of the ICPD+5 process, shows how constraints can be overcome and how broad principles can be operationalized. This was the basis for formulating operational and technical perspectives on further implementation of the DND and the ICPD-PA.

19. In order to update the work already done, the Joint Secretariat will continue to monitor country implementation of the recommendations of the DND/ICPD, including the key actions adopted at the UNGASS. Assuming that ICPD+10 will have to be completed by September 2004, activities described below and summarized in table 1, are proposed for the period 2002-2004:

(i) Convening of the Third Meeting of the Working Group to define guidelines for the substantive preparation of the ICPD+10 review process, including the schedule of events in preparation for the regional assessment and the inputs of sub-regional population and development institutions (ECA, December 2002 );

(ii) Finalization and dissemination of a detailed country questionnaire on the implementation of the DND/ICPD and follow-up as required. Given the experience of the ICPD+5 review process, it is suggested to use a team approach for the preparation of the questionnaire i.e. a team comprising of Experts in population and development, reproductive health, gender issues, IEC and economy (ECA, November 2002-February 2003);

(iii) Preparation of 15 country in-depth evaluation reports (3 countries per sub-region) which themes will be selected among the seven thematic areas identified by the Follow-up Committee (Country experts/ ECA-SRDCs, January-March 2003);

(iv) Preparation by sub-regional institutions of sub-regional reports on ICPD+1O as inputs into the regional report (Sub-regional institutions, January-April 2003);

(v) Comparative analysis of country in-depth evaluation reports (ECA/SRDCs, April-May 2003);

(vi) Preparation of a comparative analysis report on population matters, policies and interventions in « reproductive rights and reproductive health, with special reference to HIV/AIDS » based on country reports prepared for the Fourth Meeting of the Follow-up Committee (ECA/Consultant, April-May 2003);

(vii) Organization of one sub-regional ICDP+10 review meeting in each of the five sub-regions (ECA/SRDCs, September-November 2003);

(viii) Analysis of data and information contained in the returned completed country questionnaires, the country in-depth evaluation reports, the sub-regional evaluation reports and the comparative analysis report (ECA/SRDCs/Consultants, November 2003-February 2004);

(ix) Production of a comprehensive Africa regional evaluation report highlighting the main achievements, including best practices and programme needs, and constraints in the goals of the DND/ICPD and formulating recommendations for the way forward (ECA/Consultant, March -April 2004);

(x) Organization of the Fifth Meeting of the Follow-up Committee to enable participants, including country experts, International Organizations, donors and NGOs, to review country-specific reports and the regional report on ICPD+10 (ECA, May 2004);

(xi) Organization of a Ministerial Meeting to endorse the findings of the ICPD+10 review process and adopt a declaration of commitment for the further implementation of the DND/ICPD (ECA, May 2004) and,

(xii) Further development of Population Information Africa (POPIA) Website for information sharing and exchange of experiences on the implementation of population policies and programmes, i.e.: improving the existing site, expanding the Web page on Follow-up Committee on the implementation of the DND/ICPD, designing a Web Page on NEPADACT and creating and managing of list serve on NEPADACT, designing a Web page dedicated to Women's Reproductive Health and Household Food Security in Africa, producing a leaflet on POPIA Website and disseminating the POPIA Website in CD-ROMs (ECA, December 2002-March 2003)

Table 1 - Proposed activities for 200O-2004

V. CONCLUSION AND RECOMMENDATIONS

13. This meeting of the Working Group is invited to pay particular attention to issues and recommendations emanating from ICDP+5 review process in order to come out with guidelines and proposals to enhance activities of the Joint Secretariat and major stakeholders towards effective monitoring and evaluation of country implementation of the DND/ICPD recommendations. Therefore, the various outcomes expected from the meeting include the following:

(i) Orientations for the scope and content of a questionnaire for evaluation of country implementation of the DND/ICPD recommendations including the key actions adopted at the UNGASS;

(ii) Proposals for follow-up activities during 2003-2004 in preparation for Africa contribution to ICPD+10 review process including the preparation of the regional evaluation report;

(iii) Guidelines for building partnerships with regional and subregional institutions, IGOs and civil society for the follow-up of the implementation of the DND/ICPD including suggestions on the role and contribution of these institutions in implementing proposals contained in (ii) above.