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Population Issues to be addressed under the United Nations System-Wide Special Initiative on Africa (UNSIA) March 1998
Prepared by United Nations Population Fund (UNFPA) for the Seventh ACC steering committee meeting

1. Population issues are one of the major concerns of African Governments because of their importance to the achievement of sustainable socio-economic development in the region. This concern has been discussed at various intergovernmental meetings, such as the African Regional Population Conference which adopted the Dakar/Ngor Declaration, the OUA Summit which endorsed a resolution on population and development, and recently the TICAD II preparatory meeting which identified population as one of the priority areas under Social Development. The measure of support given by the African countries to the International Conference on Population and Development (ICPD) Programe of Action in 1994 was also a reflection of this concern. It was in the light of the recommendations and commitments made at these regional and global events that it was agreed at the retreat held on 9 February 1998 in New York that population will be the fifth priority area of the United Nations System-wide Special Initiative on Africa (UNSIA).
   
2. UNFPA, being the lead UN agency for the follow-up and implementation of the ICPD Programme of Action, is fully committed to working in partnership with African governments, all parts of the United Nations System, development banks, bilateral aid agencies, non-governmental organisations and civil societies to improve the quality of life of the population in sub-Saharan Africa. Africa is a priority region for UNFPA and other UN agencies and UNSIA provides a good framework for ensuring partnership and collaboration for population interventions in the region, and for achieving Conference goals (Regional and International) which are beyond the resources and mandate of any one UN agency.
   
3. Bearing in mind discussions held at the Regional Consultative meeting of the UNSIA in Addis Ababa (March 1997), the Retreat in New York (February 1998) and the emphasis on value added in the implementation of UNSIA, the population component of the Initiative will focus on those population issues where UNSIA partners can make a difference. In this regard, reference is made to the important goals of major regional and international conferences namely : ICPD, Dakar Regional Population Conference and the Fourth World Conference on Women (FWCW). These goals include :

• increase accessibility through the primary health care system of fully integrated and high quality reproductive health and information services to individuals of appropriate ages;

• reduction of maternal mortality ratio by one half its current level in the year 2000 and another half by 2015;

• increase contraceptibe prevalence from 10% to 20% by the year 2000 and 40% by year 2010;

• reduction of infant mortality rate (IMR) by 1/3 of the 1990 level by the year 2000. An IMR below 35 per 1000 births should be achieved by 2015;

1. The above goals will contribute to the overal efforts to achieve sustainable socio-economic development that meets human needs and ensure well-being, and protects the natural resources on which all life depends.
   
2. In the light of the above, the critical population and development areas identified for collaboration and coordination with other agencies under the Initiative are the following :
   
3. Reproductive health : The thrust of this area will be for UNFPA and the proposed collaborating UN agencies mentioned below to work with African Governments to develop effective and comprehensive strategies aimed at reducing maternal morbidity and mortality, increasing contraceptive prevalence and preventing and controlling sexually transmitted diseases including HIV/AIDS. The Maternal Mortality Ratio (MMR) in Africa which averages 878/100,000 is unacceptably high compared to figures in other developing parts of the world. It differs from subregion to subregion, worst for East Africa and West Africa with MMR figures of 1,061 and 1,023 per 100,000 live births respectively. The HIV/AIDS prevalence figures as at December 1997 show that, sub-Saharan Africa accounts for 20.8 million of the total 30.6 million people living with HIV or AIDS world-wide. About half of the newly infected cases are adolescents.
   
4. Reduction of this high maternal morbidity and mortality would be achieved by ensuring that reproductive health components are integrated in the health sector reforms and in the minimum health care package at the primary health care level. Health infrastructure will be extended to enable delivery of integrated reproductive health information and services at the grassroots level. UNFPA will take the lead in ensuring that the provisions of the Programme of Action of the ICPD are fully integrated into the health policies of the countries. As part of the strategies to reduce maternal morbidity and mortality, efforts will be made to ensure that the full range of reproductive health services will be available to all who need them. These will include services for family planning, and maternal care, promote the prevention of harmful practices and violence against women, prevention and management of reproductive tract infection including STDs, and advocacy for an increase in the age at marriage and for reduction in teenage pregnancy. It is proposed that UNSIA will be used as an avenue to coordinate the efforts of governments, UN agencies (WHO, UNFPA, UNICEF, UNDP, UNIFEM), the World Bank and other donors to achieve the goal of reducing the maternal mortality ratio by 50% of its current levels by the year 2000 and by another 50% by the year 2015.
   
5. In view of the rapid spread of HIV infection and the impact on socio-economic development in sub-Saharan Africa, special efforts will be made within the context of UNAIDS and RH programmes to review and strengthen with African governments the strategies developed to prevent, manage and control the spread of STDs, particularly HIV/AIDS in sub-Saharan Africa. UNFPA and the proposed partners UNAIDS, WHO, UNDP, UNICEF, World Bank and other external partners, will also undertake a major advocacy campaign to enlist the support and commitment of African governments at the highest level to address the HIV/AIDS epidemic. Awareness will also be created about the high maternal morbidity and mortality among policy makers. This will help to increase political support and financial commitment from national governments for RH including HIV/AIDS prevention and control programs.
   
6. Education : Population Family Life Education (POP/FLE) contributes to improving the quality of basic education since it introduces contents which have direct relevance to the learners. It also emphasises participatory education which facilitates learning. POP/FLE influences gender attitudes, responsible behaviour and the development of self esteem. Under UNSIA, Population Family Life Education for both in-and out-of-school population would have the objective to create awareness and positive attitudes on health including reproductive health, human rights including reproductive rights and gender issues. The linkages between reproductive health/reproductive rights and other rights of women such as, employment, education, socio-economic status; gender equity and equality; protection againsst HIV/AIDS infection; environment; the importance of basic education of young people, particularly girls; the elimination of gender-based violence and harmful traditional practices will form part of the POP/FLE messages. UNFPA in collaboration with proposed partners UNESCO, WHO, UNICEF, UNIFEM, African Development Bank (ADB) and others who are interested will collaborate with Governments to review the status of ongoing programmes in order to develop the relevant messages and to ensure that population family life education becomes institutionalized in African countries.
   
7. Formulation/Revision of National Population Policy : UNFPA has been assisting countries in the formulation/revision of national population policies, taking into consideration recommendations of international conferences and adopting a multisectoral approach to population and development. Under the Initiative, and in collaboration with other agencies, UNFPA will continue to play the lead role to facilitate and support the formulation/revision and implementation of comprehensive national population policies and to ensure that the objectives of the population policies are reflected in other development/sector policies and programmes. These population policies will take into account pertinent and emerging issues (such as empowerment of women and gender equality, health including RH and the special needs of adolescents and youth, education, employment, water and sanitation, environment and natural resources. Action plans for the implementation of the population policies will be developed/revised by UNFPA in collaboration with proposed partners such as the FAO, ILO, the World Bank, UNDP, UNIFEM and UNICEF to improve their relevance, and guide better implementation, monitoring and evaluation of the national population policies/programmes.
   
8. Gender Disaggregated Benchmark data : UNFPA will assist countries to have benchmark gender disaggregated basic social services and demographic data for planning, monitoring, and evaluation of programmes under the Initiative as well as other development sectors. Relevant information necessary to monitor basic social services will be collected during the Common Country Assessments, Demographic and Health Surveys and Censuses. The 2000 round of censuses provide a unique opportunity for the UN partners to identify the indicators for which data will be required for monitoring and evaluation purposes of UNSIA and other development sectors.
   
9. National Capacity Building : UNFPA will assist African governments to build national capacity through training, south-south cooperation and technical assistance to manage and implement the population policy action plans; health including reproductive health and population family life education programmes. UNFPA proposes that WHO, UNICEF, UNESCO, UNDP, UNIFEM, the World Bank and other partners will work with African governments to formulate national human resources development action plans for the creation of critical masses of human resources in the population areas. The implementation of the action plan will call for the joint development of training curricula and support to the training of health care providers and other appropriate personnel. This will also include strenghening of the population/planning departments to coordinate the multi sectoral approach involved in the implementation of population policies and utilization of population variables in development planning. Building capacity in this area will be linked to such activities in other sectors.
   
10. Resource Mobilization : UNFPA will continue to advocate for a sustained political commitment and financial support for Population and Development in the context of the resource mobilization efforts of UNSIA. The advocacy will focus on both domestic and external resource mobilization and the creation of a conducive environment to support population programmes in sub-Saharan Africa. Special efforts will be made to increase the external resources for population programmes in the region.