During the 2009 Israel–Gaza conflict, non-emergency health services were all but extinguished in the Gaza Strip. Over the 23 days of fighting, 5,000 women went into labor. Many of the 1,300 civilians who died during the conflict were newborns and mothers who were left without access to skilled birth attendants. The United Nations Population Fund (UNFPA) was the first agency on the ground after the ceasefire, working to prevent countless additional injuries and deaths.
Even before a massive earthquake struck Haiti in 2010, the small nation was considered the most dangerous place to be pregnant in the Western Hemisphere. Women there faced a one in 47 chance of dying of maternal causes over their lifetime. The earthquake increased the challenges of this poor country, where only 25 percent of births take place in hospitals or health centers. Following the quake, UNFPA responded rapidly to protect the health of women in displacement camps and in rural areas, strengthening the capacity of local midwives and providing essential supplies. To reduce rates of gender-based violence in camps, UNFPA installed streetlights in camps, concentrating on areas in which women were especially vulnerable to violence. And, working with partners, UNFPA has constructed maternity centers in rural areas to meet the needs of pregnant women.
|Two young women recover from fistula surgery at a nationally run clinic in N’Djaména, Chad. Obstetric fistula is a common problem due to a culture that marries girls at such a young age. UNFPA and the government of Chad are working to develop a clinic specifically to perform this surgery. Photo: Micah Albert, Courtesy of Photoshare|
What is UNFPA?
Governments in developing countries often need financial and technical help in setting up and maintaining reproductive health programs. They need emergency assistance after natural disasters and warfare, and they need programs that are consistent and reliable. The good news is that one multilateral agency is fully capable of providing such help.
Established in 1969, UNFPA is the largest population assistance organization in the world, currently operating in more than 150 countries. Originally called the United Nations Fund for Population Activities, the organization is still known by its old acronym. UNFPA works in more countries than any other donor agency, and plays a key role in regions where few donors provide population assistance. UNFPA only provides assistance at the request of host governments, and operates only voluntary programs. Often, UNFPA runs programs in conjunction with local or national population assistance organizations.
UNFPA is guided by the Millennium Development Goals (MDGs). Adopted in 2000, the MDGs set ambitious goals for eradicating poverty, empowering women, improving health, and protecting the environment. One of the MDG targets, under Goal 5 (to improve maternal health), is to achieve universal access to reproductive health and family planning services by 2015. “Working for the survival and wellbeing of women and girls is a human rights imperative. And in order to take advantage of women’s full potential in the development of their nations, they must be able to plan their lives and families,” says Babatunde Osotimehin, executive director of UNFPA. “This is why the international community is determined to making universal access to reproductive health a priority.”
UNFPA operates in accordance with the Programme of Action, developed in 1994 at the International Conference on Population and Development in Cairo (ICPD). Its main objectives are to provide universal access to reproductive health services, achieve universal primary education and close the gender gap in education, reduce maternal and infant mortality, increase life expectancy, and reduce HIV infection rates.
|An auxiliary nurse and midwife (ANM) provides health services to a pregnant woman in Rajasthan, India. The ANM lives in a room above the health center of the tiny village so she is available at all hours to attend to those who need her help. Photographer: RN Mittal c/o Ray Rajat/UNFPA, Courtesy of Photoshare|
Why is UNFPA Needed?
There are 222 million women in the developing world who want to delay or end childbearing, but are not using modern contraception—a situation called “unmet need for family planning.” Family planning is essential for avoiding injuries and deaths caused by mistimed or unwanted pregnancies. One-third of maternal deaths could be prevented with the use of contraception.
The number of women with unmet need expands each year as the number of women of reproductive age continues to grow. Since 2000, when the MDGs were adopted, the number of women ages 15-49 in the developing world has increased by over 230 million. That figure is projected to increase by another 50 million between now and the 2015 MDG deadline.
Who Supports UNFPA?
UNFPA is funded by voluntary contributions from governments and intergovernmental organizations; it is not part of the regular United Nations budget. In 2010, UNFPA’s income from governments and private donors totaled $491.2 million. The top donors were the Netherlands, Sweden, Norway, U.S., Denmark, and Finland. Every single country in sub-Saharan Africa, Latin America, and the Caribbean gave, even if their contributions were small and purely symbolic.
During the Bush Administration, the President withheld congressionally appropriated funding for UNFPA for seven consecutive years, citing unfounded claims that the agency participates in coerced abortion activities in China. This withholding caused the agency to accrue a deficit of approximately $244 million.
The 2009 Omnibus spending bill, signed by President Obama, included $50 million for UNFPA. In 2010, the U.S. gave $55 million, and in 2011 it contributed $50 million. Obama’s 2012 budget includes a $47 million request for UNFPA. After a long hiatus, the United States has once again joined over 180 countries to support increased access to reproductive health services around the world.
UNFPA does not provide abortion services. The agency seeks to minimize dependence on abortion as a method of family planning, opting instead to promote preventive services. UNFPA opposes fertility targets, quotas, and China’s one-child policy. The pilot program that UNFPA manages in China is designed to educate officials about the superior effectiveness of voluntary programs.
- In 2008, the Campaign to End Fistula provided 4,000 women with treatment for fistula (a debilitating childbirth injury) with support from UNFPA.
- A UNFPA-backed street theater and rap performance campaign in Ghana triggered an 80 percent rise in condom use in just six months.
- A UNFPA-funded clinic in Otavalo, Ecuador serves more than 1,000 people per month. As a result, the contraceptive prevalence rate in this community has risen from 10 to 40 percent.
- In 2009, UNFPA provided 7,500 hygiene kits and 1,600 clean delivery kits to internally displaced women in Somalia.
- In order to improve rural access to reproductive health care—including skilled birth attendants—UNFPA provided funding and technical support to an accelerated midwife training program run by the Ethiopian Ministry of Health. Midway through 2012, 1,600 midwives had already graduated.
- Beginning in 2008, UNFPA has worked on the Joint Program on Female Genital Mutilation and Cutting. The program promotes the abandonment of FGM by educating citizens about the harmful consequences of the practice, engaging government leaders and local officials to promote its abandonment, motivating religious leaders to protect women’s health, and training journalists to report on the issue.
- When tropical storms struck Central America in October 2011, rising waters left hundreds of thousands of people displaced. UNFPA stepped in to deliver desperately needed flood-relief services to victims. In Guatemala, UNFPA coordinated health brigades to provide emergency maternal health care and conduct epidemiological surveillance in affected communities. In Nicaragua, UNFPA worked to prevent gender-based violence in temporary shelters, and trained 50 local psychologists to provide physical and mental assistance to victims of sexual violence.