Public choices, private decisions: sexual and reproductive health and the millennium development goals /

Includes bibliographical appendices and notes.

Contents
Foreword vii
Preface ix
Acknowledgements xi
Acronyms xiii
Executive Summary 1
Section 1: Introduction 21
ICPD and the MDGs – moving forward together 23
What is sexual and reproductive health? 24
Reproductive rights 26
Section 2: The current situation 31
The global burden of SRH-related diseases and risks 31
Measuring progress in key areas of SRH 34
Why hasn’t SRH been given higher priority? 47
Section 3: The impact of ensuring universal access to SRH and rights on achieving each of the MDGs 57
A contextual issue: population dynamics and progress on the MDGs 58
Goal 1: Eradicating extreme poverty and hunger 59
Goal 2: Achieve universal primary education 63
Goal 3: Promote gender equality and empower women 68
Goal 4: Reduce child mortality 74
Goal 5: Improve maternal health 78
Goal 6: Combat HIV/AIDS, malaria and other diseases 86
Goal 7: Ensure environmental sustainability 92
Goal 8: Global Partnerships 97
Boxes
1.1 Millennium Development Goals 22
1.2 ICPD definition of reproductive health 25
1.3 Reproductive rights as human rights 28
3.1 Reducing teen pregnancies can complement efforts to address barriers to gender equity in schooling 67
3.2 Access to family planning changes women’s lives 72
3.3 Improving family economies with microcredit and access to family planning 73
3.4 The three ‘stages of delay’ to seeking obstetric care 82
3.5 Obstetric fistula – a devastating condition caused by obstructed
labor 83
3.6 Emergency contraception and the reduction of recourse to
abortion 86
3.7 Population growth stresses natural resources 94
4.1 World Health Assembly resolution 58.31 107
4.2 Lessons from past experiences of integration 111
4.3 Special considerations for SRH 113
4.4 Integrating SRH services with those for HIV/AIDS 117
4.5 Mass media outreach in SRH 121
4.6 Quality of care increases contraceptive use 123
4.7 Missed opportunities to expand family planning services 126
4.8 ICPD recognizes adolescents’ rights to reproductive health 130
4.9 Factors that make health services youth-friendly 131
iv
Contents
Section 4: What needs to be done 103
Task 1: Integrating SRH analyses and investments into national poverty reduction strategies 104
Task 2: Integrating SRH services into strengthened health systems 108
Task 3: Systematically collecting data 118
Task 4: Acting on the Reproductive Health Quick Impact Initiative 119
Task 5: Meeting the needs of special populations 129
Requirements for effective action 137
Appendices 147
Appendix 1: Messages from the UN Millennium Project Reports 147
Appendix 2: MDG interventions by area as recommended by
the UN Millennium Project 153
Notes 159