Family Planning in Asia and the Pacific - International Council on ...
Family Planning in Asia and the Pacific - International Council on ... Family Planning in Asia and the Pacific - International Council on ...
family plann
SESSION 1: Chang
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SESSION 1: Chang<str<strong>on</strong>g>in</str<strong>on</strong>g>gC<strong>on</strong>text of <str<strong>on</strong>g>Family</str<strong>on</strong>g><str<strong>on</strong>g>Plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g>Moderator:Dr. Anrudh Ja<str<strong>on</strong>g>in</str<strong>on</strong>g>, Dist<str<strong>on</strong>g>in</str<strong>on</strong>g>guished Scholar, Populati<strong>on</strong><str<strong>on</strong>g>Council</str<strong>on</strong>g>The objective of <str<strong>on</strong>g>the</str<strong>on</strong>g> sessi<strong>on</strong> was to review <str<strong>on</strong>g>the</str<strong>on</strong>g> currentsituati<strong>on</strong> of fertility decl<str<strong>on</strong>g>in</str<strong>on</strong>g>e <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Asia</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>Pacific</str<strong>on</strong>g> bydiscuss<str<strong>on</strong>g>in</str<strong>on</strong>g>g successes, chang<str<strong>on</strong>g>in</str<strong>on</strong>g>g needs <str<strong>on</strong>g>and</str<strong>on</strong>g> challenges.The sessi<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g>cluded presentati<strong>on</strong>s from twooverarch<str<strong>on</strong>g>in</str<strong>on</strong>g>g papers developed as technical resourcesfor <str<strong>on</strong>g>the</str<strong>on</strong>g> c<strong>on</strong>sultati<strong>on</strong>, as well as a presentati<strong>on</strong> related toreproductive health commodity security. <str<strong>on</strong>g>Asia</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g><str<strong>on</strong>g>Pacific</str<strong>on</strong>g> was a good place to take stock of <str<strong>on</strong>g>the</str<strong>on</strong>g> situati<strong>on</strong>s<str<strong>on</strong>g>in</str<strong>on</strong>g>ce many countries had served as pi<strong>on</strong>eers for familyplann<str<strong>on</strong>g>in</str<strong>on</strong>g>g. The sessi<strong>on</strong> addressed c<strong>on</strong>traceptive methodswith<str<strong>on</strong>g>in</str<strong>on</strong>g> reproductive health <str<strong>on</strong>g>and</str<strong>on</strong>g> advocacy for women’seducati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> ec<strong>on</strong>omic development.<str<strong>on</strong>g>Family</str<strong>on</strong>g> plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g programmes <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Asia</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>Pacific</str<strong>on</strong>g><str<strong>on</strong>g>and</str<strong>on</strong>g> achiev<str<strong>on</strong>g>in</str<strong>on</strong>g>g MDG5b byDr. Amy O. Tsui, Director, The Bill <str<strong>on</strong>g>and</str<strong>on</strong>g> Mel<str<strong>on</strong>g>in</str<strong>on</strong>g>da GatesInstitute of Populati<strong>on</strong> <str<strong>on</strong>g>and</str<strong>on</strong>g> Reproductive Health, JohnHopk<str<strong>on</strong>g>in</str<strong>on</strong>g>s UniversityThe presentati<strong>on</strong> focused <strong>on</strong> a review of trends <str<strong>on</strong>g>in</str<strong>on</strong>g>patterns of government resp<strong>on</strong>ses to fertility levels<str<strong>on</strong>g>and</str<strong>on</strong>g> c<strong>on</strong>traceptive service provisi<strong>on</strong>, as well as a reviewof variati<strong>on</strong>s <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>traceptive practice levels, useeffectiveness <str<strong>on</strong>g>and</str<strong>on</strong>g> equity <str<strong>on</strong>g>in</str<strong>on</strong>g> coverage. The <str<strong>on</strong>g>Asia</str<strong>on</strong>g>n <str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>Pacific</str<strong>on</strong>g> regi<strong>on</strong> was <str<strong>on</strong>g>the</str<strong>on</strong>g> site of <str<strong>on</strong>g>the</str<strong>on</strong>g> historic beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>gs ofnati<strong>on</strong>al family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g programmes, which predatedpopulati<strong>on</strong> development frameworks. The <str<strong>on</strong>g>in</str<strong>on</strong>g>itial familyplann<str<strong>on</strong>g>in</str<strong>on</strong>g>g programmes were often embedded <str<strong>on</strong>g>in</str<strong>on</strong>g> ec<strong>on</strong>omicdevelopment plans, stimulated by voluntary <str<strong>on</strong>g>Family</str<strong>on</strong>g><str<strong>on</strong>g>Plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g</str<strong>on</strong>g> Associati<strong>on</strong>s <str<strong>on</strong>g>and</str<strong>on</strong>g> promoti<strong>on</strong> of family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>gservice delivery. Early family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g programmes weredata driven from <str<strong>on</strong>g>the</str<strong>on</strong>g> beg<str<strong>on</strong>g>in</str<strong>on</strong>g>n<str<strong>on</strong>g>in</str<strong>on</strong>g>g, based <strong>on</strong> f<str<strong>on</strong>g>in</str<strong>on</strong>g>d<str<strong>on</strong>g>in</str<strong>on</strong>g>gs fromnati<strong>on</strong>al household surveys <str<strong>on</strong>g>and</str<strong>on</strong>g> well-m<strong>on</strong>itored throughvarious <str<strong>on</strong>g>in</str<strong>on</strong>g>formati<strong>on</strong> systems. Also, family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>gwas often positi<strong>on</strong>ed with<str<strong>on</strong>g>in</str<strong>on</strong>g> high-level coord<str<strong>on</strong>g>in</str<strong>on</strong>g>at<str<strong>on</strong>g>in</str<strong>on</strong>g>gadm<str<strong>on</strong>g>in</str<strong>on</strong>g>istrative entities, a phenomen<strong>on</strong> which was notseen <str<strong>on</strong>g>in</str<strong>on</strong>g> o<str<strong>on</strong>g>the</str<strong>on</strong>g>r regi<strong>on</strong>s of <str<strong>on</strong>g>the</str<strong>on</strong>g> world.India was <str<strong>on</strong>g>the</str<strong>on</strong>g> first country to adopt family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g<str<strong>on</strong>g>in</str<strong>on</strong>g> its nati<strong>on</strong>al ec<strong>on</strong>omic development plan <str<strong>on</strong>g>in</str<strong>on</strong>g> 1951; itwas followed by Sri Lanka, Bangladesh/Pakistan <str<strong>on</strong>g>and</str<strong>on</strong>g><str<strong>on</strong>g>the</str<strong>on</strong>g> Republic of Korea <str<strong>on</strong>g>in</str<strong>on</strong>g> 1959 to 1961, <str<strong>on</strong>g>and</str<strong>on</strong>g> Malaysia,Ind<strong>on</strong>esia, Philipp<str<strong>on</strong>g>in</str<strong>on</strong>g>es, Thail<str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> Nepal between1965 <str<strong>on</strong>g>and</str<strong>on</strong>g> 1975. A grow<str<strong>on</strong>g>in</str<strong>on</strong>g>g percentage of governmentswere provid<str<strong>on</strong>g>in</str<strong>on</strong>g>g direct support for <str<strong>on</strong>g>the</str<strong>on</strong>g> provisi<strong>on</strong> ofc<strong>on</strong>traceptives.The presentati<strong>on</strong> also addressed c<strong>on</strong>traceptive methodmix, use effectiveness <str<strong>on</strong>g>and</str<strong>on</strong>g> coverage <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g> regi<strong>on</strong>.C<strong>on</strong>traceptive prevalence levels were high, althoughsignificant variati<strong>on</strong> was apparent. The higher <str<strong>on</strong>g>the</str<strong>on</strong>g>populati<strong>on</strong> c<strong>on</strong>traceptive prevalence rate, <str<strong>on</strong>g>the</str<strong>on</strong>g> less likely<str<strong>on</strong>g>the</str<strong>on</strong>g>re would be significant disparity by socio-ec<strong>on</strong>omicstatus, whe<str<strong>on</strong>g>the</str<strong>on</strong>g>r measured <str<strong>on</strong>g>in</str<strong>on</strong>g> terms of <str<strong>on</strong>g>in</str<strong>on</strong>g>come, assetsor educati<strong>on</strong>. The populous countries <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>Asia</str<strong>on</strong>g> <str<strong>on</strong>g>and</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g><str<strong>on</strong>g>Pacific</str<strong>on</strong>g> showed low <str<strong>on</strong>g>in</str<strong>on</strong>g>equity <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>traceptive use, whichsuggested that government commitment <str<strong>on</strong>g>and</str<strong>on</strong>g> privatesector supply assured a degree of c<strong>on</strong>traceptive accessthat corresp<strong>on</strong>ded well to <str<strong>on</strong>g>the</str<strong>on</strong>g> dem<str<strong>on</strong>g>and</str<strong>on</strong>g> for c<strong>on</strong>tracepti<strong>on</strong>am<strong>on</strong>g married couples.The presentati<strong>on</strong> also addressed reproductive healthcommodity security <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g> regi<strong>on</strong>. Ch<str<strong>on</strong>g>in</str<strong>on</strong>g>a, India <str<strong>on</strong>g>and</str<strong>on</strong>g>Iran were examples of countries that had been largelyself-sufficient <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g>ir family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g programme, withcommercial access to c<strong>on</strong>traceptive commodities hav<str<strong>on</strong>g>in</str<strong>on</strong>g>gbeen made through <str<strong>on</strong>g>the</str<strong>on</strong>g> private sector. Afghanistan,Bangladesh <str<strong>on</strong>g>and</str<strong>on</strong>g> Ind<strong>on</strong>esia were examples of countriesthat had accepted <str<strong>on</strong>g>in</str<strong>on</strong>g>ternati<strong>on</strong>al assistance <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g> <str<strong>on</strong>g>in</str<strong>on</strong>g>itialstages of <str<strong>on</strong>g>the</str<strong>on</strong>g>ir family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g programmes. Thematurity of family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g programmes <str<strong>on</strong>g>in</str<strong>on</strong>g> <str<strong>on</strong>g>the</str<strong>on</strong>g> regi<strong>on</strong>provided c<strong>on</strong>siderable equity <str<strong>on</strong>g>in</str<strong>on</strong>g> coverage for many, butnot all, countries.A review of partial c<strong>on</strong>traceptive security <str<strong>on</strong>g>in</str<strong>on</strong>g>dex scoressuggested uneven security <str<strong>on</strong>g>in</str<strong>on</strong>g> c<strong>on</strong>traceptive procurementability across <str<strong>on</strong>g>the</str<strong>on</strong>g> regi<strong>on</strong>. That could hide <str<strong>on</strong>g>the</str<strong>on</strong>g> role of anactive private sector. Decentralizati<strong>on</strong> <str<strong>on</strong>g>in</str<strong>on</strong>g> procurementcould pose challenges <str<strong>on</strong>g>and</str<strong>on</strong>g> it could be difficult todeterm<str<strong>on</strong>g>in</str<strong>on</strong>g>e to what extent <str<strong>on</strong>g>the</str<strong>on</strong>g>re were earmarked funds<str<strong>on</strong>g>in</str<strong>on</strong>g> government budgets for c<strong>on</strong>traceptive procurement.Households were a major source of domestic spend<str<strong>on</strong>g>in</str<strong>on</strong>g>g<strong>on</strong> reproductive health <str<strong>on</strong>g>and</str<strong>on</strong>g> family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g. A highpercentage of total f<str<strong>on</strong>g>in</str<strong>on</strong>g>anc<str<strong>on</strong>g>in</str<strong>on</strong>g>g that was c<strong>on</strong>sumer-basedwas an <str<strong>on</strong>g>in</str<strong>on</strong>g>dicati<strong>on</strong> of susta<str<strong>on</strong>g>in</str<strong>on</strong>g>able c<strong>on</strong>traceptive security.The future agenda of family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g for <str<strong>on</strong>g>the</str<strong>on</strong>g> regi<strong>on</strong>needed to take <str<strong>on</strong>g>in</str<strong>on</strong>g>to c<strong>on</strong>siderati<strong>on</strong> populati<strong>on</strong> momentum<str<strong>on</strong>g>and</str<strong>on</strong>g> growth which would put pressure <strong>on</strong> exist<str<strong>on</strong>g>in</str<strong>on</strong>g>g familyplann<str<strong>on</strong>g>in</str<strong>on</strong>g>g resources; governance <str<strong>on</strong>g>and</str<strong>on</strong>g> policy models forc<strong>on</strong>traceptive security would vary country to country<str<strong>on</strong>g>and</str<strong>on</strong>g> no <strong>on</strong>e programme model could fit every situati<strong>on</strong><str<strong>on</strong>g>and</str<strong>on</strong>g> factors <str<strong>on</strong>g>in</str<strong>on</strong>g>fluenc<str<strong>on</strong>g>in</str<strong>on</strong>g>g c<strong>on</strong>traceptive dem<str<strong>on</strong>g>and</str<strong>on</strong>g> would bewide rang<str<strong>on</strong>g>in</str<strong>on</strong>g>g, both across <str<strong>on</strong>g>and</str<strong>on</strong>g> with<str<strong>on</strong>g>in</str<strong>on</strong>g> countries.The presentati<strong>on</strong> closed with some comments <strong>on</strong> how tofur<str<strong>on</strong>g>the</str<strong>on</strong>g>r <str<strong>on</strong>g>the</str<strong>on</strong>g> agenda for family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g: One suggesti<strong>on</strong> was <str<strong>on</strong>g>the</str<strong>on</strong>g> development of a regi<strong>on</strong>alplan of acti<strong>on</strong> around family plann<str<strong>on</strong>g>in</str<strong>on</strong>g>g. The MaputoPlan of Acti<strong>on</strong> for <str<strong>on</strong>g>the</str<strong>on</strong>g> Operati<strong>on</strong>alisati<strong>on</strong> of <str<strong>on</strong>g>the</str<strong>on</strong>g>C<strong>on</strong>t<str<strong>on</strong>g>in</str<strong>on</strong>g>ental Policy Framework for Sexual <str<strong>on</strong>g>and</str<strong>on</strong>g>Reproductive Health <str<strong>on</strong>g>and</str<strong>on</strong>g> Rights 2007-2010 waspresented as a possible framework; It was suggested that all entry po<str<strong>on</strong>g>in</str<strong>on</strong>g>ts at which family13
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