Abstract

PIP: If the current rate of contraceptive prevalence holds constant, the global population will double in 43 years, with almost all of the anticipated growth in developing countries. Over the past two decades, understanding has increased of the relationships among population, the environment, and sustainable economic development. This better understanding has led to a focus of attention upon human development and reproductive health, especially women's health and status. By improving people's lives through better education, health, economic opportunities, and the protection of their reproductive rights, it is assumed that people will want and have fewer children. These concepts were widely debated during the 1994 International Conference on Population and Development (ICPD) in Cairo and were eventually embraced by most of the participating delegations. Women's health advocates, physicians, social scientists, family planning managers, and health policymakers have worked hard since the ICPD to bring an high level of global attention and acceptance to the ideals articulated in the final ICPD document. Acceptance represents progress and a certain degree of global consensus on population and development issues, but difficult and costly efforts to realize the goals of the ICPD remain to be implemented. Countries should focus upon the achievable. Salient issues in developing countries will likely be the cost and sustainability of new human development/reproductive health programs, program effectiveness in reducing continued high levels of fertility, and the social and cultural appropriateness of new programs. With regard to this latter concern, most ideals of women's health, adolescent sexuality, empowerment, and rights are decidedly Western. Developing countries, however, are already dealing with a wide range of Western-oriented social, political, and economic reforms. They must now face the concept of empowering women and re-examining their approach to adolescent sexuality. Care must therefore be taken to avoid a backlash against the people and institutions which are the focus of human development and reproductive health programs.