Cairo goals for reproductive health: where do we stand at 10 years?

Ten years ago, 179 countries—including the United States—agreed on a Programme of Action that revolutionized international population policy. In the Programme adopted at the International Conference on Population and Development in Cairo, the notion of " population control " was replaced with a more comprehensive approach to reproductive health, as a means to achieve development and population stabilization by improving the lives of women and men worldwide [1]. The Programme identified policy goals to be reached by 2015, including: increasing the percentage of deliveries attended by skilled caregivers; decreasing infant and child mortality; improving the social, economic, and educational status of women; increasing access to contraceptive care; and increasing life expectancy. With its broad scope, the Programme engaged forcefully with the intrinsic interconnectedness between reproductive health and other aspects of social and economic development. The ability to delay or space childbearing, for example , can allow women to participate more fully in educational and economic opportunities, and advance women's roles in society. At the same time, a woman's status in a relationship may dictate whether she is able to negotiate contraceptive use with her partner in the first place. In addition, delaying or spacing childbearing may be critical to the survival of a family during difficult economic times. Adequate birth spacing also leads to better health outcomes for women and their children, while poor health status due to poverty can increase maternal and child mortality. The goals established at Cairo encompass a wide range of activities that can advance reproductive health, both in the developed and developing worlds. As advocates for reproductive health, we are naturally concerned with reducing injuries and death from pregnancy and childbirth, increasing the chances that a child will survive infancy, preventing HIV infections and deaths from AIDS, and ensuring access to family planning care. At the same time, improving these outcomes requires not just providing reproductive health services, but also thinking outside of the " reproductive health " box. Programs that enable girls to continue in school, economic support for women (whether it is welfare support in the United States or micro-loans in some developing countries), access to health care, efforts to alleviate poverty and its effects, and legal rights for women are all important goals relevant to reproductive health. Cairo's ambitious goals, however, are far from being reached. Lack of resources and lack of political support have both contributed to the slow pace of …