The ICPD Programme of Action: pious hope or a workable guide?

The consensus achieved at the 1994 International Conference on Population and Development (ICPD) signaled a move away from discussing population issues in the context of demographic targets, toward global recognition that the problems associated with rapidly growing human populations are part of a broader human development agenda. Devoid of demographic targets, the ICPD program of action instead challenges countries to change their approach to population programs, family planning, and reproductive health. World Fertility Survey and Demographic and Health Survey data indicate a high level of unwanted fertility in almost all countries covered. The lack of availability or inaccessibility of family planning services is but one reason why there is so much unmet need. There would be greater uptake of family planning if services were planned with community involvement and oriented toward clients, offering them real choices and paying more attention to them as individuals and their overall circumstances. That expansion in concept and of services is at the core of the Cairo agenda. A number of countries around the world have started taking steps to broaden existing family planning and related programs to include other reproductive health information and services. Mexico and India are examples of two developing countries which are making program and structural changes in order to implement the ICPD recommendations, while most African countries have welcomed the approach and are looking for technical and resource help for implementation.