A Decade after Cairo

The Programme of Action issued by the 1994 UN International Conference on Population and Development was the first and most wide-ranging international policy document to promote the concepts of reproductive rights and reproductive health. Its major recommendation was that population programmes should provide comprehensive reproductive health services integrated and coordinated with each other and with other health services. It put women at its centre and expressly rejected the use of incentives and targets in family planning services. But the Programme of Action is still far from being implemented because health services are declining or have collapsed; the underlying conditions determining women's health and their control over childbearing are deteriorating; fundamentalisms opposing women's rights are on the rise; and neo-Malthusian thinking is as ingrained as ever in development institutions, donor agencies and government departments. These negative forces on women's health can be attributed to the implementation of neo-liberal economic and health policies over the past two decades. The Programme of Action, together with the accompanying political organising by international women's organisations and population groups, did not challenge neo-liberalism sufficiently, but endorsed it in several respects. It thereby undermined its ground-breaking principles and goals of reproductive health.