Family Planning and Family Planning and Reproductive Health Reproductive Health

A tale of three revolutions and A tale of three revolutions and an unfinished Agendaan unfinished Agenda

Family planning and Family planning and reproductive health- reproductive health-

A tale of three revolutionsA tale of three revolutions

The Reproductive RevolutionThe Reproductive Revolution

“And God blessed them, and God said unto them, Be fruitful and multiply, and replenish the earth, and subdue it.”

Holy Bible: Genesis 1:28

Crowded planet: Global Crowded planet: Global population hits 7 billionpopulation hits 7 billion

October 31, 2011 October 31, 2011

World's World's seven billionth babyseven billionth baby is born. is born. Danica May Danica May CamachoCamacho, a girl born in , a girl born in Philippine capital Manila, is Philippine capital Manila, is chosen by UN to symbolically chosen by UN to symbolically mark global population mark global population milestone.milestone.

Population Clock 2011Population Clock 2011

Every minuteEvery minute266 births266 births108 deaths108 deaths158 natural increase158 natural increase

World population grows by World population grows by about 83 million annually. about 83 million annually.

World PopulationWorld Population

First billion around First billion around 18001800 Second billion 1930 (130 years)Second billion 1930 (130 years) ThirdThird 1960 (30 years)1960 (30 years) Fourth Fourth 1974 (14 years)1974 (14 years) FifthFifth 19871987 (13 years)(13 years) SixthSixth 1999 (12 years)1999 (12 years) Seventh Seventh 2011 (12 years)2011 (12 years)Projected population Projected population 8 0848 084 mid- 2025mid- 2025 9 587 mid- 20509 587 mid- 2050

The Reproductive The Reproductive RevolutionRevolutionTotal fertility rateTotal fertility rate World World 2.52.5 More DevelopedMore Developed 1.71.7 Less Developed Less Developed 2.62.6 Less Developed (excl. China)Less Developed (excl. China) 3.03.0 Least Developed Least Developed 4.54.5

Population Reference Bureau 2011 World Population Reference Bureau 2011 World Population Data SheetPopulation Data Sheet

World fertility, 2.5 children per woman, is half the level in 1950-1955 (5 children per woman).

ContraceptionContraception

From medical indications From medical indications

to to

a way of lifea way of life

Women aged 15-49, married Women aged 15-49, married or in union, currently using or in union, currently using contraceptives (2009)contraceptives (2009)

MillionMillion WorldWorld 739739 More developed regionsMore developed regions 117117 Less developed regionsLess developed regions 622622

Least developed countriesLeast developed countries 4646Other less developed countriesOther less developed countries

576576(United Nations Population Division (United Nations Population Division 2012)2012)

EgyptEgyptTotal fertility rateTotal fertility rate 2.92.9Contraceptive prevalence Contraceptive prevalence 60 %60 %Population mid-2011Population mid-2011 82.6 million82.6 million

Projected populationProjected population millionmillion Mid-2025Mid-2025 100.9 100.9 Mid-2050Mid-2050 123.5123.5

Population under age 15Population under age 15 30.8%30.8%

Population momentum

Population will continue to grow as more young people join the reproduction pool.

Infertility and the Infertility and the population problempopulation problem

In a world that needs vigorous control of population In a world that needs vigorous control of population growth, concerns about infertility may seem odd, but the growth, concerns about infertility may seem odd, but the adoption of a small family norm makes the issue of adoption of a small family norm makes the issue of involuntary infertility more pressing. If couples are urged involuntary infertility more pressing. If couples are urged to postpone or widely space pregnancies, it is imperative to postpone or widely space pregnancies, it is imperative that they should be helped to achieve pregnancy when that they should be helped to achieve pregnancy when they so decide, in the more limited time they will have they so decide, in the more limited time they will have available.available.

Fathalla MF. The agony of infertility. WHO Bulletin 2010. Fathalla MF. The agony of infertility. WHO Bulletin 2010.

Family planning and Family planning and reproductive health- reproductive health- A tale of three revolutionsA tale of three revolutions

Reproductive revolutionReproductive revolution

Contraceptive Contraceptive technology revolutiontechnology revolution

““And Onan knew that the seed And Onan knew that the seed should not be his; and it came to should not be his; and it came to pass, when he went into his pass, when he went into his brother’s wife, that he spilled brother’s wife, that he spilled it it on on the ground, lest that he should give the ground, lest that he should give seed to his brother.”seed to his brother.”

Holy Bible: Genesis 38:9Holy Bible: Genesis 38:9

The contraceptive technology The contraceptive technology revolutionrevolution

Contraception outside the bedroomContraception outside the bedroom Long acting contraceptionLong acting contraception Effective reversible contraceptionEffective reversible contraception

Women aged 15-49, married Women aged 15-49, married or in union, currently using or in union, currently using contraceptives (2009)contraceptives (2009)

Any method Modern methods Any method Modern methods

WorldWorld 62.7 %62.7 % 56.1 %56.1 %

More developed regionsMore developed regions 72.472.4 61.361.3

Less developed regionsLess developed regions 61.261.2 55.255.2

Least developed countriesLeast developed countries 31.431.4 25.025.0

Other less developed countriesOther less developed countries 66.066.0 60.260.2

(United Nations Population Division 2012)(United Nations Population Division 2012)

Family planning and Family planning and reproductive health- reproductive health- A tale of three revolutionsA tale of three revolutions

Reproductive revolutionReproductive revolution Contraceptive technology Contraceptive technology

revolutionrevolution

Sexual revolutionSexual revolution

““And the eyes of them both were And the eyes of them both were opened, and they knew that they opened, and they knew that they werewere naked; and they sewed fig naked; and they sewed fig leaves together, and made leaves together, and made themselves aprons.”themselves aprons.”

Holy Bible: Genesis 3:7Holy Bible: Genesis 3:7

The dissociation of sex The dissociation of sex from reproductionfrom reproduction Sex without reproductionSex without reproduction Reproduction without sexReproduction without sex

Sex: A duty became a Sex: A duty became a pleasurepleasure

The Homo sapiens is the sexiest of The Homo sapiens is the sexiest of

the primates.the primates.

Or is it?Or is it?

The forgotten ApeThe forgotten Ape

Lola Ya Bonobo, or "Lola Ya Bonobo, or "Bonobo Bonobo ParadiseParadise" in the Lingala language, " in the Lingala language, is an 86-acre sanctuary set in is an 86-acre sanctuary set in verdant hills 20 miles south of verdant hills 20 miles south of Kinshasa, Democratic Republic of Kinshasa, Democratic Republic of the Congo, founded bythe Congo, founded by Claudine Claudine AndréAndré, a Belgian woman raised in , a Belgian woman raised in the Congo,the Congo,

Make love, not warMake love, not war

"Bonobos use sex to deflate tension. "Bonobos use sex to deflate tension.

Competition for the best food could Competition for the best food could

cause a fight, so they defuse it by cause a fight, so they defuse it by

having sex first." having sex first."

Claudine AndréClaudine André

In Bonobo Paradise, In Bonobo Paradise, who rules?who rules?

Bonobos are perceived to be Bonobos are perceived to be matriarchal. Females tend to matriarchal. Females tend to collectively dominate males by collectively dominate males by forming alliances. Although male forming alliances. Although male bonobos are individually stronger, bonobos are individually stronger, they cannot stand alone against a they cannot stand alone against a united group of females.united group of females.

Family planning and Family planning and reproductive health- A tale reproductive health- A tale of three revolutionsof three revolutions

The Reproductive The Reproductive RevolutionRevolution

The Contraceptive The Contraceptive Technology RevolutionTechnology Revolution

The Sexual RevolutionThe Sexual Revolution

AND THE WINNERS ARE? AND THE WINNERS ARE?

Family planning and Family planning and reproductive health- A reproductive health- A tale of three revolutionstale of three revolutions

AND THE WINNERS ARE AND THE WINNERS ARE WOMENWOMEN

Women and the Women and the reproductive reproductive revolutionrevolutionThe emergence of the The emergence of the

woman from behind the woman from behind the

mothermother

Women and the Women and the contraceptive contraceptive revolutionrevolution

Women for the first time hadWomen for the first time had women-controlled methodswomen-controlled methods which which they could use, even independent they could use, even independent of the cooperation of their male of the cooperation of their male partners, to regulate their fertility partners, to regulate their fertility and to enjoy sexual life without and to enjoy sexual life without fear of unwanted ill-timed fear of unwanted ill-timed pregnancy.pregnancy.

Women and the sexual Women and the sexual revolutionrevolution

In the early 20th century, Marie Stopes, a In the early 20th century, Marie Stopes, a British leader in the family planning British leader in the family planning movement, noted that a popular demand movement, noted that a popular demand of women was for a simple pill or drug to of women was for a simple pill or drug to make their husbands less, rather than make their husbands less, rather than more, passionate, and women often said more, passionate, and women often said they liked everything about marriage, they liked everything about marriage, except “the going to the bed side of it”.except “the going to the bed side of it”.

Family Planning and Family Planning and Reproductive HealthReproductive Health--A tale of three A tale of three revolutionsrevolutions

An Unfinished An Unfinished AgendaAgenda

Family Planning and Family Planning and Reproductive Health Reproductive Health

An Unfinished AgendaAn Unfinished Agenda

The Reproductive The Reproductive RevolutionRevolution

The neglected tragedy of The neglected tragedy of maternal mortalitymaternal mortality in in developing countriesdeveloping countries

An unfinished agendaAn unfinished agenda

GLOBAL VILLAGE

DAILY REPRODUCTIVE HEALTH NEWS_____________________________________________________

DEATH TOLL IN HUMAN REPRODUCTION

1370 women reported killed during physiological duty; thousands more, seriously injured.

Every minuteEvery minute

One woman dies from One woman dies from complications related to complications related to pregnancy and childbirthpregnancy and childbirth

““I am going to the sea to fetch a new I am going to the sea to fetch a new baby, but the journey is long and baby, but the journey is long and dangerous and I may not return."dangerous and I may not return."

A Tanzanian mother, about to give A Tanzanian mother, about to give birth, birth,

speaking to her older children.speaking to her older children.

Local African folkloreLocal African folklore

Lifetime risk of Lifetime risk of maternal deathmaternal death

The adult lifetime risk of maternal The adult lifetime risk of maternal death (the probability that a 15-death (the probability that a 15-year-old female will die eventually year-old female will die eventually from a maternal cause) is from a maternal cause) is 1 in 311 in 31 in sub-Saharan Africa, in sub-Saharan Africa, 1 in 111 in 11 in in Afghanistan, and Afghanistan, and 1 in 43001 in 4300 in in developed regions. In Belgium, developed regions. In Belgium, the risk is the risk is 1: 10 900.1: 10 900.

WHO 2010.WHO 2010.

“In front of the door a couple of neighbour women are standing, muttering and whispering. The ten children have just come back from school and are standing around bewildered. Inside, the house had a terrible look. There is a huge pool of blood in the kitchen, and tracks go into the shop and through the living room. And the bedroom! It looks like someone has been murdered. The bedding is all awry, a wash basin, the floor…everything covered with blood.

“In front of the door a couple of neighbour women are standing, muttering and whispering. The ten children have just come back from school and are standing around bewildered. Inside, the house had a terrible look. There is a huge pool of blood in the kitchen, and tracks go into the shop and through the living room. And the bedroom! It looks like someone has been murdered. The bedding is all awry, a wash basin, the

floor…everything covered with blood. Frau Schultz is lying in bed, pale as wax, and sunken as warmed-over death”

Lisbeth Burger (German midwife)Breslau, 1936

Women are not dying because of diseases we cannot treat. They are dying because societies have yet to make the decision that their lives are worth saving.

Family Planning and Family Planning and Reproductive Health Reproductive Health

An Unfinished AgendaAn Unfinished Agenda

The Reproductive RevolutionThe Reproductive Revolution

The contraceptive The contraceptive technology revolutiontechnology revolution

Worldwide, more than 120 Worldwide, more than 120

million women aged 15 to 49 million women aged 15 to 49

who are married or in a union have who are married or in a union have

an an unmet need for family planningunmet need for family planning. .

United Nations MDG Report 2011United Nations MDG Report 2011

Family Planning and Family Planning and Reproductive Health Reproductive Health

An Unfinished AgendaAn Unfinished Agenda

The Reproductive The Reproductive RevolutionRevolution

The Contraceptive The Contraceptive Technology Revolution Technology Revolution

The sexual revolutionThe sexual revolution

The pandemic of sexually-The pandemic of sexually-transmitted infectionstransmitted infections

Nearly a million people acquire Nearly a million people acquire

a sexually transmitted infection a sexually transmitted infection

(STI), including the human (STI), including the human

immunodeficiency virus (HIV), immunodeficiency virus (HIV),

every day. every day.

HIV  transmission in intimate HIV  transmission in intimate partner relationships in Asiapartner relationships in Asia

Most women are acquiring HIV not because of their own Most women are acquiring HIV not because of their own sexual behaviors but because their partners engage in unsafe sexual behaviors but because their partners engage in unsafe behaviors. behaviors.

More than 90% of women living with HIV acquired the More than 90% of women living with HIV acquired the virus from their husbands or from their boyfriends while in virus from their husbands or from their boyfriends while in long-term relationships. long-term relationships.

At least 50 million women are at risk of acquiring HIV from At least 50 million women are at risk of acquiring HIV from their intimate partners. These women are either married or their intimate partners. These women are either married or are the regular partners of men who engage in higher-risk are the regular partners of men who engage in higher-risk sexual behaviors.sexual behaviors.

UNAIDS 2009UNAIDS 2009

`̀AAbstinencebstinence, , bbeingeing

faithfulfaithful and and ccondomondom use use are the ABC of are the ABC of protection against STIs, protection against STIs, including HIV. including HIV.

An unmet need for An unmet need for womenwomen

Woman-controlled Woman-controlled methods for protection methods for protection against sexually against sexually transmitted infections transmitted infections (STIs)(STIs)

Family Planning and Family Planning and Reproductive Health Reproductive Health

An Unfinished AgendaAn Unfinished Agenda

A question of the A question of the willwill or the or the walletwallet??

World military World military expenditure 2010expenditure 2010

World military expenditure in World military expenditure in 2010 is estimated to have been 2010 is estimated to have been $1.6 trillion$1.6 trillion, an , an increaseincrease of 1.3 of 1.3 per cent in real terms. per cent in real terms.

Stockholm International Peace Stockholm International Peace Research Institute (SIPRI) .11 Research Institute (SIPRI) .11 April 2011.April 2011.

World military World military expenditure 2010expenditure 2010 The region with the largest increase in The region with the largest increase in

military spending was military spending was South AmericaSouth America, with a , with a 5.8 per cent increase, reaching a total of 5.8 per cent increase, reaching a total of $63.3 billion.$63.3 billion.

The The Middle EastMiddle East spent $111 billion on spent $111 billion on military expenditure in 2010, an increase of military expenditure in 2010, an increase of 2.5 per cent over 2009. The largest absolute 2.5 per cent over 2009. The largest absolute rise in the region was by Saudi Arabia.rise in the region was by Saudi Arabia.

Estimated spending in Estimated spending in AfricaAfrica increased by increased by 5.2 per cent, led by major oil-producers 5.2 per cent, led by major oil-producers such as Algeria, Angola and Nigeria.such as Algeria, Angola and Nigeria.

“We must not fear daylight just because it almost always illuminates a miserable world.”

Belgian artist, Rene Magrittes

Family planning and Family planning and reproductive healthreproductive healthA tale of three revolutionsA tale of three revolutions Reproductive revolutionReproductive revolution Contraceptive technology revolutionContraceptive technology revolution Sexual revolutionSexual revolutionAn unfinished agendaAn unfinished agenda The neglected tragedy of maternal mortalityThe neglected tragedy of maternal mortality Unmet need for family planningUnmet need for family planning Pandemic of sexually- transmitted infectionsPandemic of sexually- transmitted infections

The future?The future?

The best way to predict the future is to make it.

Peter Drucker

Nothing is Nothing is I m possible.I m possible.

The word itself says:The word itself says:

I’m possibleI’m possible

Belgian actress Audrey HepburnBelgian actress Audrey Hepburn

Hartelijk dankHartelijk dank

Merci beaucoupMerci beaucoup

Vielen DankVielen Dank

Thank you very muchThank you very much