Why Is Funding for International Family Planning Critical for Youth?

International family planning and reproductive health programs provide health care choices that improve women's health and lives. These programs provide women with the means to improve their reproductive health—postponing pregnancies that place very young women at high risk, spacing the births of children, preventing dangerous pregnancies at then end of women's reproductive years, and avoiding unplanned pregnancies. The ability to plan and space pregnancies reduces maternal and infant mortality as well as other strains on families, communities, resources, and the environment. Sadly, women and men in many parts of the world, especially the world's poorest areas, lack access to the family planning services they need.

"As articulated in various international human rights treaties, reproductive health includes the right to health, the right to family planning, the right to reproductive self-determination, and the principle of nondiscrimination, which ensures that reproductive health care services are equally provided to all women."[1] Although the United States has been a leader in fighting for international human rights, its current lack of commitment to international family planning has undermined the progress of these human rights treaties with regard to women's rights.

A number of international treaties support reproductive rights for women: the Universal Declaration of Human Rights (passed after World War II and supported by the United States); the International Covenant on Civil and Political Rights (ratified by the U.S. Senate in 1992); the International Covenant on Economic, Social and Cultural Rights; the Convention on the Elimination of All Forms of Discrimination Against Women; and the Convention on the Rights of the Child. The Senate has not ratified the last three treaties.

International Family Planning Programs and Funding

U.S. population assistance to other countries is provided through the U.S. Agency for International Development (USAID), Office of Population and by U.S. foreign missions, nongovernmental organizations, and the United Nations Population Fund (UNFPA). These agencies fund family planning and related reproductive health services, providing technical training, communications outreach, and contraceptive commodities. The United States helps fund family planning services in developing countries in Africa, Asia, Latin America, and the newly independent states of Eastern Europe. By law, no U.S. funds may be used for abortion services. International family planning and reproductive health programs provide health care choices that assist women in realizing their human rights, including their right to health and their right to decide freely and responsibly the number and spacing of their children.

Impact of international family planning—The health benefits of family planning are well documented. Research has confirmed that safe and effective contraception helps to reduce maternal mortality by reducing the number of pregnancies, including high risk and/or unintended pregnancies. Family planning can also improve children's health and survival by helping women space births to more than two years apart; by helping very young women and older women, especially those with four or more children, to prevent pregnancy. The fact is that, especially in the developing world, when a mother dies in childbirth, her infant doesn't long survive her.

Family planning programs annually provide modern methods of contraception to hundreds of millions of couples. Since 1983, women's use of modern contraceptives has more than doubled; today, 58 percent of married women of reproductive age use contraception.

Unmet Need—U.S. funding for international family planning is appropriated annually through the foreign operations appropriations bill. During FY1996 and FY1997, a conservative Congress slashed international family planning funds by one-third, from $547 million in 1995 to $385 million in 1997. Despite attempts by President Clinton to significantly increase international family planning dollars, Congress continued to under fund the programs. Despite modest increases in the last five fiscal years,

• FY1999—$385 million
• FY2000—$372.5 million
• FY2001—$425 million
• FY2002—$446.5 million
• FY2003—$446.5 million,
• FY 2004 - $429.5 million,
• FY 2005 - $437.3 million
• FY 2006 - $435.6 million.

U.S. funding still lags significantly behind its 1995 level. Indeed, President Bush's budget request for FY2004 was a mere $425 million. Additionally, in 2002, President Bush eliminated U.S. funding to UNFPA.

Because of its size and wealth, the United States remains one of the largest bilateral donors to international family planning programs. However, the United States also ranks last of 22 major donors when its contribution is gauged against the gross national product (GNP). For instance in FY1999, the United States provided only 0.1 percent of its GNP for official development assistance. Declining still further in recent years, the U.S. contribution falls far short of the 0.7 percent of GNP encouraged by the international community.

INTERNATIONAL FAMILY PLANNING AND YOUTH

So, how does this all affect young people? The world has more than three billion people under the age of 25 and more than 1.1 billion between the ages of 15 and 24. Over eighty percent of these youth live in developing countries, as do 87 percent of youth ages 10 to 19. Some 715 million (62 percent) live in Asia; 184 million (16 percent), in Africa; and 105 million (nine percent), in Latin America and the Caribbean. By comparison, another 98 million (nine percent) live in Europe; 43 million (four percent), in North America; and four million (0.4 percent) in Oceania. When it comes to the future and the quality of life on the planet, the decisions these young people make regarding their sexual and reproductive health—including the timing and size of their families—may well be the single most important factor influencing world population and the environment over the next century. Consider:

• Sexual activity—Worldwide, the vast majority of young people initiate sexual intercourse before age 20. Between half and two-thirds of adolescent women in Latin America and the Caribbean are sexually active, as are three-quarters or more of teenage women in industrialized countries. In many sub-Saharan African countries, more than nine in ten females initiate sex before age 19.
• Teenage births—Fifteen million teens give birth each year. In the least developed nations, one in six births occurs to a young woman aged 15 to 19.
• Risk of death for teen mothers—The risk of dying from complications related to pregnancy and childbirth is 25 times higher for women under age 15 and twice as high for women ages 15 to 19 as it is for women in their twenties.
• HIV infection—Half of all new HIV infections occur in people under age 25. Most HIV-infected youth do not realize that they are infected. In hard-hit countries, young women are being infected with HIV at a much higher rate than are their male peers.
• Sexually transmitted infections—Every day, 500,000 young people are infected with a sexually transmitted infection (STI). Some 23 million adolescent women may be infected with chlamydia, which is often without symptoms, and which can leave women infertile. The highest rates of gonorrhea are among women ages 15 to 19 and men ages 20 to 24.
• Genital mutilation—As many as two million young girls are exposed to genital mutilation each year.
• Forced sex—Too often, young people's sexual experience occurs under circumstances of force and/or coercion, leaving them highly vulnerable to STIs and unintended pregnancy.

Each of these statistics says that access to accurate information and to family planning services is critical to the health of young people, wherever they live. Improving the health of young people requires community support, equal access to education for girls, and the meaningful participation of young people in programs and policies. It also requires the commitment and leadership of government at all levels.

In 1994 at the International Conference on Population and Development, the international community affirmed the right of young people to age-appropriate reproductive health information and services—services that safeguard their right to privacy, confidentiality, respect, and informed consent. The international community has also affirmed that the right and responsibility of parents to provide guidance in sexual health matters should not bar youth's access to reproductive health information and services.

Unmet Need—When young people are denied clear, accurate information about sexuality and reproduction, they may be ill prepared for sex and unable to protect themselves from unintended pregnancy and STIs. Young women face additional risks because, in many nations, they face substantial barriers to basic education. For example, 60 percent of children worldwide who are not enrolled in school are female.

The challenges of preparing the next generation for adulthood are remarkably similar across developed and developing nations. Adults must recognize that unintended, early pregnancy often results from inadequate access to information and services, unwanted or coerced sexual activity, unprotected sex, or ineffective use of contraception. Youth's unmet need for contraception is greater than among any other age group.

1. Center for Reproductive Law & Policy. International Family Planning and Reproductive Health Programs: When Will the U.S. Government Fulfill Its Commitment. New York: The Center, 2001.

Last Updated November 2007