PSDA - Population and Sustainable Development Alliance - Resources - Post-2015 position and input: Illustrative targets and indicators for the integration of SRHR and Population Dynamics into the SDG and Post-2015 Frameworks

Integration of SRHR and Population Dynamics into the SDG and Post-2015 Framework:

Illustrative targets and indicators

WORKING DRAFT v. 25.4.14

INTRODUCTION1

PSDA is an international alliance of civil society organisations that care about sexual and reproductive health and rights (SRHR), population dynamics2 and sustainable development, and the linkages between these issues. We believe that it is important that SRHR and population dynamics are included in the next international development agenda, not only as priorities in their own right, but also because they are relevant to a range of development priorities and intrinsic to the overall achievement of sustainable development. For this reason, in this document we share under different thematic areas a number of possibilities for the integration of SRHR and population dynamics into the post-2015 framework. We are not unrealistic in our expectations and do not expect these options to be embraced in full, but instead seek to provide a number of potential in-roads and illustrative targets and indicators. The paper is a working draft, to be modified and updated as the Open Working Group positions evolve and as the post-2015 framework develops.

By 2050 the world’s population is projected to increase from 7 billion in 2011 to 9.6 billion.3 In the same time period the proportion of the world population living in urban areas will grow from 52 per cent to 67 per cent.4 A growing and increasingly affluent world population has implications for planetary boundaries and determines the number and location of people requiring access to food, water and sanitation, health and education services at local, national and regional levels. In this way, population dynamics influence the scale and the shape of the development challenges we face. Demography is not destiny: An estimated 222 million or one in four women in developing countries want to avoid pregnancy but have an unmet need for modern contraception.5 Ensuring that everyone can exercise their right to ‘decide freely and responsibly the number, spacing and timing of their children’6 must be a key development priority. The post-2015 framework can and must address the challenges and seize the opportunities presented by demographic change, by considering population dynamics, data and projections when identifying and measuring development goals and targets, and prioritizing universal access to sexual and reproductive health and rights.

ILLUSTRATIVE TARGETS AND INDICATORS

We recommend that all targets and indicators in the post-2015 framework use data disaggregated by sex, age, disability, location (rural/urban), wealth quintiles and other characteristics as appropriate, to help address inequalities, including those experienced by women and girls and youth.

Sources are indicated for targets and indicators proposed by UN agencies and other organisations.

Please note that our proposals are by no means comprehensive and focus only on PSDA’s core areas of focus and expertise. While additional pressing issues, including addressing social inequalities, fulfilling human rights, ensuring sustainable consumption and production, and poverty alleviation, are beyond the scope of this

1For further information please refer to PSDA’s briefing (2013): Population dynamics, reproductive health and sustainable development: Critical links and opportunities for post-2015.

2Population dynamics refer to demographic trends and changes including population growth, population decline, ageing, urbanization and migration which influence the size, composition and spatial distributions of populations.

3UN Population Division (2013) World Population Prospects: The 2012 Revision.

4UN Population Division (2012) World Urbanization Prospects: The 2011 Revision.

5Guttmacher Institute & UNFPA (2012) Adding It Up: Costs and Benefits of Contraceptive Services - Estimates for 2012.

6United Nations General Assembly. Report of the International Conference on Population and Development. A/94/10/18. Programme of Action. New York: UN;1994.

paper, PSDA fully supports and calls for relevant goals, targets and indicators to advance these issues within the post2015 framework.

FOCUS AREA

Targets

Indicators / measurement areas

1.Health and Wellbeing for

1A. Universal access to sexual and

A1.

Maternal mortality ratio (Source: MDG indicator

All7

reproductive health and rights

5.1, UN Women)

 

(Source: UNFPA, adapted from

A2.

Unmet need for quality modern contraceptives by

 

HLP).

 

choice (Source: adapted from MDG indicator 5.6 and

 

 

 

 

UN Women)

 

 

A3.

Contraceptive prevalence rate, including by marital

 

 

status (Source: adapted from MDG indicator 5.3)

 

 

A4.

Infant mortality rate (MDG indicator 4.2)

 

 

A5.

Proportion of births attended by skilled health

 

 

personnel (Source: MDG indicator 5.2, UN Women)

 

 

A6.

Available emergency obstetric facilities per

 

 

100,000 population

 

 

A7.

Existence of effective referral systems for

 

 

emergency obstetric facilities

 

 

A8.

Age of mother at birth of first child ever born

 

 

(Source: UN Women)

 

 

A9.

Existence of monitoring and protection

 

 

mechanisms for protection and fulfillment of women’s

 

 

sexual and reproductive rights (adapted from UNFPA)

 

 

A10. Elimination of inequalities in access to quality

 

 

sexual and reproductive health services particularly for

 

 

young people and other marginalised groups, by

 

 

wealth quintile, age, sex, location, marital status,

 

 

sexual orientation and other characteristics as

 

 

appropriate (Source: adapted from UNFPA)

 

 

A11. Percentage of adolescent girls and boys (10-19

 

 

years, in and outside of school) who have completed at

 

 

least one year of comprehensive sexuality education,

 

 

designed in line with UNESCO/UNFPA guidance, in

 

 

school curricula (Source: adapted from UNFPA)

 

 

 

 

2.Food Security and Good

2A. Systematic use of population

A1.

Proportion of national plans of action for food

Nutrition

data in planning for food security

security and nutrition that effectively use population

 

and good nutrition for all

data and projections

 

 

 

 

 

2B. Eradicate malnutrition among

B1.

Prevalence of anaemia in women screened for

 

pregnant and breastfeeding women

haemoglobin levels with levels below 110 g/l for

 

 

pregnant women and below 120 g/l for non-pregnant

 

 

women

 

 

B2.

Percentage of pregnant and breastfeeding women

 

 

with a BMI of less than 18.5

 

 

B3.

Percentage of community service providers with

 

 

knowledge of key nutrition messages and actions at

 

 

critical stages in the life cycle of women and children

 

 

 

 

3.Universal Access to

3A. All adolescent girls and boys

A1.

Completion of at least one year of comprehensive

Education

(10-19 years, in and outside school)

sexuality education, designed in line with

 

complete comprehensive sexuality

UNESCO/UNFPA guidance, distinguishing school and

 

education

non-school providers and participants (Source: UNFPA)

 

 

 

 

 

3B. All adolescent girls and boys

B1.

Secondary school enrollment and completion rates,

 

complete at least secondary

by sex and age (Source: UNFPA)

 

education, with recognized and

B2.

Measure(s) for improved quality and learning

 

measurable learning outcomes

 

outcomes (UNFPA)

 

(UNFPA)

 

 

 

 

 

 

 

 

3C. Adolescents and youth, ages

C1.

Percentage of young people not in education or

 

15-24 who have left school, have

employment (UNFPA)

 

basic competencies as well as

 

 

 

technical or vocational skills,

C2.

Youth unemployment rate (UNFPA)

 

sufficient to qualify for paid

 

 

 

employment or self employment

 

 

 

(UNFPA)

 

 

 

 

 

 

7 Targets and indicators to address the unmet business of MDG 5 (improve maternal health) and areas neglected by the MDGs.

4.Achieve Gender Equality

4A. Prevent and eliminate all forms

A1. Proportion of women aged 15-49 who have ever

and the full realization of

of gender based violence (adapted

been in a partnership reporting physical and or sexual

Women’s Human Rights

from HLP)

violence in their lifetime (Source: UN Women)9

and Women’s

 

A2. Existence of laws, policies and multi-sectoral plans

Empowerment8

 

 

 

of action to address and eradicate gender based

 

 

violence, including rape, marital rape and sexual

 

 

harassment

 

 

A3. Percentage of victims and survivors of gender

 

 

based violence with access to essential services,

 

 

including appropriate medical, legal and psychosocial

 

 

services (Source: adapted from UNFPA)10

 

 

A4. Rates of female genital mutilation and other

 

 

harmful traditional practices (Source: UN Women)

 

 

A5. National policies and programmes that provide

 

 

“safe spaces” to the most vulnerable adolescent girls,

 

 

who are not in school, lack adequate parental

 

 

protection, live in poverty, etc (Source: UNFPA)

 

 

 

 

4B. Change perceptions, attitudes

B1. Percentage of people who think a woman can

 

and behaviours that condone and

refuse to have sex with her husband under any

 

justify violence against women and

circumstance (Source: adapted from UN Women)

 

girls (Source: UN Women)

 

 

 

 

 

4C. End child marriage (Source:

C1. Percentage of women aged 20-24 who were

 

HLP)

married or in a union before age 18 (Source: UN

 

 

Women)

 

 

 

 

4D. Protect and fulfill women’s

D1. Unmet need for quality modern contraceptives by

 

sexual and reproductive rights,

choice (adapted from MDG indicator 5.6 and UN

 

including developing monitoring and

Women)

 

protection systems (Source: UNFPA)

D2. Existence of monitoring and protection

 

 

 

 

mechanisms for protection and fulfillment of women’s

 

 

sexual and reproductive rights (Source: adapted from

 

 

UNFPA)

 

 

 

 

4E. Guarantee women’s political

E1. Percentage of women in legislative bodies

 

autonomy and participation in

E2. Percentage of women in leadership in appointed

 

decision making

 

positions

 

 

 

 

 

5.Universal and

5A. Systematic use of population

A1. Proportion of national plans for ensuring universal

Sustainable Access to

trends and projections in planning

and sustainable access to water and sanitation that

Water and Sanitation

for ensuring universal and

effectively use population data and projections

 

sustainable access to water and

 

 

sanitation

 

 

 

 

 

5B. Everyone uses a basic, safe and

B1. Percentage of population using a basic improved

 

sustainable

drinking-water source with a total collection time of 30

 

drinking water supply and

minutes or less for a roundtrip including queuing.

 

handwashing facilities

(Source: adapted from JMP/WHO/UNICEF)

 

when at home, all schools and

B2. Average weekly time spent in water collection

 

health centres

 

(including waiting time at public supply points)

 

provide all users with basic drinking

 

(Source: adapted from UN Women)

 

water supply

 

 

 

and adequate sanitation,

B3. Percentage of community drinking water source

 

handwashing facilities

with illumination at night

 

and menstrual hygiene facilities,

B4. Percentage of population using an adequate

 

and inequalities

 

sanitation facility (Source: JMP/WHO/UNICEF)

 

in access to each of these services

 

 

 

have been progressively eliminated

B5. Percentage of primary and secondary schools with

 

(Source: adapted from

gender-separated sanitation facilities on or near

 

JMP/WHO/UNICEF) 11

premises, with at least one toilet for every 25 girls, at

 

 

least one toilet for female school staff, a minimum of

 

 

one toilet and one urinal for every 50 boys and at least

 

 

one toilet for male school staff

 

 

B6. Percentage of primary and secondary schools with

 

 

a private place for washing hands, private parts and

 

 

clothes; drying re-usable materials; and safe disposal

 

 

of used menstrual materials

 

 

 

8PSDA supports a stand-alone goal on gender equality and women’s empowerment as well as mainstreaming / integration of gender equality into all other goals through appropriate targets and gender-sensitive indicators (UN Women, UNFPA).

9For all UN Women references see: UN Women (2013) A transformative stand-alone goal on achieving gender equality, women’s rights and women’s empowerment: Imperatives and key components.

10For UNFPA references see: UNFPA (2013) Empowering People to Ensure a Sustainable Future for All and UNFPA (2014) Empowering Adolescents and Youth to Ensure a Sustainable Future for All.

11See JMP/WHO/ UNICEF (2013) Post2015 WASH targets and indicators.

 

 

B7. Percentage of hospitals, health centres and clinics

 

 

with improved gender separated sanitation facility on

 

 

or near premises (at least one toilet for every 20 users

 

 

at inpatient centres, at least four toilets – one each for

 

 

staff, female, male and child patients – at outpatient

 

 

centres).

 

 

B8. Percentage of hospitals, health centres and clinics

 

 

with a private place for washing hands, private parts

 

 

and clothes; drying reusable materials; and safe

 

 

disposal used menstrual materials

 

 

 

6.Sustainable Cities and

6A. All metropolitan regions, cities

A1. Proportion of metropolitan regions, cities and

Human Settlements

and towns adopt and implement

towns adopting and implementing policies and

 

policies and strategies for

strategies for sustainable and effective urban planning

 

sustainable and effective urban

and design, including effective use of population data

 

planning and design, with

and projections

 

systematic use of population data

 

 

and projections (Source: adapted

 

 

from UNHABITAT)

 

 

 

 

 

6B. Urban development planning

B1. Proportion of urban development policies taking

 

and policies prioritize the safety of

into account the safety of women and girls

 

women and girls

B2. Proportion of urban spaces rehabilitated to ensure

 

 

 

 

the safety of women and girls

 

 

 

7. Ensuring Stable and

7A. Ensure universal access to

A1. Proportion of national climate change adaptation

Peaceful Societies,

rights-based sexual and

plans that integrate population dynamics and sexual

Disaster Risk Reduction,

reproductive health services,

and reproductive health

and Climate Change

including rights-based and voluntary

A2. Proportion of public funds spent in developing

Mitigation and

family planning, for all communities,

countries on climate adaptation allocated to ensure

Adaptation

especially in areas prone to conflict

universal and comprehensive services for sexual and

 

and instability and as strategies for

 

reproductive health and rights

 

increasing resilience in areas most

 

 

 

vulnerable to disaster and climate

A3. Unmet need for quality modern contraceptives by

 

change

choice in areas prone to conflict and instability and

 

 

most vulnerable to disasters and climate change

 

 

A4. Available emergency obstetric facilities per

 

 

100,000 population in areas prone to conflict and

 

 

instability and most vulnerable to disasters and climate

 

 

change

 

 

A5. Existence of effective referral systems for

 

 

emergency obstetric facilities in areas prone to conflict

 

 

and instability and most vulnerable to disasters and

 

 

climate change

 

 

 

 

7B. Ensure the implementation of

B1. Implementation of the Minimum Initial Service

 

minimum standards for responding

Package for Reproductive Health in Crisis Situations

 

to the sexual and reproductive

(MISP), in the initial stages of an emergency or

 

health needs and rights of women

disaster, including climate-related disasters

 

and girl survivors of conflict and

B2. Maternal mortality ratio in emergency and disaster

 

disaster, at the initial stages of an

 

situations and in settlements for populations displaced

 

emergency

 

due to conflict, instability and disaster, including

 

 

 

 

climate-related disasters

 

 

B3. Contraceptive prevalence rate in emergency

 

 

situations/settlements for populations displaced due to

 

 

disaster, including climate-related disasters

 

 

B4. Prevalence rates of sexual and gender-based

 

 

violence in disaster and emergency settings

 

 

 

 

7C. Systematic use of population

C1. Proportion of disaster preparedness strategies and

 

data in disaster preparedness

climate change adaptation and mitigation strategies

 

strategies and climate change

that utilize population data and projections

 

adaptation and mitigation strategies

 

 

 

 

8. Conservation of

8A. Ensure universal access to

A1. Unmet need for quality modern contraceptives by

Ecosystems and

sexual and reproductive health

choice in communities in and around areas of high

Sustainable

services, including access to rights-

biodiversity, protected areas and conservation priority

Management of Oceans

based and voluntary family planning

areas, including forests and coastal and marine areas

and Seas, Forest and

for all communities, especially those

 

Biodiversity and other

in and around areas of high

 

Natural Resources

biodiversity, protected areas and

 

 

conservation priority areas,

 

 

including forests and coastal and

 

 

marine areas

 

 

 

 

 

8B. Integration of population

B1. Proportion of national plans and strategies for

 

dynamics and sexual and

conservation and management of natural resources

 

reproductive health, including

that integrate population dynamics and rights-based

 

rights-based and voluntary family

consideration of sexual and reproductive health

 

planning, into national plans and

B2. Allocation of funds for implementation of plans for

 

strategies for conservation and

 

the conservation and management of natural

 

management of natural resources

 

resources that integrate population dynamics and

 

 

 

 

rights-based consideration of sexual and reproductive

 

 

health

 

 

 

9.Rights-based Governance

9A.Systematic use of population

A1. Improvements in capacity to prepare population

and Accountability12

trends and projections in the

projections and to use them for the formulation of

 

formulation of development

national, subnational and sector development

 

strategies, goals and targets

strategies, goals, targets and policies (Source: UNFPA)

 

(Source: UNFPA)

 

 

 

 

 

9B.Access to timely and complete

B1. Improvements in institutional capacities to

 

data for population trends and

generate quality data, disaggregated by age, sex,

 

projections (Source: UNFPA)

location, wealth quintiles, among other categories,

 

 

including birth and death registration, censuses,

 

 

service-related management and information systems

 

 

(Source: UNFPA)

 

 

 

 

9C.Universal birth and death

C1. Estimated proportion of births and deaths that are

 

registration (Source: UNFPA)

registered

 

 

 

ABOUT PSDA

The Population and Sustainable Development Alliance (PSDA) is an international network of civil society organisations that work together on population, sexual and reproductive health and rights and sustainable development issues. We believe that population dynamics are of critical importance for sustainable development and can be positively influenced through accelerating progress towards universal access to sexual and reproductive health and rights (SRHR).

info@psda.org.uk

12 Targets for a governance goal and to be mainstreamed throughout the framework relevant both from a human rights-based approach. Based on the UNFPA proposal (2013) Empowering People to Ensure a Sustainable Future for All.