Thirty years ago, the world came together at the International Conference for Population and Development (ICPD) in Cairo and put people’s sexual and reproductive health and rights at the heart of global development. 

Since then, we have made enormous strides in fulfilling the ICPD agenda. But millions are still denied their health and rights every day – something that can and must end.

What have we achieved?

In the wider European region*, fewer women die giving birth, have children when they are still teenagers, and face problems with access to contraceptives, according to a recent regional review report:

Maternal mortality halved

Maternal mortality almost halved from an average of 22 to 12 deaths per 100,000 live births between 2000 and 2020

Maternal mortality halved

Teenage pregnancy down

Adolescent birth rates dropped by nearly 50 per cent from an average of 20.3 to 12.6 births per 1,000 women aged 15 to 19 years between 2000 and 2020

Teenage pregnancy down

Unmet need for family planning reduced

The share of reproductive-age women who have their needs for family planning satisfied with modern methods increased from a median value of 66.7 per cent in 2000 to 75.9 in 2022

Unmet need for family planning reduced

When crises cut off health care, community members fill the gaps

When crises cut off health care, community members fill the gaps

UNFPA-supported mobile health units are delivering crucial prenatal and postnatal care, family planning, and reproductive health services to women and girls displaced by the 2023 earthquakes in Türkiye’s Hatay Province. 

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Photo: UNFPA Türkiye/Eren Korkmaz

Despite the remarkable gains witnessed over the past three decades, progress has slowed in some areas, or even reversed, and the most affluent and privileged have generally seen much greater gains than those less well-off.  Millions have been excluded from progress, in part due to the multiple, compounding forms of marginalization and discrimination they confront daily. Inequalities continue to permeate every society, depriving large numbers of people of fundamental sexual and reproductive health and rights.

Research from 25 countries around the world shows that barriers to health care have fallen more quickly for women of higher socio-economic status, and less quickly for those belonging to disadvantaged ethnic groups. In Albania, for example, gains in access to health care have been faster for richer than poorer segments of society, and more pronounced for ethnic Albanians than for minority groups such as Roma.  

Where is progress stalling?

Maternal mortality

Progress in reducing maternal mortality has slowed in the wider European region, and there has been an increase in maternal deaths between 2015 and 2020 in 18 of 52 countries with data

Maternal mortality

Modern contraceptive use

The use of modern contraceptives remains extremely low in parts of Eastern Europe and Central Asia; in five countries more than half of women do not use any form of contraception

Modern contraceptive use

Bodily autonomy

One in four women of reproductive age cannot exercise autonomy in making decisions about their bodies and health

Bodily autonomy

HIV epidemic

160,000 people were newly infected with HIV in Eastern Europe and Central Asia in 2022, a 49 per cent increase since 2010 and the largest increase of any region in the world during this period

HIV epidemic

Women with disabilities

Women and girls with disabilities are up to 10 times more likely to experience gender‐based violence, including sexual violence

Women with disabilities

Gender-based violence

The share of individuals believing it is justifiable for a man to beat his wife has increased over time in half of countries in the region with data, especially among younger people

Gender-based violence

With millions of people in the region being held back from fulfilling their potential by often overlapping forms of discrimination and marginalization, a new vision is gaining momentum, one in which expanding  the rights and well-being of individuals strengthens societies, and vice versa. 

In this light, dismantling discrimination and exclusion is not only a human rights imperative, but crucial for putting countries in a better position for dealing with the challenges they are facing. With many countries in the region experiencing low birthrates and, increasingly, population decline, measures to better integrate women, minorities and other marginalized groups into the economy and public life are becoming ever more important. They are much-needed investments in human capital that strengthens countries’ demographic resilience. 

To ensure that the next 30 years of progress includes everyone, we must pivot towards providing comprehensive, universal and inclusive sexual and reproductive health care and guaranteeing rights for all. 

This means designing tailored and targeted health programmes that address the multiple ways economic, social, political and environmental injustice impact people’s health and rights. It also means moving beyond measuring human experiences in broad averages and committing to the collection of disaggregated data across a variety of factors.

Stories from the region

  • Women with disabilities in Turkmenistan claim their rights

    Many people with disabilities in Turkmenistan are not able to access sexual and reproductive health services and information. To meet their needs, UNFPA and the Society of the Blind and Deaf of Turkmenistan created sexual and reproductive health videos accompanied by sign language interpretation.

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  • From fear to empowerment: One woman's journey with HIV in Georgia

    People living with HIV in Georgia often face difficulties accessing health care and other services because of widespread misconceptions and stigma. UNFPA is working to increase awareness and understanding, especially among young people, so that people with HIV can live free from discrimination and everyone feels safe seeking out information, testing and treatment.

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  • Supporting women with disabilities in North Macedonia realize their right to give birth

    With support from UNFPA, North Macedonia is making progress in dismantling barriers preventing people living with disabilities from accessing sexual and reproductive health services. Sashka Smilkova, who is deaf and has a severe spinal deformity, is among an increasing number of women living with disabilities who receive the support they need to realize their dream of having a baby.

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  • Health mediators playing key role in improving equal access to health care for Albania’s most vulnerable communities

    People from the most vulnerable groups, including those from the Roma and Egyptian communities, face difficulties accessing health care in Albania, and improvements have been slow for the most marginalized. With UNFPA support, health mediators are working to increase access to health care services, including sexual and reproductive health services, for those left behind.

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Interactive global report

www.unfpa.org/SWP2024