INTRODUCTION

The High-level Meeting to Review the Implementation of the Programme of Action of the International Conference on Population and Development and the Bali Declaration on Population and Sustainable Development and to Make Recommendations for Further Action was held at Bangkok from 24 to 27 March 1998. The Meeting was convened in response to the recommendations made by the ESCAP Committee on Poverty Alleviation through Economic Growth and Social Development, which had met at Bangkok in October 1996.

The major objective of the Meeting was to identify key future actions that needed to be undertaken in order to meet the objectives of recommendations contained in the Bali Declaration on Population and Sustainable Development (adopted at the Fourth Asian and Pacific Population Conference in August 1992) and the Programme of Action (adopted in Cairo in September 1994).

In order to identify the key future actions, the Meeting reviewed the progress that had been made in implementing the recommendations contained in the above instruments, discussed the constraints and obstacles that had been encountered in the attempts to implement them and reviewed the challenges that were still faced.

The Meeting noted that the ESCAP region was characterized by extreme diversity in terms of the prospects for population change, resource endowments, gender equality and equity, and planning systems, among others, and further that countries of the ESCAP region were undertaking reforms to adjust to and benefit from the opportunities posed by the process of globalization, However, even within that diverse situation, the Meeting was able to identify several key actions that should receive urgent attention from all development partners.

The Programme of Action adopted in Cairo in 1994 represented both elements of continuity with the Bali Declaration on Population and Sustainable Development, adopted in Bali in 1992, and a significant shift with regard to the underlying goals and principles on which population and development programmes were to be based.

One aspect of continuity was the right of individual countries to autonomy in population policy. Other elements of continuity included a primary health-care focus in the discussion of population issues, and similar treatment of the issues of migration and urbanization, and called for the integration of demographic factors into development planning.

However, the Programme of Action, with its focus on a broader approach to reproductive health and gender equality, equity and the empowerment of women, was rooted in a human rights approach, rather than targets for fertility reduction. It involved a major paradigm shift with regard to the way population and development policies and programmes were to be formulated and implemented. That shift placed individual welfare at the centre of all development programmes, including population programmes.

In response to the recommendations contained in the Programme of Action and the Bali Declaration, countries of the ESCAP region had been reorienting their population and development policies and programmes according to their particular demographic, economic, socio-cultural and political situations. Those efforts had met with varying degrees of success, with some countries reporting significant progress. A number of factors accounted for that variation in the amount of progress, including the diversity of the countries in the region; the obstacles posed by the priorities of the countries; programme implementation constraints (such as a shortage of human and financial resources, and capable management); as well as other cultural factors. The diversity covered a number of aspects: population size and growth; levels and trends of fertility and mortality; levels and rates of economic development; the impact of internal and international migration; approaches to development planning and programme implementation; the socio-cultural, religious and ethnic composition of the population; and women's autonomy, to mention only a few.

The diversity among countries had widened since the Fourth Asian and Pacific Population Conference in 1992. Fertility rates had declined to below the replacement level in many countries of the region, whereas in some others they remained at pre-transitional levels, or had declined only marginally. In countries where replacement fertility had been achieved only recently, the population would register a considerable increase before stabilizing. Similarly, mortality levels also showed extreme diversity, being particularly pronounced among women of reproductive age and among children during infancy and early childhood.

Those differences manifested themselves in the age structure, from populations characterized by the rapid "ageing" of population, to those showing continuing growth of the population in "adolescent" and "young adult" years.

One phenomenon worthy of note was an increase in female age at marriage and decline in the age difference between spouses as a result of increasing education and declining gender disparity in education. While those trends influenced gender relations, they also raised important policy issues relating to the provision of reproductive health services for cohorts of unmarried adolescents and young adults. Furthermore, in some countries of the ESCAP region, abortion remained at exceedingly high levels, threatening the lives of mothers and children, particularly when the abortion was performed under unsafe conditions. That arose from high levels of "unmet need" for contraception, a lack of choice in terms of contraceptive methods, and inadequate access to services for adolescents and young adults.

Similarly, the range of fertility levels prevailing among the countries of the region held implications for the adoption of the reproductive health approach. Those countries whose fertility was below the replacement level would be likely to want to maintain their current fertility levels. However, the adoption of a reproductive health approach would be easier in such countries than in those where fertility levels were high, the health service infrastructure inadequate, and available resources stretched to the limit.

Despite the progress being made in improving the role and status of women in the ESCAP region, the attainment of gender equality, equity and the empowerment of women remained a distant goal in many countries. The nature and extent of those differences varied among the countries. Where gender equality was restricted, women had limited ability to make informed choices, including in matters related to family formation.

The countries of the ESCAP region were also diverse in terms of their economic performance. During the past two decades, the diversity had also increased, with some of the countries demonstrating sustained higher levels of economic growth than others, notwithstanding the events of the past year affecting some East and South-East Asian countries.

The increasing trends towards the globalization of markets and economic restructuring, whereby the role of markets was increasing, had resulted in unprecedented levels of capital flows into the region and between the countries of the region. In turn, those had resulted in the movement of labour across borders on a larger scale than before. The above had impacts on development, some of which operated through their effects on demographic variables, either directly or indirectly. Concurrently, many countries were also changing their planning strategies, shifting from the "top-down" to the "bottom-up" approach, and giving greater emphasis to decentralization and the role of non-governmental organizations (NGOs), the community and civil society at large.

Given the varying degree of success in implementing the recommendations of the Programme of Action, and the continuing relevance of the recommendations, there was a great need for continuing as well as accelerating efforts towards the realization of its goals.