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New York, Evaluation Office, United Nations Population Fund [UNFPA], 2016. 24 p.This evaluation focuses on how UNFPA performed in the area of family planning during the period covered by the UNFPA Strategic Plan 2008-2013. It provides valuable insights and learning which can be used to inform the current UNFPA family planning strategy as well as other relevant programmes, including UNFPA Supplies (2013-2020). All the countries where UNFPA works in family planning were included, but the evaluation focuses on the 69 priority countries identified in the 2012 London Summit on Family Planning as having low rates of contraceptive use and high unmet needs. The evaluation took place in 2014-2016 and was conducted by Euro Health Group in collaboration with the Royal Tropical Institute Netherlands. It involved a multidisciplinary team of senior evaluators and family planning and sexual and reproductive health and rights specialists, which was supervised and guided by the Evaluation Office in consultation with the Evaluation Reference Group. The outputs include a thematic evaluation report, an evaluation brief and country case study notes for Bolivia, Burkina Faso, Cambodia, Ethiopia and Zimbabwe.
New York, Evaluation Office, United Nations Population Fund [UNFPA], 2016 Apr. 214 p.The purpose of the evaluation was to assess the performance of UNFPA in the field of family planning during the period covered by the Strategic Plan 2008-2013 and to provide learning to inform the implementation of the current UNFPA Family Planning Strategy Choices not chance (2012-2020). The evaluation provided an overall independent assessment of UNFPA interventions in the area of family planning and identified key lessons learned for the current and future strategies. The particular emphasis of this evaluation was on learning with a view to informing the implementation of the UNFPA family planning strategy Choices not chance 2012-2020, as well as other related interventions and programmes, such as the Global Programme to Enhance Reproductive Health Commodity Security (GPRHCS- 2013-2020). The evaluation constituted an important contribution to the mid-term review of UNFPA strategic plan 2014-2017. The evaluation features five country case study reports: Bolivia, Burkina Faso, Cambodia, Ethiopia, and Zimbabwe.
Ensuring the complementarity of country ownership and accountability for results in relation to donor aid: a response.
Reproductive Health Matters. 2011 Nov; 19(38):141-5.This paper focuses on the topic of improving the impact of sexual and reproductive health development assistance from European donors. It touches on country ownership and accountability and uses International Health Partnership+ (IHP+) as an example. In addition, it discusses the need for better funding data and more activity around sexual and reproductive health and rights. It concludes with recommendations for improving aid impact and effectiveness and improving outcome measures.
New York, New York, United Nations Population Fund [UNFPA], 2007.  p.The influence behind faith-based organizations is not difficult to discern. In many developing countries, FBOs not only provide spiritual guidance to their followers; they are often the primary providers for a variety of local health and social services. Situated within communities and building on relationships of trust, these organizations have the ability to influence the attitudes and behaviours of their fellow community members. Moreover, they are in close and regular contact with all age groups in society and their word is respected. In fact, in some traditional communities, religious leaders are often more influential than local government officials or secular community leaders. Many of the case studies researched for the UNFPA publication Culture Matters showed that the involvement of faith-based organizations in UNFPA-supported projects enhanced negotiations with governments and civil society on culturally sensitive issues. Gradually, these experiences are being shared across countries andacross regions, which has facilitated interfaith dialogue on the most effective approaches to prevent the spread of HIV. Such dialogue has also helped convince various faith-based organizations that joining together as a united front is the most effective way to fight the spread of HIV and lessen the impact of AIDS. This manual is a capacity-building tool to help policy makers and programmers identify, design and follow up on HIV prevention programmes undertaken by FBOs. The manual can also be used by development practitioners partnering with FBOs to increase their understanding of the role of FBOs in HIV prevention, and to design plans for partnering with FBOs to halt the spread of the virus. (excerpt)
Geneva, Switzerland, WHO, 2007. 55 p.The concepts and principles in this document build on the World Health Organization's active ageing policy framework, which calls on policy-makers, practitioners, nongovernmental organizations and civil society to optimize opportunities for health, participation and security in order to enhance quality of life for people as they age. This requires a comprehensive approach that takes into account the gendered nature of the life course. This report endeavors to provide information on ageing women in both developing and developed countries; however, data is often scant in many areas of the developing world. Some implications and directions for policy and practice based on the evidence and known best practices are included in this report. These are intended to stimulate discussion and lead to specific recommendations and action plans. The report provides an overall framework for taking action that is useful in all settings. Specific responses in policy, practice and research is undoubtedly best left to policy-makers, experts and older people in individual countries and regions, since they best understand the political, economic and social context within which decisions must be made. (excerpt)
New York, New York, United Nations Population Fund [UNFPA], 2006 Dec.  p.A human rights-based approach to programming is a conceptual framework and methodological tool for ensuring that human rights principles are reflected in policies and national development frameworks. Human rights are the minimum standards that people require to live in freedom and dignity. They are based on the principles of universality, indivisibility, interdependence, equality and non-discrimination. Through the systematic use of human rights-based programming, UNFPA seeks to empower people to exercise their rights, especially their reproductive rights, and to live free from gender-based violence. It does this by supporting programmes aimed at giving women, men and young people ('rights holders') the information, life skills and education they need to claim their rights. It also contributes to capacity-building among public officials, teachers, health-care workers and others who have a responsibility to fulfill these rights ('duty bearers'). In addition, UNFPA strengthens civil society organizations, which often serve as intermediaries between governments and individuals, and promotes mechanisms by which duty bearers can be held accountable. (excerpt)
Lancet. 2007 May 26; 369(9575):1789-1790.Although pelvic organ prolapse is a significant problem in affluent countries, the situation in developing countries is far worse. This is mainly a result of high fertility with early marriage and childbearing, many vaginal deliveries, and in certain countries such as Nepal, frequent heavy lifting. In Nepal, fertility until recently was very high and most deliveries take place at home, with only 14% in a health facility and less than 3% by caesarean section. In developing countries, the extent and effects of morbidity associated with pelvic organ prolapse are seldom acknowledged, because of patients' embarrassment. However, studies in Nepal, supported by the United Nations Population Fund (UNFPA), have begun to identify the suffering of women with this disorder. Findings indicate that 10% of women have pelvic organ prolapse, of whom about half require operative management (30.9% with stage II, 12.6% with stage III, and 1.4% with stage IV or procidentia). Women report difficulty in sitting (82%), walking (79%), and lifting (89%), all of which affect their acceptance as full family and community members. The social consequences of prolapse are substantial, and include physical and emotional isolation, abandonment, divorce, ridicule, low self esteem, abuse, lack of economic support, and domestic violence. In Nepal, UNFPA is supporting efforts to identify women with pelvic organ prolapse through reproductive health camps and to contract gynecologists to treat these women at district hospitals. We suggest that more attention should be given to acknowledging the profound consequences of uterine organ prolapse and establishing programmes in developing countries to prevent and manage this frequently severely debilitating condition. (full text)
New York, New York, United Nations Population Fund [UNFPA], 2006.  p.Even in times of peace, it is usually women who look after children, the sick, the injured and the elderly. When emergencies strike, this burden of care can multiply. In many cases, women become the sole providers and caretakers for their households, and sometimes the families of others -- especially when men have been killed, injured or must leave their communities to fight or rebuild. During crisis and in refugee situations, women and girls become the ultimate humanitarian workers. They obtain food and fuel for their families, even when it is unsafe to do so. They are responsible for water collection, even when water systems have been destroyed and alternate sources are far away. They help to organize or rebuild schools. They protect the vulnerable and care for sick and disabled family members and neighbours. Women are also likely to take on additional tasks, including construction and other physical labour, and activities to generate income for their families. In many conflict zones, women's actions also help to bring about and maintain peace. Women care for orphaned children who might otherwise become combatants. They organize grass-roots campaigns, sometimes across borders, to call for an end to fighting. When the situation stabilizes, women work together to mend their torn communities. They help rebuild, restore traditions and customs, and repair relationships -- all while providing care for the next generation. (excerpt)
The ICPD vision: How far has the 11-year journey taken us? Report from a UNFPA panel discussion at the IUSSP XXV International Population Conference, Tours, France, 19 July 2005.
New York, New York, UNFPA, 2006. 54 p.UNFPA, the United Nations Population Fund, decided to sponsor a Panel debate at the 25th IUSSP International Population Conference on progress towards achievement of the Plan of Action following the International Conference on Population and Development (ICPD), which took place in Cairo, Egypt in 1994. The title of the debate was "The ICPD Vision: How far has the eleven-year journey taken us?" Four distinguished speakers were invited to act as panel members. Two demographers, Professors John Cleland and Ian Pool, both advocated for a much stronger focus on population dynamics and were critical of the ICPD and, to some extent, also of the Millennium Development Goals (MDGs) for not paying sufficient attention to macro-level demography. Two supporters of the Cairo agenda, Dr Pascoal Mocumbi and Professor Gita Sen, both stressed some important gains in the eleven years since the ICPD, but also stressed some of the constraints on significant progress including inadequate attention to health systems and the roles of wider political and cultural shifts. This document begins with an introduction and commentary on the panel debate by Professor John Hobcraft, which tries to place the discussions in their wider context. The second part contains revised statements from the four Panel participants: Professors John Cleland, Ian Pool and Gita Sen; and Dr Pascoal Mocumbi. The discussion was lively and the issues raised are of huge importance. The panelists were asked to relate their remarks not only to the ICPD, but also the MDGs, particularly the first goal of halving poverty by 2015. (excerpt)
New York, New York, United Nations Population Fund [UNFPA], 2005.  p.Contraceptives, drugs, and medical supplies required for reproductive health services in developing regions cost US$1.84 billion in 2000, will cost $2.34 billion in 2005, and will rise in cost to $3.43 billion by 2015. Annual costs will be 86 per cent higher, in constant dollars, in 2015 than in 2000 (Figure 1). These estimates cover contraceptives for family planning, condoms for protection against HIV and other sexually transmitted infections, and drugs and medical supplies for safe deliveries and other reproductive health services. Drugs and medical supplies make up over half the total cost, contraceptives around one-third, and condoms for protection the remaining one-eighth or so. The estimates are detailed in this report, which attempts to assess the overall costs of reproductive health commodities, which UNFPA has traditionally had a major role in helping provide for developing regions. These commodities are essential to achieve the goal of providing universal access to reproductive health care, as mandated in 1994 by the International Conference on Population and Development. The report is not intended to specify the quantities and cost of commodities needed in particular countries but rather tries to arrive at estimates of global requirements. Nevertheless, the calculations are based on detailed consideration of regional and even country data where they are available. The report assesses the number of cases in developing regions of each relevant reproductive health condition, projects these numbers over 15 years, determines the commodities required as part of appropriate treatment, estimates the proportion of cases that do receive such treatment, specifies how coverage should rise in the future, and calculates the commodity costs for all the cases to be covered. (excerpt)
New York, New York, UNFPA, 2005 Mar. 30 p.The Millennium Project Report identifies the mounting of vigorous campaigns to combat violence against women as a possible "quick win" action that should be taken to accelerate achievement of the MDGs. The goal is to mobilize leadership at the national, regional and global levels to make violence unacceptable. The Network of African Women Ministers and Parliamentarians has made a commitment to combating gender-based violence (GBV) by taking the lead in developing innovative interventions including: drafting and lobbying for appropriate legislation; raising awareness through advocacy; building partnership by enhancing national, regional and international networks; and raising community awareness about gender-based violence. This kit is a contribution to the realization of the Network's goal. It is a tool whose aim is to outline the problem of gender-based violence, elaborate its linkages to poverty, reproductive health, HIV/AIDS and conflict, and discuss its impact on a nation's development. The kit refers to international commitments made by governments combined with other regional and international instruments, which they can use to mount national campaigns to halt gender-based violence in all its forms. It is designed to serve as a basis for advocacy work, and as a tool to assist policy and decision makers to contribute to the achievement of the MDGs. (excerpt)
From microfinance to macro change: integrating health education and microfinance to empower women and reduce poverty.
New York, New York, United Nations Population Fund [UNFPA], 2006. 26 p.This document is a call to action for development agencies, governments, MFIs and donors that are committed to finding practical strategies to fulfill the shared vision for human development. Built upon the backbone of a poverty alleviation mechanism already reaching more than 66.6 million of the world's poorest families, the proposed strategy calls for combining reproductive health education with microfinance services in developing countries. The first section of the document acknowledges and reviews the intimate link between poverty, poor health outcomes and inequality. The next section presents microfinance as an effective poverty reduction strategy and reviews the evidence for its impact on poverty as well as its broader impacts. The third section proposes microfinance as a vehicle for improving reproductive health outcomes, HIV prevention and women's empowerment by combining health education with microfinance programs. Summaries of case study institutions in Bolivia that are already employingthis strategy are presented, along with evidence of the impact of combined microfinance and health education services. Finally, recommendations for action are made to development agencies, governments, MFIs and donors to promote and expand this essential strategy. (excerpt)
New York, New York, United Nations Population Fund [UNFPA], 2005. 29 p.The modern human rights system is based on a series of legally binding international treaties that make use of principles of ethics and social justice, many of which are directly relevant to population issues and reproductive health. Agencies throughout the United Nations system are adopting a right-based approach to replace the former 'basic needs' approach. Under a human rights framework, governments are the primary duty bearers. They have obligations to put in place equitable laws and systems that enable individuals to enjoy their rights, and to seek judicial recourse under the rule of law when they have been violated. As rights holders, people can claim the rights that are recognized as legitimate entitlements. This approach emphasizes the empowerment of those who are affected by policies and their participation in the decision-making process. By emphasizing fundamental values, a rights-based approach can shape effective population, development, reproductive health and gender equality programmes and policies. UNFPA is convinced that the effective integration of a human rights-based approach into programmes will advance equality, social inclusion, accountability and fairness in the distribution of resources in society. As human rights lie at the core of the mandate of the UN, both the UN Secretary-General's Programme for Reform (1997) and its second phase, An Agenda for Further Change (2001) outlined the adoption of a human rights-based approach (HRBA) by all UN agencies. It is UN's policy to make human rights a crosscutting priority for the whole system. In line with the ICPD, the promotion and protection of human rights are fundamental to the work of UNFPA at all levels. (excerpt)
New York, New York, UNFPA, 2005.  p.As of 2004, progress in reproductive health is evident in many countries, where family planning is the norm and fewer women are dying in childbirth. But much more needs to be done, especially in those countries with far to go in meeting development goals. Three actions are central to saving women's lives: family planning, skilled attendance at birth, and access to emergency obstetric care. Ten years after the International Conference on Population and Development (ICPD) in Cairo, more than half a million women still die each year from complications of pregnancy and childbirth. Lack of care heightens the risk to mothers and babies: one third of all pregnant women worldwide receive no health care during pregnancy, and 60 per cent of all deliveries take place outside of health facilities. Poverty makes the dangers even greater: the lifetime risk of a woman dying in pregnancy or childbirth in sub-Saharan Africa is 1 in 16, compared to 1 in 2,800 in developed countries. The Cairo conference called for universal access to reproductive health care by 2015. (excerpt)
PLoS Medicine. 2006 Apr; 3(4):e211.One of the most unsettling images for newcomers to many parts of Africa is the sight of undernourished women bearing unfeasibly large vessels of water long distances over rough terrain to supply the needs of their families. A sense of outrage that anyone should have to live like this in the 21st century forms the basis of the humanitarian imperative that drives development programs, especially those that focus on basic needs such as access to safe water. When such a program reduces from three hours to 15 minutes the time that women spend fetching water each day, surely it can be described as a success, without the need for any "scientific" assessment of what has been achieved? In this issue of PLoS Medicine, we publish a study that did assess such a program. Mhairi Gibson and Ruth Mace (DOI: 10.1371/journal. pmed.0030087)--from the University of Bristol, United Kingdom--compared villages in Ethiopia that benefited from a tapped water supply with other villages that did not. Outcome measures included the nutritional status of women and children, mortality rates, and birth rates. There were a number of surprising findings, most notably the large increase in birthrate in the villages where the water supply intervention took place. (excerpt)
UN Chronicle. 2005 Dec;  p..Afghan women have one of the world's highest maternal mortality rates. They face many obstacles when it comes to accessing health care: most are rural and do not live close to or cannot access medical facilities, if the need arises. The few existing facilities do not necessarily specialize in obstetric and gynaecological care and cannot always offer quality care. Many Afghan families do not recognize signs of complication during pregnancy and delivery, and may not seek medical attention soon enough to save the lives of mothers and babies. Also ongoing insecurity and cultural norms in the country often keep women from leaving the house to seek urgently needed medical care. Because of cultural pressures, families are reluctant to present women to male doctors, and few female doctors are trained to meet the overwhelming medical needs of women; these conditions constitute a death sentence for thousands of women each year. It is estimated that about 25 per cent of Afghan children die before their fifth birthday from mostly preventable illnesses. The World Health Organization reports that children in Afghanistan are particularly at risk of dying from diarrhoeal diseases that, according to surveys, result in 20 to 40 per cent of all deaths of children under five--an estimated 85,000 children per year. Diarrhoea is also a significant cause of malnutrition, which is a major contributing factor in children's death from other diseases. (excerpt)
Commission gives high priority to monitoring global trends - UN Population Commission meeting, Mar 28-31, 1994 - includes information on preparation of action program to be recommended at the Sep 5-13, 1994 International Conference on Population and Development, Cairo, Egypt.
UN Chronicle. 1994 Jun; 31(2): p..The effect of population growth on the environment, the role and status of women, and the demographic implications of development Policies were among major topics discussed by the Population Commission at its twenty-seventh session (28-31 March, New York). "The most important lesson we have learned is that population growth and other demographic trends can only be affected by investing in people and by promoting equality between women and men", Dr. Nafis Sadik, Executive Director of the UN Population Fund (UNFPA) and Secretary-General of the 1994 International Conference on Population and Development, told the 26-member body. In the single text approved during the session, for adoption by the Economic and Social Council, the Commission asked that high priority be given to monitoring world population trends and policies, and to strengthening multilateral technical cooperation to address population concerns. (excerpt)
Population 2005. 2004 Jun; 6(2):15.A conference titled, “Cairo and Beyond: Reproductive Rights and Culture” was organized by the Dutch government and the United Nations Population Fund (UNFPA) on International Women’s Day, March 8th in Amsterdam. The event concluded with a pledge to “break the silence and taboos on culture and religion and their relation to reproductive and sexual health and rights,” by Agnes van Ardenne, Dutch Minister for Development Cooperation and Thoraya Ahmed Obaid, Executive Director of UNFPA. They also promised “to establish a permanent dialogue on these vital issues.” Over 100 experts from around the world attended the event and participants agreed that although progress has been made in the ten years since the 1994 ICPD in Cairo, many substantial challenges still remain. The conference focused specifically on those challenges related to the interconnections between culture and reproductive rights. (excerpt)
Population 2005. 2004 Apr; 6(1):15.According to a United Nations Population Fund (UNFPA) press release, emergency medical supplies were airlifted and arrived in Port-au-Prince, Haiti in March. Weeks of civil conflicts have led to the destruction and looting of much of Haiti’s health-care system and sexual violence continues to reach alarming levels. The supplies included drugs and materials for safe childbirth and for treatment of rape and sexually transmitted infections. Also included in the airlift were emergency obstetric supplies and equipment for clinics and hospitals that were looted during the civil unrest that has ravaged Haiti in recent months. UNFPA plans to manage the distribution of the supplies throughout the country with the help of the United Nations Children’s Fund (UNICEF) and the Pan American Health Organization (PAHO). Since the crisis began, the three agencies have been working together to reduce maternal mortality. (excerpt)
Population 2005. 2003 Jun; 5(2):16.The founders of the grassroots campaign “34 Million Friends of UNFPA” announced May 1 that it had raised $1 million to support the United Nations Population Fund, mostly in small donations. More than 100,000 Americans have contributed to the campaign to help replace funds withheld by the United States Administration last July. “This campaign highlights the power of individuals to make a difference,” said Thoraya Ahmed Obaid, UNFPA executive director. “It also shows that the American people support the right of all women to have quality health care and to be able to plan their families.” UNFPA will use the campaign’s first million dollars to make pregnancy and childbirth safer for women; reduce the spread of HIV/AIDS; equip hospitals with essential supplies; support adolescents and youth; and prevent and treat obstetric fistula, a debilitating condition that results from obstructed labor. (excerpt)
Population 2005. 2003 Dec; 5(4):9.A survey conducted by the United Nations Population Fund (UNFPA), in collaboration with the International Center for Migration and Health, has tracked startling statistics regarding the health system in Iraq. According to UNFPA, the number of women who die from pregnancy and childbirth in Iraq has close to tripled since 1990. Among the causes of the reported 310 deaths per 100,000 live births in 2002 are bleeding, ectopic pregnancies and prolonged labor. In addition, stress and exposure to chemical contaminants are also partly to blame for the rise in miscarriages among Iraqi women. Access to medical facilities is becoming more difficult for women due to breakdowns in security and weakened communication and transport systems. This has caused nearly 65 per cent of Iraqi women to give birth at home, the majority without skilled help. (excerpt)
Trafficking in women, girls and boys. Key issues for population and development programmes. Report of the UNFPA Consultative Meeting on Trafficking in Women and Children, Bratislava, Slovak Republic, 2-4 October 2002.
New York, New York, UNFPA, 2002.  p.The Consultative Meeting on Trafficking in Women and Children was held in Bratislava, Slovakia, from 2 to 4 October 2002. The encounter brought together 60 participants from 30 countries, including government and NGO representatives, as well as key persons from UNFPA and other UN agencies. UNFPA’s concerns with this contemporary issue are rooted in the historic Programme of Action adopted in Cairo at the 1994 International Conference on Population and Development (ICPD). The complex trafficking issues are seen by the Fund as being directly related to the focus in the Programme of Action upon gender equality, women’s empowerment, violence against women, and reproductive health and rights. Trafficking in persons for the purpose of labour and commercial sexual exploitation is a modern form of slavery, according to Article 3 of United Nations Protocol 2000, which supplements the UN Convention against Transnational Organized Crime, adopted by the General Assembly in November 2000. (“The Protocol to Prevent, Suppress and Punish Trafficking in Persons, Especially Women and Children” has been signed by 80 countries.) The agreed definition was helpful to the participants at the Bratislava meeting as they pursued their agenda. At the outset, participants set the objectives they wished to achieve during their deliberations: building a common understanding of trafficking issues and their impact on reproductive health and rights; identifying approaches, methods and good practices in tackling the issues; identifying UNFPA’s comparative advantages as well as possible partners for implementing actions at field level. The meeting framed trafficking as a gender and development problem, and much attention was devoted to the exploration of gender perspectives. The situation facing children at risk was, therefore, discussed in terms of girls and boys; similarly, the gender of the traffickers was highlighted for the insights that might be revealed. The gendered dimension of poverty itself was viewed as an important reason for trafficking, notably because of the poverty-driven construct of ideas and attitudes regarding women and children that so easily permits their bodies to be turned into commodities. (excerpt)
The second meeting of the Working Group for the Prevention and Treatment of Obstetric Fistula, Addis Ababa, 30 October -1 November, 2002.
New York, New York, UNFPA, 2003. 38 p.Much of the meeting was devoted to presentation of needs assessments from 12 African countries. Nine countries were surveyed by Engender Health; the African Medical and Research Foundation surveyed Kenya; and the Women’s Dignity Project assessed the situation in Tanzania. Dr. Catherine Hamlin and Ruth Kennedy also presented information about the situation in Ethiopia. The assessments provide a clear and informed base—for the first time—on which to build a realistic plan of action to combat fistula in the region. This information should also help to bring the tragedy of fistula out from under its shroud of shame and secrecy. We expect this will result in increased support for many of the best programmes already in place in Africa and in the creation of a regional network for fistula prevention and treatment. (excerpt)
[New Delhi], India, UNFPA, 1999.  p.The prevalence of RTI/STDs in India, as known from community and institution-based studies, is reviewed in the study. The study also puts RTI prevalence into a wider context by reviewing regional and international sources. The multifaceted relationship between RTI/STDs and HIV/AIDS is explored in terms of demographic synergy, biological plausibility, commonality in risk as well as treatment-seeking behaviour and prevention aspects. A brief review of country experiences in RTI/STD management has also been included in the study. Because of the close linkage between RTI/STD and HIV/AIDS, the report advocates for integrating RTI/STD prevention in primary health care in the country. The silent epidemic - silent because the low status of women in many parts of India makes women suffer in silence or even feel too ashamed to seek treatment - needs to be acknowledged and a campaign mounted to confront it squarely. (excerpt)
[A guide to providing reproductive health services] Guia para prestacao de services em saude reprodutiva.
Fortaleza, Brazil, Secretaria da Saude, 1998. xxvi, 432 p.The Viva Mulher [Healthy Woman] Program developed by the Secretariat of Health of the State of Ceará (SESA-CE), in partnership with several local, national and international institutions, was conceived after recognition of the unfavorable health situation of women throughout the State. Sensitized by the size of the problem and encouraged by other successful initiatives, such as the Community Health Agent program and the Healthy Child program, the results of which were translated into a reduction in infant mortality and an increase in the coverage of Basic Health Actions, the State Government resolved to promote a broad mobilization of institutions interested in the problems so as to develop intensive joint efforts involving society as a whole in an attempt to make a significant change in the health profile of women in Ceará. The first concrete act was the holding of the "Woman, Health, Life" seminar in Fortaleza in August 1992, which had more than 1,000 participants, to launch the Healthy Woman program on the basis of directives from the Ministry of Health (PAISM). The Healthy Woman program was associated from the beginning with the United Nations Population Fund (FNUAP), which proposed to offer technical assistance and financial resources through a four-year cooperation project with the State Government. The Pan American Health Organization (PAHO), collaborating agencies of the U.S. Agency for International Development (AID) and other international entities later joined in the process and have been cooperating in various complementary manners. (excerpt)