Putting the Nairobi Summit in Context: Looking Back Over the Past 25 Years
Six thousand delegates, long registration lines, a big conference center, a few familiar faces, and lots of unfamiliar ones. The Nairobi Summit brought together dozens of heads of state, ministers of health, and global decisionmakers. Getting on the Wi-Fi and finding meeting rooms posed minor challenges — that’s life when attending these meetings. But I attended to learn, to participate, and to observe how our field — and related fields — are evolving. The Nairobi Summit provided the chance to look at how the International Conference on Population and Development (ICPD) Programme of Action has moved forward since it was adopted in 1994. Unlike most of the meetings I attend, which focus on the narrower topic of family planning, this meeting covered a much broader agenda. Sessions addressed a wide range of issues that are linked to the big theme of population and development — partnerships, financing, violence against women and girls, gender, HIV, mental health — just to mention a few. With so many committed individuals in attendance, it promised to be an interesting meeting with the opportunity to reconnect with colleagues from around the world, meet new people, and gain insight into emerging topics. As I sat in a meeting room, I reflected on why this meeting matters to the world and how population and development issues have evolved over the past 25 years.
When I was in graduate school before ICPD in 1994, the focus of work in population and development tended to be national population policies, demographic targets that translated into new users of contraception, and a push for providers to comply with those targets. Coercive measures to achieve user goals were not uncommon — sterilization camps and postpartum IUD insertions without the woman’s consent are a couple of examples of practices that countries put in place to achieve those targets. These policies tended not to view women as either empowered or drivers of their own futures. Family planning was medicalized, with the stereotypical paternalistic male provider making the decision for the woman. Certainly, there was a growing movement to change things. The global feminist movement was not new and the 1994 ICPD reflected those changes, turning the status quo on its head. But for someone like me, a demographer working in research, the changes brought on by ICPD were both startling and refreshing.
ICPD changed the way that population and development issues were framed. No longer did high-level policies drive results; instead, women were encouraged to decide for themselves. Ideas like informed choice, and later, rights-based approaches, emerged as new ways of looking at family planning — focusing on the individual. The ICPD Programme of Action was broad, touching a wide array of topics and issues — from the role of government and civil society in population and development activities to ending harmful practices to enhancing quality of care and the ways that women obtain family planning. The ICPD Programme of Action was a long document with lots of priorities and objectives, but no benchmarks. Because it included so many initiatives without indicators and benchmarks, it has been difficult to objectively measure national and global progress toward the ICPD goals.
While the role of the individual as the focus of family planning and other development activities that advance human capital remains a priority, the emergence of topics such as the demographic dividend, the Millennium Development Goals, and the Sustainable Development Goals have contributed to mainstreaming and reinforcing the importance of key aspects of the ICPD Programme of Action. These efforts, while putting the individual at the center of decision-making, also reinforce the impact of individual decisions on the community, state, and national context. Evidence shows that women have fewer children, the children are healthier and better educated, and the health of the mother is also better. Families and communities fare better, setting the stage for increased economic growth. ICPD helped moved from a top-down policy environment to a bottom-up environment, in which the individual’s decisions impact the macro-level environment.
Now, with the ICPD25 Nairobi Summit behind us, I reflect on some of the priority topics that emerged. Youth empowerment continued to get a lot of attention — economic empowerment coupled with sexual and reproductive health empowerment so that young people drive their own destiny. Gender-based violence was mentioned often, as was advancing the rights of people with disabilities. Universal health care — and how to pay for those services — got some attention, but not as much as I expected. The agenda was broad, complex, and comprehensive. Reflecting on those few days in Nairobi, I heard diverse voices from around the world — from high-level decisionmakers and a crown princess to program managers and grassroots activists. I’m happy to have had the chance to be at the summit, participating and contributing, sharing our experiences, tools and approaches, and — in my own way — being a part of advancing gender equality, access to family planning, and change paradigms for how development efforts are designed and carried out.
