Foreign Relations of the United States, 1981–1988, Volume XLI, Global Issues II

295. Paper Prepared in the Agency for International Development¹

Washington, June 1985

UN DECADE FOR WOMEN CONFERENCE

Forward Looking Strategies

Health and Family Planning

This Position Paper submitted by the Agency for International Development (AID) is reflective of international sectoral policies and is not to be confused with domestic sectoral policies

PROBLEM:

Women in developing countries are at high risk of developing health problems because of workload, exposure to communicable diseases, closely spaced pregnancies, and lack of access to health care. Women are also largely responsible for the health of their children (both preventive measures and curative care). Efforts must be made to improve women’s access to, utilization of, and benefits from health care, including family planning.

RELATIVE IMPORTANCE OF THE ISSUE TO THE UNITED STATES:

Women’s health is of major concern to the U.S. not only as an absolute good but also as a means to increased economic productivity and improved children’s growth and development. The Conference is a unique opportunity for the U.S. to present a strong position and highlight the need for specific focus on women’s health in LDC populations. The position paper complements and is consistent with the health and population positions stated in the U.S. documents “Forward Looking Strategies.”²

UNITED STATES POSITION:

If women are to achieve their potential as contributors to the economic development of their communities, regions, and nations, they must be freed from the burden of disease and disability that impinges on their performance. This means women must have economic, geographic, and social access to health care appropriate to their needs. Such care should include appropriate technologies, the proper mix of health care providers (including female medical personnel at all levels and upgrading the training of traditional providers like midwives), free informed choice of treatments, and availability of services for women when and where they can be used without jeopardizing women’s economic or family responsibilities.

The U.S. delegation urges host countries and donors alike to improve training programs for women in health and family planning and to decrease barriers to their economic advancement in these areas. Because income, health, and opportunities for advancement are directly related to educational levels, the U.S. endorses education for girls and women as an integral part of this strategy.

BACKGROUND:

Women are particularly vulnerable to health problems because of pregnancy, especially closely spaced pregnancies. When the physiological load of pregnancy and lactation is superimposed upon heavy demands for physical labor (including productive work as well as carrying firewood and water), poor nutrition, and exposure to environmental contamination and contagious diseases, the end result is often a progressive deterioration of women’s health and nutrition status over their reproductive years. This vicious circle can be broken in several ways—improving women’s economic status, increasing the period between pregnancies, and improving health care. All three problems need to be addressed. One thread running through all three is the need for education for girls and women so that they can earn more income, control their own fertility, and demand and utilize better health care.

An analysis of the health constraints affecting women reveals that many are related to their roles as women, not the least of which is the role of water fetching and transporting. Many women spend from four to eight hours a day drawing, carrying, managing, and using water. Improvements in water supply and sanitation lighten the burden of women and children freeing energy and time for other productive tasks that produce income. Women should be involved in the planning and implementation of water and sanitation projects.

The United States continues to support primary health care, education and training for girls and women, economic opportunities for women, and informed choice about health and family planning.

BUDGETARY IMPLICATIONS: No need for additional budget. Proposed action programs should be incorporated into existing activities and over-all budget levels.³

1. Source: Department of State, Organization and Conference Files—Other Federal Agency and Channel: Nairobi World Conference for Women, 1985, Lot 90D327, Papers for Nairobi Conf. 1985. No classification marking. Drafted by McGuire and cleared on June 28 in PPC/PDPR, S&T/PO, and SAA/S&T.
2. A March 7 paper, entitled “Informal Working Paper on Agenda Item 3: Forward-Looking Strategies,” is in Department of State, Organization and Conference Files—Other Federal Agency and Channel: Nairobi World Conference for Women, 1985, Lot 90D327, VI. E. Agenda Item 3 Forward Looking Strategies Classified 1985.
3. In an August 26 information memorandum to Armacost, Newell provided an analysis of the outcome of the World Conference for Women held in Nairobi in July 1985. (Department of State, Organization and Conference Files—Other Federal Agency and Channel: Nairobi World Conference for Women, 1985, Lot 90D327, Miscellaneous World Conference)