Health and Population Dynamics; Employment and Decent Work for All, Social Protection, Youth, Education and Culture

This brief by the High-Level Task Force for ICPD offers policy recommendations relevant to the two themes of the June 2013 session of the OWG on the SDGs: health/population dynamics; and employment/decent work for all, social protection, youth, education and culture.

Matters of health, education, employment, population dynamics and youth are closely inter-twined. Following an introduction to key issues and inter-linkages under each theme, the recommendations are therefore presented in one listing, as they are mutually-reinforcing and relevant across the subject areas.

This brief focuses on three priorities for achieving poverty reduction and sustainable development:

  • The empowerment of women and girls and gender equality;
  • The rights and empowerment of adolescents and youth;
  • And sexual and reproductive health and rights.

Women and young people are the two largest demographic groups in the world facing inequalities, with limited opportunities, restricted choices and freedoms. Women are half the world’s population, half the assets for driving and leading sustainable social, economic and environmental development. They are a large share of the world’s agricultural workforce and family breadwinners; stewards of local environments; peace-builders in crisis and conflict-affected communities; and, increasingly, political and business leaders. They commonly bear primary responsibility for raising the children who will be the planet’s workforce and leaders. Today’s world also has the largest generation of young people under the age of 25 in history, totaling 3 billion. Adolescents (10-19 years old) represent almost half of them, or 1.2 billion. Many live in poverty, are unemployed or out of school. They face limited opportunities to fulfill their aspirations, especially the case for adolescent girls.

The discrimination and inequalities faced by women, adolescents and youth have detrimental consequences and implications for addressing global population and sustainable development challenges, including for educational attainment, health (especially sexual and reproductive health), income-earning potential and productivity. Investments in women and young people, and in sexual and reproductive health and rights, are fundamental human rights, and also provide essential foundations for a sustainably developed world rooted in principles of equality and equity, human dignity and social justice.

Key Issues under the Theme of Health & Population Dynamics

Population dynamics are determined by individuals’ choices and decisions about marriage, childbearing, health and where they live. Therefore, mitigating and resolving the challenges of today’s population trends and dynamics—including urbanization, migration, ageing, population growth and decline, unsustainable patterns of consumption and production—can be turned into new horizons of opportunity for achieving sustainable development if individuals and families are able to enjoy expanded rights, freedoms and choices.

In particular, advancing gender equality and the empowerment of women, adolescent girls and youth needs to be central to the post-2015 agenda, including the fulfillment of their sexual and reproductive health and rights as a key factor in their ability to stay healthy, complete their education, be productive and engage fully in social, economic and political life.

In the arena of health and population dynamics, the centerpiece is ensuring that all individuals and couples are able to exercise their sexual and reproductive health and rights, including through universal access to sexual and reproductive health, with particular attention to equity. These are basic rights of all individuals to make free and informed decisions about their sexuality, health, relationships, marriage and childbearing without any form of discrimination, coercion or violence; to have the information and means to do so; and to achieve the highest attainable standard of sexual and reproductive health.

Many people, especially women, adolescents and youth, are denied these rights, to the detriment of themselves, their families and communities, and to prospects for achieving social, economic and environmental sustainability. Sexual and reproductive health problems have huge costs and consequences for people’s health, well-being and ability to lead productive lives, as well as consequences for economic development and public budgets. These problems, however, can be prevented with known cost-effective solutions, with high payoffs for poverty reduction, human capital accumulation, gender equality, the health and education of women, children and young people, halting the spread of HIV, labour productivity, enabling economic growth, and balancing population and development dynamics with the planet’s resources. Some examples of these beneficial effects are provided below.

When women and couples are able to determine the size of their families, families tend to be smaller or the size they can best provide for, with increased investments per child and better chances of breaking cycles of poverty and marginalization.

Countries in which young people constitute a large share of the population can reap the ‘demographic dividend’, which has been an important factor behind economic growth in various regions and countries, through implementation of relevant social and economic policies. Specifically, investments in education, including comprehensive sexuality education, and in sexual and reproductive health can enable adolescents and young people, especially girls and young women, to delay marriage and childbearing and seize educational and expanded employment opportunities. The result is a higher-skilled, more productive workforce with fewer children and elderly dependents, more investments per child, and increased savings and investments that can generate productivity and economic growth. With the right policies, a young and productive workforce can also contribute to pension and social protection systems for older age groups and for their own security later in life.

Access to sexual and reproductive health information, education and services (including voluntary family planning), and the ability of women and young people to exercise their sexual and reproductive rights, can help reduce growing population pressures on food, land, water, energy, housing, education, health and other resources. Together with unsustainable patterns of production and consumption, these pressures are projected to be severe. For example, with a projected growth of the world population to 9 billion by 2050, increasing urbanization and rising incomes, the Food and Agriculture Organization estimates that food production will have to increase by 70%. Coupled with major shifts in consumption and production patterns, sexual and reproductive health services can help alleviate these pressures, address the challenges and mitigate the consequences.

Healthier and smaller families can be more resilient to crises, displacement or environmental challenges, and can relieve local pressures on limited resources and fragile ecosystems. It is the poorest women and families who often inhabit eco-fragile, underserved areas with limited sanitation, infrastructure and alternative energy sources, and for whom meeting basic needs, including sexual and reproductive health and rights, are especially pressing priorities.

Despite the benefits of investments in sexual and reproductive health for sustainable development, the realities are that 222 million women would like to avoid or space pregnancies but are not using an effective method of contraception; 287,000 women and adolescent girls die every year from maternal mortality, a leading cause of death for girls aged 15 to 19 in many developing countries; 16 million adolescent girls give birth every year, with substantial risks for their own and their newborn’s health and survival; and every day, 2,400 youth become infected with HIV. One in 5 of all new HIV infections are occurring among young women who, beyond their heightened risks due to anatomical susceptibility, are especially vulnerable due to gender discrimination, gender-based violence and limited income-earning opportunities which expose them to abuse, exploitation, sexual coercion and violence.

Fulfilling unmet need for modern contraception could save the lives of 79,000 women and adolescent girls by preventing maternal deaths, save the lives of 1.1 million infants under the age of one, and avoid 54 million unintended pregnancies, 21 million unplanned births and 16 million unsafe abortions.

Various studies estimate the significant savings from investing in family planning. One study estimated that meeting the demand for family planning in 16 countries of sub-Saharan Africa could save the education sector over one billion dollars. Another estimated that developing countries can save a total of $11.3 billion in maternal and newborn health care alone. Similar benefits can be accrued from investments in other sexual and reproductive health services, which prevent maternal deaths and injuries, HIV and the close to 500 million new cases of curable sexually transmitted infections that occur every year; and the consequences of unsafe abortion, which cost close to one billion dollars annually in sub-Saharan Africa alone due to out-of-pocket expenditures to treat complications, and lost income due to death and disability.

Despite the high impact, cost-effectiveness and net savings that universal access to sexual and reproductive health services can yield to families, social and economic development, public budgets and the environment, investments to date have been far from adequate.

Key Issues on Employment/Decent Work for All, Social Protection, Youth, Education and Culture

The Secretary-General’s High-Level Panel on Global Sustainability (2012) affirms that “the next increment in global growth could well come from the full economic empowerment of women”. Studies have estimated that if women’s employment rates were raised to the same level as men’s, the GDP of industrialized countries would rise by 9% in the United States, 13% in the euro-zone and 16% in Japan. The additional benefits and economic boost from women’s increased employment could be even greater in countries with lower female participation in the labour market. In addition, women who have control over household resources invest considerably more of their income in their children’s health, nutrition and education than men, thereby strengthening the prospects of their children for breaking out of poverty. Women are also a large share globally of family breadwinners and food producers, but have limited opportunities for accessing and controlling productive assets. Furthermore, many of the world’s poorest people, especially women, make their livelihoods directly from the land and environment, and are or can be positioned as stewards of local ecologies. With adequate supports and assistance to meet basic family survival needs, they can contribute to sustainability.

Yet women and young people face pervasive structural inequalities. Gender discrimination undermines countries’ abilities to unleash the full economic and productive contributions of women. Globally, women are far more likely than men to be unemployed and underemployed, to work in the unregulated informal sector or in vulnerable employment, or to be trafficked for purposes of sexual exploitation. Worldwide, women earn on average 10-30% less than men for the same or similar work. They do not have equal access to financial and banking services, skills development and use of ICTs, land and property ownership, or farming supports and agricultural investments – even though they represent almost half of the developing world’s agricultural workforce.

In Africa, for example, total agricultural outputs could increase by up to 20% if women had equal access with men to agricultural inputs. Discrimination against women in the workplace, including on the basis of their reproductive function, is widespread. Women are subjected to pregnancy tests and fired because they are pregnant, among other forms of maternity-related discrimination. Even where legislation is in place, gaps in enforcement can be vast, and informal sector workers are often excluded from protections.

Youth unemployment is high in most countries, young women face particular gender-related barriers, and working youth are often in low-opportunity activities: 73 million young people are unemployed, an increase of 3.5 million since 2007, and they continue to be almost three times more likely to be unemployed than adults. In low and middle-income countries, where 90% of the world’s youth live, roughly two‐thirds of them are not working or studying, or are engaged in irregular employment or in the informal sector. This means that a significant proportion of an entire generation is not achieving their full economic potential. Additional barriers to decent work opportunities are faced by the 120 million youth and 497 million women who are illiterate, most often rural and poor women and adolescent girls.

Despite progress, many children and adolescents are not in school, especially those living in poverty or in crisis and conflict-affected settings. In addition, gender biases and stereotypes commonly reinforced by educational systems lead to imbalances in the pursuit of occupations: for example, women tend to be overrepresented in the humanities and social sciences, and underrepresented in science and technology.

The fulfillment of sexual and reproductive health and rights is a major determinant of educational attainment by women and girls and of their ability to secure decent work opportunities. Protection of these basic rights enables girls and young women to delay marriage and childbearing, complete their education and acquire skills for entry into the workforce; enables women to determine the number, timing and spacing of children, which affects their ability to secure and remain in decent work and seek better opportunities; and allows women and couples to better balance their productive and reproductive roles and responsibilities, with improved income-earning prospects for themselves as well as for their children and families. By contrast, failure to invest in sexual and reproductive health and rights translates into severe problems for health and productivity, and limits girls’ educational achievement and women’s labour force participation, with consequences at individual and family levels and for economic development. Sexual and reproductive problems most affect individuals at the prime of their lives and productivity: One estimate found that the equivalent of $15 billion in productivity is lost every year from pregnancy-related deaths among women and the deaths of newborns after their mothers die.

Furthermore, violence against women and girls is one of the most pervasive and widespread human rights violations in the world that seriously impairs their health and productivity, and their social, economic and political participation. The devastating consequences include severe trauma, illness and death; sexual and reproductive health problems, including the spread of HIV and other sexually transmitted infections, and limited contraceptive use, including of condoms; hampers survivors’ productivity, as well as the educational achievement and personal development of the children who witness or experience domestic violence and sexual abuse; and costs billions of dollars annually to public budgets, in addition to the income and productivity losses suffered by the women and employers affected.

On the other hand, ensuring women’s and girls’ educational and economic opportunities is an important means to prevent sexual and reproductive health problems and to reduce violence against women and girls: economic autonomy enables women to both avoid abusive relationships in the first place, as well as escape them. But, especially for women living in poverty and/or who have children, lack of economic security and limited income-earning opportunities are major barriers to their freedom to leave violent partners.

Finally, another important factor to consider in unequal employment and decent work opportunities is the major share of unpaid household work and caregiving that falls disproportionately on women and girls. These include nurturing of children, caring for the elderly and the ill, and the long hours spent in obtaining basic necessities such as water and fuel. Though unremunerated and unrecognized in national GDP accounts in most countries, these are essential contributions made by women and girls. Gender-responsive family-supportive policies, fostering the shared responsibilities of men and boys, and investing in basic infrastructure and reduced time burdens on women and girls are all necessary, with significant benefits for individuals, families, societies and economies.

Key Principles and Recommendations

  • The sustainable development agenda must be rooted in principles of human rights, equality and equity, with emphasis on poverty eradication, non-discrimination and gender equality. Meaningful progress toward sustainable development will not be achieved unless the needs and rights are fulfilled of populations living in poverty or marginalized, in conflict and post-conflict settings and environmentally-fragile areas; migrants, slum dwellers, rural populations, indigenous communities, older persons, people living with HIV and disabilities; those in high-risk occupations, domestic work and other parts of the informal sector; and those who are discriminated against based on sexual orientation and gender identity or any other factor. Particular attention must be paid to women, adolescents and youth, as they are the largest demographic groups worldwide facing inequalities.
  • Achieving sustainable development requires mutually-reinforcing investments in three essential areas: the empowerment of women and girls and gender equality, the rights and empowerment of adolescents and youth, and sexual and reproductive health and rights. These are matters of human rights and human dignity, first and foremost; and also prerequisites for sustainable development in the social, economic and environmental spheres. These universally-relevant priorities are applicable to all countries, rich or poor, regardless of social or economic context or stage of development. They are central to eradicating poverty, to expanding people’s opportunities and choices for advancing sustainable, equitable development and to human capital accumulation.
  • Human Rights, including the sexual and reproductive health and rights of women and adolescent girls, must be placed at the centre of population and sustainable development policies. This entails:
    1. Reviewing and revising legislation and policies to protect the human rights of women and girls and to eliminate gender- and age-discriminatory provisions across social, cultural, economic, civil and political rights, including through gender-responsive policies for equal education, livelihood and work opportunities;
    2. Legal and policy reforms and public education campaigns to create an enabling environment for the exercise of sexual and reproductive health and rights by all, without discrimination, coercion or violence on any grounds, regardless of sex, age, race, ethnicity, income, occupation, marital, HIV, disability or migrant status, sexual orientation and gender identity, or any other grounds; and to prohibit and penalize violations of these rights, including abuses such as coercive family planning, forced sterilization and forced abortion;
    3. Eliminating harmful practices against girls, especially by ending early and forced marriage and female genital mutilation, and by ending gender disparities in the legal age of marriage and raising and enforcing the minimum legal age of marriage where needed.
  • Advance and accelerate implementation of universal access to an essential package of quality, integrated and comprehensive sexual and reproductive health information, education and services, with priority attention to women, adolescent girls and young people and on ensuring equity for poor and marginalized communities. This involves:
    1. Increasing and sustaining investments in sexual and reproductive health as a priority of national health plans, budgets and development cooperation;
    2. Ensuring particular attention to the availability of the full range of effective, voluntary family planning and modern methods of contraception, including male and female condoms and emergency contraception; quality maternity care for all pregnant women and adolescent girls; access to compassionate treatment of the complications of unsafe abortion and expanding access to safe abortion services; and prevention, diagnosis, treatment and care related to HIV and sexually transmitted infections;
    3. Integrating HIV and AIDS-related care with other sexual and reproductive health services;
    4. Integrating prevention, care and support for survivors of gender-based violence. Within a life-cycle approach,
    5. rapidly expanding access to youth-friendly sexual and reproductive health information, education and services for adolescents and youth, while also
    6. ensuring services are equipped to meet the needs of older women and men.
    7. Spousal and parental requirements to receive health services should be eliminated, as should practices and prohibitions that bar access to medically-safe contraceptive information and methods and other services.
  • In the area of education, particular attention should be paid to:
    1. Eliminating illiteracy among adult women, adolescent girls and young people and improving functional literacy skills;
    2. Achieving universal access to at least secondary education for all children;
    3. Eliminating gender gaps at all levels of education;
    4. Improving the quality and content of education for today’s employment market, including by eliminating gender stereotypes and biases in curricula and teaching practices, including as regards occupational aspirations; and,
    5. As part of overall improvements in the quality and relevance of education, providing universal access to comprehensive sexuality education2 for all adolescents and youth, in and out of school. Comprehensive sexuality education should be made available as a basic right and to help young people stay healthy, complete school, plan their lives and navigate their passage into adulthood. It is also a key element for enabling countries to secure the demographic dividend and leverage a better balance of population dynamics for sustainable development.
    6. Partnerships between schools, businesses, the private sector and community organizations should be established to facilitate young people’s successful school-to-work transitions, as well as for expanding access to, and training in, the use of ICTs –all with attention to equal opportunities for young women.
    7. Children and adolescents must be protected from violence, discrimination, sexual harassment and bullying in schools, and on the way to and from school; and all girls and boys should be provided with confidential, youth-friendly supports and services in cases of violence, abuse and harassment.
  • In the area of employment and decent work, particular emphasis should be placed on:
    1. Ensuring women’s equal access to decent work, livelihood and employment opportunities, including through legal and policy provisions, for their equal pay with men; equal land, property and inheritance rights; access to productive assets, banking and financial services and the ability to start and register a business; agricultural supports; and technologies and ICTs.
    2. Gender-responsive, family-friendly labour policies and social protection systems should be adopted or strengthened that can support women’s equal opportunities for decent work, inter alia, through maternity and paternity leave policies, flexible work arrangements, the provision of affordable child and elderly care and supports for the care of people living with HIV, disabilities or illness; and
    3. Public education on the importance of gender equality and shared rights and responsibilities of men and boys, including in household management and childrearing.
    4. Laws, policies and employer-based measures should be adopted to prevent sexual harassment and any form of gender-based violence in workplaces, including through complaint and redress mechanisms; and to establish supportive and flexible policies and programmes for women subjected to domestic abuse and violence.
  • Strengthening policy and legal provisions and enforcement to prohibit discrimination in education and employment based on pregnancy or motherhood status, HIV or disability, sexual orientation and gender identity, or any other factor. This includes special supports for pregnant girls, and young mothers and fathers, to enable them to complete their education and balance education, work and family responsibilities; and the prohibition of mandatory pregnancy testing and of HIV testing as a requirement for employment, or of pregnancy, motherhood or HIV status as grounds for dismissal.
  • Reducing prevalence of violence against women and girls through sustained primary prevention programmes and social mobilization campaigns, and ensuring universal access for all victims/survivors of gender-based violence to critical services. The latter should include 24-hour hotlines; psychosocial and mental health support; treatment of injuries; post-rape care, including emergency contraception, post-exposure prophylaxis for HIV prevention and access to safe abortion services in all cases of violence, rape and incest; police protection, safe housing and shelter; documentation of cases, forensic services and legal aid; and referrals and longer-term support for women and their children.