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New York/Bangkok/Kuala Lumpur, 10 April 2019— The global sexual and reproductive health and rights movement that began in the 1960s transformed the lives of hundreds of millions of women, empowering them to take key decisions about their own bodies and shape their own futures. But despite the gains made over the past 50 years since the establishment of UNFPA, the United Nations sexual and reproductive health agency, the world still has a long way to go to address inequalities and inequities before rights and choices are claimed by all, according to the State of World Population 2019, released by UNFPA today.

On the journey towards rights and choices, women and girls have faced social and economic barriers every step of the way. A coalition of civil society, activists, and organizations such as UNFPA have been helping tear down those barriers.

The efforts of the reproductive rights movements have dramatically reduced the number of unintended pregnancies and maternal deaths, and have cleared the way for healthier, more productive lives for untold millions, says the new UNFPA SWOP report titled Unfinished Business: The Pursuit of Rights and Choices for All.

The report traces advances in sexual and reproductive health and rights on the anniversaries of two important milestones. It has been 50 years since UNFPA began operations in 1969 as the first United Nations agency to address population growth and reproductive health needs. It is also the 25th anniversary of the 1994 International Conference on Population and Development (ICPD), where 179 governments called for all people to have access to comprehensive reproductive health care, including voluntary family planning, and safe pregnancy and childbirth services – putting individual rights and choice at the heart of sustainable development.

Much has been achieved since 1969, says the report. Globally, the average number of births per woman was 4.8 then, compared to 2.9 in 1994 and 2.5 today; fertility rate in the least developed countries dropped from 6.8 in 1969, to 5.6 in 1994 and 3.9 in 2019; and the number of women who died from pregnancy and childbirth-related causes has decreased from 369 per 100,000 live births in 1994, to 216 in 2015. In addition, 24 per cent of women used modern contraceptives in 1969, compared to 52 per cent in 1994 and 58 per cent in 2019.

However, reproductive rights are still out of reach for too many women, including the more than 200 million women and adolescent girls – over half of them in Asia and the Pacific - who want to exercise their right to choose whether or when to have children, how many and with whom, but cannot access modern contraceptive information and services.

“Despite the increasing availability of contraceptives over the years, hundreds of millions of women today still have no access to them, and to the reproductive choices that come with them,” said UNFPA Executive Director Dr. Natalia Kanem. “Without access, they lack the power to make decisions about their own bodies, including whether or when to become pregnant.  The lack of this power—which influences so many other facets of life, from education to income to safety—leaves women unable to shape their own futures.”

“The obstacle underlying all others, as ever, remains gender inequality and the inequities that result from it,” explained Dr. Annette Sachs Robertson, Deputy Regional Director for UNFPA in Asia and the Pacific, at the regional SWOP report launch in Kuala Lumpur, Malaysia today.

“As long as gender inequality persists and women are not empowered, and as long as we do not collectively strengthen efforts to tackle it, we will not fully realise ICPD’s vision of rights and choices for all. Furthermore, equitable access to quality sexual and reproductive information and services for all will bring better health outcomes and enhanced opportunities, including for the most disadvantaged in our communities.”

UNFPA’s annual flagship report includes, for the first time, data on women’s ability to make specific decisions governing their sexual and reproductive health and reproductive rights, including contraception use and health care. Across the 51 countries where this information is available, 57 per cent of women who are married or in a relationship are able to make their own choices over all of these areas, demonstrating the need to strengthen rights and decision-making for all women in the most intimate aspects of their lives.

“I call on world leaders to re-commit to the promises made in Cairo 25 years ago to ensure sexual and reproductive health and rights for all,” said Dr. Kanem. “The world will have a historic opportunity to complete the unfinished business of the ICPD at the Nairobi Summit on ICPD25 to be held in Kenya in November, where governments, activists and stakeholders will rally to protect the gains made so far, and fulfill the promise of the ICPD agenda, so that no one is left behind.”

“Malaysia was one of the 179 countries that helped bring about the ICPD Programme of Action, recognising its importance for social and economic development,” noted Marcela Suazo, UNFPA Representative in Malaysia, where the Asia-Pacific SWOP launch took place in the presence of Foreign Minister Dato’ Saifuddin Abdullah who officiated at the event. “We look forward to the Government’s continued support for this rights-based platform heading into the Nairobi Summit, to further capitalise on the significant gains already made for women and girls, and to address the challenges that remain as Malaysia accelerates efforts to accomplish the SDGs for which fulfilling ICPD is so crucial.”

The SWOP report also features 15 champions of change, several from Asia-Pacific including Malaysia’s Sivananthi Thanenthiran, Executive Director of the Asian-Pacific Research and Resource Centre for Women (ARROW), who have broken barriers in their own context and influenced the landscape of sexual and reproductive health and rights into what it is today.

“I salute these champions,” said Dr. Kanem. “We all have a role in pushing back against forces that would see us return to a time when women had little say in reproductive decisions or, for that matter, in any area of their lives,” she added. “The fight for rights and choices must continue until they are a reality for all.”


Selected facts and figures from the report:

● Number of deaths of women from pregnancy-related causes per 100,000 live births:                 

Worldwide: 369 in 1994; 216 in 2015.

Asia-Pacific: 316 in 1994; 127 in 2015

Thailand: 25 in 1994; 20 in 2015

● Modern contraceptive prevalence rate:

Worldwide: 24 in 1969; 52 in 1994; 58 in 2019.

Asia-Pacific: 22 in 1969; 58 in 1994; 62 in 2019

Thailand: 18 in 1969; 72 in 1994; 76 in 2019

● Fertility rate, or average number of births per woman:

Worldwide: 4.8 in 1969; 2.9 in 1994; 2.5 in 2019.

Asia-Pacific: 5.9 in 1969; 2.8 in 1994; 2.1 in 2019

Thailand: 5.8 in 1969; 1.9 in 1969; 1.4 in 2019

● The highest unmet needs for sexual and reproductive health services are among marginalized groups, including minority ethnic groups; young people; unmarried people; lesbian, gay, bisexual, transgender and intersex people; people with disabilities; and the rural and urban poor.

● An estimated 800 million women alive today were married when they were children.

● Every day, more than 500 women and girls in countries with emergency settings die during pregnancy and childbirth.


For more information, please contact:

Roy Wadia, UNFPA Asia-Pacific, Bangkok:  +66 848 752 634;

Celeste Hibbert, UNFPA Asia-Pacific, Bangkok:  +66 93 124 8313;

Tengku Aira Tengku Razif, UNFPA Malaysia, Kuala Lumpur: +60 12 256 7003;