Beyond Cairo: changing directions for population policies in the Asia-Pacific region.

This article reviews post-Cairo thinking about population policies, program strategies by governments in the Asia-Pacific region, and the prospects for implementing reproductive health (RH) services. Cairo's action plan emphasizes development of broad social policy, sustainability, and RH. There is no mechanism of enforcement. Asia is very diverse in population size, trends in fertility and mortality, rates of economic development, patterns of migration, and development approaches. RH approaches are not controversial in Asian countries that are below, have, or are approaching replacement level fertility. Economic crises have occurred since the 1994 Cairo Plan. The region needs the Cairo focus on women's empowerment and a humane attitude to women in family planning (FP) implementation. The Cairo approach to human rights, equitable gender relations, RH and rights, and poverty alleviation is needed. It is not possible to specify what kind of FP program inputs will produce specific impacts, without considering broader policy and program contexts. Satisfaction of unmet need would more than exceed targets for fertility decline in 13 of 17 Asian countries. A focus on unmet need could take 10 years. All approaches require an expansion of service outreach. Research can determine cost effectiveness of essential RH services. RH requires institutional structures that promote a holistic view, gender sensitive quality care, and community participation. There is a need to retrain, upgrade skills, and reorient attitudes. Available financial services must be effectively used. RH must not dilute scarce FP resources.