Reproductive health needs worldwide: constraints to fertility control

Reproductive health, defined in the 1994 UN Cairo Conference on Population and Development, is discussed and its limits identified. Mortality and morb idity impacts of components of male and female reproductive health are quan tified. Use is made of survey data and the estimates of deaths and disease burdens provided by the Global Burden of Disease Inquiry. Maternal causes a re the greatest contributors to the total disease burden among women aged 1 5-44 years. In developing countries, up to half of those who want to delay or avoid further pregnancy are not using contraception. Worldwide, induced abortion accounts for 61 000 deaths annually. Sexually transmitted diseases and other illnesses also result from unsafe sexual practices, resulting in at least I million deaths each year. These deaths-and an overall disease b urden of 50 million disability-adjusted life years-are entirely preventable . Constraints include, lack a of international commitment to improving repr oductive health, social and economic factors, lack of biomedical research, insensitive social science research, and inadequate knowledge. Men and wome n have the right to demand better services and the knowledge and conditions in which to use them. Those in the more developed countries have the respo nsibility of ensuring adequate financial and technical support to make repr oductive health possible everywhere.