General Articles

The Underlying Millennium Development Goal: Universal Access to Reproductive Health Services

The Millennium Development Goals (MDGs) articulate objectives for resolving some of the most complicated and urgent social problems of our time and are commonly accepted as a framework for measuring development progress.1 Emanating from the Millennium Declaration, the MDGs are a tool to help governments and advocates mobilize resources and implement programs that ensure sustainable and equitable development world wide. According to the UN, the MDGs are a test of political will to build stronger partnerships and offer the world a means to accelerate the pace of development and to measure results.2 The eight MDGs bind countries to increase their efforts and collaborate to achieve the following:

  1. Eradicate extreme poverty and hunger
  2. Achieve universal primary education
  3. Promote gender equality and empower women
  4. Reduce child mortality
  5. Improve maternal health
  6. Combat HIV/AIDS, malaria, and other diseases
  7. Ensure environmental sustainability
  8. Develop a global partnership for development

Advocates are calling for official recognition of the missing MDG, universal access to reproductive health services, by 2015.

Access to Reproductive Health Services and Information Underlies all the other MDGs

Some of the MDGs, such as ending HIV/AIDS, cannot be accomplished without addressing sexual and reproductive health. The evidence shows that all of the MDGs, however, are advanced when all people have access to comprehensive sexuality education, family planning, and other reproductive health services. For example, MDG #5 calls for a three-quarters reduction of the 1990 maternal mortality ratio by 2015. Advocates explain that reducing early pregnancy and empowering women to space their pregnancies are necessary components of improving maternal mortality.

Likewise, eradicating extreme poverty and hunger will rely on universal access to reproductive health services. According to a new report by the Global Health Council, "Poor reproductive health among youth is a poverty issue. Low levels of youth reproductive health can and do negatively impact economic development."3 The report goes on to explain, "Early pregnancy contributes to intergenerational transmission of poverty through a variety of pathways. Pregnant girls may be expelled from school, either by law or from the failure of schools to enforce the rights of girls. Without education or employable skills, unmarried pregnant girls are often poorly prepared to take on the responsibilities of childrearing and face diminishing prospects for income generation. In Latin America, studies documented that girls who became mothers in adolescence were more likely to remain poor throughout their lifetimes, and their children were more likely to be poor."4

This scenario illustrates how both access to education (MDG #2) and the empowerment of young women and girls (MDG #3) are interrelated with each other as well as with the eradication of poverty (MDG#1). Missing from the MDGs, however, is the clear articulation of the issue at the intersection of these problems-access to reproductive health information and services.

Progress on Adding the Ninth MDG

The International Parliamentarians Conference on the Implementation of the International Conference on Population and Development (ICPD) was held in October in Strasburg, Germany. Over 130 parliamentarians from 90 countries recommitted themselves to implementing the ICPD Programme of Action (agreed upon ten years ago by the governments of the world in Cairo) with the goal of bringing about sexual and reproductive rights and health for all by 2015. Recognizing the link between reproductive health and sustainable development, the Parliamentarians also decided that the goals agreed upon in Cairo do classify as a ninth MDG and agreed to use their individual and collective influence to help realize its acceptance. According to the Parliamentarians, the Millennium Development Goals will remain an empty promise without realizing the ICPD goals.5

"For many women in developing countries, pregnancy is still a death penalty," said Agnes van Ardenne, the Dutch Minister for Development Cooperation, one of the six ministers who joined the Conference. She also announced that during the Dutch presidency of the European Union, Europe intends to fill the estimated financial gap of $75 million (U.S. dollars) needed for reproductive health commodities in 2004.6

The Kenyan Minister of Health, Kaluki Ngilu, commented on the current lack of funding, "Comparing expenditures in defense with those in health, one almost senses that there is some conspiracy against poor people. The greatest defense my fellow African women need is access to affordable reproductive health services."7

More information on the Millennium Development Goals at the United Nations Population Fund.


  1. About the Goals, World Bank Group (September 2004), accessed on 12 November 2004.
  2. Why Do the Millennium Development Goals Matter? From the Secretary-General’s 2003 Report on Implementation of the United Nations Millennium Declaration, (New York: UN Development Programme and the UN Department of Public Information, DPI/2321-September 2003-25M), accessed on 12 November 2004.
  3. C. Zwicker and K. Ringheim, Commitments: Youth Reproductive Health, the World Bank, and the Millennium Development Goals, (Washington, DC: Global Health Council and the William and Flora Hewlett Foundation, 2004).
  4. Ibid., 9.
  5. "Parliamentarians strive to commit the United Nations to establish a ninth Millennium Development Goal," Planetwire, 20 October 2004, accessed on 12 November 2004.
  6. Ibid.
  7. Ibid.