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Blog by Lydia Zigomo
UNFPA Regional Director, East and Southern Africa 

“Woman is the thread. Woman is the needle. She is the weaver of family and society.” 

This wisdom reminds us of our interconnectedness, from each woman’s family to the human family. The inspiring words of our Executive Director, and the results of the 2024 State of World Population Report critically remind us of the complex human capital challenges women and young people in Small Island Developing States (SIDS) face. As the frontline of climate change, these islands are at the center of the impact, deepening inequalities. 

The 2024 State of World Population Report, titled “Interwoven Lives, Threads of Hope: Ending Inequalities in Sexual and Reproductive Health and Rights,” highlights both the persistent inequalities and discrimination hindering sexual and reproductive health gains for women and girls and the remarkable progress achieved since the landmark 1994 International Conference on Population and Development (ICPD) held in Cairo. 

Across the world, global maternal mortality has declined by one-third. Contraceptive use has doubled, becoming increasingly accessible to millions more women and couples. More pregnancies are planned and wanted than ever before. 162 countries have enacted laws against domestic violence. Girls have reached parity with boys in primary school enrollment and now exceed boys in post-secondary enrollment.

However, this progress has slowed in recent years, leaving millions behind. A quarter of women still cannot make decisions about their bodies, including with their partners, and nearly one in ten have no choice in using contraception. Shockingly, between 2016 and 2020, the global annual reduction in maternal deaths was zero. This stagnation is not due to a lack of knowledge or tools but rather a failure to confront the deep-seated inequalities in our health systems. Disparities in access to healthcare, often greater within countries than between them, are fueled by gender inequality, racial discrimination, and misinformation.

In our island states in the Indian Ocean, numerous challenges continue to exacerbate inequalities that hinder achieving sexual and reproductive health rights and the Sustainable Development Goals (SDGs). Climate change, natural disasters, economic shocks, and health crises disproportionately affect our populations. Women and girls bear the brunt of these challenges, facing increased risks to their health, safety, and rights.

Consider Samueline from the southern part of Madagascar, who gave birth to a healthy baby girl in Ambovombe Hospital. She is one of the fortunate ones. Tragically, 60 to 70 percent of women who arrive at the hospital lose their babies. Pregnancies do not stop during droughts and crises

The 2024 SWOP report emphasizes the urgency of addressing these inequalities, especially for communities most likely to be left behind. As we reflect on progress over the past 30 years since the adoption of the landmark ICPD Programme of Action and look toward the next Global Development Agenda beyond 2030, it remains critical to increase visibility and support for populations at risk of being left behind, including indigenous populations, persons with disabilities, rural youth, and undocumented migrants, particularly in SIDS.

By 2050, a quarter of the world’s population will be in Africa, shaping our future in significant ways. Africa’s unprecedented population growth will impact geopolitics, global trade, migration, and nearly every aspect of life. 

We need to review existing population policies and institutional capacities to integrate mega-trends and inform investments in climate-resilient health systems and social support structures. There is also a call to facilitate increased domestic investments to reach populations facing increased invisibility. We need to ensure universal access to sexual and reproductive health, gender equity and equality, and bodily autonomy. Additionally, we have to root out biases from our health systems by investing in equitable care and ensuring that everyone, regardless of their background or circumstances, has the right to make decisions about their bodies and futures.

Moreover, we need to strengthen national statistical systems to ensure timely, disaggregated, and quality data to ascertain population vulnerabilities, and scale up efforts by governments and partners to identify populations at risk from the impact of cyclical natural disasters and implement measures to reduce the impact at individual, household, and community levels.

The fabric of humanity is strong because our fates are woven together. It is also rich and beautiful, composed of billions of threads, each one of us unique. Our strength and resilience come not from any individual strand but from the collective, interwoven whole. The way forward, how we proceed and succeed, is by working together.