The Political Importance of Indicators in Global Development Efforts: Maintaining the Focus on Reproductive Health in the Sdg Era

In the latter twentieth century, population policies were institutionalized in many developing countries confronted by rapid population growth. Global collective action aimed to reduce birth rates through national family planning efforts. Their sometimes coercive methods led reform advocates to engineer a backlash against demographic targets and fertility-related policy levers, culminating in the 1994 Cairo Agenda. The Millennium Development Goals (MDGs, 2000-15) reframed the international development agenda and sidelined Cairo’s goal of reproductive health and rights for reasons of political expediency. MDG5 aimed to reduce maternal mortality ratios (MMRs). It attracted resources, became the focus of national and international efforts, and maintained attention on reproductive health. Substantial progress towards all three health-related MDGs resulted from funding increases, invigorated country actions and global partnerships, and scale up of new interventions. The Cairo and the MDG agendas led to the adoption of an array of global and national reproductive health indicators that have helped clarify the magnitude of problems. The resultant expectations have helped sustain a reproductive health movement and served as a rallying call, comparable to the earlier international population movement, along with a vigorous countermovement. The world has now transitioned from the MDGs to the 17 more ambitious Sustainable Development Goals (SDGs). The new 2030 agenda has 17 goals, 169 targets and still more indicators, many of varied quality for monitoring phenomena of interest. There is only one SDG, whose 13 targets include the three health MDGs but a limited vision of issues such as provision of safe, legal abortion. This paper examines attempts to institutionalize key reproductive health indicators in the UN’s global development efforts and their operation as instruments of imagination, with particular reference to the MMR; and explores the prospects for sustaining focus on reproductive health in the 2030 agenda and for addressing the needs of marginalized groups.