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Title page
Contents
Preface 4
Acknowledgements 5
Abbreviations 13
Executive summary 15
ICPD30 review 16
Changing demographic and socioeconomic realities in the UNECE region 17
Key findings 19
Population dynamics and sustainable development 20
Families, sexual and reproductive health over the life course 23
Inequalities, social inclusion and rights 28
The way forward 32
ICPD30 review in the UNECE region 34
Chapter 1. Population dynamics and sustainable development 39
Introduction 40
Changing demographic and socioeconomic realities in the UNECE region 42
Development of capabilities 53
Fulfilling potential: health and well-being across the life course 63
Fulfilling potential: access to employment opportunities 80
Population-environment linkages: sustainable use of resources 88
The way forward: strengthening demographic resilience by investing in human development throughout the life course 92
Chapter 2. Families, sexual and reproductive health over the life course 95
Introduction 96
Bodily autonomy and access to sexual and reproductive health information 97
Meeting the need for sexual and reproductive health services, including family planning 104
Sexual and reproductive health 121
The way forward: the need for essential, integrated packages of SRH information and services 141
Chapter 3. Inequalities, social inclusion and rights 143
Introduction 144
Gender equality and women's empowerment 145
Poverty and socioeconomic inequality 176
Social Inclusion of marginalized and vulnerable groups 185
The way forward: combating discrimination and inequalities to unlock development potential for all 196
The way forward: addressing setbacks and accelerating progress 198
Bibliography 203
Appendix. Technical notes 218
Figure 1.1. Total fertility rate (live births per woman) and mean age at childbearing in the UNECE region, 1994-2023 43
Figure 1.2. Life expectancy at birth, UNECE region, 1994-2023 45
Figure 1.3. Population pyramids, UNECE and Central Asia, 1994, 2023 and 2050 47
Figure 1.4. Net number of migrants (thousands), UNECE region, 1994-2023 49
Figure 1.5. Participation rate in organized learning one year before the official primary school entry age, 2020 (SDG Indicator 4.2.2) 55
Figure 1.6. Upper secondary completion rate, UNECE median, 2000-2020 (SDG Indicator 4.1.2) 56
Figure 1.7. Average PISA science performance score, UNECE median, 2018 57
Figure 1.8. Share of older persons in training or education, UNECE median, 2015 and 2022, by age group and gender 58
Figure 1.9. Proportion of youth and adults finding, downloading, installing and configuring software in the previous 3 months, UNECE median, 2021 60
Figure 1.10. Share of the population aged 55 to 74 using the Internet weekly, median for UNECE, the European Union (EU), and Eastern Europe, the Caucasus... 61
Figure 1.11. Share of men and women in the UNECE region using the Internet weekly by age group, UNECE median, 2015 and 2021 62
Figure 1.12. UHC service coverage index, 2000-2021, UNECE average (SDG Indicator 3.8.1) 64
Figure 1.13. Share of households with expenditures on health greater than 10 per cent of total household income or expenditure, UNECE median and select... 65
Figure 1.14. Age-standardized premature mortality rate from cardiovascular disease, cancer, diabetes, chronic respiratory disease (from 30 to under 70 years,... 69
Figure 1.15. Age-standardized overall premature mortality rate (from 30 to under 70 years, per 100,000 population) from cardiovascular disease, cancer, diabetes... 71
Figure 1.16. Age-standardized prevalence of current tobacco use among people aged 15 years and older, UNECE median, 2000-2020 (SDG Indicator 3.a.1) 73
Figure 1.17. Suicide mortality rate (deaths per 100,00 population), UNECE average, 2000-2020 (SDG Indicator 3.4.2) 76
Figure 1.18. Suicide mortality rate (deaths per 100,000 population), by age group and gender, UNECE average, 2020 77
Figure 1.19. Labour force participation rate by age group and gender, UNECE median, 2000-2022 81
Figure 1.20. Average effective labour market exit age in years, UNECE median, by gender (2000-2020) 82
Figure 1.21. Unemployment rate by age group and gender, UNECE median, 2022 (SDG Indicator 8.5.2) 84
Figure 1.22. Unemployment rate by disability status, 2021 (SDG Indicator 8.5.2) 85
Figure 1.23. Proportion of youth aged 15-24 years not in education, employment or training, UNECE median, 2000-2021 (SDG Indicator 8.6.1) 86
Figure 1.24. Carbon dioxide emissions per unit of GDP at purchasing power parity (kilograms of CO₂ per constant 2017 United States dollars), UNECE average,... 89
Figure 1.25. Carbon dioxide emissions per unit of GDP at purchasing power parity (kilograms of CO₂ per constant 2017 United States dollars), 2015 and 2020... 90
Figure 2.1. Share of women aged 15-49 making their own decisions regarding their sexual and reproductive health and rights, select countries (SDG Indicator 5.6.1) 99
Figure 2.2. Percentage of women aged 15-49 making their own decisions regarding sexual relations, contraceptive use and reproductive health care,... 100
Figure 2.3. Extent to which countries have laws and regulations that guarantee full and equal access for women and men aged 15 and older to sexual and... 105
Figure 2.4. Share of married or in-union women aged 15-49 with an unmet need for any modern method of family planning, 2015 and 2023 107
Figure 2.5. Contraceptive prevalence among married or in-union women aged 15-49, by modern or traditional method, 2023 109
Figure 2.6. Adolescent birth rate (per 1,000 women aged 15-19), UNECE average, 2000-2020 (SDG Indicator 3.7.2) 112
Figure 2.7. Adolescent birth rate (per 1,000 women aged 15-19), 2015 and 2020 113
Figure 2.8. Adolescent birth rate (per 1,000 women aged 15-19), Roma population and total population, select countries, 2018/2019 114
Figure 2.9. Induced abortions per 1,000 live births, 2010 and 2019 118
Figure 2.10. Induced abortions per 1,000 live births for women under age 20, 2010 and 2019 120
Figure 2.11. Maternal mortality ratio per 100,000 live births, UNECE average, 2000-2020 (SDG Indicator 3.1.1) 122
Figure 2.12. Maternal mortality ratio per 100,000 live births, 2015 and 2020 (SDG Indicator 3.1.1) 123
Figure 2.13. Neonatal mortality rate (per 1,000 live births), UNECE average, 2000-2021 (SDG Indicator 3.2.2) 125
Figure 2.14. Neonatal mortality rate (per 1,000 live births), 2015 and 2021 (SDG Indicator 3.2.2) 127
Figure 2.15. Number of new HIV infections, Eastern Europe and Central Asia, 2000-2022 132
Figure 2.16. Estimated ART coverage among people living with HIV, 2010 and 2021/2022 134
Figure 3.1. Women in parliaments (SDG Indicator 5.5.1) and managerial positions (SDG Indicator 5.5.2), UNECE median, 2000-2022/2023 147
Figure 3.2. Labour force participation rate by gender, 2022 150
Figure 3.3. Gender pay gap as percentage difference in average monthly earnings, UNECE median, 2000-2020 151
Figure 3.4. Gender pay gap as difference in monthly earnings, select countries, 2015 and 2020 152
Figure 3.5. Total paid maternity and parental leave available to mothers in weeks, 2015 and April 2022 155
Figure 3.6. Total paid paternity and parental leave reserved for fathers, 2015 and April 2022 157
Figure 3.7. Share of children aged 0-2 years enrolled in early childhood education or care services, 2015 and 2020 159
Figure 3.8. Select working patterns of heterosexual couples aged 25-49 whose youngest child is under the age of 6, UNECE median, 2000-2020 161
Figure 3.9. Share of heterosexual couples aged 25-49 with both partners working full-time, by age group of youngest child, 2019 162
Figure 3.10. Time spent on unpaid care and domestic work, male to female ratio, select countries and years (SDG Indicator 5.4.1) 163
Figure 3.11. Share of women and men in paid work who find it difficult to fulfil family responsibilities because of the amount of time spent on work, select countries 164
Figure 3.12. Share of women and men who indicated their mental health and work situation worsened during the COVID-19 pandemic, select countries 165
Figure 3.13. Share of the population aged 18 and older who agree it is sometimes or always justifiable for a man to beat his wife, select countries,... 169
Figure 3.14. Share of the population aged 18 and older who agree it is sometimes or always justifiable for a man to beat his wife, by age, select countries, 2017-2022 170
Figure 3.15. Share of women aged 20-24 who were married or in a union before the age of 18, select countries, 2015-2022 (latest year available) (SDG Indicator 5.3.1) 173
Figure 3.16. Share of Roma women and all women aged 20-24 who were married or in a union before the age of 18, select countries, 2018/2019 174
Figure 3.17. Proportion of the population living below the national poverty line, 2020 and 2015 (when available) (SDG Indicator 1.2.1) 177
Figure 3.18. Share of people at risk of poverty or social exclusion, select countries, 2015 and 2022 179
Figure 3.19. Share of people at risk of poverty or social exclusion by age group and gender, UNECE median, 2022 180
Figure 3.20. Parity indices for achieving a minimum level of proficiency in reading and math, lower secondary students, the ratio of immigrant students to native-born... 182
Figure 3.21. Whether or not legal frameworks are in place to promote, enforce and monitor equality and non-discrimination on the basis of sex, percentage of achievement,... 186
Figure 3.22. Percentage of the population having felt discriminated against or harassed in the previous 12 months, by disability status, 2014-2019... 188
Figure 3.23. Percentage of the population aged 18+ indicating that they would not like to have members of various groups as neighbours, UNECE median, 2000-2020 189
Figure 3.24. Detected victims of human trafficking per 100,000 population by age group and sex, UNECE average, 2007-2021 194
Boxes
Box 1. Key initiatives addressing demographic change and population ageing 51
Box 2. The European Union adopts a comprehensive approach to mental health 79
Box 3. Strengthening demographic resilience across Europe 93
Box 4. WHO Action Plan for Sexual and Reproductive Health (2016) and progress reports (2019, 2022) 101
Box 5. Generations and Gender Programme 166
Box 6. European Pillar of Social Rights Action Plan 184
Box 7. Combating ageism 192
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