Growing up in rural Kenya with my parents, my childhood days -- life was very challenging, especially for women and girls.
From the early age of 10, I knew I wanted to be a doctor and wanted a better life for myself and for my parents, but opportunities such as these back in those days did not come easy.
It was very difficult for many young people in my village, especially girls, to get a good education and break the cycle of poverty because beyond the village there were not that many opportunities. Most parents were not keen to educate girls.
Most of the girls in my village dropped out of school after primary school to get married or to work as domestic workers in the city to supplement their family's income. My father was approached many times with marriage proposals for me and he turned them down.
I was lucky, unlike other girls in my village who were married off at a very early age. Today, I am now happily married with two children and three grandchildren, a choice that I made myself, but a choice many girls back then could not make.
Going to high school for girls was rare and going to college or university much rarer. It was, therefore, quite a source of interest in the village when I became the first girl in my village to go to high school and then proceed to university. That was my breakthrough and the rest, as they say is history!
Today I am the head of the United Nations Population Fund (UNFPA) in Zimbabwe, the UN reproductive health rights agency, but the circumstances I fought hard to overcome to be successful are still a reality for many girls out there. It is what drives me every day as we work hard to make a difference in the lives of women and young people, especially girls!
UNFPA was established in 1969 and this year we celebrate 50 years of delivering rights and choices for all.
This week as UNFPA, we launch findings from the State of the World Population Report which covers growth and trends in world population and demographics.
The report findings show that the global reproductive rights movement that began in the 1960s transformed the lives of hundreds of millions of women, empowering them to govern their own bodies and shape their own futures.
But despite the gains made over the past 50 years, the world still has a long way to go before rights and choices are claimed by all, according to the report. It is unfinished business.
On the journey towards rights and choices, women and girls have faced social and economic barriers every step of the way. UNFPA, working with governments and other coalitions of civil society, activists, and organisations have been helping tear down those barriers. These efforts have dramatically helped reduce the number of unintended pregnancies and maternal deaths, and have cleared the way for healthier, more productive lives for millions of people, according to the report.
This year is also the 25th anniversary of the 1994 International Conference on Population and Development (ICPD), where 179 governments called for all people to have access to comprehensive reproductive healthcare, including voluntary family planning, and safe pregnancy and childbirth services.
Much has been achieved since 1969 globally, says the report. A few highlights below:
The average number of births per woman was 4,8 then, compared to 2,9 in 1994 and 2,5 in 2019;
Fertility rate in the least developed countries dropped from 6,8 in 1969, to 5,6 in 1994 and 3,9 in 2019;
The number of women who died from pregnancy-related causes has decreased from 369 per 100 000 live births in 1994, to 216 in 2015,
24 percent women used modern contraceptives in 1969, compared to 52 percent in 1994 and 58 percent in 2019.
Our cooperation with the Government of Zimbabwe began in 198, with support to the 1982 Census. Under the leadership of the Government of Zimbabwe and working with various implementing partners, the country has made some progress in ensuring reproductive health and rights.
Notably in the area of access to contraceptives. Zimbabwe's contraceptive prevalence stands at 67 percent from 59 percent in 2015 and 42 percent in 2005.
This is commendable because this rate is one of the highest in the region.
In addition, although still high, Zimbabwe's maternal mortality rate reduced from 960/100 000 live births in 2009 to 614/100 000 live births in 2015.
These are important steps towards improving access to reproductive rights.
Towards girls' empowerment, a programme known as the Sista2Sista has touched the lives of more than 60 000 young women aged 10-19 since its inception in 2013.
Some of the outcomes tracked by the programme include incidence of pregnancy, school drop-out or re-entry, contraceptive uptake, sexual abuse and child marriage.
Over the past six years of implementation, the teenage fertility rate among beneficiaries in the implementation districts has remained well below the district averages. All this has been achieved through great partnerships and collaborations with various partners working in the area of reproductive health and rights.
The Governments of Britain, Ireland, Sweden and the European Union have been unwavering in their support to reproductive health and rights issues.
However, as we celebrate those achievements towards attainment of reproductive rights, we must also reflect on what still needs to be done. Far too many women and young people are still facing challenges accessing reproductive health information and services as well as rights.
The report is telling us that as many as 200 million women worldwide who want to prevent a pregnancy cannot access modern contraceptive information and services. In Zimbabwe we need to step up efforts to address some of these issues:
High maternal deaths -- nine women dying a day due to pregnancy-related complications is too high a number. We must step efforts to ensure women have access to quality maternal healthcare
Reducing teenage fertility -- approximately one in 10 adolescent girls aged 15-19 give birth every year and many die or are injured in childbirth as they are bodies are not yet ready for the process
Gender-Based Violence remains a challenge in Zimbabwe affecting one in three women and girls -- this prevents them from reaching their full potential in life. The prevalence of child marriage is yet another hindrance to the development of girls
There are limited opportunities for young people's development in the country
High HIV infections, especially among young people
And all this can be done. The results of the SWOP 2019 Report are showing us that little by little, we will get there. As we launch the State of the World Population Report, we must be reminded that many girls, women, young people are depending on us, our decisions and our work to change their circumstances and live better, healthy and reproductive lives. This, therefore, calls on all of us to redouble our efforts and ensure that no one is left behind in the pursuit of rights and choices. UNFPA remains committed to support the Government of Zimbabwe to make this a reality.
Dr Esther Muia is a medical doctor by profession and the UNFPA Country Representative for Zimbabwe.