Yet in many countries policies and programmes to provide the services they need or reinforce family and community support do not exist. Women make up the highest proportion of older people, particularly the very old, and many carry the burden of a history of poverty, illiteracy, ill health, gender violence, and discriminatory treatment. Mortality decline has been uneven. In some countries there have been reversals of gains in life expectancy. In countries with economies in transition in Eastern Europe, life expectancy has particularly declined in the context of increased social stress , poor nutrition and deteriorating health services.
Maternal mortality is also a critical area for attention and action.
It takes the lives of almost 600,000 women each year. As the demand for smaller families has increased and the access to safe and accessible contraception has improved, fertility level have declined. Over 150 million couples still have an unmet need for contraception. Other unmet needs for reproductive health, including family planning and sexual health, services remain extremely high, including the need for infertility services. In countries where significant increases in contraceptive access and acceptance have been effected, recourse to abortion has declined dramatically.