A broad overview was provided of the changes occurring in women's health in the context of donors. In the 1990s, women's health issues began to be addressed by reproductive health rather than by family planning and maternal and child health programs in official and nongovernmental development programs (NGOs). The World Health Organization definition of reproductive health includes the right of to regulate and control their own fertility. There is international donor recognition, such as the United Nations Population Fund support for the WHO definition, children by choice, and reproductive health services for women. Family planning programs have tended to use the "welfare approach" of targeting women as mothers, and their children. Welfare programs began distribution of contraceptives, when the US Agency for International Development began in the 1960s its policy of contraceptive promotion. Target populations in developing countries were reached through social welfare and health service programs, which included women as passive recipients. The issues of poverty, environmental degradation, and violence were unheeded. The period of 1975-85 marked the emergence of discussion about women's role in society. Links were made between high fertility and low status. The research focus was on determinants of fertility decline, regardless of equity issues. Women were encouraged to become involved in political, social, economic, and education activities as a means of creating a "favorable climate for pursuing population...goals." The development literature relegated women to the subordinate position of meeting demographic objectives. The focus on poverty alleviation opened up the literature to the complexities of the relationships between fertility, education, and work. Empowerment has grown out of the framework and enhanced development. Reproductive health programs are still limited in their offerings, but there has been expansion through the linkages with NGOs. Women's preparatory meetings before the Cairo conference have stressed that gender equity and reproductive rights be placed within a broad framework with policy support.