Reducing deaths of mothers during pregnancy and childbirth is the key indicator of success for the UNFPA, which was initially set up as a trust fund in 1967 before being integrated into the UN system in 1969.

This goal, it says, will be achieved through every young person having their potential fulfilled, every pregnancy being wanted and every childbirth being safe.

The pivotal moment for the agency was 1994, the year the International Conference on Population and Development met in Cairo. The conference was widely considered a significant milestone in the fight for women’s rights, as reproductive health came to be viewed as “a state of complete physical, mental and social wellbeing”.

The work was no longer about population control but women’s empowerment, according to Laura Laski, who heads the sexual and reproductive health team for the agency today. She believes inequality, both economic and in terms of gender, and a lack of leadership are the biggest impediment to effecting change. That and a health system “which you only know is functioning when it delivers for women”.

There has been progress in some areas: maternal mortality has dropped by 45% since 1990 but still remains stubbornly high in sub-Saharan Africa and elsewhere in the developing world, which together still account for 99% of the deaths.

Laski gives Eritrea as an example of a country in Africa that has reached Millennium Development Goal 5 and describes Latin America and the Caribbean as making “solid progress” with regards to women’s rights.

According to World Health Organisation figures, unsafe abortion is responsible for 13% of maternal deaths. with the majority occurring in the developing world, yet as an agency UNFPA does not promote abortion. Instead it focuses on the prevention of unwanted pregnancy and safe post-abortion care, says Laski.

Another important milestone for the agency was 2012, when its remit was expanded to include adolescents. The world’s 1.8 billion young people were the focus of last year’s population report which called on them to seize full control of their life and health choices as a route to achieving their full development potential. The report was later attacked by Christian rights groups as promoting the “right to drugs” and encouraging “sexual anarchy”.

The agency also runs programmes and campaigns to tackle child marriage and female genital mutilation – both proved to reduce a woman’s chances of surviving in childbirth – and has been a key player in international discussions on the sustainable development goals that replace the UN targets set in 2000.

But 20 years since Cairo, progress has been patchy, laws to protect women’s equality are not being implemented and, although UNFPA handed out 780m condoms last year, 200 million people who want to access modern forms of contraception are left wanting. Until that gap is closed, a world where “every pregnancy is wanted” still seems a way off.

In praise of...

Zufan Fentahun doesn’t recall many details from her marriage as she was only a toddler. The teenager, now 18, is from the Amhara region of Ethiopia, which has one of the highest rates of child marriage in the country.

As is custom in her area she was betrothed to her new husband by her parents but was due to stay in her family home until the age of 12 or 13. The legal age of marriage, for boys and girls, in Ethiopia is 18.

But her life did not follow the hazardous path destined for many child brides: forced sex, premature pregnancy, sexually transmitted diseases, female genital mutilation or fistula – which occurs as a result of prolonged, obstructed labour.

Aged seven she was one of the first girls to enrol in a UNFPA programme called Berhane Hewan, which helps young girls take control of their lives through education. With support from the programme, which means Light for Eve in Amharic, she threatened to take her parents to court if they did not agree to annul the marriage.

Her life has since dramatically changed direction: she is about to go into her final year at secondary school where she is studying the sciences and she tutors other young girls determined to also avoid ending up as child brides.

Berhane Hewan operates on the principles of keeping girls in school, educating the community against the early marriage and unprotected sex within the community and working with the government to ensure they factor girls into their programming.

“It gave me my first taste of education and supported me in a way my parents were unable to,” she says. “Had the project not been here, I would have succumbed to fistula, sexually transmitted infections and HIV, which has been the fate of many girls in my area.”

Reducing deaths of mothers during pregnancy and childbirth is the key measure of success for UNFPA.

Without UNFPA’s intervention, Fentahun says she “would have been the mother of children by now, or worse, would have died in the process”. For now, she is focusing on her career, she wants to be a doctor, and doesn’t see herself getting officially married for “another 10 years at least”.

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