UNITED NATIONS — Twenty years after a landmark United Nations summit meeting in Cairo called on countries around the world to allow women greater control over their health and destiny, women worldwide have fewer children, are less likely to die of childbirth and have made great strides in literacy, according to a major report released Wednesday by the world body.

But a closer look at the report’s numbers reveals marked disparities. For instance, in the poorest communities, “women’s status, maternal death, child marriage” and other indicators of women’s well-being have “seen little progress in the last 20 years,” the report concludes.

In poor countries, for instance, pregnancy and childbirth are the leading cause of death among young women ages 15 to 19. Women continue to be paid less and they are more likely to work in jobs that are “less secure and with fewer benefits,” according to the report, by the United Nations Population Fund.

“Men have to change,” Babatunde Osotimehin, the fund’s executive director, told reporters here. “They have to accept gender equality.”