Cairo at 10: Progress in Latin America and the Caribbean

Highlights of the Technical Report

 

Here are a few highlights from the 45-page draft Technical Report of the March 9-11 health and population policy meeting in Santiago, Chile, where some 300 health ministers and other policy-makers from 41 countries are evaluating regional progress toward implementation of the goals of the International Conference on Population and Development. [Unofficial translation and paraphrase from the Spanish original.]

 

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Substantial progress has been made in all regions of the world, but many gaps and shortfalls remain.

 

PRIMARY AND SECONDARY EDUCATION

·        In Guatemala and Mexico, economic incentives for girls increase their school attendance.

·        In Chile, Cuba, Panama and Mexico, new measures avoid drop-outs or marginalization of pregnant students and teenage mothers.

·        Revision of school texts to eliminate negative gender stereotypes and discriminatory images has taken place in 8 countries, including Chile.

·        Illiteracy rates have been reduced in all countries in the region, however gaps remain in achieving minimum education for all girls and boys. In 2000, official illiteracy rates ranged from 1.5 percent to over 50 percent.

 

HIV/AIDS

·        Two million people in Latin America and the Caribbean live with HIV/AIDS.

·        Prevalence in the region is above 1 percent in 12 countries, all in the Caribbean.

Most countries have adopted new regulations and developed programs to prevent and control HIV transmission.

 

REPRODUCTIVE RIGHTS

Many countries have adopted laws to ensure the exercise of reproductive rights and access, without discrimination, to reproductive health services.

·        The new constitutions of Ecuador, Peru and Venezuela include the right for individuals to make free and responsible decisions on the number of children, without discrimination, violence or coercion;

·        Population policies in Mexico, Nicaragua and Peru recognize the principles that guarantee reproductive rights and access to family planning and reproductive health services;

·        In Brazil, the law establishes universal integrated health care.

 

VIOLENCE AGAINST WOMEN

·        At least eight countries in Latin America and the Caribbean, including Chile, have set up high level commissions to formulate national plans or programs to address violence against women.

·        Several countries in the region are reducing family and sexual violence by:

Raising awareness of all citizens through national prevention campaigns;

Creating institutions to protect victims of violence;

Providing health care services for victims of family violence.

 

POLITICAL PARTICIPATION

·        In Costa Rica, the Electoral Supreme Tribunal required political parties to have 40 percent women on their lists of candidates for municipal elections.

·        In Dominican Republic, women must by law be 40 percent of local government officials.

·        In Ecuador, minimum participation for women in electoral positions is 35 percent.

 

INFORMATION RESEARCH AND TRAINING

·        The extended MercoSur countries, including Chile, agreed to use common methods in their 2000 censuses in order to generate comparative data.

·        Specific surveys on health, demography and family planning were carried out in 12 countries, generating new data on fertility rates, child mortality, family planning methods, HIV/AIDS and domestic violence.

·        Online census data is available in 7 countries, including Chile.

 

RIGHTS AND EQUITY

·        Most countries have stronger public awareness of discrimination against women.

·        Many countries have created bodies responsible for women’s issues or have strengthened existing ones.

·        Some countries have new programs targeting poor women and female heads of households with aid in access to housing, job training and micro-credit.

·        Saint Kitts and Nevis have new laws on sexual harassment and equal pay for equal work.

·        Chile, Colombia and El Salvador have conducted family and community education programs on the importance of sharing responsibility in the home and child rearing.

 

ATTENTION TO NEEDS OF OLDER PERSONS

·        The rights of older persons are protected in the constitutions of at least 19 countries.

·        Several national development plans include national policies for older persons and sectoral programs in health and social security.

 

RESOURCES

·        Investment by the international community is short of commitments made in Cairo in 1994. Donor countries are providing only about $3.1 billion of the $6.1 billion they pledged to invest by 2005.

·        While some countries have received support from international organizations, the volume of international assistance has been dropping in others, such as Mexico and Nicaragua.

·        Nineteen countries in the region have increased or sustained resources for implementing health programs in general and reproductive health programs in particular.

 

CHALLENGES

·        Maternal death rates continue high in many countries, even though most deaths could be prevented through access to family planning, skilled attendance at childbirth and emergency obstetric care.

·        While there has been progress to address gender inequality, especially in education where women now outnumber men in schools in most of the region, discriminatory practices persist and are reflected in the high concentration of women in careers and disciplines with little market value attached to them.

·        Gender violence continues, despite the enactment of many laws against it.

·        Lack of funds and human resources persist.

 

ECONOMY

·        In Latin America, 42 percent of people still live in poverty, unchanged since 1994.

·        High unemployment persists, particularly among women and young people.

 

POPULATION GROWTH

·        As the 21^st century began, population growth in 19 Latin American countries was less that 1 percent per year. The lowest rate was in the Caribbean, at 0.9 percent.

·        People under the age of 15 constitute nearly 40 percent of the population in Belize, Bolivia, Guatemala, Haiti, Honduras, Nicaragua and Paraguay.

 

LIFE EXPECTANCY

·        More than two thirds of the region’s countries had a life expectancy of 70 years in the period 2000 – 2005, and progress is expected to continue.

 

INFANT MORTALITY

·        Infant mortality has continued a downward trend, with the lowest rates in the Caribbean. In the early years of the 21st century, Barbados, Chile, Costa Rica, Guadalupe, Martinique, Puerto Rico, St. Lucia, and Trinidad and Tobago had rates below 15 per 1000 live births. In Cuba, Guadalupe and Martinique, it was 10 per 1000 live births.

·        The disparity between the rates for urban and rural areas and for educated and educated mothers has not declined.

 

MATERNAL MORTALITY

·        Red tape and scarce information --identification, classification and registered cases – restrict the adequate measure of incidents.

·        In Guatemala and Haiti less than half of births receive qualified medical attention.

·        In rural areas of Bolivia, Guatemala, Haiti and Peru, more than 70 percent of births are not attended by a health professional.

 

PREGNANCY AND CONTRACEPTIVES

·        Teen pregnancy has increased in Brazil, Chile, Colombia, Haiti, Jamaica, Dominican Republic and Uruguay. In countries that have reported a decrease, such as Nicaragua, the rate continues to be high (100 or more per 1000 live births)

·        The use of contraceptives among teens varies considerably: in Costa Rica and Cuba over 60 percent report the use of contraceptives, and in Bolivia, Guatemala, Haiti and Honduras under 30 percent report the use of contraceptives.

 

PENDING ISSUES

 

·        The past ten years have shown that mere economic growth is not enough to achieve social equity and reduce poverty. Redistributive policies are required.

·        Greater political stability demands profound changes in institutions and in ways of exercising power. There is a need to confront the vices that erode citizens’ confidence in governments, such as corruption, impunity, inefficiency and the concentration of power in the hands of a few.

·        Reform of strategic government sectors like health and education has been erratic.

·        Some countries have either failed to incorporate changes into their national development plans or their everyday management or their local planning. In other cases they lack concrete actions and their compliance is rhetorical only or takes the form of laws that are not put into practice.

·        Health care is very inequitably distributed—the rich have access to the best quality and the poor have comparatively little access to care that is often inadequate.

·        Reproductive health care in some countries is restricted to maternal and infant care. Adolescents and men in particular are often left out.

·        Maternal mortality continues at high levels in many countries, which is the more worrying because it is preventable. We must reach more people with the appropriate measures. Low levels of international cooperation and scarce national resources hurt both quality and quantity of services.

·        The number of girls enrolled in school is greater than boys in most of the region, but gender equity is a long way from being considered a critical aspect of development and poverty reduction. Even in education, discrimination persists, visible in the concentration of women in low-wage disciplines.

·        For both cultural and institutional reasons, laws to prevent domestic and sexual violence have been inadequate, especially in cases where it is not viewed as a crime.

·        Quality education for all is still restricted for institutional reasons and budget shortfalls.

·        More and better data collection is essential.