Transcript Document

ICPD
20 and Beyond
Paradigm Shift in Population
and Development
 It’s comprehensive vision for development took into
account the inextricable link between population
dynamics and sustainable development.
 It acknowledged people as the most important
resource of a country and stressed their entitlement to
a healthy and productive life, free from discrimination
and stressed promoting individual rights and dignity as
vital for economic growth and sustainable
development.
Central Pillars
 Supporting access to family planning,
 Sexual and reproductive health and rights, including
HIV
 Advancing gender equality,
 Insisting on equal access to education for girls,
 Eliminating violence against women,
 Focusing on issues relating to population data and
Protecting the environment.
Indicators
 % of Primary Health care facilities offering Integrated
Reproductive health services
 Contraceptive Prevalence Rate
 % of births attended by a trained (midwifery) heath
personnel
 % of population with access to primary health services
 Maternal Mortality ratio
Caribbean Context
 Mainly small island developing countries, majority with
populations below 1 million
 Significant progress and most classified as middleincome countries (2nd in world)
 Economic base not diversified, and liable to shocks
 Geographically vulnerable to natural disasters
 High indebtedness - very little fiscal space to invest in
development
 Migration of trained persons
Significant progress
 Stabilization of population growth – access to FP, decline
in fertility
 Commitment to adult SRH -
 Maternal Mortality rates relatively low, but stagnant
 Life expectancy increased
 HIV prevalence still around 1%, but decline in new
infections and in deaths
Change in Age Structure
2000-2010
Significant Progress
 Gender laws, policies in place in some countries
 HIV prevalence still around 1%, but decline in new
infections and in deaths
 Progress in women’s education, participation in public
life - 2 female Prime Ministers
 Willingness to adopt an evidence-based approach
increasing – census conducted
 Signatories to conventions, proud of leadership in
NCDs, gender and youth.
Maternal Mortality Ratio
140
120
100
80
MMR
60
40
20
0
Barbados Trini &Tob Jamaica Suriname
Lags in achieving the
PoA: Maternal Mortality
Maternal
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Stagnated over past several years in several countries
–why?
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Related to quality of care, scarce human resources
(esp. midwives and nurses), NCDs, monitoring
systems.
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Cultural and social factors
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Human Resources (esp. midwives and nurses), NCDs,
monitoring systems.
Universal Access to Sexual
and Reproductive Health
•
Legal and cultural barriers to access to SRH services
for persons below the age of 18
•
Absence of youth-friendly services
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Resistance to sexuality education in schools
•
High stigma, discrimination and even violence against
LGBT community, and lack of access to services
•
HIV prevalence high (Decline 25% in several countries)
Teen-Pregnancy
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High proportion of births (about 20%) to teen mothers
Mis-match between laws on age of sexual consent (16
years) and maturity for access to contraception and HIV
testing (18 years)
Pregnant girls and teen mothers drop out of education
system – policy results in continuing cycle of lack of
opportunity and exclusion
Little support from “baby fathers” , and family
Some good examples, but contradictions make effective
implementation difficult
“Choice”? Planned?
Need for comprehensive policy
Gender Equality
•
Violence and citizen security major concerns
•
Violence against women, especially sexual violence, very
high - between 3 and 8 times global average
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Concerns around self-image, opportunities and mental
health of young men, expressed as domestic
violence/violence against women
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Cultural norms see male violence as justified and “sign he
cares”
Data and evidence
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Limited national and sub-regional capacity for data
collection, analysis, use
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Insufficient inter-censal data collection
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Lack of trust makes collection of data difficult
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Lack of evidence –based planning
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Insufficient attention to linking different sectors for a
holistic understanding of issues, and the development
of multi-sectoral solutions.
Risk-factors to Progress
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Legislative and policy barriers
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Cultural , religious beliefs and leadership
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Popular conceptions of sexuality
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Capacity gaps – small size, migration
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Planning gap – including cross-sectoral
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Resource gaps – especially linked to Middle-Income
status, HIV
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Lack of investment in health, SRH
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Lack of equity
Favourable Trends
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Reviews of legislation, policies in several countries
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Willingness to draft new policies on population, SRH,
gender, youth, migration
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Debate and dialogues on difficult issues now in public
space – eg MSM
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Re-vitalisation of sub-regional mechanisms, CARICOM
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Willingness to reach out to communities, young people,
use social media,
Favourable Trends
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Good examples of what does work, good practice
(SRH and disability, teens , youth parliament and
YAGs)
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Effective engagement of key stake-holders –eg FB
leaders, parliamentarians
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Renewed emphasis on Family Planning - focus on
sexual decision-making, especially for adolescents
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Strong Political Commitment , including from highest
levels, following visit of ED
Achievements
Inclusive approach – commitment to participation of a
wide range of stake-holders, the community.
Empowerment-oriented
Move from Targets which mask vast disparities, to
“universal access” and equity.
Partnerships for development
Accountability
PARTNERSHIPS
Broad partnership is needed between governments and
NGOs to assist in the formulation, implementation,
monitoring and evaluation of population and development
objectives and activities.
NGOs are important voices of the people, and are well
known for their innovative, flexible and responsive
programme design and implementation including grass roots
participation, and because quite often they are rooted in and
interact with constituencies that are poorly served and hard
to reach through government channels.
THANKS!