Transcript Review and Evaluation of the

Implementation of the Cairo Programme of
Action in the Caribbean: Evaluating Progress
and Renewing Commitment
 Part I
Introduction
ICPD Beyond 2014
 The Cairo Programme of Action (1994) was originally
envisaged as a 20 year programme of action
 However, in 2010 the United Nations General Assembly
decided to extend the Cairo Programme “beyond 2014”
 Much has been achieved, but significant gaps remain in the
implementation of the programme
 The goals and objectives of the Programme remain highly
relevant to the Caribbean
About this Presentation
Part 1: Introduction
Part II: Population, Sustained Economic Growth, Poverty and Inequality
Part III: International Migration and Development: Challenges and Opportunities
Part IV: Population Ageing and the Rights of Older Persons
Part V: The Rights of Persons with Disabilities
Part VI: Gender Equality, Equity and Empowerment of Women and Girls
Part VII: Sexual and Reproductive Rights and Health
Part VIII: Achieving Universal Access in HIV Prevention, Treatment, Care and Support
Part IX: Conclusions and Recommendations for the Further Implementation of the
ICPD programme of Action Beyond 2014
Part II
Population, Sustained Economic Growth,
Poverty and Inequality
Recent Trends in Growth, Poverty and
Inequality
 Relatively strong growth for much of the 1990s and 2000s
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until 2008.
The Caribbean has been hit hard by the global economic
crisis
Continuing high levels of inequality
Extreme poverty largely eliminated except from Belize,
Suriname, and Guyana.
Poverty , measured against national poverty lines (a more
relative concept of poverty), persists
Determinants of Poverty and Inequality
 Unemployment and underemployment
 Low skill, low productively, low pay work
 Extensive informal sector in some countries
 Weak social protection systems
 Single parent households
 Adolescent pregnancy
 Urban Rural differentials
 Chronic-non communicable diseases
Poverty Alleviation Strategies in the
Caribbean
 Economic restructuring, diversification, raising productivity
 Promotion of Small and Medium Enterprises (SMEs)
 Micro-credit schemes (e.g. The Micro Enterprise Loan
Facility, Trinidad and Tobago)
 Extension of social protection systems (e.g. Non-contributory
pensions, free health care or medication)
 Conditional cash transfer programmes (e.g. PATH, Jamaica;
BOOST, Belize)
The Way Forward
 Social, labour market and economic policy should target
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reductions in inequality.
Productivity and competitiveness must be upgraded to
reignite growth particularly in labour intensive, job creating
sectors
Strengthen investment in human capital
Introduction of a social protection floor with gradual
improvements to the level of coverage.
Invest in children and adolescents to break intergenerational
transmission of poverty
Labour market information systems should be strengthened
to facilitate the skills match required by employers
Part II
 International Migration and Development:
Challenges and Opportunities
Trends in Migration
 Emigration from the Caribbean is long established
 By 2010 there were 6.7 million people born in the
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Caribbean living outside the region (compared to a
domestic population of 43 million).
Predominantly in the United States, and to a lesser extent
Europe and Canada.
The global economic global crisis reduced migration flows
to some extent
But demand for skilled labour in developed economies is
likely to remain a strong pull factor
Intra-Caribbean migrants (0.75 million in 2010) mainly
migrate from lower income to higher income countries
International Migration: Barrier or facilitator
to Development?
 Loss of skilled workers and costs associated with their
training, a situation that is particularly acute in the health
and education sectors.
 Breakdown/disintegration within family – particularly
impact on children left behind by migrant parents
 Migration also brings benefits:
 to the migrant themselves through the acquisition of
skills or better employment
 remittances
 the contribution of the diaspora including investment;
development of businesses; the transfer of knowledge
and skills ; and the development of beneficial networks
International Migration: Barrier or facilitator
to Development?
 Return migration – between 2 and 10 per cent of most
Caribbean countries are return migrants
 Regional integration and economic development under
CSME, as yet not fully realised.
 Access to health, education and related services especially
for dependants is unevenly addressed under CSME
 Lack of implementation of the CSME migration policy
Policies to Leverage Migration for
Development
 Engage the diaspora in national development
 Meet skills shortages through managed immigration
 Renewal of efforts to liberalise the movement of people
within the CARICOM Single Market and Economy CSME
 Facilitate flows of remittances through the development of
relevant financial services
 Build capacity to manage borders in order to reduce
undocumented migration including trafficking in persons,
and ensure that the human rights of migrants are protected
Part IV
Population Ageing and the
Rights of Older Persons
The Caribbean Population by age group
(Millions of persons)
30
25
20
15
10
5
0
1950
1975
2000
2025
2050
0-14
15-59
60+
2075
2100
Economic Security of Older Persons
 Only those in formal sector employment receive earnings
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related pensions
Some countries provide non-contributory pensions
although in most cases they are very low
Many older persons do not receive a pension
Some older persons working beyond retirement age
although often in informal employment
Ability to work, however, limited because of age, health or
disability
Healthcare and Non-Communicable Diseases
 Provision of high quality health care for the ageing
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population will be a challenge
Changes in morbidity profile of the population:
epidemiological transition will lead to more chronic and
degenerative ailments
NCDs already a major problem for the sub-region
Risk factors linked to unhealthy lifestyles
Access to services, treatment and drugs
Greater demands by the elderly – limited provision of free
care
Costs are both human and financial - will require
increased government expenditure
Living arrangements, Care Services,
and Long Stay Institutions
 Creation of an enabling environment for independent
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living and self reliance – key ICPD objective for older
persons
Support for independent living – programmes e.g. home
help; home nursing and day care have been promoted
Despite the choice towards independence – many live with
other family members
Often this leads to mutual resentment and abuse
Elder abuse a major concern
Long stay institutions are increasingly used as an option for
the aged – these need to be regulated and monitored
Social Participation of Older Persons, Equality,
and Protection against Discrimination
 Loneliness and isolation a major problem for older persons
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– men more likely to report loneliness
Financial situation, health and geographic location - limits
social participation
Formation of Associations to enhance the quality of life
and represent the interests of older persons
Promotion of positive image of older persons through
organisation of activities focussing on older persons
To enhance quality of life – focus and commitment should
be include necessary social and financial support systems
The rights of older persons needs to be enshrined in
legislation – to protect against discrimination and illtreatment at all levels
Part V
The Rights of Persons with Disabilities
Legislation relating to disabilities
 Eight Caribbean countries have now ratified the Convention on the
Rights of Persons with Disabilities (CRPD) and four have signed the
Optional Protocol which establishes monitoring procedures.
 Guyana passed the Persons with Disabilities Act in 2010, although more
generally there is a lack of comprehensive anti-discrimination
legislation protecting the rights of persons with disabilities
Progress made to include people with disabilities
in the region
 Attempts made to make the education system more accessible and inclusive to
children with disabilities through teaching Braille and sign language in some
countries (Barbados and Dominica among others). In Trinidad and Tobago and
Jamaica support assistants enable children with disabilities to attend
mainstream schools.
 Provision of vocational training and sheltered employment to persons with
disabilities. The Government of Jamaica is targeting 5 per cent of jobs to be
filled by persons with disabilities
 Progress in infrastructure and building codes which facilitates equal
participation in social, economic and cultural life by persons with disabilities
 Governments in collaboration with NGOs have been working to improve
habitation and rehabilitation services through provision of prostheses, assistive
devices, and training.
 Provision of sexual and reproductive health information and services
The Way Forward
 All governments should ratify and implement the International
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Convention on the Rights of Persons with Disabilities (CRPD)
and its Optional Protocol
Governments should seek to increase participation by persons
with disabilities within mainstream education.
Workplaces should be forced to make reasonable adjustments to
enable them to hire more persons with disabilities. Provision of
more employment opportunities to persons with disabilities
through sheltered or supported employment if necessary.
All new buildings and public spaces to be accessible to persons
with disabilities
Persons with disabilities should have access to sexual and
reproductive health and family planning services
Part VI
Gender Equality, Equity and
Empowerment of Women and Girls
Progress made in the region
Legislation and Policies that promote gender equality
 Ratification and accession of CEDAW; the Belém do Pará
Convention; the ICPD Programme of Action and the Beijing
Platform of Action
 Development and implementation of National Gender
Polices
Participation in the labour market
 An expansion of opportunities for women in the labour
market with increases in the female labour force
participation rate in most Caribbean countries
 Implementation of policies aimed at encouraging women’s
participation in the formal economy
Progress made in the region
Women’s Representation in Political Processes and Public
Life
 Four Female Prime Ministers over the last 15 years
 Increase in education, training and support to women who
are interested in politics and decision-making
Gender Based Violence
 Countries have developed and implemented action plans to
prevent gender based violence
 Policies and legal frameworks implemented to protect
victims of domestic violence
 Improved coordination between different agencies
 Training for front-line intervention workers that deal with
cases of domestic abuse.
Best Practices aimed at promoting gender
equality in the region
 The Caribbean Institute for Women in Leadership (CIWIL)
 In Belize, the Women in Politics (WIProject) that provided training to
women who wanted to enter local or national politics (or who were
already active in politics).
 Implementation of a domestic violence protocol in Belize in
partnership with ECLAC
 A domestic and sexual violence prevention protocol developed with the
support from UNFPA and UN Women in Suriname.
 In Belize with the assistance of UNICEF, the National Women’s
Commission established the Belize Gender Info database which serves
as a primary monitoring tool that tracks the progress on the
implementation of the national gender policy.
Challenges
 Women still concentrated in the informal sectors or in certain sectors
of employment (for example tourism or the public sector). Women’s
work in the home and as carers makes a substantial but largely
unrecognised contribution to national economies
 Most Caribbean countries continue to fall short of the threshold of 30
% considered necessary by the Inter-Parliamentary Union for female
parliamentarians to have an impact on decision-making.
 The Caribbean still has one of the highest rates of sexual violence in
the world (UNODC and WB; 2007)
 Data gaps as Caribbean statistical offices are characterised with very
limited resources, limited specialist skills (for example experts in
statistics, demography and geographic information systems), and high
turnover of staff.
Way Forward
 In order to continue progress towards the goal of equal access for women to the
labour market and social security, policies should focus on three broad areas:
equalities legislation and mechanisms for enforcement of legislation; job creation
and stimulation of employment for women especially in rural areas; and policies to
help women combine work with caring responsibilities.
 Government and employers should also support women and men in sharing
responsibilities and combining work and family life.
 Use quotas to increase female participation in national politics.
 Better coordination amongst the various providers of services in order to reach
victims of gender based violence
 Improve the response from the key institutions such as the police, health, social
services and the legal system
 Need for institutional strengthening and capacity development of National
Women’s/Gender Bureaux.
Part VII
Sexual and Reproductive
Rights and Health
Progress of SRH made in the region
Legislation and Policies
 Belize, Suriname, Trinidad & Tobago, St. Lucia and
Grenada have developed their Sexual and Reproductive
Health National Policy
 Increase in women’s access to sexual and reproductive
health services including information, counselling,
educational and awareness programmes
Adolescent sexual and reproductive health
 A decrease in adolescent fertility
 Development of youth friendly spaces for the delivery of
services and youth-friendly information
Progress of SRH made in the region
Health and Family Life Education (HLFE) Programmes
 HFLE programmes are being implemented in out-ofschool settings in some countries
Inclusion of men in SRH services
 Other countries are taking men's SRH clinics to work
places (Saint Lucia, Saint Vincent and the Grenadines,
Guyana), emphasizing detection and treatment for prostate
cancer (Cuba, Jamaica) and training of people who work
with men, for example prison offices (Dominica)
Improving maternal health
 Maternal mortality is being reduced
Best Practices
 Jamaica has recently developed a Policy for the
Reintegration of Adolescent mothers into the formal
education system.
 A Caribbean Regional Curriculum Framework for
Health and Family Life Education to be used and
adapted by member states and implemented in
schools across the region (UNICEF, CARICOM and
EDC, 2008).
Challenges
 Women’s access to sexual and reproductive health services
in rural areas, women living in poverty, and adolescents is
an ongoing challenge
 While it is policy to supply contraceptives through clinics,
it is common that supplies are exhausted. Individuals
(mostly women) then have to seek it at higher cost
elsewhere
 In the area of adolescent sexual and reproductive health,
there are inconsistencies between law and policy regarding
access to contraceptives.
 Even though adolescent fertility has fallen, it is still too
high
Way Forward
 Political leaders are encouraged to play a highly visible role
in the promotion and legitimisation of family planning
services and to expand and upgrade training.
 The supply of contraceptives through the primary health
care system needs to be more reliable
 Protocols for safe abortions or treating unsafe abortions are
needed in the Caribbean.
 More SRH programmes should be designed to serve the
needs of adolescents, and particular attention paid to those
who are victims of sexual violence
Part VIII
Achieving Universal Access to HIV
Prevention, Treatment, Care and Support
Caribbean: New Infections per year
45,000
40,000
35,000
30,000
25,000
20,000
15,000
10,000
5,000
1990
1995
2000
2005
Adults and children newly infected with HIV
Low and high estimates
2010
Caribbean: AIDS-Related deaths
30,000
25,000
20,000
15,000
10,000
5,000
0
1990
1995
Deaths per year
2000
2005
High and low estimates
2010
National Responses
Programme responses
 National responses focus on prevention, treatment and
care
 Much attention given to PMTCT programmes and on
voluntary testing and counselling
 Behaviour change communication interventions have also
been developed
Policies and Plans
 All countries have national HIV Strategic plans and a few
(Barbados & Guyana) have national HIV & AIDS policies
 A number of plans have incorporated a gender component
 Many countries have national workplace policies and/or
developing policies
Most at risk groups
 Men who have sex with men (MSM)
 Female partners of MSM
 Commercial sex workers
 Clients of commercial sex workers
Challenges
Access to Funding and ARV Medication
 Funding is a major challenge because many Caribbean
countries are not eligible for funding
Stigma
 Infringement of fundamental human rights - stigma and
discrimination – discriminatory laws
 Behaviour change remains an intractable problem
The Way Forward
 HIV programmes need to become more efficient and
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should be integrated with sexual and reproductive health
services
Target interventions to address local infection patterns
among most at risk groups
AIDS related deaths should be eliminated through the
universal provision of treatment and care
Ending stigma and discrimination for persons living with
HIV
Continue to improve the quality of information available
about HIV and AIDS
Part IX
Conclusions
Conclusions
 The Cairo Programme set out an ambitious set of goals
and objectives aimed, ultimately, at “meeting the
needs and improving the quality for life of present and
future generations”
 This review has shown that population concerns, and
the ICPD Programme, remain of critical importance to
the future sustainable development of the Caribbean.
 Therefore completion of the Cairo Programme should
form a central part of the post 2015 development
agenda.