Implementation of the Cairo Programme of Action in the Caribbean: Evaluating Progress and Renewing...
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Caribbean Forum on Population, Migration and Development Georgetown, Guyana, 9-10 July 2013 Implementation of the Cairo Programme of Action in the Caribbean: Evaluating Progress and Renewing Commitment
Implementation of the Cairo Programme of Action in the Caribbean: Evaluating Progress and Renewing Commitment
Implementation of the Cairo Programme of Action in the
Caribbean: Evaluating Progress and Renewing Commitment
Slide 2
Introduction Part I Part I
Slide 3
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
Slide 4
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
Slide 5
Population, Sustained Economic Growth, Poverty and Inequality
Part II
Slide 6
Recent Trends in Growth, Poverty and Inequality Relatively
strong growth for much of the 1990s and 2000s 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
Slide 7
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
Slide 8
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)
Slide 9
The Way Forward Social, labour market and economic policy
should target 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
Slide 10
Part II International Migration and Development: International
Migration and Development: Challenges and Opportunities
Slide 11
Trends in Migration Emigration from the Caribbean is long
established By 2010 there were 6.7 million people born in the
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
Slide 12
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
Slide 13
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
Slide 14
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
Slide 15
Population Ageing and the Rights of Older Persons Part IV
Slide 16
The Caribbean Population by age group (Millions of
persons)
Slide 17
Economic Security of Older Persons Only those in formal sector
employment receive earnings 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
Slide 18
Healthcare and Non-Communicable Diseases Provision of high
quality health care for the ageing 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
Slide 19
Living arrangements, Care Services, and Long Stay Institutions
Creation of an enabling environment for independent 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
Slide 20
Social Participation of Older Persons, Equality, and Protection
against Discrimination Loneliness and isolation a major problem for
older persons 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 ill- treatment at
all levels
Slide 21
The Rights of Persons with Disabilities Part V
Slide 22
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
Slide 23
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
Slide 24
The Way Forward All governments should ratify and implement the
International 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
Slide 25
Gender Equality, Equity and Empowerment of Women and Girls Part
VI
Slide 26
Progress made in the region Legislation and Policies that
promote gender equality Ratification and accession of CEDAW; the
Belm do Par 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
womens participation in the formal economy
Slide 27
Progress made in the region Womens 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.
Slide 28
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 Womens 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.
Slide 29
Challenges Women still concentrated in the informal sectors or
in certain sectors of employment (for example tourism or the public
sector). Womens 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.
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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 Womens/Gender
Bureaux.
Slide 31
Sexual and Reproductive Rights and Health Part VII
Slide 32
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 womens 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
Slide 33
Progress of SRH made in the region Health and Family Life
Education (HLFE) Programmes HFLE programmes are being implemented
in out-of- school 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
Slide 34
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).
Slide 35
Challenges Womens 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
Slide 36
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
Slide 37
Achieving Universal Access to HIV Prevention, Treatment, Care
and Support Part VIII
Slide 38
Caribbean: New Infections per year
Slide 39
Caribbean: AIDS-Related deaths
Slide 40
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
Slide 41
Most at risk groups Men who have sex with men (MSM) Female
partners of MSM Commercial sex workers Clients of commercial sex
workers
Slide 42
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
Slide 43
The Way Forward HIV programmes need to become more efficient
and 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
Slide 44
Conclusions Part IX
Slide 45
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.