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.

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.

Central Pillars

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 middle-

income 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.

Barbados Trini &Tob Jamaica Suriname0

20

40

60

80

100

120

140

MMR

Maternal Mortality Ratio

Lags in achieving the PoA: Maternal Mortality

Maternal • Stagnated over past several years in several countries

–why?

• Related to quality of care, scarce human resources

(esp. midwives and nurses), NCDs, monitoring

systems.

• Cultural and social factors

• Human Resources (esp. midwives and nurses), NCDs,

monitoring systems.

• Legal and cultural barriers to access to SRH services

for persons below the age of 18

• Absence of youth-friendly services

• 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)

Universal Access to Sexual and Reproductive Health

Teen-Pregnancy

• 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

• Concerns around self-image, opportunities and mental

health of young men, expressed as domestic

violence/violence against women

• Cultural norms see male violence as justified and “sign he

cares”

Data and evidence

• Limited national and sub-regional capacity for data

collection, analysis, use

• Insufficient inter-censal data collection

• Lack of trust makes collection of data difficult

• Lack of evidence –based planning

• Insufficient attention to linking different sectors for a

holistic understanding of issues, and the development

of multi-sectoral solutions.

Risk-factors to Progress

• Legislative and policy barriers

• Cultural , religious beliefs and leadership

• Popular conceptions of sexuality

• Capacity gaps – small size, migration

• Planning gap – including cross-sectoral

• Resource gaps – especially linked to Middle-Income

status, HIV

• Lack of investment in health, SRH

• Lack of equity

Favourable Trends

• Reviews of legislation, policies in several countries

• Willingness to draft new policies on population, SRH,

gender, youth, migration

• Debate and dialogues on difficult issues now in public

space – eg MSM

• Re-vitalisation of sub-regional mechanisms, CARICOM

• Willingness to reach out to communities, young people,

use social media,

Favourable Trends

• Good examples of what does work, good practice

(SRH and disability, teens , youth parliament and

YAGs)

• Effective engagement of key stake-holders –eg FB

leaders, parliamentarians

• Renewed emphasis on Family Planning - focus on

sexual decision-making, especially for adolescents

• 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!