Population, Gender, and Development in Latin America
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Transcript of Population, Gender, and Development in Latin America
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Population, Gender, andDevelopment in
Latin America
Kimberly GrahlingCharles McKittrick
Mark RobinsonGary Wu
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Agenda
• Why is population control so important and what other issues influence growth?
• What Latin American countries are doing to control population growth and the results are they seeing
• Puerto Rico and Peru
• Desired long-term results and our conclusions
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The Importance of Population Control
LIMITED RESOURCES!
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The Economics of Population• Fertility and education
• GDP Per Capita = GDP / Population
ISIExport orientationPrivatizationInflationEconomic enclavesDebtExchange ratesetc.
Decrease
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The Importance of Population Control
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Drivers of High Population• Colonial legacy
• Culture of machismo
• Agrarian economy
• Lack of education
• Lack of access to birth control
• Religious influence
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Latin American governments• % of governments thinking their country’s
population was too high in 1999:
Source: 1999 World Population Data Sheet, Population Reference Bureau
Central America 88%Caribbean 47%South America 15%
Population Control Participants
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Foreign governments• Spend $2 billion/year subsidizing family planning
worldwide.• Largest contributors:
– United States through U.S. AID– Netherlands– Germany– United Kingdom– Japan
Source: United Nations and New York Times
Population Control Participants
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Nongovernmental Organizations (NGOs) - Funded by local and foreign governments
• International– U.N. Population Fund– World Health Organization
• U.S.-based– International Planned Parenthood Federation– Family Health International– The Population Council– Pathfinder International
Population Control Participants
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Nongovernmental Organizations (NGOs)• Private donors
– Ford Foundation– Rockefeller Foundation– Mellon Foundation– MacArthur Foundation– Gates Foundation
Population Control Participants
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U.S. AID Funding in Latin America for health and family planning FY2000
CountryFunding
($000) TFRHaiti 22,300$ 4.8Peru 13,500$ 3.5Bolivia 13,000$ 4.2El Salvador 7,145$ 3.6Guatemala 6,000$ 5.1Honduras 4,318$ 4.4Nicaragua 4,000$ 3.9Brazil 2,900$ 2.3Paraguay 2,000$ 4.4Jamaica 1,450$ 2.8
Source: U.S. AID and Population Reference Bureau
Population Control Participants
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• Sterilization• Long-term, low-cost, convenient
Population Control Tools
• Increased access to modern birth control• Reversible• Higher efficacy rates than traditional methods
• Family planning education• Most important aspect of population control
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• Measured by Total Fertility Rate (TFR)• U.S. has a TFR of 2.0.• TFR of 2.1 is replacement-level fertility
• Latin America’s TFR fell from 5.9 in the 1950’s to 2.9 in 1999.
• Population will double in ~38 years
• Population control policies have reduced population growth rate in Latin America
Results
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Source: World Population Beyond 6 Billion, Population Reference Bureau
Results
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Case StudiesSuccessful vs. unsuccessful examples of population
control programs
Case Studies of Two Women's Health Projects in BoliviaGender, Power and Population Change, Population Reference Bureau
Puerto Rico
Peru
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What are the parameters of success?
Initially sought to compare effective vs. ineffective examples
Traditional Metrics - focus on short term results:
• Funds invested to number of client visits, IUDs inserted, pills distributed
• Births per thousand - TFR
New Metrics - focus on medium & long term results
• Quality of service
• Impact on client's health and well-being
• Participant internalization of health knowledge and responsibility
• How participation has affected health and well-being in the medium and long term.
Case Studies of Two Women's Health Projects in BoliviaGender, Power and Population Change, Population Reference Bureau
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Puerto Rico: Effective results ...
Low Cost - high efficiency - Immediate results
• Population control expenditures 100% more effective in raising per capita income than expenditures in accelerating conventional economic growth (General Electric Tempo Research Center)
• $5 of birth control = $100 of economic development (Lyndon Johnson's '65 speech to UN)
• Every prevented birth worth 2.6 times per capita output…
births prevented in Puerto Rico ('68) = $3,600 per birth
• Study suggested that improved management efficiency and more permanent birth control might result in over $12.5M gain for Puerto Rico
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Puerto Rico: Effective results…but at what cost?
• By 1968 ~34% of women of child bearing age had been sterilized - 2/3s of whom were still in their early twenties
• Lowest natural population increases in Latin America: 19.1/thousand vs. 29/thousand
Year Age Percent Sterilized1947-48 15 + 6.6
1948 n/a 6.91953-54 20 + 16.5
1965 20-49 341968 20-49 35.3
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Puerto Rico: Context and players
Primary participants:
• Puerto Rican government
• NGOs
• Foreign governments
• Private donors to NGOs (with linked economic interests)
Population Control Policies:
• Sterilization
• IUD & the Pill
Rationalization:
• Demand Statistics
Sterilization
1) Underdeveloped health-care services
2) Abortion difficult to obtain (2 year prison term)
3) Non-prescription use of the pill
4) IUD's expensive and poorly distributed
5) Sterilization is free
6) Reimburse $50 and 90% of hospital cost
7) Sterilization post partum - consent is obtained during labor
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Peru: Family Planning and Good Intentions
Fujimori places family planning at forefront of national agenda (4/95)
• Method for reducing poverty in Peru.
• Goal: state to prevent the birth of 500,000 Peruvians by 2000
• Population control linked to shift in market-oriented economic policies
Good intentions
• 1st step in reducing poverty decrease size of low income families
• Accessible family planning for all classes
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Peru: Family Planning and Good Intentions
Case Studies of Two Women's Health Projects in BoliviaGender, Power and Population Change, Population Reference Bureau
Population Control Tool-set• Network of clinics• Access to latest techniques (including female condom and Norplant)
• Voluntary sterilization program • (including vasectomies for men and tubal ligations for women)
• Three most practiced forms of contraception in Peru:(1) Abstinence / 'natural methods'; (2) IUD; (3) Tubal ligation
• Abortion Illegal - though ~ 300K abortions performed a year• 1 in 3 pregnancies end in abortion
Primary Participants• Peruvian government
• U.S. AID
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Peru: Family Planning and Good Intentions
Case Studies of Two Women's Health Projects in Bolivia
Constraints:• Catholic Church:
• Moral arguments
• Church claims plan ignores declining birth rate;
• Blames the poor for the country's economic problems.• Cultural:
• Male perception of loss of control over women
• Fear of male impotence
Economic
• 1/2 of Peru's 23 million people live in poverty
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Peru: Family Planning and Good Intentions
Results & Pitfalls
• '97 sterilization's result in 26,000 fewer births in '98
• Quotas motivate State health-care workers to take advantage of rural poor women
• Promotions and cash incentives stimulate hurried, low quality care
• Going rate: two dresses and a t-shirt.
YearFemale
SterilizationsMale
Sterilizations1995 10,000 n/a1996 30,000 n/a1997 110,000 10,000
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Future Trends: An Alternative Viewpoint
Population control guided by improving human welfare instead of reducing overcrowding
• Invest in the conditions that facilitate use of programs in addition to the programs themselves.
Integrated approaches to service delivery• Emphasis on continued education and growth
• Focus on interpersonal relationships
New Paradigm: • Health more complex than medical service and necessarily linked to
education, human rights, personal empowerment
• Transforms relationship between clinician and patient so delivery more effective
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Positive Results of Population Control
Women have fewer children
More opportunities for education and work
Women gain higher-paying jobsWomen achieve higher
economic status
Economy gains from more productive workers
Higher standard of living
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Four Key Indicators of Women’s Quality of Life
Region 1970 1990 1970 1990 1970 1990 1970 1990Latin America and the Caribbean 89% 103% 39% 52% 64 70 5.0 3.2
Life Expectancy
(years) FertilityGirls Enrolled in Primary School
Women Aged 15-44 Using
Modern Contraception
Source: Women in Poverty: A New Global Underclass, Family Health International
Positive Results of Population Control
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Conclusions• Humane population control cannot be achieved
with only one tool
• Population control as a development tool is a long- term undertaking
• Education is a key component of economic development
• The most effective population control policies focus on both genders.
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The End
Questions and Answers
Perguntas e Respostas
Preguntas y Respuestas
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Costs and Benefits of One Additional Year of Schooling For 1,000 women in
Pakistan (estimated):Costs•Schooling costs for 1,000 women = $30K
Benefits•Increase in wages = 20%
•Child deaths averted = 60
•Alternative health intervention to save 60 lives = $48K
•Total births averted = 500
•Alternative family planning costs per 500 births averted = $33K
•Total maternal deaths averted = 3
•Alternative costs per 3 averted maternal deaths = $7.5K
Results
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Source: World Population Beyond 6 Billion, Population Reference Bureau
Results