The Subregional Headquarters for the Caribbean of the Economic Commission for Latin America and the Caribbean (ECLAC), in collaboration with the United Nations Population Fund (UNFPA), organized a two-day expert meeting to commemorate the fifteenth anniversary of the International Conference on Population and Development (ICPD). The goal of the meeting was to assess the implementation of the Programme of Action (POA) of the ICPD. The objectives were to discuss achievements, challenges and gaps experienced in the implementation of the Programme of Action of the ICPD and the way forward. The meeting was held in Antigua and Barbuda, 20-21 August 2009, at the Jolly Beach Hotel, Antigua and Barbuda. Attending the meeting were government representatives of 15 Caribbean countries and a number of non-governmental organizations and experts in the areas of population and development, sexual and reproductive health and rights, and gender. In total over 80 participants attended the meeting. The list of participants is annexed to this report. This report gives a brief overview of the meeting. For each agenda item, a short description of the presentations and ensuing discussions is given. A more detailed overview of the situation in the region can be found in the background document and the tabulated overviews of country policies and programmes in the appendix of that document. The background document incorporates information provided by the countries in the Caribbean subregion before, during, and after the meeting. The draft version was sent to all participants and comments have been included. The country briefs and panel presentations can be found in the Population Division (CELADE) section of the website of ECLAC headquarters. At the end of the meeting the conclusions of the meeting were presented. Those and the agenda and list of participants are annexed to the report. The meeting followed the agenda as detailed below: 1. Review of the implementation of the Cairo Programme of Action in the Caribbean (1994 – 2009): Achievements and Constraints Presentation of country briefs; discussion and comments Panel Discussion 1: Population and Development in the Caribbean Panel Discussion 2: Reproductive health, rights and gender in the Caribbean Panel Discussion 3: Vulnerable groups in the Caribbean Agenda Item 1: Opening Ceremony
The opening ceremony featured statements by Mr. Neil Pierre, Director of the ECLAC Subregional Headquarters for the Caribbean; Ms. Marcela Suazo, Director of UNFPA Latin America and the Caribbean Regional Office; the Honourable Jacqui Quinn Leandro, Minister of Education, Gender, Sports and Youth, Antigua and Barbuda; and Dr. Jacqueline Sharpe, President, International Planned Parenthood Federation (IPPF). After welcoming participants, Mr. Pierre gave an overview of the history and background of ICPD and its regional meetings. He explained that the purpose of the meeting was to celebrate achievements, to acknowledge gaps and challenges, and to derive practical recommendations for accelerating the progress of the POA. The commitment of the Subregional Headquarters of ECLAC for the Caribbean to provide further assistance to the region in fulfilling the Programme of Action was reiterated. Ms. Suazo stressed the importance of the integrated approach of population and development that was fundamental to the ICPD POA. She gave an overview of the developments regarding ICPD in the Caribbean subregion touching on a wide variety of issues, such as, migration, human trafficking, adolescent fertility and early sexual initiation, the feminization of HIV, and the importance of family planning. The Honourable Jacqui Quinn Leandro emphasized the importance of the meeting for the region. She noted that because of the current global crisis, the region faced a critical economic time in the Caribbean. She gave examples of the impact it has had and would have on Antigua and Barbuda. She stressed that the crisis should not have costs in terms of the ICPD agenda and pointed to the need for continued commitment to the implementation of the ICPD in the next five years and beyond. The feature address was delivered by Dr. Jaqueline Sharp, President, IPPF, who reiterated the value of the ICPD POA and observed its relevance as the roadmap for population and development. She stated that the Millennium Development Goals would not be achieved if the ICPD POA was not implemented. She referred to the problem in the Caribbean subregion of early sexual initiation, limited use of contraceptives, and the linkages between poverty, reproductive health, early pregnancy, and gender inequality, which made sex and reproductive health education crucial. Among the points she identified that needed to be addressed were the provision of access to sexual and reproductive health services for adolescents, reinforcement efforts for voluntary family planning, revisiting the commitments made in providing services to youth and interventions to reduce the stigma towards persons living with HIV/AIDS. Agenda Item 2: Review of the Implementation of the Cairo Programme of Action in the
The Populations Affairs Officer of the ECLAC Caribbean Subregional Headquarters and the ECLAC Consultant presented a summary of the meeting’s background document. It was explained that due to the short preparation time and limited response from the countries of the region to requests for data and information, the input and comments of the meeting were important for completing the final document. The inter-relationship between population growth and other areas of development and the importance of the ICPD in acknowledging that integrated model was stressed. Participants were reminded that signing on to ICPD POA meant a commitment by governments which carried certain responsibilities to their populations. The context in relation to population, the economy and social development was sketched. The progress in achieving economic and human development in the Caribbean region was acknowledged as well as the many programmes and policies that had been put in place in relation to the ICPD POA. It was shown that the Caribbean subregion was in the unique situation of facing favourable dependency ratios and that it was important to take measures to reap the demographic dividend before further ageing led to a less favourable situation. More detailed attention was given to migration, ageing and older persons and to emerging issues. This latter issue of public debt and the financial crisis was presented as a major threat to the ICPD Plan of Action. It was further explained that reproductive health care did not only refer to family planning. The overburdened emergency obstetric care facilities and addressing the reproductive health needs
The meeting recognized the challenges that existed in the region with the availability of timely, reliable data as noted in the draft report. Particular attention was drawn to some of the statistics in the report which were deemed as dated and, in some cases, questionable. Several participants expressed concern about the comparability of the poverty rates featured in the presentation. As mentioned in the presentation and explained in the report, these were not comparable. With respect to the preparation of the ICPD report, the ECLAC representative explained that country inputs were solicited through a questionnaire. The responses from the National Statistical Offices (NSOs) were not forthcoming, therefore, the statistics and tables featured in the report were, in some cases, the same as those used in previous ICPD reports. Recognizing the value of the report as a medium for reflecting Caribbean realities, an appeal was made to all countries and agencies to supply the ECLAC Caribbean office with updated tables and other data, which would be used to update and revise the draft report. A deadline of 4 September 2009 was set for countries to make their submissions. Agenda Item 3: Country Briefs
Country representatives presented short briefs which covered the status of implementation of the ICPD POA and challenges encountered in their respective countries. Country briefs were prepared by the following countries: Antigua and Barbuda, Aruba, Bahamas, Belize, Dominica, Grenada, Jamaica, the Netherlands Antilles, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, and Trinidad and Tobago. Besides basic statistics of indicators related to ICPD, national policies and programmes that were supportive to the ICPD Plan of Action were presented. Achievements were made in the
reduction of poverty, the decline in fertility, in the reduction of mother to child transmission, the
presentations reserved ample space for the constraints that were encountered and the challenges that
The ensuing discussions concentrated on the challenges facing countries and their causes. The issues of ageing permeated the discussion. Given the implications of this phenomenon on the economic and social structures, a call was made for the introduction of public policies that would address demographic ageing. On the issue of disability an appeal was made to the meeting to ensure that the necessary mechanisms were in place to deliver services to that group, especially if they were expected to make some contribution to their societies. Countries were urged to ratify and accede to the United Nations Convention for persons living with disabilities. A significant part of the discussion was centred on the high rate of teenage pregnancies, which continued to be a major social issue for all countries in the region. Recognizing the myriad of issues related to often single, adolescent mothers and their impact on the teens and communities as a whole, several calls were made for the development of a constructive and holistic approach to tackling those issues. Appeals were made for the development of policies and interventions that protected the youths. The proposed interventions included a re-examination of the way that sex education was handled in secondary schools, including a review of the teaching of Health and Family Life Education (HFLE), and information transfer to teenage students and the formulation of strategies that would encourage teenagers to delay their sexual debut. Results from a study in the Netherlands Antilles showed a correlation between compulsory education and declines in teenage pregnancy. On those grounds, the role of institutions of socialization, such as the school, was underscored. Adjustments to the civil code were proposed, for example, putting the burden of disproving of fatherhood by the man. Saint Kitts and Nevis, with support from the United Nations Children’s Fund (UNICEF), was in the process of implementing social programmes to help support teenagers. The meeting highlighted the issue of education and the underperformance of males and stressed that the quality of education needed to be addressed since universal education had been achieved. Other issues such as the inter-linkage between education, the labour market, high crime and gang culture and the high level of migration and resulting brain drain should also be considered. The meeting appealed for the use of data from the region to formulate better policies that would benefit underperforming males. Peer pressure, degenerative text in music, class size (large classes), frequency of meetings between teachers and parents, predominance of female teachers in schools were other factors that did not favour better performance of boys. The need to improve communication and cooperation among and within ministries was discussed. A call was further made to standardize and improve the quality of data and, more specifically that of metadata, in the region. Reference was made of the work which was being done in the region on the construction of a manual for the standardization of definitions and methodology for vital statistics. The discussions resulted in the following recommendations: Given the global population dynamic, urgent steps should be taken to address the social, economic and other implications of increases in the ageing population; Efforts should be made to deliver services and provide information to persons with There was a need for the formulation of policies and measures that addressed the There was a need to place greater emphasis on the quality, availability and accessibility of data, and to move towards the standardization of data in the region. Agenda Item 4: Population and Development in the Caribbean
The Economic Development Officer of the Subregional Headquarters of ECLAC for the Caribbean made a presentation on the global economic crisis and the economic implications for the Caribbean. He described the root of the crisis in the United States and the serious situation in which the highly indebted countries of the Caribbean subregion found themselves, as a consequence. He showed that a fall in tourism, remittances, investments and recession or possible contraction of GDP had been measured or could be expected and the prospects were alarming because of the large public debts, fiscal and current account deficits. Countries were warned of a possible currency crisis that some countries in the region were already facing and governments were urged to redouble their efforts to improve transparency, speed and efficiency in public spending. He further offered to undertake a study on the efficiency of public spending in the Caribbean. The second presentation was provided by the representative of Antigua and Barbuda, who stressed the importance of a balanced integrated development process. She touched on the issue of the new lifestyle-related, non-communicable diseases and the need for a national food and nutrition policy. The increases in crime and drug abuse were presented as new threats and she called for better collaboration and cooperation within and among ministries, a more efficient and effective government, engagement of the private sector and civil society, the formation of a National Task Force and the need for monitoring, evaluation, and strengthening of the national data gathering machinery. In the third presentation, the representative of the Caribbean Community (CARICOM) Secretariat discussed migration in the Caribbean in relation to population and development. He highlighted the diverse and sensitive situation in the subregion regarding migration, and the necessity of migration for both migrants as well as receiving countries. He mentioned the difficulties in measuring migration because of a lack of data and the supportive measures taken by CARICOM and governments concerning social security, rights and protocols. The representative of HelpAge International concentrated on population ageing in the Caribbean. The critical issues affecting older people in the Caribbean, such as chronic poverty, lack
pointed to the contributions of older persons as resources for family stability, assistance to (grand)
Participants indicated overwhelming support for the proposal made by the ECLAC representative for the conduct of a study on “Efficiency of public spending in the Caribbean”. Suggestions were made for the assessment of some dimensions such as gender, and in relation to that issue, the representative of the Caribbean Policy Development Centre (CPDC) called for the participation of civil society groups and networks at national and regional levels. On the issue of migration, the meeting highlighted the following: (a) in Antigua and Barbuda high risks were more prevalent among migrant women which might be based on poor access to support; (b) a study conducted in Aruba revealed that a significant share of children of (Spanish-speaking) migrants did not attend school; (c) a clinic record system should be introduced in the region, considering the mobility of the population; (d) a study should be carried out on the effect of migration on ageing as young persons moved out and retired persons migrated back; and (e) address the situation of deportees who often received very little or no support which might lead them back to crime. The attention of the meeting was drawn to a missing dimension in the approach to dealing with crime and violence, citing that the ageing population was one of the most vulnerable groups. In that regard, an appeal was` made for assessing the impact on older persons as they did not have an opportunity to be relocated if their neighbourhood environment changed. The poor housing conditions of older people were highlighted as an issue that needed attention. A recommendation was made for the creation of a partnership between CARICOM and HelpAge International to establish a policy that would address the standards of institutions for older persons. The introduction of a universal pension scheme that would provide social protection and benefit the growing ageing population was debated. The need for adequate social pensions was stressed. In this regard, it was stated that women were especially vulnerable as they worked in the informal sector and therefore had limited access to other pension systems. It was noted, however, that a non-contributory system was not an incentive to saving. The availability of comparable datasets was discussed. The meeting pointed to the CARICOM initiative for harmonization in the Caribbean; issues of metadata; collection of data; and the status of implementation. It was felt that data could help spur political will which was invaluable for policy formulation. Agenda Item 5: Reproductive Health, Rights and Gender in the Caribbean
The first presentation was on Reproductive Health and Rights. The presenter identified the following key issues: the availability and accessibility of reproductive health education and services, sexual and reproductive rights and health of young people, maternal mortality, HIV/AIDS, and ageing. She gave many examples of achievements in the region. Among the challenges she identified were: the need to standardize and improve data, persistent high maternal mortality and unsafe abortion, early sexual initiation and high teenage pregnancy, level and quality of care, reproductive health for males, information and rights of disabled persons, integration of HIV/AIDS into reproductive health programmes, need for more research and standardized studies especially regarding Most At-Risk Populations (MARPS) (such as men who have sex with men (MSM) and sex workers). She said that the establishment of a stigma unit by the Pan Caribbean Partnership against HIV AIDS (PANCAP) was a positive development to address homophobic attitudes. The representative of the Caribbean Family Planning Affiliation (CFPA) made a presentation focusing on family planning. He stated that numbers were useful but that it was necessary to go beyond them. Poverty and inequality were linked to high maternal mortality, low contraceptive prevalence, high adolescent fertility and an increasing number of females living with HIV, leading to greater poverty for women. He explained how poverty increased the role of power in defining social/sexual relationships. Considering the low fertility, unmet needs might be overstated but adolescents still need better and unrestricted access. As most births to adolescents were unplanned, education was needed but also change of culture, for example, towards buying condoms and a change in the treatment of girls towards sex activity. The third presentation on gender in relation to the ICPD was delivered by the representative of the University of the West Indies (UWI). She said that education was the best way to empower women but it was not a ‘silver bullet’ to ensure equal income and participation at higher levels. The high level of teenage pregnancies, domestic violence, sexual harassment, trafficking of women, discrimination at work, irresponsible behaviour of boys and men to partners, families and households were some of the main challenges presented. She also paid ample attention to male underperformance and related issues, such as, too many female teachers, absentee fathers, and a curriculum and teaching method that was not relevant for boys. School and homes were violent spaces and it was necessary to eliminate that culture. Macho-type behaviour was often a shield for socio-economic failure. She called for a paradigm shift from responding only to victims to addressing the root causes and stated that the gathering, processing and dissemination of information was important. The representative of the Caribbean Coalition of National AIDS Programme Coordinators (CCNAPC) covered the issue of HIV and AIDS. She described the role of CCNAPC and enlightened participants about the AIDS epidemic in the Caribbean. Although more men were infected, at age 15-24, three to six times as many girls got infected (there might be a bias as more women were tested). Prevention among high-risk groups such as the imprisoned, homosexuals and sex workers was important. She elaborated on risk factors such as a sub-culture of hidden bisexual behaviours caused by legal and cultural barriers; and stigmatization and discrimination which led to evading testing and treatment. Caribbean gender roles contributed to the spread of HIV, for example, girls who wanted a ‘man’ and not a ‘boy’; social forces such as peer pressure from males which influenced their behaviour. In closing, she pointed to the risk involved in early age sexual activity. Discussion and comments
The Caribbean-specific Millennium Development Goals were mentioned as an example of focusing on gender issues. With regard to the increase in HIV/AIDS cases in the region, the meeting was reminded that there were a number of “imported cases”. Therefore, the lack of a means of tracking HIV/AIDS cases and the movement of those persons in the region might lead to double counting of cases. Participants stated that consideration should be given to the impact of religion on family planning. They also noted the rise in the number of HIV/AIDS cases among older persons because sexual activity, due to improved health and drugs such as Viagra, was extended and, in particular, its impact on older women. While the situation of resistance from the church on the issues of family planning and condom use still existed, the situation on the ground did not show the existence of any resistance to the use of family planning; a divide existed between what was advocated by the Church and the practices of the population. The need for closer examination of the situation of young girls and their early sexual debut was reiterated. In many instances that was not by choice as there were many cases of forced early sexual debut. The situation should be examined through a child protection lens and strategies for dealing with the issue needed to be developed. Other issues, such as transactional sex and the situation of girls showing greater interest in dating older men, should receive some attention. The culture of violence and phenomena such as ‘Sugar Daddies’ and ‘Dons’ was again referred to as causes and issues to be tackled. A call was made for the development of strategies to benefit persons with disabilities and reflect their realities. The need for the dissemination of information in a format accessible to persons with disabilities was also underscored. Attention was drawn to the initiative undertaken in Jamaica to support persons with disabilities. Consideration should be given to the issue of human trafficking in the region. In that regard, the meeting welcomed the research which was being conducted in Barbados, Guyana and Trinidad and Tobago by the International Organization for Migration (IOM). The study was a source of information on trafficking of women and it called for a closer examination of the migration situation on the region. It was observed that as the region was already at replacement level, the situation with net migration compounded the situation. Consideration should be given to the implication of those trends on public policy, migration policy and the labour policies. Agenda Item 6: Vulnerable Groups in the Caribbean
The representative of Trinidad and Tobago made a presentation on the situation of older persons in the Caribbean. After a brief introduction on ageing and its impact in the Caribbean, she outlined the challenges of older persons and development. She mentioned challenges, such as, intergenerational links, older persons as mentors, elderly abuse, income security, gender inequality in built-up pension rights and the role of caretaking (children and parents) in female labour participation. She touched on opportunities such as the elderly as mentors, pension for the informal sector, and budget allocation. She discussed the health and well-being of the elderly, the impact of non-communicable diseases and demand for long-term care, training on ageing for the health sector, accessible and affordable healthcare and medication, healthy lifestyles, and increased HIV/AIDS. In closed she discussed discrimination and elder abuse, the elderly and disasters, quality and affordability of accommodation, and the need for elderly friendly infrastructures. The representative of Barbados made a presentation on the disabled as a vulnerable group. From personal experience, she shared facts about persons with disability (PWD) and the notion that the number of PDW would increase with ageing, extended life, and the increase of violent crimes, accidents and unhealthy life styles. She said that data availability was limited and countries did not respond. She noted that, unfortunately, the Caribbean was behind in the world and that despite many calls for action there were still many problems for PWD. Disability was not ‘sexy’ and was often met with discomfort and there was no visibility for PWD. In the Caribbean, there was no legislation (except for Saint Vincent and the Grenadines), and only one country (Jamaica) had ratified the Convention on Disability. The Caribbean had modified the Millennium Development Goals but disability had been omitted. The lack of enrolment in schools of disabled children was another example given by her. The only way forward was to involve PWD: “Nothing about us without us” she gave as the mantra. The representative of, the Caribbean Regional Network of People Living with HIV/AIDS (CRN+) made a presentation on persons living with HIV/AIDS (PLWHA). She exemplified the problems faced by PLWHA such as stigmatization, social exclusion, ignorance and confidentiality breaches. Next she explained that the CRN+ was the only regional network of scope in the Caribbean which sought to empower, enhance and improve the quality of life of PLWHA and facilitated support groups. She identified the following challenges: access to care treatment and support, continued stigma and discrimination, involvement of PLWHA, the criminalization of HIV, limited access resources and the absence of legislation to protect PLWHA against human rights violations, such as denying of employment and breaching of confidentiality by health workers. This led to PLWHA not accessing care, treatment and support services for fear of disclosure. She further noted that vulnerable groups such as commercial sex workers (CSW), MSM, and migrants were under-served and that there was resistance of certain sectors to align themselves with PLWHA networks. The final presentation was made by the representative of Aruba on the position of migrants in the Caribbean. He gave an overview of migration and migrants by providing various statistics on
another country; the intention to stay, requesting and granting of naturalizations, and the question of
The representative of the Caribbean Centre for the Blind (CCB) recognized the contribution of the representative of Barbados and apprised the meeting of her re-election to the post of General Secretary of the CCB and her being awarded the James Alves award for her achievements. He said that the issue of blindness should receive greater focus especially in the broader context of the ageing, since as persons aged they became more susceptible to eye diseases and blindness. Against that backdrop, a call was made for the Plan of Action to take due cognizance of that reality. It was pointed out that while vulnerable groups continued to be marginalized they were in fact the best yardsticks for measuring progress. The omission of issues such as sexual orientation was not only important in relation to the prevention of HIV/AIDS, but also in relation to human rights. The Lesbian Gay Bisexual and Transgender (LGBT) community was marginalized in the region, including in the background report of the meeting. Likewise, legislation in the region failed to account for sex workers, persons who were trafficked and a person’s sexual orientation. Neither were they accounted for in the discussions on gender. It was advised that it was critical to include those vulnerable groups in the discussions as failure to do so might send a skewed message. It was also felt that the issue of drug use was omitted from the report and was not included in discussions in the meeting. On the issue of the universal pension fund, representatives recommended the region to invest more energy into preparing persons for retirement through public education and the value of retirement plans. Item 7: Discussion of meeting's outcome
The representatives of ECLAC and UNFPA presented the conclusions and way forward. It was agreed that participants would send their comments before 4 September 2009 and the conclusions would subsequently be taken to and presented at the upcoming regional ICPD-meeting in Santiago, Chile. The conclusions of the meeting appear as annex III of the report. Item 8: Closing Statements
The Director of the UNFPA Latin America and Caribbean Regional Office reiterated the importance of ICPD in population and development in the region. She thanked the Government of Antigua and Barbuda for hosting the meeting, and expressed her gratitude to ECLAC for its role in organizing the meeting. She commended the participants for interesting, fruitful, and stimulating presentations and discussions. In closing, the representative of Antigua and Barbuda congratulated participants and organizers for a very successful meeting and made a Call for Urgent Action: “For further implementation of the ICPD Programme of Action, it is urgent that the Governments in the Caribbean sub region take stock of the challenges and priorities here There is a need for a five year sub regional strategy so that governments working together and in collaboration with civil society organizations, Parliaments and UN agencies, can reach the targets of ICPD and the MDGs, with the establishment of clear priorities and results, benchmarks and mechanisms of implementation and monitoring. In this sense, Antigua and Barbuda would like to take forward this proposal and request and Urgent Call for Action for the Caribbean sub region towards 2014 and beyond.” PROGRAMME
J. Yolanda Goodwin, Director, Economic Policy and Planning, Ministry of Finance, the Economy and Public
Administration, 3rd Floor, ACT Building, Church and Market Streets, St John’s. Tel: (268) 462-5935; Fax:
Statchel Edwards, Chief Statistician (Ag.), Statistics Division, ACT Building, Market and Church Streets,
Tracelyn Joseph, Statistician, Social Demographic and Environment, Church Street, St. John’s. Tel: (268)
Cleon Athill, Director of Youth Affairs, Ministry of Education, Youth Affairs, Gender and Sports, Queen
Oritta Zachariah, Medical Officer of Health, Medical Division, Ministry of Health. Tel: (268) 764-3722;
Maria Regina Kelley, Assistant Director, - Health Social Services, Department of Social Services, P.O. Box
Senator Kerryann Ifill, Deputy President of the Senate, Parliament Buildings, Bridgetown, St. Michael. Tel:
Justina Charles, Senior Community Health Nurse (Ag.), Ministry of Health, Primary Health Care Department,
The Honourable Glynis C.B. Roberts, Minister for Tourism, Fourth Floor, Ministerial Complex, Botanical
Hon. Keith Mondesir, Minister of Health, 2nd Floor, Sir Stanislaus James Blvd., Waterfront, Castries. Tel:
Corneil Williams, Social Statistician, Ministry of Sustainable Development, Wellington Road, P.O. Box 186,
Jennifer Rouse, Director, Division of Ageing, Ministry of Social Development, 78 Independence Square, Port
Minister Omayra Victoria Elisabeth Leeflang, Minister of Education, Health and Social Welfare, La Bonanza-
Netherlands, 69-71 Edward Street, TRINRE-Building, 3rd floor, Port of Spain, Trinidad and Tobago. Tel:
Isiuwa Iyahen, Assistant Representative, UN House, Marine Gardens, Hastings, Christ Church, Barbados.
Erica Goldson, Assistant Representative, United Nations Population Fund, 1 Coney Drive, Gordon House,
As part of the activities to commemorate the fifteenth anniversary of ICPD, ECLAC in collaboration with UNFPA, organized a Subregional Expert Meeting to assess the implementation of the Programme of Action of the International Conference on Population and Development (ICPD) held in Antigua and Barbuda, 20-21 August 2009. This meeting involved the participation of government representatives of 15 Caribbean countries and a number of NGOs and experts in the areas of population and development, sexual and
In the English- and Dutch-speaking Caribbean subregion, population growth has effectively declined and fertility rates are now around replacement levels while life expectancy is relatively high. The interaction between population and development has led to the improvement of the lives of millions in the Caribbean subregion. With the majority of the countries being classified as high-income economies and nearly all of the rest as middle income, the region is one of the more developed in the world. Abject poverty is not a widespread phenomenon in the Caribbean, however, pockets of poverty still exist. Current accurate data on poverty in the region are not readily available or accessible and where data are available, it is not comparable between countries due to the fact that the method of measuring poverty data is not unambiguous. In spite of being middle and high income countries, Caribbean countries are highly vulnerable due to huge debt burdens and high exposure to natural hazards, limited natural resources, limited economic diversification and challenges with institutional capacities. These and other factors keep the Caribbean vulnerable to poverty unless measures are put in place to enhance resilience in these areas. Most countries in the region are still in a particularly favourable period for development in which the working-age population increases relative to the population of economically dependent ages. However, the benefits of this situation are not automatic; we need to continue to invest in youth development. Soon, this equation will be reversed as the share of older persons steadily increases, and the Caribbean society will have to face the challenges related to population ageing. Current trends and the negative effects of the global financial and economic crisis, may present countries with additional challenges of achieving the agreed goals and commitments of the
The English and Dutch Speaking Caribbean countries have made significant progress in achieving economic and human development. Most governments have put in place programmes and policies on social protection to address the needs of the most vulnerable populations, such as children and youth, women, the elderly, indigenous peoples, persons with disabilities, people living with HIV and their families. However, the sustainability of such programmes could be jeopardized as a result of the global financial crisis. In the area of population and development, many countries in the region have made efforts to integrate population issues in planning and development frameworks and strategies. Concerning the issue of migration, several countries have taken steps to include this issue in development planning and have made efforts toward the formulation of migration policies to manage its impact. Intra-regional migration measures are being taken to address and manage this issue, particularly as it relates to movement of skilled labour in the region. In the Caribbean, there is a general acknowledgment of the importance of addressing the challenges posed by an increasingly ageing population. All governments have developed programmes and interventions for social protection of older persons. In regards to data, efforts have been made to increase the capacity for the collection and analysis of high quality data, particularly population and housing census data, through training, capacity-building and south-south cooperation. Another area that has seen advancement is the harmonization and standardization of definitions and methodologies concerning census data within the context of the 2010 Round of Census. Most countries in the region have met or surpassed the targets for universal primary education and have introduced with the support of the CARICOM HFLE curriculum at most educational levels including out-of-school youth. In the Caribbean, family planning services are highly developed. Emergency contraception is provided by all family planning associations in the Caribbean region. In the area of HIV and AIDS, national efforts to scale-up HIV prevention are being undertaken and access to antiretroviral drugs is widely available in all countries at limited or no cost. Advancements have been made in reducing mother to child transmission of HIV and the use of male and female condoms have increased. Gender machineries have also been put in place in nearly all countries in the region. In all Caribbean countries there are criminal sanctions for sexual offences and rape, indecent assault,
measures for cases of assault and gender-based violence, including speedy actions to injunctions and
Although short-term policy measures are needed to deal with the international economic crisis, governments should avoid reducing social expenditures and not lose sight of the long-term vision for development planning. In this context, it is critical to maintain and reinforce political commitment to the goals of ICPD, as well as to provide adequate financial support to maintain required levels of implementation. Most Caribbean countries can still reap the benefits of the demographic dividend to properly prepare for the challenges of investing in youth and responding to the needs of an ageing society. Addressing unemployment among youth, extending the coverage and quality of secondary and tertiary education and promoting youth participation in country-led processes are key needs to be addressed. There is a trend of underachievement of boys in the education sector that is of concern to countries. Related to this is the role of men as parents and role models in public and private spheres Countries also face the challenge of providing adequate social provisions for older persons in the context of enhanced demand for long-term care, particularly for poor women. This will require the strengthening of intergenerational solidarity mechanisms. It is important that Caribbean governments follow the recommendations of the Brasilia Declaration, including the development of an International Convention for the Protection of the Rights of Older Persons. A significant part of the population in the Caribbean is living with disabilities. The physical infrastructure is far behind levels necessary to guarantee equal participation in all aspects of social, economic and cultural life. Increased investments are needed in order to create conditions that permit self-reliance and dignity for persons with disability. The Caribbean population is among the most mobile in the world and the issue of the brain drain in the areas of health and education is one of the main challenges. Efforts should be made to create opportunities to encourage skilled workers, particularly among the youth to remain in the region. If not properly addressed, the brain drain of skilled health workers could undermine the attainment of the health-related Millennium Development Goals. The human rights of undocumented migrants are also an area of concern as is the capacity of some receiving countries to properly plan and to provide adequate social protection to this group. Caribbean countries are encouraged to ratify the Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families. Although progress has been made in implementing measures against international trafficking for the purposes of sexual exploitation and forced domestic servitude, much more efforts are needed. In recognition of the new Millennium Development Goals target to achieve universal access to Sexual and Reproductive Health (SRH) services by 2015, Caribbean countries should seek to promote the linkages between reproductive health and HIV services and programmes and make them available to the most vulnerable populations. This will increase the overall effectiveness and quality of culturally-sensitive services in meeting the sexual and reproductive needs of the population, including those of persons with disabilities, devoid of stigma and discrimination. In the last two decades, improvements in reducing maternal mortality and, in some countries, infant and child mortality have stagnated. It is recognized that there is a need to better understand the factors behind this situation. This should include an assessment of the improvement of the quality of antenatal and emergency obstetric care in hospitals. An increased access to reproductive health services for rural, hinterland and other marginalized populations through rights-based and culturally sensitive approaches should be prioritized. The Caribbean has the largest generation of adolescents ever in history. Recognizing this, the region should prepare to meet the SRH needs of this group. There continues to be a disconnect between the age of marriage and the age of consent in many countries which inhibits access to SRH services and commodities by young people. There is a general recognition that young people are engaged in sexual activity at an early age and there is need to protect them against early unplanned pregnancy and HIV infection. This should be addressed in the context of social protection and young people’s access to education, employment and participation. In this context, adolescent and teenage pregnancy remains a critical challenge in the region. The socio-economic impact of the high level of adolescent motherhood contributes to the intergenerational transmission of poverty. Adolescent fertility also impacts the opportunities of girls and women to advance in the education and employment sectors. To tackle this issue, a series of measures should be considered: understanding the cultural determinants of sexual initiation and early motherhood; encouraging the full implementation of comprehensive sexuality education (HFLE) in schools; promoting access to SRH information, counselling, services; including commodities for sexually active adolescents and youth; and preventing all forms of pressure and sexual abuse and exploitation. Despite the advancements made in HIV and AIDS, some key challenges still exist: HIV prevention programmes are still not always reaching vulnerable groups with HIV education, Behavioural Change Communication (BCC), testing and counselling and post-exposure prophylaxis, and the linkage of HIV programmes with SRH services, is still not mainstreamed in several countries. Stigma and discrimination remains widespread and impacts the access to follow-up prevention, treatment, care and support services for People Living with HIV and AIDS (PLHIV) and the recognition of the rights of PLHIV to access SRH services. Gender inequalities manifest themselves in terms of feminization of poverty, vulnerability to HIV and AIDS, and gender-based violence. In the area of gender equality, most countries have enacted legislation and ratified key international conventions. Despite this, underresourcing of gender equality programmes is a significant problem. Women continue to be underrepresented in governance and political structures at decision-making levels across the Caribbean. The recent launch of the Caribbean Institute for Women in Leadership (CIWIL) will hopefully address this challenge. Political and financial support should be provided to this initiative. Sexual assault rates remain high and while legal frameworks exist to respond to these violations, challenges remain in the enforcement of legislation. The burden of family care is highly feminized as women remain the primary caretakers of children and other dependants, including the elderly. Single women-headed households account for approximately half of all households in many parts of the Caribbean. Most of these households are more vulnerable to poverty than other households. Ensuring the consistent availability of data is a challenge faced by countries in the region. Statistics related to migration and disability are even largely absent. This has a direct impact on evidenced-based planning and development efforts. In order to adequately address the socio- economic and socio-demographic challenges stated above, it is very important to have accurate and timely data of good quality with proper metadata available. This is important in order to not only understand the magnitude and dynamics of the variable but also to have appropriate evidence-based, decision-making processes, including for the development of policies and programmes to improve the quality of the life for all. In this regard, there is a need to produce timely and good quality census results, avoiding the situation faced during the previous census round. Likewise, improving existing registers and their use is important. Increasing the analytical capacities and strengthening the coordination and communication between the various ministries, government agencies and the civil society is essential in this process. It should be recognized that the full implementation of the Programme of Action of the ICPD and the key actions for its further implementation are integrally linked to global efforts to eradicate poverty and to achieve sustainable development. Population dynamics are thus important factors in development and in our efforts to achieve the internationally agreed development goals, including the Millennium Development Goals, as these goals are mutually reinforcing. Therefore increasing financial efforts to implement the ICPD Programme of Action should be considered as a key contribution to the life and the human rights of the people, as well a smart investment with high economic and social returns. The way forward: towards 2014 and beyond
The serious impact of the economic and financial crisis together with the five-year countdown to 2014 present the need for an Urgent Call for Action if the goals of the ICPD Programme of Action and the Millennium Development Goals are to be met. More than ever, the Goals will not be achieved unless more progress is made to guarantee universal access to reproductive health by 2015. In this light, consolidation of achievements is imperative. Too much is at stake for the Caribbean people to allow gains to be lost. Also, the critical human rights and development challenges that governments have together identified during these two days of deliberation call for the prioritization of actions with the establishment of clear results and with identifiable targets. The Caribbean subregion is in a singular position to call for the definition of a five-year strategy with country-led and sub regional mechanisms for assessing progress and correcting actions. A strong partnership of governments, parliamentarians, civil society organizations should jointly with development agencies, join efforts to achieve further progress in the period ahead. Prioritization in key challenges identified in this meeting is a must. The identification of lessons learned and best practices can spearhead knowledge sharing initiatives through south-south collaboration among countries and other knowledge sharing practices can be put in motion. Given the fact that the priorities here identified will be relevant in the decades to come, Governments in the subregion should ratify their commitment to carry the ICPD agenda forward, beyond 2014. A process of reflection will concomitantly need to take place in order to prepare the follow up agenda of ICPD for the Caribbean people. The UNFPA Subregional Office of the English- and Dutch-speaking Caribbean, with the assistance of the Caribbean Subregional Headquarters of ECLAC, stands ready to use all its resources, human/technical and financial to give support to Governments and civil society in support of this endeavour.