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Budget Analysis for Investments in Children in Saint Lucia

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Budget Analysis for Investments in Children in Saint Lucia Budget Analysis for Investments in Children in Saint Lucia BUDGET ANALYSIS FOR INVESTMENTS IN CHILDREN IN SAINT LUCIA Published by UNICEF Office for the Eastern Caribbean Area First Floor, UN House Marine Gardens, Hastings Christ Church Barbados Tel: (246) 467 6000 Fax: (246) 426 3812 Email: [email protected] Website: www.unicef.org/easterncaribbean This Study was commissioned by the UNICEF Office for the Eastern Caribbean Area and UN Women Multi-Country Office - Caribbean The contents do not necessarily reflect the policies or views of the organizations. Authors: Zina Nimeh, Arthur Van de Meerendonk, Franziska Gassmann, Jouke Wortelboer, Eli Stoykova and Daphne Francoise Nimeh, Z., Van de Meerendonk, A., Gassmann, F., Wortelboer, J. and Stoykova, E., Francoise, D. (2015). Budget Analysis for Investments in Children in Saint Lucia, UNICEF Office for the Eastern Caribbean Area. All rights reserved. 2015 Budget Analysis for Investments in Children in Saint Lucia CONTENTS Acknowledgments x Executive summary 2 1 Introduction 12 1.1 Structure of the report 13 1.2 Government actors 13 1.3 Data and methodology 13 1.4 Limitations 14 1.5 Process 14 2 Economic and Social Context 16 2.1 Economic and fiscal environment 16 2.2 Fiscal operations and management and the social budget 19 2.3 Demographic trends 21 2.4 Labour market 23 2.5 Poverty and child well-being 25 2.6 Conclusion 30 3 Education 32 3.1 Short overview of the education system in Saint. Lucia 32 3.2 Policies and planning 33 3.2.1 Laws and other basic regulations concerning education 33 3.2.2 Administration and management of the education system 33 3.3 Overview of programmes 33 3.3.1 Early childhood education (ECE) services 33 3.3.2 Primary school services 34 3.3.3 Secondary school services 36 3.4 The education budget 41 3.4.1 Education financing 41 3.4.2 Methodology and data 42 3.4.3 Budget analysis 44 3.4.4 Allocation per programme 47 3.4.5 Spending execution 48 3.5 Education benefit incidence analysis 49 3.6 Discussion 52 4 Social Protection 55 4.1 Introduction 55 4.2 Policies and planning 56 4.2.1 The National Strategic Framework (NSPP) 56 4.3 Overview of the programmes 56 4.3.1 Cash transfer programmes 57 4.3.2 Programmes that combine cash transfers and non-cash transfers 57 4.3.3 Active labour market programmes 59 4.3.4 Education support programmes (non-cash transfers) 62 ii 4.4 The social protection budget 64 4.4.1 Methodology and data 64 4.4.2 The budget of the Ministry of Social Transformation 66 4.4.3 Spending execution 69 4.4.4 The Saint Lucia Social Development Fund (SSDF) budget 70 4.4.5 Financial analysis of the social protection programmes 74 4.4.6 Key Performance Indicators 80 4.5 Assessment of social protection benefits 86 4.6 Discussion 90 5 Child Protection 93 5.1 Short overview of child protection issues in Saint Lucia 93 5.2 Overview of programmes 95 5.2.1 Child protection programmes – Ministry of Health 95 5.2.2 Child protection programmes – Ministry of Social Transformation, Local Government and Community Empowerment 97 5.2.3 Child protection programmes – Ministry of Home Affairs and National Security 97 5.2.4 The National Action Child Protection Committee 98 5.3 The child protection budget 98 5.4 Assessment of child protection initiatives 102 5.5 Discussion 105 6 Health Care 107 6.1 Overview of health conditions 107 6.2 Governance, policies and planning 109 6.3 Overview of programmes 110 6.3.1 Health services and professionals 110 6.3.2 Medicines 112 6.4 The health budget 113 6.4.1 Health care financing 113 6.4.2 Methodology and data 114 6.4.3 Budget analysis 116 6.4.4 Medical and administrative costs 122 6.4.5 Allocation per programme 122 6.4.6 Spending execution 124 6.5 Assessment of health benefits 125 6.6 Discussion 129 7 Concluding Remarks and Future Outlook 131 7.1 Highlights from the report 131 7.2 General recommendations 138 7.3 Future outlook 139 8 References 141 9 Annex 149 iii LIST OF FIGURES Figure 2-1: GOSL Public Debt (left) and Debt/GDP (right), 2003–2013 17 Figure 2-2: Population pyramid in 2001 and 2010 22 Figure 2-3: Distribution of population per area (per cent) 23 Figure 2-4: Distribution of individuals by wealth quintiles, different household size, as a percentage 26 Figure 2-5: Distribution of individuals by wealth quintiles, different number of children in the household, as a percentage 26 Figure 2-6: Distribution of individuals by wealth quintiles, households by different age of household head, as a percentage 27 Figure 2-7: Distribution of individuals by wealth quintiles, households by gender of household head, as a percentage 28 Figure 2-8: Distribution of children among wealth quintiles, as a percentage 28 Figure 3-1: Enrolment rates primary education 2000-201 (as a percentage) 35 Figure 3-2: Adjusted net primary enrolment rates in the Caribbean, 2010 (as a percentage) 35 Figure 3-3: Gender Parity Index for the adjusted net primary enrolment rate, 2011 36 Figure 3-4: Primary completion rate, 2010 (as a percentage) 36 Figure 3-5: Net enrolment rates secondary education in Saint Lucia, 2000-2012 39 Figure 3-6: Net enrolment rate secondary, all programmes, 2010 39 Figure 3-7: Public spending on education, 2010, (as a percentage of GDP) 42 Figure 3-8: Allocation of expenditure for the Central Administration, 2013/14 47 Figure 3-9: Allocation of expenditure in Primary Education, 2013/14 48 Figure 3-10: Allocation of expenditure in Secondary Education, 2013/14 48 Figure 3-11: Education expenditures by level of education, 2012/13 50 Figure 3-13: Distribution of students by gender, for each level of education 51 Figure 4-1: Overview of social protection programmes 57 Figure 4-2: Allocation of expenditure for social transformation, 2009/10 and 2013/14 69 Figure 4-3: Allocation of expenditure for local government, 2013/14 69 Figure 4-4: SSDF income, 2009-2014 71 Figure 4-5: Income, programme and administration expenditures SSDF, 2010-2014 73 Figure 4-6: Coverage rates of PAP and average wealth scores by region, 2013 87 Figure 4-7: Distribution of PAP beneficiaries by regions, 2013 88 Figure 5-1: Social protection and child protection programmes in Saint Lucia. 96 Figure 5-2: Charged children by gender 103 Figure 6-1: Birth, death and infant mortality ratios for Saint Lucia , 2001–2012 108 Figure 6-2: Fertility rates in the Caribbean, 2011 (in births per woman) 109 Figure 6-3: Life expectancy at birth, Caribbean Region, 1980 and 2011 (in years) 109 Figure 6-4: Condensed Budget MOH Economic Classification 2009-2014 119 Figure 6-5: Central Health Administration (recurrent only), 2007/08 and 2013/14 123 Figure 6-6: General Hospitals, 2013/14 123 Figure 6-7: Human Services, 2013/14 124 Figure 6-8: Total health expenditures (THE) in the Caribbean region, 2009-12 (average, as a percentage) 125 Figure 6-9: Government health expenditures in the Caribbean region, 2012 (as a percentage) 126 Figure 6-10: Government expenditure on health per capita at PPP (NCU per US$), 2012 126 Figure 6-11: Out-of-pocket expenditures in the ECCU (as a percentage), 2012 127 Figure 6-12: Out-of-pocket expenditure as a percentage of total health expenditure by poverty incidence, 2006 (percentage of people living on less than US$2 PPP per day) 127 BUDGET ANALYSIS FOR INVESTMENT IN CHILDREN IN SAINT LUCIA iv LIST OF TABLES Table 1-1: Overview of activities and outputs 15 Table 2-1: Selected economic and social indicators for Saint Lucia, 2008–2013 17 Table 2-2: The Budget Calendar of Saint Lucia 19 Table 2-3: Population structure (as a percentage) 21 Table 2-4: Dependency Ratios (per cent) of working age population 22 Table 2-5: Key Labour Market statistics (as a percentage) 23 Table 2-6: Unemployment rate by age group and sex, 2013 24 Table 2-7: Employed Population by Status of Employment and Sex (per cent), 2013 25 Table 2-8: Overall well-being rates, by age group, as a percentage of all children in the age group 30 Table 3-1: Monitoring Indicators Early Childhood Education (MOE) 2008/09-2012/13 34 Table 3-2: Key performance indicators primary education, Ministry of Education, 2008/09-2012/13 36 Table 3-3: Key performance indicators secondary education, Ministry of Education, 2008/09-2012/13 41 Table 3-4: Conversion Table MOE 43 Table 3-5: Condensed Budget MOE, Administrative classification, 2009-2014 44 Table 3-6: Recurrent, capital and total expenditure of MOE, 2009-2014 45 Table 3-7: Condensed Budget MOE Economic classification, 2009-2014 46 Table 3-8: Salary expenditures MOH, 2009-2014 46 Table 3-9: Expenditure per student, 2009-2014 47 Table 3-10: Deviation of expenditure from revised budget (recurrent), 2008/09-2011/12 49 Table 3-11: Expenditures per student for pre-school, primary, secondary and tertiary education, 2012/13 50 Table 3-12: Distribution of students by wealth quintiles, as a percentage of all students attending a particular level of education 51 Table 3-13: Total expenditures for schooling by education level and wealth quintile 51 Table 3-14: Total spending for education for boys and girls, MICS 52 Table 3-15: Total spending for education in urban and rural areas, MICS 52 Table 4-1: Number of cash transfer programmes’ beneficiaries 58 Table 4-2: Female share among cash transfer programmes’ beneficiaries 58 Table 4-3: Cash transfers and services’ beneficiaries share (15-65) age group 59 Table 4-4: Summary of ALMPs in Saint Lucia 60 Table 4-5: Number of reported ALMPs beneficiaries 61 Table 4-6: Female share among ALMPs beneficiaries 61 Table 4-7: ALMPs’ beneficiaries share (15-65) age group 62 Table 4-8: Summary of child related social protection
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