Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Public Disclosure Authorized Report No. 40047 - GLB Realizing Rights through Social Guarantees An Analysis of New Approaches to Social Policy in Latin America and South Africa The World Bank Group Social Development Department February 2008 ©2007 The International Bank for Reconstruction and Development / The World Bank 1818 H Street NW Washington DC 20433 Telephone: 202-473-1000 Internet: www.worldbank.org E-mail: [email protected] All rights reserved This volume is a product of the staff of the International Bank for Reconstruction and Development/ The World Bank. The findings, interpretations, and conclusions expressed in this paper do not necessarily reflect the views of the Executive Directors of The World Bank or the governments they represent. The World Bank does not guarantee the accuracy of the data included in this work. 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All other queries on rights and licenses, including subsidiary rights, should be addressed to the Office of the Publisher, The World Bank, 1818 H Street NW, Washington, DC 20433, USA, fax 202-522-2422, e-mail [email protected]. Preface This study seeks to contribute to the consideration of social guarantees as tools for social policy design and service delivery that can advance the protection and fulfillment of social and economic rights. It suggests ways to develop and explore a range of policy options that improve the delivery of social services from a rights perspective, while furthering social inclusion and democratic governance. The application of a social guarantee framework could significantly change the way in which social policies are implemented in Latin America, and can have a direct and positive impact on poor and vulnerable groups. Social guarantees are sets of legal or administrative mechanisms that determine specific entitlements and obligations, related to certain rights, and ensure the fulfillment of those obligations on the part of the state. The social guarantees approach, researched extensively by the Chilean Foundation for Overcoming Poverty (FUNASUPO) and pioneered in the Chilean health system, moves beyond a purely normative framework to give concrete meaning to economic and social rights by integrating a rights-based perspective into social policy. This study investigates the social guarantee approach not as a template to replicate in programs across countries, but rather as a framework for evaluating, monitoring, and suggesting improvements in social policy in any country context. It highlights the importance of understanding and building upon the existing socio-political context of each country. To illustrate the applicability of this approach in diverse country contexts, the study draws on four case studies from Latin America and on the case of South Africa, in order to analyze how the concept of social guarantees can be made operational to improve lives, particularly of the poor. The study was initiated at the request of the Organization of American States (OAS), and aims to serve as an input to the OAS Meeting of Ministers and High-level Authorities in Social Development in May 2008. A draft was circulated at the Second Meeting of the Inter-American Committee on Social Development in Washington DC on October 23, 2007. More broadly, this work hopes to support cross-regional learning and contribute to the policy dialogue among international development agencies and government counterparts regarding rights-based approaches to social policy and service delivery. The governments of Chile and South Africa have already initiated dialogue and exchange of practices on their distinct approaches to protecting social and economic rights. i Acknowledgements This report was prepared by a team led by Andrew Norton and Estanislao Gacitúa Marió and consisting of Flávia Carbonari, Sophia Georgieva, Lisandro Martín, Rachel Nadelman, Yoshinori Suzuki, and Nazumi Takeda from the World Bank. The report was prepared in collaboration with staff from the Chilean Foundation for Overcoming Poverty (FUNASUPO), Leonardo Moreno and Mauricio Rosenbluth, with inputs from the Organization of American States (Francisco Pilotti and Rosana Martinelli), the Inter-American Development Bank (Jacqueline Mazza and Claudio Santibañez); and the United Nations Economic Commission for Latin America and the Caribbean (Carmen Artigas, Gabriela Salgado and Ana Sojo). Background country reports, which have been drawn upon extensively for this report, were prepared by Leonardo Moreno, Mauricio Rosenbluth, Enrique Raajevic, and Rene Cortinez (Chile); Thelma Gómez and Tomás Rosada (Guatemala); Enrique Vasquez (Peru); Fernando Filgueira and Sergio Lijtenstein (Uruguay); and Sibonile Khoza (South Africa). The team is grateful to Deborah Davis for her insightful edits to the report and to Danielle Christophe for her assistance with its publication. Peer reviewers were Reidar Kvam (Regional Safeguards Adviser, World Bank’s Development Effectiveness Unit, Latin American and Caribbean Region); Varun Gauri (Senior Economist, World Bank’s Development Economics Research Group), and Caroline Moser (Brookings Institution). Preliminary findings of the report were presented and discussed during a conference held at ECLAC Headquarters in Santiago, Chile, between April 2nd and 4th, 2007, with representatives from the Chilean Ministry of Planning (MIDEPLAN), Organization of American States (OAS), IADB, ECLAC, UK’s Department for International Development (DFID), United Nations Children’s Fund (UNICEF), United Nations Office of the High Commissioner for Human Rights (OHCHR), Universidad Alberto Hurtado de Chile, Universidad del Pacífico del Peru, Universidad Católica del Uruguay, Universidad Católica Boliviana, Universidad Rafael Landivar de Guatemala, Facultad Latino Americana de Ciencias Sociales (FLACSO), FUNASUPO, and civil society organizations. ii ABBREVIATIONS AND ACRONYMS ANEP National Administration for Public Education (Uruguay) APAFA Parent Association (Peru) APCI Agency of International Cooperation (Peru) ASSE State Health Service Administration (Uruguay) AUGE Acceso Universal con Garantías Explícitas (Chile) AVISA Años de Vida Saludable Perdidos BPS Social Insurance Bank (Uruguay) CAS Country Assistance Strategy (World Bank) CDD Community-Driven Development CEIS Centros de Educacion Inicial(Peru) CEM Country Economic Memorandum (World Bank) CENACEP Community Pre-school Learning Centers (Guatemala) CENAN Centro Nacional de Alimentación y Nutrición (Peru) CES Board of Secondary Education (Uruguay) CETP Council for Technical-Professional Education (Uruguay) CGE Commission on Gender Equality (South Africa) CLC Community Law Center (South Africa) CMU Country Management Unit CODICEN Board of Central Directors (education sector, Uruguay) COEDUCA Committee on Education (Guatemala) CONASAN National Council for Food and Nutritional Security (Guatemala) CP Civil and Political (Rights) CSO Civil Society Organization DAC Development Assistance Committee DECRG Development Economics Research Group (World Bank) DFID Department for International Development (UK) DGA Democracy and Governance Assessment DHS District Health System (South Africa) DISSE Office for Social Security in Case of Illness (Uruguay) ECLAC Economic Commission for Latin America and the Caribbean (United Nations) ESC Economic, Social, and Cultural (Rights) ESSALUD Social Security in Health (Peru) ESW Economic and Sector Work FISSAL Intangible Solidarity Fund for Health (Peru) FLACSO Facultad Latino Americana de Ciencias Sociales FONADIS National Disability Fund (Chile) FONASA National Health Fund (Chile) FONDEP National Fund for Educational Development (Peru) FUNASUPO Fundación para la Superación de la Pobreza (Foundation for Overcoming Poverty, Chile) GDP Gross Domestic Product GOVNET Governance Network (DAC) IACHR Inter-American Commission on Human Rights IADB Inter-American Development Bank IAMC Institutions for Collective Medical Attention (Uruguay) IAMPP Institutions for Private Medical Attention (Uruguay) ICESCR International Covenant on Economic, Social and Cultural Rights IDASA Institute for Democracy in South Africa IGSS Guatemalan Institute for Social Security iii IIHR Inter-American Institute for Human Rights ILO International Labor Organization INICTEL National Institute for Investigation and Training in Telecommunications (Peru) INP National Institute for Provisional Normalization (Chile) ISAPRE Instituciones de Salud Provisional (Chile) IVS Disability, Seniority and Survival Program (Guatemala) JUNAEB National Association for Educational Support and Scholarships (Chile) JUNJI National Association