Project document Appraisal and Conclusions from the 1994-2009 Review of the Implementation of the Cairo Programme of Action in the Caribbean Economic Commission for Latin America and the Caribbean (ECLAC) The document was prepared under the direction of Neil Pierre, Director of the ECLAC Subregional Headquarters for the Caribbean. The coordination was done by Taeke Gjaltema, Population Affairs Officer, Subregional Headquarters of the Caribbean of ECLAC. It was written and prepared by Taeke Gjaltema, Petrina Lee Poy and Louise Ebbenson. Harold Robinson coordinated the participation of UNFPA in the preparation of the report while contributions were made by Glen Smith (UNFPA) and Jewel Quallo-Rosberg (UNFPA). Furthermore, the preparation of the report benefited from comments of Paulo Saad (ECLAC), Hetty Sarjeant and Easton Williams. Maureen Afoon, Maren Jiménez and Fernanda Stang revised the text. UNFPA provided valuable financial support for both the organisation of the seminars and the preparation of the reports. The views expressed in this document, which has been reproduced without formal editing, are those of the authors and do not necessarily reflect the views of the Organization. Cover design: Alejandro Vicuña Leyton LC/W.318 Copyright © United Nations, February 2010. All rights reserved Printed in Santiago, Chile – United Nations ECLAC – Project Documents collection Appraisal and Conclusions from the 1994-2009 Review of the Implementation… Contents Abstract............................................................................................................................................ 5 Introduction...................................................................................................................................... 7 I. Review and Appraisal of the Implementation of the Cairo Programme of Action in the Caribbean, 1994-2009 ................................................................................................... 9 A. Introduction....................................................................................................................... 9 B. Context and dimensions of population and development .............................................. 11 1. Population trends.................................................................................................... 11 2. Economic trends..................................................................................................... 13 3. Social trends........................................................................................................... 15 4. Environmental concerns and natural disasters ...................................................... 16 5. Human rights .......................................................................................................... 17 C. Review of the implementation of the ICPD (1994-2009): achievements and constraints........................................................................................ 18 1. Population, sustained economic growth and sustainable development................. 18 2. International migration............................................................................................ 20 3. Population ageing................................................................................................... 22 4. Gender equality, equity and empowerment of women........................................... 24 5. Family, population structure and interdependence between productive and reproductive live/social protection ................................................................... 28 6. Sexual and reproductive rights............................................................................... 29 7. Reproductive health................................................................................................ 31 8. HIV and AIDS ......................................................................................................... 36 9. Emerging issues ..................................................................................................... 39 D. Conclusions.................................................................................................................... 41 1. Population, sustained economic growth and sustainable development................. 41 2. International migration............................................................................................ 42 3. Ageing and older persons....................................................................................... 42 4. Gender equality, equity and empowerment of women........................................... 42 5. Connection between productive and reproductive work: policies on care and family ..................................................................................... 43 6. Reproductive health and sex education ................................................................. 43 7. Sexual and reproductive rights............................................................................... 44 3 ECLAC – Project Documents collection Appraisal and Conclusions from the 1994-2009 Review of the Implementation… 8. HIV and AIDS ......................................................................................................... 44 9. Emerging issues ..................................................................................................... 44 Annex ................................................................................................................................... 47 II. Conclusions of the Caribbean on the implementation of the Programme of Action of Cairo 15 years after its adoption........................................................................................ 63 A. Context........................................................................................................................... 63 B. Achievements................................................................................................................. 64 C. Challenges and opportunities......................................................................................... 65 D. The way forward: towards 2014 and beyond ................................................................. 67 Index of Tables Table 1 Average annual rate of reduction of total fertility rate ................................................... 32 Table 2 Teenage births in four countries.................................................................................... 34 Table I.1 Demographic information .............................................................................................. 47 Table I.2 Social development....................................................................................................... 53 Table I.3 Economic development................................................................................................. 57 Table I.4 Reproductive health and family planning ...................................................................... 58 Table I.5 Other reproductive health indicators ............................................................................. 60 Table I.6 HIV/AIDS prevalence in the Caribbean......................................................................... 61 Index of Boxes Box 1 HIV and AIDS in the Caribbean in 2007 ........................................................................ 37 4 ECLAC – Project Documents collection Appraisal and Conclusions from the 1994-2009 Review of the Implementation… Abstract The countries of English- and Dutch-speaking Caribbean have made significant progress in its economic and human development. Most governments have implemented programs and policies of social protection for vulnerable groups of the population, but its sustainability could be jeopardized because of the global financial crisis. In this cyclical factor is compounded by large external debts of these countries, high exposure to natural disasters, limited natural resources, limited economic diversification and some challenges to their institutional capacities. Although short-term policies are needed to address the current economic crisis, governments should avoid reducing social spending and not lose sight of the long-term perspective which should guide the development plans. In this context it is important to maintain and strengthen the political commitments made to the objectives of the Programme of Action of the International Conference on Population and Development (ICPD-PA), signed in 1994, and to provide the necessary financial support to pursue implementation. This, broadly speaking, is the scenario described and analyzed in the evaluation of the implementation of the ICPD-PA in the Caribbean region 15 years after its approval, whose two main results are represented in this document. The first is the subregional report, the basis of the evaluation of the implementation of the Program of Action adopted in Cairo, which is presented as the first chapter of this document. The second are the conclusions arising from the “Caribbean Subregional Meeting to Assess the Implementation of the Programme of Action of the ICPD 15 years after its adoption”, which took place in Antigua and Barbuda from 20 to 21 August 2009. These conclusions comprise the second component of the document, both in its original English version (second chapter) and in Spanish (third chapter). 5 ECLAC – Project Documents collection Appraisal and Conclusions from the 1994-2009 Review of the Implementation… Introduction