Overview: Latin America

This compendium of profiles for 30 Latin American and Caribbean countries includes 10 from the Caribbean, eight from Central America and 12 from South America. Haiti is the only least-developed country in the region. At the beginning of 2003, the region’s total population was 534 million and was growing at a rate of 1.46 per cent — down from 1.72 per cent during 1990-1995.

Throughout the region, development needs, including needs related to population and reproductive health, remain pressing. Meeting these needs — and meeting the goals and targets for 2015 set down in the 1994 ICPD Programme of Action and the Millennium Summit of 2000 — will require concerted and continuous interventions aimed at further improving economic and social conditions. Aggregate gross domestic product (GDP) for the economies of the region registered essentially no per capita growth in either 2001 or 2002, largely because of external shocks. Through the end of 2002 the hoped-for positive effects of globalization, privatization, austerity and freer trade have remained disappointing, despite the considerable reform efforts made by many countries.

Problems of poverty and inequality are, however, generating increased interest, as the results of recent elections (in Ecuador and Brazil, Latin America’s biggest country) underscore. In addition, issues such as HIV/AIDS, international migration and ageing are assuming higher priority in policies and programmes, along with support of social programming and decentralization.

The failure — as of early 2003 — to include sexual and reproductive health and rights as a priority in poverty reduction efforts continues to be disappointing, undermining long-term prospects. While progress continues to be made in the supply of services, progress in addressing sexual and reproductive rights and health concerns is mixed. Women’s groups and their allies, despite their long tradition of support for women’s health and empowerment, will need to find new ways of mobilizing social and political leverage if they are to be successful in this important area. Analyses indicate that differentials in access to sexual and reproductive health information and services (particularly family planning, antenatal care, safe delivery and the prevention of sexually transmitted infections) are more tied to income levels than in other regions.

While progress has been made over the past 12 years in improving antenatal care and in promoting safe motherhood in the region, women’s lifetime risk of dying in pregnancy or childbirth remains far too high, 1 to 160. The Millennium Development Goal of lowering the maternal mortality ratio by three quarters deserves to be included (and is indeed being accorded a high priority) in ongoing poverty reduction efforts. Most countries of the region have elaborated formal public policies related to gender equality and have created women’s institutes or offices. The main challenge continues to be to improve this institutional base, while moving forward towards more effective strategies in empowering women economically, politically and socially. The region has taken notable steps in addressing gender violence.

In recent years contraceptive prevalence levels for modern methods have continued to rise in the region, reaching 59.9 per cent according to a United Nations report using data available as of 30 June 2001. This is a level somewhat above the average prevalence rate for the world (55.6 per cent), for more-developed regions (59.2 per cent), or for the less-developed regions as a whole (54.9 per cent). During the past decade, the use of modern methods increased annually by more than 2 percentage points in three countries in the region, with large gains also occurring in at least 10 other countries. But at least three countries continue to experience large unmet needs for contraception of over 20 per cent.

With the high risk of HIV/AIDS infection and a high teenage fertility rate (estimated for 2000-2005 at 71 births per 1,000 girls aged 15-19), the countries of the region need to continue to build upon their efforts to meet adolescents’ needs for reproductive health information and services.

Confronting sexually transmitted infections, including HIV/AIDS, remains one of the region’s most daunting challenges. The Caribbean has the second highest incidence of HIV/AIDS, after sub-Saharan Africa, of any subregion in the world. On the positive side, Brazil has made a breakthrough in providing drugs and services free or at an affordable cost. This initiative has been coupled with growing prevention and advocacy efforts (supported by many concerned partners, including governments and international and domestic organizations).

Various events in Latin America and the Caribbean have advanced earlier policy and programme initiatives. The Second Forum on HIV/AIDS/STDs, held in Cuba in April 2003, built on the first such forum and on the Conference of Horizontal Technical Cooperation on HIV/AIDS/STDs, both held in Brazil in 2000.

These efforts involved many concerned NGOs, networks, regional public and private institutions and international agencies in the process of sharing experience, technical knowledge and best practices. Recent regional initiatives concerning reproductive health are being undertaken with diverse support, including from foundations, the European Commission and the OPEC (Organization of Petroleum Exporting Countries) Fund.

With assistance from the United Nations system, including the Bretton Woods organizations, many countries are increasingly utilizing more systematic approaches in their efforts to promote sustainable economic and social development, with a special emphasis on reducing poverty within the framework of the Millennium Development Goals. For example, UNDP’s 2002 Human Development Report states that 22 Latin American and Caribbean countries have produced one or more human development reports.

The countries of the region have also been active in drafting Common Country Assessments (CCAs), United Nations Development Assistance Frameworks (UNDAFs), Sector-Wide Approaches (SWAps) and Poverty Reduction Strategy Papers (PRSPs) and in enhancing ownership of policies and programmes. These efforts are beginning to pay dividends to a growing number of countries in the region. Such dividends include HIPC debt reductions, grants and International Development Association loans linked to governments’ poverty reduction efforts.

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