21
Social Policies and MDGs
LAC and the MDGsProgress since 1990 and remaining challenges.
The region in the world context Specific characteristics that affect development policies in the region.
Going beyond averagesHighlighting the need to address within country inequalities with social policy.
The IDB, and social development in the regionThe Bank has gradually adapted itself to better serve the region’s main challenges.
The IDB and the MDGsThe Bank has and continues to support progress in areas of special need for intervention with regards to the MDGs.
Goal 1 Eradicate extreme poverty and hunger
Goal 2 Achieve universal primary education
Goal 3 Promote gender equality and empower women
Goal 4 Reduce child mortality
Goal 5 Improve maternal health
Goal 6 Combat HIV/AIDS, malaria, and other diseases
Goal 7 Ensure environmental sustainability
Goal 8 Develop a global partnership for development
LAC and the MDGs
For most indicators the region is well positioned to achieved the goals set for 2015
Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day
0 5 10 15 20 25 30 35
Latin America and the Caribbean
Developing World
Halve, between 1990 and 2015, the proportion of people who suffer from hunger
0 5 10 15 20 25 30 35
Latin America and the Caribbean
Developing World
Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
0 10 20 30 40 50 60 70 80 90 100
Latin America and the Caribbean
Developing World
Reduce by two thirds, between 1990 and 2015, the under-five mortality rate
0 10 20 30 40 50 60 70 80 90 100
Latin America and the Caribbean
Developing World
Proportion of population using improved sanitation
0 10 20 30 40 50 60 70 80 90
Latin America and the Caribbean
Developing World
1990
1990
2005
2005
Goal 2015
LAC and the MDGs
In the case of some indicators, while the general goal was maintained, indicators that are more relevant to the region have been recommended and monitored as progress towards the MDGs.
ECLAC measures of indigence in LAC
23
13
11
9
0
5
10
15
20
25
1990 1994 1998 2002 2006 2010 2014
Required for achieving the poverty MDG Trend
Goal
National poverty lines in LAC in general tend to yield much higher values compared to those used for the MDG1 indicator
Net school enrollment in LAC (% )
0
10
20
30
40
50
60
70
80
90
100
secondary primary
While primary school enrollment is on track, the remaining challenge for the region is secondary schooling as a development goal
LAC and the MDGs
Latin America stands out in many respects from the rest of the world. Among other things the region has historically been the
most urbanized among developing countries.
Urban population in LAC (% of total)
0
10
20
30
40
50
60
70
80
90
1960 1965 1970 1975 1980 1985 1990 1995 2000 2005
Urban population by regions (% of total)
0
10
20
30
40
50
60
70
80
90
East Asia &Pacific
Europe &Central Asia
Latin America& Caribbean
Middle East& NorthAfrica
South Asia Sub-SaharanAfrica
The region in the world context
499 531
1,161
1,662
2,212
3,83877%
72%
37%
22%
10%
20%
0
500
1000
1500
2000
2500
3000
3500
4000
4500
South Asia Sub-SaharanAfrica
East Asia &Pacific
Middle East& NorthAfrica
Europe &Central Asia
Latin America& Caribbean
GD
P p
erca
pita
con
stan
t (U
S$ 2
000)
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
Pov
erty
hea
dcou
nt r
atio
at $
2 a
day
(PP
P) (
% o
f po
pula
tion
)
4%
Latin America has much higher rates of poverty compared to what would be expected given the income level in the region
(22% compared to 4%).This figures reflect the high inequality levels in the region.
The region in the world context
El Salvador (2004)Proportion of population with access to improved sanitation facilities on average equals 44.2%
MDG 7
Source: IDB. EQxIS. Information System on Social Indicators and Equity. SDS/POV, MECOVI. Accessed on 2/6/2008. Estimations based on data from Dirección General de Estadística y Censos (DIGESTYC), Encuesta de Hogares de Propósitos Múltiples, 2004.
11.8
27.1
39.6
60.8
81.6
0
10
20
30
40
50
60
70
80
90
Q1 Q2 Q3 Q4 Q5
Income quintiles
Going beyond averages
Honduras (2005)Net attendance ratio in secondary education on average equals 42.7%
MDG 2
Source: IDB. EQxIS. Information System on Social Indicators and Equity. SDS/POV, MECOVI. Accessed on 2/6/2008. Estimations based on data from Instituto Nacional de Estadística, Encuesta Permanente de Hogares de Propósitos Múltiples. May, 2005.
17.9
26.7
43.3
55.3
65.1
0
10
20
30
40
50
60
70
Q1 Q2 Q3 Q4 Q5
Income quintiles
Going beyond averages
Bolivia (2002)Proportion of births attended by skilled health personnel on average equals 74.2%
MDG 5
Source: IDB. EQxIS. Information System on Social Indicators and Equity. SDS/POV, MECOVI. Accessed on 2/6/2008. Estimations based on data from Instituto Nacional de Estadística, Encuesta Continua de Hogares. November-December, 2002.
48.1
61.8
80.685.6
95
0
10
20
30
40
50
60
70
80
90
100
Q1 Q2 Q3 Q4 Q5
Income quintiles
Going beyond averages
Loans to social sectors as % of total loans (IDB 1985-2006, includes emergency loans)
15%
25%
35%
45%
55%
65%
75%
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
*Moving average 3 years.
8th replenishment
The IDB, and social development in the region
In the mid 1990s, after its eighth replenishment of resources, the IDB increased its support to social sector development in the region
Bank's portfolio in select areas 1990-06 (US$ billions)
6.2
6.9
21
4.8
2.3
2.2
0.6
0 5 10 15 20 25
Micro enterprises
Environment
Health
Education
Urban Development
Water and Sanitation
Social Investment
Cash transfer programs
The IDB, and social development in the region
Examples of Bank support to social programs in the region
The Bank continues to support Conditional Cash Transfer programs in Brazil, Mexico, Honduras, El Salvador, Nicaragua, Colombia, Peru, Panama and Argentina among other countries.
The Bank has also recently supported many initiatives to help youth at risk and excluded groups transition into the labor market with projects in Peru, Dominican Republic, Panama, Argentina, Chile, Paraguay, Colombia, Honduras, Haiti, Mexico, Venezuela.
The Bank is also supporting health reforms in many countries including Colombia, Peru, Guatemala, Brasil y Ecuador
The Bank currently supports Early Childhood Care and Development in Paraguay, Ecuador, Colombia, Peru among other countries.
The IDB and the MDGs
SCL Structure to respond to challenges in LAC
Social Protection and Health Division
SCL
Science and Technology Division
Gender and Diversity Unit
Education Division
The IDB and the MDGs
Innovative projects in education – MDG #2 • The Program to Support Universal Basic Education in Ecuador (EC-L1018; $295 million),
approved in November of 2007, includes a number of innovations to reinforce larger governmental strategies to increase the level of expenditure in the education sector and improve the efficiency of this expenditure. Key components target the contracting, allocation and reprofiling of the teaching force to ensure that all schools have teachers and that all children receive a quality service, thus increasing coverage and quality in rural, indigenous and border-areas; the creation and institutionalization of mechanisms such as standardized tests and education census to increase the transparency and accountability of the system and improve the efficiency of expenditure; and the piloting new models of school management.
• The Escuela Viva Program in Paraguay (PR-L1017; $45 million), approved in July of 2007, was the first policy-based loan in education approved by the Bank. Building on the support the Bank has given to country’s education sector over the course of the last 13 years, the loan seeks to institutionalize a results-based approach in the Ministry of Education and to ensure that all activities it undertakes are aligned with national plans for education. The specific objectives of this operation are to increase access to, retention in and termination of a quality cycle of basic education (nine years), particularly for the country’s poor and marginalized populations.
The IDB and the MDGsSpecific examples of Bank Projects
The IDB and the MDGsSpecific examples of Bank Projects
Innovative projects in Early Childhood Development – MDG #2
• It is often argued that children coming from poor or excluded communities lack many of the skills needed to succeed in formal schooling. Research shows that skill gaps among individuals develop early on, often before formal schooling begins, and that these gaps tend to be major determinants of economic and social success. Children who begin primary school at a disadvantage frequently find it difficult to overcome that disadvantage, and often the gap between them and their peers widens during their school years.
• The Program Nuestros Niños in Ecuador (EC-0157, $45 million), which completed six years of execution in 2006, includes a number of innovations hailed as ‘best practices’ and revealed key lessons learned in the provision of early childhood education services: (1) the success (lower costs, higher coverage, establishment of quality standards, more effective programs) of moving away from traditional “centros integrados” to more innovative early childhood education modalities; (2) the success (improved transparency and accountability, increased participation of civil society and NGOs) of establishing a competitive bidding mechanism to finance early childhood education programs; (3) the various inefficiencies among the main three child service providers reinforced the importance of the introducing a culture of transparent and competitive bidding mechanisms to assign resources in the sector; (4) the involvement of various providers spurred the creation of the regional association of providers of child services (UNODENA) that was very supportive of the Program and helped protect its executing unit; (5) conditions in the Social Sector PBL (EC0216) were instrumental in the creation of FODI and thus the institutionalization of the Program; (6) support from the Technical Cooperation (ATN/SF-8485-EC) to prepare the operating guidelines and procedures based on the Program experience was critical for the adequate institutionalization and launching of the FODI.
Innovative projects In nutrition and health, MDGs #1, 4, 5
• An iron deficiency during pregnancy commonly leads to difficult pregnancies and at-risk, unhealthy babies. Iron is also especially important for babies aged 6-24 months, a time known as the “weaning period”, since an iron deficiency in these months may lead to premature weight loss (wasting) and health vulnerabilities, including cognitive delays, that can last a lifetime.
• The Basic Nutrition Program in Guyana (GY-0068, 1120/SF-GY, $5 million), launched in March 2005 as part of Guyana’s poverty reduction strategy, seeks to improve maternal and child health via nutrition to fight poverty. The innovative pilot program promotes mothers’ knowledge of nutrition through education on infant feeding practices, especially breastfeeding – recognized worldwide as a sound nutritional practice that is especially important in developing countries – and focuses on reducing anemia among low-income pregnant women and children. Noting that previous efforts to distribute iron tablets were rejected in communities in Guyana and other developing countries because of adverse reactions, health officials decided instead to distribute an iron salt, known as “sprinkles”, which can be mixed with porridge and other infant foods and is more easily accepted by beneficiaries. An evaluation showed that anemia was reduced by 40 percent among children who received the sprinkles iron supplement for more than one year compared with those who did not receive the supplement.
The IDB and the MDGsSpecific examples of Bank Projects
Expansion of Conditional Cash Transfers, MDGs #1, 2, 4, 5.
• Although at a time of rapid urbanization in many countries, particularly low-income countries, there is increasing need for attention to urban poverty, not enough is known about what works in the fight against urban poverty. One of the innovative approaches to tackle rural poverty, the use of cash-based incentives to promote desired investments in human capital, has recently been expanded to urban areas in Mexico, Brazil, and Colombia. Conditional Cash Transfer (CCT) programs are spreading rapidly throughout the developing world as a means to reduce poverty and increase human capital accumulation.
• The Colombia Multiphase Program to Support Second Stage of Familias en Acción Phase I (CO-L1021, $306 million), approved in December 2007, supports the expansion of the conditional cash-transfers program to urban areas. In its second phase, this Program also supports the design and implementation of the Social Protection Network against Extreme Poverty (REDEP), a Government initiative to provide integrated and preferential access to social services to people in extreme poverty. This multi-sectoral focus will carry out actions in the sectors of citizen identification, income and employment generation, education, health, housing, nutrition, family dynamics, banking, and legal support.
The IDB and the MDGsSpecific examples of Bank Projects
Child mortality & Maternal health, MDGs #4, 5.
• The PARSalud Program in Peru (PE-0146, $87 million), which finished executing its first phase in 2007, supports Peru’s health reform with the goal of increasing access to efficient and quality health services for the poor. Its main objective is the reduction of maternal and infant mortality through a focus on empowering the poor via strengthening the demand side, while improving the quality of the supply side of health programs and services. By prioritizing regions with the highest incidence of these problems and the least access to effective and quality services, the project invested in improving the availability and quality of primary care centers and rural clinics. During the first phase, infant mortality fell from 33 deaths per 1,000 live births in 2000 to 23 per 1,000 in 2004 and under 5 mortality decreased from 47 per 1,000 in 2000 to 31 per 1,000 in 2004. Secondly, the first phase also tackled inequalities in access, expanding health insurance coverage under the Seguro Integral de Salud (SIS). SIS improved access for persons in lower income quintiles, including indigenous populations, with a basic health care package now covering 21.3 percent of the population; this is the largest share of all sources of coverage. Thirdly, the Government of Peru (GoP) also began to deal with geographic inequalities under the first phase of the project by proposing a decentralization of the governance structure of the health sector to the regions. These important advances of the GoP should be sustained under the proposed second phase of this project currently in preparation (2008).
The IDB and the MDGsSpecific examples of Bank Projects
The IDB and the MDGsSpecific examples of Bank Projects
Promoting gender equality and empowering women, MDG #3.
• The Adolescent Reproductive Health Program in Medellín-Colombia (CO-T1020, $750,000), approved in 2006, is a technical cooperation that supports gender equality by promoting healthy life-styles through information and training services for adolescents. Since teen pregnancy is one of the main reasons why young girls drop out of secondary school, reducing the adolescent pregnancy rate in Medellin will support this MDG. It will do so by improving the knowledge among adolescents about sexual and reproductive health and providing key services. The programs main components include the following: (i) expanding access to information and reproductive health services; (ii) capacity building at the municipal and community levels; (iii) social communication and outreach; and (iv) research, monitoring and evaluation.
The IDB and the MDGsSpecific examples of Bank Projects
Ensuring environmental sustainability Environment, MDG #7.
• Support for the SEDAPAL Water for All Program - Phase I: Expansion, Sewerage Systems for 9 Projects in Lima and Callao (PE-L1020, US$50 million). The objective of the program is to help attain the millennium targets of extending and improving access to water and sewer service for poor neighborhoods in Metropolitan Lima. The program aims improve the beneficiary population’s quality of life and environment, extending access to and coverage of the water and sanitation service. The three projects financed by this potential loan would directly benefit 284,000 inhabitants through new connections to water and sewer service, with additional beneficiaries through improvement to the water supply system (new reservoirs, household metering, sectoring, among others). The three projects, scheduled to become operational in 2008, are: Carabayllo, Sargento Lorentz, and the Amauta Valley. The proposed program is based on results, and a Performance-Driven Loan (PDL) is deemed the best instrument to support the Peruvian government’s and SEDAPAL's Water for All Program.
