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Technical Meeting, July 6-9, 1999, Ottawa, Canada [First Ladies Conference] [Binder] [1]
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Technical Meeting, July 6-9, 1999, Ottawa, Canada [First Ladies Conference] [Binder] [1]
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Rabner
USA.
NINTH CONFERENCE
NEUVIÈME CONFERENCE
NOVENA CONFERENCIA
OF SPOUSES OF
DES EPOUSES DES
DE ESPOSAS DE JEFES
HEADS OF STATE
CHEFS D'ÉTAT ET
DE ESTADO Y DE
AND GOVERNMENT
DE GOUVERNEMENT
GOBIERNO DE
OF THE AMERICAS
DES AMERIQUES
LAS AMERICAS
CANADA 1999
TECHNICAL MEETING
July 6 to 9
1999
Ottawa, Canada
Canada
OTTAWA DECLARATION
DRAFT
We, the Spouses of Heads of State and Government of the Americas and
CANADA
1999
Delegates gathered in Ottawa, Canada from September 29 to October 1, 1999,
under the title "Women of the Americas: Agents of Change," in affirmation of our
will and determination to contribute to the well-being of the people of our nations,
subscribe to the following Declaration:
1.
Whereas Spouses of Heads of State and Government of the Americas
occupy a unique position that can enable them to mobilize public attention
and to exercise influence on social issues, we recognize that we have the
opportunity and obligation to act as agents of change, exercising this
influence for the well-being of our peoples and those of the hemisphere,
each of us in a manner appropriate to our culture and in accordance with
the interests of our country.
2.
Whereas all countries of the Hemisphere face common social challenges
and goals, we affirm once again our determination to work together,
pooling our knowledge and efforts, to strengthen the well-being of the
people of the Americas.
3.
Whereas the context of a new millennium poses new challenges and
opportunities, we recognize that it is essential to approach these societal
challenges and goals in a vigorous and integrated way with the
participation of, and for the benefit of, all sectors of society.
4.
Whereas the greatest good can be achieved by working on behalf of those
sectors of society most in need, we firmly believe that it is imperative to
focus our efforts on behalf of these sectors, particularly women and
children who are among the most vulnerable in every society.
5.
We reaffirm the initiatives undertaken by our governments, in the
Declaration of the Santiago Summit of the Americas, to overcome
poverty, promote education and eradicate discrimination in the
Hemisphere.
6.
We recognize the need for, and encourage enhanced participation by civil
society in planning, decision-making, implementation and evaluation with
regard to measures to advance the social and economic development of
our countries.
1
7.
We reiterate our commitment to, and recognize the current validity of, the
previous Declarations subscribed to by Spouses of Heads of State and
Government of the Americas.
8.
We continue to applaud and encourage efforts undertaken by countries of
CANADA
1999
the Hemisphere to meet the objective of eradicating measles in the region
by the year 2000.
9.
We continue to encourage and support the implementation of programs
and policies to promote and strengthen the role of women, particularly
rural women, in all aspects of the political, social and economic life of our
countries.
10.
We reiterate our commitment to the principle that the enjoyment of health
is fundamental to the well-being of all human beings. We encourage
efforts made by the countries of the Hemisphere to promote good health
for women and children in particular, through preventive measures and the
reduction of risk factors that most imperil their health. We commend and
continue to support the actions taken by countries in the region to reduce
maternal mortality and morbidity.
11.
We acknowledge and value efforts to improve the condition and quality of
life of women throughout the Hemisphere. We commend and encourage
efforts to reduce and prevent family violence, to promote the
empowerment of women, to improve their opportunities for education and
training, and to incorporate women in decision-making structures.
12.
We underscore the importance of continuing to support and encourage the
well-being of women and children. Thus, we confirm that the themes
Women's Health and A Healthy Start: Investing in Children from Zero to
Six are priority issues for this Conference.
13.
We are conscious that without a birth certificate it is almost impossible for
children to obtain health care, schooling registration, and other essential
services. Therefore, we declare our firm support for the establishment of
accurate child registration systems in Latin America.
14.
We firmly declare our intent to support all efforts to reduce deaths among
children under five years of age due to communicable diseases and
nutritional deficiencies for which effective interventions and preventive or
treatment measures are available.
2
15.
We recognize that, in order to secure children's rights to education, we
must continue our efforts to develop a specific Latin American perspective
on early childhood education. This will encourage training of child care
specialists and the establishment of networks among experts on this topic.
CANADA
1999
16.
We recognize the need to emphasize education on violence in our
societies, as a means to inculcate values and principles in our children that
will enable them to grow and flourish in a safe and secure environment.
17.
We declare our firm intention to raise awareness and mobilize public
support in our societies on behalf of effective local initiatives to reduce the
transmission of HIV/AIDS, particularly from mothers to children.
18.
We declare our firm support for the improvement of prenatal and maternal
care through the training of health care providers, strengthened community
participation, and efforts to increase public awareness.
19.
We acknowledge and support the invaluable contribution of domestic and
international non-governmental organizations to the social and economic
well-being of the peoples of this Hemisphere, with particular emphasis on
early childhood development and women's health.
20.
We agree that, in observance of the International Decade for a Culture of
Peace and Non-Violence for the Children of the World, proclaimed by the
United Nations for the decade 2000-2010, we will focus our energies on
realizing the human potential of our children, making them aware of their
rights, and strengthening their capacity to create and enjoy an environment
of peace throughout their lives.
21.
We therefore firmly declare that the right of children to receive love and
protection from both parents, as well as their right to develop in a social
context of freedom and tolerance, are universally recognized rights,
disregarding cultural and political circumstances.
22.
We recognize and extend our sincere gratitude for the invaluable role
played by international co-operation agencies and non-governmental
organizations in supporting and facilitating the implementation of the
initiatives set forth in this Declaration.
23.
We express our appreciation to the spouse of the Prime Minister of
Canada, Mrs. Aline Chrétien, and to the people and the Government of
Canada, for the kind hospitality extended during our stay.
3
24.
We acknowledge
as the host of the 10th
Conference of Spouses of Heads of State and Government of the
Americas.
25.
This declaration is signed in three original languages: English, French and
CANADA 1999
Spanish, in the City of Ottawa on October 1, 1999.
4
Programme for the Entrepreneurial
Development of Rural Women
(PADEMUR)
Presented at the Technical Meeting of the Ninth Conference of Spouses of
Heads of State
and Government of the Americas
July, 1999
-
IICA
DEPARTMENT
S
Allos
miss.
IN
RATIONALE
More than 550 million persons in rural areas, representing 60% of the world's
population, live in poverty; 70% are women. They represent 1/3 of the work force
and account for 2/3 of all hours worked. They posses 1% of the property in the
world and receive only 1/10 of the income.
20% of the Gross Domestic Product of the agricultural sector is contributed by
women, who work approximately 14-18 hours per day generating between 38% and
66% of monetary and non-monetary family income.
Yet their access to land has been restricted even in agricultural reforms, due to
cultural values and legislative regulations, limiting further their access to credit.
Only 7% of the credit programs in rural areas work with women.
Some 50% of agricultural production is carried out by women, specially in non-
traditional and post-harvest activities. Their numbers are underestimated in censuses
and national statistics, leading to the invisibility of women and their contributions.
Rural organizations have less female than male members and women have almost no
participation at the decision making level, therefore, female leadership needs to be
explored and strengthened.
ORIGIN OF PADEMUR
As means of helping reverse current conditions and bring about effective and sustainable
changes for women, during the Summit Meeting on the Economic Advancement of Rural
Women, held in Geneva, Switzerland, in February 1992, a
group of First Ladies requested bilateral funding agencies to
have as a primary focus the condition of rural women and
increase the allocation of resources to projects aimed at same.
Within this context, the Inter-American Development Bank
(IDB) and the Inter-American Institute for Cooperation on
Agriculture (IICA), were requested to design a technical
cooperation project entitled Women as Food Producers in the
Andean Region, Southern Cone and the Caribbean.
PROGRAMME FOR THE ENTREPRENEURIAL DEVELOPMENT OF RURAL WOMEN
2
In consequence, 18 national research projects results were presented between 1993-
1995.
Based on these analysis, at the Sixth Conference, held in Paraguay in 1996, the First
Lady of Panama, as Secretary Pro-Tempore of the Conference of Wives of Heads of
State and Government of the Americas, reiterated the need for a programme aiming to
improve the socioeconomic conditions of women and their access to decision-making
processes, with a view to generating a gender-equitable sustainable development.
The Inter-American Board of Agriculture (IABA) received and approved the proposal
to create such Programme (Resolution 330)
At the Seventh Conference, held in Panama in October 1997, this Programme was
presented and approved, and with the support of IICA and other political entities,
specially in Central America have adopted resolutions to strengthen it.
DIMENSIONS OF PADEMUR
HEMISPHERIC
REGIONAL
NATIONAL
Hemispheric Dimension
Actions will focus on Hemispheric political support. The Hemispheric Coordination
Council is responsible for regulating the execution of the programme, ensuring that
the conceptual approach, strategy, technical and operating guidelines are observed and
the objectives achieved.
It is comprised of a First Lady delegate from each region (Caribbean, Central
America, Andean and Southern), a Representative of FERURAL and a Representative
of IICA, which will be in charge of the Executive Secretariat. The chairmanship will
be held by the Secretariat Pro-Tempore of the Conference of Wives of Heads of State
and Government of the Americas.
Regional Dimension
PROGRAMME FOR THE ENTREPRENEURIAL DEVELOPMENT OF RURAL WOMEN
3
Actions of the Regional Council will focus on the political, regional and intra-
regional levels, establishing strategic alliances, formulating technical and operative
guidelines, and securing financial resources.
The Chairmanship will be excised by the the First Lady elected by the others.
National Dimension
Actions of the National Committee will focus on the political and economic support of
national organizations, establishing inter-institutional alliances that will ensure
horizontal cooperation, effective articulation, and participation of all sector of society.
The National Committee is comprised of the First Lady, the Minister of Agriculture,
Minister of Women's Affairs, Representatives of the public and private sectors, Civil
Society and rural women leaders of grassroots organizations that work with
development, gender equity and women's programs, and a Representative of IICA,
who will provide cooperation and technical assistance.
GENERAL
OBJECTIVE
To promote and support actions aimed at
improving the living conditions, position in society,
and role of rural women in sustainable
development.
SPECIFIC OBJECTIVES
I.
COMPONENET: Policies and Fora
Promote activities that raise awareness, provide visibility and recognition of the
contributions of rural women to the process of rural sustainable development, as
well as those that strengthen the rights to participate in social, political, economic
and social endeavors.
II. COMPONENT: Support to Institutions and Organizations
Support to public, private sector, and civil society institutions in incorporating a
gender perspective into their organizations, policies, objectives and activities
III. COMPONENT: Strengthening of Integration of Women into Entrepreneurial
Activities
PROGRAMME FOR THE ENTREPRENEURIAL DEVELOPMENT OF RURAL WOMEN
4
Promote the participation of women into income-earning and productive business
activities encouraging the creation of networks
IV. COMPONENT: Fund for Women Entrepreneurs FERURAL and UNIDAS
Create long-term funding instruments that will allocate resources from different
sources to carry out Programme activities and projects.
FERURAL (Hemispheric) is a long-term, multilateral financial instrument
sponsored by donor development organizations such as Inter-American Development
Bank in association with the Inter-American Institute for Cooperation on Agriculture
(IICA). Its objective is to provide innovative forms of credit to rural women.
National FERURAL'S are being created to raise and channel financial and technical
resources at a national level.
UNIDAS FUND is the Special Technical Cooperation Fund for the Entrepreneurial
Development Programme for Rural Women. It was created in 1997 for the purpose
of providing technical assistance which is not considered in the credit fund.
This fund may receive financial and technical resources for hemispheric, national and
regional initiatives within the Entrepreneurial Development Programme for Rural
Women (PADEMUR). it is administered by IICA and the AgriFuture Foundation.
HOW DOES PADEMUR OPERATE?
The Conference of Wives of Heads of State and Government of the Americas is the
hemispheric coordinating body. IICA is the international organization responsible for its
execution through the Sustainable Rural Development Directorate.
The Regional Council is formed by the First Ladies of the Region and their actions are
coordinated through IICA's Regional Centers. At local level, National Committees are
formed by the First Lady of the country, ministries of agriculture and women's
development, institutes of rural development, representatives of civil society, and rural
women leaders of grassroots organizations. There actions are coordinated by the
Technical Cooperation Agencies (TCAs) that IICA has in each country.
IICA
Conference of Wives of
Heads of State and
HEMISPHERIC
SUSTAINABLE
Government of the
RURAL
Americas
DEVELOPMENT
DIRECTORATE
Regional Council
REGIONAL
REGIONAL
CENTERS
National )GRA
IICA'S LOCAL
NATIONAL
DEVELOPMENT
Committee
OFFICES
(TCA'S)
NATIONAL COMMITTEE
FIRST LADY
PUBLIC
PRIVATE
CIVIL SOCIETY
Ministry of
Chamber of
Cooperatives
Agriculture
Industry and
Commerce
Ministry of
NGO's
Women's
Development
Financial
Institutions
Networks of
Grassroots
Public Offices
Organizations
IICA
Financial and Technical Cooperation
FERURAL (Financial) AND UNIDAS (Technical) FUNDS
ACHIEVEMENTS AND ONGOING ACTIVITIES
1 Structure and development
Constitution of National Committees in the Central America countries, Panama,
Belize throughout 1997, and Argentina in 1998.
Formation and constitution of Central American Regional Council, San Salvador,
El Salvador, June 1998.
Formation and constitution of Caribbean Network of Rural Women Producers,
Trinidad and Tobago and Jamaica, April and May 1999.
PROGRAMME FOR THE ENTREPRENEURIAL DEVELOPMENT OF RURAL WOMEN
6
Formation and constitution of the Inter-American Rural/Peasant Farming Business
Organization (Santiago de Chile, November 1998).
Articulation of horizontal cooperation networks on gender (Honduras and Panama,
June 1998 through January, 1999)
2. Research and Conceptualization
Position papers on the conditions of rural women and rural sustainable development
Updated information on legal, social, and economics status of rural women, and
advances in gender-equity policies. Alternatives for the participation and development
of rural women in a new rural scenario:
Rural women in the Development of Latin America and the Caribbean, Discussion
Paper, March 1999.
Gender Perspective and New Rurality, Discussion Paper, May 1999.
Advance Report for the Governing Board of the Regional Conference on the
Integration of Women in the Economic and Social Development of Latin America
and the Caribbean, Curaçao, June 3-4, 1999
Recognition of a New Rural Scenario, March 1999
New Rurality, Discussion Paper, May, 1999
Sustainable Rural Development and IICA's Technical Cooperation: Value and
Relevance, 1998-2002, October 1998.
Seminar on rural development and Ibero-American Cooperation:
Recognition of a new rural scenario in the Americas and Europe, Evora, Portugal,
June 14-17, 1999
3. Promotional materials
Videos
Situation of rural women in the Hemisphere, 1997
The conditions of rural women and advances of PADEMUR Programme, 1998
Brouchures
PADEMUR Progress Report, 1998
Promotional materials of PADEMUR, 1999
4. Direct Technical Assistance
CENTRAL AMERICA REGION
Technical Workshop for the Representatives of the First Ladies Offices of Central
America in cooperation with the Office of the First Lady of Costa Rica, June 1999
PROGRAMME FOR THE ENTREPRENEURIAL DEVELOPMENT OF RURAL WOMEN
7
Design of the National Programme for Gender and Development for Rural
Women in Honduras, and the National Fund for Rural Women (National
FERURAL) as part of the Reconstruction Plan of the Agricultural Sector due to
the devastation of Hurricane Mitch, in coordination with the Ministry of
Agriculture and the National Committee.
Development of data collecting instruments for the social and economic axis as
part of the "Coordinating Commission of the National Women Fora in charged of
the Supervision of the Commitments relating to women in the Peace Accords.
Guatemala, March 1999.
Development of the programme and data collecting instruments for Women's
Provincial Fora, Panama, December, 1998.
CARIBBEAN REGION
Haiti: Development of a credit strategy for 3000 rural women in 29 communities
within the KrediFanm Programme
Dominican Republic: Evaluation of the Milk Bank, February 1999
In Coordination with the Dominican Republic Government development of
Training for Rural Leaders on Gender and Sustainable Rural Development,
May-June, 1999.
ANDEAN REGION
Bolivia: Support to the development and institutionalization of public policies on
gender and rural women.
Ecuador: National Programme of Rural Development (PRONADER) gender
perspective systematization.
SOUTHERN REGION
Brazil: incorporation of gender perspective to the Programme of Alleviation of
Poverty for the Northeastern Region
Chile: Support to the Eighth Conference of the Wives of Heads of State and
Government of the Americas, Santiago, September, 1998.
Paraguay: Gender Training Manual for the Agricultural Sector in cooperation
with the Secretary of Women.
5. Training
Video-Conference Workshop: Gender Equity: A Challenge for Sustainable Rural
Development, in coordination with IICA/Texas A&M University, September,
1998
Incorporation of gender perspective in the proposals of Municipal Sustainable
Planning, Brazil, June, 1999
PROGRAMME FOR THE ENTREPRENEURIAL DEVELOPMENT OF RURAL WOMEN
8
Gender sensitivity training in the Project Collaborative Network for Vegetable
Research and Development in Central America, Dominican Republic and Panama
(REDCAHOR), Honduras, February, 1999.
Gender sensitivity training workshop for the technical personnel of the Ministry
of Agriculture and Husbandry, San Jose, Costa Rica, May 18-19, 1999
Strategic Planning Workshop for the Gender and Sustainable Rural Development
for Central America, Panama, Belize, Peru, Bolivia and Ecuador, San Jose, Costa
Rica, April, 1999
Workshop for the Strengthening of Rural Micro-enterprises, King's House,
Kingston, Jamaica, May 14, 1999.
6. Conferences and fora
Participation in the following conferences:
Inter-Agency Group for the Alleviaton of Poverty, 1998.
Second International Conference on Women in Agriculture from June 29 to July
2, 1998, Washington, D.C organized by IICA in coordination with the United
State Department of Agriculture
Panel on Access of Women to Land. San José, Costa Rica, February 19, 1999
Twenty-Seventh Meeting of the Governing Board of the Regional Conference on
the Integration of Women in the Economic and Social Development of Latin
America and the Caribbean, San Salvador, El Salvador, April, 1999
Hurricaine Mitch: Effects on Women and Women's Participation in the
Reconstruction and Transformation of Central America, Honduras, May, 1999
Rural Women and Projects of Social Investment. Lima, Peru, June 23-25, 1999
Training Summit on Grassroots Community Building for the 21st Century, Fresno,
California, June 1999
Second Inter-Agency Meeting on Gender, San Jose, Costa Rica, June 1998
Seminar-Workshop: Rural Women and the Sustainability of Social and Production
Projects. Social Network of Latin America and the Caribbean, Peru, June 1999
Twenty-eighth Meeting of the Governing Board of the Regional Conference on the
Integration of Women in the Economic and Social Development of Latin America
and the Caribbean, Curaçao, June 3-4, 1999
Planning Seminar of the REDCAHOR Project, Costa Rica, June 1999
Provincial Fora on Women, Commemorating International Women's Day. Office
of the First Lady and Ministry of Youth, Women, Childhood and the Family.
Panama, March 1999
Sixth Meeting of the External Advisory Council of the IDB on Women in
Development, Panama, February 1999
PROGRAMME FOR THE ENTREPRENEURIAL DEVELOPMENT OF RURAL WOMEN
9
7. RESOLUTIONS AND AGREEMENTS
Resolution No. 330 of the IABA, Ninth Ordinary Meeting, held in Chile in October
1997: (a) to contribute technical and financial measures needed to execute an initiative
of hemispheric scope to promote and strengthen the entrepreneurial development of
rural women; (b) to establish a special fund to raise money to finance IICA's activities
in this initiative; (c) to coordinate with financial and technical organizations to support
this programme in a joint effort.
The Central American Agricultural Council (CAC) made up of the ministers of
agriculture of the subregion, has adopted various resolutions:
Resolution 7 (April 1998): "Congratulate IICA for the work it is doing to support
the ministers of agriculture and the offices of the First Ladies of Central America
in relation to issues having to do with women food producers, gender,
communication and sustainable development."
Resolution 8 (April 1998): Ask IICA's Sustainable Rural Development
Directorate in coordination with the CAC Secretariat to develop and launch a
Central American initiative for sustainable rural development which incorporates
the continuation of the Programme for the Integration of Rural Women in
Agribusiness Productive Chains, and other things such as: the creation of a
regional fund for rural development; support for the countries in formulating and
executing projects; creating and strengthening microenterprises engaged in
production, processing and services; horizontal cooperation and interchange of
successful experiences among countries in and outside the region.
Resolution 9 (April 1998): To support IICA's arrangements with the Swedish
Cooperation Agency to continue strengthening and working with countries in
terms of gender, communication and sustainable development.
Resolution 1 (February 1999): (1) Support the initiative to increase income and
productivity of rural women as requested by the Conference of Wives of Heads of
State and Government of the Americas, with support from IDB and IICA; (2) Propose
that among the priorities for the first phase of this initiative, preference be given to
those countries directly affected by Hurricanes Mitch and George where the
conditions of rural women have been heavily affected. (3) Ask IICA and IDB to
prepare a specific fundraising proposal for funding this first phase, to be included in
the proposals that the Central American Integration System (SICA) presents to the
meeting of the Consultative Group of Stockholm.
Agreement with the Swedish International Development Authority (SIDA) for the
execution of the project The Gender Perspective in Sustainable Rural Development,
which is part of the UNIDAS Technical Cooperation Fund
Technical Cooperation Agreement among the Agricultural Development Institute
(INDAP), the Foundation for the Promotion and Development of Women (PRODEMU)
and IICA, for the formulation and execution of the project PADEMUR in the countries of
the Southern Cone. Chile, June 1999.
PROGRAMME FOR THE ENTREPRENEURIAL DEVELOPMENT OF RURAL WOMEN 10
07/JUL. 6. 19991 11: 29PMx 1 8 DFAIT LXD₈₆
HOLIDAY INN TDAD
NO. 1034 P. 3/4 003
July 05, 1999
Port of Spain
TRINIDAD
Resolution of the First Meeting of the Spouses of Heads of State and
Heads of Government of the Caribbean Region.
BE IT RESOLVED:
That the First Meeting of Spouses of Heads of State and Heads of
Government of the Caribbean agree:
to make a formal request to the Ninth Conference of Wives of Heads of
State and Government of the Americas, to be held in Ottawa, Canada
1999; that it include on its agenda for consideration, the subject "The
Development and Promotion of Rural Women Producers';
to subscribe to the theme of Women's Health to be addressed as 'Rural
Women's Health; and
that future hemispheric meetings for technical advisers be held at the end
of July to allow for resolutions from the annual meeting of the Spouses
of Heads of State and Heads of Government of the Caribbean, which
usually takes place during the first week of July, to reach this
hemispheric body in time for discussions;
07/CJUL 6. 1999 11:29PM 180 FAIT LXD
HOLIDAY INN TDAD
NO. 1034-P. 4/4 004
And be it further resolved that these proposals be brought to the
attention of the preparatory meeting for the said Ninth Conference of
Wives of Heads of State and Government of the Americas currently in
session in Ottawa, Canada.
Oma Panday- Trinidad and Tobago
Norma Hughes - Anguilla
Beverley Arthur - Barbados
Joan Musa - Belize
Edris O'Neal - British Virgin Islands
Marietta Mitchell - Grenada
Yvonne Hinds - Guyana
Gerî Benoit Préval - Häiti
For Carmen Lizzette Campo de Fenandez, Clarissa Leon - Dominican
Republic
Ninth Conference of Spouses of Heads
of State and Government of the Americas
Women of the Americas: Agents of Change
Ottawa, Canada September 29 - October 1, 1999
Draft Conference Program
Wednesday, September 29
3:00 - 6:00 pm
Registration
6:00 - 7:30 pm
Opening Ceremony and Reception
National Art Gallery
Thursday, September 30
7:30 am - 9:00 am
Registration
9:00 am - 9:30 am
Follow-up Report to the Eighth Conference
A 30-minute presentation summarizing actions taken by
Spouses since the last conference
9:30 am - 9:45 am
A Healthy Start: Investing in Children 0-6
Status Report by UNICEF on early childhood development in
the Hemisphere
9:45 am - 10:00 am
Why Zero to Six Matters
A 10 to 5-minute presentation by a leading expert (to be
determined) on early childhood development and why the years
0 to 6 are critical determinants of a child's long term life
chances
10:00 am - 10:30 am Remarks from Spouses
3 Spouses deliver their remarks on the first theme: A Healthy
Start: Investing in Children 0-6
10:30 am - 10:45 am Coffee break
10:45 am - 11:30 am Remarks from Spouses
Spouses deliver their remarks on the theme: A Healthy Start:
Investing in Children 0-6
11:30 am - 12:30 pm Spouses and Delegations tour NGO exhibits
Approximately 60 NGOs from the Americas whose missions
are relevant to the Conference themes will be invited to
participate in an NGO fair where they can exchange ideas and
experiences and exhibit information on their programs
12:45 pm - 2:15 pm
Lunch
Spouses to lunch separately at Daly's restaurant in the Westin.
Buffet luncheon to be served to other conference participants in
another room
2:30 pm - 4:00 pm
Remarks by Spouses
Spouses deliver their remarks on the theme: A Healthy Start:
Investing in children 0-6
4:00 pm - 4:15 pm
Coffee Break
4:15 pm - 5:00 pm
Remarks by Spouses
Spouses deliver their remarks on the theme: A Healthy Start:
Investing in children 0-6
5:00 pm - 7:15 pm
Break
7:15 pm - 7:30 pm
Spouses travel to cocktail reception/dinner
7:30 pm - 8:15 pm
Cocktail Reception
Canadian Museum of Civilization
8:15 pm - 10:30 pm
Dinner and Cultural Event
Canadian Museum of Civilization
Friday, October 1
9:00 am - 9:15 am
Women's Health
Status Report by PAHO on the health conditions of women in
the Hemisphere
9:15 am - 10:30 am
Spouses remarks
Spouses deliver their remarks on the second theme: Women's
Health
10:30 am - 11:00 am Coffee Break
11:00 am - 12:00 pm Spouses and Delegations tour NGO exhibits
12:15 pm - 1:15 pm Lunch
Spouses dine separately at Daly's. Buffet lunch will be served
to other conference participants in another room
1:30 pm - 2:30 pm
Telehealth Presentation
(1:30-1:40 pm)
A 10-minute introduction on Telehealth
(1:40-2:15 pm)
Live demonstration of telehealth technology as an
efficient and effective means of providing health care services to rural
and remote communities
(2:15-2:30 pm)
Telehealth Video
2:30 pm - 3:15 pm
Remarks by Spouses
Spouses deliver their remarks on the second theme: Women's
Health
3:15 pm - 3:30 pm
Coffee Break
3:30 pm - 4:30 pm
Remarks by Spouses
Spouses deliver their remarks on the second theme: Women's
Health
4:30 pm - 5:00 pm
Spouses are driven to Parliament Hill
5:00 pm - 6:30 pm
Closing Ceremony and signing of Ottawa Declaration
SENT BY:US OTTAWA/AMB/POL
; 7-16-99 ; 15:34 ;
6132388750-
12024562878;# 2/ 4
AMBASSADOR OF THE UNITED STATES OF AMERICA
OTTAWA, CANADA
July 16, 1999
MEMORANDUM
TO:
Nicole Rabner
Office of the First Lady of the United States of America
FROM:
Gordon D. Giffin GDJ
Ambassador of the United States to Canada
SUBJECT:
Visit of the First Lady to Ottawa, Canada
It was good to sce you last week in Ottawa. I am confident that the
First Lady's trip here in September will provide meaningful support for
enhanced relations in the hemisphere. As I mentioned during your visit, it is
my hope that we will be able to use a brief amount of her time in Ottawa,
outside of the conference, to foster the extraordinary economic tics between
the United States and Canada.
Canada and the U.S. sharc the largest trading relationship in the world
across the world's longest undefended border. On average, over $1 billion
per day of commerce crosses our 5,500 mile long common border cach year.
The personal and economic ties which span the border are almost impossible
to quantify.
All of that said, much more nceds to be done to enhance the lives and
livelihoods which transcend this border. In upstate New York, for example,
the economy and society is as much (or more) focused on Canada than it is
on Binghamton or Suffern. The largest and fastest growing employer in
Plattsburgh, New York is Montreal-based Bombardier (where they assemble
subway cars bound for New York City). The integration between Detroit
and Windsor, Ontario (as well as Oakville and Oshawa) in the automotive
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business is virtually seamless. The lives of real people on our side of the
border are affected every day by the policies which we implement with
respect to trade and border management. This is not foreign policy theory,
rather it makes a real difference to real people.
Canada and the U.S. entered into a free trade agreement in 1989
which was expanded five years later to include Mexico and became
NAFTA. There are many success stories which illustrate how beneficial this
trading relationship has been. However, more importantly, I envision a brief
session with the First Lady where Canadian and American business interests
(roughly 20-25 people) provide their insight regarding the future policies
which will be necessary to continue the remarkable and mutually beneficial
growth we have experienced over the past ten years.
Ottawa, situated just 50 miles from the border at Ogdensburg, New
York is a perfect place for such a brief discussion. It could include the
following types of participants:
- representatives of the St. Lawrence Seaway
from Masena, New York to discuss shipping issues
on the St. Lawrence and Great Lakes;
- representatives from General Motors, Ford and
Chrysler to discuss enhancing auto trade;
- representatives of major Canadian companies such
as Bombardier, Quebecor (world's largest printing
company), Teleglobe (telecom) and Canadian
National Railway (recently acquired Illinois
Central) which have substantial operations in the
U.S. with thousands of employees in the U.S. to
discuss policies to enhance economic development
on our side of the border;
- representatives of major U.S. companies such as
Kodak, IBM, Walmart and UPS which have significant
operations in Canada to discuss similar policies going
the other direction;
- representatives of energy companies on both sides of
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the border to discuss how enhanced access to low cost
Canadian energy can lower costs in New York and
New England and eliminate the need for construction
of more capacity with attendant environmental benefits;
- representatives of small communities such as Burlington,
Vermont, Plattsburgh, New York to discuss how
important policies which foster cross-border commerce
arc to the economic health of these areas. These people
would include municipal or country officials and Chamber
of Commerce representatives.
I would plan to carefully select the participants and refine the focus of
the discussions. The presence of the First Lady would emphasize how
important these issues are to the U.S. Government. Also, I believe she
would learn more about the integration of our economies, permitting her to
develop more insight about policies which would facilitate prosperity in
communities all along our northern border. This dialogue would take place
within a few minutes of the conference she is attending, either the Embassy
or the Residence.
I am prepared to discuss this in more detail at your convenience.
Technical Meeting
Ninth Conference of Spouses of Heads of State
and Government of the Americas
CANADA
1999
Ottawa, Canada, July 6 - 9, 1999
Delegate Binder
1.
Agenda
2.
Conference Overview
3.
Conference Regulations
4.
Draft Follow-up Report by Countries
5.
Follow-up Report Summaries
Presentation 1: Measles Eradication, Violence Against Women, Maternal Mortality and Healthy
Schools
Pan American Health Organization (PAHO)
Presentation 2: Business Development Program for Rural Women (PADEMUR)
Inter-American Institute for Cooperation on Agriculture (IICA)
Presentation 3: Horizontal Cooperation Project to Promote Child Development
Fundación Integra
Presentation 4: Rural Women and Social Development
Unit for Social Development and Education (UDSE) Organization of American States (OAS)
Presentation 5: Maternal Mortality Initiative
United States Agency for International Development
6.
Follow-up Reports
Presentation 1: Measles Eradication, Violence Against Women, Maternal Mortality
and Healthy Schools
Pan American Health Organization (PAHO)
CANADA 1999
Presentation 2: Business Development Program for Rural Women (PADEMUR)
Inter-American Institute for Cooperation on Agriculture (IICA)
THIS DOCUMENT WILL BE DISTRIBUTED AT THE TECHNICAL MEETING
Presentation 3: Horizontal Cooperation Project to Promote Child Development
Fundación Integra
Presentation 4: Rural Women and Social Development
Unit for Social Development and Education (UDSE) Organization of American States (OAS)
Presentation 5: Maternal Moriality Initiative
United States Agency for International Development
7.
Current Activity Summaries
Presentation 1: Violence Against Women, Eradication of Poverty/ Economic Empowerment,
Education/Information Network, Participation of Women in Power and Decision-Making Structures
Inter-American Women's Commission (CIM)
Presentation 2: Reproductive Health
Inter-American Development Bank (IDB)
Presentation 3: Investing in Early Childhood and Poverty Reduction in Latin America
Inter-American Development Bank (IDB)
8.
Reports on Current Activities
Presentation 1: Violence Against Women, Eradication of Poverty/ Economic Empowerment,
Education/Information Network, Participation of Women in Power and Decision-Making Structures
Inter-American Women's Commission (CIM)
Presentation 2: Reproductive Health
Inter-American Development Bank (IDB)
Presentation 3: Investing in Early Childhood and Poverty Reduction in Latin America
Inter-American Development Bank (IDB)
2
9.
Summary of Projects for Possible Endorsement at Ninth
Conference
A Healthy Start: Investing in Children 0-6
CANADA 1999
Project 1: International Symposia on Early Childhood Education
Unit for Social Development and Education (UDSE) Organization of American States (OAS)
THIS DOCUMENT WILL BE DISTRIBUTED AT THE TECHNICAL MEETING
Project 2: Registration of Children Across the Americas
United Nations Children's Fund (UNICEF)
THIS DOCUMENT WILL BE DISTRIBUTED AT THE TECHNICAL MEETING
Project 3: Early Childhood Development in the Latin America and the Caribbean Region
United Nations Children's Fund (UNICEF)
Project 4: Cooperation between Health and Education Sectors in Support of a Comprehensive
Approach to Child Development
Unit for Social Development and Education (UDSE) Organization of American States (OAS)
Project 5: Integrated Management of Childhood Illness
Pan American Health Organization (PAHO)
Women's Health
Project 6: Prevention of Domestic Violence through Children's Education
Inter-American Children's Institute (IACI)
Project 7: The DESAPER project and Global Health Challenges
Pan American Health Organization (PAHO)
Project 8: Prevention of AIDS in Mothers and Children
United Nations AIDS Program (UNAIDS)
10.
Projects for Possible Endorsement at Ninth Conference
A Healthy Start: Investing in Children 0-6
Project 1: International Symposia on Early Childhood Education
Unit for Social Development and Education (UDSE) Organization of American States (OAS)
THIS DOCUMENT WILL BE DISTRIBUTED AT THE TECHNICAL MEETING
3
Project 2: Registration of Children Across the Americas
United Nations Children's Fund (UNICEF)
THIS DOCUMENT WILL BE DISTRIBUTED AT THE TECHNICAL
MEETING
CANADA 1999
Project 3: Early Childhood Development in the Latin America and the
Caribbean Region
United Nations Children's Fund (UNICEF)
Project 4: Cooperation between Health and Education Sectors in Support of a Comprehensive
Approach to Child Development
Unit for Social Development and Education (UDSE) Organization of American States (OAS)
Project 5: Integrated Management of Childhood Illness
Pan American Health Organization (PAHO)
Women's Health
Project 6: Prevention of Domestic Violence through Children Education
Inter-American Children's Institute (IACI)
Project 7: The DESAPER project and Global Health Challenges
Pan American Health Organization (PAHO)
Project 8: Prevention of AIDS in Mothers and Children
United Nations AIDS Program (UNAIDS)
11.
Draft Summary of Current and Future Actions to be undertaken by the
Spouses of Heads of State and Government of the Americas
THIS DOCUMENT WILL BE DISTRIBUTED AT THE TECHNICAL
MEETING
12.
Draft Conference Agenda
4
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Divider Title:
Agenda
Technical Meeting
Ninth Conference of Spouses of Heads of State
and Government of the Americas
CANADA 1999
Ottawa, Canada, July 6 - 9, 1999
Room 200, West Block, Parliament Hill
Monday July 5
NINTH CONFERENCE
OF SPOUSES OF
Delegations arrive at Macdonald-Cartier Airport
HEADS OF STATE
AND GOVERNMENT
Hemisphere Summit Office officials will meet delegates at the airport and provide
OF THE AMERICAS
transportation to the Sheraton Hotel - 150 Albert Street, Ottawa
Hemisphere Summit Office (LXD)
Department of Foreign Affairs
Check in, accreditation and delivery of folders with working documents
and International Trade
125 promenade Sussex Dr.
Free evening
Ottawa, Canada KIA 0G2
Tel: (613) 944-1692
Fax: (613) 944-1737
Tuesday, July 6
E-mail: [email protected]
Morning
Delegations arrive at Macdonald-Cartier Airport
NEUVIÈME CONFERENCE
DES ÉPOUSES DES
Hemisphere Summit Office officials will meet delegates at the
CHEFS D'ÉTAT ET
airport and provide transportation to the Sheraton Hotel - 150
DE GOUVERNEMENT
Albert Street, Ottawa
DES AMÉRIQUES
Bureau du Sommet hémisphèrique (LXD)
Check in, accreditation and delivery of folders with working
Ministere des Affaires étrangères
documents
et du Commerce international
125 promenade Sussex Dr.
11:45 am
Ottawa, Canada KIA 0G2
Heads of delegations and International co-operation agency
Tél: (613) 944-1692
representatives depart the Sheraton Hotel by motorcoach
Télec (613) 944-1737
Courriel : [email protected].
12:15 pm
Arrival of heads of delegation to the Lester B. Pearson Building
125 Sussex Drive, Ottawa
NOVENA CONFERENCIA
DE ESPOSAS DE JEFES
12:30 - 2:00 pm
Inaugural Luncheon hosted by Mrs. Aline Chrétien
DE ESTADO Y DE
9th floor, Tower A, Lester B. Pearson Building
GOBIERNO DE
125 Sussex Drive, Ottawa
LAS AMERICAS
Oficina de la Cumbre Hemisférica (LXD)
2:00 pm
Delegates depart the Lester B. Pearson Building by motorcoach
Ministerio de Asuntos Exteriores y
Comercio Internacional
for Parliament Hill
125 promenade Sussex Dr.
Ottawa, Canada KIA 0G2
2:15 - 2:30 pm
Inauguration of the Technical Meeting
Tel: (613) 944-1692
Room 200, West Block, Parliament Hill
Fax: (613) 944-1737
Chair: Dr. Chaviva Hosek
E-mail. [email protected]
Director, Policy and Research
Office of the Prime Minister
2:30 3:00 pm
Methodology for the Technical Meeting
Government
Gouvernement
of Canada
du Canada
Canada
3:00 - 3:30 pm
Review of Draft Follow-up Report from 8th Conference
3:30 - 4:00 pm
Coffee Break
CANADA 1999
4:00 - 5:45 pm
Agency Follow-up Reports on projects endorsed at
previous Conferences
(4:00 - 4:20 pm)
Measles Eradication, Violence Against Women, Maternal
Mortality and Healthy Schools
Ms. Julia Wayand, Office of External Relations
Pan American Health Organization (PAHO)
(4:20 - 4:30 pm)
Questions and answers
(4:30 - 4:50 pm)
Business Development Program for Rural Women (PADEMUR)
Ms. Clara Solis-Araya, Director, Sustainable Development
Inter-American Institute for Cooperation on Agriculture (IICA)
(4:50 - 5:00 pm)
Questions and answers
(5:00 - 5:10 pm)
Horizontal Cooperation Project to Promote Child Development
Ms. Veronica Baraona, Office of the First Lady of Chile
Fundación Integra
(5:10 - 5:15 pm)
Questions and answers
(5:15 - 5:25 pm)
Rural Women and Social Development
Dr. Gaby Fujimoto, Senior Specialist in Education
Unit for Social Development and Education (UDSE)
Organization of American States (OAS)
(5:25 - 5:30 pm)
Questions and answers
(5:30 - 5:40 pm)
Maternal Mortality Initiative
Ms. Carol Dabbs, Team Leader, Population, Health and Nutrition
Bureau for Latin America and the Caribbean
United States Agency for International Development (USAID)
(5:40 - 5:45 pm)
Questions and answers
5:45 pm
Delegates and International co-operation agency representatives
depart Parliament Hill by motorcoach for the Sheraton Hotel
7:00 pm
All delegates and International co-operation agency
representatives depart the Sheraton Hotel by motorcoach for the
docks
7:30 - 10:00 pm
Boat tour on the Ottawa River (includes dinner)
2
10:15 pm
All delegates and International co-operation agency
representatives return to the Sheraton Hotel by motorcoach
CANADA 1999
Wednesday, July 7
8:00 am
Delegates and International co-operation agency representatives
depart by motorcoach from the Sheraton Hotel to Room 200,
West Block, Parliament Hill
8:30 - 10:15 am
Presentations by international cooperation agencies on
current and proposed initiatives
(8:30 - 8:50 am)
Violence Against Women. Eradication of Poverty/ Economic
Empowerment, Education/Information Network, Participation of
Women in Power and Decision-Making Structures
Ms. Carmen Lomellin, Director
Inter-American Women's Commission (CIM)
(8:50 - 9:00 am)
Questions and answers
(9:00 - 9:20 am)
Reproductive Health
Mr. Ricardo Moran
Social Development Division
Inter-American Development Bank (IDB)
(9:20 - 9:30 am)
Questions and answers
(9:30 -10:05 am)
Investing in Early Childhood and Poverty Reduction in
Latin America
Mr. Ricardo Moran, Social Development Division
Inter-American Development Bank (IDB)
(10:05 - 10:15 am)
Questions and Answers
10:15 - 10:45 am
Coffee Break
10:45 - 12:15 pm
Presentations of projects for inclusion in the Conference
agenda on the theme "A Healthy Start: Investing in Children
0 to 6"
(10:45 - 11:05 am) International Symposia on Early Childhood Education
Dr. Gaby Fujimoto, Senior Specialist in Education
Unit for Social Development and Education (UDSE)
Organization of American States (OAS)
(11:05 - 11:15 am) Questions and answers
3
(11:15 - 11:35 am) Registration of Children Across the Americas
Ms. Gladys Acosta, Regional Education on Gender
Regional Office - Bogotá
United Nations Children's Fund (UNICEF)
CANADA 1999
(11:35 - 11:45 am) Questions and answers
(11:45 - 12:05 pm) Early Childhood Development in the Latin America and the
Caribbean Region
Ms. Gladys Acosta, Regional Education on Gender
Regional Office - Bogotá
United Nations Children's Fund (UNICEF)
(12:05 - 12:15 pm) Questions and answers
12:15 - 2:00 pm
Lunch (open)
A list of nearby restaurants is provided in the information
package
2:00 - 3:00 pm
Presentation of projects for Conference agenda on theme of
"A Healthy Start: Investing in Children 0 to 6" (continued)
(2:00 - 2:20 pm)
Cooperation between Health and Education Sectors in Support
of a Comprehensive Approach to Child Development
Dr. Gaby Fujimoto, Senior Specialist in Education
Unit for Social Development and Education (UDSE)
Organization of American States (OAS)
(2:20 - 2:30 pm)
Questions and answers
(2:30 - 2:50 pm)
Integrated Management of Childhood Illness
Ms. Julia Wayand, Office of External Relations
Pan American Health Organization (PAHO)
(2:50 - 3:00 pm)
Questions and answers
3:00 - 4:00 pm
Discussion of projects presented on theme of "A Healthy
Start: Investing in Children 0-6" (continued)
4:00 - 4:30 pm
Coffee Break
4:30 - 5:00 pm
Presentation of projects for Conference agenda on theme of
"Women's Health"
(4:30 - 4:50 pm)
Prevention of Domestic Violence through Children's Education
Mr. Brian Ward, Representative in Canada
Inter-American Children's Institute (IACI)
(4:50 - 5:00 pm)
Questions and answers
4
5:00 - 6:00 pm
Conference Regulations
6:00 pm
Delegates and International co-operation agency representatives
depart Parliament Hill by motorcoach for the Sheraton Hotel
CANADA 1999
Free Evening
Thursday, July 8
8:00 am
Delegates and International co-operation agency representatives
depart by motorcoach from the Sheraton Hotel to Room 200,
West Block, Parliament Hill
8:30. - 9:30 am
Presentation of projects for Conference agenda on theme of
"Women's Health" (continued)
(8:30 - 8:50 am)
The DESAPER project and Global Health Challenges
Ms. Julia Wayand, Office of External Relations
Pan American Health Organization (PAHO)
(8:50 - 9:00 am)
Questions and answers
(9:00 - 9:20 am)
Prevention of AIDS in Mothers and Children
Dr. Mercedes Weissenbacher
United Nations AIDS Program (UNAIDS)
(9:20 - 9:30 am)
Questions and answers
9:30 - 10:30 am
Discussion of projects presented on theme of "Women's
Health"
10:30 - 11:00 am
Coffee Break
11:00 - 12:30 pm
Review of draft Ottawa Declaration
12:30 - 2:00 pm
Lunch (open)
2:00 - 3:00 pm
Review of draft Ottawa Declaration (continued)
3:00 - 4:35 pm
Presentation on Telehealth
(3:00 - 3:05 pm)
Introduction
Ms. Elizabeth Mulholland
Senior Advisor, Policy and Research
Office of the Prime Minister
5
(3:05 3:35 pm)
The Nature and Functions of Telehealth
Dr. Mamoru Watanabe, Professor Emeritus of Medicine
University of Calgary
CANADA 1999
(3:35 4:05 pm)
The Canadian Women's Health Network
Ms. Madeline Boscoe, Executive Coordinator
Canadian Women's Health Network
(4:05 4:35 pm)
The First Nations Health Information System
Ms. Lucy Papineau, Acting Director
Social Development & Health Mohawk Council of Akwesasne
4:35 pm
Delegates and International co-operation agency representatives
depart Parliament Hill by motorcoach for the Sheraton Hotel
5:30 pm
All delegates and International co-operation agency
representatives depart the Sheraton Hotel by motorcoach for
Gatineau Park
6:30 pm
Barbecue followed by entertainment
Willson House, Gatineau Park
9:30 pm midnight
Delegates and International co-operation agency representatives
return to the Sheraton Hotel by motorcoach
Friday, July 9
8:00 am
Delegates and International co-operation agency representatives
depart by motorcoach from the Sheraton Hotel to Room 200,
West Block, Parliament Hill
8:30 10:00 am
Review draft of Summary of Current and Future Actions to
be Undertaken by the First Spouses
10:00 - 10:30 am
Coffee Break
10:30 - 11:30 am
Presentation on the Parallel NGO Events
Ms. Elizabeth Mulholland
Senior Advisor, Policy and Research
Office of the Prime Minister
11:30 am noon
Questions and answers
Noon
Delegates depart by motorcoach for the Westin Hotel
(site of the 9th Conference of Spouses of Heads of State and
Government of the Americas)
6
12:30 - 2:00 pm
Working Lunch, Westin Hotel (Confederation III)
Chair: Ms. Louise Leger, Executive Director
Hemisphere Summit Office
Discussion on Draft Agenda of 9th Conference of Spouses of
CANADA 1999
Heads of State and Government of the Americas
2:00 - 4:00 pm
Logistical information for the 9th Conference
(Press, security, protocol, distribution of forms, folders, etc.)
4:00 - 4:30 pm
Coffee Break
4:30 - 6:00 pm
Logistical information for the 9th Conference (continued)
6:00 - 6:30 pm
Closing Remarks
Dr. Chaviva Hosek, Director
Policy and Research
Office of the Prime Minister
6:30 pm
Delegates depart the Westin Hotel for the Sheraton Hotel by
motorcoach
7:00 pm
Farewell Cocktail Reception
Penthouse, Sheraton Hotel
Saturday, July 10
Departure of delegates
7
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2
Divider Title:
NINTH CONFERENCE OF SPOUSES OF HEADS OF STATE
AND GOVERNMENT OF THE AMERICAS
Ottawa, Canada
September 29 - October 1, 1999
CANADA
1999
OVERVIEW
Background
The Conference of Spouses of Heads of State and Government of the Americas
originated in 1980, when the First Spouses of Central America decided to gather
to exchange experiences and integrate goals, projects and mechanisms for action
NINTH CONFERENCE
OF SPOUSES OF
and cooperation between their nations. The Conference became an annual event in
HEADS OF STATE
1991, in Venezuela. It turned into a hemispheric event in 1994, when Canada and
AND GOVERNMENT
the United States participated in it for the first time.
OF THE AMERICAS
Hemisphere Summit Office (LXD)
The Ninth Conference of Spouses of Heads of State and Government of the
Department of Foreign Affairs
and International Trade
Americas will be hosted by Canada from September 29 to October 1. 1999. The
125 promenade Sussex Dr.
eight previous conferences have been held in Chile (1998), Panama (1997),
Ottawa. Canada KIA 0G2
Bolivia (1996), Paraguay (1995), Saint Lucia (1994). Costa Rica (1993),
Tel: (613) 944-1692
Fax: (613) 944-1737
Colombia (1992) and Venezuela (1991).
E-mail: Danielle [email protected]
Context: Canada and the Inter-American Agenda
NEUVIÈME CONFERENCE
DES ÉPOUSES DES
In 1990, Canada officially joined the Organization of American States. This was
CHEFS D'ÉTAT ET
the result of Canada's decision to become a more involved and active partner in
DE GOUVERNEMENT
the Americas. Since then, Canada has been increasingly involved in the new Inter-
DES AMÉRIQUES
American agenda, particularly through its human security and human rights
Bureau du Sommet hemispherique (LXD)
concerns, the anti-personnel mine initiative, trade liberalization and partnerships
Ministère des Affaires etrangères
et du Commerce international
with civil society.
125 promenade Sussex Dr.
Ottawa, Canada KIA 0G2
Canada's hosting of the Ninth Conference of Spouses is thus consistent with its
Tél: (613) 944-1692
Télec (613) 944-1737
enhanced profile in the region. It is part of a broader Inter-American agenda that
Courriel [email protected]
includes five other major hemispheric events to be hosted by Canada over the next
three years. These five high profile events are: the XIII Pan American Games (July
NOVENA CONFERENCIA
DE ESPOSAS DE JEFES
23 to August 8, 1999), the American Business Forum followed by the Hemispheric
DE ESTADO Y DE
Trade (FTAA) Ministerial (November 1 to 4, 1999), the Organization of
GOBIERNO DE
American States General Assembly (June 2000) and the Summit of the Americas
LAS AMERICAS
(Spring of 2001).
Oficina de la Cumbre Hemisterica (LXD)
Ministerio de Asuntos Exteriores y
Comercio Internacional
The Ninth Conference of Spouses of Heads of State and Government of the
125 promenade Sussex Dr.
Americas
Ottawa, Canada KIA 0G2
Tel: (613) 944-1692
The Conference of Spouses traditionally focuses on social welfare themes, such
Fax: (613) 944-1737
as health, education, violence, and increased participation in society of women
E-mail: Danielle [email protected]
and children. This year, the themes selected are: A Healthy Start: Children from
0-6, and Women's Health. Both themes are of common relevance for all countries
in the region, and at the same time, broad enough to accommodate a large number
of sub-themes, depending on the priorities and interests of each country.
Government Gouvernement
of Canada
du Canada
Canada
It has been customary for the host country to hold a Technical Meeting previous to
the Conference itself. During these technical meetings. government delegates and
technical advisors from each country, and international cooperation agencies,
follow up on projects endorsed at previous conferences, present new projects for
information and/or consideration. Delegates also review and revise draft
CANADA
1999
Conference documents, and discuss logistical and security preparations for the
Conference. This year, the Technical Meeting will be held in Ottawa from
July 6 to 9.
During the Conference itself, the First Spouses endorse the projects previously
discussed and approved at the Technical Meeting. On the last day, they sign a
declaration committing to the agreements reached at the Conference.
A significant aspect of these Conferences is the participation of International
Cooperation Agencies. Working closely with these agencies, the Conference
provides a very useful forum for advocacy and support for international
cooperation based on programs and projects of regional and national interest.
Some of the international cooperation agencies that will be present at the Ninth
Conference are: the Inter-American Development Bank (IDB), the Inter-American
Institute for Co-operation on Agriculture (IICA), the Organization of American
States (OAS), the Pan-American Health Organization (PAHO), the United Nations
AIDS Program (UNAIDS). the United Nations Children Fund (UNICEF), and the
Inter-American Children's Institute (IACI), among others.
Participation of Non-Governmental Organizations
In somewhat of a departure from the previous conferences, the Ninth Conference
will include a Non-Governmental Organizations (NGOs) Fair. The objective of
this event is to bring together non-governmental organizations from Canada and the
rest of the hemisphere that are active in the areas of early childhood development
and women's health, enabling them to share ideas and experiences, to meet and
exchange information with international cooperation agencies and amongst each
other. Each First Lady has been invited to select two NGOs from her own country
to participate in the Fair, whose mandates are relevant to the themes of the
Conference.
On each morning during the Conference, the First Spouses will have one hour to
tour the Fair. The first day will be dedicated to those NGOs whose mandate is
relevant to early childhood development, and the second day will be on Women's
Health. In the afternoon, NGOs will have an opportunity to meet with international
cooperation agencies and other government departments to share information and
explore opportunities for collaboration.
Clinton Presidential Records
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Divider Title:
REGULATIONS OF THE PLENARY
CONFERENCE OF SPOUSES OF HEADS OF STATE AND
GOVERNMENT OF THE AMERICAS
CANADA
1999
GENERAL PROVISIONS
Article 1: Participants
Heads of Delegation, Technical Advisors, and Guest Delegates make up the
delegations of the countries attending the Conference of Spouses of Heads of State
and Government of the Americas.
Article 2: Types of Participants
The Heads of Delegation are defined as the First Ladies. They are the Spouses of
Heads of State and Government, or their daughters who have officially assumed
that role, and the Government Delegates from those countries where there is no
First Lady.
The Government Delegates are defined as the participants designated by the
governments where there is no First Lady. The rights of participation of the
Government Delegates shall follow the order of precedence.
The Technical Advisors are defined as those members of the team of the First Lady
or Government Delegate responsible for coordinating the substantive aspects of the
Conference.
The Guest Delegates are defined as the representatives of International
Organizations and the representatives of Non Governmental Organizations.
NOTE: Technical Advisors and Guest Delegates are alternate
delegates, and are subject to protocol precedence.
CONFERENCE ORGANIZATION
Article 3: Language
The Pro-Tempore Secretariat will provide English-French-Spanish simultaneous
interpretation and translation services.
Article 4: Quorum
Quorum shall be constituted by one half plus one of the Spouses of Heads of State
and Government and the Government Delegates participating in the Conference.
Article 5: Speech Rules
The Pro-Tempore Secretariat will offer the floor to the speakers according to the
order established prior to the meeting. The Pro-Tempore Secretariat may call a
speaker to order when his/her observations do not relate to the subject being
discussed.
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1999
Article 6: Speech Limitations
a)
The Pro-Tempore Secretariat shall determine the maximum time granted to
each Head of Delegation to make her country's speech based on the time
availability and the order defined in the Agenda. The order will be based
according to the issue and the order of submission.
b)
The Pro-Tempore Secretariat may reduce the time for an alternate
delegate's intervention to a period shorter than that granted to the Head of
Delegation.
c)
During a debate, the Pro-Tempore Secretariat may read the list of speakers
and declare the list as closed. However, the Head of Delegation may be
granted the right to respond if a speech given after the closing of the list
makes it advisable.
Article 7: Proposals and Amendments
Countries shall submit their observations to the Draft Declaration within the time
limit established by the Pro-Tempore Secretariat. Any specific additional
observation may be submitted during the debate scheduled for this purpose in the
agenda.
Article 8: Designation of Alternate Representation
If working groups are to be established, counselors, technical advisors, experts or
individuals of a similar category designated by the First Lady or Government
Delegate may act as members of said working groups. However, these persons
may not participate in plenary sessions.
Article 9: Voting Right
Each Delegation shall have the right to one vote. The Head of Delegation. or the
person designated by the latter as her alternate, shall be vested with said voting
right.
Article 10: Decision-Making Procedure
a) Decisions shall preferably be made by consensus.
b) In the event any delegation requests to vote on a proposal, voting shall be
carried out by roll call and hand raising.
c) Proposals shall be approved by majority vote of the attending delegations.
Article 11: Organization of Sessions
2
Recognizing the value of the debate, and in order to make the best use of time
during this Conference, the following dispositions are to be observed:
a)
Extension of the Plenary.
Each Plenary should not extend beyond three hours so that all Heads of
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1999
Delegation may have the opportunity to expound within the time limit set by
the Pro-Tempore Secretariat.
b)
Closing of the speaker's list.
The organization of the debate demands that the list of speakers who wish
to participate be finalized one week prior to the Conference.
c)
Extension of the interventions.
The time of the programmed interventions must not exceed the limit
established by the Pro-Tempore Secretariat. Any extempore intervention
during the Plenary cannot exceed the time allotted for the scheduled
interventions. It is suggested that the extempore interventions do not exceed
two minutes.
Article 12: Response Rights
a) During the sessions, the delegations may use the right to respond at the end of
the Plenary, within the established time limit.
b) Each delegation, using its right to respond, shall be allowed only two
interventions per theme in a single session.
FINAL DISPOSITIONS
Article 13: Conference Host Country
When deciding on the country that in each opportunity shall be the host country for
the Conference, the following order should be observed:
The hemisphere has been divided into 5 Regions:
North America
Central America
Caribbean
Andean Pact
South Cone
One of the countries of each Region shall be the host country for the Conference
according to the consecutive order set forth above. Should none of the countries in
the corresponding Region express its willingness to be the host country for said
event, one of the countries in the next successive Region will be invited to be the
3
host country for the Conference. In this case, the proposal shall be decided with
the vote of the Heads of Delegations attending the meeting.
Article 14: Participation
All countries of the region that have expressed their interest in implementing the
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programs proposed in the final Declaration of the Ninth Conference of
Spouses of Heads of State and Government of the Americas have the right to
participate in them.
Note: The deadline for submission of the recommendations on the Regulations
governing the Plenary Sessions of the Ninth Conference of Spouses of Heads
of State and Government of the Americas and future ones is August 16, 1999.
4
Clinton Presidential Records
Digital Records Marker
This is not a presidential record. This is used as an administrative
marker by the William J. Clinton Presidential Library Staff.
This marker identifies the place of a tabbed divider. Given our
digitization capabilities, we are sometimes unable to adequately
scan such dividers. The title from the original document is
indicated below.
4
Divider Title:
DRAFT FOLLOW-UP REPORT
ON THE COMMITMENTS ADOPTED AT THE
8ᵀᴴ CONFERENCE OF SPOUSES OF HEADS OF STATE
AND GOVERNMENT OF THE AMERICAS (SANTIAGO 1998)
CANADA 1999
1.
Healthy Schools
In Argentina, four programs have been implemented to improve the
living conditions of children in schools, by providing adequate nutrition, good
hygiene and health care, in a co-ordinated fashion by different Ministries and
Provincial Governments. Two of the programs are national (National Child
Nutrition Program or PRANI and the Children's Assistance Program or
PROAME) and the other two are being carried out in the Province of Buenos
Aires only (Child Development Units Program and School Meal Service).
Although no final evaluation has been made, strong support has been
expressed by civil society and by provincial and municipal agencies.
Canada has offered health services for children under six living at risk
through two programs: the Community Children's Action Program intended
to integrate parental involvement into the educational needs of their children.
Program officials pay visits to households, to provide individualized
assistance for child development, nutritional therapy, collective kitchens and
traditional native medicine programs. The second is the Aboriginal Head Start
Early Intervention Program, which focusses on native children up to the age of
six who live in urban centres and communities in northern Canada. Some
56,000 children and parents are covered by these programs.
The healthy schools program is fully operative in Chile as reported in
the follow-up program in 1998, and progress is being made to improve the
quality of education through the Ministry of Education, which is training
teachers and changing the school curriculum for all primary and intermediate
schools. The school day has been extended to eight hours.
A healthy school strategy has been established in Colombia through a
seminar/workshop for 27 coordinators in different Departments and districts.
Subsequently, two documents containing the general guidelines and strategic
vision were prepared, published and widely distributed. With support from the
Pan American Health Organization (PAHO), financing was provided to
prepare a video on healthy schools, which was distributed to all the
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1999
Departmental health directorates.
In the Dominican Republic, the program is in an experimental stage. The
subject was included in the school curriculum with activities to promote health
and foster good hygiene habits.
The healthy schools project in El Salvador continues to benefit
600,000 children in rural and marginalized urban zones. The objective is to
provide all schools with health and nutrition services, school lunches,
infrastructure and curriculum support. It is also hoped that 100% of school
councils will participate in the program, to provide teachers with the
methodologies they require to detect certain disabilities, particularly visual
and auditory, and to promote health practices.
With participation of the health and education sectors and the support
of PAHO, the European Union and UNICEF, Guatemala established a
national healthy schools program whose objectives are to vaccinate 100% of
school children and to support all the institutions that serve the school-age
population. The goals are to encourage closer coordination between the
Ministries of Health and Education in preparing educational materials, in
promoting the program at the national level, and in promoting vaccinations for
children.
Guyana has stressed vaccination programs and better nutrition in
schools. The Ministry of Health, PAHO and the United Nations Development
Program (UNDP) participate in these programs.
2
With assistance from the Inter-American Development Bank, the
World Bank and different NGOs, the Haitian government has implemented a
program for health and nutrition in schools. It also hopes to improve the
sanitary conditions in schools and other community facilities where
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shortcomings currently exist.
Honduras organized a pilot project in four schools, with the
participation of a consultative committee, an inter-institutional technical
committee, a private consultant and the First Lady. As part of the project,
school lunches were introduced, water was fluorinated, training was provided
to cope with family violence, and oral health was promoted. In addition,
vegetable gardens were developed, support for a water desalinization plant
was arranged with the Spanish government, and anti-parasite monitors were
established. Sports facilities and sanitary installations were improved in one
of the schools. A project document was prepared by the Office of the
President of the Republic, in search of financing from Stockholm. Because the
results of the pilot project were positive, it was then applied to approximately
3,000 formal and informal schools as well as to education centres.
Different activities were carried out in Panama, such as school meals,
workshops to prevent drug use by children and adolescents, oral health,
environmental education workshops, poultry farms and vegetable gardens on
school grounds. All children between the ages of five and eleven are covered
by the school lunch program. Coordination has been established between the
education and health sectors to form school monitors to treat and prevent
diseases in school children, mainly dengue and smoking.
Peru prepared a Healthy School project, involving 2280 school
monitors, 500 teachers and 500 school coordinators. The project was
supplemented by providing chlorinated water in each classroom in each
school.
3
Trinidad and Tobago implemented a project to establish a
vaccination program, child development clinics, dental clinics and educational
programs.
Uruguay established eye health programs, the supply prescription of
glasses for those in need, oral health, anti-parasite programs and medical
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1999
check-ups in schools in socio-economically depressed areas.
2.
Sex Education for Girls
Argentina has implemented different programs targeted to different
groups, including a sex education program for the staff of residential schools,
programs for teenagers on prevention and sexual health care, a nation-wide
educational program for responsible parenthood, a national comprehensive health
plan for adolescents, and a workshop on teenage pregnancies.
Canada has established Centres of Excellence under its women's
health program, which carries out different projects on sexual health for girls
and women. Also, Health Canada presented a national health strategy for
women, whose main objectives are to ensure that policies and programs are
tailored to the different health needs of women. The program also facilities
research on women's health and better health services for women, including
preventive measures.
The Ministry of Education in Chile has organized sex education
campaigns in all schools supported by the First Lady, and orientation sessions
for young people at the Family Foundation, which is chaired by the First
Lady. Financing comes from the national budget, and the program is
continuing during 1999.
4
In Colombia, a strategy was established to strengthen sex education
projects in schools, and policies were developed to cope with sexual and
reproductive health. The strategies were carried out through awareness
training and communication in workshops and meetings with teachers, pupils,
CANADA 1999
community leaders, universities and the directors of associations of private
schools. Government ministries, national institutes and NGOs also
participated.
The Dominican Republic has included sexual health in its school
programs, and has provided sex education workshops for teachers and
youngsters. The General Education Act was amended to benefit girls and women
by promoting gender equity in the family and in society. The achievements
include sex education forums and the use of non-sexist language in schools.
The Ministry of Education of El Salvador has placed greater attention
on sex education and reproductive health in primary and intermediate public
and private schools. It has also trained educators to teach sex education and
reproductive health.
Guatemala established a training program for teachers and parents,
and has offered guidance sessions for teenagers in different schools at the
national level. The Ministries of Health and Education, NGOs and PAHO
participated in these sessions. Special schools for parents were established in
10 Departments.
Guyana made a contribution to the teaching of responsible sexuality
and reproductive health in schools through a series of meetings, a seminar and
therapy. It also held workshops for pregnant teenagers who have had to leave
school, teaching them skills to enable them to find jobs and become more self-
sufficient.
Haiti contributed to sex education by printing relevant information on
posters and notices in schools.
5
Nicaragua held meetings and a national congress to agree upon and
institutionalize a policy to promote sex education for young people. The
Ministry of Education, political parties, religious institutions, state
organizations, international organizations, ethnic communities from the
Atlantic coast, the educational community, parents, students, and business
CANADA 1999
associations participated in the meetings.
Panama included the subject of sex education in school curricula at
the primary and middle school levels, and established a national
interinstitutional commission and 21st century municipal district committees to
prevent early pregnancy.
This year, Peru trained 9,200 primary and secondary school teachers,
and prepared and delivered educational materials, spots and videos on
prevention and sex education for students, teachers and parents. The
Ministries of Health and Education, the IDB, the World Bank, USAID, the
GTZ and UNFPA as well as private entities participated in the funding of
these activities.
In Trinidad and Tobago, the goal was to teach girls responsibility
and self-awareness in the field of human sexuality. Seminars and classes were
held to provide information and to discuss the sexual needs of adolescents.
Another goal was to reduce the teenage pregnancy rate by including the topic
of sex education in the school curriculum, and provide training for teachers.
Apart from the Ministry of Health and NGOs, UNICEF, UNESCO, UNAIDS
and the German Embassy took part.
In Uruguay, presentations, school activities and educational sessions
were held for parents on this issue.
6
3.
HIV/AIDS prevention for adolescents
In Argentina, the Ministry of Health, the World Bank and NGOs have
cooperated in launching campaigns in the mass media, as well as focussed
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1999
activities to raise national awareness levels of HIV prevention. Training in the
educational sector and financing for civil society organizations was also
provided.
Brazil has developed educational strategies for the prevention of
HIV/AIDS targeted to children and teenagers, teachers and educators.
Government Ministries, NGOs, the IDB, UNAIDS, UNICEF, the UNDP,
UNESCO and PAHO participated in funding the strategies. Working networks
have been established at the national level with educational professionals who
are experts in sexuality, AIDS and drug abuse. As a result, 183 979 teachers
have been trained, and some four million students have received information
on preventing STD/AIDS.
A variety of initiatives are under way in Canada in the area of
education and information dissemination. Examples include: A media literacy
training model is being developed for adolescent programs to help young men
and women gain the decision-making skills to develop a healthy approach to
sexuality; a sexuality education best practice sources book to provide youth-
friendly resource material for educators and public health professionals. In
addition, in order to strengthen its surveillance and knowledge base, Health
Canada has recently initiated a national, multi-centre cross-sectional
surveillance system for street kids to monitor rates of STDs and risk
determinants of this population.
7
Colombia has had an intersectoral plan since 1994, whose general
objective is to raise the awareness of individuals, families and society on the
different ways in which HIV/AIDS is transmitted and to promote values,
attitudes and behaviours that make for responsible sexuality. Government
Ministries, PAHO, UNICEF, Colombian agencies and NGOs were the
principal participants.
CANADA 1999
With a national HIV/AIDS prevention plan, sex education programs in
schools and the awareness campaign in mass media, the Dominican Republic
has raised awareness on the transmission and prevention of HIV. The Ministry
of Public Health, UNAIDS, the UNDP and NGOs participated in the
campaign.
The Ministry of Health of El Salvador has designed a national
HIV/AIDS prevention and control plan at the intersectoral level, which targets
its activities toward different groups, particularly youth. NGOs, organizations
that combat AIDS and universities are the main participants. The main
achievement of the plan has been the unification of efforts of all sectors
involved in the struggle to control and prevent HIV/AIDS. Future activities
include following up on the national plan, boosting epidemiological
surveillance, and designing specifically-targeted research tools in cooperation
with NGOs and universities. As well, advisory services in health centres and
hospitals will be strengthened.
Guatemala implemented an information program on AIDS and the
means of preventing the disease, and has offered seminars, courses and
information sessions in secondary schools on AIDS prevention. Campaigns
are also being carried out to prevent drug use. The Ministries of Health and
Education, the National Youth Council, NGOs and PAHO are participating in
these efforts.
8
Guyana has a policy to combat HIV/AIDS by promoting informed
and responsible behaviour and reducing STD/HIV/AIDS-related deaths and
infections among young people. Large-scale campaigns to raise awareness and
HIV/AIDS education programs have also been implemented in schools.
CANADA 1999
Haiti is engaged in a radio, press and television campaign on the
prevention of sexual diseases.
Honduras has also carried out several projects in this field, including
extensive information and education campaigns for the prevention of
HIV/AIDS. With the assistance of Government Ministries and International
Cooperation Agencies (PAHO, USAID, GTZ, EU, IDB and others), the
impact of the prevention campaigns has been focussed on vulnerable groups.
A bill has been tabled for the control and prevention of HIV. The bill is still
being debated in Congress.
With the cooperation of civil society, Panama prepared a national
sexual and reproductive health plan, which includes an HIV/AIDS component.
It established a sexual and reproductive health committee by executive decree,
and a Public Health Policy Council. NGOs also participated, planning
marches for World AIDS Day, specifically with young people. Seminars for
youths were also held on this issue in different parts of the country.
Peru prepared a national campaign to prevent STD/HIV/AIDS among
young people, which is still awaiting funding. It also prepared a project
entitled "Young people working for healthy and safe sexuality" financed by
UNAIDS.
Trinidad and Tobago conducted seminars to provide teenagers with
the information they need to help them take informed and responsible sexual
decisions.
9
Uruguay has implemented different projects for HIV prevention in
schools (children and teenagers) with the support of UNAIDS, UNICEF, the
European Union and the GTZ of Germany. Law 1589 was passed in 1997,
making it compulsory to offer HIV tests to all pregnant women and to provide
antiretrovirus medication for those testing positive. One achievement was that
the Ministry of Public Health and NGOs worked together on this issue for the
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1999
first time.
4. Hemispheric Program to Strengthen the Inclusion of Rural Women in
Entrepreneurial Chains and Socio-economic Democratization
In conjunction with different Ministries, Provincial Councils and IICA,
Argentina introduced a rural women's program that trains women in
weaving, gardening, beekeeping, fruit growing and carpentry. The program
includes the establishment of libraries and cultural centres. A meeting on the
situation of rural women in Argentina was held in June 1998, attended by 30
rural working women who are leaders in their respective communities. A
program on local communications and integration centres in rural areas could
not get under way due to a lack of funding.
Canada recognizes women's essential role as economic partners for a
prosperous agri-food industry. To promote and support initiatives enabling
women to participate to a much greater extent in policy development and the
decision-making process, the Federal Minister of Agriculture holds annual
business meetings with leaders of agricultural organizations.
Through the Office of Rural Women, Agriculture and Agri-Food Canada
conducts regular meetings with rural women leaders to exchange information
on priority issues and activities and to obtain their input in Departmental work
planning.
In 1998, the Rural Women's Office of Colombia's Ministry of
Agriculture and Rural Development implemented the following programs:
First, strengthening in the fields of entrepreneurship, organization and
community participation for rural women to enable them to achieve
representation and the power of participation in National, Regional and local
10
decision-making bodies. The activities involved are: training and advisory
services in production; technical and financial support for production projects
led by rural women; promotion of rural education with a gender perspective;
training for community mothers and representatives of rural organizations in
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the preparation of soy-based foods. The second strategy was institution-
building to encourage organizations in the agricultural sector to incorporate
gender perspectives. The third was to strengthen the management and
interinstitutional coordination capacity of the Rural Women's Office, and the
fourth was a special project on the socioeconomic stabilization and
consolidation of women and rural families displaced by guerrilla warfare.
The Dominican Republic established a loan portfolio for rural women
(with funding from the Government and the IDB), provided training
programs for rural women and created the regional rural women's network
sponsored by FAO.
El Salvador's national policy on agriculture and livestock seeks to
improve the situation of women in rural areas by promoting their property
rights, access to resources, employment, markets and trade. National and
international banks were encouraged to establish soft lines of credit that
women could use to buy land. As well, access by women to the Ministry of
Agriculture's commercial information system was promoted.
Guatemala included the topic of rural women in its agricultural
development agenda, and established a national committee composed of
representatives of public institutions, NGOs and the cooperative movement.
The programs for the promotion of rural women run by the Office of the First
Lady was also strengthened.
Guyana's policies in this area include the creation of women's groups
in rural regions to discuss and share experiences as well as the provision of
training for rural women in sewing, knitting and crafts to make them more
self-sufficient. The result has been an increase in the number of women with
skills they can use to help support their families.
11
Haiti has promoted social and economic development by guaranteeing
loans for women to improve the quality of their products and their living
conditions. The UNDP and UNICEF are participating in this program.
In Honduras, 14 312 women living in extreme poverty received
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1999
training in socio-productive areas, for an investment of close to Lps$12.2
million. Some 87 food stores were organized in different communities with
participation by the female beneficiaries of the voucher projects. Financial
support was provided for 280 female micro-entrepreneurs involved in
different production activities, for an investment of some Lps$7 million.
Nicaragua's goals include the design of gender policies in the public
agricultural and environmental sectors. The two main strategies were Laws 57
and 97, and the establishment of gender units in the different Ministries. The
Nicaraguan Women's Institute acted as coordinators and the First Lady
participated as an honorary member of the CIPRES committee. The results
include transfer of property titles to women, greater access by women to
credit, training and technical assistance, and the creation of a rural women's
unit in INIM.
Panama's strategies in this area were the establishment of provincial
coordination teams; classification and preparation of profiles for self-managed
projects in all the Provinces and the three indigenous districts; preparation and
dissemination of work guidelines for forums; organization of a national rural
and indigenous women's network; and creation of a national rural and
indigenous women's commission. Twenty-four Provincial and district forums
were held to train 1,500 rural facilitators, who were also provided with
medical, dental and gynecological treatment.
The Ministry of Agriculture of Peru supported various programs for
rural development and poverty reduction with a gender perspective. Activities
in Peru to consolidate economic units headed by women are based on two
strategies: (1) linkage of government demand for goods and services to be
supplied by micro-enterprises promoted under the infrastructure and social
12
support program (PAR); and (2) identification of market opportunities. These
activities are promoted through marketing, economic management, internal
organization and personal development. Micro-enterprises have been
encouraged in different areas such as sewing, food, crafts, footwear, business
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1999
and services.
Trinidad and Tobago established working networks for rural women
to help them become financially viable. Seminars and presentations were
made on skills and production, market identification, technology transfers and
food management. A Conference of Spouses of Heads of State of the
Caribbean was scheduled for July 1999 for the purpose of establishing a
network for rural Caribbean women. The First Lady has been extremely active
in this area, working with Ministries, NGOs and IICA.
In Uruguay, an agreement to support rural women in fabric design was
reached with the National Settlement Institute.
5.
Multilateral Horizontal Cooperation Project - INTEGRA
Argentina, Chile, Honduras, Panama and Peru appointed national
project coordinators to participate in the first meeting of the CIDI/OAS-
Integra Foundation horizontal cooperation project, a project developed to
promote childhood development (April 1999 in Quito, Ecuador). They also
participated in a seminar held in Santiago, Chile, to exchange ideas on past
experiences and ongoing projects.
Under this project, five-day study trips have been organized to enable
the directors and technical teams in the region to visit institutions with good
organizational management.
13
6.
Domestic Violence
With assistance from UNICEF, an instrument for reporting cases of
violence against women was established in Argentina (Buenos Aires). A
program to provide assistance for abused children and a safe house for abused
women and their children was also created. A telephone hotline was set up to
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1999
provide technical, legal and psychological counselling, assistance and
guidance in cases of family violence. A provincial program to prevent family
violence was also established in the province of Buenos Aires. This program
includes four elements: community prevention; guidance for assistance units;
professional development days; and training for the police. There has been an
increase in the number of complaints laid since the telephone hot lines were
set up and publicized. Training for court and police staff who receive
complaints has led to greater effectiveness in investigating and resolving
cases.
The Federal Government has renewed its commitment to reduce family
violence in Canada. Since this is a long-term problem, the commitment is
also long-term. Health Canada coordinates the Family Violence Initiative, and
in collaboration with health care professionals and NGOs, it works in
identifying best practices to prevent and respond to the abuse of women.
In 1998, Federal-Provincial/Territorial Ministers Responsible for the
Status of Women developed a Declaration of Violence Prevention. The
Declaration outlines common goals and principles shared across jurisdictions
in Canada, and a common commitment to address and prevent violence
against women.
Chile is continuing with last year's program, and is examining the law
against domestic violence that has been in effect for four years. Parliament is
studying the possibility of filling in gaps in that law to make its enforcement
easy and effective.
14
The presidential program "Make Peace" in Colombia is a key tool in the
policy for national reconciliation and peace, consolidating democratic
relations in the family, school and community. It is a national program in
which all the institutions in the health, education, protection and justice
CANADA
1999
sectors on the National and Regional levels will participate. It will establish
institutional and community mechanisms for early detection of domestic
violence, providing comprehensive assistance for its victims, and reducing the
levels of domestic violence, child abuse and sexual abuse throughout the
country. Although the program has not been officially launched, a national
policy has been established, and joint projects have been designed that will
allow for a sustainable impact. Legislation on domestic violence will be re-
formulated and the different representatives of civil society, local governments
and NGOs will be asked to introduce strategies for prevention and assistance.
In the Dominican Republic, the campaign to prevent domestic
violence has been stepped up, with the cooperation of various Government
Ministries, NGOs, the IDB, the UNFPA and PAHO. The policies include a
program contained in the Law to Prevent Domestic Violence; an education
campaign; a pilot violence prevention program in two communities;
participation in the Inter-American Convention to Prevent and Eradicate
Violence Against Women; the establishment of police detachments to assist
women; the creation of social services for the victims of domestic violence;
and programs for psychological treatment and emotional support provided by
the Ministry of Public Health.
El Salvador seeks to prevent and detect domestic violence through a
program to improve family relations. It has also created temporary shelters for
abused women. The Ministry of Education, the Human Rights Commission,
health care units, hospitals, the national police force and the Office of the
Attorney General, among others are partners in this initiative. As a result,
action has been taken in 10,153 cases and another 87,655 cases have been
assisted.
15
Guatemala passed a Domestic Violence Prevention and Eradication
Law, and a program to prevent and eradicate domestic violence was
established in the Office of the First Lady, in cooperation with the Ministries
in social areas. A program was launched to sensitize employees of different
public sector institutions and NGOs.
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1999
Guyana passed legislation on domestic violence, and began training
programs for police officers. Training for judges, magistrates and legal
professionals will begin shortly. As a result, the public is more aware of this
issue, and in future, the country plans to establish shelters and treatment
centres for families and individuals affected by the problem.
Haiti has begun a public awareness campaign on this issue. It has also
tabled legislation to prevent domestic violence.
To date, Honduras has no national plan to prevent domestic violence,
although a law establishing the National Women's Institute was passed in
August 1998, giving it the status of a Ministry. A Special Women's
Prosecutor was also created, and a law on the prevention of domestic violence
was passed. The results include a positive change in society's approach to the
problem of domestic violence, which is partly because women have broken
their silence and are laying public charges.
Nicaragua has created Women and Children's Commissions and a
National Committee to prevent the abuse of women, children and teenagers.
With participation of INIM, the National Police Force, the Supreme Court, the
National Assembly, the National Committee to Protect the Rights of Children
and Adolescents, the Ministry of Family Affairs, the Network of Women
Against Violence and NGOs, a higher profile has been given to the abuse of
women, children and teenagers. The Ministry of Health now considers
violence to be a public health issue.
16
Panama established the following goals: to establish an institutional
system to address domestic violence; to define a national policy to deal with
the problem; to create the first centres to assist abused women; to include the
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1999
subject of non-violence in the primary and middle school curricula; and to
implement a protocol for dealing with complaints about domestic violence.
Progress includes the National Report on Violence against Women, which will
be presented to the United Nations Human Rights Commission; the opening
of the first shelter for abused women; inclusion of the issue in 27 mini-
summits for boys and girls; a program of 27 forums for rural and indigenous
women; support for the campaign "A Life Without Violence is Our Right";
and last, by the mass distribution of 10 500 copies of the Law against
Violence (Law 27).
Peru reported intensive activity to legislate against domestic violence,
including criminal legislation. Different programs, projects and activities have
been implemented in 1998-1999 to reduce domestic violence. The Ministry
for the Promotion of Women and Human Development (PROMUDEH) has
been creating and strengthening multi-sectoral channels to prevent and address
domestic violence, nation-wide, and has already established 22 networks in
different Departments. The Ministry of Education has implemented prevention
programs to sensitize the educational community and the public to violence
prevention, and has provided training for teachers in order to create social
structures that can provide assistance for children needing guidance.
Trinidad and Tobago has implemented public education programs
for non-violence, conflict resolution and anger management. Treatment and
rehabilitation services have been established for the victims of domestic
violence. Legislation on this issue has also been revised. Shelters for victims
and support groups for both victims and perpetrators have been established.
17
7.
Senior Citizens
Argentina has established a seniors program to address the basic
needs of people over the age of 60. To date the program has 10 164
beneficiaries in the province of Buenos Aires. A study was also conducted in
the city of Buenos Aires to learn about the aging population.
CANADA
1999
Brazil developed a National Policy for Seniors and an Action Plan for
implementing it, as well as a National Program of assistance for Homes for
the Aged. Assistance was provided to 302 361 elderly persons and more than
seven million seniors received flu, pneumonia and tetanus vaccinations.
Canada has been very active in developing and supporting a host of
activities associated with the International Year of Seniors (1999). Among
them are the promotion of participation in society of seniors; the training of
social/home care workers to look after seniors; and a project to foster the use
of leisure and recreation. In addition, the National Strategy on Aging,
developed in 1994, to meet the needs of seniors in the country, remains as
relevant today as it was five years ago.
Colombia has provided subsidies for 100,000 seniors through its
Social Solidarity Network and nutritional and leisure support for 50,000
seniors living in extreme poverty. Municipal policies for assistance to this age
group were strengthened in 800 cities. In short, 150,000 elderly people have
received support. Finally, programs for assistance to seniors have been
included in the public policies of 32 departments and 1068 municipalities.
The Dominican Republic has begun an analysis to prepare legislation
on assistance to seniors. It has also established a National Senior Citizens'
Council.
18
Through different programs and policies (public dormitories, meals,
assistance in purchasing basic staples, health policy for seniors, the National
Policy on Assistance to Seniors, among others), El Salvador has increased the
social participation of seniors thanks to the extension of health coverage
CANADA
1999
services, an increase in the interest of this age group in establishing
associations, and a better understanding of their rights. Sixty-five percent of
the proposed goals were achieved. Future plans are to implement fully the
National Policy on Assistance to Seniors to increase the participation of
seniors in society, to strengthen organization and to encourage families to
keep their aging relatives at home.
Guatemala passed a Seniors Protection Act. It is also preparing a
national policy for seniors, with the participation of the Ministries of Public
Health, Education and the Attorney General. A National Directory has been
prepared that includes public and private institutions working with seniors.
This directory will be used to co-ordinate actions at the national level.
With assistance from PAHO/WHO, Guyana will declare a Year of
Seniors. It has implemented a program entitled "Active Aging Makes the
Difference" which consists of walks for seniors. Finally, it has launched a
gerontology program with PAHO/WHO.
Honduras passed a law on special treatment for seniors, retirees and
pensioners with disabilities, and launched a project to create a Senior Citizens'
Institute. The Family Allowance Program has issued vouchers to seniors; a
Seniors Commission has been established, and discounts are provided on the
cost of private medical services and medications for seniors.
19
Panama's National Policy takes the form of public promotion
programs and services. Both the central and provincial governments maintain
networks of programs and services for seniors that includes: a comprehensive
human and social development program (comprehensive care for seniors; a
program to protect seniors; programs to promote their civic involvement; and
a project of the National Senior Citizens' Council that provides temporary
CANADA
1999
subsidies for seniors from very poor families. Different government
ministries, the Panama City Government and many homes and residences for
seniors participate in these projects. Training and refresher courses have been
provided for the technical staff of the National Directorate of Seniors, and for
staff that assist seniors living in Homes. Training events have also been held
for senior citizens, groups and associations, benefiting some 300 people.
In Peru, the Ministry of Women's Promotion and Human
Development has promoted the subject of seniors among decision makers
(members of Congress, Deputy Ministers, the media, opinion leaders, city
halls, etc.). It has also gained credibility with civil society as the main
institution responsible for this issue. It has implemented the first recreational
and sports program for seniors (2,000 participants) and a teaching program in
recreation and sports for seniors. In the medium term, it plans to formulate a
national policy on the elderly and to hold an event to celebrate and recognize
senior women. A pilot project will be carried out to establish a Senior
Citizens' Advocacy Group in conjunction with 10 local governments.
Trinidad and Tobago offers government-funded social assistance,
promoting intergenerational activities that involve civil society and the student
population. A study is being carried out on how to improve existing programs,
with the participation of government agencies, NGOs and UNESCO.
20
8.
Women's Leadership
Argentina has carried out a federal women's plan, financed by the
Inter-American Development Bank, to improve the formulation, monitoring
CANADA
1999
and evaluation of public policies and programs to promote women in the
country. The objectives will be achieved through institutional strengthening
and support for local initiatives. A Training Program in Political Leadership
for women has been designed, and a Tripartite Committee has been
established on equal opportunities for men and women in the work force. The
committee is composed of representatives of government, business, and
unions. The objectives are to build a consensus among social players to
promote equal access, treatment and training for both sexes, to foster
strategies for equal opportunities for men and women in the labour market,
and to build professional and technical capacity. A scholarship has been
established jointly with the NGO Fundación Mujeres en Igualdad to enable
female university students to take a year of postgraduate studies abroad.
Canada's approach regarding women's leadership has been to
encourage political parties to set targets, rather than to take legal or
constitutional measures. In addition, the Federal Government acts to ensure
that gender balance is considered when proposing candidates for appointments
to federal boards and agencies.
Canada's Employment Equity Act (1986) is designed to ensure equitable
participation of four designated groups in federally regulated industries, and
women are included among those groups. Finally, the Government of Canada
has also provided funding support for projects undertaken by women's and
other equality-seeking organizations, which are aimed at addressing the issue
of the participation of women in decision making.
21
In 1998, Colombia included the Plan for Equal Opportunities for Men
and Women in its 1998-2002 National Development Plan, whose main
objective is to boost participation and leadership of women. Different
government agencies and women's NGOs participate in this initiative.
Women's participation in public life is outstanding at the individual level;
Noteworthy as well, is passage of legislation on quotas for women employed
CANADA
1999
in decision-making levels in public administration. This legislation establishes
that as of September 1999, a minimum of 30% of positions will be filled by
women, on the highest decision-making level and on other levels.
The Dominican Republic increased the number of women in
decision-making positions in the public and private spheres, thanks to an
amendment to the Electoral Act that includes a quota of 25% of women
running for Congress and municipal government. Provincial women's offices
have also been established to foster women's participation in civic affairs and
leadership at the local level.
In El Salvador, a Gender Unit was established in the Training School
to promote participation by women in designing national and municipal public
policies. A training plan was designed and developed on gender theory, and
civic participation for the experts and managers of the school to guide the
promotion of women's participation in municipal councils. Consultations
were held at the national level with representatives of civil society
organizations, political parties and government agencies to gather proposals
and suggestions on how to apply the national women's policy. To promote the
exercise of women's civic rights and their social and political recognition, an
institutional work plan was designed to carry out promotional campaigns that
encourage women to obtain national identity documents and cards and to
register at the polls.
Guatemala established the National Women's Forum with
democratically elected female representatives from different ethnic groups,
public institutions and civil society. The forum has representatives in different
parts of the country. The National Program on Equal Opportunities for
Women was prepared and approved for women in different sectors.
22
Guyana is promoting the inclusion of women in all decision-making
areas at the national and local levels, and is working toward women's equality
public posts. Parliament passed the Decree on a National Policy for Women.
The National Women's Commission was also tasked with promoting the
CANADA
1999
gender approach at all levels of government, and an Inter-Ministerial
Committee was established to provide technical advice on the design of
policies and programs in this regard. Moreover, the Women's Leadership
Institute was created to train women in leadership.
Haiti invites women to participate in political life by encouraging
them to vote. The country has launched a campaign to promote women
through photographs and paintings of women who have had a significant
impact on the country's public life.
In Honduras, Congress has been asked to pass a law to increase the
quota of women in politics and in positions in the public administration. The
Honduran Federation of Women's Associations and NGOs are participating.
This year, five women held senior positions in government, which is
unprecedented in the country's history. The main goal is to achieve 50:50
participation in public posts by men and women.
Nicaragua provided training to strengthen women's leadership in
eight departments, including the autonomous indigenous regions on the
Atlantic coast. Workshops are being held in eight departments, and women are
playing a larger role in community development. It is hoped that women will
hold more public posts in the future.
Panama focused its efforts on providing training opportunities for the
female directors of women's NGOs and the 13 public institutions that have a
Women's Office integrate the gender perspective. Another goal is to establish
a Bank of Women gender specialists to offer training opportunities for
decision-makers to raise their awareness of this issue. Eighty percent of
Government Ministers and Directors attended the workshop.
23
Peru has created different bodies to promote women, such as the
Commission on Women, Human Development and Sports, the Women's
Rights Advocacy Office and the Ministry of Women's Promotion and Human
Development. To promote greater participation by women in the country's
political life, laws have been passed stipulating that all lists of candidates must
include at least 25% men and women. The number of women in the national
CANADA
1999
police force has increased, and starting in the year 2000, women will be able
to join the merchant marine. Job training programs have also been developed
to increase the work options of women.
Trinidad and Tobago is carrying out the Training and Public
Awareness Program in Gender and Development, whose participants include
Members of Parliament, Government Ministers, the business sector, the media
and labour unions. The main achievement has been to obtain greater support
and acceptance by society of women in public posts and the political arena.
9.
Education for Rights and a Culture of Peace
Argentina is carrying out a program to compile and publish stories,
myths, beliefs and folklore for public libraries and schools.
Brazil has a voluntary civic service program for young people who
have just completed school, who are trained as "citizen agents" to protect
human rights, in conjunction with local organizations and community
associations. Human rights are included as a cross-cutting issue in the basic
guidelines for national education. Special courses have also been given in
police academies and for police officers.
24
The Office of the First Lady of Colombia is promoting a program to
build peace in the family, schools and the neighbourhood. The key tool is the
presidential "Make Peace" program, whose strategies are to design, copy and
distribute materials to position the program as the national leader in promoting
CANADA
1999
a culture of peace in the family, in disseminating education materials on
children and women's rights, and producing a national bulletin. One of the
main achievements has been the coordination of institutional efforts.
In the Dominican Republic, two projects were developed: "Young
Leaders for Peace" and "Participation of Children in Building Democracy,"
creating a national network for the promotion of a culture of peace. A
campaign for the promotion of human and children's rights was also initiated.
Guatemala prepared written educational materials to hold and
publicize public awareness sessions. Training has been provided for teachers,
parents and community leaders, with multiplier effects. Activities were
co-ordinated with the Office of the First Lady of El Salvador, and technical
cooperation was obtained to tap the experiences of that country. The
Ministries of Education, Health and Culture, the Peace Department, the
Human Rights Commission, NGOs, UNESCO and PAHO participated in this
endeavour.
Guyana is carrying out educational programs such as the
Canada/Caricom Bilateral Gender Equity Fund, which is still in the initial
stages, with a view to sensitizing the public through the media, parents'
associations, community groups and others.
Haiti has focussed its efforts on designing a civic education program
for schools to teach children about their duties to form part of a healthy
society. The aim is also to teach children about democratic practices such as
tolerance, respect and determination. Teachers are being trained to promote
democratic rules, values and ideals.
25
Honduras carried out a project on "Education for Human Rights and
the Culture of Peace," financed by UNESCO. The project is a complement to
a pilot project of the First Lady for a museum of the child and family, which
will be financed by a World Bank loan. The project consists of installing an
amphitheatre to project special videos and films on the peace process and the
importance of peace and human rights for the country's future.
CANADA
1999
Panama invited 19 countries to participate in the Americas project on
human rights and a culture of peace. B$30,000 was allocated per country
(B$25,000 for the national project and B$5000 for the regional project).
Panama carried out its project through an interactive exhibition to promote
human rights, with participation by universities and international agencies
such as the UNDP, UNESCO and the IDB. At present, work is being done on
the regional project, which will compile the experiences of all the participating
countries in a document to be published at a later date.
Peru's strategies for promoting a culture of peace include
strengthening the mechanisms for interinstitutional coordination by promoting
national events to highlight human rights and to monitor and evaluate the
issue, so that national projects can be according to the needs. The results
include the dissemination and promotion of basic ideas on human rights, and
of national and international mechanisms for their protection, through
seminars, workshops and human rights programs targeted to government
institutions and civil society.
Trinidad and Tobago is holding public consultations on gender and
ongoing human rights education. A manual has been produced to assist
teachers in promoting the human rights of children by government ministries,
UNESCO, UNICEF and different NGOs.
26
10.
21st Century Schools: Training for Life
Argentina is carrying out a public health surveillance project, the
Carmen project and a program of preventive care for women's health to
CANADA 1999
reduce cancer of the uterus and prevent cancer through early diagnosis and
treatment. Under the last program, exfoliative cytology is being performed for
all sexually active women over the age of 18. The breast cancer prevention
program performs mammograms of women over the age of 40.
Colombia has established the goal of setting guidelines in different
areas of the curriculum. These guidelines were based on research on planning,
design, evaluation and quality control, publication and dissemination of
documents. Different national and international agencies participated, and all
the goals have been achieved. The general objective of the Carmen project is
to improve public health and to reduce deaths and illnesses caused by the main
non-transmittable diseases, through a cooperative program of integrated
actions for prevention and promotion. The Ministry of Health has begun to
develop and implement the Carmen project, and expects to establish a project
protocol for Colombia this year.
The Dominican Republic focussed on standards to prevent cervical-
uterine and breast cancer. It also provided training for parents and teachers by
disseminating UNICEF's "For Life" materials.
Haiti has launched a national education and training program to
improve the quality of education, including pre-school education and
education of children with disabilities. The program was made possible by the
education sector, the IDB, UNICEF, French cooperation and several NGOs.
Peru is working on training parents, health monitors and promoters,
teachers and health care staff, with assistance from the Ministries of Education
and Health, NGOs, USAID, UNICEF and PAHO.
27
Trinidad and Tobago is strengthening its monitoring systems for
early detection of outbreaks of infectious diseases, and has established
networks for the exchange of information. The First Lady has also inaugurated
a mobile clinic to monitor non-contagious diseases.
CANADA 1999
28
Clinton Presidential Records
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5
Divider Title:
PRESENTATION
and
Organization: Pan American Health Organization (PAHO)
Presenter:
Julia Wayand
Subject:
Measles Eradication, Violence Against Women, Maternal
CANADA 1999
Mortality and Healthy Schools
Description
Measles elimination: The Spouses of Heads of State and Government of the
Americas support PAHO's goal to eradicate measles by the year 2000. One of
the main activities to reach this is the implementation of the organization's
vaccination strategy in the Hemisphere. So far in 1999 there are only 400
reported cases of measles left in the Americas.
Domestic violence: In general there has been a lot of progress in the eradication
of domestic violence in Latin America. PAHO jointly with the countries in the
region provide technical evaluations of the experiences and annual action plans
that include expected results and progress indicators. In addition the organization
continues to mobilize resources for the region.
Maternal mortality: The main objective of this initiative is to contribute to the
rapid reduction of maternal mortality in the Americas through determined
support for specific regional and national plans.
Healthy schools: The goal of this initiative is to contribute to sustainable human
development and social capital, enabling future generations with the knowledge
and skills to care for their own families' health and to create supportive
environments and conditions conducive to health in the communities where they
study, work and live.
3
PRESENTATION
2
Organization: Inter-American Institute for Co-operation on Agriculture
(IICA)
Presenter:
Clara Solís-Araya
CANADA
1999
Subject:
Hemispheric program for the gender equity and development
of rural women (PADEMUR)
Background
At the 1997 Conference of Spouses Heads of State and Government of the
Americas that was held in Panama, the Spouses committed to support a
hemispheric program for the inclusion of rural women in entrepreneurial
production chains and socio-economic democratization. The main objective of
this program is to support efforts to improve the living conditions and
positioning of women in the rural development process in Latin America and the
Caribbean through:
visualization, recognition and strengthening of the contributions made by
rural women to the rural development process;
strengthening of public, private and civil society institutions and
organizations that serve the rural sector, through inclusion of the gender
perspective in strategies, programs and projects they carry out;
creation and promotion of a financing mechanism to adequately
implement the entrepreneurial initiatives of rural women; and
institutionalization of the gender perspective in IICA.
Follow-up report
Under the PADEMUR program, a project on Gender in Sustainable Rural
Development is being implemented, which was designed to take into account the
lessons learned in the project entitled Communications, Gender and Sustainable
Development carried out in 1998. PADEMUR fits into the new institutional
working framework of IICA on sustainable rural development. The main
objective of this project is to promote institutionalization of the gender approach
in IICA's policies and projects linked to sustainable rural development. The
PADEMUR project has achieved the following:
The contribution of rural women to rural development has been
recognized through documents, meetings and workshops;
PADEMUR's main activities have been targeted to Central America and
Panama in response to the mandate of the Ministers of the region.
National PADEMUR committees have been consolidated throughout the
region which already have developed plans of action that stress
preparation of a national analysis of rural women, public policies for rural
CANADA 1999
women, programs to promote production, actions by Non-Governmental
Organizations to foster production, and lessons learned;
In April 1999, a programming workshop was held with the countries of
Central America, Panama and Belize to define PADEMUR's plan of
action for this year. Further, it was agreed to introduce PADEMUR in the
Andean region;
In the Caribbean, IICA has provided technical training to establish a
network of female agro-entrepreneurs. A workshop is planned for July
1999, which will be attended by the Spouses of Heads of State and
Government of the region, the Ministers of Agriculture and the Networks
of Female Agro-Entrepreneurs;
IICA has defined a strategy to introduce the PADEMUR program in
South America. To date, the greatest progress has been made in Chile,
where the National Committee has been consolidated, a first draft of a
profile of rural women has been prepared, and an inter-institutional
agreement has recently been signed. The program is also being launched
in Paraguay, Argentina and Brazil.
PRESENTATION 3
Organization: INTEGRA Foundation
Presenter:
Verónica Baraona
Subject:
Multilateral Horizontal Co-operation Project - INTEGRA
CANADA 1999
Foundation
Background
During the Eighth Conference of Spouses of Heads of State and Government of the
Americas, which was held in Santiago, Chile, in September 1998, an action plan
was developed to support the Multilateral Horizontal Co-operation Project being
carried out by the INTEGRA Foundation. The main objective of this project is to
promote child development and to make it easier for women living in poverty to
join the labour force. The project will allow participants to share and transfer
experiences relating to early childhood education, growth, child protection and
comprehensive development among children under six years of age.
Follow-up report
Activities for 1999
From April 15 to 16, the preparatory meeting of the co-ordinators from each
participating country was held in Quito, Ecuador. The purpose of the meeting was
to allow the co-ordinators from each country to get to know one another and to
agree on upcoming activities for the year.
From June 16 to 18, a seminar entitled Co-operation to Promote Child
Development in the Americas was held in Santiago, Chile, with participants
from Argentina, Bolivia, Costa Rica, Ecuador and Chile. The purpose of this
seminar was to provide an opportunity for the institutions participating in the
project and guests to share their experiences.
From July 6 to 8, a seminar entitled "Cooperation to Promote Child Development
in the Americas" will be held in San José, Costa Rica, with participants from
Costa Rica, Honduras, Panama and Chile. This seminar is being organized by the
IMAS [Joint Social Assistance Institute].
PRESENTATION 4
Organisation: Organization of American States (OAS)
Presenter:
Dr. Gaby Fujimoto
Subject:
Rural Women and Social Development
CANADA
1999
Background:
The Action Plan of the 8th Conference of Spouses of Heads of State and
Government of the Americas, held in Santiago, Chile in September, 1998,
endorsed the Hemisphere Program to support integration of Rural Women into the
productive chain and socio-economic democratization. One of the main
objectives of this program is to promote and support all efforts aimed at
improving the quality of life and participation of women in the rural development
process of Latin America and the Caribbean
Follow-up report:
On June 24 and 25 the Rural Women in Social Investment Project seminar was
held in Lima, Peru. Funding for this activity comes from the OAS - Inter-
American Council for Internal Development (CIDI) and technical support was
provided by the OAS unit for social development and education.
PRESENTATION
Organization: United States Agency for International Development (USAID)
Presenter:
Carol Dabbs
Subject:
Maternal mortality
CANADA 1999
Background
In the La Paz Declaration, the Spouses of Heads of State and Government of the Americas
reiterated their commitment to reducing maternal mortality and morbidity by carrying out
regional projects with participation by governments and international agencies.
Follow-up report
To that end, the United States Agency for International Development presents activities
undertaken following the Sixth Conference of Spouses.
The main objectives of the project are to improve obstetrical care by providing training for
health-care workers. Some of the results expected are better access to health services to enable
communities to respond rapidly to complications during pregnancy, and increased medical care
for pregnant women.
Clinton Presidential Records
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marker by the William J. Clinton Presidential Library Staff.
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6
Divider Title:
a
PRESENTATION
and
REPORTS FOR THE NINTH CONFERENCE OF WIVES OF HEADS OF
STATE AND GOVERNMENT OF THE AMERICAS
PAN AMERICAN HEALTH ORGANIZATION
Includes:
- PROGRESS IN THE REGIONAL PLAN FOR THE REDUCTION OF
MATERNAL MORTALITY
- PROGRESS IN THE ERADICATION OF DOMESTIC VIOLENCE
- MEASLES ERADICATION IN THE AMERICAS
- FOLLOW-UP REPORT: "XXI CENTURY SCHOOLS, EDUCATING
FOR LIFE"
Washington, D.C., June 30 1999
REPORT FOR THE NINTH CONFERENCE OF WIVES OF HEADS OF
STATE AND GOVERNMENT OF THE AMERICAS
PAN AMERICAN HEALTH ORGANIZATION
PROGRESS IN THE REGIONAL PLAN FOR THE REDUCTION OF
MATERNAL MORTALITY
1. Background
Maternal mortality remains a serious public health problem in the Americas.
Every year, an estimated 25,000 maternal deaths occur from causes related to
pregnancy, childbirth, puerperium and the complications of abortion. Although
maternal death produces high social costs to families, communities and society as
a whole, maternal mortality is preventable and the interventions are cost-effective.
The commitment to reduce maternal mortality was approved by Member
Governments in both national policy agendas and by being signatories to
international declarations such as the International Conference on Population and
Development, Cairo, September 1994 and the Fourth World Conference on Women,
Beijing, 1995.
Since 1993, the agendas of the Conferences of First Ladies of the Americas
and the Caribbean included commitments to promote and support the development
and strengthening of national policies and specific plans and programs aimed at the
rapid reduction of maternal mortality. Since then, each Conference has renewed this
commitment to continue support for the regional initiative to reduce maternal
mortality. In 1996 an agreement on a regional initiative to reduce maternal mortality
was signed at the Conference of First Ladies in La Paz, Bolivia.
However, despite the progress made in recent years, the objectives of the
initiative have still not been met.
2. Program Objectives of the Regional Initiative of First Ladies in Support of
the Plans for the Reduction of Maternal Mortality.
2.1. General Objective
To contribute to a rapid reduction in maternal mortality in the Americas
through determined support for specific regional and national plans.
2.2. Specific Objectives
1. To promote the formulation or strengthening of national policies and specific
plans and programs for the rapid reduction of maternal mortality.
2. To support national information, communication, and education campaigns to
increase public awareness about the importance and consequences of maternal
mortality and promote greater action for its prevention.
3. To encourage the mobilization of public and private institutions, non-
governmental organizations (NGOs), grassroots organizations, and other entities
so that, within in their particular sphere of activity, they will contribute to the
formulation of national and local plans and to the execution of measures with
a substantial impact leading to a rapid reduction in maternal mortality.
3
4. To facilitate information exchange among countries regarding operations
research on successful experiences that will make it possible to identify and
overcome the barriers to access and appropriate utilization of the health services
or the factors that prevent health programs for women from having a greater
impact.
5. To promote programs to improve information systems in order to monitor the
epidemiological surveillance indicators for maternal mortality at the country and
regional level and maintain a vigorous epidemiological surveillance system at
the community and institutional level.
3. Progress
Since September 1998, the most significant advances to reduce maternal
mortality in the Region are:
3.1. Regional
- Review of the legislation: Bolivia, Ecuador, El Salvador, Peru, and the
Dominican Republic finalized a study on the regulatory framework applicable
to family health, maternity, women, and indigenous populations.
- Formation of a Regional Task Force: As agreed at the World Summit for
Children, the Interagency Coordinating Committee for the Americas met at
PAHO Headquarters in February 1999 to analyze activities conducted by the
different agencies to reduce maternal mortality. At that time, the Interagency
Coordinating Committee formed a Task Force with the responsibility of
facilitating interagency coordination and implementation to improve maternal
4
mortality indicators. The Task Force, coordinated by PAHO, includes the Inter-
American Development Bank (IDB), United Nations Population Fund
(UNFPA), U.S. Agency for International Development (USAID), United
Nations Children's Fund (UNICEF), and World Bank. Countries targeted for
priority action in 1999 are Nicaragua, Haiti, and Peru.
At the second meeting of the Task Force, held in April 1999, each participating
agency reported on the progress on interagency coordination and in Nicaragua,
Haiti and Peru to implement national plans for the reduction of maternal
mortality.
- Publications of several reproductive health documents including
WHO/UNICEF/UNFPA Americas Region Consultation on Maternal
Mortality have been produced and circulates.
- Global meeting jointly sponsored by UNICEF/WHO/UNFPA to discuss
"Systematizing experiences in implementing women-friendly health
services". Meeting conclusions recommend countries support efforts to
improve quality of care for women's health services in maternal health.
- International Women's Health Day celebrations in many countries calling
public attention to unacceptable levels of access and cost to women's health
services.
-
Regional assessment of the goals of the World Summit for children indicate
there are still many inequities in the region and that significant advances in
reduction of maternal mortality have not been detected in the last seven
years. As a result the Ministers of Health of the Americas renewed their
commitment to finding solutions to this serious problem.
5
3.2. Country Initiatives
The following are country activities that have stimulated policies, programs/
health services, development and community participation to maintain maternal
mortality on the public and policy agenda.
3.2.1. Policy
-
Bolivia: provision of basic health insurance in April 1999. Insurance
benefits address the health needs of women to facilitate rapid reduction of
maternal mortality.
-
Ecuador: formulation of a National Plan for the Reduction of Maternal
Deaths has to strengthen the surveillance of community committees with the
mandate to reduce maternal deaths and improve operations research in
emergency hospital obstetric care. The Plan seeks to raise political and
government awareness about the consequences of maternal death to the
family and society as a whole.
-
Haiti: reactivation of the National Plan for the Reduction of Maternal
Mortality. Plan implementation is spearheaded by the Ministry of Health
and supported by international technical and financial cooperation.
Appointment of a consultant to serve as focal point for Plan activities.
-
Dominican Republic: upgrading human resources to strengthen nursing and
health workers in essential obstetrical care. Haiti: 400 Cuban nationals are
providing services, which have considerably strengthened primary health
care.
6
-
El Salvador: significant progress is anticipated as a new reproductive health
policy recently promulgated by the Ministry of Health is implemented.
-
Nicaragua: formulation of a new national plan for reducing maternal
mortality with the participation of the Ministry of Health and several
international cooperation agencies.
3.2.2. Programs Activities
-
Peru: in light of the high maternal and perinatal mortality rates, one of the
key objectives of maternal, perinatal and family planning programs is to
reduce cases of maternal death. The Ministerial resolution of February 1999
called for the formation of a National Committee for the Prevention of
Maternal and Perinatal Mortality to disseminate information on the National
Plan of Action for the Reduction of Maternal and Perinatal Mortality and
promote its implementation, monitoring, and evaluation. The political
commitment assumed by the Government has been fundamental for program
activities to advance in: training, the delivery of essential obstetric care, and
epidemiological surveillance of maternal deaths. The National Committee
for the Prevention of Maternal Mortality programmed a series of activities on
Healthy and Safe Motherhood for the months of May and June 1999. For
example: events providing free care to pregnant women, training for health
workers in different areas (obstetric emergencies, management of incomplete
abortion, quality of care, etc.), communication and information campaigns
through the media, free childbirth care, public debates, school for parents,
among others.
7
-
Dominican Republic, Brazil, Paraguay, Bolivia, Ecuador, Honduras and
Nicaragua continued efforts to improve statistical information and
epidemiological surveillance of maternal deaths. Among the strategies
implemented is maternal mortality audits to establish relevant informational
basis for program planning.
8
3.2.3. Community Participation
-
Various countries, in their efforts to raise consciousness and promote public
participation have developed reproductive health fairs with an emphasis on
maternal mortality. Haiti is an example of this strategy.
-
San Julián in Santa Cruz, Bolivia implemented an information,
communication, and education model with community participation.
Cotopaxi- Ecuador implemented a pilot model to introduce quality maternal
health. The executing agency of both projects is Quality Assurance, a non-
governmental organization in conjunction with PAHO supported by a
USAID grant, participates in the regional initiative for the reduction of
maternal mortality. Honduras also implemented programs with the support of
Quality Assurance.
To this end the QA project has organized combined Quality design training
workshop in each of the pilot countries Bolivia, Ecuador, and Honduras.
At this point in time community and facility baseline assessments have been
conducted in all 3 countries. The Quality design workshops have launched
the working teams who have selected specific components for (re) design,
and are currently in the implementation phase. In addition each team has
identified indicators to monitor the outcomes of these Quality Design
interventions on the desired changes.
9
REPORT FOR THE NINTH CONFERENCE ON WIVES OF HEADS OF
STATE AND OF GOVERNMENT OF THE AMERICAS
PAN AMERICAN HEALTH ORGANIZATION
PROGRESS IN THE ERADICATION
OF DOMESTIC VIOLENCE
1. Background
In the last twenty years various efforts have been carried out to address
violence against women. The problem of violence within families has gained
visibility and has been widely studied and analyzed. Recently several World
Summits have focused on Family Violence: The Summit on Infancy in 1990, the
1993 Conference on Human Rights and the World Conference on Women in 1995.
Moreover, this recognition has resulted in policies and actions of many
governments that respond to this social problem.
During the United Nations Women's Decade (1975-1985), women's
organizations throughout the world have advocated including violence against
women as a priority.
The United Nations General Assembly (UN) adopted its first resolution on
violence against women in November 1985. Since then, the UN has sponsored
various meetings of Experts Groups and has continued analysis through its
Commission on the Condition of Women, the Economic and Social Council,
the Office of Statistics, and the Committee of Crime Prevention and Control.
The enforcement of two international agreements that recognize gender-
10
based violence as a violation of human rights, has generated a new legal
framework for approaching this subject: the "Declaration of the United Nations on
Violence Against Women" and the "Inter-American Convention for the Prevention,
Sanction and Eradication of Violence Against Women". The latter was drafted by
the Inter-American Commission on Women of the Organization of American States
(OAS) and has been ratified by the great majority of countries. In addition, the
Pan American Health Organization (PAHO), in different documents, recognizes
that family violence and, in particular, violence towards women, girls, and boys, is
a public health priority.
Since 1994 PAHO has mobilized more than seven million dollars for the
countries of the Latin America region to support efforts to prevent and address
violence in family relations.
In May 1997, the Fiftieth World Health Assembly, endorses WHO's
integrated plan of action on violence prevention and urges the Member States to
collaborate with WHO in attaining the objectives and implementing the tasks of
said plan.
The Conferences of Wives of Heads of States and of Government of the
Americas held in 1995 and 1996 have officially declared support for the
drafting and implementation of policies, as well as for educational campaigns at the
regional level. These campaigns are directed towards preventing and eliminating
every form of domestic violence (Project of Declaration of La Paz, VI Conference
of Wives of Heads of States and of Government of the Americas).
The Preparatory Technical Meeting for the VIII Conference of the Wives of
Heads of States and of Government of the Americas held in Santiago, Chile from
23 to 26 June 1998 selected domestic violence as a priority subject for the VIII
Conference to be held in September, 1998. At the meeting PAHO/WHO will
11
present the project that is currently being implemented in ten countries of the
Region of the Americas.
The Interparlamentarian Health Conference held in La Habana, May 1999,
gathered more than 100 representatives of Parliaments of 18 countries that for the
first time defined a health agenda that incorporates violence prevention and
eradication as a commitment. The Conference will request to the Regional
representatives to include violence against women and girls in their agendas
for future summits in the year 2000.
12
2. Objective of PAHO's Initiative on Domestic Violence Prevention and
Control
Development of coordinated efforts of the Government and civil society to
eradicate domestic violence.
Domestic violence is a public health and human rights problem that
manifests itself in mortality and morbidity of women, girls, boys, young people
and the elderly; it affects their quality of life and has important implications for
equity, efficiency, quality and sustainability of health services.
3. Progress
Since 1995, the Women, Health and Development Program of PAHO/WHO,
in coordination with the health sector, has provided technical cooperation in
municipalities of Belize, Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica,
Panama, Ecuador, Bolivia and Peru. PAHO has also facilitated the sharing of
positive experiences among the countries of the Americas, such as the Regional
Meeting on Norms and Protocols for the detection, prevention and care of
intrafamily violence, in El Salvador, July 1998, the symposium on Masculinity from
a Gender Perspective in Panama, May 1999, and the Regional Meeting on
Epidemiological Surveillance in Violence to be held in August of 1999 in El
Salvador. The project promotes the coordination among different government
institutions and other social entities in designing comprehensive approaches to
domestic violence. These approaches are based on responses of victims of domestic
violence, collected during a multicenter study that PAHO/WHO carried out in ten
countries of the Americas, "The Critical Path that Women Victims of Violence
follow in Search for Assistance". PAHO/WHO also identified appropriate social
13
entities that could participate in carrying out a Comprehensive Model of Care for
Violence. Similarly, protocols were prepared for addressing domestic violence in
health institutions. A RAP research protocol was prepared and is being executed
in 30 localities of Central America.
In coordination with other United Nations agencies and Inter-American
(OAS) agencies, efforts have been proposed for the implementation at the country
level. In this regard, the Inter-American Development Bank (IDB) approved a
similar project to PAHO/WHO's for Argentina, Brazil, Mexico, Paraguay,
Dominican Republic, and Venezuela. In cooperation with PAHO/WHO, the IDB
produced a video on domestic violence against women, as a social and economic
development problem, which has been distributed in the region for dissemination
through national television.
Although PAHO/WHO's project targets violence toward women, its model
approach focuses on the interventions at the municipal level and addresses violence
toward girls/boys, young people and the elderly, taking into consideration the
characteristics of each group. At the national level, the project pursuits the
development of policies and legal norms to strengthen institutional capacity to
address intrafamily violence.
4. Principal Achievements of the Participating Countries
In general, in the countries of Latin America there has been progress with
regard to the eradication of violence, particularly concerning the penalization with
respect to physical and sexual abuse. We will give a brief overview of
achievements of each country with the objectives of the Project:
Belize has formed a National Commission to address domestic violence in
which government institutions, as well as non-governmental organizations,
14
participate. The country has trained the health sector staff and a National Plan
against Violence was implemented in 1998. Campaign to Zero Tolerance to
Violence launched by the end of 1998.
In Bolivia, the National Health Secretariat, the Department of Gender
Issues, and the Office of the First Lady have developed actions related to the subject
and it was incorporated into the National Strategic Health Plan. With the
participation of municipal governments, local networks have been formed in project
site to identify the prevalence of violence and to address and prevent violence.
Intensive training was provided to personnel of health sector, judicial, police and
armed forces,
Costa Rica formulated a State Plan against Domestic Violence (PLANOVI)
in which different institutions are involved, and which resulted in a Comprehensive
Model of Care at the local level. It should be pointed out that three national media
Campaigns created awareness of the harm of domestic violence and that hundred
of public staff members were trained. Three thousand modules and ten thousand
brochures in intrafamily violence prevention were prepared and disseminated in
1998.
In Ecuador, non-governmental organizations and government institutions
have coordinated their efforts to address domestic violence. The Ministry of Health
has officially recognized intrafamily violence as a public health problem and has
established strategies for addressing it. It is noteworthy to mention that in project
support areas --Cuenca, Guayaquil and Quito-- research and training have been
promoted for health workers to address domestic violence. The participation of the
Women's Movement has been a key in developing this initiative.
El Salvador has created a National Program Against Domestic Violence
coordinated by the Institute of Women. The health sector has been integrated to
15
develop eight municipal training sessions for health workers and to incorporate
domestic violence in Health Sector Reform.
In Guatemala different Government institutions carry out activities related
to violence and a registry of domestic violence among these institutions has been
set up. Health workers have been trained and municipal level centers have been set
up in four localities.
Honduras, by decree of law, has set up Family consultation centers in
several regions under the coordination of the Ministry of Health. The government
and non-governmental organizations have prepared a National Plan Against
Violence on the basis of which a broad training process for staff members (state and
non-governmental) has been implemented.
In Nicaragua, the Women's Institute has set up Commissariats of Women
in coordination with the Ministry of Government and other institutions of the
Government. The health sector has joined this effort by implementing the model
in four municipalities of the country and training health workers in addressing and
preventing domestic violence.
Panama has integrated the struggle against violence into its municipal
initiative "21st Century Municipalities". The health sector prepared: a sectorial plan,
a National Commission Against Violence, protocols of treatment, registries of the
violence facts, training for personnel, and documented to the experience of four
localities.
In Peru, the National Forum was established with the participation of
Municipalities, that included the legal sector, the Ministries of Education, Justice,
Women, Human Development, and Health; the Police; the Women Center, Flora
Tristán; PAHO and the UNDP. A Multisectorial model of care was developed, and
16
a Plan of Operation was prepared and published in 1998. At the end of this same
year, a multisectorial agreement was signed for design and implement national
strategies to address intrafamily violence. A broad-training process for government
and non-governmental personnel was developed. The Ministry of Education has
incorporated intrafamily violence in its curricula for 1-12 grades. In 1998 Peru
provided training for more than 3,000 multisectorial personnel. Sixty-five
community based support groups for women and men are functioning in Peru.
For the rest of the countries of the Region of the Americas, PAHO/WHO's
strategy is to make available the successful experiences, the prepared technical
instruments, and provides the necessary technical assistance.
5. Successful Experiences
The efforts to prevent domestic violence, in particular violence toward the
women and girls, as well as to offer care to those that live in violent situations,
imply complex processes that require commitment and involvement of multiple
actors of the public and civil sector. In general, the countries are working at three
levels: at the local or micro level, where networks of community organization,
representatives of the public and private sectors, and community leaders, have been
created. These networks devise and implement strategies for preventing violence
against women and serve the people living in these situations, as defined in their
action plans with targets and expected results. The second level of action is the
intermediate or sectorial level, that includes the health sector's activities concerning
policy development, monitoring of domestic violence, registration, and
implementation of protocols and training plans. The third level refers to the
national or macro level, which includes a legal framework for strengthening the
institutional capacity to address violence and to empower its victims. Another
aspect is the generation of inter-institutional plans.
17
6. Obstacles
Family Violence towards children and women is not a new or isolated
phenomenon. Studies in different countries suggest that between 30 to 50% of
families suffer violence in its various expressions. For many centuries society
assessed "certain discipline" for children and women as a cultural value necessary
for the "cohesion of the family" and for the social order.
It is debatable whether humans are predisposed to violence. The excessive
behaviors, as well as the victims of violence, are influenced socially through social
systems and learned behavior. Perhaps that is the most serious consequence of
violence in our society, because these factors may perpetuate the abuse.
Changing social acceptance of domestic violence, the behavior patterns that
result in domestic violence and generating public policies preventing domestic
violence remain obstacles. Their change requires political will, as well as medium
and long-term comprehensive, participatory and sustainable actions of the
government.
Immediate actions are necessary for violence victims that are accessible
-physically and economically-- and that can easily access the legal system. Also,
it is important to address the prevention of violence, and to develop programs for
behavioral change and for controlling actual abuses.
7. Monitoring and Evaluation
The Pan American Health Organization/World Health Organization jointly
with the countries, provides technical evaluations of the experiences and annual
plans of action that include expected results and progress indicators. In addition, the
18
organization continues to mobilize resources for the Region of the Americas on this
subject.
8. Basic data on the Initiative
This initiative consists of two projects: Central America that includes
Belize, Guatemala, El Salvador, Honduras, Nicaragua, Costa Rica, and Panama, and
the Andean Subregion that includes Bolivia, Peru, and Ecuador.
19
PROJECT OF CENTRAL AMERICA
Name:
"Toward a Model of Comprehensive Care of Domestic Violence:
Expanding and Consolidating Interventions Coordinated between
the State and Civil Society"
Time:
1998-2001
Amount:
US$3.175.670
Donors:
Governments of Sweden and Norway
PROJECT ANDEAN SUBREGION
Name:
"Violence against Women and Girls: A Proposal to Establish
Coordinated Community Interventions in Three Countries of the
Andean Subregion"
Time:
1995-1999 (a second phase is in the process of preparation)
Amount:
US$1.634.206
Donor:
Government of The Netherlands
20
REPORT FOR THE NINTH CONFERENCE OF WIVES OF HEADS OF
STATE AND GOVERNMENT IN THE AMERICAS
PAN AMERICAN HEALTH ORGANIZATION
MEASLES ERADICATION IN THE AMERICAS
1. Introduction
During the XXXVIII Meeting of the Directing Council of the Pan American
Health Organization held in September 1995, in Washington D.C., the Ministries
of Health of the Americas unanimously approved the Measles Eradication Plan of
Action, calling for the eradication of measles by the year 2000. Support towards this
hemispheric effort was initially pledged by the First Lady of the United States. Mrs.
Hillary Rodham Clinton, during her visit to PAHO on the occasion of the World
Health Day 1995. The decision to eradicate measles was stimulated by the
successful eradication of poliomyelitis from the Region in 1991, making the
Americas the first region in the world to achieve this public health landmark. As
part of these goals, PAHO has been forcefully advocating for and providing
technical cooperation towards strengthening national surveillance systems for
vaccine-preventable diseases in the Region, to ensure timely public health
responses.
In October of 1995, during the V Conference of Wives of State and Government
in the Americas, the First Ladies agreed to contribute towards the target of measles
eradication in the Americas by the year 2000. The First Ladies committed
themselves to closely work with the Ministers of Health and international
organizations to promote and provide follow-up to this goal. Toward this end, the
First Ladies elaborated a Plan of Action, which outlined critical steps in their own
countries in support of measles eradication. These included guaranteeing the
21
purchase of vaccines and cold chain equipment in every country; guaranteeing the
participation of civil society, evaluating the progress of national objectives in
measles eradication; accompanying the process of regional vaccination campaigns;
and disseminating this commitment on a national and international level.
In consecutive meetings held in 1996, 1997 and 1998, the First Ladies reiterated
their commitment to be facilitators and mobilizers of this Plan until the transmission
of indigenous measles virus was stopped in every country of the Americas by the
deadline of the year 2000.
The Pan American Health Organization recognizes the critical role played by
the First Ladies of the Americas towards the goal of measles eradication. While
great progress has been made towards interrupting measles transmission in most
countries of the Americas, the virus continues to circulate in some areas of the
Region. Only 16 months remain until the target date of achieving the goal of
hemispheric measles eradication. Achieving and maintaining a measles-free
Americas will require sustained efforts from all sectors of society to fully implement
the PAHO recommended vaccination strategy to eradicate this disease from the
Western Hemisphere.
2. Measles Situation in the Americas
Great progress has been made towards achieving this goal, with a marked
reduction in the annual number of reported cases. For 1998, the provisional number
of confirmed cases in the Region stands at 12,908, which represents a 76%
reduction when compared to the 53,683 confirmed cases in 1997. The Americas had
achieved a record low level of measles cases in 1996. However, in 1997 there was
a resurgence of the disease due to an importation from Europe to Brazil, which then
spread to several countries in the Region and has resulted in over 100 measles-
22
related deaths in the past two years in both countries; most occurring among
unvaccinated infants and preschool-aged children. The measles outbreaks in Brazil
and Argentina in 1997 have demonstrated the lethality of measles virus. A major
contributing factor to the resurgence of measles in Brazil and Argentina was the
failure to fully implement the measles eradication strategy. Once measles virus was
re-introduced into these areas, it was virtually impossible to stop it by rapidly
implementing emergency measles vaccination.
The extreme infectivity of measles virus underscores the importance of reaching
and maintaining high measles immunity in infants and preschool-aged children,
especially those living in urban environments. Experience in the Americas is
showing that the high population density of cities greatly facilitates measles virus
circulation between infected and susceptible individuals, especially when the
number of susceptible infants and children is high due to low vaccination coverage
in routine measles programs.
Complacency has clearly been a major obstacle to achieving the goal of measles
eradication, together with problems that have arisen as countries put in place new
decentralized financial and administrative systems to manage their health systems,
including immunization programs. The latter is causing delays, particularly in the
allocation of resources for routine vaccination activities and for emergency outbreak
situations in some countries. To avoid some of these obstacles, PAHO requests the
support of the First Ladies in establishing laws that ensure national financing of
recurrent cost of vaccines and other inputs.
PAHO also calls upon the support of the First Ladies of the Americas in urging
countries to take a proactive approach in the final stages of the measles eradication
initiative. Besides full implementation of the PAHO recommended vaccination
strategy, every country should target for vaccination other groups potentially at
high-risk for measles, such as health workers and other high risk adults, close
23
border collaboration between countries to prevent the spread of outbreaks, and the
orderly planning of national vaccine supplies.
During these key 16 months left to fulfill the hemispheric goal of measles
eradication, the First Ladies of the Americas will remain critical allies to heighten
the attention of measles eradication from the highest political levels to the most
remote areas of every country.
3. Remaining Obstacles to Measles Eradication
First, the countries of the Americas need to keep up their guard by maintaining
the highest population immunity possible in infants and children through routine
immunization services, and also by targeting vaccination to specific groups of
adults who are at highest risk for exposure to measles virus. The latter include
university students, health care workers, military recruits, migrant workers,
international travelers and persons working in the tourist industry.
Second, all countries need to carry out follow-up measles vaccination campaigns
among children 1-4 years old, at least every 4 years to avoid the accumulation of
susceptible children. This is an important component of the vaccination strategy
recommended by PAHO for measles eradication.
Third, all the countries in the Americas should place high priority on measles
surveillance to conduct rigorous case and outbreak investigations. Additional staff
is required to coordinate the implementation of an active measles surveillance
program in all countries of the Region.
Fourth, the countries should assign sufficient resources to maintain adequate
stocks of measles vaccines and other supplies, to carry out routine immunization
24
services, for scheduled follow-up vaccination campaigns and to quickly implement
control measures in the event of an outbreak.
25
Major obstacles to measles eradication in the Americas
Insufficient dissemination and promotion of the measles eradication goal.
Lack of full implementation of PAHO's recommended vaccination strategy for
measles eradication in all countries.
Lack of at least 95% measles vaccination coverage in every district of every
country.
Shortages of vaccine supplies to deal with emergency situations and to carry out
scheduled immunization campaigns.
Suggested Action towards the Eradication of Measles
Urge Ministries of Health to guarantee national resources to maintain an
adequate stockpile of measles containing vaccines readily available for
scheduled vaccination activities and emergency situations.
Urge Ministries of Health in all countries to call upon the collaboration of the
private medical sector to ensure that all children are properly vaccinated against
measles and the disease is reported in a timely way.
Support the implementation of measles emergency plans in Bolivia, Brazil, the
Dominican Republic and Paraguay.
Call upon all sectors of society to support the eradication of measles from the
Americas.
Promote the establishment of vaccine laws that create specific budget lines
-
to cover recurrent costs of vaccines and other inputs in order to maintain
countries free of measles.
26
Confirmed Measles Cases, 1997-1999*
Region
Country
Total Confirmed Cases
1997
1998
1999*
Andean
Bolivia
7
1,004
660
Region
Colombia
67
104
13
Ecuador
0
0
0
Peru
95
10
0
Venezuela
27
4
0
Brazil
Brazil
52,284
2,135
117
Central
Belize
0
0
0
America
Costa Rica
26
20
1
El Salvador
0
0
0
Guatemala
8
1
0
Honduras
5
0
0
Nicaragua
0
0
0
Panama
0
0
0
English-
Anguilla
0
0
0
speaking
Caribbean
Antigua &
0
0
0
Barbuda
Bahamas
1
0
0
Barbados
0
0
0
Cayman Islands
0
0
0
Dominica
0
0
0
Grenada
0
0
0
Guyana
0
0
0
Jamaica
0
1
()
Montserrat
0
...
...
Netherlands
...
...
...
Antilles
St. Kitts & Nevis
0
0
0
St. Lucia
()
0
0
St. Vincent &
0
0
0
Grenadines
Suriname
0
0
0
Trinidad & Tobago
1
0
0
27
Turks & Caicos
0
0
0
British Virgin
0
0
0
Islands
U.S. Virgin Islands
0
...
...
Latin
Cuba
0
0
0
Caribbean
Dominican
1
10
78
Republic
French Guiana
...
...
...
Guadeloupe
116
2
...
Haiti
0
3
0
Martinique
0
...
...
Puerto Rico
0
0
0
Mexico
Mexico
0
0
0
North
Bermuda
0
...
...
America
Canada
579
12
3
United States
138
89
40
Southern
Argentina
125
9,435
186
Cone
Chile
58
4
25
Paraguay
143
70
0
Uruguay
2
4
9
Total
53,683
12,908
1,132
* Data as of 12 June 1999
Source: Country reports
28
NINTH CONFERENCE OF WIVES OF HEADS OF STATE AND
GOVERNMENT OF THE AMERICAS
PAN AMERICAN HEALTH ORGANIZATION AND THE WORLD
BANK
FOLLOW-UP REPORT: "XXI CENTURY SCHOOLS, EDUCATING FOR
LIFE"
1. Background
In 1997 the proposal "XXIst Century Schools: educating for life" was submitted
at the VII Meeting of Wives of Heads of State and of Government of the Americas
carried out in Panama for consideration of the participating First Ladies. The
proposal was a result of the engagement of numerous international cooperation
agencies and the auspices of the Pan American Health Organization (PAHO/WHO)
and the World Bank.
The activities planned between the "Health Promoting Schools" Initiative of the
Pan American Health Organization and the School Health and Nutrition Program
of the World Bank, in support of the initiative continued during 1998 and into the
current year with many difficulties due to limited resources.
2. Purpose
The goal of this partnership is to contribute to sustainable human
development and social capital, enabling future generations with the knowledge and
skills to care for their own and their families' health, and to create supportive
environments and conditions conducive to health in the communities where they
study, work and live. The purpose of the partnership is to strengthen the capacity
of governments, institutions and organizations in developing effective strategies to
implement school health and nutrition programs; as well as to monitor and evaluate
their success.
29
Developing methods and tools: Workshops to inform and train education
and health sector personnel to identify constraints on the health of school children
were carried out in Brazil, Bolivia, Chile, Colombia, Mexico and Panama. These
instruments will include youth risk behavior surveys; rapid assessment tools to
identify strengths and weaknesses in the education and health systems; situation
analyses based on key-informants interviews and existing data and beneficiary
surveys. Workshops and short training sessions will also be offered in coordination
with the health and education authorities to assist countries in conducting
assessments of the health needs of schoolchildren; and of the opportunities and
difficulties in the health and education sectors for increasing health promotion
strategies through their schools. Assistance with monitoring and evaluation of
school based health programs and interventions will also be available to all
countries, including cost-effectiveness analyses and studies of how intersectorial
strategies and programs can function. The Partnership will also assist countries
with implementing school-based health risk behavior surveys and surveillance.
Analysis of current practices and experiences: The implementation of a
Regional Study will help to review and document the most relevant issues and
experiences. A review of current practices, recognized good practices, well tried
interventions, regional and global experiences in school based health programming
will help identify strategic options, costs and essential technical inputs, and guide
the development of tool kits to assist the development of new programs. In depth
case studies will be carried out in countries where a particularly successful and
innovative strategy or program is identified and the results will be disseminated to
help other countries also improve their efforts to create health promoting schools.
Design, implementation and evaluation of plans of action: Workshops will
be supported to promote the development of plans of action, review joint policies
and intersectorial coordination and exchange knowledge and experiences. This
would include but not be limited to teacher training, epidemiological surveillance
30
(health and anthropometric data, youth risk behaviors and others), curriculum
design and development of educational materials. The workshops will facilitate the
development of country-specific strategies, and the identification of inputs -
knowledge, material and financial resources - required to implement a national
school health program.
Mobilization of resources: The partnership will review and assist in
preparing project proposals as well as help countries in preparing technical
cooperation agreements among countries, mobilize needed resources and establish
partnerships with different sectors to further improve the health promoting potential
of their schools.
Dissemination of knowledge, practices and materials: The Partnership will
support the dissemination of information of the knowledge, activities and practices
in promoting health through schools among all countries, using a variety of media
channels; and will also help countries implement and participate in different forums
to exchange experiences and discuss good practices to promote the health of school
children.
3. Synthesis of Activities
An analysis of the health issues of school children in the countries was
presented in the document "The Ten that go to the School: Programming of School
health in Latin America and the Caribbean, published in English and Spanish. The
document contributed with a review of salient methodological and conceptual issues
involved in the implementation of school health programs. The document describes
the main issues concerning to the health of the school age children in the region and
reviews the principal responses and school health experiences of the countries.
PAHO/WHO and the World Bank hope that the document will be useful to the
Offices of the First Ladies interested in carrying on activities of advocacy in favor
31
of the health of the school children. PAHO/WHO and the World Bank continued
to collaborate with the respective Offices of the 1st Ladies to prepare plans of action
to improve school health programs in their countries and to organize advocacy
activities such as seminars, round tables, or press conferences in order to present the
document to the professional entities, political community and to the public in
general.
During 1999, the World Bank, and PAHO/WHO have jointly carried out a
Regional Study on school health in Latin America and the Caribbean. Site visits to
selected countries in the region have been carried out to observe school health
program activities, interview school officials, teachers, health personnel, parents
and students about the school health activities. Their perceptions and
recommendations to improve school health activities will be incorporated into the
conclusions of the study. The study will review the programs in progress, describe
the main health issues affecting the school population and examine in depth the
most successful experiences. During 1999 case studies in district school health
programs in El Salvador, Chile, Colombia, Argentina, Panama and Jamaica. The
case studies contribute a body of evidence on the benefit of promoting health
through education and of implementing health promotion and education
interventions in schools. The Offices of the 1st Ladies in many of the countries are
taking an active role in the implementation of this study and particularly in the
strategy for the dissemination of its results.
The Pan American Health Organization and the World Bank provided
technical and financial collaboration to school health initiatives in Colombia,
Honduras, Bolivia and Grenada. The close coordination between technical
personnel of PAHO and World Bank, we hope will contribute to the development
of projects that incorporate good practices in health promotion in schools at the
same time facilitating a very participatory process of planning and implementation
which would contribute to strengthening country capacity in this area.
32
4. Lessons Learned and Future Perspectives
The following is a summary of the principal activities carried out by the Pan
American Health Organization (PAHO/WHO) through its Division of Health
Promotion and Protection and by the School Health and Nutrition Program of
the World Bank.
4.1. The Latin American Network of Health Promoting Schools:
Following its II Meeting in Mexico City, April 1998, a pamphlet was
produced which outlines the mission, purpose and strategy of the Network to help
member countries advocate for the establishment and strengthening of health
promotion in their schools. The Network also published the first news bulleting
"Experiences" which contains a brief summary of the presentations at the II
Meeting. These publications are presently only available in Spanish. However, an
English summary of each document is available on the Network WEB site.
The WEB site of the LANHPS was launched this year in Spanish and
English. The WEB site has several sections: Country profiles with a description of
the school health activities that are under way in each country, these are grouped by
sub region (North America, Caribbean, Andean region, Central America and South
America), there is also a section for the Network news. There are sections for
students, teachers, parents, health educators and other health personnel. There is
a section for resources, which offer many conceptual and operational documents,
teaching and training materials. There is Partnership section that includes the
activities of the World Bank and PAHO/WHO and also the activities with
PAHO/WHO Collaborating Centers in the area of school health promotion.
Contributions from the First Ladies office concerning the activities they are doing
in school health are included.
33
The Colombian Network of Health Promoting Schools is organizing the III
Meeting of the LANHPS for 2001. During the II Network Meeting there were two
workshops offered, one on Life Skills Education in Schools and another on
Priorities for Teacher Training. Beside providing an opportunity to representatives
of the sectors of health and education of the participating countries to share the
developments and experiences taking place in their countries, the III Network
Meeting will stress the need to strengthen National Commissions (formed by
representatives of the Health, Education and other sectors), and partnerships.
Colombia was designated host country of the next meeting of the LANHPS
to be carried out by the year 2000. Mexico will perform until then as coordinating
country of the network and accordingly assumes the responsibility for the
publication of a newsletter and the preparation of the terms of reference that will
formalize the operation of the LANHPS. During this II Meeting of the LANHPS
two workshops were also held concerning the following subjects:
-
Teaching training in health education and health promotion:
PAHO/WHO is developing teacher-training modules with classroom
educational materials for the pre-service training of teachers from Universities of
Argentina, Chile, Colombia, Ecuador, Costa Rica, Mexico and Uruguay.
-
Implementation of Life Skills Education and Promotion of Mental
Health at schools
Also with support from its collaborating center Education Development
Center, PAHO is developing a pilot proposal to establish and strengthen the
teaching of life skills as part of the Initiative for Health Promoting Schools. A
workshop held in Mexico provided insightful information on the needs of many
countries in this area. An expert meeting is being organized at PAHO to further
34
develop the conceptual and operation framework for life skills education in schools.
4.2. The Regional Study and the Case Studies
The situation analysis carried out in 6 countries (Argentina, Bolivia,
Colombia, El Salvador, Ecuador and Panama) will provide insights on several key
issues concerning the implementation and sustainability of school health programs.
The situation analysis includes a review of existing documents from the Ministries
of Health and Education, as well as universities and NGOs that work in the area of
school health, several interviews with key players, and focus groups.
The results of the situation analysis will be useful for the First Ladies and
for health and education officials to argue in favor of support for school health
programs. Increased advocacy and resource mobilization will be expected as a
result of the situation analysis, to strengthen health promotion activities in schools.
4.2.1. Preliminary Results of the Situation Analysis
Colombia, Ecuador, Bolivia: Detailed information of the health and
education status of school children was collected and reviewed, identifying the
major problems and priorities and outlining the interrelationship among health and
education factors. A description of the different school health programs at the
national level and some at regional and provincial level. Details of some
experiences are included that illustrate certain aspects of said programs. The
preliminary reports also include a review of major strengthens and weaknesses of
the programs and propose future lines of action.
35
El Salvador: A study of a specific experience in this country is included,
although it is not a situation analysis of school health. The experience of the
Healthy Schools Program, carried out by the Ministry of Education and the
Secretary of the Family and other organizations in the rural areas of the country is
an interesting and innovative experience where the First Lady of El Salvador has
been involved. It has provided a vehicle to improve health and education to many
rural areas. The review of this program is part of an on-going evaluation of the El
Salvadorian Government to decide if the program would be extended to poor rural
areas.
4.2.2. Preliminary Results of the Case Studies:
Panama: the focus of the case study in this country is the school food and nutrition
program, which are implemented in isolated areas of Panama. This intervention
was started in 1997 and was strengthened by a strong emphasis on the participation
of parents and the community.
Colombia: the case study focuses on the experience of the Ministry of Health and
called "Fe y Alegria" in the implementation of Life Skills Education in Schools in
Bogota, Manizales, Bucaramanga and Medellin. The participation of health
personnel in different aspects of teaching life skills, particularly knowledge,
attitudes and practices of students and parents in such topics as sexuality, violence
and substance abuse.
4.3. Technical Cooperation
PAHO/WHO has provided technical cooperation in the last year to several
countries, with the objective of strengthening the Health Promoting Schools
initiative in the region:
36
Argentina, in collaboration with the Ministry of Health, in support of the
implementation of a new framework and materials in 1200 schools.
Brazil, continues support of the national School Health initiative.
Honduras, in collaboration with the Ministry of Health and Education and with the
support of the office of the First Lady, a national program of school health was
prepared with special emphasis on disaster preparedness.
Costa Rica, continued strengthening of the Joint National Commission and the
formulation of a national plan of action in School Health.
Colombia, support of teacher training activities in Bucaramanga, as well as
continued support of the school health initiatives of the Municipality of Bogota and
Cali
Guatemala, continued support for the preparation of teacher training materials and
monitoring of the national Health Promoting Schools initiative and the Network of
Health Promoting Schools.
El Salvador continued support of the national Healthy Schools program that is
being implemented with active participation of the 1st Lady.
Colombia, Chile, Nicaragua, and Panama, continued support and strengthening
of the national networks of Health Promoting Schools.
Grenada, support with preparing a project proposal to extend the Family Life
Education curriculum and the health promotion activities to all schools in the
country.
37
4.4. On the side of the World Bank:
School health components form part of health, education and social security
projects in the following countries:
Argentina, continued support for the school-based extracurricular programs for
youth as part of the Third Secondary Education Project.
38
Bolivia, school lunch programs and primary health care integration included in a
Social Investment Fund Project.
Brazil, continued support for the health education component as part of the
Innovation in Basic Education Project.
Chile, continued support for the Primary Education Improvement Project provides
health screening and referral to 250,000 first graders every year. The project also
finances the printing of health manuals for primary teachers and yearly intensive
training for teachers serving as facilitators.
Dominican Republic, school nutrition programs to include school feeding,
micronutrients and deworming as part of the Second Basic Education Development
project.
El Salvador, strengthening of a component to improve health nutrition programs
included in the Education Reform Project.
Mexico, continued support of the basic health care package through schools as part
of the Second Basic Health Care Project.
Panama, continued support of the school nutrition project aimed at meeting the
nutritional needs of children in poor areas, and increasing school attendance in
selected underserved districts included in the Social Investment Fund.
Paraguay, health seminar and lectures are delivered through schools to school
children as part of a Community Based Rural Water Systems and the Development
of Village Committees.
39
G
a
PRESENTATION 2
THIS DOCUMENT
WILL BE DISTRIBUTED
DURING THE
TECHNICAL MEETING
G
2
PRESENTATION 3
HORIZONTAL COOPERATION PROJECT TO PROMOTE CHILD
DEVELOPMENT
BY THE RESEARCH CENTRE FOR COMPREHENSIVE DEVELOPMENT
(CIDI) OF THE OAS
AND THE INTEGRA FOUNDATION OF CHILE
Summary
Background
This initiative arose from the meeting of First Ladies of the Americas in 1998. The
Integra Foundation of Chile submitted the project to the OAS, with sponsorship from
seven countries, and the project was approved for a one-year period, for 1998.
Sponsoring Countries
Argentina, Bolivia, Chile, Costa Rica, Ecuador, Honduras, Panama and Peru.
General Objective of the Project
To promote child development among the poor and to make it easier for women
living in poverty to join the labour force by sharing and transferring the lessons
learned from the successful management of programs for children aged 0 to 6.
Specific Objectives for 1999
To have programs and institutions in the Americas attend meetings and exchange
ideas relating to early childhood education and child development programs with
a view to enhancing and modernizing management of such programs.
To ensure that those programs and institutions become familiar with the experiences
of Chile's Integra Foundation and can establish cooperation plans to transfer
organizational policy, technical products, teaching methods and/or management
strategies.
Activities for 1999
Two regional seminars will be held to share experiences, one in Chile and one in
Costa Rica.
A webpage entitled "Childhood and Women in the Americas" will be designed.
Management and technical teams will be offered study tours in institutions carrying
out child development and early childhood education programs that are successfully
protecting the children of working women in Argentina, Costa Rica and Peru.
2
Chile's Integra Foundation will offer a technical-advice and management program
in four countries in the region: Ecuador, Honduras, Panama and Bolivia.
Educational material and other technical/methodological products will be adapted
and transferred to countries within the region.
INSTITUTIONS TAKING PART IN THE PROJECT
Argentina:
Women's Branch, Ministry of External Affairs
Bolivia:
Office of the First Lady, and Alternative Education
Department
Chile:
Integra Foundation
Costa Rica:
IMAS [Joint Social Assistance Institute]
Ecuador:
CONAMU [National Women's Council]
INNFA [National Institute for Children and the
Family]
ORI [Operation Child Rescue]
PRONEPE [National Program for Early Alternative
Childhood Education]
Ministry of Social Welfare and the Inter-American
Development Bank, "Our Children" Child
Development Program
Honduras:
IHNFA [Honduran Institute for Childhood and the
Family]
Panama:
Early Childhood Education Directorate, Ministry of
Education
Peru:
Early Childhood and Primary Education Directorate,
Ministry of Education
Overall Coordination
of the Project:
Integra Foundation, Chile
3
ACTIVITY REPORT
APRIL - JUNE 1999
1999 Project Plan
Project activities began with a preparatory meeting of the Coordinators from each
participating country. The meeting was held in Quito, Ecuador, from April 15 to 16,
1999. The purpose of the meeting was to allow the coordinators from each country
to get to know one another and to agree on upcoming activities for the year.
Coordinators Meeting in Quito
Project coordinators from Argentina, Costa Rica, Ecuador, Honduras, Panama, Peru
and Chile met for a two-day meeting. The only person unable to attend was the
coordinator from Bolivia. Participants approved the various project activities, the
schedule, the topics for the seminars, as well as the participation and commitments
of each country present
Transfer of Educational Materials
The Integra Foundation's educational materials were presented at the Quito meeting,
and two complete sets were delivered to two early childhood education institutions
in Ecuador, which are already starting to adapt these materials. These institutions
also showed these materials to other institutions in Ecuador.
Webpage
Not all the institutions involved in the project have Internet access. Progress was
made in providing access, and we have been in contact with four of the institutions
by e-mail.
There have been very preliminary discussions of the objectives and usefulness of the
webpage. There are still no definitions.
4
Upcoming Activities
Seminar entitled "Cooperation to Promote Child Development in the Americas,"
with participants from Argentina, Bolivia, Costa Rica, Ecuador and Chile. This
seminar was held in Santiago, Chile from June 16 to 18. The purpose of this seminar
was to provide an opportunity for the institutions participating in the project and
guests to share their experiences. (These outside institutions covered their own
costs.) The seminar was funded by Chile's Integra Foundation.
Seminar entitled "Cooperation to Promote Child Development in the Americas,"
with participants from Costa Rica, Honduras, Panama and Chile. This seminar
will be held in San José, Costa Rica, from July 6 to 8, and is being organized by a
team from the IMAS [Joint Social Assistance Institute].
PRESENTATION 4
RURAL WOMEN AND SOCIAL DEVELOPMENT
STATUS REPORT
OF AN INITIATIVE BEING CARRIED OUT BY THE OAS IN SUPPORT OF
THE ACTION PLAN OF THE 8ᵀᴴ CONFERENCE OF WIVES OF HEADS OF
STATE AND GOVERNMENT OF THE AMERICAS
1. The Action Plan of the 8th Conference of Wives of Heads of State and
Government of the Americas, held in Santiago, Chile, on September 28, 29 and
30, 1998, endorsed the Hemispheric Program to Support Integration of Rural
Women into the Productive Chain and Socio-Economic Democratization. One
of the main objectives of this Program is to "Promote and support all efforts
aimed at improving the quality of life and participation of women in the rural
development process of Latin America and the Caribbean."
2. In 1993 the Social Network of Latin America and the Caribbean was created as
a forum for cooperation, open to the participation of the social investment funds
and similar governmental institutions established throughout the Hemisphere in
order to overcome poverty. To achieve its objectives, the Social Network
organizes, with financial and technical support from the OAS and other
organizations, seminars and workshops devoted to the analysis of best practices
in areas that the members of the Network have defined as strategic for poverty
reduction.
3. Taking into account the Action Plan of the 8th Conference, the Social Network
approved the following topic for one of the seminars to be carried out during
1999: Rural Women in Social Investment Projects. This workshop will be
carried out in Lima, Peru, June 24 and 25, and will be hosted by Peru's Social
Investment Fund-FONCODES (Fondo Nacional de Compensación y Desarrollo
Social). Funding for this activity comes from the OAS Inter-American Council for
Integral Development (CIDI), and technical support is provided by the OAS Unit
for Social Development and Education.
4. The OAS Unit for Social Development and Education could present a report on
the results of the workshop on Rural Women in Social Investment Projects at the
Ninth Conference.
2
PRESENTATION
S
LAC Maternal Mortality Initiative
USAID Bureau for Latin America & the Caribbean
Implementing Partners
PAHO
USAID/Quality Assurance Project
USAID/MotherCare Project
Source: World Health Organization, 1991
1
Why focus on Maternal
Mortality?
Among women 15-45 years old,
maternal morbidity and mortality cause
the most Disability Adjusted Life Years
(DALYs) lost. (18%)
Large inequities in service delivery
between the richest and poorest
segments of the population
Source: World Health Organization, 1991
2
Inequities in Delivery Care
12
71
40
15.1
+ Peru
20
-
- Bolivia
13.3
0
Poorest
2nd
3rd
4th
Richest
20%
income quintiles
20%
Source: World Health Organization, 1991
How can Maternal
Mortality be prevented?
O
Prevent Unintended Pregnancies
Family Planning
Use Skilled Birth Attendants
nurses,nurse-midwives,physicians
Care for Obstetric Emergencies
early recognition
Essential Obstetric Care
Source: World Health Organization, 1991
4
Why focus on
Essential Obstetric Care
80% of maternal deaths are directly related
to pregnancy
Previous interventions aimed at pre-natal
care, traditional birth attendant training,
and identifying high risk pregnancies have
had little impact on reducing maternal
mortality
80% of all post-partum deaths occur during
the first week post-partum¹
Source: World Health Organization, 1991
What is Essential Obstetric
Care?
managing problem pregnancies
(anemia, diabetes, etc.)
medical treatment of complications
Comprehensive
Basic
(hemorrhage, sepsis, eclampsia, etc.)
manual procedures (removal of
placenta, repair of episiotomies, etc.)
monitoring labor (includes Partograph)
neonatal special care
surgical interventions
anesthesia
blood replacement
Source: World Health Organization, 1991
6
Hypothesis:
Why these activities?
Reduce Maternal Mortality and Morbidity
Increase Use of Maternal Health Services
Timely and Appropriate Seeking of Care
Accessible and Acceptable Services
Effective Mobilization of Resources
Generate Community Demand
Improve Service Quality
Develop Policies and Plans
Source: World Health Organization, 1991
7
Target Countries
Pilots for Community
Policy Component
& Services
Bolivia
Components
Brazil
Dominican Republic
Ecuador
Honduras
Ecuador
El Salvador
COMAYAGUA
COTOPAXI
Guatemala
Haiti
the Bolivia
Honduras
SAN JULIAN
Nicaragua
Paraguay
Peru
Source: World Health Organization, 1991
8
Strategic Objective
More effective delivery of Essential Obstetric Care
Indicator #2
Indicator #1
% sub-national
% births attended
units1 with
by trained
maternal
personnel
mortality
committees with
annual reports
(in target countries)
Source: World Health Organization, 1991
9
Strategic Objective Indicator # 1
% Births Attended by Trained Health Professionals
90
100
69
5% in DR
80
62
7% in El
60
Salvador
40
20
no changes
0
in the other 9
DR
El Salvador
countries
1997
1998
Source: World Health Organization, 1991
10
Expected Quality Services
4
Results
Result #1: Increased capacity of
community to recognize and
respond to pregnancy related
complications by accessing
health services.
Indicators (in the 3 pilot districts):
1) % adults who can name danger
signs;
2) % adults expressing intent to use
health services (in the event of
obstetric complications)
Community Demand Indicator # 1
% Adults in Pilot Areas
Naming Hemorrhage as a Danger Sign
Pregnancy
Delivery
Postpartum
60%
57%
50%
40%
30%
22%
19%
20%
16%
10%
7%
10%
6% 6%
2%
0%
Bolivia
Ecuador
Honduras
n = 278
n = 600
n = 324¹
Source: World Health Organization, 1991
1.?
Community Demand Indicator # 2
% of Adults in Pilot Areas
Expressing Intent to Use Health Services
Pregnancy
Delivery
Postpartum
92%
100%
75%
80%
60%
52%
53%
50%
60%
42%
39%
40%
20%
0%
Bolivia
Ecuador
Honduras
n = 952
n = 600
n = 3241
Source: World Health Organization, 1991
14
Result #2
Development,
testing,
evaluation,
and
dissemination
of approaches
to enhance the
standards at the
One
use of
first level
of referral
Indicator
Services
% targeted facilities in
pilot areas with the
capacity to provide
Essential Obstetric Care
Quality of Services Indicator
% targeted facilities in pilot areas with
the capacity to provide Essential Obstetric Care
100
75
84
80
60
40
33
20
25
20
O
HON BOL ECU
1997
1998
Source: World Health Organization, 1991
16
Result #3
Intensive
implementation of
EOC aspects
of the PAHO Plan
to reduce
Maternal Mortality
Policies & Plans
Indicators
# target countries with:
1) policies and/or plans &
2) funded programs
for:
a) community
mobilization &
b) delivery of EOC
Policies and Plans Indicators
for Community Mobilization and
Delivery of Essential Obstetric Care
Policies and/or Plans for:
Community Mobilization:
10 countries (Nicaragua is partial)
Delivery of EOC services at first level of referral:
9 countries (Haiti does not have and Nicaragua is partial)
Funded Programs for:
Community Mobilization: (2 full, 7 partial)
Bolivia & DR full funding; Brazil, El Salvador, Ecuador,
Guatemala, Honduras, Paraguay, and Peru partial funding
Delivery of EOC services at first level of referral: (3 full, 6 partial)
Bolivia, DR & Peru full funding; Brazil, El Salvador, Ecuador,
Guatemala, Honduras, and Nicaragua partial funding
Source: World Health Organization, 1991
18
Quality Services
EL