Environmental Scan Caribbean

Modalities of Delivery Stabilization of Population growth – CPR varies Commitment to adult SRH - Unmet need for FP varies Maternal Mortality decreased Progress in Women’s education, participation - 2 female Prime Ministers Census conducted in most countries Signatories to conventions, proud of leadership in NCDs, gender, and youth. Progress made on ICPD

Lags in achieving the PoA Maternal Mortality: Stagnated over past several years in several countries Related to quality of care, scarce human resources (esp. midwives and nurses), NCDs, monitoring systems. Cultural and social factors

Legal and cultural barriers to access to SRH services for persons below the age of 18 Absence of youth-friendly services Resistance to sexuality education in schools High stigma, discrimination and even violence against LGBT community, and lack of access to services HIV prevalence high Universal Access to Sexual and Reproductive Health

Teen-Pregnancy High proportion of births (about 20%) to teen mothers Mis-match between laws on age of sexual consent (16 years) and maturity for access to contraception and HIV testing (18 years) Pregnant girls and teen mothers drop out of education system – policy results in continuing cycle of lack of opportunity and exclusion Little support from “baby fathers”, and family Some good examples, but contradictions make effective implementation difficult “Choice”? Planned? Need for comprehensive policy

Gender Equality Violence and citizen security major concerns Violence against women, especially sexual violence, very high - between 3 and 8 times global average Concerns around self-image, opportunities and mental health of young men, expressed as domestic violence/violence against women Cultural norms see male violence as justified and “sign he cares”

Data and evidence Limited national and sub-regional capacity for data collection, analysis, use Insufficient inter-censal data collection Lack of trust makes collection of data difficult Lack of evidence –based planning Insufficient attention to linking different sectors for a holistic understanding of issues, and the development of multi-sectoral solutions.

Favourable Trends Reviews of legislation, policies in several countries Willingness to draft new policies on population, SRH, gender, youth, migration Debate and dialogues on difficult issues now in public space – eg MSM Re-vitalisation of sub-regional mechanisms, CARICOM Willingness to reach out to communities, young people, use social media,

Favourable Trends Good examples of what does work, good practice (SRH and disability, teens, youth parliament and YAGs) Effective engagement of key stake-holders –eg FB leaders, parliamentarians Renewed emphasis on Family Planning - focus on sexual decision-making, especially for adolescents Strong Political Commitment, including from highest levels, following visit of ED

Risk-factors to Progress Legislative and policy barriers Cultural, religious beliefs and leadership Popular conceptions of sexuality Capacity gaps – small size, migration Planning gap – including cross-sectoral Resource gaps – especially linked to Middle-Income status, HIV Lack of investment in health, SRH Lack of equity

Regional Contributions 1.Sound inputs to policy and legislation reform (analysis, convening inter-sectoral process, working with stakeholders to address religious and cultural factors) 2.Sound and sustainable resource- mobilization (human and $$) 3.Maximize impact of high-level commitment through review process, visibility, accountability related to ICPD +20

Thank You