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LC/L.4061(CRPD.2/3)

21 September 2015

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ORIGINAL: SPANISH

Second session of the Regional Conference on Population and Development in Latin America and the Caribbean

Population dynamics as an axis of sustainable development: the Montevideo Consensus as a tool for reducing inequality in the framework of human rights

Mexico City, 6-9 October 2015

OPERATIONAL GUIDE FOR IMPLEMENTATION AND FOLLOW-UP OF THE MONTEVIDEO CONSENSUS ON P OPULATION AND DEVELOPMENT

15-00859

The Operational guide for the implementation and follow-up of the Montevideo Consensus on Population and Development is the outcome of a lengthy participatory process that began at the first meeting of the Presiding Officers of the Regional Conference on Population and Development in Latin America and the Caribbean, held in Santiago, in November 2014. This document, which was prepared by the Latin American and Caribbean Demographic Centre (CELADE)-Population Division of the Economic Commission for Latin America and the Caribbean (ECLAC), with inputs from the Division for Gender Affairs of ECLAC and the United Nations Population Fund (UNFPA), is the contribution of the Presiding Officers of the Regional Conference on Population and Development in Latin America and the Caribbean to the second session of the Regional Conference, to be held in Mexico City, on 6-9 October 2015.

CONTENTS

Scope of the operational guide

I. Background

II. Frameworks for implementing the regional agenda on population and development

III. Making operational the priority measures of the montevideo consensus on population and development

A. Full integration of population dynamics into sustainable development with equality and respect for human rights

B. Rights, needs, responsibilities and requirements of girls, boys, adolescents and youth

C. Ageing, social protection and socioeconomic challenges

D. Universal access to sexual and reproductive health services

E. Gender equality

F. International migration and protection of the human rights of all migrants

G. Territorial inequality, spatial mobility and vulnerability

H. Indigenous peoples: interculturalism and rights

I. Afro-descendants: rights and combating racial discrimination

SCOPE OF THE OPERATIONAL GUIDE

This document is the contribution of the Presiding Officers of the Regional Conference on Population and Development in Latin America and the Caribbean to the second session of the Regional Conference, to be held in Mexico City, on 6-9 October 2015. It is a technical tool intended to provide the countries of the region with specific guidelines for implementing the priority measures[1] set forth in the Montevideo Consensus on Population and Development, and offers relevant inputs for monitoring that implementation at the national and regional levels.

The Operational guide is a tool aimed at promoting the practical implementation of the Montevideo Consensus on Population and Development, which in turn constitutes regional follow-up to the Cairo Programme of Action beyond 2014. Consistently with paragraph 3 of the general principles of the Montevideo Consensus, every country has the sovereign right to decide whether or not to apply the recommendations contained in the Cairo Programme of Action and in the Consensus, subject to its national laws and development priorities and in a manner consistent with universally agreed international human rights.

As a general principle, the possible lines of action, goals and tentative indicators set forth in this Operational guide are not intended to be comprehensive; rather, they correspond to measures, goals and indicators that could be adapted and complemented at the national level, depending on the specific circumstances in each country.

In particular, as noted by the Presiding Officers in agreement 13 adopted at their second meeting in Santiago, the indicators contained in the Operational guide need to be revised, specified further and aligned with the indicators that emerge from the process of the Sustainable Development Goals and the follow-up to the Programme of Action of the International Conference on Population and Development beyond 2014. Accordingly the Presiding Officers also recommended in that agreement that the Regional Conference, create a working group to this end at its second session, which should also take into account the indicators for regional follow-up to the Montevideo Consensus on Population and Development.

The first section hereafter, on background, offers more detailed information on the Operational guide and the preparation of its contents.

[1] Referred to in the Montevideo Consensus as “priority actions”

I. BACKGROUND

The Montevideo Consensus on Population and Development was the outcome of the first session of the Regional Conference on Population and Development in Latin America and the Caribbean, held in Montevideo from 12 to 15 August 2013. It represents the most significant intergovernmental agreement signed in the region in the area of population and development, and has become a key piece of the process of reviewing the Programme of Action of the International Conference on Population and Development and its follow-up beyond 2014. In this respect, in its resolution 2014/1, the United Nations Commission on Population and Development took note of the outcome documents from the regional conferences on population and development, and recognized that they provided region-specific guidance on population and development beyond 2014.

The broad support that the Montevideo Consensus on Population and Development has received in the region has enabled the countries of Latin America and the Caribbean to adopt common positions in international forums, and has shown a possible path whereby the global accord to implement the Programme of Action of the International Conference on Population and Development beyond 2014 can be reconciled with region-specific circumstances.

Although the Montevideo Consensus on Population and Development covers all the major population and development issues in Latin America and the Caribbean and forms the basis for a comprehensive, up-to-date roadmap for the future of regional action in this area, it requires a number of additional clarifications to make it into an operational agenda. This point is recognized in the concept note, entitled “Population dynamics as an axis of sustainable development: the Montevideo Consensus as a tool for reducing inequality in the framework of human rights, prepared by CELADE-Population Division of the Economic Commission for Latin America and the Caribbean (ECLAC), as technical secretariat of the Regional Conference, for the first meeting of the Presiding Officers, which was held at ECLAC headquarters in Santiago on 12 and 13 November 2014. On that occasion, it was agreed that the second session of the Regional Conference, to be held in Mexico City, would have for examination and approval a set of operating guidelines for implementing the Montevideo Consensus on Population and Development. It was also decided to create an ad hoc working group to prepare a draft of such an operational guide, the outcome of which is the present document.

In particular, agreement 13 adopted by the Presiding Officers at their first meeting requested the secretariat to work in consultation with the coordinator of the working group and its member countries —with the support and collaboration of the United Nations Population Fund and with the active participation of civil society— on the preparation of a draft proposal, based on the conceptual note mentioned above, for the development of the operating guidelines. As well, the Chair of the Presiding Officers suggested that the outcome of the second session of the Regional Conference on Population and Development should be an instrument that would offer countries not only clear and specific guidance for implementing the Montevideo Consensus but also the means for monitoring that implementation, i.e. an instrument to ensure that the Consensus is put into effect.

At its meeting in Santiago on 14 November 2014, the working group defined the scope of the exercise to be performed with the priority measures of the Consensus, indicating that its work would be geared to finding the most effective way to support their implementation and follow-up, without establishing rankings or priorities among the measures. That exercise presupposed the definition of possible lines of action, targets and tentative indicators, which the guide would present in specific tables for each priority measure in the Montevideo Consensus on Population and Development.

Agreement 14 adopted at the first meeting of the Presiding Officers highlighted the importance of follow-up and accountability as key components for ensuring implementation of the priority measures of the Montevideo Consensus. In this same vein, the working group decided to take into account any existing tools and mechanisms of accountability that might be useful.

In December 2014, the secretariat sent to members of the working group a preliminary proposal for classifying the priority measures of the Montevideo Consensus on Population and Development according to the degree of complexity that would be involved in implementing them, and taking into account the scope of the measure and its level of generality. The proposal included a first evaluation of the existing monitoring mechanisms that could support follow-up to each priority measure in the Montevideo Consensus. It was also recognized that some measures needed to be treated in a differentiated manner, especially those that were very broad and stand out from the more obviously operational measures. The next step was to operationalize a group of priority measures selected from each chapter of the Consensus: these were analysed at a workshop to review progress in preparation of the operational guide, which was held in Mexico City on 26 and 27 March 2015 and attended by most of the members of the ad hoc working group. On the basis of the workshop’s conclusions, the secretariat completed the guide, giving operational form to the remaining priority measures, which were submitted for consideration by the working group members on 20 April 2015.

On 30 April, after the secretariat had considered and incorporated the working group’s suggestions, the first draft of the Operational guide was distributed to all the member States of the Regional Conference on Population and Development in Latin America and the Caribbean. The countries then had until 20 May to convey new comments and suggestions, which the secretariat considered and included in a second draft, which was considered by the Presiding Officers of the Regional Conference at their second meeting, held in Santiago from 24 to 26 June 2015.

At that meeting, the Presiding Officers requested in agreement 8 that the Latin American and Caribbean Demographic Centre (CELADE)-Population Division of ECLAC use the observations on the second draft shared at that meeting as a basis for preparing a third draft of the Operational guide, to be sent to the countries by 7 July for comment by 10 July, and subsequently incorporate the views received into the draft. The Presiding Officers also agreed, in agreement 9, that the resulting version of the guide would form their contribution to the second meeting of the Regional Conference on Population and Development, to be held in October 2015 in Mexico City.

The Presiding Officers also recommended, in agreement 11, that the Regional Conference on Population and Development adopt a resolution endorsing the Operational guide as a technical tool for steering the implementation and follow-up of the priority measures of the Montevideo Consensus on Population and Development, with a particular emphasis on implementing the suggested lines of action.

The treatment of the priority measures of the Montevideo Consensus on Population and Development in the chapters of the Operational guide does not establish any sort of ranking, but recognizes the need for differentiated treatment of some of the measures, especially those that stand out as particularly broad, general or abstract in comparison to those that are clearly more operational. As well, a number of priority measures are considered, in whole or in part, in existing regional or international instruments and mechanisms (for example, the Sustainable Development Goals and the outcomes of the sessions of the Regional Conference on Women in Latin America and the Caribbean), and consequently their implementation and follow-up can be complemented by the mechanisms stipulated in those instruments and mechanisms, or by other priority measures dealing with the same issues in a convergent manner.

The issues considered in chapter J of the Montevideo Consensus on Population and Development, which refer to the frameworks needed for its adequate and effective implementation and follow-up, have received special treatment in the Operational guide as they are of strategic importance and cut across all the topics it examines. These strategic topics, which are essential for the implementation of the Consensus, are considered in section II, before the operationalization of the priority measures in section III.

The preparation of the guide also required efforts to achieve harmonization and consistency so that the rationale for the different priority measures would be balanced and coherent, notwithstanding the differences in their complexity.

Each thematic chapter in section III begins with an introduction that offers an overview, recognizing that the chapter is more than the sum of operationalized priority measures, and that linkages of synergy and complementarity can be established among them. That introduction is followed by a table that develops each of the measures in depth.

On the one hand, the emphasis is placed on the possible lines of action for the priority measures in which the Montevideo Consensus on Population and Development renews the commitments of the member States of ECLAC: these are lines of action selected to fulfil or give effect to the priority measure. On the other hand, there is reference to measures that are already sufficiently advanced in other spheres, whether in the programmes and policies of other funds, specialized agencies or programmes of the United Nations, in the jurisprudence of the treaty bodies, or in the reports or standards issuing from special proceedings of the Human Rights Council.

Within this framework, the priority measures of a more general nature are presented in a simple table format that sets out the scope of the measure, the existing instruments and mechanisms (regional and international) through which the measure can be achieved.

For operationalizing the remaining measures, the tables first propose possible lines of action, which suggest how the measure could be fully implemented. In addition, some plausible targets and tentative indicators are sketched out in light of regional and international experience.

The possible lines of action, targets and tentative indicators for each priority measure are not exhaustive, but rather a reference that can be adapted and complemented at the national level in keeping with the specific circumstances in each country.

It should be noted that some targets have a fixed time horizon for implementation (for example, the year 2020 or 2030), because they are drawn from other instruments, such as the Sustainable Development Goals, with which the Montevideo Consensus on Population and Development —and, by extension, the Operational guide— are intended to establish synergies.

Among the tentative indicators included in the tables, some relate to impact and others to process. Process indicators are used for priority measures concerning procedural or institutional matters, such as the adoption of a specific rule or the signing of a specific international instrument for the protection of rights.

The tentative indicators should be disaggregated by sex, age, urban or rural residence, ethnicity and socioeconomic status, where relevant and appropriate in relation to the characteristics and specific features of the respective topics. However, for some priority measures, a minimum disaggregation is specified in the comments section. Some indicators need further operationalization, which will depend on the particular national context.

The tentative indicators may be drawn from various sources, whether national (for example, censuses, surveys, administrative records and national reports presented to various multilateral bodies) or international, originating with specialized agencies and multilateral organizations (including statistics, standardized national reports, and reports of special rapporteurs).

Lastly, as noted earlier, the indicators contained in the Operational guide need to be revised, specified further and aligned with the indicators that emerge from the process related to the Sustainable Development Goals and the follow-up to the Programme of Action of the International Conference on Population and Development beyond 2014. This is noted in agreement 13 adopted at the second meeting of the Presiding Officers, which recommends that the Regional Conference create an ad hoc working group for that purpose at its second session.

II. FRAMEWORKS FOR IMPLEMENTING THE REGIONAL AGENDA ON POPULATION AND DEVELOPMENT

This section of the Operational guide corresponds to chapter J of the Montevideo Consensus on Population and Development, which refers to the frameworks needed for its adequate and effective implementation. The issues considered in this chapter are strategic and indispensable for the implementation of the Montevideo Consensus and therefore require special treatment, as they cut across all the topics developed in the rest of the guide.

The chapter focuses on measures or actions that are deemed indispensable for the adequate and effective implementation of the Montevideo Consensus on Population and Development in the region, and they will require a clear decision and ongoing support and strengthening on the part of governments over the medium and long terms. Generally speaking, the measures considered refer to five main aspects. One aspect that was considered of primary importance is the need for countries to have a permanent institutional structure devoted to population and development issues in an integrated manner going beyond the traditional sectoral or “line-ministry” approach. Such a structure should include a permanent and regularly functioning national mechanism for inter-ministerial and interagency coordination, to include civil society organizations, consistently with the modalities and specific features of each country.

Second, it identifies the need to strengthen sources of statistical information, with particular attention to official statistics and conventional sources of demographic information. They should be given the financial and technical sustainability needed to produce and process sociodemographic information for the countries and the region.

Third, the chapter highlights the need to strengthen regional education and training programmes dealing with population and development, to ensure financial support for existing programmes (at both the regional and the country level), and the development of new sources consistent with specific demands, taking advantage of the available technological advances, in order to guarantee the technical capacities that countries need to deal with issues relating to population and development and to formulate public policies.

A fourth fundamental aspect is the need to create monitoring and accountability mechanisms, both regional and national, as a way of ensuring adequate progress in effective implementation of the Montevideo Consensus on Population and Development. Those mechanisms must also be capable of encouraging active participation on the part of civil society.

A fifth aspect is that implementation of the priority measures will require assured financial resources for putting the Montevideo Consensus on Population and Development into effect, both through international cooperation and through national budget allocations.

A permanent institutional structure devoted to population and development issues

The need to define and implement an institutional structure devoted to population and development issues at the country level is set out in priority measure 99 in chapter J. It calls explicitly for establishing and strengthening a permanent institutional structure as well as a mechanism for inter-institutional coordination that includes civil society organizations. This measure addresses the concern that the absence of a coordinating institutional structure may imply partial or fragmented treatment of the sociodemographic issues, in contrast to a comprehensive vision with a broad focus on population and development. It is clear that the sectoral institutions by themselves have serious limitations when it comes to dealing with population issues in an integrated manner and monitoring them effectively. The measure also highlights the need to ensure that the institutional structure for population and development issues explicitly includes mechanisms to guarantee participation by civil society. In this regard, priority measure 99 is closely linked with priority measure 107 in the same chapter of the Montevideo Consensus.

Creating and maintaining a permanent institutional structure and a mechanism for interagency coordination will generally require such lines of action as these:

•Define the institutions that are to comprise the mechanism, and their roles, depending on the population issues to be addressed.

•Designate the institution that will be responsible for coordination, and define its roles (including its function as focal point for monitoring implementation of the Montevideo Consensus on Population and Development and as interlocutor with the Regional Conference, and serving as liaison with the other institutions).

•Create the mechanisms for achieving such coordination, to the extent possible with legal or formal backing.

•Establish mechanisms and procedures for including civil society organizations.

•Allocate the necessary budgetary resources for financing the coordinating institution and the coordination mechanisms.

In addition, priority measure 3 of chapter A provides greater detail on possible, lines of action, targets and tentative indicators for implementation of the institutional structure for population and development.

Building more robust information sources

The question of sources and systems of information on population and development is addressed in priority measures 102, 103 and 104 of the Montevideo Consensus on Population and Development. This is again a cross-cutting issue that arises throughout the Consensus and is therefore dealt with in various chapters of this guide. It is recognized that the region has made substantial progress in boosting governments’ capacities to collect, process, analyse and disseminate sociodemographic information, and in particular that obtained through population censuses. However, there are still challenges when it comes to the adequate disaggregation and geographical coding needed to characterize specific population groups and territorial subdivisions so as to integrate approaches such as a gender, interculturalism, and the growing need for local and participatory planning. As well, it is essential to formulate and strengthen legal and regulatory frameworks for the regular conduct of censuses and the use of vital statistics and other administrative records that can be of great help with topics that are difficult to measure.

As in the case of the institutional structure, the information aspect also poses the need for systemic treatment of sources and of data and coordination among the entities producing them, in order to avoid overlap and dispersal of sources and data and thereby enhance the quality, relevance and timeliness of information and economize resources.

The development of sociodemographic information is in fact stressed as one of the key lines of action throughout the Montevideo Consensus on Population and Development and this guide. The more general lines of action include the following:

•Develop countries’ capacity to produce, disseminate and use sociodemographic information for formulating public plans and policies in the various sectors.

•Develop forward-looking information for assessing the economic and social impact of population dynamics as a way of generating awareness of the linkages between population dynamics and development policies.

•Ensure that statistics contain all the disaggregations needed to identify and characterize population groups of relevance for public policies, incorporating the gender focus and the intercultural perspective, such as adolescents —including those under age 15— and youth, older persons, persons with disabilities, persons with care needs, persons subject to violence, women, indigenous peoples and Afro-descendent populations, populations exposed to natural disaster risks, migrants and displaced persons, among others.

•Focus efforts on democratizing access to all databases, for example by developing online consultation and processing tools.

•Maintain a constant process of training in the preparation and use of analyses of sociodemographic information.

Priority measure 103 of the Montevideo Consensus makes explicit the requirement to have sufficient human and financial resources to improve population information systems, in keeping with targets 17.18 and 17.19 of the Sustainable Development Goals relating to the availability of timely, reliable and high-quality data disaggregated by group, so as to measure, through indicators, the progress achieved toward sustainable development. In the context of the recommendations of the Advisory Group on a Data Revolution for Sustainable Development, it is important to work in coordination with the Statistical Conference of the Americas of ECLAC, and especially with its working groups on population, gender statistics, institutional strengthening, monitoring of the Sustainable Development Goals and statistics on childhood and adolescence. In addition, the support of agencies such as the United Nations Population Fund (UNFPA), the United Nations Children’s Fund (UNICEF), the Pan American Health Organization (PAHO), the Inter-American Development Bank (IDB) and the World Bank is vital. It is also important to achieve financial and technical sustainability for a set of tools that already exist for generating and processing sociodemographic information on countries of the region, for example the REDATAM software and the various regional databases developed by CELADE-Population Division of ECLAC.

Training and capacity-building on population and development matters

The issue of training for giving continuity to population and development activities in support of the Montevideo Consensus on Population and Development is recognized in priority measure 106, in which countries agreed to design and implement training strategies in the area of population and development. The need to train human resources in population and development issues has been expressed systematically and urgently by the countries of Latin America and the Caribbean. The shortage of trained personnel can be explained in part by the fact that, while formal courses and programmes do exist in some countries of the region, they are insufficient to ensure generational succession or to offset the leakage inherent in the high turnover rate among government officials. This shortage is critical for national statistics offices attempting to carry out population censuses, and also for the various sectoral and development planning institutions that are unable to include population aspects in public plans and policies. Limitations on the availability of training make it very difficult for the officials responsible for population issues to gain a comprehensive vision of these issues. The training of human resources includes the need to equip civil society with the knowledge it needs to participate in decision-making and in monitoring and evaluating policies in these areas.

A number of efforts have recently been made to address these needs, including the re-launch of the Intensive Regional Course on Demographic Analysis offered by CELADE-Population Division of ECLAC. As well, several countries in the region have training programmes in the area of population and development, and some of them are of long standing and high quality. Yet there is still no mechanism to assure the funding needed to make such programmes permanent and sustainable. Strategies are also needed to ensure the complementarity of measures in ways that will take best advantage of available resources, develop specific courses for existing needs, and make maximum use of technological advances and new approaches to training.

As a general line of action, this guide proposes the formulation and development of a training strategy in population and development issues, covering the following elements among others:

•Preparation of an inventory of the existing supply and directories of trained resources. The Latin American Population Association (ALAP) and national population associations, as well as CELADE, can support these activities and have inventories that can be updated.

•Integration and harmonization for articulating and complementing the various available programmes and resources, and for filling the persistent gaps relating to certain topics, territorial levels and modalities of supply.

•New approaches and non-traditional methods of training in population and development issues, taking advantage of available technological advances.

Monitoring and accountability

The issue of monitoring and accountability for implementation of the Montevideo Consensus is covered in priority measures 101 and 107, the second of which refers to the participation of civil society and social movements. Priority measure 101 refers to the commitment to create a regional monitoring and accountability mechanism for following up the Montevideo Consensus on Population and Development. In order to meet this commitment, States members must agree upon an accountability procedure and set deadlines for it, which will involve designing a standardized tool based on the Operational guide, including a list of regionally comparable indicators.

Priority measure 105 refers to the need to ensure sufficient financial resources for implementing the Montevideo Consensus on Population and Development and putting in place clear and effective transparency and accountability mechanisms. The priority measures herein identify various mechanisms, instruments and regional and international bodies that can support the monitoring of the various measures in the Montevideo Consensus, in ways that will make use of available resources and avoid duplication of efforts. At the same time, the drafters of the guide made a special effort to specify possible lines of action, targets and tentative indicators for the different priority measures, to serve as the basis for oversight and accountability in each country. In this regard, the mobilization of necessary financial resources, both at the national level and from international cooperation sources, is an unavoidable line of action for implementing the Montevideo Consensus on Population and Development. Efforts must be made to shift parameters and adopt methodologies other than the existing income-based country classification criteria, in order to reflect more accurately and fairly each country’s development level, national complexities and poverty in its multiple dimensions.

With respect to the remaining priority measures contained in chapter J, the adoption of a regional agenda on population and development (as proposed in priority measure 100), pursuant to the decisions taken at the second meeting of the Presiding Officers, consists of implementation of the Montevideo Consensus itself, and it may be operationalized by means of this guide. Priority measure 108 refers to the eighth meeting of the Statistical Conference of the Americas of ECLAC, to be held in November 2015, which is to consider a proposal for harmonizing health indicators, now being prepared by the respective working group.

Financial resources for implementing the Montevideo Consensus on Population and Development

Lastly, full implementation of the Montevideo Consensus on Population and Development in the context of follow-up to the Programme of Action of the International Conference on Population and Development beyond 2014, as expressed in priority measure 105, will require a firm and ongoing commitment on the part of countries and international cooperation to assure and mobilize the necessary financial resources. The guide identifies, under the various topics, the related international organizations that can support the different lines of action. Priority measure 46 offers greater detail on the bodies that can be used to raise funding for primary health care, and which can serve as an example for other topics. The Sustainable Development Goals and the guidelines for development financing that are part of the 2030 Agenda for Sustainable Development strategies offer important frameworks for fundraising.

III. MAKING OPERATIONAL THE PRIORITY MEASURES OF THE MONTEVIDEO CONSENSUS ON POPULATION AND DEVELOPMENT

A. FULL INTEGRATION OF POPULATION DYNAMICS INTO SUSTAINABLE DEVELOPMENT WITH EQUALITY AND RESPECT FOR HUMAN RIGHTS

It is impossible to adopt forward-looking policies for improving people’s lives without taking into account population dynamics, which determine the number of people, where they will live, and the composition and age structure of future populations. Population is intrinsic to development: it is shaped by economic, social and environmental forces and in turn it gives shape to future economic, social and environmental conditions. As the preamble to the Montevideo Consensus on Population and Development notes, “population dynamics —growth and decline, changes in the age structure, urbanization, migration and changing household and family structures— influence the opportunities for human development, are shaped by the decisions that people take and are essential for planning economic and social growth as well as for the three pillars of sustainable development: social, economic and environmental.”

This first chapter of the Montevideo Consensus on Population and Development presents three main topics that characterize the regional vision of development: development that eradicates poverty and breaks the cycles of exclusion and inequality (priority measure 1); a human rights approach to development (priority measure 2); and development that is sustainable (priority measures 5 and 6). There is an insistence throughout all the chapters of the Montevideo Consensus that this development is intrinsically linked to population dynamics.

In addition to delineating the regional vision of development, chapter A also underlines the importance of integrating population issues into public policies and planning in order to achieve the development goals mentioned above. The Montevideo Consensus on Population and Development calls for establishing an institutional structure to address population and development issues in a comprehensive and sustainable manner. The central task here is to ensure full integration of the population dynamics into the planning of sustainable development, sectoral policies, and public policies and programmes (priority measure 4). The mainstreaming of population dynamics into sustainable development planning is a central focus of population and development activities. Consequently, it must involve various institutions of government responsible, for example, for the areas of health, education, pensions, gender affairs and planning. This broad range of public agencies involved in population and development issues underscores the need to designate a coordination body within government (priority measure 3) to ensure integrated treatment of population and development topics.

The Montevideo Consensus on Population and Development echoes the calls made at the International Conference on Population and Development, held in Cairo in 1994. Chapter A of the Montevideo Consensus reflects the follow-up to the three main goals of chapter III of the Cairo Programme of Action, “Interlinkages between population, sustainable economic growth and sustainable development”: goal 3.4 on integration of population concerns in development and planning strategies; goal 3.16 on population and development policies and programmes aimed at achieving poverty eradication, sustained economic growth in the context of sustainable development and sustainable patterns of consumption and production; and goal 3.28 on population, environmental and poverty eradication factors are integrated in sustainable development policies, plans and programmes and the reduction of both unsustainable consumption and production patterns.

Priority measure 1

Reinforce the public policies and actions needed to eradicate poverty and break the cycles of exclusion and inequality as a condition for achieving development in the region.

Comments

Poverty in all its manifestations represents, in and of itself, a denial of rights, and eradicating poverty is a moral imperative for the region which governments must assume. The objective of reducing poverty also relates to the role that the factors of population dynamics play in policies designed to break cycles of poverty and exclusion. Not only is this the first measure called for in the Montevideo Consensus on Population and Development, it is also the substance of Sustainable Development Goal 1: 2 “end poverty in all its forms everywhere”. The call to put an end to all forms of discrimination is repeated throughout the Montevideo Consensus for various groups that have suffered exclusion and denial of their rights. This call to break the cycles of exclusion and inequality can also be found in Sustainable Development Goal 10, “reduce inequality within and among countries”. Although progress in reducing poverty is measured in all countries of the region, and will be subject to review under the Sustainable Development Goals, and there has been some forward movement in Latin America and the Caribbean in breaking the cycles of exclusion and inequality, better measurement tools are still needed. Accordingly, it is necessary to continue reviewing methodologies for measuring poverty and inequality in order to capture the complexity and national specificities of the issue. As well, knowledge of the role of population dynamics in terms of these goals is not sufficiently developed or disseminated, or appreciated by public policymakers.

Priority measure 2

Apply a human rights approach with a gender and intercultural perspective in addressing population and development issues, and step up efforts to recognize, promote and uphold relevant goals in order to eliminate inequalities and foster social inclusion.

Comments

The second priority measure presents a guiding principle for population and development policies —the importance of a human rights approach with a gender and intercultural perspective— and it is closely linked with the first measure. The rights approach holds that the international rights framework is accepted and offers a coherent system of principles and rules in the development area. Consequently, it is important that population policies should adopt this approach, as well as the gender and cultural diversity perspective. This approach constitutes the basis for actions designed to break cycles of exclusion and inequality, in which the multiple dimensions of social exclusion must be considered, such as those that affect victims of violence, migrants and displaced persons, differently abled persons, people subject to geographical and generational stigmatization, and those facing discrimination on the basis of race, ethnicity or sexual orientation.

The human rights approach is reflected in a cross-cutting manner in all chapters of the Montevideo Consensus on Population and Development, for which reason it is suggested that priority measure 2 should be monitored against the specific lines of action, targets and indicators listed in other chapters.

Priority measure 3

Build and strengthen national and subnational public institutions with responsibility for population and development issues, and ensure that they function in an integral and sustainable manner with the active participation of non-governmental stakeholders.

Possible lines of action

1. Explore the models of other countries that have a functioning institutional structure for population and development, evaluate their principal challenges, and select the model most appropriate for the country. 2. Adopt an institutional structure for population and development, including the designation of a public institution to provide technical support and coordinate actions on the issue. 3. Guarantee the sustainability of the population and development institutional structure, in financial and political terms, and identify the main challenges. 4. Promote the design and implementation of policies and programmes based on a prior assessment of the existing mechanisms for coordination among different sectors to ensure that population and development issues are handled in an integrated manner. 5. Strengthen the institutions working in different sectors (such as pensions, health, education, gender and planning) on population and development issues, including training and updating of their personnel, and facilitate the long-term retention of specialized human resources. 6. Establish formal channels for civil society participation, facilitate and encourage participation by the poorest and most marginal groups, and create a process for interactive debate and feedback to ensure that all stakeholders recognize that their contribution is meaningful. 7. Establish budgets for the civil society participation mechanism. 8. Promote the development of a public institutional structure on population and development matters at the subnational level.

Targets

1. To have an established institutional structure defined to ensure the integrated treatment of population and development issues. 2. To have a public institution designated and operating as coordinator of population and development measures. 3. To have formal mechanisms established and operating to allow active participation by non-governmental stakeholders.

Tentative indicators

1. Existence of a focal point on population and development issues prior to the third meeting of the Presiding Officers of the Regional Conference on Population and Development. 2. Existence of a public institution responsible for coordinating population and development issues, acting as the country’s counterpart to the Regional Conference on Population and Development, before the third session of the Conference. 3. Existence of a mechanism for broad participation, including by -governmental stakeholders.

Related instruments, forums and mechanisms

1. Existing national frameworks for population and development.

2. National frameworks created for follow-up and monitoring of the Sustainable Development Goals.

Comments

The Montevideo Consensus on Population and Development calls for establishing an integrated and sustainable institutional structure responsible for population and development matters, the central task of which is to ensure full integration of population dynamics into the planning of sustainable development, sectoral policies, and public programmes and policies in general (priority measure 4). The integration of population dynamics into sustainable development planning is a central focus of population and development activities. Consequently, it must involve different institutions of government responsible for such areas as health, education, pensions, gender and planning. This broad range of public agencies involved in population and development matters underscores the need for a coordination body within government (as proposed in this priority measure) to ensure the comprehensive treatment of population and development issues.

Priority measure 4

Ensure full integration of population dynamics into sustainable development planning, sectoral policies and public policies and programmes in general ―in particular in development and land-use planning― at national and subnational levels, drawing on sociodemographic knowledge and information and harnessing technological advances.

Possible lines of action

1. Develop a national plan using this guide for implementation of the Montevideo Consensus on Population and Development in order to ensure integration of population issues into public policies and planning so as to achieve sustainable development with equality and respect for human rights. 2. Develop long-term forecasts showing the impact of population dynamics on economies. 3. Promote the production, dissemination and use of socioeconomic statistics disaggregated by population group, for example women, older persons, adolescents, and indigenous peoples and Afro-descendants. 4. Strengthen the national statistics system, the civil registry, censuses and other sociodemographic information systems. 5. Strengthen national capacities for handling population and development issues. 6. Prepare a national plan for implementing the Montevideo Consensus on Population and Development. 7. Produce the information needed to evaluate the economic impact of changes in the age structure (for example through the system of national transfer accounts).

Targets

1. Fully incorporate population dynamics into sustainable development planning, sectoral policies and public policies and programmes in general.

Tentative indicators

1. Availability of a national plan for implementing the Montevideo Consensus on Population and Development before the third session of the Regional Conference on Population and Development in Latin America and the Caribbean, which takes account of interaction with other sectoral government plans. 2. Availability of long-term forecasts of the sectoral impacts (pensions, health, education) of population dynamics, with the most detailed geographical disaggregation possible. 3. Availability of socioeconomic statistics, disaggregated by population groups that are especially relevant to policymaking and sensitive to demographic changes, for example women, older persons, adolescents and indigenous peoples.

Comments

This measure is complementary to priority measures 86 and 94 on inclusion of special population dynamics for indigenous peoples and for Afro-descendants, respectively.

Priority measure 5

Pursue sustainable development as a means of securing now and in the future human well-being for all peoples on an equitable basis, and ensuring that the linkages between population, resources, the environment and development are fully recognized, appropriately administered and maintained in a harmonious and dynamic balance with a thriving biodiversity and healthy ecosystems.

Related instruments, forums and mechanisms

This measure combines two objectives of the Sustainable Development Goals referring to sustainable development with a particular focus on ecosystems: Goal 14, (“Conserve and sustainably use the oceans, seas and marine resources for sustainable development”), and Goal 15 (“Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss”).

Comments

It is suggested that priority measure 5 should be monitored in the framework of Sustainable Development Goals 14 and 15. Population is one of the most important factors for environmental change. Consequently, in order to achieve sustainable development it is essential to take into account the transformations that are produced through demographic dynamics, a point that links this measure directly to priority measure 4. In the content of priority measures 5 and 6, it is important to generate linkages between the implementation of the Montevideo Consensus on Population and Development and the implementation of the outcome of the United Nations Conference on Sustainable Development (Rio+20).

Priority measure 6

Guarantee sustainable production and consumption patterns and avoid exacerbating the undesirable climate change phenomena brought about by human activity.

Related instruments, forums and mechanisms

Priority measure 6, like priority measure 5, is aligned with the specific objective of Sustainable Development Goal 12 (“Ensure sustainable consumption and production patterns”).

Comments

It is suggested that priority measure 6 should be monitored in the framework of Sustainable Development Goal 12. This measure is linked in a general way with chapter G of the Montevideo Consensus on Population and Development, on territorial inequality, spatial mobility and vulnerability, and in particular with priority measure 83, “Promote inclusive development of natural resources, avoiding the social and environmental damage that this may cause.”

B. RIGHTS, NEEDS, RESPONSIBILITIES AND REQUIREMENTS OF GIRLS, BOYS, ADOLESCENTS AND YOUTH

According to current United Nations estimates, Latin America and the Caribbean will have 630 million inhabitants in 2015, of which nearly 52% will belong to the 0-29 age group, the reference group for this chapter. Within that age group, children under 15 years number 164 million, representing 26.1% of the total,[2] adolescents (10 to 19 years of age) 112 million, or 17.8% of the total, and young people (15 to 29 years) 162 million, or 25.6% of the total.[3]

Just as important as the proportion of the population represented by children, adolescents and youth is the fact that its members are recognized as having rights, in various international instruments including the broadly ratified Convention on the Rights of the Child,[4] in the Programme of Action of the International Conference on Population and Development,[5] and in national legislation. Governments must guarantee those rights and attend to the demands of this age group so that this stage of their life will be full and satisfying. At the same time, social investment in this population segment is indispensable for sustainable development in its three pillars —social, economic and environmental— for it is at this stage of life that the central milestones of adulthood begin to define themselves. A healthy adulthood, well-educated, socially integrated and culturally sensitive to the broad issues of equality and sustainability, will encourage people to develop their capacities, to exercise their rights, and to contribute to sustainable development.

The specific rights of girls, boys, adolescents and youth, and recognition of such rights, vary within reference groups. For example, children, technically persons under 18 years of age, are protected by the Convention on the Rights of the Child, as noted above. The notions of maturity and evolving capacities contained in this Convention (articles 12.1 and 14.2, respectively) and the notion of progressive autonomy raised in the Montevideo Consensus on Population and Development (priority measure 11) are very important. Furthermore, the three groups referenced by this measure overlap during some periods (children with adolescents and adolescents with youth), inevitably creating a degree of ambiguity. In fact, the relevance and implications of some priority measures in this chapter vary for the three reference groups, and this will affect the way those measures are operationalized.

This chapter covers 11 priority measures (7-17). Measure 7, on general aspirations for the best possible life for children, adolescents and young people, is treated in an abbreviated manner in order to estimate, essentially, what can be implemented and monitored through other priority measures of the Montevideo Consensus on Population and Development and other international instruments, forums and mechanisms. The 10 remaining priority measures are spelled out in full tables, using the standard descriptors and criteria agreed. Five priority measures (11-15) deal directly with sexuality and reproduction, with an emphasis on guaranteeing comprehensive sexual education (11), ensuring access to sexual and reproductive health care including contraceptive methods and the exercise of sexual and reproductive rights (12), preventing pregnant adolescents from dropping out of school, and preventing pregnancy among adolescents and eliminating unsafe abortion (14), and helping adolescents avoid subsequent pregnancies (15). Among the other priority measures there is one that seeks to guarantee youth participation in decisions and policies, another on investment in youth, with the emphasis on education (9), a third on strengthening youth employment and promoting decent work (10), a fourth on preventing violence, promoting harmonious coexistence and guaranteeing access to justice (16), and a final one on data availability and quality (17).

The measures in this chapter are intimately linked with those of chapter D on universal access to sexual and reproductive health services. In fact, some of the lines of action, targets and indicators for the priority measures of chapter B could correspond, at least in part, to the equivalent age cohorts in chapter D. Consequently, it is reasonable to apply principles of economy and complementarity in this case and to work with common lines of action, goals and indicators, with the age specification indicated above, where appropriate, as will be explained in the “comments” line of the tables.

Priority measure 7

Guarantee for all boys, girls, adolescents and young people, without any form of discrimination, the chance to live a life free from poverty and violence, and to enjoy protection and exercise of their human rights, a range of opportunities and access to health, education and social protection.

Related instruments, forums and mechanisms

Among the relevant international instruments are: (i) the Universal Declaration of Human Rights (various articles of which are taken up in later priority measures); (ii) the Convention on the Rights of the Child (various articles of which are taken up in later priority measures); (iii) the Ibero-American Convention on the Rights of Youth (various articles of which are taken up in later priority measures); (iv) the United Nations System-wide Action Plan on Youth (Youth SWAP), which focuses on five areas: employment and entrepreneurship; protection of rights and civic engagement; political inclusion; education, including comprehensive sexuality education; and health; (v) some targets of the Millennium Development Goals, especially Goals 1, 2 and 4; and (vi) the Sustainable Development Goals, especially Goals 1, 3, 4, 5, 10 and 16, and the following targets: target 1.1 (“By 2030, eradicate extreme poverty for all people everywhere, currently measured as people living on less than $1.25 a day”); target 3.2 (“By 2030, end preventable deaths of newborns and under-five children”); target 3.7 (“By 2030, ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes”); target 4.1 (“By 2030, ensure that all girls and boys complete free, equitable and quality primary and secondary education leading to relevant and effective learning outcomes”); target 4.2 (“By 2030, ensure that all girls and boys have access to quality early childhood development, care and pre-primary education so that they are ready for primary education”); target 4.3 (“By 2030, ensure equal access for all women and men to affordable quality technical, vocational and tertiary education, including university”); target 5.2 (“Eliminate all forms of violence against all women and girls in public and private spheres, including trafficking and sexual and other types of exploitation”); target 8.6 (“By 2020, substantially reduce the proportion of youth not in employment, education or training”); target 10.4 (“Adopt policies, especially fiscal, wage and social protection policies and progressively achieve greater equality”); and target 16.2 (“End abuse, exploitation, trafficking and all forms of violence and torture against children”).

Among the priority measures of the Montevideo Consensus on Population and Development that contribute to implementing priority measure 7 are: priority measure 9 on investment, with the emphasis on education; priority measure 10 on employment opportunities; priority measure 13 that includes several relevant lines of action, including one (number 2), which proposes the provision of comprehensive oversight and support systems for adolescent mothers, as well as real incentives for remaining in school; and priority measure 16 on violence prevention, harmonious coexistence and access to justice.

The aspects referring to exercise of rights and range of opportunities are very general, but they can be considered achievable with implementation of all the priority measures relating to rights and opportunities that apply to this group. With respect to oversight bodies and mechanisms, the most important are those that have binding systems of accountability, such as the Convention on the Rights of the Child, for which the Committee on the Rights of the Child has been operating since 1991 and in which 191 of the 194 Member States of the United Nations participate. As well, UNICEF has key input to offer in this area, and should play a leading role in promoting and monitoring this priority measure, particularly as it relates to children. The same holds for the Ibero-American Youth Organization (OIJ) with respect to this priority measure and its application and follow-up in the case of adolescents and young people.

Comments

This is a multidimensional priority measure targeting many and varied aspects that by definition apply to the reference age group (boys, girls, adolescents and young people), such as: (i) escape or avoid poverty; (ii) live free from violence; (iii) live free of discrimination; (iv) receive protection; (v) exercise human rights; (vi) have options; and (vii) have access to health care, education, decent work and social protection. Most of these objectives are expressed in a very general way, which makes specific and concrete monitoring difficult. Given this diversity of objectives and their generality, this priority measure can perhaps best be fulfilled by implementing other international instruments and other priority measures of the Montevideo Consensus on Population and Development.

Priority measure 8

Guarantee also the existence of mechanisms for the effective participation, without any form of discrimination, of adolescents and young people in public debate, in decision-making and in all policy and programme phases, in particular on matters that affect them directly, and strengthen institutional mechanisms for youth.

Possible lines of action

1. Endow the institutions responsible for promoting and enforcing the rights of adolescents and young people with informal and open channels and forums where adolescents and young people can participate and express their opinions. 2. Establish rules and procedures and mechanisms to guarantee the inclusion of young people and adolescents in the advisory bodies of the various public institutions involved in policies that concern them. 3. Define mechanisms to guarantee the inclusion and participation of adolescents and young people in the advisory and deliberative bodies of the legislative sphere, in particular in the processing of legislation that concerns them. 4. Establish publicly available virtual and/or physical forums for consulting adolescents and young people on public decisions that affect them, and promote, encourage and facilitate participation in those forums by adolescents and young people. 5. Document the experiences and lessons learned from the existing youth mechanisms in the region, in order to promote more effective work and a stronger influence on public policies affecting young people. 6. Create mechanisms for mainstreaming the perspective of adolescents and young people and their organizations in all national policies.

Targets

1. To have in place an institutional structure for youth affairs that defines, implements, and successfully promotes participation by adolescents and young people in public affairs. 2. Increase the number of public bodies with mechanisms for effective participation by young people and adolescents in public policies that affect them, in all their phases. 3. Ensure that adolescents and young people have the opportunity to submit observations and comments on proposed legislation, especially that affecting them, during its legislative processing. 4. Ensure that adolescents and young people express their opinions directly (through virtual or physical means) and have an influence on public decisions that affect them. 5. Increase participation by adolescents and young people in spheres of interest to them. 6. Increase youth participation in public affairs, including elections.

Tentative indicators

1. Absolute and relative number of government forums that have mechanisms for adolescents and young people, including those under age 18, to participate in public decisions that affect them, taking into account the corresponding legal and institutional particulars and the progressive development of children. 2. Percentage of adolescents and young people, including those under age 18, who have participated in an instance of public policymaking, taking into account the corresponding legal and institutional particulars and the progressive development of children. 3. Percentage of adolescents and young people who consider that their country offers them adequate forums and mechanisms for participation in public affairs. 4. Percentage of parliamentarians in the youth age group.

Related instruments, forums and mechanisms

Ibero-American Convention on the Rights of Youth, article 21, (“Youth Participation”).

Sustainable Development Goals, target 16.7 (“Ensure responsive, inclusive, participatory and representative decision-making at all levels”).

Comments

Adolescents, especially those under age 18, must be considered as “young people” where there is no specific mention of this group, as they face specific limitations in terms of their visibility and formal and political recognition; this is why those under 18 years of age are mentioned explicitly in two indicators. National laws do set age limits for some types of participation, particularly in elections, but participation can be channelled through other means. It is particularly important to include these in measurements concerning those aged under 18, as they could be excluded from certain sorts of participation but still need opportunities to participate and ways in which their voices, and those of their organizations, can be heard.

The percentage of voters among young people may be another useful indicator, although it may not mean much when voting is mandatory and when there is no simple procedure to avoid voting. With respect to forums for participation, as with all or nearly all the indicators for institutions or policies, verifying them will require special information sources (for example ad hoc reports) and specific procedures (for rigorous and representative evaluation of sources).

Priority measure 9

Invest in youth, through specific public policies and differentiated access, especially through the provision, without discrimination, of universal, free, public, secular, high-quality, intercultural education in order to ensure that this stage of life is full and satisfactory, to enable them to develop as autonomous individuals with a sense of responsibility and solidarity and with the ability to tackle creatively the challenges of the twenty-first century.

Possible lines of action

1. Guarantee universal coverage of free, secular, intercultural and non-discriminatory public education, ensuring all the resources this implies. 2. Institute comprehensive programmes of support for public education designed to boost its quality, ensure it is secular and intercultural, and promote retention at all levels. 3. Improve school management at all levels, from the ministry or secretariat to the classroom. 4. Update school education, incorporating the progress of the technological revolution. 5. Facilitate access to information and communications technologies (ICTs) for general school performance by students. 6. Take advantage of new technologies to improve teaching and learning. 7. Update school curricula. 8. Promote good learning practices in classrooms on the basis of comparative international experience, considering the specific features of each national and subnational situation. 9. Improve teacher training. 10. Improve working conditions for teachers. 11. Attract the highest skilled to the teaching profession. 12. Introduce systems for monitoring and evaluating the coverage and quality of education.

Targets

1. Have all public education institutions offer, without discrimination, instruction that is secular, intercultural, free and of high quality. 2. All children, adolescents and youth to have access, without discrimination, to public institutions that are secular, intercultural, free end of high quality. 3. Reduce gaps, particularly quality gaps, between public and private education, especially at the primary and secondary levels.

Tentative indicators

1. Percentage of the school population attending educational establishments that offer free, secular, intercultural and non-discriminatory education. 2. Investment in public education per student, by educational level and type of education (at least public or private). 3. Quality of education by level and type of education (at least public or private).

Related instruments, forums and mechanisms

Universal Declaration of Human Rights, article 26.

Ibero-American Convention on the rights of youth, article 22 (“Right to Education”).

Sustainable Development Goals, targets 4.1, 4.2 and 4 .3 (cited above under priority measure 7).

The Universal Declaration of Human Rights has an accountability mechanism, the Universal Periodic Review, based on reports from countries and rapporteurs. The Convention on the Rights of the Child and its accountability mechanism could also be important, as noted under priority measure 7, although in this case the most relevant provision is article 28 on the right to education. Because it deals with education issues, the United Nations Educational, Scientific and Cultural Organization (UNESCO) has an obvious role in promoting and monitoring this priority measure. The Organization of Iberoamerican States for Education, Science and Culture has established a set of targets in this area for 2021 (see [online] http://www.oei.es/metas2021.pdf).

Comments

This priority measure contains several points that are complicated to measure in detail (i.e. by establishment), such as the secular, intercultural and non-discriminatory nature of education and its quality. For the moment, specific measurement of these points remains an unresolved challenge. Whatever measurement method is chosen, the indicators should be disaggregated by age, sex, area of residence, socioeconomic level and ethnicity.

Priority measure 10

Promote and invest in labour and employment policies and special training programmes for youth to boost personal and collective capabilities and initiative and to enable them to reconcile studies and work activities, without precarious working conditions and guaranteeing equal opportunities and treatment.

Possible lines of action

1. Implement specific occupational training programmes for youth. 2. Establish incentives for hiring young people. 3. Introduce systems of incentives and assistance to help young people find employment. 4. Create public works programmes for young professionals and technicians. 5. Provide technical support and concessional loans for young entrepreneurs. 6. Implement programmes to facilitate reconciliation of employment and studies. 7. Adopt, regulate and enforce labour legislation to punish discrimination against young people at social risk.

Targets

1. Reduce the youth unemployment rate. 2. Raise the percentage of young people with decent work. 3. Increase the number of young people trained through special youth training schemes.

Tentative indicators

1. Youth unemployment rate by age group (15-19 years, 20-24 years and 25-29 years). 2. Percentage of decent jobs among employed youth. 3. Percentage of young people not in education, employment or training. 4. Percentage of young people not in education, employment or training who are engaged in unpaid work. 5. Percentage of young people who are overqualified for the work they perform.

Related instruments, forums and mechanisms

Sustainable Development Goals, target 8.6 (cited above under priority measure 7).

Ibero-American Convention on the Rights of Youth, article 26 (“Right to work”), article 27 (“Right to conditions of work”) and article 28 (“Right to social protection”).

Given that this priority measure pertains to labour, the International Labour Organization (ILO) has an obvious role in supporting and monitoring it. In fact, the notion of decent work comes from ILO, which in 1999 defined it thus: “Decent work sums up the aspirations of people in their working lives. It involves opportunities for work that is productive and delivers a fair income, security in the workplace and social protection for families, better prospects for personal development and social integration, freedom for people to express their concerns, organize and participate in the decisions that affect their lives and equality of opportunity and treatment for all women and men” (for details on recent progress on measuring decent work, see ECLAC/ILO, “Advances and challenges in measuring decent work”, The employment situation in Latin America and the Caribbean, No. 8, (LC/L.3630), Santiago, May 2013).

Comments

Tentative indicators 3 and 4 are not intended to capture the stigmatizing concept of “NEET” (“not in education, employment or training”), but rather to show the structural inequalities and lack of opportunities that affect young people especially badly. Additional indicators should include those relating to underemployment or informal employment, although these could be incorporated into the measurement of decent work (depending on how that measure is operationalized). In view of the well-documented social and labour inequality in almost all the countries of the region, indicators should be disaggregated by sex, area of residence, socioeconomic level and ethnicity.

Priority measure 11

Ensure the effective implementation from early childhood of comprehensive sexuality education programmes, recognizing the emotional dimension of human relationships, with respect for the evolving capacity of boys and girls and the informed decisions of adolescents and young people regarding their sexuality, from a participatory, intercultural, gender-sensitive, and human rights perspective.

Possible lines of action

1. Review and share national experience in the provision of comprehensive sexuality education. 2. Regulate and finance the provision of comprehensive sexuality education in schools. 3. Review curricula to ensure the inclusion of comprehensive sexual education in schools. 4. Train teachers and facilitators for comprehensive sexuality education activities. 5. Prepare evidence-based and human-rights-based teaching materials for comprehensive sex education, including the definitions of sexual and reproductive rights agreed upon in the Montevideo Consensus on Population and Development and the Programme of Action of the International Conference on Population and Development. 6. Implement information and awareness-raising programmes on sexual and reproductive health, including inter-institutional programmes of comprehensive sexuality education involving ministries of health and education and campaigns targeted at adults, in particular fathers and mothers, on the emerging symbolic and behavioural patterns relating to sexuality among the new generations. 7. Establish mechanisms for technical support to schools and other institutions, including health-care establishments, as appropriate, for providing comprehensive sexuality education, as well as guidance on sexual and reproductive matters. 8. Establish opportunities for adolescents and young people to participate in all phases relating to the delivery of comprehensive sexuality education. 9. Structure systems for regular evaluation of comprehensive sexuality education programmes and adapt them to the needs of the target population and to sociocultural changes. 10. Promote comprehensive sexuality education programmes for children and adolescents not in the education system, though health-care establishments or in other forums.

Targets

1. All public and private education institutions to have programmes of comprehensive sexuality education aligned with the Montevideo Consensus on Population and Development and international standards. 2. Increase the number and proportion of children, adolescents and young people with information and knowledge about sexual and reproductive issues, appropriate to their ages. 3. Increase the number and proportion of children, adolescents and young people who take informed decisions in sexual matters with a degree of autonomy consistent with their age.

Tentative indicators

1. Consistency of the official curriculum for comprehensive sexuality education with the criteria of the Montevideo Consensus on Population and Development and with international standards. 2. Percentage of children, adolescents and young people who have completed an annual comprehensive sexuality education course for each school level. 3. Percentage of children, adolescents and young people who have information and knowledge about sexual and reproductive topics adequate for their respective ages.

Related instruments, forums and mechanisms

Ministerial Declaration “Preventing through Education”, signed in Mexico 2008.

Ibero-American Convention on the Rights of Youth, article 23 (“Right to sexual education”).

Convention on the Rights of the Child, article 34 of which relates to this topic.

Comments

The description of this priority measure contains a number of qualifiers that cannot be taken for granted (for example, “recognizing the emotional dimension of human relationships, from early childhood, with respect for the evolving capacity of boys and girls and the informed decisions of adolescents and young people regarding their sexuality, from a participatory, intercultural, gender-sensitive, and human rights perspective”) and are difficult to evaluate in detail (i.e. by establishment), which is why indicator 1 takes a general approach that would require further discussion in order to put it into practice. Tentative indicators 2 and 3 would have to be disaggregated by age, considering children’s evolving capacities and progressive autonomy, by gender and by variables capturing social and gender inequality.

International standards in this area refer to the International Technical Guidance on Sexuality Education, prepared by UNESCO, UNICEF, the World Health Organization (WHO), UNFPA and the Joint United Nations Programme on HIV/AIDS (UNAIDS) (see [online] http://unesdoc.unesco.org/images/0018/001832/183281e.pdf).

The Ministerial Declaration “Preventing through Education” contains specific targets with respect to comprehensive sexuality education, which could be incorporated into this guide. These are the following: (i) by 2015, reduce by 75% the gap in the number of schools under the jurisdiction of the education ministries that are not providing comprehensive sexuality education. (ii) by 2015, reduce by 50% the gap in the number of adolescents and young people without coverage by health services that appropriately address their sexual and reproductive health needs. There is no permanent institutional arrangement, nor any official follow-up mandate, nor even any baseline for monitoring the Declaration. Nevertheless, the International Planned Parenthood Federation/Western hemisphere Region (IPPF/WHR), the Democracy and Sexuality Network (Demysex), the Mesoamerican Coalition for Comprehensive Sexuality Education and the member associations of IPPF/WHR publish regular reports on progress in fulfilling the commitments assumed in the Declaration (see [online] https://www.ippfwhr.org/es/publicaciones/evaluaci%C3%B3n-de-la-implementaci%C3%B3n-de-la-declaraci%C3%B3n-ministerial-prevenir-con-educaci%C3%B3n).

Priority measure 12

Implement comprehensive, timely, good-quality sexual health and reproductive health programmes for adolescents and young people, including youth-friendly sexual health and reproductive health services with a gender, human rights, intergenerational and intercultural perspective, which guarantee access to safe and effective modern contraceptive methods, respecting the principles of confidentiality and privacy, to enable adolescents and young people to exercise their sexual rights and reproductive rights, to have a responsible, pleasurable and healthy sex life, avoid early and unwanted pregnancies, the transmission of HIV and other sexually transmitted infections, and to take free, informed and responsible decisions regarding their sexual and reproductive life and the exercise of their sexual orientation.

Possible lines of action

1. Adopt specific national legislation, with the appropriate regulations and protocols, to protect universal access for adolescents and young people to sexual and reproductive health services. 2. Adopt specific national legislation to guarantee exercise of the sexual and reproductive rights of adolescents and young people. 3. Create or strengthen adolescent health programmes, with an explicit component of sexual and reproductive health, in ministries and secretariats of health. 4. Guarantee regular budget funding as needed for sexual and reproductive health services and programmes for adolescents and young people. 5. Establish the physical, institutional and operational infrastructure for sexual and reproductive health services and programmes targeted especially at adolescents. 6. Institute health check-ups for adolescents, including a sexual and reproductive health component. 7. Train specialists in sexual and reproductive health care for adolescents and young people and in providing them with counselling on these issues. 8. Define and implement youth- and adolescent- friendly protocols in all public and private health services. 9. Define and implement protocols for violence prevention, detection and treatment, with an emphasis on sexual violence, in care for young people.

Targets

1. Eliminate the barriers that obstruct or limit universal access for adolescents and young people to sexual and reproductive health services. 2. Eliminate the barriers that obstruct or limit adolescents and young people in the exercise of their sexual and reproductive rights. 3. Establish sexual and reproductive health programmes for adolescents and young people through the health ministry. 4. Provide local sexual and reproductive health services with staff trained and motivated to offer a service that is friendly to adolescents and young people. 5. Meet the demand for contraception among adolescents and young people. 6. Reduce unplanned pregnancies among adolescent girls and young women. 7. Reduce violence, particularly sexual violence, against adolescents and young people.

Tentative indicators

Existence of a legal framework guaranteeing the exercise of sexual and reproductive rights for adolescents and young people, including universal access to timely and high-quality comprehensive reproductive health services. 2. Number of health centres that offer youth- and adolescent- friendly services and guarantee confidentiality and respect for sexual orientation and gender identity. 3. Percentage of adolescents and young people whose demands for contraception are met with modern methods. 4. Percentage of women aged 20-24 years who had their first child before the age of 20 years. 5. Percentage of births to adolescent mothers that are unplanned.

Related instruments, forums and mechanisms

Millennium Development Goals, target 5B.

Sustainable Development Goal, targets 3.7 (“By 2030 ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes”) and target 5.6 (“Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development, the Beijing Platform for Action and the outcome documents of their review conferences”).

Comments

The description of this priority measure contains a number of qualifications that cannot be taken for granted (for example, regarding “comprehensive, timely, good-quality sexual health and reproductive health programmes for adolescents and young people, including youth-friendly sexual health and reproductive health services with a gender, human rights, intergenerational and intercultural perspective”), and that can be difficult to measure with existing sources and conventional methodologies. One possibility is to use the concept of “friendly services” as benchmarks and quantify their care, or even rate their quality. Consequently, the sources used for monitoring must take this complexity into account, as well as the technical details of indicators 2 and 3, which may look complex at first sight, but are resolved for practical purposes by specialized surveys such as demographic and health surveys (DHS) and international reproductive health surveys. Given the high indices of inequality in early reproduction patterns and in adequate and timely contraceptive protection, the indicators must be broken down at least by gender and by socioeconomic, rural-urban and ethnic status.

Priority measure 13

Introduce or strengthen policies and programmes to prevent pregnant adolescents and young mothers from dropping out of school.

Possible lines of action

1. The measures contained in priority measures 11 and 12, intended to avoid total and unwanted adolescent pregnancy. 2. Provide comprehensive oversight and support systems for adolescent mothers, in view of their greater risk and the possible social and health complications of adolescent pregnancy, and include in these systems effective incentives for remaining in school. 3. Eliminate discriminatory provisions and practices that lead to the expulsion of pregnant adolescents and young mothers from the education system or make it difficult for them to remain. 4. Implement programmes for reconciling motherhood with school attendance, such as flexible hours, special timetables, day-care services and support for care and child-raising (conditional upon remaining in school).

Targets

1. Have in place an institutional scheme that encourages pregnant adolescents and young mothers to remain in school. 2. Eradicate the legal and institutional barriers that encourage or cause pregnant adolescents and young mothers to drop out of school. 3. Increase the number of schools that have an institutional scheme to promote and facilitate school retention for pregnant adolescents and young mothers. 4. Increase the proportion of pregnant adolescents and young mothers who remain in the education system.

Tentative indicators

1. Number of laws, policies and rules that discriminate against pregnant adolescents or young mothers. 2. Number of rules that promote the inclusion of pregnant schoolgirls and schoolgirl mothers. 3. Percentage of schools that have special programmes for reconciling motherhood with school attendance. 4. Percentage of pregnant adolescents and young mothers who have access to the education they need.

Related instruments, forums and mechanisms

Sustainable Development Goals, target 8.6 (cited above under priority measure 7).

Comments

As an alternative, indicator 1 could be establishment-based: number of educational establishments with anti-discrimination rules.

Priority measure 14

Prioritize the prevention of pregnancy among adolescents and eliminate unsafe abortion through comprehensive education on emotional development and sexuality, and timely and confidential access to good-quality information, counselling, technologies and services, including emergency oral contraception without a prescription and male and female condoms.

Possible lines of action

1. The measures included in priority measures 11 and 12 relating to comprehensive sexuality education and access to sexual and reproductive health services for adolescents. 2. Legislate and create programmes to guarantee universal and timely access to emergency oral contraception for adolescent girls, including those under the age of 15 years. 3. Provide safe services for terminating pregnancy among adolescent girls and young women, consistent with relevant national legislation.

Targets

1. Meet the demand for emergency contraception for adolescent girls, including those under 15 years, and young women. 2. Reduce pregnancy during adolescence. 3. Prevent pregnancies before the age of 1 years. 4. Avoid unsafe abortions among adolescents, including those aged under 15 years.

Tentative indicators

1. Fertility rate among adolescent girls (aged 15-19 years). 2. Fertility rate among girls aged under 15 years. 3. Percentage of satisfied demand for emergency contraception among women aged under 30 years.

Related instruments, forums and mechanisms

Sustainable Development Goals, targets 3.7 and 5.6 (cited above under priority measure 12).

Comments

This measure is closely associated with priority measures 11 and 12 and, in the case of safe abortion, with priority measures 40 and 42, and can thus be implemented and monitored through those measures (as in the case of unsafe abortion, provisions with respect to which are operationalized under priority measure 42). The exception is emergency contraception, which falls exclusively under this priority measure. Given that emergency contraception is rather new in the region, measurement of unmet demand may be complex and the difficulty may vary by country. In the absence of this indicator, indicators on use of emergency contraception in a reference group could be used, for example the percentage of adolescents, including those under age 15, and sexually active young people who made use of emergency contraception in a given period of risk exposure. However, a low value here could reflect lack of access to emergency contraception or widespread and efficient use of regular contraception. Indicators should be disaggregated at least by five-year age group (10-14 years, 15-19 years, 20-24 years and 25-29 years), socioeconomic category, area of residence and ethnicity.

Priority measure 15

Design intersectoral strategies to help young women avoid subsequent pregnancies, including antenatal, childbirth and post-partum care, access to contraceptive methods, protection, support and justice.

Possible lines of action

1. The measures contained in priority measures 11 and 12 relating to comprehensive sexuality education and access to sexual and reproductive health services for adolescents. 2. Implement intersectoral programmes (health, education, social protection and justice) for counselling and support of pregnant adolescents and young mothers. 3. Promote programmes for comprehensive monitoring of adolescent mothers, with emphasis on preventing subsequent pregnancy and providing access to contraception.

Targets

1. Ensure effective and coordinated implementation of intersectoral strategies to help girls avoid subsequent pregnancies during adolescence. 2. Increase access for adolescent mothers to comprehensive care, support, counselling and contraceptive services to prevent subsequent pregnancies during adolescence. 3. Reduce subsequent pregnancies in adolescence.

Tentative indicators

1. Existence of a programme for comprehensive monitoring of adolescent mothers, with emphasis on preventing subsequent pregnancies and providing access to contraception. 2. Percentage of adolescent mothers receiving post-partum care who have been offered and provided with contraception in order to avoid another pregnancy. 3. Percentage of adolescent mothers with two or more children.

Related instruments, forums and mechanisms

Sustainable Development Goals, targets 3.7 and target 5.6 (cited above under priority measure 12).

Comments

This measure is closely linked to other priority measures (in particular measures 11, 12 and 14).

Priority measure 16

Guarantee for boys, girls, adolescents and young people the opportunities and the basis for harmonious coexistence and a life free from violence, through intersectoral strategies to address the factors that disrupt harmony in the community and foment violence, to provide education from early childhood that promotes tolerance, an appreciation for diversity, mutual respect and respect for human rights, conflict resolution and peace, and to ensure protection, timely access to justice and compensation for victims.

Possible lines of action

1. Design and implement intersectoral strategies against violence of all types, in particular against girls, boys, adolescents and young people. 2. Implement comprehensive education against violence. 3. Develop courses on harmonious coexistence, good treatment and gender equity in schools. 4. Establish rules for peaceful coexistence within schools, as well as plans for proper treatment among management, teaching staff and students. 5. Promote programmes to prevent youth violence and gender-based violence. 6. Institute programmes of psychosocial and judicial support for girls, boys, adolescents and young people who have suffered violence. 7. Design and implement strategies for communication and social mobilization against violence and in favour of peaceful settlement of disputes. 8. Design and implement policies for the economic and social inclusion of youth, with a particular emphasis on young people at risk and in vulnerable situations. 9. Implement, with the support of parents and community leaders, extracurricular programmes for the use of free time. 10. Strengthen the institutions of the justice system so as to reduce impunity in cases of violence against girls, boys, adolescents and young people. 11. Promote family assistance and support for girls, boys, adolescents and young people, including the involvement of fathers in child-rearing.

Targets

1. To have in place intersectoral legislation, strategies, policies and programmes to prevent violence and foster healthy coexistence among girls, boys, adolescents and youth. 2. Have in place health services prepared to detect sexual violence and treat it comprehensively. 3. Have in place a comprehensive system of education against violence, including gender-based violence and sexual abuse. 4. Prevent and stop violence against girls, boys, adolescents and young people. 5. Prevent violence committed by girls, boys, adolescents and young people.

Tentative indicators

1. Existence of intersectoral strategies to eradicate violence, with a focus on girls, boys, adolescents and young people. 2. Index of relative frequency of violence against girls, boys, adolescents and young people. 3. Index of relative frequency of violence perpetrated by girls, boys, adolescents and young people.

Related instruments, forums and mechanisms

Sustainable Development Goals, target 16.2 (“End abuse, exploitation, trafficking and all forms of violence and torture against children”).

Convention on the Rights of the Child, articles 3 and 8, inter alia.

Ibero-American Convention on the Rights of Youth, articles 4 and 11.

Also relevant is the follow-up mechanism of the Convention on the Elimination of All Forms of Violence against Women, as it relates to girls, adolescents and young women. The same holds for the Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women (Convention of Belém do Pará 1994) and the Follow-up Mechanism to the Convention of Belém do Pará (MESECVI).

Comments

The goals and indicators must take into account the particular situation of indigenous and Afro-descendent boys, girls, adolescents and young people, pursuant to priority measure 89 (combating violence, in the chapter on indigenous peoples) and priority measure 93 (overlapping dimensions of racial, gender and generational inequalities, in the chapter on Afro-descendent persons). Special attention must also be paid to boys, girls, adolescents and young people with some type of disability. The relative frequency indices may be recorded as occurrences during a reference period or as cumulative percentages. Calculating these will require precise definitions of what constitutes violence (possibly including distinctions between degrees of violence). In this case, self-declaration in surveys is preferable as a source to police reports or legal records. Indicators should be disaggregated at least by sex, five-year age group, socioeconomic condition, area of residence and ethnicity.

Priority measure 17

Guarantee also reliable statistical data, disaggregated by sex, age, migration status, race and ethnicity, cultural variables and geographical location, with regard to education, health, in particular sexual health and reproductive health, employment and the participation of adolescents and young people.

Possible lines of action

1. Improve the coverage, timeliness and quality of vital statistics and official records in general, and ensure that they contain an age distinction for identifying children, adolescents and youth. 2. Include specific surveys on children, adolescents and youth, and demographic and health surveys, in the official, regular national survey programme, and seek to harmonize contents and basic tables. 3. Establish national information systems that integrate the various sources and use common codes, for example georeferencing. 4. Democratize access to all databases, for example through online database consultations and processes. 5. Promote participation by adolescents and young people in national information systems. 6. Promote participation by girls, boys, adolescents and young people in the design, analysis and use of information survey results, taking into account the technical nature of these processes. 7. Apply criteria of transparency, diffusion, sustainability and quality to official data on this age group.

Targets

1. Have available complete, timely and high-quality vital records. 2. Have available regular statistics on education, sexuality, employment, participation and other themes relevant to the reference group. 3. Conduct regular surveys covering childhood, adolescence and youth, and demography and health. 4. Have available national information systems that integrate different sources, use common codes (e.g. georeferencing) and allow social and territorial disaggregations. 5. Have available online tools for consultation and processing of official databases, including censuses.

Tentative indicators

1. Existence of vital statistics registries, surveys and censuses, and other relevant records providing adequate, timely and disaggregated information for all phases of development of children, adolescents and young people. 2. Existence of policies and programmes that make regular and systematic use of information on childhood, adolescence and youth. 3. Percentage of the population, of civil society organizations and of academia that expresses satisfaction with the availability of information on childhood, adolescence and youth.

Related instruments, forums and mechanisms

Sustainable Development Goals, target 17.18 ( “By 2020, enhance capacity-building support to developing countries, including for LDCs and SIDs, to increase significantly the availability of high-quality, timely and reliable data disaggregated by income, gender, age, race, ethnicity, migratory status, disability, geographical location and other characteristics relevant in national contexts”).

The Statistical Conference of the Americas of the Economic Commission for Latin America and the Caribbean should play a leading role in promoting and monitoring this priority measure, along with UNICEF and OIJ as mentioned above.

Comments

Other priority measures of the Montevideo Consensus on Population and Development, such as measures 4, 98 and 103, pursue the same objective as this one, but in reference to other population groups or the population in general.

This measure is complementary to priority measures 90 and 98, in terms of generating disaggregated information on indigenous peoples and Afro-descendants, respectively, and including a gender and generational perspective.

C. AGEING, SOCIAL PROTECTION AND SOCIOECONOMIC CHALLENGES

Population ageing is a worldwide phenomenon. In 2015, in Latin America and the Caribbean, the population aged 60 years and over numbered over 70 million, representing 11.2% of the regional total. In another 15 years, this segment will expand to over 119 million, and will represent 16.7% of the total population. The past 50 years have seen notable gains in life expectancy. Never in human history have people lived so long as they do today.

This reality poses some profound questions about the needs and interests of a population segment that is growing steadily and swiftly. The social protection systems that were created in the 1960s in Latin America and the Caribbean still fell short of those achieved in Europe. A longer life brings with it opportunities for people in good health, but the reality shows that the understanding of morbidity is still limited in the region and while people are living longer, they do not always enjoy a high quality of life. As a result, health costs per capita for the over-65 age group are three to five times higher than for young people. Ageing also affects pensions and retirement allowances, as the numbers of beneficiaries increase and benefits are paid over a much longer time.[6] Similarly, as the population ages an ever greater proportion of persons can expect to reach an age —75 years or more— at which they are at greater risk of becoming frail and of developing multi-morbidity conditions that require care on a continuing basis.[7]

The Montevideo Consensus on Population and Development includes 15 priority measures dealing with the issue of population ageing and social protection (priority measures 18 to 32). The topics covered by the priority measures relate to participation, social insurance, education, health, care, dignified death, work, violence, discrimination, savings, and public policies, among other matters. Most of these topics form part of a range international human rights instruments, declarations and United Nations General Assembly resolutions, conventions of the International Labour Organization (ILO), reports and standards prepared for the special proceedings of the Human Rights Council, and the jurisprudence of treaty bodies, among other sources, including some instruments adopted within ECLAC.

The Inter-American Convention on protecting the human rights of older persons is the most recent international instrument and was adopted by the General Assembly of the Organization of American States (OAS) on 15 June 2015,[8] with the signature of Argentina, Brazil, Chile, Costa Rica and Uruguay.[9] The purpose of this Convention is to promote, protect and ensure the recognition and full enjoyment and exercise, on an equal basis, of all the human rights and fundamental freedoms of older persons, in order to contribute to their full inclusion, integration, and participation in society. The Convention is based on the recognition that all existing human rights and fundamental freedoms apply to older persons and that they should be fully and equally enjoyed on an equal footing with the rest of society. It also provides an interpretation of human rights as they relate to ageing and standardizes very important rights that have not been explicitly addressed in any other international human rights instrument, including the right to life and dignity in old age, the right to independence and autonomy and the rights of persons receiving care.

The Inter-American Convention on protecting the human rights of older persons is an essential instrument for the application of matters addressed by this chapter of the Montevideo Consensus on Population and Development, as is the Madrid International Plan of Action on Ageing, the Programme of Action of the International Conference on Population and Development[10] and the key actions for the further implementation of the Programme of Action of the International Conference on Population and Development;[11] and —in the instruments of ECLAC— the Regional Strategy for the Implementation in Latin America and the Caribbean of the Madrid International Plan of Action on Ageing, adopted in 2003, the Brasilia Declaration, adopted in 2007; and the San José Charter on the Rights of Older Persons in Latin America and the Caribbean, adopted in 2012. The synergy between these instruments and the Consensus is obvious, and they are mutually reinforcing.

This chapter treats the various measures in a differentiated manner. The idea is to explain in detail those that have not been considered sufficiently in policies, plans and programmes for older persons in the region, and where the Montevideo Consensus on Population and Development makes a contribution by reinforcing existing recommendations.

Priority measure 18

Formulate policies with a gender perspective to ensure a good quality of life in old age, not only for urban dwellers, but also for those who live in rural and forest areas.

Related instruments, forums and mechanisms

The mainstreaming of the gender perspective in policies pertaining to older persons is addressed in the Convention on the Elimination of All Forms of Discrimination against Women (1979) (United Nations, Treaty Series, vol. 1249, page 13), which entered into force on 3 September 1981; the Proclamation on Ageing, adopted in General Assembly resolution 47/5, of 16 October 1992; General Assembly resolution 57/117, “The situation of older women in society”, of 18 December 2002; the Madrid International Plan of Action on Ageing and the Political Declaration adopted at the World Assembly on Ageing (Madrid, 8-12 April 2002).

The Committee on the Elimination of Discrimination against Women also addresses the topic in decision 26/III, on ending discrimination against older women through the Convention (A./57/38, part I), of 5 July 2002, and general recommendation No. 27 on older women and protection of their human rights (CEDAW/C/GC/27), of 16 December 2010.

Several targets of the Sustainable Development Goals also complement this measure: target 6.2 (“By 2030, achieve access to adequate and equitable sanitation and hygiene for all, and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations”); target 11.2 (“By 2030, provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, persons with disabilities and older persons”); and target 11.7 (“By 2030, provide universal access to safe, inclusive and accessible green and public spaces, particularly for women and children, older persons and persons with disabilities”).

Comments

This measure relates to priority measure 20: “Design policies at the national, federal and local levels to guarantee quality of life, the development of potential and the full participation of older persons, taking account of the need for intellectual, emotional and physical interaction and the different situation of men and women, with emphasis on the groups that are most susceptible to discrimination, such as older persons with disabilities, those without economic resources or pension coverage, or those who live alone or lack a support network.” It is also linked, more generally, to chapter E of the Montevideo Consensus on Population and Development, which deals with aspects of gender equality.

Priority measure 19

Design and implement public policies, plans and programmes —at all political and administrative levels— that take into account changes in the age structure, in particular population ageing, and the opportunities and challenges associated with these changes over the medium and long term.

Possible lines of action

1. Prepare periodic reports that take into account the medium- and long-term financial and economic impact of changes in the age structure, based on long-term projections of the population by age in different sectors (health, education, pensions). 2. Incorporate the results of these reports into public policies, plans and programmes at all political and administrative levels and in planning for sustainable development in general.

Targets

Take into account in public policies, plans and programmes the medium and long-term social and economic impacts of changes in the age structure of the population.

Tentative indicators

1. Existence of public policies, plans and programmes that consider the impact of the evolving age structure over the medium and long terms.

Related instruments, forums and mechanisms

Political Declaration of the Second World Assembly on Ageing: article 8 (“We commit ourselves to the task of effectively incorporating ageing within social and economic strategies, policies and action while recognizing that specific policies will vary according to conditions within each country. We recognize the need to mainstream a gender perspective into all policies and programmes to take account of the needs and experiences of older women and men”).

Madrid International Plan of Action on Ageing, paragraph 15 of the introduction (“Mainstreaming ageing into global agendas is essential. A concerted effort is required to move towards a wide and equitable approach to policy integration. The task is to link ageing to other frameworks for social and economic development and human rights. Whereas specific policies will vary according to country and region, population ageing is a universal force that has the power to shape the future as much as globalization”).

Comments

This measure, together with priority measure 25 (the central part of which is to “formulate policies to take advantage of the unique opportunity provided by the demographic dividend”), seeks to develop policy responses to changes in the age structure, a key issue for population and development. These measures also fall within the general framework of priority measure 4 of chapter A, which refers to “integration of population dynamics into sustainable development planning”. An important prerequisite for the success of these measures is implementation of priority measure 3, which will provide the institutional support needed to design and execute these policies.

Demographic change is one of the most significant forces shaping the outcomes of social policy, but it is not evident in the short term. Its impact is immediately apparent when a mid- to long-term approach is adopted, as recommended by priority measure 19. Several governments, aware of the impacts of population ageing, have begun to develop official long-term budgetary projections, including Australia, New Zealand and the United States, as well as the European Union. ECLAC has also conducted long-term forecast studies on public spending for a number of countries in the region.

There is no standard definition for what constitutes medium and long term in a demographic context. In general, however, the timeframe should be measured in decades, rather than in years. For example, in the studies mentioned above, the projection timeframes vary from 40 to 70 years.

Priority measure 20

Design policies at the national, federal and local levels to guarantee quality of life, the development of potential and the full participation of older persons, taking account of the need for intellectual, emotional and physical interaction and the different situation of men and women, with emphasis on the groups that are most susceptible to discrimination, such as older persons with disabilities, those without economic resources or pension coverage, or those who live alone or lack a support network.

Possible lines of action

1. Prepare 5-year or 10-year plans for defining intervention priorities and action strategies on behalf of older persons. 2. Prepare and apply programmes and deliver services for fostering the independence of older persons in rural and forest areas, including persons with disabilities. 3. Strengthen the administrative powers and capabilities and the inter-agency links of public agencies serving older persons. 4. Guarantee the effective provision of the budgets and resources needed to pursue actions that should be undertaken on behalf of older persons. 5. Strengthen the technical capacity of government personnel through training and upgrading of personnel and facilitate the sustainability and retention of specialized human resources. 6. Conduct periodic assessments of government-implemented programmes, projects and services targeting older persons. 7. Guarantee participation by older persons in institutional consultation and accountability processes at all levels. 8. Ensure that older persons, in particular older women, are included and represented in planning for rural and urban development. 9. Promote the ratification of the Inter-American Convention on protecting the human rights of older persons, if it has not already been ratified.

Targets

1. Have public policies and programmes in place to enable all older persons increase their autonomy and quality of life, according to their needs and aspirations. 2. Achieve ratification of the Inter-American Convention on protecting the human rights of older persons.

Tentative indicators

1. The percentage of older persons in different situations of vulnerability (disabilities, lack of economic resources and/or social security coverage, living alone) who are the beneficiaries of public policies and programmes designed to increase their autonomy and quality of life. 2. Percentage of consultation and institutional accountability processes related to ageing and the older adult population in which older persons participate. 3. Ratification by the country of the Inter-American Convention on protecting the human rights of older persons.

Related instruments, forums and mechanisms

Political Declaration of the Second World Assembly on Ageing, article 8 (cited under priority measure 19).

The Madrid International Plan of Action on Ageing incorporates specific recommendations for the development of policies related to employment, migrants, gender equality, education, poverty reduction, health, disabilities and care. It also includes recommendations on the institutional structure in its section on implementation measures.

The mainstreaming of the gender perspective in policies pertaining to older persons is addressed in the Convention on the Elimination of All Forms of Discrimination against Women (1979), (United Nations, Treaty Series, vol. 1249, page 13), which entered into force on 3 September 1981; the Proclamation on Ageing, adopted by General Assembly resolution 47/5, of 16 October 1992; General Assembly resolution 57/117, “The situation of older women in society”, of 18 December 2002; as well as the Madrid International Plan of Action on Ageing and the Political Declaration adopted at the Second World Assembly on Ageing (Madrid, 8-12 April 2002).

The Committee on the Elimination of Discrimination against Women also addresses the topic in its decision 26/III on ending discrimination against older women through the Convention (A/57/38, part I), of 5 July 2002, and general recommendation No. 27 on older women and protection of their human rights (CEDAW/C/GC/27), of 16 December 2010.

In the ECLAC sphere, the Regional Strategy for the Implementation in Latin America and the Caribbean of the Madrid International Plan of Action on Ageing (2003) contains a particular reference to the development of policies and programmes in all the priority areas. In section V “Implementation and follow-up of the regional strategy” it establishes, as the first objective, “Incorporation of the issue of ageing into all spheres of public policy in order to adjust State actions to reflect demographic changes and the aim of building a society for all ages”, and sets forth six specific recommendations for action in this regard.

The 2012 San José Charter on the rights of older persons Latin America and the Caribbean also contains a specific section on this topic, stressing the creation and strengthening of institutions responsible for older persons at the national level (see [online] http://www.cepal.org/publicaciones/xml/2/50162/SanJosecharter.pdf).

Comments

This measure is related to priority measure 18: “Formulate policies with a gender perspective to ensure a good quality of life in old age, not only for urban dwellers, but also for those who live in rural and forest areas.”

Priority measure 21

Ensure the inclusion and equitable participation of older persons in the design and application of policies, plans and programmes that concern them.

Possible lines of action

1. Include older persons in consultation processes at all levels of decision-making. 2. Ensure that older persons can participate with voice and vote in the advisory boards of the institutions responsible for matters relating to ageing. 3. Encourage older persons to see themselves as capable of influencing election outcomes. 4. Work to ensure that the growing influence of older persons in election processes is not perceived in a negative manner by other groups within society. 5. See that older women have the opportunity to participate in public and political life, to hold public office, and to obtain the information to present themselves as candidates for election. 6. In cases where these do not already exist, encourage the establishment of older persons’ organizations at all levels. 7. Provide financial and technical support to older persons’ organizations to assist in their operations and self-management. 8. Create an environment that facilitates participation by older persons in volunteer activities.

Targets

1. Ensure the existence of formal or informal forums in which older persons and public officials can meet to discuss their respective rights and responsibilities and to work together. 2. Ensure that volunteer programmes include older persons among their members. 3. Guarantee facilities to ensure access for older persons at voting stations.

Tentative indicators

1. Percentage of programmes for older persons designed with their participation. 2. Percentage of older persons who are volunteers. 3. Percentage of older persons who voted in the latest elections. 4. Percentage of older persons who engage in local forums on policymaking and programmes.

Related instruments, forums and mechanisms

The United Nations Principles for Older Persons include participation, and declare that older persons should “participate actively in the formulation and implementation of policies that directly affect their well-being and share their knowledge and skills with younger generations” and that “they should be able to form movements or associations of older persons” (United Nations, resolution 46/91 on Implementation of the International Plan of Action on Ageing and related activities, of 16 December 1991).

The Madrid International Plan of Action on Ageing sets forth, in its priority direction 1 on “Older persons and development”, the objective of recognizing the social, cultural, economic and political contribution of older persons. It makes recommendations such as: to offer opportunities, programmes and support to encourage older persons to participate or continue to participate in cultural, economic, political and social life and lifelong learning; and to provide information and access to facilitate the participation of older persons in mutual self-help, intergenerational community groups and opportunities for realizing their full potential. Its objective on the participation of older persons in decision-making processes at all levels includes recommendations to: take into account the needs and concerns of older persons in decision-making at all levels; encourage, when they do not already exist, the establishment of organizations of older persons at all levels to, inter alia, represent older persons in decision-making; and take measures to enable the full and equal participation of older persons, in particular older women, in decision-making at all levels.

The Committee on the Elimination of Discrimination against Women, in its general recommendation No. 27 on older women and protection of their human rights, declared that “States parties have an obligation to ensure that older women have the opportunity to participate in public and political life and hold public office at all levels and that older women have the necessary documentation to register to vote and run as candidates for election” (CEDAW/C/2010/47/GC.1).

Article 4 of the Inter-American Convention on protecting the human rights of older persons, which refers to “ General Duties of States Parties”, provides that States shall “adopt and strengthen such legislative, administrative, judicial, budgetary, and other measures as may be necessary to give effect to and raise awareness of the rights recognized in the present Convention, including adequate access to justice, in order to ensure differentiated and preferential treatment for older persons in all areas.”

Comment

This measure is related to priority measure 27: “Include older persons as a priority focus of public policy and as fundamental stakeholders in the formulation and implementation of policies aiming to improve the quality of life of older persons.”

Priority measure 22

Eradicate the multiple forms of discrimination that affect older persons, including all forms of violence against older women and men, taking into account the obligations of States with respect to ageing with dignity and rights.

Possible lines of action

1. Pass legislation eliminating formal and substantive discrimination on the basis of age and assign the corresponding obligations to public and private players. 2. Review laws regularly, and amend them if necessary, to ensure that they do not discriminate, either formally or substantively, against older persons in the exercise of their human rights. 3. Draw up action plans to combat formal and substantive discrimination against older persons in the exercise of their human rights. 4. Educate and train public officials to combat discrimination, including judges and candidates for positions in the justice system. 5. Adopt suitable measures —legislative, administrative or other— to guarantee differential and preferential treatment for older persons in all spheres. 6. Employ incentives or penalties to encourage public and private players to change their attitude and their behaviour towards older persons. 7. Create programmes to boost awareness about the systemic discrimination that older persons suffer in the exercise of their human rights. 8. Establish accessible mechanisms in the courts, the administrative authorities, national human rights institutions or public defenders’ offices to handle complaints of discrimination against older persons. 9. Repeal laws that discriminate against widows with respect to their inheritance rights and protect them from dispossession of their lands.

Targets

1. Make society aware of the multiple forms of discrimination that affect older persons. 2. Ensure the existence of procedures and protocols to offer preferred and preferential treatment to older persons. 3. Ensure that all public officials understand and are committed to fulfilling their obligation of non-discrimination with regard to older persons.

Tentative indicators

1. Percentage of persons who consider that older persons are discriminated against as a group. 2. Percentage of government institutions that have instituted protocols for giving preferred and preferential treatment to older persons. 3. Percentage of older persons in situations of neglect. 4. Percentage of government institutions that treat non-discrimination against older persons as a competence their staff must have.

Related instruments, forums and mechanisms

The Committee on Economic, Social and Cultural Rights, in its general comment No. 20, established that: “Age is a prohibited ground of discrimination in several contexts. The Committee has highlighted the need to address discrimination against unemployed older persons in finding work, or accessing professional training or re-training and against older persons living in poverty with unequal access to universal old age pensions due to their place of residence” (Committee on Economic, Social and Cultural Rights, general comment No. 20 “Non-discrimination in economic, social and cultural rights”, (E/C.12/GC/20), 2 July 2009).

The Madrid International Plan of Action on Ageing has as a central theme the need to ensure “the full enjoyment of economic, social and cultural rights, and civil and political rights of persons and the elimination of all forms of violence and discrimination against older persons”, and its recommendations on labour and health include various provisions relating to non-discrimination on the basis of age or other factors (see [online] http://undesadspd.org/Portals/0/ageing/documents/Fulltext-E.pdf).

This measure is also related to the Sustainable Development Goals and their targets, in particular target 5.2 (“Eliminate all forms of violence against all women and girls in public and private spheres, including trafficking and sexual and other types of exploitation”), target 10.2 (“By 2030 empower and promote the social, economic and political inclusion of all irrespective of age, sex, disability, race, ethnicity, origin, religious or economic or other status”), target 10.3 (“Ensure equal opportunity and reduce inequalities of outcome, including through eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and actions in this regard”), and target 16.1 (“Significantly reduce all forms of violence and related death rates everywhere”).

Article 5 on Equality and non-discrimination of the Inter-American Convention on protecting the human rights of older persons prohibits discrimination based on the age of older persons. Article 9 on the Right to safety and a life free of violence of any kind establishes that, “Older persons have the right to safety and a life without violence of any kind, to be treated with dignity, and to be respected and appreciated regardless of their race, color, sex, language, culture, religion, political or other opinions, social origin, nationality, ethnicity, indigenous and cultural identity, socio-economic status, disability, sexual orientation, gender, gender identity, economic contribution, or any other condition.” Article 10 on the Right not to be subjected to torture or cruel, inhuman or degrading treatment or punishment, establishes that “Older persons have the right not to be subjected to torture or cruel, inhuman, or degrading treatment or punishment.” In all cases the obligations of the States are identified in regard to the protection of rights.

Comments

The goals and indicators must consider the particular situation of indigenous and Afro-descendent boys, girls, adolescents and young people, pursuant to priority measure 89 (which refers to combating violence, in the chapter on indigenous peoples) and priority measure 93 (referring to the need to take into account overlapping dimensions of racial, gender and generational inequalities, in the chapter on Afro-descendent persons).

The Inter-American Convention on protecting the human rights of older persons provides a definition of “multiple discrimination” and “age discrimination in old age”. The former is understood as “Any distinction, exclusion, or restriction toward an older person, based on two or more discrimination factors”, and the latter as “Any distinction, exclusion, or restriction based on age, the purpose or effect of which is to annul or restrict recognition, enjoyment, or exercise, on an equal basis, of human rights and fundamental freedoms in the political, cultural, economic, social, or any other sphere of public and private life.”

The indicator of the perception of older persons as a group suffering discrimination was included in the Mexico City Survey on Discrimination (EDISCdMx 2013), carried out in June 2013 in all the city’s municipalities. Similarly, questions were included about the perceptions of European citizens with regard to job security and labour mobility in the Eurobarometer Survey and the perception of mistreatment of older persons in Latinobarómetro. In Colombia, the Ministry of Health and Social Protection included several questions on perception in the Health, Well-being and Ageing (SABE) Survey of 2013 (for example: perception of support, security and well-being, quality of care, and so forth).

Priority measure 23

Establish or consolidate human rights programmes to tackle and eliminate violence against older persons in the public and private spheres.

Possible lines of action

1. Establish or strengthen mechanisms to prevent violence, in any of its manifestations, within the family, in long-term care services, in the workplace, and in the media. 2. Provide training and raise the awareness of public officials, medical personnel, family caregivers or other persons who provide services to older persons, to enable them to detect violence or abuse in all spheres, to advise on the measures to take if abuse is suspected and, in particular, to encourage the reporting of abuse to the competent authorities. 3. Promote suitable and accessible measures for reporting cases of violence against older persons, and strengthen the judicial and administrative mechanisms for addressing them, including adequate compensation to victims, within a reasonable timeframe. 4. Produce statistical information on the scope, the causes and the effects of violence against older persons, disaggregated by age, sex, place of residence, disability or other basis of discrimination. 5. Create support services, such as shelters, counselling and rehabilitation, for older persons who have been victims of violence in the home (including those living in rural and isolated areas). 6. Establish criminal penalties, civil recourse and compensation to protect older persons against all types of violence, including sexual violence and harassment in the workplace. 7. Investigate, prosecute and punish all acts of violence against older persons, including sexual violence. 8. Take adequate awareness-raising and other measures to protect older persons against financial abuse, including fraud or deceit. 9. Pass legislation prohibiting the subjection of older persons to scientific experiments, medical treatment or institutionalization without their free and informed consent.

Targets

1. Ensure that any older person who has suffered violence has access to adequate and timely complaint mechanisms. 2. Ensure that any older person who has suffered violence has access to victim support services. 3. Ensure that any older person who has undergone medical treatment or been placed in a long-term care facility has declared his or her free and informed consent. 4. Eliminate violence affecting older persons in the public and private spheres.

Tentative indicators

1. Percentage of older persons who have requested support services for victims of violence. 2. Percentage of older victims who have filed complaints of neglect and abuse. 3. Percentage of older persons who have given their free and informed consent before receiving medical treatment or being placed in a long-term care facility. 4. Percentage of older persons who are familiar with programmes geared towards protection of their human rights.

Related instruments, forums and mechanisms

The Madrid International Plan of Action on Ageing includes specific recommendations regarding abuse of older persons, in objectives 1 and 2 of issue 3 (“Neglect, abuse and violence”) under priority direction 3 (“Ensuring enabling and supportive environments”).

On ensuring enabling and supportive environments, objective 1 calls for “elimination of all forms of neglect, abuse and violence against older persons”, and objective 2 recommends the “creation of support services to address elder abuse.” (see [online] http://undesadspd.org/Portals/0/ageing/documents/Fulltext-E.pdf).

Related instruments, forums and mechanisms

The Committee on the Elimination of Discrimination against Women, in its general recommendation 27, declares that “States parties have an obligation to recognize and prohibit violence against older women, including those with disabilities, in legislation on domestic violence, sexual violence and violence in institutional settings. States parties should investigate, prosecute and punish all acts of violence against older women, including those committed as a result of traditional practices and beliefs. States parties should pay special attention to the violence suffered by older women in times of armed conflict, the impact of armed conflicts on their lives, and the contribution that older women can make to the peaceful settlement of conflicts as well as to reconstruction processes. When addressing sexual violence, forced displacement and the conditions of refugees during armed conflict, States parties should give due consideration to the situation of older women. States parties should take into account relevant United Nations resolutions on women and peace and security when addressing such matters, including, in particular, Security Council resolutions 1325 (2000), 1820 (2008) and 1889 (2009).” (United Nations, “General recommendation Nº 27 on older women and protection of their human rights”.

The Committee against Torture, in general comment No. 2, establishes that States parties must, among other obligations, prohibit, prevent and redress torture and ill-treatment in all contexts of custody or control, including institutions that provide care for the elderly. The Committee has also issued repeated recommendations to States parties that, in their reporting, they should present data disaggregated by age, gender and other key factors so that the Committee can adequately evaluate implementation of the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment.

The measure is also related to Sustainable Development Goals and their targets, particularly target 5.2 (“Eliminate all forms of violence against all women and girls in public and private spheres, including trafficking and sexual and other types of exploitation”), and target 16.1 (“Significantly reduce all forms of violence and related death rates everywhere”).

Article 9 (“Right to safety and a life free of violence of any kind”) of the Inter-American Convention on protecting the human rights of older persons prohibits discrimination based on the age of older persons, establishing that “Older persons have the right to safety and a life without violence of any kind, to be treated with dignity, and to be respected and appreciated regardless of their race, color, sex, language, culture, religion, political or other opinions, social origin, nationality, ethnicity, indigenous and cultural identity, socio-economic status, disability, sexual orientation, gender, gender identity, economic contribution, or any other condition.” Article 10 (“Right not to be subjected to torture or cruel, inhuman, or degrading treatment or punishment”) establishes that “Older persons have the right not to be subjected to torture or cruel, inhuman, or degrading treatment or punishment.” In all cases, the obligations of States are identified in regard to the protection of rights.

Comments

The objectives, goals and indicators must take into account the particular situation of indigenous older persons, pursuant to priority measure 89 (which refers to protection against all forms of violence, in the chapter on indigenous peoples).

Priority measure 24

Give the highest priority to older persons in plans for disaster prevention, mitigation and relief, including disaster preparedness, relief worker training on emergency prevention and response and the availability of goods and services.

Possible lines of action

1. Identify older persons who are vulnerable (due to chronic diseases, dementia or reduced mobility) in planning for disaster management. 2. Sensitize and train workers who play key roles in disaster management as to the specific needs of older persons. 3. Promote interagency and intersectoral collaboration for taking older persons into account in official disaster management activities. 4. Ensure that older persons are represented in national and local disaster management committees. 5. Make use of older persons’ knowledge in the design and implementation of disaster risk reduction activities. 6. Review disaster management plans regularly to ensure that older persons are included as a priority attention group. 7. Ensure that personnel providing care and services to older persons are aware of and informed about their responsibilities. 8. Adjust humanitarian aid distribution plans to ensure that older persons have adequate access to food and water. 9. Guarantee the safety and accessibility of shelters for older persons, especially those with functional limitations and those requiring medical care. 10. Restore access to health and care services for older persons, with attention to the reestablishment of treatments essential for maintaining or recovering their health. 11. Include older persons as beneficiaries of housing reconstruction programmes. 12. Take steps to prevent violence against older persons, and in particular sexual abuse and gender violence. 13. Evaluate the lessons learned and the specific impacts on older persons in the post-disaster phase.

Targets

1. Include older persons as a priority group for attention in national disaster management strategies. 2. Include specific measures for older persons in programmes of humanitarian assistance and disaster relief agencies. 3. Ensure that data from needs assessments and figures on morbidity and mortality during disasters are compiled and disaggregated by age and by gender in order to appreciate the needs of older persons and respond to them more adequately.

Tentative indicators

1. Percentage of older persons who have received appropriate assistance during a disaster. 2. Percentage of older persons targeted by the programmes of humanitarian aid and disaster relief agencies. 3. Percentage of post-disaster reconstruction programmes that have included older persons.

Related instruments, forums and mechanisms

The Madrid International Plan of Action on Ageing addresses this subject in objective 1 of issue 8, under priority direction 1 (“Equal access by older persons to food, shelter and medical care and other services during and after natural disasters and other humanitarian emergencies”).

The San José Charter on the rights of older persons in Latin America and the Caribbean declares the following with respect to this topic: “We draw attention to the vulnerability of older persons in emergency situations and following natural disasters and undertake to work to: (a) include priority, preferential assistance for older persons in disaster relief plans; (b) prepare national guidelines that include older persons is a priority group given preferential treatment in disaster preparedness, relief worker training and the availability of goods and services; (c) give priority and preferential treatment to the needs of older persons during post-emergency or post-conflict reconstruction.”

The measure is also related to the Sustainable Development Goals, particularly target 13.1 (“Strengthen resilience and adaptive capacity to climate related hazards and natural disasters in all countries”) and target 13.3 (“Improve education, awareness raising and human and institutional capacity on climate change mitigation, adaptation, impact reduction, and early warning”).

Article 29 (“Situations of risk and humanitarian emergencies”) of the Inter-American Convention on protecting the human rights of older persons establishes that “States Parties shall adopt all necessary specific measures to ensure the safety and rights of older persons in situations of risk, including situations of armed conflict, humanitarian emergencies, and disasters, in accordance with the norms of international law, particularly international human rights law and international humanitarian law. States Parties shall adopt assistance measures specific to the needs of older persons in preparedness, prevention, reconstruction, and recovery activities associated with emergencies, disasters, and conflict situations. States Parties shall foster the participation of interested older persons in civil protection protocols in the event of natural disasters.”

Comments

In 2012 the Pan American Health Organization (PAHO) prepared a detailed guide on the inclusion of older persons in disaster management (see Pan American Health Organization, Guidelines for Mainstreaming the Needs of Older Persons in Disaster Situations in the Caribbean: A Contribution to World Health Day 2012 Ageing and Health, Washington, D.C., 2012).

Between 2008 and 2011, the Office of the United Nations High Commissioner for Refugees (UNHCR) provided funding to HelpAge International to second two experts on ageing to the Global Production Cluster. Their role was to help cluster members working in the field to identify and respond to the protection risks facing older persons affected by conflicts and natural disasters, as well as to incorporate their needs into evidence-based protection programming (see the conclusion of this work in Protecting older people in emergencies: good practice guide [online] http://www.globalprotectioncluster.org/_assets/files/tools_and_guidance/age_gender_diversity/HelpAge_Older_People_Best_Practices_EN.pdf.

Priority measure 25

Formulate policies to take advantage of the unique opportunity provided by the demographic dividend and that include coordinated investments in education and health and the creation of decent work on the basis of intergenerational solidarity.

Related instruments, forums and mechanisms

The creation of enabling conditions for reaping benefits from the demographic dividend must include investing in education, health and employment, in order to achieve empowerment and representation. In this regard, many of the Sustainable Development Goals promote the fruition of the demographic dividend. The most directly related to this objective are Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”) and Goal 4 (“Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all”). Others can play a contributing role: Goal 10 (“Reduce inequality within and among countries”), Goal 11 (“Make cities and human settlements inclusive, safe, resilient and sustainable”) and Goal 16 (“Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels”).

Comments

The need to invest in education and health and to generate decent work is a central theme of chapter B of the Montevideo Consensus, on Population and Development, dealing with “Rights, needs, responsibilities and requirements of girls, boys, adolescents and youth”. Chapter B also mentions the great opportunity offered by the demographic dividend, mentioning that “Considering that the 15-29 age group in the region now numbers some 160 million persons —in other words, young people account for one quarter of the population— and that the demographic dividend offers a unique opportunity for social investment in adolescence and youth, based on intergenerational solidarity, an investment which is essential for the three pillars of sustainable development: social, economic and environmental.” Follow-up to priority measure 25 may be conducted under three specific measures of chapter B: priority measure 7 (“Guarantee for all boys, girls, adolescents and young people, without any form of discrimination, the chance to live a life free from poverty and violence, and to enjoy protection and exercise of their human rights, a range of opportunities and access to health, education and social protection”), priority measure 9 (“Invest in youth, through specific public policies and differentiated access, especially through the provision, without discrimination, of universal, free, public, secular, high-quality, intercultural education in order to ensure that this stage of life is full and satisfactory, to enable them to develop as autonomous individuals with a sense of responsibility and solidarity and with the ability to tackle creatively the challenges of the twenty-first century”) and priority measure 10 (“Promote and invest in labour and employment policies and special training programmes for youth to boost personal and collective capabilities and initiative and to enable them to reconcile studies and work activities, without precarious working conditions and guaranteeing equal opportunities and treatment”). Priority measure 25 is also linked to priority measure 122 of chapter J on “Frameworks for the implementation of the future regional agenda on population and development”, in which the representatives of the countries participating in the first session of the Regional Conference on Population and Development in Latin America and the Caribbean, under follow-up recommendations, asked the United Nations Population Fund “to strengthen cooperation activities with the Governments of the region in the framework of their commitment to strengthen investment in youth and, in particular, to intensify efforts to coordinate actions relating to access to quality education, including comprehensive sexuality education, gender equality, decent work for youth and their access to quality health care, including sexual health and reproductive health services, in conjunction with other cooperation agencies and other bodies in the United Nations system.”

Priority measure 26

Bring health policies into line with the challenges of the varied and changing epidemiological profile arising from ageing and the epidemiological transition, reinforcing the fight to eradicate communicable diseases and implementing actions for the prevention and treatment of chronic diseases traditionally referred to as non-communicable, but now known to be strongly influenced by conditions of social and economic vulnerability in the early years of life, and ensure that these policies take into account gender, age, regional, ethnic and socioeconomic specificities.

Possible lines of action

1. Reinforce and promote multisectoral measures to prevent and control non-communicable diseases (NCDs). 2. Adopt policies to reduce the prevalence of the main risk factors for NCDs and reinforce the protective factors. 3. Enhance the coverage, equitable access and quality of care for the four main NCDs (cardiovascular diseases, cancer, diabetes and chronic respiratory diseases) and others that have national priority. 4. Strengthen countries’ capacity for surveillance and research on NCDs, their risk factors and their determinants, and use research results as the basis for designing and implementing policies. 5. Put in place education programmes on habits for healthy living.

Targets

1. Ensure that the national social protection system in the field of health considers universal and equitable access to measures regarding NCDs. 2. By 2030, reduce by one third premature mortality from non-communicable diseases (NCDs) through prevention and treatment, and promote mental health and well-being (target 3.4 of the Sustainable Development Goals). 3. By 2030 end preventable deaths of newborns and under-five children (target 3.2 of the Sustainable Development Goals). 4. Reduce disability resulting from chronic diseases.

Tentative indicators

1. Morbidity rate associated with non-communicable diseases. 2. The rate of premature mortality from non-communicable diseases. 3. Preventable deaths of newborns and children under age five.

Related instruments, forums and mechanisms

This priority measure is linked with Sustainable Development Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”). Other lines of action, goals and indicators related with the prevention and control of non-communicable diseases are found in the Plan of Action for the Prevention and Control of Noncommunicable Diseases in the Americas 2013-2019 of the Pan American Health Organization (PAHO).

Numerous instruments of international law recognize the human right to health. Article 25, paragraph 1, of the Universal Declaration of Human Rights asserts that “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services.”

The International Covenant on Economic, Social and Cultural Rights contains the most comprehensive stipulation in international law concerning people’s right to health. Pursuant to the first paragraph of article 12 of the Covenant, States parties recognize “the right of everyone to the enjoyment of the highest attainable standard of physical and mental health”, while the second paragraph of the same article mentions, by way of example, various “steps to be taken by the States parties to the present Covenant to achieve the full realization of this right.”

General comment No. 14 of the Committee on Economic, Social and Cultural Rights indicates in paragraph 25, that “With regard to the realization of the right to health of older persons, the Committee, in accordance with paragraphs 34 and 35 of General Comment No. 6 (1995), reaffirms the importance of an integrated approach, combining elements of preventive, curative and rehabilitative health treatment. Such measures should be based on periodical check-ups for both sexes; physical as well as psychological rehabilitative measures aimed at maintaining the functionality and autonomy of older persons; and attention and care for chronically and terminally ill persons, sparing them avoidable pain and enabling them to die with dignity”.

Older persons’ right to health forms part of the Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights (Protocol of San Salvador), of 17 November 1988, which came into force on 16 November 1999.

Related instruments, forums and mechanisms

The jurisprudence of the treaty bodies also incorporates the right to health for older persons. For example, general comment No. 6 of the Committee on Economic, Social and Cultural Rights, on the economic, social and cultural rights of older persons (E/1996/22) and general recommendation No. 27 of the Committee on the Elimination of Discrimination against Women, on older women and protection of their human rights (CEDAW/C/GC/27), December 16, 2010.

There are resolutions of the United Nations General Assembly dealing with the topic, such as resolution 46/91, on Implementation of the international plan of action on ageing and related activities, of 16 December and resolution 31/113, on Specific measures to meet the need for a decent living environment for the most vulnerable groups of society, of 16 December 1976.

Specific recommendations on the health of older persons can be found in the Vienna International Plan of Action on Ageing, adopted by the World Assembly on Ageing in Vienna, in August 1982, and in the Political Declaration and Madrid International Plan of Action on Ageing, adopted at the Second World Assembly on Ageing (Madrid, 8-12 April 2002).

There are specific policies of the World Health Organization (Active Ageing: A Policy Framework, Geneva, 2002; Global Strategy; and Plan of Action on Public Health, Innovation and Intellectual Property, adopted in 2008) and of the Pan American Health Organization (Caribbean Charter for Health Promotion, First Caribbean Conference on Health Promotion (convened by PAHO, WHO and Caribbean Cooperation in Health, 1-4 June 1993 in Port of Spain) and the Plan of Action on the Health of Older Persons Including Active and Healthy Ageing (adopted by the 49th Directing Council, 61st session of the Regional Committee (Washington D.C., 28 September-2 October 2009)).

In the framework of ECLAC, the topic is part of the Regional Strategy for the Implementation of the Madrid International Plan of Action on Ageing, of 2003, the Brasilia Declaration, of 2007 and the San José Charter on the rights of older persons in Latin America and the Caribbean, of 2012.

Comment

The goals and indicators must take into account the particular situation of indigenous peoples and Afro-descendants, supplemented with the priority measures referring to the right to health of indigenous peoples (priority measure 87) and of Afro-descendants (priority measure 95).

Priority measure 27

Include older persons as a priority focus of public policy and as fundamental stakeholders in the formulation and implementation of policies aiming to improve the quality of life of older persons.

Related instruments, forums and mechanisms

The United Nations Principles for Older Persons include the principle of participation, and declare that older persons should participate actively in the formulation and implementation of policies that directly affect their well-being and share their knowledge and skills with younger generations and should be able to form movements or associations of older persons (United Nations General Assembly resolution 46/91, on Implementation of the International Plan of Action on Ageing and related activities, of 16 December 1991).

The Madrid International Plan of Action on Ageing sets forth, under priority direction 1 (“Older persons and development”), objective 1 on “recognition of the social, cultural, economic and political contribution of older persons” (which includes recommendations such as to “offer opportunities, programmes and support to encourage older persons to participate or continue to participate in cultural, economic, political and social life and lifelong learning” and “provide information and access to facilitate the participation of older persons in mutual self-help, intergenerational community groups and opportunities for realizing their full potential” and objective 2 on “participation of older persons in decision-making processes at all levels” (which includes recommendations to “take into account the needs and concerns of older persons in decision-making at all levels”; “encourage, when they do not already exist, the establishment of organizations of older persons at all levels to, inter alia, represent older persons in decision-making”; and “take measures to enable the full and equal participation of older persons, in particular older women, in decision-making at all levels’).

The Committee on the Elimination of Discrimination against Women, in its general recommendation No. 27 on older women and protection of their human rights, declares that “States parties have an obligation to ensure that older women have the opportunity to participate in public and political life and hold public office at all levels and that older women have the necessary documentation to register to vote and run as candidates for election.”

Comments

This measure is related to priority measure 21: “Ensure the inclusion and equitable participation of older persons in the design and application of policies, plans and programmes that concern them.”

Priority measure 28

Foster policies to encourage individuals to save during their active, productive life so that in the long run they can enjoy a decent old age.

Possible lines of action

1. Develop a strategic national plan on active ageing, one that takes a comprehensive, multisector approach to active ageing, focused either on older workers as a specific target group or on meeting their needs within a broader framework designed to address the challenges of working life (for example, work-life balance). 2. Introduce legislation to prohibit discrimination on the basis of age in the labour market. 3. Introduce programmes to encourage the transfer of experience and know-how from older to younger workers (for example, mentoring programmes for entrepreneurs). 4. Introduce fiscal incentives for employers (for example, reducing the social contribution rates) to encourage the retention of older workers. 5. Develop national policies for lifelong learning that include guarantees of education, training and skills development for older workers. 6. Set up programmes to support people in preparing for retirement through savings plans and participation in social security systems. 7. Mount a national campaign of financial education for retirement (for example, send out a yearly letter to workers, projecting their eventual annual retirement incomes). 8. Measure the untapped potential of older persons for active and healthy ageing, through such tools as the Active Ageing Index developed by the Economic Commission for Europe (ECE). 9. Ensure that policies take into account healthy ageing.

Targets

1. Increase the proportion of older persons leading an active life. 2. End poverty among older persons. 3. Increase the proportion of working-age adults who are contributing to the social security system.

Tentative indicators

1. The Active Ageing Index. 2. Number and proportion of older persons living below the poverty line. 3. Percentage of working-age adults contributing to the social security system. 4. Existence of policies aimed at ensuring healthy ageing.

Related instruments, forums and mechanisms

The content of this measure is also encompassed in the San José Charter on the rights of older persons in Latin America and the Caribbean, in agreement 8: “Promote fulfilment of the right of older persons to work and have access to income-generating activities by means of the following actions: (a) Promote the development of measures designed to ensure equal treatment and equal opportunities, especially with regard to working conditions, guidance and training at all levels, in particular equality in vocational training and job placement; (b) Adopt active employment policies that promote the participation or re-entry of older workers in the labour market, based on country-specific opportunities; (c) Promote legal reforms and economic incentives to enable older persons to continue working beyond the retirement age, in accordance with their capacity, experience and preferences, including measures such as gradually reducing the working day, part-time employment and flexible hours; (d) Disseminate information on the right to retire, preparations for retirement and its advantages, as well as on the possibilities of other vocational or voluntary activities; (e) Promote entrepreneurship and access to credit”.

Related instruments, forums and mechanisms

The content of this measure is also encompassed in the Madrid International Plan of Action on Ageing, under priority direction 1 (“Older persons and development”, issue 1 (“Active participation in society and development”), objective 1 (“Recognition of the social, cultural, economic and political contribution of older persons”), with the following recommended actions: (a) Ensure the full enjoyment of all human rights and fundamental freedoms by promoting the implementation of human rights conventions and other human rights instruments, particularly in combating all forms of discrimination; (b) Acknowledge, encourage and support the contribution of older persons to families, communities and the economy; (c) Provide opportunities, programmes and support to encourage older persons to participate or continue to participate in cultural, economic, political, social life and lifelong learning; (d) Provide information and access to facilitate the participation of older persons in mutual self-help, intergenerational community groups and opportunities for realizing their full potential; (e) Create an enabling environment for volunteering at all ages, including through public recognition, and facilitate the participation of older persons who may have little or no access to the benefits of engaging in volunteering; (f) Promote a wider understanding of the cultural, social and economic role and continuing contribution of older persons to society, including that of unpaid work; (g) Older persons should be treated fairly and with dignity, regardless of disability or other status, and should be valued independently of their economic contribution; (h) Take account of the needs of older persons and respect the right to live in dignity at all stages of life; (i) Promote a favourable attitude among employers regarding the productive capacity of older workers as being conducive to their continued employment and promote awareness of their worth, including their self-awareness, in the labour market; (j) Promote civic and cultural participation as strategies to combat social isolation and support empowerment.

This priority measure is also linked with Sustainable Development Goal 3 (“Ensure healthy diets and promote well-being for all at all ages”), and particularly target 3.4 (“By 2030 reduce by one third premature mortality from non-communicable diseases through prevention and treatment, and promote mental health and well-being”).

Comments

The Active Ageing Index (AAI) is an analytical tool launched by the European Commission and the Economic Commission for Europe (ECE) with the objective of helping policymakers to develop policies for active and healthy ageing. This index could serve as an indicator of an active life.

With regard to the indicator of the number and proportion of older persons below the poverty line, it is important to consider alternative measurement methods that capture more than just lack of income.

Priority measure 29

Foster the development of and access to palliative care, to ensure a dignified, painless death.

Possible lines of action

1. Create a national programme of palliative care for older persons suffering from a life-threatening illness or one that limits their life expectancy. 2. Devote sufficient economic resources to guarantee the availability and accessibility of essential drugs for pain relief, and better access to technology. 3. Train health workers in issues relating to respect and pain management, and the health consequences of age-based discrimination. 4. Create accessible, fair and safe procedures for handling complaints and imposing penalties on health professionals guilty of discriminating against or disrespecting the dignity of older persons with terminal illnesses. 5. Promulgate and enforce laws and regulations, including health protocols and hospital procedures, that will protect the right to die without pain and with access to modern treatments. 6. Provide psychosocial support to the family to minimize the stress associated with illness and care, and to improve family well-being. 7. Provide the family with information and training regarding the illness so that it can participate more effectively in care, relief and support for the older person. 8. Offer support to family members in coordinating the appropriate services, including financial, medical and legal guidance.

Targets

1. Have in place a national programme of palliative care. 2. Expand the supply of training programmes and skills upgrading schemes relating to palliative care for physicians, nurses and other professionals. 3. Make pain relief drugs more available and readily accessible.

Tentative indicators

1. Percentage of older persons with terminal illnesses who have access to specialized care at home. 2. Percentage of primary health-care centres that have included palliative care as a basic service. 3. Number of physicians available in palliative care units per million inhabitants within a defined population.

Related instruments, forums and mechanisms

General comment No. 14 of the Committee on Economic, Social and Cultural Rights (2000) on the right to the highest attainable standard of health (article 12 of the Covenant on Economic, Social and Cultural Rights) includes a series of obligations of States parties, such as non-discriminatory access to facilities, goods and services, the supply of essential drugs as defined by WHO, and the adoption and application of a public health strategy. In the context of palliative care, persons with a terminal illness must have access to adequate health care, basic medications for controlling symptoms, and terminal care, and palliative care should be included in national health policies.

The Committee on the Elimination of Discrimination against Women has held, in its general recommendation No. 27 on older women and protection of their human rights, that, with respect to the right to health, States parties must provide medications to treat chronic and non-communicable diseases, long-term health and social care, including care that allows for independent living, and palliative care.

Access to essential medicines, according to the WHO definition, is part of the minimum essential contents of the right to the highest attainable standard of health. The WHO Model List of Essential Medicines currently includes 14 palliative care medications.

In his report of 1 February 2013, the Special Rapporteur on Torture held that governments must guarantee access to essential medicines as part of their minimum core obligations under the right to health, and that the denial of relief from pain and suffering may constitute inhuman and degrading treatment according to the definition in the Convention against Torture.

The San José Charter on the rights of older persons in Latin America and the Caribbean calls for promoting “the development of and access to palliative care to ensure that older persons with terminal illnesses die with dignity and free of pain.”

Article 6 (“Right to life and dignity in old age” ) of the Inter-American Convention on protecting the human rights of older persons establishes that “States Parties shall take steps to ensure that public and private institutions offer older persons access without discrimination to comprehensive care, including palliative care; avoid isolation; appropriately manage problems related to the fear of death of the terminally ill and pain; and prevent unnecessary suffering, and futile and useless procedures, in accordance with the right of older persons to express their informed consent.”

Comments

According to WHO, palliative care improves the quality of life for patients and families coping with life-threatening illnesses, by mitigating pain and other symptoms and providing spiritual and psychological support from the time of diagnosis until the end of life, and through the mourning period.

Essential medicines are considered to be those that cover people’s priority health-care needs. They are selected in light of the prevalence of the diseases they treat and their safety, effectiveness and comparative cost-effectiveness. Existing health systems are supposed to have essential medicines available at all times, in sufficient quantities, in the appropriate pharmaceutical forms, with guaranteed quality, and at a price that is affordable for individuals and the community.

The Inter-American Convention on protecting the human rights of older persons defines palliative care as “active, comprehensive, and interdisciplinary care and treatment of patients whose illness is not responding to curative treatment or who are suffering avoidable pain, in order to improve their quality of life until the last day of their lives. Central to palliative care is control of pain, of other symptoms, and of the social, psychological, and spiritual problems of the older person. It includes the patient, their environment, and their family. It affirms life and considers death a normal process, neither hastening nor delaying it.”

Priority measure 30

Promote the development of allowances and services relating to social security, health and education in the social protection systems targeting older persons to improve their quality of life, economic security and social justice.

Possible lines of action

1. Create continuing education programmes (training and retraining) for older persons. 2. Reinforce programmes to combat illiteracy among older men and women. 3. Facilitate access and active participation for older persons in recreational, cultural and sporting activities sponsored by public and private organizations, associations and institutions. 4. Promote training for older persons in the use of information and communication technologies. 5. Achieve universal social security coverage, with at least minimum levels of protection, guaranteeing progressively higher levels in line with the updated social security standards of the International Labour Organization (ILO). 6. Promote the production and dissemination of information on pensions in a manner readily understandable for the entire population. 7. Train organizations representing pensioners and older persons in the financing and management of pensions, so that they can establish effective relationships with policymakers. 8. Promulgate legislation protecting the rights of workers vis-à-vis private pension funds. 9. Gradually expand the scope of social security coverage for independent workers, domestic workers and workers in rural areas, adapting the scope of benefits, contributions and administrative procedures accordingly.

Targets

1. Ensure that all older persons have access to social security. 2. Ensure that all older persons have access to the health system. 3. Eradicate illiteracy among older men and women.

Tentative indicators

1. Percentage of older persons receiving benefits under social security programmes and the average amount of the benefit. 2. Percentage of older persons with access to the health system. 3. Percentage of illiterate older persons. 4. Percentage of older persons receiving

non-contributory pensions and the average amount of the benefit.

Related instruments, forums and mechanisms

The International Covenant on Economic, Social and Cultural Rights provides in article 9 that “The States Parties to the present Covenant recognize the right of everyone to social security, including social insurance”, a provision that implicitly includes recognition of the right to old-age benefits. The Committee on Economic, Social and Cultural Rights has declared in its general comment No. 6 that “in so far as respect for the rights of older persons requires special measures to be taken, States parties are required by the Covenant to do so to the maximum of their available resources.”

The International Labour Organization (ILO) has general standards relating to social security: the Social Security (Minimum Standards) Convention, 1952 (No. 102); the Income Security Recommendation, 1944 (No. 67); and the Social Protection Floors Recommendation, 2012 (No. 202).

The Madrid International Plan of Action on Ageing includes social security in issue 7 (“Income security, social protection/social security and poverty prevention”), under priority direction 1 (“Older persons and development”), and education under issue 4 (“Access to knowledge, education and training”), also under priority direction 1.

This priority measure is also related to the Sustainable Development Goals and their targets, in particular target 1.3 (“Implement nationally appropriate social protection systems and measures for all, including floors, and by 2030 achieve substantial coverage of the poor and the vulnerable”), target 3.4 (“By 2030 reduce by one-third pre-mature mortality from non-communicable diseases (NCDs) through prevention and treatment, and promote mental health and well-being”) and target 10.4 (“Adopt policies especially fiscal, wage, and social protection policies and progressively achieve greater equality”).

Comment

This priority measure is related to priority measure 32: “Extend social protection and social security systems, with a gender perspective, to include those women who have devoted their lives to productive work, whether as domestic workers, women in rural areas or informal workers”. In addition, the health area is addressed in priority measure 26: “Bring health policies into line with the challenges of the varied and changing epidemiological profile arising from ageing and the epidemiological transition, reinforcing the fight to eradicate communicable diseases and implementing actions for the prevention and treatment of chronic, diseases traditionally referred to as non-communicable, but now known to be strongly influenced by conditions of social and economic vulnerability in the early years of life, and ensure that these policies take into account gender, age, regional, ethnic and socioeconomic specificities”.

Priority measure 31

Include care in social protection systems, through allowances, social and health-care services and economic benefits that maximize autonomy, in particular for older persons, and guarantee the rights, dignity and well-being of families and older persons, including the right to a dignified death with proper care, without any form of discrimination or violence.

Possible lines of action

1. Create home care programmes that include a personal caregiver, medical and gerontological check-ups, and adaptations to the dwelling, among other things. 2. Create services that promote community-based care alternatives for dependent older persons. 3. Legislate to regulate long-term care institutions from the viewpoint of the rights and dignity of dependent older persons, and create mechanisms for supervising them. 4. Legislate to protect workers providing care to a dependent older family member, including leave form work, flexible hours, and labour protection. 5. Create programmes that provide time off, counselling and training for caregivers for dependent older persons. 6. Create services to facilitate information and coordination of assistance for caregivers for dependent older persons. 7. Give budget priority to creating appropriate infrastructure and technology to facilitate the tasks of caring for dependent older persons. 8. Create public transfer programmes for non-professional caregivers working with dependent older persons (a decent basic wage, or citizen’s wage for caregivers, including social security benefits).

Targets

1. Ensure that every older person requiring care services receives them. 2. Have caregivers included in the social security system. 3. Have family caregivers receive a financial benefit for their care work.

Tentative indicators

1. Percentage of older persons receiving home care consistent with their needs and characteristics. 2. Percentage of caregivers who have social security benefits. 3. Percentage of family caregivers who have a decent basic income.

Related instruments, forums and mechanisms

Questions relating to care are part of the Convention on the Rights of Persons with Disabilities (articles 16, 19 and 20) and of various United Nations General Assembly resolutions (resolution 31/37 XXXVIII of 1973 and resolution 46/91 on the United Nations Principles for Older Persons). They also form part of the Vienna International Plan of Action on Ageing (1982) and the Madrid International Plan of Action on Ageing (2002).

In the jurisprudence of the treaty bodies, the Committee on Economic, Social and Cultural Rights addresses the matter in general comment No. 6 on the economic, social and cultural rights of older persons (E/C.12/1995/16/Rev.1) of 1995. Regarding the right to an adequate standard of living, article 11 of the Covenant interprets this as meaning that older persons must be able to satisfy their basic needs, including food, income, care, self-sufficiency.

The Committee on the Elimination of Discrimination against Women, in its general recommendation No. 27, held that, when it comes to labour and pension benefits, States parties should ensure that older women, including those who have responsibility for the care of children, have access to appropriate social and economic benefits such as childcare benefits, as well as access to all necessary support when caring for elderly parents or relatives.

The measure is also related to the Sustainable Development Goals and their targets, in particular target 5.4 (“Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies, and the promotion of shared responsibility within the household and the family as nationally appropriate”).

Article 12 of the Inter-American Convention on protecting the human rights of older persons (“Rights of older persons receiving long-term care”) establishes that “older persons have the right to a comprehensive system of care that protects and promotes their health, provides social services coverage, food and nutrition security, water, clothing, and housing, and promotes the ability of older persons to stay in their own home and maintain their independence and autonomy, should they so decide.” It added that “States Parties shall design assistance measures for families and caregivers through the introduction of services for those providing care to older persons, taking into account the needs of all families and other forms of care, as well as the full participation of older persons and respect for their opinions. States Parties shall adopt measures toward developing a comprehensive care system that takes particular account of a gender perspective and respect for the dignity, physical, and mental integrity of older persons.”

Comment

The right to a dignified death with proper care, and without any type of discrimination or violence, as mentioned in this priority measure, 31, is also addressed in priority measure 29 (in relation to dignified death and in priority measure 23 (regarding the elimination on all forms of violence). The compilation of statistical information on care and unpaid work is considered under priority measure 53.

Priority measure 32

Extend social protection and social security systems, with a gender perspective, to include those women who have devoted their lives to productive work, whether as domestic workers, women in rural areas or informal workers.

Possible lines of action

1. Ensure that the objective of gender equality is a special motivation in the process of reforming and extending social protection and social security systems. 2. Adopt special programmes to guarantee coverage for women who have devoted their lives to productive work, as domestic workers, women in rural areas or informal workers. 3. Assess the impact on women of pension re forms that have reinforced the link between benefits received by contributors and their working life. 4. Promulgate legislation to guarantee that time taken away from the labour market to provide care services is properly credited in pension systems. 5. Promote legislation to ensure that divorce and separation do not penalize women in the social protection and social security systems.

Target

1. Ensure that social protection and social security systems have a gender focus and include women who have devoted their lives to productive work, as domestic workers, women in rural areas and informal workers.

Tentative indicators

1. Percentage of female domestic workers covered by social protection and social security systems. 2. Percentage of rural women covered by social protection and social security systems. 3. Percentage of female informal workers covered by social protection and social security systems.

Related instruments, forums and mechanisms

The International Covenant on Economic, Social and Cultural Rights provides in article 9 that “The States Parties to the present Covenant recognize the right of everyone to social security, including social insurance”, a provision that implicitly includes recognition of the right to old-age benefits. The Committee on Economic, Social and Cultural Rights has declared, in general comment No. 6, that “in so far as respect for the rights of older persons requires special measures to be taken, States parties are required by the Covenant to do so to the maximum of their available resources.”

The Committee on the Elimination of Discrimination against Women, in its general recommendation No. 27 on older women and protection of their human rights, includes a specific section on “Work and pensions entitlements”, in which it declares the following: “States parties have an obligation to facilitate the participation of older women in paid work without facing any discrimination based on their age and sex. States parties should ensure that special attention is paid to overcome problems that older women might face in their working life and that they are not forced into early retirement or similar solutions. States parties should also monitor the impact of gender pay gaps on older women. States parties have an obligation to ensure that retirement ages in both the public and private sectors do not discriminate against women. Consequently, States parties have an obligation to ensure that pension policies do not discriminate against women, even when they opt to retire early, and that all older women who worked have access to adequate pensions. States parties should adopt all appropriate measures, including, where necessary, temporary special measures, to guarantee such pensions. States parties should ensure that older women, including those who have responsibility for the care of children, have access to appropriate social and economic benefits such as childcare benefits, as well as access to all necessary support when caring for elderly parents or relatives. States parties should provide adequate non-contributory pensions on an equal basis with men to all women who have no other pension or insufficient income security and State-provided allowances should be available and accessible to older women, particularly those living in remote or rural areas.”

This priority measure is also linked to the Sustainable Development Goals and their targets, particularly target 1.3 (“Implement nationally appropriate social protection systems and measures for all, including floors, and by 2030 achieve substantial coverage of the poor and the vulnerable”) and target 5.4 (“Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies, and the promotion of shared responsibility within the household and the family as nationally appropriate”).

D. UNIVERSAL ACCESS TO SEXUAL AND REPRODUCTIVE HEALTH SERVICES

This chapter of the Montevideo Consensus on Population and Development recognizes sexual rights[12] and reproductive rights as an integral component of human rights, going a step further than the recognition of reproductive rights in the Programme of Action of the International Conference on Population and Development[13] and placing Latin America and the Caribbean at the global vanguard in terms of rights recognition. As a result, sexual rights, reproductive rights, sexual health and reproductive health overlap, sometimes intricately, in the priority measures.

Progress towards the target of universal access to reproductive health services, as set forth in the Cairo Programme of Action and reiterated in target 5B of the Millennium Development Goals, has been insufficient and uneven. For example, the target on maternal mortality contained in the Millennium Development Goals is one of those that have not been met in Latin America and the Caribbean. According to the 2014 report on the Millennium Development Goals, maternal mortality in the Caribbean remains high, at a rate of 190 maternal deaths per 100,000 live births in 2013, compared to a goal of around 80 maternal deaths per 100,000 live births. In Latin America, the maternal mortality rate is much lower, at 72 maternal deaths per 100,000 live births in 2010, but it too is very far from the target. Moreover, these averages mask great inequalities that cut across the sexual and reproductive health agenda. These inequalities relate to age, race, ethnicity or area of residence, and they affect in particular certain groups of women, for whom many of the indicators, in particular those for maternal mortality, are poor. It is estimated that 8,800 women die every year in Latin America and the Caribbean from causes related to pregnancy, childbirth or post-partum, and most of these deaths are preventable, which betrays a gap in the protection of women’s rights in many spheres of their life, such as lack of education, scant empowerment, lack of adequate and timely health services, and lack of quality statistics that would give visibility to the problem.

On the other hand there have been some positive outcomes: for example, the Caribbean has experienced the sharpest decline of any region in the number of new cases of HIV infections, which fell by 43% between 2001 and 2011. Despite this, however, the Caribbean region remains the worst affected, after sub-Saharan Africa: in 2011, 1% of adults were infected with HIV. In Latin America and the Caribbean overall, the objective of achieving universal access and treatment for combating HIV/AIDS is within reach. In 2011, 68% of persons infected with HIV in the region were receiving treatment, the best record of all developing regions.

This chapter contains 14 priority measures: (i) on universal access to sexual and reproductive health, priority measure 33 calls for promoting, protecting and guaranteeing sexual health and rights and reproductive rights, priority measure 37 deals with guaranteeing universal access to good-quality sexual and reproductive health services, priority measure 38 addresses detection and treatment of HIV/AIDS, priority measure 41 looks at promoting sexual and reproductive health for men, priority measure 44 promotes broad access to contraceptive methods, and priority measure 46 aims to guarantee sufficient financial, human and technological resources; (ii) on maternal health, priority measure 39 focuses on detecting HIV/AIDS in pregnant women and preventing vertical transmission, priority measure 40 deals with eliminating the preventable causes of maternal morbidity and mortality, priority measure 42 with ensuring (consistent with legislation) services for safe abortion and comprehensive post-abortion care, priority measure 43 with ensuring comprehensive care during the reproductive process, including assisted fertility treatments, and priority measure 45 with raising the quality of antenatal care and ensuring compassionate care at childbirth; (iii) on legislation, priority measure 34 calls for promoting policies to enable persons to exercise their sexual rights, priority measure 35 deals with reviewing legislation to guarantee access to services and information for sexual and reproductive health services, and priority measure 36 addresses eradicating discrimination based on sexual orientation and gender identity.

This chapter also ties in with several other chapters of the Montevideo Consensus on Population and Development, primarily chapter B on the rights, needs, responsibilities and requirements of girls, boys, adolescents and youth (especially priority measures 11, 12, 14 and 15) (measures concerning safe abortion, including for adolescents, are considered here in chapter D); chapter E, on gender equality; chapter F on migrants (especially priority measure 72); chapter G on gender equality; chapter H on indigenous peoples (priority measure 87); chapter I on Afro-descendants (priority measure 95); and chapter J on frameworks for the implementation of the regional agenda on population and development, in particular follow-up and accountability (priority measures 101 to 104 and 108), and consequently the lines of action, goals and indicators need to be harmonized. As well, the chapter relates to other instruments adopted by the international community, which are cited in priority measure 33 and covered more specifically in the corresponding priority measures.

Priority measure 33

Promote, protect and guarantee sexual health and rights and reproductive rights in order to contribute to the fulfilment of persons and to social justice in a society free from all forms of discrimination and violence.

Related instruments, forums and mechanisms

This priority measure, and chapter D in general, also relate directly to various international instruments and mechanisms such as follow-up to the Programme of Action of the International Conference on Population and Development and the Beijing Platform of Action and their subsequent developments, the Convention on the Elimination of All Forms of Discrimination against Women, the United Nations 2030 Agenda for Sustainable Development and the Sustainable Development Goals, the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families, the Declaration on the Rights of Indigenous Peoples, the Indigenous and Tribal Peoples Convention (No. 169) of ILO, the outcome of the high-level plenary meeting of the General Assembly known as the World Conference on Indigenous Peoples, the Report of the Working Group of Experts on People of African Descent, the Convention on the Rights of the Child, the Follow-Up Mechanism to the Convention of Belém do Pará (MESECVI) on violence against women and the Commission on the Status of Women.

As well, this priority measure relates to other agreements contained in various consensus documents of the Regional Conference on Women in Latin America and the Caribbean, the Santo Domingo Consensus (2013) (“Promote, protect and guarantee the complete fulfilment of the sexual rights and reproductive rights of women of all population groups throughout the life cycle by implementing laws, policies, rules, regulations and programmes incorporated into national and subnational budgets, insofar as physical autonomy is a fundamental dimension of women’s empowerment and their participation in the information and knowledge society on an equal basis”); agreement 6.a of the Brasilia Consensus (2010) (“To guarantee the conditions and resources for the protection and exercise of women’s sexual and reproductive rights throughout the lifecycle and across population groups, free of all forms of discrimination, based on the integrated approach promoted in the programme of action of the International Conference on Population and Development”); and agreement xxiv of the Quito Consensus (2007) (“To ensure that sexual and reproductive rights which are human rights and that universal access to comprehensive health care, which includes sexual and reproductive health care, are considered to be an essential condition for guaranteeing women’s participation in political affairs and in paid work and, hence, in decision-making positions for all women and, as a matter of priority, for young women, the poorest women, indigenous women, Afro-descendent women, rural women and women with disabilities”).

Comments

This broad measure seeks to create conditions to promote, protect and guarantee the exercise of sexual and reproductive rights and to ensure full access to sexual and reproductive health services. These conditions have to do with the development of regulatory frameworks, the creation or strengthening of service networks of varying complexity and quality, for all people and throughout the national territory, the development of care models within primary health care, the availability of trained human resources, the assurance of financial resources, and the development of information systems.

This foregoing can be achieved through other priority measures of the Montevideo Consensus on Population and Development, in particular those contained in this chapter D, those specific to adolescents and young people in chapter B (priority measures 11, 12, 14 and 15), those relating to gender equality in chapter E (priority measure 59), to migrants in chapter F (priority measure 72), to indigenous peoples in chapter H (priority measure 87) and to Afro-descendants in chapter I (priority measure 95). It also relates to the priority measures of chapter J (priority measures 99 to 108), which set the framework for implementing the regional population and development agenda and address the development and strengthening of information sources for monitoring, training and the mobilization of funding.

Priority measure 34

Promote policies that enable persons to exercise their sexual rights, which embrace the right to a safe and full sex life, as well as the right to take free, informed, voluntary and responsible decisions on their sexuality, sexual orientation and gender identity, without coercion, discrimination or violence, and that guarantee the right to information and the means necessary for their sexual health and reproductive health.

Possible lines of action

1. Ensure that there are specific normative frameworks in place covering sexual rights with respect to sex, age, gender, gender identity, sexual orientation, marital status, health status or HIV/AIDS status. 2. Develop mechanisms for applying legislation and normative frameworks on sexual rights, and the financial resources needed to put them into practice. 3. Implement programmes of comprehensive sexuality education from early childhood, with a participatory, intercultural, gender and human rights focus. 4. Implement antidiscrimination programmes based on the protection and promotion of all human rights, including sexual rights, sexual orientation and gender identity. 5. Implement programmes to prevent, combat and punish all forms of violence, including any type of physical, verbal, psychological or economic abuse, sexual harassment or sexual violence, rape and any other form of coercive sexual relationship within or outside marriage, during armed conflicts, forced displacements, disaster situations or other conditions of vulnerability. 6. Promote measures to guarantee the right to information regarding sexual and reproductive health and sexual and reproductive rights. 7. Establish complaint and redress mechanisms for cases of discrimination.

Targets

1. Promulgate or reinforce and implement specific national legislation on sexual rights, and create complaint and redress mechanisms for cases of discrimination. 2. Reduce indices of sexual violence (physical, verbal, psychological or economic abuse, sexual harassment or sexual violence, rape and any other form of coercive sexual relationship within or outside marriage, during armed conflicts, forced displacements, disaster situations or other conditions of vulnerability). 3. Have in place normative frameworks that guarantee the right to information, consistent with other human rights, in matters relating to sexual and reproductive rights, including access to services.

Tentative indicators

1. Mandatory normative frameworks that are specific as to sexual rights by area, including health, education and gender equality. 2. Percentage of people reporting that they have been victims of sexual violence. 3. Percentage of people reporting that they have been victims of discrimination because of their sexual orientation or gender identity. 4. Number of deaths of women at the hands of their partner or former partner and number of feminicides in countries where this nomenclature is used. 5. Existence of research on the protection of reproductive rights and containing recommendations in this respect. 6. Percentage of the population aged 15 and over making free and informed decisions about sexuality, disaggregated by age, gender, ethnicity, sexual orientation, gender identity and socioeconomic level.

Related instruments, forums and mechanisms

Brasilia Consensus.

Santo Domingo Consensus.

As intergovernmental measures and agreements concerning sexual rights are more recent, there is no specific mechanism for such follow-up, and it would be desirable for the second session of the Regional Conference on Population and Development in Latin America and the Caribbean to consider adopting an appropriate mechanism in cooperation with the machineries of the Regional Conference on Women in Latin America and the Caribbean.

Comments

This measure is complementary to priority measure 36 on eradicating discrimination based on sexual orientation and gender identity in the exercise of sexual rights and the manifestations thereof, as well as with the priority measures of chapter E on gender equality, in particular those on reducing gender-based violence and violence against women.

While there are no specific mechanisms for protecting sexual rights, civil society and experts on the issue have made contributions such as the Yogyakarta Declaration and “Sexual rights: an IPPF declaration” by the International Planned Parenthood Federation (IPPF), which define basic standards to assist the United Nations and member States in moving forward with guaranteeing protection for sexual rights. Specialized surveys will be needed to measure some of the indicators, especially number 6.

Priority measure 35

Review legislation, standards and practices that restrict access to sexual and reproductive health services, including the provision of comprehensive user-friendly services for adolescents and youth, and guarantee access to full information on all of the service options available to all persons, without any form of discrimination, in order to ensure that the highest international standards of protection of human rights and fundamental freedoms are met in the region.

Possible lines of action

1. Identify the existing gaps in legislation and regulations, or any contradictions vis-à-vis the international human rights framework that foster discrimination or that impede universal access to sexual and reproductive health services. 2. Amend legislation and regulations as necessary to ensure access to complete and comprehensive information on all the options of services for all persons, without discrimination of any kind. 3. Publicize progress in legislation and regulations on sexual and reproductive health rights and care. 4. Establish mechanisms for the enforcement of rights and for monitoring the established goals and verifying their progress and observance, nationally and regionally. 5. Mount campaigns to bring about the cultural change needed for the protection and observance of sexual and reproductive rights.

Targets

1. Eliminate constraints on access to sexual and reproductive health information and services. 2. Increase the percentage of people who are familiar with the specific national legal framework governing sexual and reproductive health rights and care. 3. Increase the percentage of health service providers who are familiar with the specific national legal framework governing sexual and reproductive health rights and care. 4. Ensure that the entire population has access to timely, high-quality sexual and reproductive health services suitable for their specific characteristics and needs. 5. Reduce the percentage of people facing discrimination in the exercise of their sexual and reproductive rights.

Tentative indicators

1. Number of information campaigns conducted on sexual and reproductive rights and access to sexual and reproductive health care. 2. Percentage of people who are aware of their rights and the conditions for access to sexual and reproductive health care. 3. Percentage of people reporting discrimination in the exercise of their sexual and reproductive rights. 4. Proportion of discriminatory laws and regulations that have been amended or reformed. 5. Proportion of the population that has experienced difficulties or problems in accessing sexual and reproductive health services. 6. Level of satisfaction from users of sexual and reproductive health services. 7. Percentage of women making decisions on their sexual and reproductive health and their reproductive rights by age, geographical area, socioeconomic level, disability status and ethnicity.

Related instruments, forums and mechanisms

Brasilia Consensus.

Santo Domingo Consensus, agreement 80 (“Enforce national and local policies and adopt preventive, punitive, protection and care measures to eliminate all forms of violence and stigma against women, girls, adolescent girls, young women, older women, indigenous and Afro-descendent women, rural women, LGBTTI persons and women with disabilities, and include the effective use of information and communications technologies with an intercultural approach in order to achieve greater inclusion and equality for all women”) and agreement 93 (“Define and develop public policies to combat discrimination and foster affirmative action on the basis of an intersectional approach that includes tackling sexism, racism, ethnocentrism, homophobia and lesbophobia”).

Convention on the Elimination of All Forms of Discrimination against Women.

Follow-up mechanism to the Convention of Belém do Pará (MESECVI).

Sustainable Development Goals, Goal 5 (“Achieve gender equality and empower all women and girls”), target 5.1 (“End all forms of discrimination against all women and girls everywhere”), target 5.c (“Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels”), and Goal 16 (“Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels”), especially target 16.b (“Promote and enforce non-discriminatory laws and policies for sustainable development”).

Comments

This priority measure is related to priority measure 34 on the exercise of sexual rights, and complements priority measure 12, which refers to implementing comprehensive, timely and high-quality programmes of sexual and reproductive health for adolescents and young people.

Priority measure 36

Design policies and programmes to eradicate discrimination based on sexual orientation and gender identity in the exercise of sexual rights and the manifestations thereof.

Possible lines of action

1. Identify discriminatory provisions and gaps in existing legislation and regulations, that foster discrimination or that impede universal access to sexual and reproductive health services, in particular discrimination based on sexual orientation and gender identity as it affects the LGBTTI (lesbian, gay, bisexual, transsexual, transgender and intersexual) population. 2. Propose and develop policies designed specifically to eradicate discrimination in the exercise of sexual rights based on sexual orientation and gender identity. 3. Make sustained efforts to promote the cultural change needed to modify the social and cultural practices that reinforce and perpetuate gender inequalities based on stereotyped roles for women and men and on unequal relationships of power that subordinate and exclude women or discriminate against them. 4. Create reparation mechanisms in the event of violation of human rights on the basis of sexual orientation or gender identity.

Targets

1. Increase the percentage of people knowledgeable about their sexual and reproductive rights. 2. Increase the percentage of people who are aware of their rights to sexual and reproductive health care. 3. Reduce the percentage of people facing discrimination, aggression or violence of different kinds, perpetrated on the basis of their sexual orientation and gender identity, in the exercise of their sexual and reproductive rights. 4. Increase the number of institutions running policies, programmes and projects aimed at sexual and reproductive health care, with an approach grounded in the protection of sexual and reproductive rights.

Tentative indicators

1. Percentage of people who are familiar with legislation and regulations on sexual and reproductive health rights and care. 2. Percentage of people reporting discrimination, based on their sexual orientation, in the exercise of their sexual and reproductive rights. 3. Number (and percentage) of reported cases of discrimination based on sexual orientation and gender identity that are resolved through formal redress mechanisms. 4. Number of public institutions running policies, programmes and projects aimed at sexual and reproductive health care, with an approach grounded in the protection of sexual and reproductive rights. 5. Proportion of discriminatory laws that have been changed or reformed in areas such as health, education, employment, safety and social protection. 6. Visibility of gender identity and sexual orientation in data collection instruments, from a rights-based approach. 7. Number of programmes and campaigns specifically targeted at eliminating stereotypes and discrimination on the basis of gender identity and sexual orientation. 8. Creation of mechanisms of reparation for violation of human rights on the basis of sexual orientation or gender identity.

Related instruments, forums and mechanisms

Brasilia Consensus, agreement 3.i (“Create mechanisms to support the political participation of young women in decision-making, free of discrimination based on race, ethnicity or sexual orientation, and to ensure that their forms of organization and expression are respected and not subjected to generational stigmatization”) and agreement. 5.b (“Formulate policies aimed at eliminating sexist and discriminatory contents in the media and train communications professionals correspondingly, valuing the dimensions of gender, race, ethnicity, sexual orientation and generation”).

Santo Domingo Consensus, agreement 80 (cited under priority measure 35), agreement 86 (“Develop mechanisms, including legislation, and sanctions to combat the use of information and communications technologies and social networks to perpetrate violent acts against women and girls, in particular the criminal misuse of such technologies for sexual harassment, sexual exploitation, child pornography and trafficking in women and girls, and new forms of violence, such as cyberbullying and intimidation and privacy violations that compromise the safety of women, girls, adolescent girls, young women, older women, indigenous women, Afro-descendent women, rural women, LGBTTI persons and women with disabilities”) and agreement 98 (“Elicit a commitment, through the creation of strategic networks, from the media and media professionals’ associations, to project a positive image of women, banishing the stereotypes and the violent content that perpetuate discrimination and violence against women, girls, adolescent girls, young women, older women, indigenous women, Afro-descendent women, rural women, LGBTTI persons and women with disabilities”).

As intergovernmental measures and agreements concerning sexual rights are more recent, there is no specific mechanism for such follow-up, and it would be desirable for the second session of the Regional Conference on Population and Development in Latin America and the Caribbean to consider discussing an appropriate mechanism, in cooperation with the Regional Conference on Women in Latin America and the Caribbean.

Comments

This priority measure is linked with priority measure 34 on the exercise of sexual rights, with priority measure 11 on comprehensive sexuality education, and priority measure 57 on establishing mechanisms for prevention, the filing of complaints and punishment for practices of sexual and occupational harassment.

It would be advisable to include questions (variables) aimed at establishing gender identity by employing categories such as: “identity undefined”, “male”, “female”, “trans male”, “trans female”) in public policy forms and records.

Priority measure 37

Guarantee universal access to good-quality sexual health and reproductive health services, bearing in mind the specific needs of men and women, adolescents and young people, lesbian, gay, bisexual and transgender persons, older persons and persons with disabilities, with special attention to vulnerable persons, persons living in rural and remote areas and to the promotion of citizen participation in the follow-up to commitments.

Possible lines of action

1. Create normative frameworks that guarantee sexual and reproductive health care, recognizing cultural diversity, sexual diversity, the life cycle and the specific needs of older persons according to their health or disability, persons who are migrants, displaced or affected or otherwise vulnerable, or persons living in rural or remote areas. These frameworks may include policies, protocols, care manuals, and so forth. 2. Establish the necessary mechanisms for enforcing legislation or for implementing other mandatory measures. 3. Ensure the allocation and ring-fencing of the funds necessary for the functioning of sexual and reproductive health programmes and services targeted at all persons, in light of their specific needs. 4. Reinforce the available human resources throughout the national territory for providing high-quality sexual and reproductive health services. 5. Facilitate community-based participation in monitoring commitments, with emphasis on promoting women’s participation. 6. Provide universal sexual and reproductive health services consistent with cultural diversity, sexual diversity, stage of the life cycle and disability status, and services networks with clear mechanisms for referral and counter-referral, including in less densely populated areas. 7. Incorporate sexual and reproductive health into primary health-care strategies to ensure the intersectoral approach needed in this area of health. 8. Ensure the availability of inputs and medicines necessary for providing sexual and reproductive health services in emergency situations. 9. Strengthen information systems for timely decision-making. 10. Include HIV prevention measures in sexual and reproductive health services, making use of opportunities arising in the context of guidance and care relating to intrafamily violence.

Targets

1. Ensure that the entire population understands the basic normative elements guaranteeing universal access to sexual and reproductive health services. 2. Ensure that all service providers are familiar with legislation or standards guaranteeing universal access to sexual and reproductive health services. 3. Ensure that the entire population has access to timely, high-quality sexual and reproductive health services consistent with their conditions, needs and requirements. 4. Ensure that health insurance covers free access to sexual and reproductive health inputs and care.

Tentative indicators

1. Availability of a network of services that guarantees sexual and reproductive health care consistent with cultural diversity, sexual diversity, the life cycle and specific conditions of health or disability, or persons living in remote areas or in emergency situations. 2. Number of public policies that ensure access to sexual and reproductive health services which are suitable in terms of cultural diversity, the life cycle, specific health conditions or disabilities, or residence in remote areas or in emergency situations. 3. Percentage of service providers who are familiar with the legislation guaranteeing universal access to sexual and reproductive health services and who have been trained to offer good-quality care. 4. Percentage of people with access to timely, good-quality sexual and reproductive health services consistent with their specific conditions, in particular their age and sex, as well as other characteristics such as sexual orientation, disability status, location within the territory and ethnicity. 5. Percentage of health professionals who are trained to provide good-quality sexual and reproductive health care. 6. Percentage of primary health care points offering comprehensive sexual and reproductive health services and inputs to save lives. 7. Existence of national standards and guidelines established to ensure that providers guarantee access to the sexual and reproductive health services provided under the law.

Related instruments, forums and mechanisms

Sustainable Development Goals, Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), target 3.1 (“By 2030, reduce the global maternal mortality rate to less than 70 per 100,000 live births”), target 3.2 (“By 2030 end preventable deaths of newborns and under-five children”), and target 3.3 (referring to ending, by 2030, the epidemics of AIDS and other communicable diseases).

Convention on the Elimination of All Forms of Violence against Women, article 5, establishes the obligation of States parties to “modify the social and cultural patterns of conduct of men and women, with a view to achieving the elimination of prejudices and customary and all other practices which are based on the idea of the inferiority or the superiority of either of the sexes or on stereotyped roles for men and women”.

ECLAC Gender Equality Observatory for Latin America and the Caribbean.

PAHO Strategy for Universal Access to Health and Universal Health Coverage.

Santo Domingo Consensus, agreement 70 (“Ensure, within the framework of strengthened health systems —endowed with budgetary, monitoring, evaluation and accountability mechanisms— universal access to expanded sexual health and reproductive health services of better quality and wider coverage”) and agreement 74 (“Implement gender-sensitive measures to guarantee access to good-quality health services, including sexual and reproductive health services, during and after disasters and in cases of emergency and for displaced persons and refugees in order to prevent mortality and morbidity”).

In addition, a background is provided by the commitment established in the Programme of Action of the International Conference on Population and Development (action 7.6).

Comment

This priority measure is related to priority measure 12 on adolescent- and youth-friendly services, and to priority measures 72, 87 and 95 on sexual and reproductive health services for migrants, indigenous peoples and Afro-descendants, respectively. It would be advisable to develop accountability and participation mechanisms to follow up on the commitments made in this area.

Priority measure 38

Promote the prevention and timely detection of and guarantee universal access to comprehensive treatment for HIV/AIDS and sexually transmitted infections and eliminate the stigma and discrimination to which persons living with the virus are often subjected.

Possible lines of action

1. In the normative frameworks on sexual and reproductive health care, maintain the specific features relating to HIV/AIDS and sexually transmitted infections (STIs) and consider measures to promote the prevention and timely detection of HIV/AIDS, and access to treatment. 2. Ensure training for all health personnel in the new evidence on HIV and AIDS and on legislation and regulations in this area. 3. Ensure that regulations on sexual and reproductive health services include measures to eliminate the stigma and discrimination to which persons living with or vulnerable to the virus are often subjected. 4. Promote the cultural change needed to eliminate the stigma and discrimination to which persons living with or vulnerable to the virus are often subjected. 5. Develop intersectoral plans with specific coordination for the prevention of HIV/AIDS. 6. Promote HIV screening of women of reproductive age. 7. Earmark the necessary resources for the functioning of sexual and reproductive health programmes and services aimed at the prevention, timely detection and treatment of HIV/AIDS and sexually transmitted infections. 8. Provide effective and non-discriminatory mechanisms for referral and counter-referral between HIV services and other health services at all levels of care.

Targets

1. End the AIDS epidemic by 2030 (based on target 3.3 of the Sustainable Development Goals). 2. Ensure that, by 2030, all persons infected by HIV have access to antiretroviral therapy. 3. Eliminate practices and rules that stigmatize or discriminate against persons living with or vulnerable to HIV, in health care and especially in health services.

Tentative indicators

1. Indicator for monitoring eradication of the epidemic: (i) Percentage of persons living with HIV; (ii) Percentage of persons with HIV who are receiving treatment; (iii) Percentage of persons undergoing HIV treatment who succeed in suppressing the viral load. 2. Proportion of rules that have been reformulated or invoked to ensure the right of persons with HIV to employment, social security and education. 3. Percentage of female HIV/AIDS victims. 4. Sustainable Development Goal indicators disaggregated by sex, age and means of transmission: (i) Annual incidence of HIV (number of new infections per 1,000 inhabitants), disaggregated by sex and age; (ii) Annual deaths from HIV/AIDS, disaggregated by sex and age.

Related instruments, forums and mechanisms

Sustainable Development Goals, Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), target 3.3 (referring to ending, by 2030, the epidemics of AIDS and other communicable diseases).

Santo Domingo Consensus, agreement 72 (“Ensure that the financial resources for HIV/AIDS prevention are allocated to specific measures grounded in scientific evidence that reflects the particular characteristics of the epidemic in each country, with special attention to geographical location, social networks and populations that are vulnerable to HIV infection, with a view to ensuring that those resources are employed as effectively as possible”) and agreement 73 (“Ensure comprehensive care for persons affected by HIV/AIDS, in particular women, girls, adolescents, young persons, orphans and vulnerable children, migrants and people in humanitarian emergencies, detained women, indigenous populations, Afro-descendants and women with disabilities”).

Brasilia Consensus, agreement 6.e (“Ensure also universal access by women in their diversity to comprehensive, high-quality sexual and reproductive health care, including care for human immuno-deficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), its prevention, diagnosis and free treatment, and especially, to carry out campaigns to promote the use of the male and female condoms”).

Quito Consensus, agreement xxv (“Implement measures and policies that take into account the linkages between social and economic vulnerabilities as they relate to women’s possibilities of participating in politics and in paid work, especially in terms of access to sexual and reproductive health care, water and sanitation, and HIV/AIDS prevention, treatment and care, with priority being placed on the poorest women and their families”).

Comments

With regard to disaggregation by sex and age, UNAIDS recommends that wherever possible data should be disaggregated by key population groups: sex workers, those of a particular sexual orientation, including men who have sex with men, and intravenous drug users, and that all HIV indicators should be measured for the entire population, as some of the greatest gaps have to do with the treatment of children.

To eradicate the HIV epidemic, UNAIDS proposes the 90-90-90 objective, according to which, by 2020, 90% of people living with HIV will know their HIV status (and 95% by 2030); by 2020, 90% of all people with diagnosed HIV infection will receive sustained antiretroviral therapy (and 95% by 2030); and by 2020, 90% of all people receiving antiretroviral therapy will have an undetectable viral load, meaning that their immune system remains strong and they are no longer infected (and 95% by 2030).

This measure is broadened in priority measure 39 on the vertical transmission of HIV and is complemented by priority measure 12 on sexual and reproductive health for adolescents and young people and priority measure 37 on access to comprehensive sexual and reproductive health services.

Priority measure 39

Strengthen measures for detection of HIV/AIDS and other sexually transmitted infections in pregnant women and for prevention of the vertical transmission of the virus.

Possible lines of action

1. Include in sexual and reproductive health care measures for ensuring that pregnant, post-partum and breastfeeding women are apprised of their HIV/AIDS and STI status and have access to preventive measures and treatment during pregnancy, delivery and post-partum depending on the time of diagnosis. 2. Earmark the necessary funding for the functioning of sexual and productive health programmes and services targeted at pregnant women for the early diagnosis of HIV/AIDS and to guarantee adequate antiretroviral therapy in order to avoid vertical transmission. 3. Develop intersectoral strategies. 4. Promote timely care for pregnant women, including antenatal check-ups. 5. Guarantee diagnostic services with counselling before and after testing.

Targets

1. Ensure that all women who are pregnant or planning a pregnancy, or who are post-partum or breastfeeding, have access to diagnostic screening and are aware of their HIV status in the first trimester of gestation. 2. Ensure that all pregnant, post-partum and breastfeeding women living with HIV receive treatment. 3. Reduce to zero the incidence of HIV in newborns. 4. Zero maternal deaths from HIV. 5. Ensure that all women living with HIV have access to information on their sexual and reproductive health and their sexual and reproductive rights.

Tentative indicators

1. Percentage of pregnant women who have access to diagnostic screening and know their HIV status. 2. Percentage of pregnant, post-partum and breastfeeding women living with HIV receive treatment and preventive guidance on vertical transmission. 3. Incidence of HIV in newborns (number of new cases per year). 4. Number of maternal deaths from HIV. 5. Percentage of women living with HIV and planning a pregnancy who have access to measures to prevent transmission of the virus, including vertical transmission.

Related instruments, forums and mechanisms

Sustainable Development Goals, Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), target 3.3 (referring to ending, by 2030, the epidemics of AIDS and other communicable diseases).

Santo Domingo Consensus, agreement 72 (“Ensure that the financial resources for HIV/AIDS prevention are allocated to specific measures grounded in scientific evidence that reflects the particular characteristics of the epidemic in each country, with special attention to geographical location, social networks and populations that are vulnerable to HIV infection, with a view to ensuring that those resources are employed as effectively as possible”) and agreement 73 (“Ensure comprehensive care for persons affected by HIV/AIDS, in particular women, girls, adolescents, young persons, orphans and vulnerable children, migrants and people in humanitarian emergencies, detained women, indigenous populations, Afro-descendants and women with disabilities”).

Brasilia Consensus, agreement 6.e (“Ensure also universal access by women in their diversity to comprehensive, high-quality sexual and reproductive health care, including care for human immuno-deficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), its prevention, diagnosis and free treatment, and especially, to carry out campaigns to promote the use of the male and female condoms”).

Quito Consensus, agreement xxv (“Implement measures and policies that take into account the linkages between social and economic vulnerabilities as they relate to women’s possibilities of participating in politics and in paid work, especially in terms of access to sexual and reproductive health care, water and sanitation, and HIV/AIDS prevention, treatment and care, with priority being placed on the poorest women and their families”).

Comment

This priority measure is complementary to priority measure 38 (on HIV), which applies to the population in general and refers to promoting prevention and timely detection and universal access to comprehensive treatment for HIV/AIDS and sexually transmitted infections, and to priority measure 37 on universal access to sexual and reproductive health services.

Priority measure 40

Eliminate preventable cases of maternal morbidity and mortality, including, within the set of integrated benefits of sexual health and reproductive health services, measures for preventing and avoiding unsafe abortion, including sexual health and reproductive health education, access to modern and effective contraceptive methods, counselling and comprehensive care in cases of unwanted and unaccepted pregnancy, as well as comprehensive post-abortion care, where necessary, on the basis of a risk- and harm-reduction strategy.

Possible lines of action

1. Strengthen primary care, establishing standards, guidelines, training for personnel, supervision of service quality and participation of community-based organizations. 2. Ensure free and compulsory care for pregnant women throughout the national territory. 3 Implement pregnancy care programmes that guarantee a minimum number of antenatal check-ups as well as quality institutional care at childbirth to prevent avoidable deaths. 4. Take the measures necessary to reduce delays in identifying and responding to obstetric emergencies. 5. Have in place strategies for targeting prevention and care among subgroups of women for which maternal mortality rates are highest: indigenous women, Afro-descendent women, rural women and others that the country may have identified. 6. Earmark the necessary resources for the functioning of sexual and reproductive health programmes and services, and in particular those for maternal care, with high standards of quality including the various measures of prevention for women of reproductive age. 7. Promote measures to prevent unwanted pregnancies.

Targets

1. To have in place maternal health programmes and services at the local level (in all municipalities). 2. Reduce to zero preventable maternal deaths and reduce other causes of maternal death to virtually zero. 3. By 2030, reduce the maternal mortality ratio by at least two thirds from the 2010 baseline (for an annual rate of reduction of 5.5%).

Tentative indicators

1. Percentage of preventable maternal deaths, by cause of death and disaggregated by race or ethnicity, place of residence, age, education level. 2. Maternal mortality rate (number of maternal deaths per 100,000 live births). 3. Percentage of births attended by skilled health personnel. 4. Postnatal care (for mother and child, at home on in a health establishment) within the first two days of birth. 5. Percentage of health centres (including primary care establishments) that have implemented updated maternal care protocols. 6. Existence of policies to strengthen the role of midwives or obstetric nurses in health services. 7. Existence of a system of referral to emergency obstetric care services. 8. Existence of maternal death surveillance systems. 9. Legal status of abortion.

Related instruments, forums and mechanisms

Sustainable Development Goals, Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), target 3.1 (By 2030 reduce the global maternal mortality rate to less than 70 per 100,000 live births”).

In the Inter-American system, the Protocol of San Salvador expressly enshrines the obligation of States to provide adequate protection for women and, in particular, to provide special care and assistance to mothers before childbirth and for a reasonable time afterwards, without discrimination of any kind (articles 3 and 15).

Santo Domingo Consensus, agreement 79 (“Ensure effective implementation and institutionalization of comprehensive education on sexuality in education systems, as a means of preventing adolescent pregnancy and maternal mortality, and to prevent unwanted pregnancies in general and guarantee women and adolescent girls the full exercise of their sexual rights and reproductive rights such that they can take free, informed and responsible decisions in relation to their sexuality, sex life and sexual orientation, including the right to motherhood of women with HIV/AIDS”).

Brasilia Consensus, agreement 6.g (“Strengthen and broaden plans and programmes that promote healthy maternity and prevent maternal mortality by ensuring universal access to health-care services, especially for indigenous and Afro-descendent adolescent girls and women”).

Comments

The development of priority measure 40 focuses on maternal health care. Other components are developed in priority measures that deal with preventing and avoiding unsafe abortion (priority measure 42) and access to modern and effective contraceptive methods and comprehensive advice and care in case of unwanted and unaccepted pregnancy (priority measure 44).

Priority measure 40 is complementary to priority measure 11 on comprehensive sexuality education, priority measure 37 on access to comprehensive sexual and reproductive health services, priority measure 87 on the rights and sexual health of indigenous peoples, in particular as they relate to reducing maternal mortality, and priority measure 95 on the sexual and reproductive health of Afro-descendent persons.

Priority measure 41

Promote prevention and self-care programmes for the sexual health and reproductive health of men.

Possible lines of action

1. Ensure that laws and regulations on sexual and reproductive health care include measures to promote prevention and self-care programmes for men. 2. Encourage men to take responsibility in sexual and reproductive health matters and in the reproductive care burden. 3. Earmark the necessary funding for upgrading and operation of sexual and reproductive health programmes targeted at men. 4. Create channels for men to participate fully in the formulation of sexual and reproductive health prevention and care plans and programmes. 5. Mount awareness raising and information campaigns to promote self-care by men in matters of sexual and reproductive health.

Targets

1. To have in place sexual and reproductive health programmes, with an intercultural focus and relevant to different ages, that encourage men to take responsibility for their sexual and reproductive health care. 2. Institute formal mechanisms to increase men’s participation in the formulation of sexual and reproductive health prevention and care plans and programmes. 3. Raise men’s awareness of the basic elements of prevention and self-care relating to their sexual and reproductive health. 4. Increase the proportion of men who practice the basic elements of sexual and reproductive health prevention and self-care.

Tentative indicators

1. Percentage of primary care centres that have implemented updated protocols, interculturally focused and relevant to different ages, on sexual and reproductive health care for men. 2. Percentage of men who are aware of the basic elements of prevention and self-care for their sexual and reproductive health. 3. Percentage of men who practice the basic elements of sexual and reproductive health prevention and self-care.

Related instruments, forums and mechanisms

Sustainable Development Goals, Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), target 3.3 (“By 2030 end the epidemic of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, waterborne diseases, and other communicable diseases”), target 3. (“By 2030 reduce by one third premature mortality from non-communicable diseases (NCD) through prevention and treatment, and promote mental health and well-being”), target 3.5 (“Strengthen prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol”), target 3.6 (“By 2020 halve global deaths and injuries from road traffic accidents”), and target 3.7 (“By 2030 ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes”).

Comment

This measure is complementary to priority measure 11 on comprehensive sexuality education, priority measure 34 on sexual rights, priority measure 37 on access to comprehensive sexual and reproductive health services, and priority measure 59 on broadening men’s access to sexual and reproductive health-related information, counselling and services.

Priority measure 42

Ensure, in those cases where abortion is legal or decriminalized under the relevant national legislation, the availability of safe, good-quality abortion services for women with unwanted and unaccepted pregnancies, and urge all other States to consider amending their laws, regulations, strategies and public policies relating to the voluntary termination of pregnancy in order to protect the lives and health of women and adolescent girls, improve their quality of life, and reduce the number of abortions.

Possible lines of action

1. Establish the necessary mechanisms to provide timely, safe, accessible and readily available abortion services for all women who need them (in cases where abortion is legal or decriminalized). 2. Ensure the necessary conditions for applying the different legal provisions in each context, including the tools needed for interpreting them in accordance with international human rights frameworks. 3. Ensure that services for the voluntary termination of pregnancy are available at the primary care level and have referral systems when necessary. 4. Encourage abortion to be performed with medications and using the manual vacuum aspiration (MVA) method. 5. Ensure that information on legal abortion and the prevention of unsafe abortion is available to all women. 6. Establish protocols for health service providers to develop the skills needed to detect and respond to situations involving the coercion or oppression of women so as to avoid abortion against their will (for example, based on their health status, such as living with HIV). 7. Eliminate all regulatory, policy, programme, administrative and cultural barriers that impede access to timely and risk-free abortion care. 8. Ensure that the legal framework eliminates the adverse impact of conscientious objection on the provision of sexual and reproductive health services, and abortion in particular. 9. Promote counselling on contraception and provide contraception methods in the context of abortion care. 10. Encourage the prevention of unwanted pregnancy, including emergency contraception, and the prevention of unsafe abortion. 11. Guarantee, regardless of the legal context, that women subjected to unsafe abortions receive timely and good-quality care to reduce the morbidity and mortality associated with complications. 12. Strengthen health institutions and ensure that there are sufficient providers of these services so as to end unsafe abortion.

Targets

1. Reduce to zero the rates of maternal morbidity and mortality due to abortion. 2. Ensure the existence of standards and protocols on the use of medical abortion medications for all instances of abortion allowed under the law. 3. Ensure that all primary health-care centres have implemented updated service protocols for the voluntary termination of pregnancy (in cases where abortion is legal or decriminalized in national or local legislation). 4. Ensure that all health centres (including primary care establishments) have implemented care protocols for the complications arising from unsafe abortion and have materials, inputs and providers duly trained to deliver this service.

Tentative indicators

1. Number of maternal deaths due to abortion. 2. Number of hospitalizations resulting from complications arising after abortion, by age group. 3. Number of women making use of legal, safe abortion services. 4. Percentage of unplanned births disaggregated by age group. 5. Percentage of health centres (including primary care establishments) that have implemented updated protocols to treat the complications arising from unsafe abortion. 6. Percentage of health centres (including primary care establishments) that have medications for abortion and trained personnel and materials for carrying out safe abortions and providing post-abortion care.

Related instruments, forums and mechanisms

Sustainable Development Goals, Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), target 3.1 (“By 2030 reduce the global maternal mortality rate to less than 70 per 100,000 live births”) and target 3.7 (“By 2030 ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes”).

Santo Domingo Consensus, agreement 78 (“Ensure, in cases where abortion is legal or decriminalized in national legislation, the existence of safe, good-quality abortion services for women with unwanted and unaccepted pregnancies”).

Brasilia Consensus, agreement 6.f (“Review laws that punish women who have undergone abortions, as recommended by the Platform for Action of the Fourth World Conference on Women, including the further initiatives and actions identified for the implementation of the Beijing Declaration and Platform for Action, as well as the Programme of Action of the International Conference on Population and Development and the general observations of the Committee against Torture of the United Nations, and ensure that abortions are performed safely where authorized by the law”).

Comments

This measure complements priority measure 37 on access to comprehensive sexual and reproductive health services, priority measure 40 on maternal mortality, and priority measure 14 which addresses, among other things, unsafe abortion in the reference group of chapter B (children, adolescents and young people).

Priority measure 43

Ensure that all women have effective access to comprehensive health care during the reproductive process and specifically to skilled, institutional, compassionate obstetric care and to the best possible maternal health services during pregnancy, childbirth and the puerperium, as well as to services that include the termination of pregnancy in those cases where the law provides for such services, and guarantee universal access to assisted fertility treatments.

Possible lines of action

1. Implement a system of essential obstetric and newborn care (EONC) that includes: (i) clinical training in essential obstetric and newborn care; (ii) continuous improvement in the quality of care in health centres; (iii) care services that are compassionate and culturally appropriate to users’ needs; and (iv) community-based measures to boost demand for and access to health services. 2. Promote participatory processes for achieving skilled childbirth care that responds to the cultural diversity of the population. 3. Ensure that essential obstetric and newborn care is an integral component of primary health care. 4. Ensure that national legislation on sexual and reproductive health care includes measures for universal access to medically assisted procedures and techniques for becoming pregnant (assisted fertilization).

Targets

1. All primary health-care centres have updated and culturally appropriate essential obstetric and newborn care protocols. 2. Achieve universal coverage for institutional maternal health services. 3. Achieve universal coverage of infertility and subfertility treatment for persons who require it.

Tentative indicators

1. Percentage of primary health-care centres that have implemented updated and culturally appropriate essential obstetric and newborn care protocols. 2. Percentage of childbirths attended in health institutions. 3. Percentage of infertile or subfertile couples and individuals receiving assisted fertility treatments.

Related instruments, forums and mechanisms

Sustainable Development Goals, Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), target 3.1 (“By 2030 reduce the global maternal mortality rate to less than 70 per 100,000 live births”).

Comments

The aspects relating to the inclusion of pregnancy termination and health services, in the cases allowed under the law, are spelled out in priority measure 42, which is also aimed at ensuring that primary health-care services have protocols to treat the complications arising from unsafe abortion. The matter of compassionate obstetric care is developed further in priority measure 45.

This measure complements priority measure 37 on access to comprehensive sexual and reproductive health services, priority measure 40 on maternal mortality, priority measure 42 on access to safe abortion services, and priority measure 45 on the detection of problems during pregnancy, including those which may be foreseen before conception.

Priority measure 44

Guarantee effective access to a wide range of culturally relevant, scientifically sound, modern contraceptive methods, including emergency oral contraception.

Possible lines of action

1. Institute information and counselling programmes on family planning methods and on free and timely access to such methods. 2. Have clear mechanisms for participation by indigenous peoples and other cultures of the country, adolescents and young people in the formulation of contraception and family planning programmes. 3. Eliminate the legal or administrative barriers that impede universal and timely access to emergency contraception. 4. Promote measures to reduce unwanted pregnancies.

Targets

1. Ensure that all primary health-care centres have implemented information and counselling protocols on family planning methods with an intercultural focus. 2. Reduce to zero the unmet demand for family planning methods. 3. Ensure universal access to emergency contraception.

Tentative indicators

1. Percentage of primary health-care centres that have implemented information and counselling protocols on modern family planning methods, including emergency oral contraception, with an intercultural focus. 2. Rate of use of contraceptive methods, by method (modern or traditional). 3. Percentage of sexually active women who report satisfied demand for methods to postpone pregnancy or to space out or limit the number of children. 4. Existence of information systems to monitor the supply and logistical handling of contraceptives. 5. Percentage of health centres that can guarantee availability of oral emergency contraception.

Related instruments, forums and mechanisms

Sustainable Development Goals, Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), target 3.7 (“By 2030 ensure universal access to sexual and reproductive health care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes”).

Comments

This priority measure complements priority measure 14, which establishes the need for timely access to emergency oral contraception without a prescription, priority measure 12 on timely and good-quality services for adolescents and young people, and priority measure 37 on universal access to good-quality sexual and reproductive health services. It also complements priority measures 87 and 95 on the right to health, including sexual and reproductive health, of indigenous peoples and Afro-descendants, respectively. Preferably, the proposed indicators should be disaggregated at least by ethnicity, age and area of residence.

Priority measure 45

Formulate plans for strengthening mechanisms for detecting problems during pregnancy, including at the preconception stage, improve the quality of antenatal care to include an intercultural perspective, guarantee the provision of a safe supply of blood for care during pregnancy, childbirth and the post-partum and puerperium period, and enhance compassionate care during delivery and birth and comprehensive perinatal care, bearing in mind the needs of women, boys, girls and families.

Possible lines of action

1. Institute information and counselling programmes on consultation before conception to create conditions that will encourage women to prepare for a wanted pregnancy. 2. Establish the mechanisms to ensure that women in all parts of the country have access to essential obstetric and newborn care to detect and treat risks before they become serious threats to the health or life of the mother or baby, and to have access to suitable treatment in case of obstetrical complications. 3. Identify the cultural barriers between health services and users, and define and implement the changes needed to provide good quality care that respects and is sensitive to the needs of all women.

Targets

1. Increase culturally appropriate consultation before conception for desired pregnancies. 2. Ensure that all primary health-care centres have implemented updated and culturally appropriate essential obstetric and newborn care to detect and treat risks before they become serious threats to the health or life of the mother or baby, and ensure access to suitable treatment protocols. 3. Increase the percentage of women receiving antenatal care, compassionate care at childbirth, and comprehensive perinatal care consistent with their cultural preference.

Tentative indicators

1. Percentage of pregnancies in which women attended a health consultation before conception. 2. Percentage of births attended in institutions in which the mother had the option to select care appropriate to her culture. 3. Percentage of live births that were preceded by four or more antenatal check-ups. 4. Percentage of pregnancies for which post-partum care is provided.

Related instruments, forums and mechanisms

Sustainable Development Goals, Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), target 3.1 (“By 2030 reduce the global maternal mortality rate to less than 70 per 100,000 live births”) and target 3.2 (“By 2030, end preventable deaths of newborns and under-five children”).

Comments

The indicator “All primary health-care centres have updated and culturally appropriate essential obstetric and newborn care protocols” is proposed in priority measure 43. Measure 45 complements priority measures 87 and 95 on the right to health, including sexual and reproductive health, of indigenous peoples and Afro-descendants, respectively.

Priority measure 46

Guarantee sufficient financial, human and technological resources in order to provide universal access to sexual health care and reproductive health care for all women, men, adolescents, young people, older persons and persons with disabilities without any form of discrimination.

Related instruments, forums and mechanisms

This measure is associated with target 3c of the Sustainable Development Goals (“Increase substantially health financing and the recruitment, development and training and retention of the health workforce in developing countries, especially in least developed countries and small island developing States”).

Comments

As noted in the discussion of the priority measures in this chapter, in order to promote, protect and guarantee health and sexual and reproductive rights, these must be made an integral part of primary health care, which in turn must be strengthened. Only in the context of primary health care is it possible to guarantee sufficient financial, human and technological resources to provide universal access to sexual and reproductive health for all persons.

In the context of the 2030 Agenda for Sustainable Development and the Sustainable Development Goals, work is now underway on:

(a) Strengthening primary health care. The 53rd Directing Council of PAHO, held in Washington D.C. from 29 September to 3 October 2014, approved the Strategy for Universal Access to Health and Universal Health Coverage, which (i) calls on Member States to establish formal mechanisms for participation and dialogue, establish national targets and goals, and define plans of action for universal access to health and universal health coverage, to strengthen governance and stewardship in the health sector, to improve the organization and management of health services, to improve human resource capacities at the first level of care, to increase the efficiency and public financing of health, to advance toward eliminating direct payment, and to facilitate the empowerment of people and communities; and (ii) requests the Director of PAHO to facilitate the leadership of the health authorities, to prioritize technical cooperation that supports countries in advancing toward universal access to health and universal health coverage, to develop measures to implement the strategy and to monitor it, to promote innovation and to strengthen the mechanisms of interagency coordination.

(b) The Report of the Open Working Group of the General Assembly on Sustainable Development Goals, presented to the United Nations General Assembly in August 2014 declares, in paragraph 12 of the proposal, that “each country has primary responsibility for its own economic and social development and the role of national policies, domestic resources and development strategies cannot be overemphasized. Developing countries need additional resources for sustainable development. There is a need for significant mobilization of resources from a variety of sources and the effective use of financing, in order to promote sustainable development. In the outcome document, the commitment to reinvigorating the global partnership for sustainable development and to mobilizing the resources necessary for its implementation was affirmed. The report of the Intergovernmental Committee of Experts on Sustainable Development Financing will propose options for a sustainable development financing strategy. The substantive outcome of the third International Conference on Financing for Development, in July 2015, will assess the progress made in the implementation of the Monterrey Consensus and the Doha Declaration. Good governance and the rule of law at the national and international levels are essential for sustained, inclusive and equitable economic growth, sustainable development and the eradication of poverty and hunger.”

(c) As part of the preparatory work for the Third Conference on Financing for Development, held in Addis Ababa in July 2015, ECLAC hosted the Latin American and Caribbean Regional Consultation on Financing for Development in March 2015. The working document presented by ECLAC, Financing for Development in Latin America and the Caribbean: a strategic analysis from a middle-income country perspective, mentions, among its conclusions, that the 2030 Agenda for Sustainable Development will bring a profound transformation in sustainable development and will require a vast mobilization of resources, along with a change in their funding, organization and allocation, that meeting the goals will entail mobilizing both public and private resources, that the capabilities for accessing private financing vary among the Latin American and Caribbean countries, that the changes in the financial landscape increase the complexity of combining the various financing options, that greater access to external resources must be complemented and balanced with improved domestic resource mobilization, that mobilizing domestic resources means more than mobilizing fiscal resources alone, and that the mobilization of domestic resources through fiscal means should be complemented by strengthening the role of development banks.

Countries of the European Union are now examining and taking steps to optimize their health care and pharmaceutical models and, in particular, pharmaceutical spending and its weight in health spending, and measures in this area will need to be addressed in light of that experience. Follow up to this priority measure also requires spending on sexual and reproductive health to be analysed as a percentage of health spending and of social public spending.

E. GENDER EQUALITY

Autonomy for women (economic, physical and in decision-making) constitutes an essential prerequisite not only for guaranteeing the full exercise of their rights but also for achieving sustainable development. While the region has made progress in implementing the Plan of Action of the Fourth World Conference on Women (Beijing, 1995), such progress has for the most part been mixed and uneven, and there remain important challenges that call for ongoing investments and government policies with respect to gender discrimination in the labour market, the sexual division of labour, violence against women, their social protection, and their sexual and reproductive health, among other matters.

This is the chapter of the Montevideo Consensus on Population and Development that contains the greatest number of priority measures (19), reflecting in part the great preoccupation with the issue and the intense discussion it attracts in specialized forums at the global and regional levels, such as the meetings held in follow-up to the World Conference on Women and the sessions of the Regional Conference on Women in Latin America and the Caribbean.

Generally speaking, and as explained in detail below, the priority measures of this chapter are clearly spelled out in existing specialized instruments, provisions and mechanisms, such as the Beijing Platform for Action, the Santo Domingo Consensus (2013), the Brasilia Consensus (2010), the Quito Consensus (2007),[14] the Convention on the Elimination of All Forms of Discrimination against Women and the Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women (Convention of Belém do Pará). As well, follow-up to many of these instruments is contemplated in the Sustainable Development Goals, in particular Goal 5 (“Achieve gender equality and empower all women and girls”), which seeks among other things to eliminate all forms of discrimination and violence against women (targets 5.1 and 5.2), to recognize the economic and social value of unpaid work, and to promote shared responsibility (target 5.4), to ensure effective participation and equal opportunities for leadership at all levels of decision-making (target 5.5), to ensure universal access to sexual and reproductive health and reproductive rights (target 5.6), to undertake reforms to give women equal rights to economic resources (target 5.a), and to adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels (target 5.c). Yet achieving gender equality, and achievements under the other Sustainable Development Goals as well, will be possible only to the extent that this objective is mainstreamed in the 2030 Agenda and that some of Goals in particular (1, 3, 4, 8, 9, 10, 16 and 17) can be implemented in synergy with Sustainable Development Goal 5.

As explained in the summary tables, there is also a strong interrelationship among the various priority measures of this chapter, and in some cases with measures located in other chapters of the Montevideo Consensus on Population and Development. Priority measure 47, for example, is closely linked with priority measure 49, as having strengthened institutional mechanisms in place is essential for promoting and reinforcing gender-sensitive budgets. Priority measure 49, in turn, taken together with priority measures 62, 63 and 64, represents a constellation of measures to make women visible in national statistics and in government budgets, especially as regards their economic contributions (including the value of unpaid work). These measures also bear an important relationship with priority measure 31 in the chapter on ageing, social protection and socioeconomic challenges. Again with reference to unpaid work, priority measure 53, which seeks to develop and strengthen universal care policies and systems, relates directly to priority measures 59 and 61 and depends, to some extent, on fulfilling priority measure 64.

Priority measures 48, 51 and 52 constitute a group of priority measures to achieve equal participation for women in the formulation and implementation of public policies and in decision-making at all levels.

Priority measures 54, 55 and 56 constitute a group of measures that seek to eliminate gender disparities in the workplace. Priority measure 54 is of broader scope with respect to labour market asymmetries, and is related to priority measures 53, 62 and 64 in terms of recognizing the productive value of unpaid domestic work and care-giving. On the other hand, priority measures 55 and 56 focus on more specific aspects, such as encouraging businesswomen to adopt leadership roles and combating sexual and other forms of harassment in the workplace.

Lastly, priority measures 57 and 58 are devoted to eliminating the various forms of violence and discrimination against women, and bear directly on important specialized mechanisms such as the Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women (Convention of Belém do Pará) and the Convention on the Elimination of All Forms of Discrimination against Women.

Priority measure 47

Fulfil the commitment to strengthen institutional machineries in order to build development policies with equality that will guarantee the autonomy of women and gender equality, and give these machineries the autonomy and the necessary human and financial resources to enable them to have a cross-cutting impact on the structure of the State, recognizing the strategic role that they play and establishing them at the highest level.

Possible lines of action

1. Promote and implement legislative measures that will strengthen the institutions advocating policies for gender equality, such as mechanisms for the advancement of women at the highest hierarchical level, and guarantee for them nontransferable and irreducible budgets as well as human resources and autonomy. 2. Publicize the regional agreements on gender equality to contribute to their effective implementation. 3. Through training, interchange and dissemination, strengthen the substantive participation of the various gender-related bodies and mechanisms in the regional conferences of the subsidiary bodies of ECLAC. 4. Through training, interchange and dissemination, strengthen national and regional mechanisms for monitoring the advancement of women, including gender observatories. 5. Encourage municipal and local governments to create gender affairs offices or units for the advancement of women, and provide them with specialized human, technical and financial resources.

Targets

1. Ensure that institutions advocating public policies for gender equality have a guaranteed budget and means to assure implementation, in the various sectors, of the measures contained in those policies. 2. Afford mechanisms for the advancement of women the highest hierarchical ranking within the government structure. 3. Establish gender equality offices or units for the advancement of women in municipal and local governments. 4. Mainstream the gender approach in the various sectors and policies.

Tentative indicators

1. Percentage of institutions advocating public policies for gender equality that have a guaranteed budget. 2. Percentage of institutions in various sectors that are implementing gender equality policies established under national plans. 3. Percentage of municipal and local governments that have gender equality offices or units for the advancement of women. 4. Hierarchical level of mechanisms for the advancement of women.

Related instruments, forums and mechanisms

Santo Domingo Consensus. In general, chapter F (“Gender equality and mechanisms for women’s empowerment”), and more specifically agreement 111 (“Strengthen institutions advocating public policies on gender equality, such as gender machineries and offices for women’s empowerment, by means of legislation and guaranteed, non-transferrable and irreducible budgets and by setting up decision-making bodies at the highest level, and build up their capacity to provide policy guidance on gender equality and women’s empowerment by endowing them with the necessary human and financial resources for a cross-cutting impact on public policies and the structure of the State with a view to devising and implementing de jure and de facto strategies for promoting women’s autonomy and gender equality”), agreement 112 (“Ensure gender mainstreaming and a focus on rights in all plans, programmes, projects and public policies, as well as the necessary coordination between State powers and social stakeholders to achieve gender equality, thus enshrining this concept as a pillar of sustainable development”) and agreement 118 (“Promote the establishment, at the municipal and local level, of entities such as gender affairs bureaux or offices for the advancement of women, endowing them with sufficient human and financial resources and the specialist expertise to empower women, provide comprehensive care and prevent violence at the local level”).

Comments

Priority measure 47 is closely related to priority measure 49, as stronger institutions are essential for promoting and implementing gender-sensitive budgets.

Priority measure 48

Fulfil the commitment to increase and enhance opportunities for the equal participation of women in adopting and implementing policies in all spheres of public authority and in high-level decision-making.

Possible lines of action

Promulgate and apply legal measures, including quota systems, to achieve parity in decision-making positions in all areas of public power.

Target

Achieve equal participation by men and women in the three branches of government.

Tentative indicators

1. Percentage of women in ministerial positions. 2. Percentage of women in the principal legislative body. 3. Percentage of women judges in the highest court of justice. 4. Proportion of municipal and local council seats held by women.

Related instruments, forums and mechanisms

Santo Domingo Consensus. In general, chapter E (“Gender equality and the empowerment of women for political participation in decision-making”), and more specifically agreement 101 (“Ensure that women have equal access to decision-making positions in all branches of government and in local governments, through legislative and electoral initiatives and measures that guarantee parity of representation in all political spheres and a commitment to strategic agendas to achieve parity in political participation and gender parity as a State policy”).

Brasilia Consensus, agreement 3.d (“Promote the creation of mechanisms which ensure women’s political partisanship and participation and which, as well as parity in candidate registers, ensure parity of outcomes, equal access to campaign financing and electoral propaganda, and women’s participation in decision-making within party structures, and support such mechanisms where they already exist; in addition, create mechanisms to sanction non-compliance with legislation in this area”).

Quito Consensus, agreement ii (“Adopt all necessary affirmative action measures and mechanisms, including the necessary legislative reforms and budgetary allocations, to ensure the full participation of women in public office and in political representative positions with a view to achieving parity in the institutional structure of the State (executive, legislative and judicial branches, as well as special and autonomous regimes) and at the national and local levels as an objective for Latin American and Caribbean democracies”).

Convention on the Elimination of All Forms of Discrimination against Women, article 7, (“States Parties shall take all appropriate measures to eliminate discrimination against women in the political and public life of the country and, in particular, shall ensure to women, on equal terms with men, the right: (a) To vote in all elections and public referenda and to be eligible for election to all publicly elected bodies; […] (c) To participate in non-governmental organizations and associations concerned with the public and political life of the country”).

Sustainable Development Goals, target 5.5 (“Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life”).

Comments

Together with priority measures 51 and 52, priority measure 48 constitutes a group of measures that seek to achieve equal participation for women in the formulation and implementation of public policies and in high-level decision-making (priority measure 51) and to prevent, punish and eradicate political and administrative harassment of women who reach decision-making positions (priority measure 52).

Priority measure 49

Take steps to promote and strengthen the preparation, implementation and accountability of gender-sensitive budgets, in order to achieve equal spending in the public sector, the inclusion of the principles of gender equality in the different stages of planning, budgeting and meeting the specific social needs of women and men.

Possible lines of action

1. Assess budgetary needs in the different spheres of government in order to fulfil the commitments given with respect to gender equality. 2. Include institutions that advocate public policies for gender equality in the process of formulating development plans and public budgets. 3. Make it an aspect of budgetary accountability to fulfil commitments with respect to gender equality, including participation in civil society organizations. 4. Foster instances for coordination between gender machineries and planning and budget departments. 5. Ensure, through legislation and other mechanisms, access to information and accountability regarding public budgets earmarked for gender equality.

Targets

1. Incorporate the gender equality focus in government budgets for the different sectors. 2. Earmark specific resources for gender equality in government budgets. 3. Ensure that mechanisms for the empowerment of women have the necessary funding to ensure their financial autonomy.

Tentative indicators

1. Percentage of government budgets that incorporate the gender focus. 2. Percentage of government budgets with funds specifically allocated to gender equality. 3. Percentage of government budgets with funds specifically allocated to women’s empowerment.

Related instruments, forums and mechanisms

Santo Domingo Consensus, agreements 112 (“Ensure gender mainstreaming and a focus on rights in all plans, programmes, projects and public policies, as well as the necessary coordination between State powers and social stakeholders to achieve gender equality, thus enshrining this concept as a pillar of sustainable development”) and 113 (“Adopt budgets with gender as a cross-cutting factor in the allocation of public funds and ensure that sufficient, protected funding is provided in all policy areas to fulfil all the commitments made by States to achieve the goals of equality and social and economic justice for women”).

Sustainable Development Goals, target 5.c (“Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels”).

Comments

Priority measure 49 is closely linked to priority measure 47, as the promotion and strengthening of gender-sensitive budgeting is essential to ensure strong institutional mechanisms.

Priority measure 50

Fulfil the commitment to promote and ensure gender mainstreaming and its intersection with perspectives on race, ethnicity, age, social class and disability status in all public policies, especially in economic and cultural policies, and coordination between branches of government and social stakeholders, including organizations of young, Afro-descendent or indigenous women, to ensure gender equality.

Related instruments, forums and mechanisms

Santo Domingo Consensus. This measure is closely associated with agreement 112 (“Ensure gender mainstreaming and a focus on rights in all plans, programmes, projects and public policies, as well as the necessary coordination between State powers and social stakeholders to achieve gender equality, thus enshrining this concept as a pillar of sustainable development”) and agreement 34 (“Strengthen the mainstreaming of gender across all areas of public policy in connection with information and communications technologies, ensuring full access to these technologies and their use by women, girls, adolescent girls, young women, older women, indigenous and Afro-descendent women, rural women, LGBTTI persons and women with disabilities on an equal and equitable basis for the social appropriation of knowledge, bearing in mind the associated regulations, costs and coverage issues and with respect for cultural and linguistic diversity”).

Sustainable Development Goals, target 5.c (“Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels”).

Comments

This priority measure is fairly broad: it involves incorporating the gender perspective into all public policies in order to guarantee gender equality, on the one hand, while on the other it calls for coordination among the branches of government and among stakeholders (government and civil society). In the latter case in particular, social disadvantages are considered to be relational, and it is therefore necessary to relate gender with social class, race, age, region, ethnic origin, physical capacity, sexuality, and all those relations in which differences among women or among groups are manifested. Specifically, some elements appear again in priority measure 47 (on strengthening institutional mechanisms for constructing policies that will guarantee women’s autonomy and gender equality), priority measure 49 (on promoting gender-sensitive budgets to achieve equal access to public sector spending), and priority measure 62 (on statistics systems and the need for information disaggregated by sex and other demographic and socioeconomic characteristics) in this chapter.

The inclusion of the gender perspective and its intersection with ethnic and racial groups is addressed in chapter H on indigenous peoples and in chapter I on Afro-descendent persons.

Priority measure 51

Promote parity and other mechanisms to ensure access to power in electoral systems as a precondition for democracy and a target for eradicating the structural exclusion of women in society, which affects mainly those in vulnerable situations, by training women leaders.

Possible lines of action

1. Identify the training needs of female leaders for moving forward with implementation of the gender equality agenda. 2. Develop training institutions for female leaders consistent with those needs. 3. Promote the development of strategies to increase women’s leadership in the various spheres.

Targets

1. Have in place training institutions for female leaders as needed to move forward with implementation of the gender equality agenda. 2. Have in place standards to ensure gender parity and women’s access to power.

Tentative indicators

1. Number of institutions providing training for female leaders. 2. Optional protocol to the Convention on the Elimination of All Forms of Violence against Women, signed. 3. Number of standards that ensure gender parity and women’s access to power.

Related instruments, forums and mechanisms

Santo Domingo Consensus. In general chapter E (“Gender equality and the empowerment of women for political participation in decision-making”) and more specifically agreement 104 (“Strengthen electoral observation and monitoring mechanisms with a gender perspective as instruments that ensure respect for women’s rights to political representation”; and agreement 106, “Use specific economic and technical measures to strengthen regional gender machineries for political training and education in support of women’s leadership, and promote the participation of the region’s women in such mechanisms, especially young, rural, indigenous and Afro-descendent women, and LGBTTI persons”).

Brasilia Consensus, agreement 3.h (“Promote also the creation and strengthening of citizens’ mechanisms for oversight of electoral processes and the establishment of institutional mechanisms to ensure compliance with legislation aimed at guaranteeing women’s political participation”).

Quito Consensus, agreements vii (“Promote regional mechanisms for providing women with political education and training for leadership such as the recently created Caribbean Institute for Women in Leadership”); and viii (“Develop electoral policies of a permanent character that will prompt political parties to incorporate women’s agendas in their diversity, the gender perspective in their content, actions and statutes, and the egalitarian participation, empowerment and leadership of women with a view to consolidating gender parity as a policy of State”).

Convention on the Elimination of All Forms of Violence against Women and Sustainable Development Goals (see priority measure 48).

Comments

Together with priority measures 48 and 52, priority measure 51 constitutes a group of priority measures aimed at achieving equal participation for women in the formulation and implementation of public policies and in high-level decision-making. This measure is also related to priority measures 53 and 54, as transforming the sexual division of labour and redistribution of the unpaid workload are a fundamental dimension of parity.

Priority measure 52

Adopt legislative measures and institutional reforms to prevent, punish and eradicate political and administrative harassment of women who reach decision-making positions through electoral means or by appointment at national and local levels, as well as in political parties and movements.

Possible lines of action

1. Develop and disseminate frameworks for the prevention of political and administrative harassment. 2. Adopt measures to punish political and administrative harassment. 3. Mount campaigns for cultural change in order to eradicate political and administrative harassment.

Targets

1. Recognize political and administrative harassment as an offence. 2. End political and administrative harassment of women who reach decision-making positions.

Tentative indicators

1. Number of complaints filed for political and administrative harassment of women who reach decision-making positions. 2. Existence of legislation and rules to sanction and punish political harassment of women.

Related instruments, forums and mechanisms

Santo Domingo Consensus. In general, chapter E (“Gender equality and the empowerment of women for political participation in decision-making”), and more specifically agreement 105 (“Enact and implement legislation to prevent, punish and eradicate political and administrative violence against or harassment of women who reach decision-making positions of all levels, via electoral means or by appointment”).

Convention on the Elimination of All Forms of Violence against Women and Sustainable Development Goals (see priority measure 48).

Comments

Together with priority measures 48 and 51, priority measure 52 constitutes a group of priority measures aimed at achieving equal participation for women in the formulation and implementation of public policies and in high-level decision-making.

Priority measure 53

Develop and strengthen policies and universal care services based on the highest human rights standards, from a gender equality and intergenerational perspective, in order to share the delivery of services between the State, the private sector, civil society, families and households and between men and women and facilitate dialogue and coordination between all the parties involved.

Possible lines of action

1. Regulate the basic conditions that guarantee equality of access to care for persons who require it. 2. Develop and implement legal frameworks to establish national systems of care that include all categories of care. 3. Integrate care services as a dimension of social protection systems, allowances, services and benefits. 4. Increase the availability and quality of care systems and, as necessary, of caregivers, by providing training and by affording cultural and economic value to the activity, including by regulating it and giving it professional status. 5. Implement measures to provide caregivers with access to jobs with flexible working hours.

Targets

1. Achieve universal coverage of care services for persons who require them. 2. Integrate care activities into social protection systems. 3. Achieve shared responsibility between men and women for providing unpaid care services. 4. Regulate professional care services.

Tentative indicators

1. Percentage of persons in need of care services who actually receive them. 2. Average number of hours devoted to unpaid work, disaggregated by sex.

Related instruments, forums and mechanisms

Santo Domingo Consensus, agreements 37 (“Promote improvements in women’s access to decent employment, redistributing care work between the State, market and society, and between men and women, facilitating training and the use of technology, self-employment and business creation in the science and technology sector, and increase the proportion of women in areas where they are underrepresented, for example, in academia and the fields of science and technology, including information and communications technologies”) and 57 (“Recognize care as a right and, therefore, as a responsibility that must be shared by men and women of all sectors of society, and by families, private companies and the State, and adopt measures, policies and programmes on care and on promoting the joint responsibility of women and men in family, working and social life in order to free up women’s time so that they can engage in employment, studies and politics and enjoy their autonomy to the full”).

Brasilia Consensus, agreements 1.b (“Foster the development and strengthening of universal care policies and services based on the recognition of the right to care for all and on the notion of sharing the provision of care between the State, the private sector, civil society and households, as well as between men and women, and of strengthening dialogue and coordination between all stakeholders”) and 1.c (“Adopt policies conducive to establishing or broadening parental leave and other childcare leave in order to help distribute care duties between men and women, including inalienable and non-transferable paternity leave with a view to furthering progress towards coresponsibility”).

Quito Consensus, agreement xxvii, “Adopt the necessary measures, especially of an economic, social and cultural nature, to ensure that States assume social reproduction, caregiving and the well-being of the population as an objective for the economy and as a public responsibility that cannot be delegated”).

Sustainable Development Goals, target 5.4 (“Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies, and the promotion of shared responsibility within the household and the family as nationally appropriate”).

Comments

This priority measure is directly related to priority measure 61, which deals with the shared responsibility of the State, the private sector, the community, families, women and men in unpaid domestic tasks and care work. It also relates to priority measure 31, regarding the inclusion of care and social protection systems, to priority measure 59, regarding the construction of new concepts of masculinity, and to priority measure 64, regarding measurement of the care economy.

Priority measure 54

Promote legislation and design and strengthen public policies on equality in the labour market in order to eliminate gender discrimination and asymmetries in relation to access to decent employment, job security, wages and decision-making on labour issues, as well as to recognize the productive value of unpaid domestic work and care work.

Possible lines of action

1. Establish the conditions to increase women’s participation in the labour force. 2. Combat the conditions of insecurity and informality that affect the female workforce primarily, and reduce women’s presence in low-productivity sectors. 3. Formulate and implement policies to ensure equal pay for work of equal value. 4. Encourage men to participate in domestic and care work.

Targets

1. Eliminate the wage gap between men and women. 2. Achieve equal participation of men and women in productive and reproductive activities.

Tentative indicators

1. Persons without income of their own, by sex. 2. Pay by type of activity or employment, by sex. 3. Unemployment rate by sex. 4. Existence of policies geared towards equal pay for equal work, regardless of sex, age, origin or other characteristics.

Related instruments, forums and mechanisms

Convention on the Elimination of All Forms of Violence against Women: Article 11 calls upon States parties to take all appropriate measures to eliminate discrimination against women in the field of employment, in order to ensure, on a basis of equality of men and women, inter alia, “the right to the same employment opportunities, including the application of the same criteria for selection in matters of employment” and “the right to equal remuneration, including benefits, and to equal treatment in respect of work of equal value, as well as equality of treatment in the evaluation of the quality of work.”

Santo Domingo Consensus, agreement 62 (“Develop and implement active labour-market and productive employment policies to ensure decent work for all women, combating the precarious and informal conditions that affect mainly the female workforce and guaranteeing equal pay for work of equal value, an egalitarian participation rate, appointment without discrimination to positions of power and decision-making and the elimination of occupational segregation, with particular attention to rural women, Afro-descendent women, indigenous women, women with disabilities and young women”).

Brasilia Consensus, agreement 1.f (“Develop active labour market and productive employment policies to boost the female labour-market participation rate, the formalization of employment and women’s occupation of positions of power and decision-making, as well as to reduce unemployment rates, especially for Afro-descendent, indigenous and young women who suffer discrimination based on race, sex and sexual orientation, in order to ensure decent work for all women and guarantee equal pay for equal work”).

Quito Consensus, agreement xxii (“Eliminate the income gap between women and men and wage discrimination in all areas of work, and to propose that legislative and institutional mechanisms that give rise to discrimination and precarious working conditions be abrogated”).

Sustainable Development Goals, target 8.5 (“By 2030 achieve full and productive employment and decent work for all women and men, including for young people and persons with disabilities, and equal pay for work of equal value”).

Comments

Priority measures 54, 55 and 56 constitute a group of measures intended to eliminate gender disparities in the labour market. Priority measure 54 has a more general thrust, and considers asymmetries relating primarily to access to decent employment, job security, wages and decision-making, while measure 55 focuses more specifically on encouraging businesswomen to exert leadership and to achieve high-level positions in companies, and measure 56 calls for the prevention and punishment of sexual and other forms of harassment in the workplace (and in education).

When it comes to recognizing the productive value of unpaid domestic work and care-giving, referred to in priority measure 54, this aspect is developed more specifically in priority measures 53, 62 and 64 of this same chapter.

This priority measure must recognize the particular situation of women and persons of African descent, and thereby respond to priority measure 93, which refers to the overlapping of inequalities in situations of racism and discrimination.

Priority measure 55

Strengthen the participation of women in high-level and decision-making positions in companies and support the training of men and women during hours that are compatible with their family life, and encourage businesswomen to adopt leadership roles.

Possible lines of action

1. Encourage women to take part in business training courses. 2. Establish conditions that will facilitate women’s participation in business training, and take measures that enable men and women to reconcile working and home life. 3. Encourage business policies that promote women to senior positions. 4. Identify and eliminate legal and customary barriers to women’s participation in senior positions.

Targets

Increase the share of women in senior positions in companies.

Tentative indicators

Percentage of women in senior positions in companies.

Related instruments, forums and mechanisms

Santo Domingo Consensus, agreements 41 (“Promote gender equity and equality in strategic and high-level managerial and decision-making positions in firms and public and private institutions, including in the information and communications technologies sector”) and 60 (“Prioritize and intensify initiatives aimed at women’s economic empowerment at the community level through means such as business education and business incubators to improve their situation and thus reduce their vulnerability to violence”).

Sustainable Development Goals, target 4.3 (“By 2030 ensure equal access for all women and men to affordable quality technical, vocational and tertiary education, including university”) and target 5.5 (“Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life”).

Comments

Priority measures 54, 55 and 56 constitute a group of measures intended to eliminate gender disparities in the labour market. While priority measure 54 considers asymmetries relating primarily to access to decent employment, job security, wages and decision-making, and measure 56 calls for the prevention and punishment of sexual and other forms of harassment in the workplace, priority measure 55 focuses more specifically on encouraging businesswomen to exert leadership and to achieve high-level positions in companies.

Priority measure 56

Establish mechanisms for preventing sexual and other forms of harassment and violence against women and men, especially in the workplace and educational settings, as well as for filing relevant complaints and punishing such practices.

Related instruments, forums and mechanisms

There is a direct link with agreement 63 of the Santo Domingo Consensus (“Promote and enforce legislation on equality in employment to eliminate discrimination relating to gender, race, ethnicity and sexual orientation and other types of discrimination in access to and security in the labour market, establishing mechanisms for filing complaints to bodies clearly identified and mandated for that purpose and determining sanctions for bullying, sexual harassment and other forms of violence against women in the workplace”).

Sustainable Development Goals: there is a general relationship with target 5.2 (“Eliminate all forms of violence against all women and girls in public and private spheres, including trafficking and sexual and other types of exploitation”).

As well, considering the broader context of combating violence against women, the follow-up to priority measure 56 could also be based on the Convention of Belém do Pará and on several measures included in chapter D of the Santo Domingo Consensus (“Gender equality and elimination of violence against women”), which are developed more specifically in priority measures 57 and 58 of this chapter.

This measure is complementary to priority measure 89 for the particular case of eliminating all forms of violence against indigenous women.

Comments

Priority measures 54, 55 and 56 constitute a group of measures intended to eliminate gender disparities in the labour market. While priority measure 54 considers asymmetries relating primarily to access to decent employment, job security, wages and decision-making, and measure 55 focuses more specifically on encouraging businesswomen to exert leadership and to achieve high-level positions in companies, priority measure 56 aims at the prevention and punishment of sexual and other forms of harassment in the workplace.

This measure is complementary to priority measure 89 for the particular case of eliminating all forms of violence against indigenous women.

Priority measure 57

Enforce existing policies and adopt, on the one hand, preventative and punitive measures, and on the other measures for protecting and caring for women in order to eradicate all forms of violence, including forced sterilization and stigma against women in public and private spheres and especially the gender-motivated violent murder of girls and women, and ensure effective and universal access to fundamental services for all victims and survivors of gender-based violence, with special attention to women in high-risk situations, such as older women, pregnant women, women with disabilities, culturally diverse groups, sex workers, women living with HIV/AIDS, lesbian, bisexual and transgender women, Afro-descendent, indigenous and migrant women, women living in border areas, asylum-seekers and victims of trafficking.

Possible lines of action

1. Promote action across State sectors, with particular attention to the justice sector, and coordination among public and private institutions for addressing all victims of violence. 2. Adopt new strategies to bring about the cultural and institutional changes needed to combat the structural factors that perpetuate violence against women. 3. Encourage initiatives for economic empowerment in order to reduce women’s vulnerability to violence. 4. Take specific measures in the various sectors (for example, the health sector) where violence against women is generated and reproduced. 5. Integrate aspects relating to violence against women into national and regional statistics programmes so as to have available data for taking timely decisions and for appreciating the many faces of this form of violence. 6. Promote the typification of the crimes of femicide and feminicide.

Targets

1. Ensure that public policies for the elimination of violence against women are effectively budgeted and enforced. 2. Ensure that victims of gender-based violence have effective access to justice. 3. Ensure that measures to eradicate gender-based violence and to guarantee access to comprehensive care services cover all women of all ages, without distinction of any kind. 4. Reduce gender-based violence.

Tentative indicators

1. Number and rate (per 100,000 inhabitants) of women 15 years and older killed by their partner or former partner. 2. Number of women filing complaints of violence, and number who gain effective access to justice. 3. Gender-based violence prevention and care policies that have an earmarked budget. 4. Number of female victims of gender-based violence who have access to comprehensive care services. 5. Number of policies that encompass special measures for at-risk women, such as older women, pregnant women, women with disabilities, culturally diverse groups, sex workers, women living with HIV/AIDS, lesbian, bisexual and transgender women, Afro-descendent, indigenous and migrant women, women living in border areas, asylum-seekers and victims of trafficking.

Related instruments, forums and mechanisms

This measure is directly related to the Convention of Belém do Pará and the Convention on the Elimination of All Forms of Discrimination against Women.

Santo Domingo Consensus; in general, chapter D (“Gender equality and the elimination of violence against women”), and more specifically agreement 80 (“Enforce national and local policies and adopt preventive, punitive, protection and care measures to eliminate all forms of violence and stigma against women, girls, adolescent girls, young women, older women, indigenous and Afro-descendent women, rural women, LGBTTI persons and women with disabilities, and include the effective use of information and communications technologies with an intercultural approach in order to achieve greater inclusion and equality for all women”), agreement 87 (“Guarantee effective access to justice and free, good-quality legal aid for women who are subjected to violence, and provide training and public awareness sessions on gender issues to those authorized to dispense justice, as well as the police and other security bodies”) and agreement 88 (“Promote the reform of legal systems and the amendment of laws which cause exclusion and harm, and ensure the removal of all systemic barriers to the effective delivery of justice”).

Brasilia Consensus: in general, chapter 4 (“Address all forms of violence against women”), and more specifically agreements 4.a (“Adopt preventative and punitive measures as well as measures for protecting and caring for women that further the eradication of all forms of violence against women in public and private spheres, with special attention to Afro-descendent, indigenous, lesbian, transgender and migrant women, and those living in rural, forest and border areas”) and 4.b (“Broaden and guarantee effective access to justice, and to free legal assistance for women in violent situations, and provide training and awareness-raising, from a gender perspective, for staff and officials responsible for administering justice”).

Quito Consensus, agreements xxvii (“Adopt measures that contribute to the elimination of all forms of violence against women and their manifestations, especially homicide of women, femicide and feminicide, as well as to the elimination of unilateral measures that run counter to international law and to the United Nations Charter, whose fundamental consequences are borne by women, girl children and adolescents”) and xxix (“Guarantee access to justice for women, adolescents and girl children who have been victims of gender violence, with no discrimination whatsoever, through the creation of legal and institutional conditions that guarantee transparency, truth, justice and the consequent reparation of the violation of their rights, strengthening public policies for protection, prevention and care with a view to the eradication of all forms of violence)”.

Sustainable Development Goals, targets 5.1 (“End all forms of discrimination against all women and girls everywhere”) and 5.2 (“Eliminate all forms of violence against all women and girls in public and private spheres, including trafficking and sexual and other types of exploitation”).

Comments

Priority measures 57 and 58 are aimed, in general, at eliminating the various forms of violence and discrimination against women. Priority measure 57 calls in particular for adopting preventive measures and measures to ensure effective access to support services for victims of violence, with special attention to those in situations of greatest vulnerability.

This measure must recognize the particular situation of indigenous and Afro-descendent women and persons, and thereby complement priority measure 89 on eradicating violence against indigenous women and priority measure 93, which refers to the overlapping of inequalities in situations of racism and discrimination.

Priority measure 58

Reaffirm the commitment and political will of Latin America and the Caribbean, at the highest level, to combat and eliminate all forms of discrimination and violence against women, including domestic violence and femicide/feminicide, and actively promote awareness-raising regarding gender mainstreaming among law enforcement personnel.

Related instruments, forums and mechanisms

As noted in the previous table, priority measures 57 and 58 are directly related to important specialized mechanisms, such as the Convention of Belém do Pará and the Convention on the Elimination of all Forms of Discrimination against Women. Article 15 of the latter Convention provides, among other things, that “States Parties shall accord to women equality with men before the law”, and that “States Parties shall accord to women, in civil matters, a legal capacity identical to that of men and the same opportunities to exercise that capacity. In particular, they shall give women equal rights to conclude contracts and to administer property and shall treat them equally in all stages of procedure in courts and tribunals”. These provisions also relate to various agreements of the Quito, Brasilia and Santo Domingo Consensuses, as well as some of the targets proposed for the Sustainable Development Goals.

Comments

Priority measures 57 and 58 are aimed, in general, at eliminating the various forms of violence and discrimination against women. Priority measure 58 calls in particular for awareness-raising and instilling the gender perspective among law enforcement personnel.

As in the case of priority measure 57, this measure must recognize the particular situation of indigenous and Afro-descendent women and persons, and thereby complement priority measure 89 on eradicating violence against indigenous women and priority measure 93, which refers to the overlapping of inequalities in situations of racism and discrimination.

Priority measure 59

Broaden the access available to men, including boys, adolescents and young men, to sexual and reproductive health-related information, counselling and services and promote the equal participation of men in care work through programmes for raising men’s awareness of gender equality, and foster the development of new masculinities.

Possible lines of action

1. Incorporate gender equality aspects into basic education. 2. Mount systematic campaigns for cultural change to promote gender equality in all social spheres, public and private, so as to help banish attitudes that reinforce gender stereotypes. 3. Take steps to promote and facilitate men’s participation in child-rearing activities, such as through paternal leave.

Targets

1. Include aspects relating to gender equality in the primary education curriculum. 2. Achieve sharing of child-rearing tasks between men and women. 3. Increase participation by men in matters relating to sexual and reproductive health.

Tentative indicators

1. Percentage of public and private schools that include gender equality in the basic education curriculum. 2. Number of government campaigns conducted in the past two years to promote gender equality. 3. Number of paternity leaves extended to male workers in private firms or in the public sector.

Related instruments, forums and mechanisms

Convention on the Elimination of all Forms of Discrimination against Women, article 5 (“States Parties shall take all appropriate measures: (a) To modify the social and cultural patterns of conduct of men and women, with a view to achieving the elimination of prejudices and customary and all other practices which are based on the idea of the inferiority or the superiority of either of the sexes or on stereotyped roles for men and women”) and article 10 (“States Parties shall take all appropriate measures to eliminate discrimination against women in order to ensure to them equal rights with men in the field of education and in particular to ensure, on a basis of equality of men and women [...] (c) The elimination of any stereotyped concept of the roles of men and women at all levels and in all forms of education by encouraging coeducation and other types of education which will help to achieve this aim and, in particular, by the revision of textbooks and school programmes and the adaptation of teaching methods”).

Santo Domingo consensuses, agreement 51 (“Eliminate sexism and gender stereotypes in education systems, books and teaching materials, and eradicate biases in teachers’ perception of boys’ and girls’ performance in sciences, including mathematics and technology, broadening the training of educators for equality and promoting teaching practices free from prejudices and stereotypes”).

Quito Consensus, agreement xx (“Formulate and apply State policies conducive to the equitable sharing of responsibilities by women and men in the family, overcoming gender stereotypes and recognizing the importance of care-giving and domestic work for economic reproduction and the well-being of society as one of the ways of overcoming the sexual division of labour”).

Comments

This priority measure places the emphasis on building new concepts of masculinity. The portion relating to men’s access to information, counselling and sexual and reproductive health services is covered more specifically in other chapters of the Montevideo Consensus on Population and Development, in particular priority measures 11, 12 and 41, while the portion relating to equal participation in care-giving is covered in priority measure 53, in this same chapter.

Priority measure 60

Develop and strengthen plans and programmes for addressing disparities in the representation and performance of boys and young men in the education system, especially in the English-speaking Caribbean.

Related instruments, forums and mechanisms

Priority measure 60 relates directly to the World Declaration on Education for All and the Framework for Action to Meet Basic Learning Needs (Jomtien, 1990), and in particular to the framework of action for the post-2015 education agenda, adopted at the World Education Forum 2015 on the basis of the evaluation of implementation over the past 15 years of the Dakar Framework for Action, which was aimed at achieving education for all by 2015.

Convention on the Elimination of All Forms of Violence against Women: in article 10, States Parties agree to take “all appropriate measures to eliminate discrimination against women in order to ensure to them equal rights with men in the field of education and in particular to ensure […] the same conditions for career and vocational guidance, for access to studies and for the achievement of diplomas in educational establishments of all categories in rural as well as in urban areas; this equality shall be ensured in pre-school, general, technical, professional and higher technical education, as well as in all types of vocational training”.

Santo Domingo Consensus, agreement 38 (“Ensure that the education system, at all levels and with respect to all forms of teaching, provides timely information to women, girls, adolescent girls, young women, older women, indigenous and Afro-descendent women, rural women, LGBTTI persons and women with disabilities on the benefits, applications and availability of vocational training opportunities in science and technology that could contribute to their personal, economic, social and political autonomy”).

Sustainable Development Goals: priority measure 60 fits within the broader context of Goal 4 (“Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all”), and in particular target 4.5 (“By 2030, eliminate gender disparities in education and ensure equal access to all levels of education and vocational training for the vulnerable, including persons with disabilities, indigenous peoples, and children in vulnerable situations”).

Comments

Although this priority measure makes special reference to the English-speaking Caribbean, it should be noted that, in the case of Latin America, while women have seen some very positive changes —which must be sustained and improved— in their access to education and in the educational levels attained, major policy efforts are still needed to improve the quality of education to prevent the entrenchment of gender stereotypes.

Priority measure 61

Ensure the sharing of responsibility between the State, the private sector, the community, families, women and men for unpaid domestic and care work, incorporating care into social protection systems through allowances, services and benefits that maximize women’s autonomy and guarantee their rights, dignity, well-being and enjoyment of free time.

Related instruments, forums and mechanisms

Santo Domingo Consensus, agreement 58 (“Achieve the consolidation of public protection and social security systems with universal, comprehensive and efficient access and coverage by means of solidary, standard, participatory financing, based on the principle of solidarity and linked to a broad spectrum of public policies that guarantee well-being, quality of life and a decent retirement and enhance the full exercise of citizenship by women, including those who have devoted their lives to productive as well as reproductive work, both paid and unpaid, female domestic workers, rural women, female informal and contract workers and, above all, women directly or indirectly affected by illness, disability, unemployment, underemployment or widowhood at any stage in their life cycle”).

Comments

Follow-up to priority measure 61 can be handled through priority measure 53, some aspects of which include shared responsibility in care provision. Similarly, integrating care into social protection systems through allowances, services and benefits is one of the goals proposed under priority measure 53.

Priority measure 62

Improve statistical systems, official indicators and administrative records, mainstreaming the gender perspective and advancing towards the full recognition of women’s economic and social contribution to the development of society.

Possible lines of action

1. Ensure disaggregation by sex in the collection and production of information in statistics systems and administrative records so as to incorporate the gender focus in different analyses. 2. Incorporate disaggregation by race, ethnic origin, socioeconomic level and place of residence, among others, into gender analysis to ensure that the decisions taken are relevant to different groups of women. 3. Develop and adopt official indicators with a gender perspective for monitoring progress toward gender equality. 4. Maintain an ongoing process of training in the preparation and use of analyses based on gender indicators.

Targets

1. Ensure that all pertinent statistics systems and administrative records have gender-disaggregated information relating to other variables in issues of priority for gender equality policies. 2. Ensure that official indicators are available for monitoring progress toward gender equality. 3. Broadly disseminate and use the statistical information produced by government offices to promote and implement public policies on gender equality.

Tentative indicators

1. Percentage of statistics systems and administrative records that have gender-disaggregated information for other variables. 2. Percentage of official systems of indicators that incorporate the gender perspective by sector.

Related instruments, forums and mechanisms

Santo Domingo Consensus, agreements 114 (“Strengthen, by means of training, exchanges of experiences and awareness-raising, regional and national instruments to monitor women’s empowerment, particularly gender observatories, ensuring that the information and data supplied are compiled using a common methodology for the purposes of comparison and analysis of the different variables at the regional level, thus ensuring that the results obtained serve as basic input material for public policies on equality in the region”) and 117 (“Strengthen the effective implementation of systems for the production of statistical information for designing policies with a gender focus, affording particular attention to methods for collecting, classifying and processing sex-disaggregated national and regional data, including gender indicators in all areas, on the basis of a common methodology implemented by all the countries of the region, with a view to promoting women’s empowerment and decision-making”).

Sustainable Development Goals, target 17.18 (“By 2020, enhance capacity building support to developing countries, including for LDCs and SIDS, to increase significantly the availability of high-quality, timely and reliable data disaggregated by income, gender, age, race, ethnicity, migratory status, disability, geographic location and other characteristics relevant in national contexts”).

Comments

Priority measures 102, 103 and 104 of chapter J of the Montevideo Consensus on Population and Development, referring to the frameworks for implementing the regional agenda on population and development, deal in a cross-cutting manner with the issue of improving data sources, including the need for financial and human resources to develop reliable, timely and quality information systems with a gender perspective, disaggregated geographically and by sex, age, race, ethnic origin and socioeconomic status.

The issue of recognizing women’s economic and social contribution to the development of societies, mentioned as part of this priority measure, is fully covered in priority measures 53 and 64 in this guide.

Priority measure 63

Strengthen the capacity of countries to prepare and disseminate the gender statistics needed for the formulation of public policies on gender equality and the empowerment of women.

Comments

Follow-up to this priority measure can be achieved through priority measure 62 (which it complements), and specifically through the line of action that calls for “Maintain[ing] an ongoing process of training in the preparation and use of analyses based on gender indicators.”

Priority measure 64

Consider measuring the care economy using specialized accounts and the creation of satellite accounts on unpaid work, and the incorporation of such accounts in the system of national accounts.

Possible lines of action

1. Amend the legal and programmatic frameworks to recognize the productive value of unpaid work. 2. Conduct specialized time use surveys to obtain up-to-date, gender-disaggregated information on unpaid work in general, and on care-giving in particular. 3. Develop proposals to create a satellite account on unpaid work in the system of national accounts.

Targets

1. Conduct national time-use surveys on an ongoing basis. 2. Include a satellite account on unpaid work in the system of national accounts, in order to measure the care economy, including the contribution to GDP of unpaid care work.

Tentative indicators

1. Total time worked (number of working hours paid and unpaid), by sex. 2. Percentage of GDP corresponding to unpaid work.

Related instruments, forums and mechanisms

Santo Domingo Consensus, agreements 54 (“Recognize the value of unpaid domestic work and adopt the necessary measures, including legislative measures, and public policies that recognize the social and economic value of domestic work”), 55 (“Define and establish instruments for the periodic measurement of the unpaid work done by women and ensure that public budgets allocate the funds required by the machineries responsible for compiling and systematizing the information for conducting national time-use surveys in order to facilitate the design of appropriate and fair public policies”) and 56 (“Urge States to establish satellite accounts for unpaid domestic work in the countries of the region”).

Brasilia Consensus, agreements 1.a (“Adopt all the social and economic policy measures required to advance towards the attribution of social value to the unpaid domestic and care work performed by women and recognition of its economic value”) and 1.d (“Encourage the establishment, in national accounts, of a satellite account for unpaid domestic and care work performed by women”).

Comments

The measurement of the care economy is an essential input for policies and programmes relating to care (priority measure 53).

Countries in various regions of the world, including several in Latin America and the Caribbean, are already conducting time-use surveys. However, the coverage, quality and periodicity of the information vary greatly, making comparative analysis difficult. As well, differing methodologies have been developed to assign economic value to unpaid work.

Priority measure 65

Implement, with the support of available technologies, multisectoral, comprehensive, integrated, coordinated, interdisciplinary and accessible services, programmes and actions targeting women that are sustainable at all levels, include specialized and confidential care in cases of violence, have sufficient resources available and that bring together sectors such as the police, the judiciary, medical and psychological services and evaluation, including sexual and reproductive health services, as well as opportunities for training and generating earnings, with a view to promoting women’s autonomy in all its forms.

Related instruments, forums and mechanisms

Priority measure 65 is fairly general in scope, embracing a variety of aspects relating to violence against women, health care, including sexual and reproductive health, and training and income generation for women’s autonomy, matters that are considered more specifically in other priority measures of this guide.

Violence against women is a central theme of priority measures 56, 57 and 58 and, in general, it has an important link to the agreements under chapter D of the Santo Domingo Consensus (“Gender equality and the elimination of violence against women”), the agreements under chapter 4 of the Brasilia Consensus (“Addressing all forms of violence against women”), agreements xxviii and xxix of the Quito Consensus, and target 5.2 of the Sustainable Development Goals. The Inter-American Convention on the Prevention, Punishment and Eradication of Violence against Women (Convention of Belém do Pará) is also a suitable mechanism for follow-up.

Sexual and reproductive health, in turn, is a central subject of a chapter D of this guide (dealing specifically with universal access to sexual and reproductive health services), while training and income generation for women appears again in priority measures 54, 55 and 56 (which focus on labour market aspects that have a significant impact on women’s economic autonomy) as well as in agreement 61 of the Santo Domingo Consensus (“Prioritize also the design and implementation of public policies and programmes designed to reduce poverty among women, on the basis of sustainable development, economic growth, technical and financial support for productive activities launched by women living in poverty, training and skills-building for employment, access to decent work and optimum use of information and communications technologies, from the perspective of equality”).

Comments

This measure complements priority measure 88 for the particular case of eliminating all forms of violence against indigenous women.

F. INTERNATIONAL MIGRATION AND PROTECTION OF THE HUMAN RIGHTS OF ALL MIGRANTS

Migrants are part of a social process in countries of the region that is highly relevant in the twenty-first century. One of the most urgent problems is the lack of protection accorded to many of these people in the course of their journeys, their integration and their return. As migration is a potentially beneficial process for countries, communities, families and individuals, the institutions, legislation and public policies that govern migration should be based on a rights approach. The international human rights framework establishes guidelines and obligations, while agreements at varying levels establish shared lines of action, and the involvement of civil society lends legitimacy to this management. The specific chapter of the Cairo Programme of Action adopted in 1994 and the agreements emerging from the Second High-Level Dialogue on International Migration and Development in 2013 constitute a framework akin to the Montevideo Consensus on Population and Development, as they emphasize the need for protection and for affirmative strategies on the part of the international community. Regional and subregional initiatives, such as the Community of Latin American and Caribbean States (CELAC) and integration arrangements, offer a platform for developing and monitoring some measures. The broad experience and commitments assumed at the Regional Conference on Migration and the South American Conference on Migration testify to the political support given to this issue. United Nations specialized agencies, funds and programmes, together with the International Organization for Migration (IOM), have specific mandates that must be considered among mechanisms for follow-up to the measures.

This chapter covers 10 priority measures. They are all interrelated and involve various common lines of action, as well as some targets and indicators. They refer both to emigration and to immigration, as well as return and transit. The summary tables refer repeatedly to regional and subregional initiatives that provide forums for follow-up, such as CELAC, the Ibero-American Organization for Social Security (OISS), integration schemes and specialized intergovernmental forums, as well as the role of the United Nations and IOM. A number of measures are very specific in nature, and presuppose the involvement of more than one country in implementing lines of action that are, in turn, common to several priority measures. Relationships with the Sustainable Development Goals are indicated in each table, for example with target 10.7 (“Facilitate orderly, safe, regular and responsible migration and mobility of people, including through implementation of plans and well-managed migration policies”) and target 8.8 (“Protect labour rights and promote safe and secure working environments for all workers, including migrant workers, particularly women migrants, and those in precarious employment”).

Priority measures 66 (on the inclusion of international migration in the 2030 Agenda for Sustainable Development) and 68 (on preparing comprehensive strategies to prevent infringement of the human rights of migrants) are broad in scope and can be covered under initiatives that already exist or are in preparation, and they are moreover to be found in various other measures of this Operational guide, where they are explained in detail. Priority measure 75 (referring to the Second High-Level Dialogue on International Migration and Development) has been fulfilled, in general, although the comments point to the need for follow-up to the agreements established in the Dialogue. The remaining measures refer to assistance and protection for migrants (priority measure 67), preparing comprehensive global and regional strategies to prevent the infringement of migrants’ human rights (priority measure 68), bilateral and multilateral social security conventions (priority measure 69), consistency and reciprocity in dealing with the various situations facing emigrants (priority measure 70), dialogue and international cooperation on migration, human rights and development (priority measure 71), protection of human rights, avoiding any form of criminalization of migration, and guaranteeing access to social services (priority measure 72), strengthening cross-sector coordination and reinforcing mechanisms for intergovernmental cooperation (priority measure 73) and strengthening cooperation among countries of origin, transit and destination (priority measure 74).

Priority measure 66

Ensure that international migration issues, including migration regularization policies are fully incorporated into global, regional and national post-2015 development agendas and strategies.

Related instruments, forums and mechanisms

This measure is very broad in scope. Its implicit purpose is to address the multiple dimensions of contemporary migration in a manner consistent with respect for the human rights of migrants, regardless of their migration status, and have this intent enshrined in the development agendas. It focuses in particular on the 2030 Agenda for Sustainable Development, and in this sense follow-up would be associated with target 10.7 c (“Facilitate orderly, safe, regular and responsible migration and mobility of people, including through implementation of plans and well-managed migration policies”). The United Nations Statistics Division proposes two indicators in this area: (1) Index on Human Mobility Governance, measuring key features of good-governance of migration, and (2) Number of migrants killed, injured or victims of crime while attempting to cross maritime, land, air borders.

There is also a need to consider and formulate policies related to migration and environmental impacts, particularly with reference to adaptation plans and risk management. The inclusion of migration issues in local development plans may be a special consideration.

In addition, as the measure makes a special point of regularizing migration, all the international and Inter-American human rights instruments (and the reports of their treaty bodies) can substitute as mechanisms, in addition to the United Nations Convention against Transnational Organized Crime and the protocols thereto. The mandates of the United Nations agencies and the action of the Global Migration Group are part of follow-up to this measure. In particular, IOM, with its mandate, assistance and programmes, represents an essential point of reference.

The action plans and commitments from the Regional Conference on Migration and the South American Conference on Migration also provide backing, in particular by including countries that have not ratified the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families. CELAC is one appropriate forum for follow-up, as are potentially other multilateral cooperation forums, such as the Summit of the Americas, the Union of South American Nations (UNASUR), the Southern Common Market (MERCOSUR), the Andean Community and the Central American Integration System (SICA). Within MERCOSUR, the residency agreement, which has been ratified by a majority of South American countries, provides for regularization of citizens of the subregion on the basis of common regional criteria, and treats the regularization of migrants’ status as central to migration policy under a perspective of regional integration.

Comments

Some of the premises of this and other measures are: (i) the need for countries to have agreements that facilitate migration so that it can be conducted through regular channels; (ii) the need to adopt strategies to improve the sources of information on migration and make such information readily accessible; and (iii) the need for starting-point indicators.

Priority measure 67

Provide assistance and protection to migrants regardless of their migration status, especially vulnerable groups, with full respect for their rights and in accordance with the provisions of the International Convention on the Rights of All Migrant Workers and Members of their Families and those of the Vienna Convention on Consular Relations, highlighting the need to afford them comprehensive attention in countries of transit and destination.

Possible lines of action

1. Create cross-sector institutions to monitor immigration regulations, policies and programmes. 2. Encourage countries that have not yet done so to ratify the International Convention on Protection of the Rights of All Migrant Workers and Members of Their Families. 3. Adopt specific national legislation on the rights of migrants, and the regulations, standards and treatment protocols needed for its application. 4. Prepare specific policies and programmes that take into account the intersectoral nature of attention to migrants’ issues. 5. Conduct ongoing evaluations of regional, subregional, extraregional and bilateral agreements for the protection of migrants. 6. Establish mechanisms for consulting civil society and involving it in the institutional structure for migration. 7. Negotiate subregional and regional measures to facilitate regular migration. 8. Adopt concrete measures against the discrimination and xenophobia that affect migrants. 9. Promote consistency between internal rules, regional agreements and the international human rights instruments to which countries have signed up.

Targets

1. Ratify the International Convention on Protection of the Rights of All Migrant Workers and Members of Their Families. 2. Have in operation legislation, institutions and policies geared specifically to protecting the human rights of all migrants. 3. Achieve full regularity in migration processes. 4. Stamp out trafficking in migrants. 5. Eliminate the discrimination and xenophobia that affect migrants. 6. Have comprehensive centres for migrants at borders.

Tentative indicators

1. Ratification and application by the country of the International Convention on Protection of the Rights of All Migrant Workers and Members of Their Families. 2. Percentage of the total population of immigrants and emigrants, women and men, with proper legal status, by national origin, age and other relevant characteristics. 3. Creation of a mechanism to determine the percentage of irregular immigrants in each country with respect to the total population. 4. Annual number (and relative share) of male and female trafficking victims who have received adequate and timely treatment in accordance with the legal framework. 5. Number (and relative share) of migrants reporting discrimination, by sex and age. 6. Number of laws and measures in place to prevent and combat discrimination. 7. Definition of trafficking as a crime under national law. 8. Number of persons convicted for human trafficking compared with the number of cases processed under national law.

Related instruments, forums and mechanisms

This priority measure is related to nearly all the other measures in this chapter. It is covered by at least two specific international instruments: the obligations flowing from ratification of the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families (17 countries in the region), and the provisions of the Vienna Convention on Consular Relations. All international and Inter-American human rights instruments (and the reports of their treaty bodies) complement these mechanisms, in addition to the United Nations Convention against Transnational Organized Crime and the Palermo protocols. The mandates of the United Nations agencies and IOM must also be considered. The action plans and commitments of the Regional Conference on Migration and the South American Conference on Migration also provide backing, in particular because they include that have not ratified the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families. CELAC is one appropriate forum for follow-up. Other multilateral cooperation forums have also made insistent reference to this measure, directly or indirectly (Summit of the Americas, UNASUR, MERCOSUR, the Andean Community, SICA and the Caribbean Community (CARICOM), among others). This priority measure also relates to target 10.7 of the Sustainable Development Goals (“Facilitate orderly, safe, regular and responsible migration and mobility of people, including through implementation of plans and well-managed migration policies”).

Comments

This measure shares contents with other measures, such as priority measure 73. Specifically, it refers to countries of transit and destination, without prejudice to establishing obligations for migrants’ countries of origin and return.

Priority measure 68

Prepare comprehensive global and regional strategies to prevent infringement of the human rights of migrants, as well as to take advantage of the benefits and face the challenges arising from migration, including those relating to remittances and skilled migration in high-demand sectors, as well as the differential participation of men and women and the transnationalization of care.

Related instruments, forums and mechanisms

Various aspects are intertwined in this priority measure, which is aimed at guaranteeing respect for the rights of migrants, regardless of their migration status, in particular those in the most vulnerable situations, consistently with international instruments, as well as to take advantage of the benefits of migration. Monitoring may therefore be combined with the other measures set forth in these tables and must be conducted in keeping with specific international instruments, such as the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families (signed by 17 countries in the region) and all the other international and inter-American human rights instruments (and the reports of their treaty bodies). The mandates of the United Nations and IOM should also be taken into account. Support is also forthcoming from the plans and commitments adopted by the Regional Conference on Migration and the South American Conference on Migration, in particular because they include countries that have not ratified the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families. CELAC, the Summit of the Americas, UNASUR, MERCOSUR, the Andean Community and SICA, among others, are appropriate forums for follow-up, although they differ in the strength of their commitments and the number of countries included.

Comments

The measure implicitly recognizes the positive impacts that migratory processes have in terms of well-being and human development, demographic replacement, unmet demand of the labour market, contribution to knowledge and understanding, and cultural enrichment in destination countries. It also implies promoting the effective application of ethical standards in the recruitment of migrant workers.

In this priority measure, rights intersect with specific dimensions that are spelled out in all the remaining measures of this chapter. Care is explicitly mentioned here, and goes hand-in-hand with the considerations of priority measure 73, for example. Remittances, considered in priority measure 70, are related to target 10.c of the Sustainable Development Goals (“By 2030, reduce to less than 3% the transaction costs of migrant remittances and eliminate remittance corridors with costs higher than 5%”). However, the region could achieve lower transaction costs sooner, so the goal must be evaluated for relevance (remittances should also be studied to see if they contribute to a reduction in asymmetry and inequality).

All the lines of action and the goals and indicators in the remaining measures contribute to follow-up of this measure.

Priority measure 69

Promote the signing of bilateral and multilateral social security conventions to enable migrant workers to accumulate years of service.

Possible lines of action

1. Adopt specific national legislation on the rights of migrant workers, in line with the provisions of the Ibero-American Multilateral Convention on Social Security. 2. Conduct periodic evaluations of social security agreements adopted by countries. 3. Negotiate agreements and conventions among member countries of CELAC and organizations at the regional (UNASUR) and subregional levels (MERCOSUR, Andean Community, SICA, CARICOM).

Targets

1. Achieve ratification and effective application of the Ibero-American Multilateral Convention on Social Security by all countries of the region. 2. Conduct periodic evaluations of the functioning of the Ibero-American Multilateral Convention on Social Security. 3. Have in place specific bilateral agreements based on the Ibero-American Multilateral Convention on Social Security in countries where the social protection system so requires, and in countries that are not members of the Ibero-American community.

Tentative indicators

1. Percentage and number of direct beneficiaries covered by the Ibero-American Multilateral Convention on Social Security in each country, in relation to the total of immigrant workers in the labour force. 2. Effective functioning and dissemination of the Ibero-American Multilateral Convention on Social Security and of subregional and bilateral agreements. 3. Number of cases satisfactorily dealt with each year. 4. Number of retired migrant beneficiaries who collect pensions each year.

Related instruments, forums and mechanisms

Ibero-American Multilateral Convention on Social Security: as of March 2015, 12 countries had ratified the Convention and nine reported that they were effectively applying it (see [online] http://www.oiss.org/-Convenio-Multilateral-.html). The Convention refers to the Ibero-American community; countries of the region that are not represented in it can nevertheless strengthen their bilateral, regional and subregional mechanisms on this basis. CELAC can also promote the Convention among its members and encourage the adoption of others, of a subregional or bilateral nature, such as within MERCOSUR and the Andean Community.

There are a number of ILO conventions that must not be overlooked, although their application is uneven from one country to another.

This priority measure is associated with target 8.8 of the Sustainable Development Goals (“Protect labour rights and promote safe and secure working environments for all workers, including migrant workers, particularly women migrants, and those in precarious employment”), for which the United Nations Statistics Division has proposed “Ratification and implementation of ILO fundamental conventions and relevant international labour and human rights standards” as an indicator.

Comments

This priority measure is very specific, and focuses on working conditions, and in particular on pension portability. It provides a suitable complement to priority measure 67, as all regular-status migrants will be covered by this measure. Bilateral agreements must always be seen as a possibility, in light of specific protocols, especially when pension systems have very different make-ups. The Ibero-American Organization for Social Security (OISS) can play a key role in follow-up to bilateral and subregional proposals.

Priority measure 70

Incorporate principles of consistency and reciprocity in dealing with the various situations faced by emigrants from the countries in the region, at all stages of the migration process, whether at the intraregional level or outside the region.

Possible lines of action

1. Adopt specific national legislation on the rights of emigrants, such as to guarantee their rights as citizens. 2. Prepare and implement specific policies and programmes that take account of the needs of emigrants and facilitate their integration into the host country. 3. Include the return of emigrants (either permanent or temporary) as a matter of interest for public policies. 4. Address the needs of family members of migrants wherever they need. 5. Facilitate remittance-sending by supporting market transparency.

Targets

1. Have in place legislation, institutions and policies geared explicitly to protecting the human rights of all emigrants. 2. Have in place initiatives to care for returnees. 3. Have in place initiatives with common basic principles to guarantee emigrants services in general, and consular services in particular. 4. Reduce the costs of sending remittances, in line with specific country targets.

Tentative indicators

1. Annual number of initiatives (and relative share) aimed at extending the consular network of services for emigrants. 2. Number of services provided to emigrants each year, by type of initiative. 3. Percentage of returnees who access specific national initiatives, out of the total of emigrants. 4. Cost of sending remittances (as a percentage).

Related instruments, forums and mechanisms

This priority measure finds precedents in the plans and commitments of the Regional Conference on Migration and the South American Conference on Migration. CELAC, in particular, and other schemes (such as MERCOSUR and the Andean Community) can incorporate these lines of action. The mandates of the United Nations agencies and the IOM should also be considered. Also relevant is target 10.c of the Sustainable Development Goals (“By 2030, reduce to less than 3% the transaction costs of migrant remittances and eliminate remittance corridors with costs higher than 5%”), with the caveats noted in the comments under priority measure 68.

Comments

This measure has to do with the governance of migration, understood as developing a government’s capacity to implement, monitor and evaluate public policies in coordination with social stakeholders and civil society, on its management of migration. The lines of action and contents of this priority measure are in general associated with priority measure 67.

“Consistency” is understood to mean a harmonious relationship among the rules and standards that comprise migration governance. The lack of consistency implies regulatory conflict and incompatibility of standards. “Reciprocity” means that countries accord each other the same or equivalent treatment.

Priority measure 71

Achieve concrete results through dialogue and international cooperation relating to migration, human rights and development in regional forums as well as in forums linked to other regions of the world, in particular North America and the European Union, with a view to reducing existing asymmetries in this area and asserting the interests of Latin American and Caribbean countries.

Possible lines of action

1. Ensure that dialogue and cooperation on migration are based on the principles of migration governance. 2. Promote dialogue and exchange of experiences between forums for regional consultations worldwide, with a view to contributing to the well-being of migrants and the global governance of international migration. 3. Coordinate measures among intergovernmental bodies on migration in terms of their relationship with countries of North America and the European Union. 4. Implement appropriately the principles of shared responsibility in all intergovernmental bodies, based on the pertinent identification of those responsibilities. 5. Promote free circulation within regional integration schemes.

Targets

1. Conduct periodic assessments of regional, subregional, extraregional and bilateral agreements for the protection of migrants. 2. Establish mechanisms for consulting civil society and involving it in the institutional structure for migration. 3. Have in place common principles and guidelines for addressing the problems that affect migrants.

Tentative indicators

1. Percentage of Montevideo Consensus on Population and Development measures covered in migration agreements. 2. Compliance rate with the measures enshrined in migration agreements.

Related instruments, forums and mechanisms

This measure has antecedents in the action plans and commitments of the Regional Conference on Migration and the South American Conference on Migration. CELAC, in particular, and other schemes (such as MERCOSUR and the Andean Community) can incorporate and reinforce the indicated lines of action, as they have their own related initiatives. The mandates of the United Nations agencies and the IOM must also be considered. The resolution adopted at the Second High-Level Dialogue of 2013 is part of a broad framework of follow-up for dialogue and cooperation.

Also to be taken into account is target 10.7 of the Sustainable Development Goals (“Facilitate orderly, safe, regular and responsible migration and mobility of people, including through implementation of planned and well-managed migration policies”).

Comments

This priority measure is related to priority measures 70 and 73. Migration governance involves developing a government’s capacity to implement, monitor and evaluate policies in coordination with social stakeholders in civil society, in its management of migration.

The targets and indicators must reflect the particular situation of indigenous peoples, particularly those whose ancestral territories were split up during the establishment of nation States, considering the comments under priority measure 88 on the territorial rights of indigenous peoples.

Priority measure 72

Protect decisively the human rights of all migrants, avoiding any form of criminalization of migration, and guarantee migrants access to basic social services in education and health, including sexual health and reproductive health, where appropriate, regardless of their migration status, with special attention to highly vulnerable groups, including unaccompanied minors, displaced persons in an irregular situation, women who are victims of violence, victims of trafficking, returnees and forcibly displaced asylum-seekers.

Possible lines of action

1. Adopt specific national legislation on the rights of migrants, including gender and childhood perspectives. 2. Prepare the regulations, standards and care protocols necessary for its application, especially in the case of accompanied and unaccompanied children and adolescents. 3. Prepare and implement policies and programmes to address the vulnerability of migrants in border areas, with special attention to women, children and adolescents. 4. Improve legislation to protect persons who migrate under mixed conditions, forcibly displaced persons, stateless persons, and asylum-seekers, in accordance with the provisions of intentional human rights law. 5. Comply fully with the provisions of the Brazil Declaration “A Framework for Cooperation and Regional Solidarity to Strengthen the International Protection of Refugees, Displaced and Stateless Persons in Latin America and the Caribbean” (2014) and its principles and standards.

Targets

1. End migration by unaccompanied minors and have in place protocols for their care. 2. Have legislation, institutions and policies devoted explicitly to protecting the human rights of all migrants, with special provisions for women, including sexual and reproductive health, and for children and adolescents, to protect their higher interest. 3. Have legislation, institutions and policies devoted to protecting migrants seeking international and humanitarian protection in the framework of the principles, standards and specific conventions in this area. 4. End statelessness among migrants.

Tentative indicators

1. Number (and relative share) of unaccompanied children and adolescents among migrants. 2. Number (and relative share) of operational programmes devoted to migrants in border areas. 3. Number (and relative share) of prophylactic treatments for sexually transmitted infections and provisions of emergency contraception for migrant women. 4. Number (and relative share) of stateless persons.

Related instruments, forums and mechanisms

This priority measure is covered by specific international instruments, as indicated in priority measure 67. The action plans and commitments of the Regional Conference on Migration and the South American Conference on Migration also provide backing, in particular by including countries that have not ratified the International Convention on the Protection of the Rights of All Migrant Workers and Members of Their Families. The 2014 Brazil Declaration “A Framework for Cooperation and Regional Solidarity to Strengthen the International Protection of Refugees, Displaced and Stateless Persons in Latin America and the Caribbean” is another important frame of reference, as it reinforces the commitments of the Cartagena+30 Process and adds elements from the international human rights framework (on refugees and humanitarian aid). In this respect, the mandates of the United Nations agencies, and in particular of the Office of the High Commissioner for Refugees (UNHCR) and the IOM are relevant.

In addition, the measure is tied to target 8.8 of the Sustainable Development Goals (“Protect labour rights and promote safe and secure working environments for all workers, including migrant workers, particularly women migrants, and those in precarious employment”).

Comments

This measure is closely related to priority measures 67 and 73, but it distinguishes groups in situations of specific vulnerability. It should be linked with the goals and indicators for protecting asylum-seekers, refugees, displaced persons and stateless persons. It is related to chapter D, priority measure 33.

Priority measure 73

Give priority, in each country, to strengthening coordination channels between sectors and between countries, to reinforcing intergovernmental cooperation mechanisms in order to guarantee the exercise of the human rights of all migrants, regardless of their migration status, from a gender-based perspective.

Possible lines of action

1. Adopt and apply specific national legislation on the rights of migrants, incorporating a gender perspective. 2. Create mechanisms for cross-sector coordination and follow-up to policies and programmes that affect migrants (within ministries of health, labour, education and social development, for example).

Targets

Have in place legislation, institutions and policies devoted explicitly to protecting the human rights of all migrants, regardless of migratory status, with explicit gender considerations.

Tentative indicators

Number of countries incorporating the gender approach in their measures relating to the Montevideo Consensus on Population and Development.

Related instruments, forums and mechanisms

Like priority measure 72, this measure is associated with all the other measures and their mechanisms. What distinguishes priority measure 73 is its emphasis on the gender perspective, which seeks to address the vulnerabilities of migrant women. This measure is thus related to target 8.8 of the Sustainable Development Goals (“Protect labour rights and promote safe and secure working environment for all workers, including migrant workers, particularly women migrants, and those in precarious employment”).

Comments

This measure is closely related to priority measures 67, 71 and 72, with which it shares subject matter, and can be viewed as cutting across all sectors.

Priority measure 74

Strengthen cooperation between countries of origin, transit and destination to address the causes and challenges of irregular migration, so as to generate safe, orderly, humane migration conditions through bilateral arrangements for labour force mobility and ensure protection of the human rights of migrants.

Comments

This measure is covered by all the lines of action, targets and mechanisms suggested in the previous priority measures of this chapter, and it therefore intersects with all the measures the chapter includes. It involves the deployment of resources and common methodologies for estimating the number of irregular migrants. In the case of emigration to countries outside the region, estimates can be obtained from the countries of destination.

This measure is targeted at irregular migration and focuses on bilateral arrangements, but these can clearly be expanded in scale, and consequently one of its main purposes is to ensure respect for the rights of migrants regardless of their migration status, through cooperation between countries in dealing with irregular migration.

Priority measure 75

Ensure that the Second High-level Dialogue on International Migration and Development, to be held in New York on 3 and 4 October 2013, leads to the adoption of a consensual outcome document and, in that regard, to submit for consideration the question of whether it would be appropriate to propose the contents and guidelines of an international convention on migration.

Related instruments, forums and mechanisms

This measure must be interpreted as follow-up to the agreements adopted in the Declaration of the Second High-Level Dialogue on International Migration and Development (A/68/L.5, 2013, sixty-eighth session, agenda item 21(e), Globalization and Interdependence: International Migration and Development). It is covered by all the previous measures. The Declaration is broad in scope and contains 34 points, the last of which calls for annual evaluation of its follow-up.

Comments

It is anticipated that one or two new global dialogues will have been held by 2020 to add strength to the guidelines directives arising from the Second High-Level Dialogue, held in 2013. All countries are expected to provide follow-up to the agreements of the Second High-Level Dialogue by fulfilling the measures in this chapter, and to renew their commitments in new global initiatives.

The South American Conference on Migration, in its substantive agreements, has proposed the preparation of a South American convention on migration.

G. TERRITORIAL INEQUALITY, SPATIAL MOBILITY AND VULNERABILITY

Latin America and the Caribbean have certain distinctive characteristics in the spatial distribution of the population. These include high rates of urbanization, with the attendant opportunities and risks, a persistent rural exodus, limited options for development in rural areas and small communities, a tendency for population and activities to be concentrated in a few dynamic centres, and the segregation and vulnerability that the poor face because of their geographical location.

Territorial and social inequalities are dialectically interwoven. Differences among subnational territories in terms of income, poverty, productivity, access to well-being and natural-resources endowment contribute to the overall contrasts in these indicators at the national level. Territorial inequalities occur at different geographical scales, between broad regions or major administrative divisions, between urban and rural areas, or between minor administrative divisions within the same city or metropolitan area. All these expressions of inequality are directly linked to the perpetuation of poverty and social inequality, the weakness of social cohesion, problems of sustainability, and governance difficulties. For this reason, it is vital to narrow the gaps among territories in order to attain greater equality. Hence the importance of policies that consider not only production convergence but also spatial convergence.

The Programme of Action of the International Conference on Population and Development, specifically chapter IX on population distribution, urbanization and internal migration, established goals and measures (9.1 to 9.25) relating to the issues addressed in this chapter and linked to population and territory within a framework of sustainable development.

The Montevideo Consensus on Population and Development takes account of these particular characteristics of the region and the specific challenges that countries face in dealing with these issues, and recognizes the advances to date and the experience built up in the region over the past few decades with respect to decentralization, development planning and territorial planning, while expressing concern over the high costs of various kinds imposed on the region by natural and socioenvironmental disasters.

This chapter contains nine priority measures that are closely related to each other and that share various lines of action. Three priority measures convey general aspirations with respect to territory (76), environmental risks (76 and 82), disasters caused by natural and socioenvironmental events (82) and the exploitation of natural resources (83): they are dealt with only briefly, on the grounds that that they can be implemented and monitored through other priority measures of the Montevideo Consensus on Population and Development and other international instruments, forums and mechanisms as detailed in the respective tables. The remaining six priority measures are set forth in detailed tables. These relate directly to issues of development and social well-being and access to basic services (77), decentralization and citizen participation at the local level (78), citizen security and creative leisure as ways to prevent social problems (79). Territorial and urban planning are presented from the perspective, on the one hand, of sustainable urban development and the strengthening of city systems and their rural environments (80), and, on the other, that of preventing and mitigating the impact of socioenvironmental disasters and environmental vulnerability (81). In direct relation to these five measures, priority measure 84 calls for the use of georeferenced sociodemographic analysis, disaggregated by specific population groups.

Among other international instruments, forums and mechanisms discussed are the Sustainable Development Goals, the General Assembly of Ministers and High Authorities of Housing and Urban Development of Latin America and the Caribbean (MINURVI) and its Santiago Declaration of 2013, the Hyogo Framework for Action 2005-2015 and the United Nations Conference on Housing and Sustainable Urban Development (Habitat III), which will take place in October 2016. The outcomes of Habitat III, as well as the review of its indicators, will need to be tied in with a number of this chapter’s priority measures.

Although the background section of the present document referred to the tentative indicators proposed under each priority measure, in the case of this chapter it is important to highlight the importance of using territorially disaggregated indicators for each of the priority measures presented in the full tables.

Priority measure 77

Promote the development and well-being of people in all territories without any form of discrimination, and provide full access to basic social services and equal opportunities for populations whether they live in urban or rural areas, in small, intermediate or large cities or in isolated areas or small rural settlements.

Possible lines of action

1. Design programmes to guarantee basic services (drinking water, sewerage and sanitation, electricity) in all territories. 2. Design health policies and programmes that include universal health coverage, access to good-quality essential health services, and access to medicines and vaccines. 3. Design inclusive, equitable and good-quality education policies and programmes in all territories. 4. Design housing policies that will improve housing quality and promote construction of new dwellings, recognizing that the type of housing option must be adequate to needs of everyone everywhere. 5. Design policies and programmes to expand and improve public spaces in all territories, with special regard to older persons, persons with disabilities, children and women. 6. Institute programmes for the formalization and comprehensive improvement of neighbourhoods, with special attention to slums and depressed areas. 7. Prepare land-use policies that help to discourage real estate speculation.

Targets

1. Ensure universal coverage of safe, accessible and affordable drinking water for everyone everywhere. 2. Achieve equitable access to adequate sanitation and hygiene services for everyone everywhere. 3. Ensure universal coverage of safe, accessible and affordable electricity services for everyone everywhere. 4. Have universal health coverage that includes access to good-quality, intercultural health services, medicines and vaccines. 5. Have an infrastructure of health care available equitably access all territories. 6. Ensure that all children have complete, free, equitable and good-quality primary and secondary education. 7. Ensure that social housing meets quality standards and technical, safety and adaptability standards for persons with disabilities, older persons and indigenous persons. 8. Ensure all population centres (in urban and rural areas) have adequate public facilities, lighting and green areas. 9. Reduce by 100% the number of people living in slums.

Tentative indicators

1. Percentage of people with access to basic services (light, water, sewage), by minor administrative division. 2. Life expectancy at birth, by sex, ethnicity and minor administrative division. 3. Percentage shortfall in basic health establishments, by minor administrative division. 4. Net primary school enrolment rate, by minor administrative division. 5. Ration between girls and boys by level of education (primary, secondary and tertiary), by minor administrative division. 6. The housing deficit, as a percentage, by minor administrative division. 7. Percentage of housing built with makeshift materials, by minor administrative division. 8. Percentage of persons living in slums.

Related instruments, forums and mechanisms

This priority measure finds support in HABITAT III; the Santiago Declaration of MINURVI; and a number of paragraphs of the outcome document of the United Nations Conference on Sustainable Development, “The Future We Want”.

With regard to the Sustainable Development Goals, the measure is related to Goal 3 (“Ensure healthy lives and promote well-being for all at all ages”), target 3.8 (“Achieve universal health coverage, including financial risk protection, access to quality essential health care services, and access to safe, effective, quality and affordable essential medicines and vaccines for all”), target 6.1 (“By 2030, achieve universal and equitable access to safe and affordable drinking water for all”), target 6.2 ( “By 2030, achieve access to adequate and equitable sanitation and hygiene for all, and end open defecation, paying special attention to the needs of women and girls and those in vulnerable situations”), Goal 10 (“Reduce inequality within and among countries”), target 10.2 (“By 2030, empower and promote the social, economic and political inclusion of all irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status”), Goal 11 (“Make cities and human settlements inclusive, safe, resilient and sustainable”), target 11.1: (“By 2030, ensure access for all to adequate, safe and affordable housing and basic services, and upgrade slums”), target 11.3 (“By 2030 enhance inclusive and sustainable urbanization and capacities for participatory, integrated and sustainable human settlement planning and management in all countries”), and target 11.a (“Support positive economic, social and environmental links in urban, periurban and rural areas by strengthening national and regional development planning”).

Comments

This priority measure is related to priority measures 78, 79 and 81 of this chapter. The indicators of this priority measure should be disaggregated by geographical area, whether by centre of population or by minor administrative division, and by urban and rural areas.

This measure must take account of the particular situation of indigenous peoples and Afro-descendants, and thereby complement priority measure 88 on the territorial rights of indigenous peoples and priority measure 96 on affirmative action policies for the development of Afro-descendent populations.

Minor administrative division is understood to mean the smallest administrative division in each country.

Priority measure 78

Expand and improve the processes of decentralization, deconcentration and participatory planning at the subnational and local levels, with emphasis on availability, accessibility and the quality of basic services, education and health, including sexual health and reproductive health and the prevention of violence against girls, adolescents and women.

Possible lines of action

1. Adopt specific national legislation on effective decentralization and local autonomy. 2. Design and promote the use of instruments for citizen participation in planning, decision-making and monitoring of decentralized public policies.

Targets

1. Have in place laws and regulations that allow for decentralization and structural and budgetary autonomy at the local level. 2. Make participation a pillar of all planning instruments. 3. Ensure coverage of good-quality basic services in education, health, sexual and reproductive health, and prevention of violence against girls, adolescents, persons with disabilities, older persons, indigenous peoples, Afro-descendants and women in all territories.

Tentative indicators

1. Average per capita annual income of subnational and local governments allocated to the provision of good-quality basic services in education, health, sexual and reproductive health, and prevention of violence against girls, adolescents, persons with disabilities, older persons, indigenous peoples, Afro-descendants and women in all territories. 2. Percentage of planning instruments that include participation in decision-making and monitoring at the subnational level. 3. Proportion of government bodies that have permanent mechanisms for effective participation by civil society, by sector (health and education) and by major and minor administrative area.

Related instruments, forums and mechanisms

The HABITAT agenda has measures that relate directly to this priority measure: a chapter on promoting decentralization and strengthening local authorities; Checklist 7 on the level of the decentralization process; and Key indicator 20 on total local government revenue from all sources in United States dollars annually, both capital and recurrent, for all local governments in the metropolitan area, averaged over the last three years (2000, 2001, 2003), divided by the population.

Sustainable Development Goals 3, 11 and 13 also relate to this priority measure.

Comments

The targets proposed under this measure relate primarily to decentralization and participation, as the issue of sexual and reproductive health and that of violence are developed in chapter D and in priority measures 56, 57 and 58 of chapter E. Specific indicators relating to the priority measures proposed in those chapters, and the indicators proposed in the present chapter, should be disaggregated by subnational level, urban or rural area and, where possible, minor administrative division. The issue of access to basic services was developed in priority measure 77 of this chapter. This measure is closely related to priority measure 84, as the availability and use of disaggregated and georeferenced sociodemographic information is essential for giving effect to decentralization, local planning and participatory decision-making.

Priority measure 79

Design programmes to promote peaceful coexistence, continuing education, creative leisure pursuits, mental health and citizen security for the population in their territories in order to prevent the current social problems associated with issues such as poverty, social exclusion, the abusive use and trafficking of drugs, and gender-based violence.

Possible lines of action

1. Formulate, implement and evaluate policies on public safety from a human rights perspective in all territories. 2. Strengthen the role of local governments and local-level public services in recovering public spaces in all territories. 3. Design programmes that offer creative leisure pursuits at the local level to all population groups. 4. Introduce cultural and recreational activities for the entire population at the local level.

Targets

1. Increase the number of crime prevention and investigation measures that are consistent with the human rights framework. 2. Reduce the number of burglaries involving home invasion and burglary with assault. 3. Enhance quality of life. 4. Reduce levels of dissatisfaction with respect to public safety. 5. Reduce juvenile delinquency. 6. Significantly reduce all forms of violence and related death rates. 7. Increase the number of organizations for young persons, older persons, indigenous persons and women that participate fully in the management of community affairs at the local level. 8. Strengthen intergenerational relations within the community in all territories. 9. Reduce the number of cases of sexual harassment on the street and on public transport.

Tentative indicators

1. Percentage of households that report being assaulted, suffering aggression, or being the victim of a crime in the past 12 months, by minor administrative area. 2. Rate of social impact crimes reported (per 100,000 inhabitants). 3. Percentage of the population participating in community recreational activities, by age group and minor administrative division. 4. Percentage of youth, older persons’ and women’s organizations, by minor administrative division. 5. Percentage of women having experienced harassment in the past 12 months, by minor administrative division.

Related instruments, forums and mechanisms

Sustainable Development Goals, Goal 1 (“End poverty in all its forms everywhere”) target 1.1 (“By 2030, eradicate extreme poverty for all people everywhere, currently measured as people living on less than $1.25 a day”), target 1.2 (“By 2030, reduce at least by half the proportion of men, women and children of all ages living in poverty in all its dimensions according to national definitions”), Goal 3 (“Ensure healthy diets and promote well-being for all at all ages”), target 3.5 (“Strengthen prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol”), Goal 4 (“Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all”) and all its targets, and, finally, target 5.2 (“Eliminate all forms of violence against all women and girls in public and private spheres, including trafficking and sexual and other types of exploitation”).

Comments

Priority measure 79 addresses several issues associated with peaceful coexistence, education, recreation, health, and security, for the purpose of preventing important social problems in the region, including poverty and social exclusion. These constitute a set of measures and lines of action to be pursued in different spheres. In this case, special attention will be paid to the issues of citizen security, recreation and public spaces. Priority measures 1 and 2 of chapter A address the issue of poverty and exclusion, while priority measures 56, 57 and 58 of chapter E consider the issue of gender violence.

Priority measure 80

Formulate development strategies for city systems to encompass territorial planning and environmental sustainability, promoting energy transition and sustainable production and consumption processes, taking into consideration social and environmental externalities, within a human rights framework, in order to promote sustainable and inclusive urban development, and strengthen all segments of such systems, including intermediate and small cities.

Possible lines of action

1. Adopt policies for territorial planning and environmental sustainability that consider the country’s city systems and their rural surroundings. 2. Design urban development policies that are conducive to people’s well-being and to the social, economic and environmental sustainability of the city system and its rural surroundings. 3. Design a sustainable energy policy that includes the use of renewable energies. 4. Create and strengthen economic, social and environmental linkages and cooperation among the country’s different cities through strategies for developing the city system and its rural surroundings. 5. Design and implement programmes to improve air quality in the country’s main urban areas. 6. Introduce a geostatistical information system that contains standardized information useful for taking planning and management decisions.

Targets

1. Include land-use planning guidelines and environmental sustainability mechanisms in the development plans of cities and their rural surroundings. 2. Have programmes or measures that promote cooperation among the cities of the system and their rural surroundings. 3. Reduce environmental pollution, especially particulate matter, in urban areas. 4. Have in place a geographic information system (GIS) that includes information on all cities and that is useful for taking territorial planning and management decisions.

Tentative indicators

1. Percentage of cities with development plans that include action to promote cooperation among cities, sustainability, resilience and the human rights framework. 2. Annual rate of reduction in concentrations of particulate matter 10 and 2.5. 3. Percentage of energy generated through sustainable production processes, solid waste recycling, treatment of grey water and sewage. 4. Percentage of city or local governments that have a geographic information system for planning and management decisions.

Related instruments, forums and mechanisms

The Habitat agenda provides for follow-up to priority measure 80 with its proposal to “promote geographically balanced settlement structures”, in which it establishes two indicators: Key indicator 11 (urban population growth: average annual growth rate of population in the urban agglomeration or in national urban areas during the last five years (1998-2003 reference period)), and Key indicator 12 (planned settlements: level at which urban land is planned in order to cater to the needs of populations).

The Santiago Declaration of MINURVI (2013) addresses this matter in agreements 3 (“To establish homogeneous methodologies and indicators that allow comparison of the performance of cities, in order to optimize regional strategies and support their strengthening through cooperation”) and 4 (“Reduce the environmental impact on cities in a [comprehensive] manner through territorial [planning])”.

Sustainable Development Goals: several are related to this priority measure, including Goal 11 (“Make cities and human settlements inclusive, safe, resilient and sustainable”), target 11.3 (“By 2030 enhance inclusive and sustainable urbanization and capacities for participatory, integrated and sustainable human settlement planning and management in all countries”), target 11.6 (“By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to air quality, municipal and other waste management”), target 11.a (“Support positive economic, social and environmental links between urban, periurban and rural areas by strengthening national and regional development planning”), and target 11.b (“By 2020, increase by x% the number of cities and human settlements adopting and implementing integrated policies and plans towards inclusion, resource efficiency, mitigation and adaptation to climate change, resilience to disasters, develop and implement in line with the forthcoming Hyogo Framework holistic disaster risk management at all levels”).

Priority measure 81

Plan and manage territorial and urban development, from a human rights and gender perspective, by formulating mobility, population settlement and activity location policies that contemplate, among their objectives, avoiding the use of vulnerable and protected areas and preventing and mitigating the impact of socioenvironmental disasters and combating the environmental vulnerability of those living in poverty and ethnic and racial groups who are subject to discrimination, as well as climate change mitigation and adaptation.

Possible lines of action

1. Create regulatory instruments for territorial and urban development that include the human rights, gender and environmental perspectives. 2. In territorial and urban development plans, implement guidelines to guarantee protection of vulnerable or protected natural areas. 3. Take action for climate change mitigation and adaptation in the area of urban and territorial development. 4. Implement sustainable urban mobility and public transportation policies that are coherent with urban and territorial development plans. 5. Provide localities with equipment, services and infrastructure to manage people’s spatial mobility. 6. In zoning plans, incorporate the identification of vulnerable and environmentally at-risk areas and determine places in which human settlement is banned. 7. Strengthen information and communications technologies. 8. Make administrative services readily available to the local population. 9. Create policies and instruments for oversight and improvement of air quality.

Targets

1. Include the population, human rights, gender and interculturality perspectives in territorial planning and urban development instruments. 2. Have in place territorial and urban development plans with measures to protect vulnerable and protected natural areas. 3. Have in place territorial and urban planning instruments that include measures of environmental mitigation and adaptation to climate change. 4. Have in place suitable, sustainable and good-quality equipment, services, infrastructure and public transit in all centres of population. 5. Identify all vulnerable and environmentally at-risk areas in the country. 6. Adopt national and local regulations governing the location of human settlements and prohibiting them in vulnerable and environmentally at-risk areas. 7. Have in place comprehensive reforestation management plans for areas at risk of erosion and landslides in the vicinity of human settlements.

Tentative indicators

1. Percentage of urban and territorial development plans that incorporate the rights, gender and interculturality perspectives. 2. Percentage of vulnerable and protected areas that have a management plan. 3. Percentage of human settlements located in vulnerable areas. 4. Number of minor administrative areas with sustainable transport systems and infrastructure.

Related instruments, forums and mechanisms

The Habitat agenda provides for follow-up to priority measure 81 with its proposals to “promote social integration and support disadvantaged groups”, “promote gender equality in human settlements development” and “prevent disasters and rebuild settlements”. Each of these identifies one or two monitoring indicators.

The Santiago Declaration MINURVI (2013) addresses this measure in agreements 1 (“To foster the development of urban policies that aim at integrating the population of informal settlements, giving access to serviced lots with urban infrastructure, community facilities and environmental sanitation, and promoting the strengthening of their human and social capital”), 5 (“Reduce the environmental impact on cities in an integrated manner through territorial ordinances”), 6 (“To encourage access to sustainable design and construction of quality housing, within the urban context, with access to services, infrastructure and facilities that foster the building and restoration of social ties”) and 8 (“To develop strategies for the prevention of risks and the management of emergencies in human settlements, [caused by] natural disasters, and to develop building techniques in order to reduce the risks through a variety of actions that include the analysis of potential disasters, the vulnerabilities, the adoption of appropriate standards of construction designs, technologies and building regulations, both in mitigation and in adaptation”).

Sustainable Development Goals, Goal 11 (“Make cities and human settlements inclusive, safe, resilient and sustainable”), and in particular target 11.2 (“by 2030, provide access to safe, affordable, accessible and sustainable transport systems for all, improving road safety, notably by expanding public transport, with special attention to the needs of those in vulnerable situations, women, children, persons with disabilities and older persons”), as well as targets 11.5 (“By 2030 significantly reduce the number of deaths and the number of affected people and decrease by x% the economic losses relative to GDP caused by disasters, including water-related disasters, with the focus on protecting the poor and people in vulnerable situations”) and 11.b (“By 2020, increase by x% the number of cities and human settlements adopting and implementing integrated policies and plans towards inclusion, resource efficiency, mitigation and adaptation to climate change, resilience to disasters, develop and implement in line with the forthcoming Hyogo Framework holistic disaster risk management at all levels”), and Goal 13, (“Take urgent action to combat climate change and its impacts”), three targets for which are relevant to this priority measure.

Comments

This measure must take account of the particular situation of indigenous peoples and Afro-descendants, and thereby complement priority measure 88 on the territorial rights of indigenous peoples and priority measure 96 on affirmative action policies for the development of Afro-descendent populations. The following indicators are also proposed for consideration: percentage of reforested areas; percentage of municipalities that have prepared risk atlases; number of days per year on which air quality falls below minimum standards; and number of decibels in the public area to measure degree of noise pollution.

ECLAC has worked with several countries in the region on economic assessments of climate change, collecting data on sectoral impacts and specific socioeconomic groups at a local level. The information generated in this way supports public policy formulation geared towards alleviating the adverse effects of climate change and taking mitigation action, with a view to achieving a path of green development and growth, with low-carbon economies based on the principles of equity and social inclusion, not only for the present but also for future generations.

Priority measure 82

Formulate and implement strategies and policies that respond fully to situations of vulnerability to natural disasters, with a multidimensional protection focus before, during and after such events.

Related instruments, forums and mechanisms

UN-HABITAT: this priority measure relates directly to the issues addressed by this agency, and specifically to the objective of “preventing disasters and rebuilding settlements” and checklist 5 on disaster prevention and mitigation instruments, which gauges the level at which disaster prevention is ensured and mitigation instruments in place. This item includes an extensive indicator 10 (“houses in hazardous locations: proportion of housing units built on hazardous locations per 100,000 housing units”).

United Nations Conference on Sustainable Development (Rio+20): paragraph 186 of the outcome of the Conference, “The future we want”, reaffirms the commitment to reduce disaster risks.

Sustainable Development Goals, Goal 13 (“Take urgent action to combat climate change and its impacts”) relates to this priority measure, more particularly through targets 13.1 (“Strengthen resilience and adaptive capacity to climate related hazards and natural disasters in all countries”) and 13.2 (“Integrate climate change measures into national policies, strategies and planning”).

Hyogo Framework for Action 2005-2015: this instruments was signed and approved in Japan in 2005 by 168 countries, which undertook to introduce into public policies the concepts of prevention and risk assessment, as well as ways of responding to disasters or the actions to be taken following a crisis. The Framework contains a series of principles which the entire international community should respect, in line with the International Strategy for Disaster Reduction. The general objective is to build the resilience of countries and communities to disasters, in order to achieve, by 2015, a “substantial reduction in disaster losses, in lives and in the social, economic and environmental assets of communities and countries.” The Framework includes five priority areas for action, together with guiding principles and practical means for building the disaster resilience of vulnerable communities, in the context of sustainable development. The following three strategic objectives provide backing for achieving the outcome called for in the Hyogo Framework for Action: (i) The more effective integration of disaster risk considerations into sustainable development policies, planning and programming at all levels, with a special emphasis on disaster prevention, mitigation, preparedness and vulnerability reduction; (ii) The development and strengthening of institutions, mechanisms and capacities at all levels, in particular at the community level, that can systematically contribute to building resilience to hazards; and (iii) The systematic incorporation of risk reduction approaches into the design and implementation of emergency preparedness, response and recovery programmes in the reconstruction of affected communities. The Framework also proposes five priorities for action (reflecting the areas identified in the process of reviewing the Yokohama Strategy): (i) ensure that disaster risk reduction is a national and a local priority with a strong institutional basis for implementation; (ii) identify, assess and monitor disaster risks and enhance early warning; (iii) use knowledge, innovation and education to build a culture of safety and resilience at all levels; (iv) reduce the underlying risk factor and (v) strengthen disaster preparedness for effective response at all levels.

Comments

It is important to bear in mind, in the strategies, policies and programmes for responding to situations of vulnerability to natural disasters, that measures differentiated by gender and age of the exposed population must be implemented before, during and after the events, and access must be assured to inputs and services for sexual and reproductive health and the prevention of gender violence.

There are a number of reasons for considering gender and disasters together, one of which is that women are more vulnerable to disasters because of the role assigned to them by society, but disasters also often provide women with a unique opportunity to challenge and change their gender-assigned status in society. Women have shown themselves to be indispensible in disaster response; they play an active role in reconstruction efforts and are more effective at mobilizing the community. Hence the need for strategies and policies that comprehensively address situations of vulnerability to natural disasters from a gender perspective, considering at least the following: (i) disaggregation of data by sex and age order to study natural disasters from a gender perspective; (ii) involvement, training and employment of women at a local level in vulnerability diagnostics and assessment, and in prevention and risk mitigation projects; (iii) identification and assessment of specific needs by sex, in the areas of health, work, education, housing and violence prevention; (iv) measures to ensure that women benefit from economic recovery and income support programmes; and (vi) establishment of childcare programmes. Chapters D (on universal access to sexual and reproductive health services) and E (on gender equality) include priority measures on possible lines of action and targets that address these issues; as well, priority measure 24 in chapter C affords particular attention to older persons and disasters.

Priority measure 83

Promote inclusive development of natural resources, avoiding the social and environmental damage that this may cause.

Related instruments, forums and mechanisms

Sustainable Development Objectives: the outcome of the United Nations Conference on Sustainable Development (Rio+20), “The future we want”, called for the creation of an open intergovernmental working group to prepare a proposed set of sustainable development goals for inclusion in the post-2015 development agenda. The resulting Sustainable Development Goals can serve for monitoring this priority measure, through goal 6 (“Ensure availability and sustainable management of water and sanitation for all”), particularly targets 6.1 (“By 2030, achieve universal and equitable access to safe and affordable drinking water for all”) and 6.6 (“By 2020 protect and restore water-related ecosystems, including mountains, forests, wetlands, rivers, aquifers and lakes”), and Goal 12 (“Ensure sustainable consumption and production patterns”), particularly targets 12.2 (“By 2030 achieve sustainable management and efficient use of natural resources”) and 12.5 (“By 2030, substantially reduce wasted generation through prevention, reduction, recycling, and reuse”).

In resolution 64/292 (28 July 2010), the United Nations General Assembly explicitly recognized the human right to water and sanitation, reaffirming that these are vital for the realization of all human rights. Resolution 64/292 calls upon States and international organizations to provide financial resources, to promote training and the transfer of technology, particularly to developing countries, in order to provide a drinkable water supply and clean, accessible and affordable sanitation for all, especially where drinking water is not always considered a resource for public use.

Comments

The member countries of ECLAC recognize the need for progress toward better and stronger governance and development of natural resources, so that these will contribute to a more diversified economy that is more sustainable in environmental terms and has synergies with respect to employment, well-being and sustainable economic development for the region over the long term. This means that governance should concern itself with the ownership, the means of appropriation and the redistribution of productivity gains so that society as a whole will benefit from a country’s endowment in natural resources. The High-Level Roundtable “Towards a vision on natural resource governance for equality in Latin America and the Caribbean”, held in January 2015, identified the elements for construction of a compact on governance of natural resources: creating a long-term State policy and strategy to ensure that extraction industries contribute to development goals through productive diversification, structural change and social inclusion; updating countries’ tax frameworks to achieve greater progressivity in State participation; institutionalizing long-term mechanisms for the stabilization, saving and investment of this income; and bolstering the capacity of public institutions to manage socioenvironmental and labour disputes associated with the development of extraction sectors.

There is also a link between natural resource exploitation and the impacts this may have on the population living in those areas, which can lead to socioenvironmental conflicts, particularly in territories inhabited by indigenous peoples. In the development of these extractive activities, especially those associated with high-tech single-product extraction, it is important to include environmental impact plans that will gauge the social and environmental risks and effects, such as plans for prevention, mitigation, correction and compensation for adverse environmental impacts. Consultation mechanisms must also be considered so that people can participate throughout the process.

Implementation of this measure implies a new approach to the governance of natural resources, one in which the territorial rights of indigenous peoples must be explicitly considered (see priority measure 88).

Priority measure 84

Promote the use of georeferenced, sociodemographic analysis, disaggregated by sex, race and ethnicity, to improve territorial planning and environmental risk management.

Possible lines of action

1. Provide training in demographic analysis topics at the local level. 2. Incorporate sociodemographic information on the entire population, as well as on population subgroups disaggregated by sex, age, race, ethnic origin and geographical location, into baseline studies, diagnostic analyses and monitoring systems using geographic information systems at different territorial scales. 3. Coordinate with the various national and subnational government bodies on the actions needed for the design and implementation of geographic information systems with information for planning the territory (cities, specific areas within the city, environmental risk zones) and for managing or programming various actions when an environmental disaster strikes. 4. Promote the availability, improvement and use of data sources, for example territorially disaggregated censuses and population forecasts so as to allow this type of analysis at different scales, and train technical personnel in their use and in the various procedures and analyses that can be conducted.

Targets

1. Have at hand diagnoses or studies that include georeferenced sociodemographic indicators that can be used to analyse land-use planning and environment risk at different geographical scales and that establish the baseline for territorial and environmental policies. 2. Have in place monitoring systems, both for preventing environmental disasters and for assessing their impact, which include a set of georeferenced sociodemographic indicators for characterizing the population at risk. 3. Achieve universal access to census data and other information sources for all users involved in achieving these targets.

Tentative indicators

1. Percentage of geographic information system analytic instruments that contain georeferenced sociodemographic information. 2. Percentage of municipal or local master plans that, in their preamble, provide for disaggregated and georeferenced sociodemographic analysis. 3. Percentage of environmental risk management plans that include georeferenced sociodemographic analysis in their diagnoses before, during and after the event.

Related instruments, forums and mechanisms

Santiago Declaration of MINURVI, agreement 3 on establishing homogeneous methodologies and indicators for comparing the performance of cities in order to optimize regional strategies and strengthen them through cooperation.

Comments

It must be borne in mind that the indicators are not easy to construct, as there is no information currently available on this issue. Thus, in order to monitor this priority measure, the necessary data sources will have to be created. This measure is linked with priority measure 82 and the measures under chapter H.

These measures are complementary to priority measures 90 and 98, in terms of generating disaggregated information for indigenous peoples and Afro-descendants, respectively.

H. INDIGENOUS PEOPLES: INTERCULTURALISM AND RIGHTS

Latin America is home to more than 800 indigenous peoples with a population estimated at 45 million in 2010. They are characterized by their broad demographic, social, territorial and political diversity, ranging from people living in voluntary isolation to those dwelling in major urban centres. The tenacious resistance of indigenous peoples finds its expression today, as part of a global process, in the introduction of new political and territorial situations based on the framework of international rights standards that are binding on States. Although the region has made undeniable progress in applying those rights, there are still persistent gaps, and inequalities remain profound, reflecting the structural discrimination affecting indigenous peoples.[15]

The Montevideo Consensus on Population and Development expresses the clear commitment of States to continue moving forward with the exercise of the rights of indigenous peoples, as a priority aspect of strengthening their democracies, a process that goes hand-in-hand with a critical view of development and the growing conviction that it must be focused on the values of equality and cultural diversity. Hence, the States agreed upon seven specific priority measures relating to indigenous peoples. At the same time, however, the situation of these peoples must be considered in a cross-cutting and comprehensive manner in all the measures established in the Consensus. Thus, the Consensus reinforces and complements the Cairo Programme of Action with regard to indigenous peoples (particularly measures 6.25, 6.26, 6.27 and 8.16, on demographic dynamics, territory and health).

Priority measure 85, on observance and application of the United Nations Declaration on the Rights of Indigenous Peoples and ILO Convention 169, implies a range of measures to implement minimum standards for the political, civil, economic, social and cultural rights of indigenous peoples. Priority measure 88, on the territorial rights of indigenous peoples, stresses guarantees of the exercise of this right as essential for the survival of these peoples. Attention should be drawn to the follow-up mechanisms for ensuring fulfillment of the rights of indigenous peoples, which are indicated in the following tables.

Taking as its framework the United Nations Declaration on the Rights of Indigenous Peoples and ILO Convention 169, the Montevideo Consensus on Population and Development includes five specific priority measures, namely: to integrate the demographic dynamics of indigenous peoples into policies (priority measure 86); to guarantee the right to health (priority measure 87), including sexual and reproductive rights; to eradicate violence (priority measure 89); to guarantee the right to information and communication (priority measure); and to guarantee participation by indigenous peoples in the official delegations to regional and international forums dealing with population and development matters (priority measure 91). Although this chapter emphasizes the collective rights of indigenous peoples, in all cases, implementation of these measures entails the articulation of individual and collective rights, identifying and taking into account the specific needs of women, children and young people, older persons and those with disabilities among the indigenous population. Synergies must be established with specific mechanisms of follow-up to the rights of indigenous peoples (pooling efforts and contributing from the region to these global processes), and joint follow-up pursued together with other forums and counterpart bodies, such as UNFPA, PAHO, and UNICEF.

Priority measure 85

Respect and implement the provisions of the United Nations Declaration on the Rights of Indigenous Peoples, as well as Convention No. 169 of the International Labour Organization on indigenous and tribal peoples —and call on those countries that have not already done so to sign it and ratify it— adapting legal frameworks and formulating the policies necessary for their implementation, with the full participation of these peoples, including indigenous peoples that live in cities.

Related instruments, forums and mechanisms

There are three mechanisms within the United Nations system that monitor the rights of indigenous peoples. These are the United Nations Permanent Forum on Indigenous Issues, the Special Rapporteur on the rights of indigenous peoples, and the Expert Mechanism on the Rights of Indigenous Peoples (the latter two established under the auspices of the Human Rights Council).

ILO has a system for overseeing the conventions ratified by the States, in order to ensure that States fulfil the respective provisions, which are binding in nature. Convention 169 has been ratified by 14 Latin American countries.

In addition, the outcome of the high-level plenary meeting of the General Assembly known as the World Conference on Indigenous Peoples, held in New York, in September 2014, in which States reaffirmed their commitments to the provisions of the Declaration and Convention 169. Article 31 of that document declares: “We request the Secretary-General, in consultation and cooperation with indigenous peoples, the Inter-Agency Support Group on Indigenous Peoples’ Issues and Member States, to begin the development, within existing resources, of a system-wide action plan to ensure a coherent approach to achieving the ends of the Declaration and to report to the General Assembly at its seventieth session, through the Economic and Social Council, on progress made. We invite the Secretary-General to accord, by the end of the seventieth session of the Assembly, an existing senior official of the United Nations system, with access to the highest levels of decision-making within the system, responsibility for coordinating the action plan, raising awareness of the rights of indigenous peoples at the highest possible level and increasing the coherence of the activities of the system in this regard.” This senior official has been appointed and is currently working on an action plan.

Lastly, it is important to consider the Alta Outcome Document from the Global Indigenous Preparatory Conference for the United Nations World Conference on Indigenous Peoples (held in Alta, Norway June 2013), representing the outcome of a global consultation process involving representatives of the indigenous peoples and nations of the seven global geopolitical regions, and which includes recommendations for the World Conference on Indigenous Peoples.

Comments

This priority measure covers all the dimensions of political, social, economic, social and cultural rights of indigenous peoples, a diversity of spheres that far exceeds the scope of monitoring under the Montevideo Consensus on Population and Development. Nevertheless, some objectives contained both in the Declaration and in Convention 169 are addressed specifically in this chapter, and in a cross-cutting manner throughout this guide. It is important, then, to note:

̶ The recognition of free determination for indigenous peoples goes hand-in-hand with growing demands for autonomy, and consequently States must respect the self-government institutions and systems of indigenous peoples, by strengthening their political, economic, social, cultural and spiritual institutions, promoting organizational and technical capacities for their internal governance and their relationships to State institutions.

̶ It is necessary to achieve full participation by indigenous peoples in State institutions, overcoming existing limitations such as access to information, economic capacity, and linguistic barriers.

̶ Consultation mechanisms are needed, in accordance with international standards, to obtain the free, prior and informed consent of indigenous peoples. Through consultation, States must reach agreements and decisions that will guarantee the rights of indigenous peoples, seeking mutual understanding and consensus in the adoption of decisions.

̶ Although the Montevideo Consensus on Population and Development focuses on indigenous peoples’ right to health (priority measure 87), attention should also be afforded to their right to education, taking into account intercultural bilingual education; as well as economic rights, especially as regards employment.

Priority measure 86

Consider the special demographic dynamic of indigenous peoples in public policy design, with special emphasis on indigenous peoples threatened with extinction, those who have no contact with the outside world, those living in voluntary isolation or that are in a phase of initial contact, and respect their right to self-determination.

Possible lines of action

1. Generate up-to-date knowledge on indigenous demographic dynamics, addressing the diversity of peoples and their territorial heterogeneity. 2. Incorporate the demographic situation of indigenous peoples into the formulation of policies in a cross-cutting manner. 3. Prioritize the allocation of resources, considering indigenous demographic dynamics. 4. Strengthen institutions with responsibilities for indigenous peoples in order to assist the integration of population matters into policies. 5. Identify situations of demographic and socioenvironmental fragility among indigenous peoples. 6. Design and apply policies to avoid the extinction of indigenous peoples. 7. Implement the United Nations guidelines for the protection of indigenous peoples living in voluntary isolation and initial contact. 8. Strengthen national capacities (of State agencies and of indigenous peoples alike) in population analysis and the interrelations with development. 9. Include population considerations in efforts to strengthen indigenous autonomy. 10. Ensure effective and full participation by indigenous peoples, including women and youth, in all the actions to be taken.

Targets

1. Establish policies take explicit account of up-to-date knowledge of indigenous population dynamics, including situations of demographic and socioenvironmental vulnerability. 2. Reverse all situations in which peoples are threatened with extinction. 3. Duly protect the rights of indigenous peoples living in voluntary isolation and in initial contact. 4. Explicitly integrate indigenous peoples’ affairs into policies, with full participation by those peoples and in accordance with the standards of international law.

Tentative indicators

1. Percentage of the public budget targeting indigenous peoples, by sector. 2. Number of indigenous peoples or communities at risk of extinction. 3. Existence of policies to integrate considerations relating to indigenous peoples into development plans, in accordance with legal standards concerning indigenous peoples. 4. Existence of policies that consider the situation of indigenous peoples living in voluntary isolation or in initial contact. 5. Existence of procedures of prior consultation with indigenous peoples and established forums for dialogue that include population questions, in accordance with international standards.

Related instruments, forums and mechanisms

It is important to establish coordination with the specific follow-up mechanisms for implementation of the rights of indigenous peoples (see priority measure 85).

Comments

This measure requires that the actions undertaken be articulated with those established under priority measure 4 on the integration of population dynamics into policies and programmes. The rationale for indicator 1 is that if governments do not allocate sufficient budgetary resources to indigenous matters by sector, it will be difficult to integrate population dynamics into policies. With respect to peoples at risk of extinction, the idea is to identify those peoples or subgroups that face extreme threats to their physical and cultural survival, from either internal or external factors, and whose population is shrinking.

Priority measure 87

Guarantee indigenous peoples’ right to health, including sexual rights and reproductive rights, and their right to their own traditional medicines and health practices, especially as regards reducing maternal and child mortality considering their socio-territorial and cultural specificities as well as the structural factors that hinder the exercise of this right.

Possible lines of action

1. Promulgate specific national legislation on the right of indigenous peoples to health, including sexual and reproductive health, and prepare regulations, standards and protocols for its application. 2. Develop intercultural health policies and programmes that include sexual and reproductive health, through negotiation of agreements, consensuses and mutual understandings, and a genuine recognition of the know-how, languages, world view and health concepts of indigenous peoples, in particular of women, adolescents and youth. 3. Promote and strengthen traditional indigenous medicine, considering each of its components: traditional indigenous agents or therapists, traditional knowledge, and natural resources. 4. Conduct comprehensive evaluations of traditional medicine, identifying the elements that make it effective and therapeutic, and complementing the empirical set of practices with symbolic and cultural dimensions. 5. Strengthen the production of information and knowledge on health problems that affect indigenous peoples, considering the indigenous world-view and using participatory processes. 6. Boost national capacities, both of State agencies and of indigenous organizations, for applying and managing intercultural and linguistically relevant health care. 7. Strengthen processes for the empowerment of indigenous women, which are crucial for their free determination.

Targets

1. By 2030, end maternal morbidity and mortality among indigenous women from preventable causes, and ensure that the levels of maternal mortality among these women do not exceed those for other women (adapted from target 3.1 of the Sustainable Development Goals). 2. By 2030, guarantee universal access for indigenous women and peoples to sexual and reproductive health services, consistent with their individual and collective rights (adapted from target 3.7 of the Sustainable Development Goals). 3. By 2030, end preventable deaths of indigenous newborns and under-five children, and ensure that the levels of infant and child mortality do not exceed those for other boys and girls (adapted from target 3.2 of the Sustainable Development Goals). 4. Increase life expectancy at birth and health-adjusted life expectancy (HALE) for indigenous peoples, eliminating the gap with the rest of the population. 5. Duly implement models of intercultural health care, in accordance with the requirements of indigenous peoples. 6. Strengthen traditional indigenous medicine.

Tentative indicators

1. Maternal mortality rate for indigenous women (Sustainable Development Goals in general). 2. Child mortality rate (under age five) among indigenous peoples (Sustainable Development Goals in general). 3. Life expectancy at birth and healthy life expectancy at birth among indigenous peoples. 4. Percentage of indigenous women attended at childbirth by intercultural health personnel. 5. Existence of intercultural sexual and reproductive health services, including preventative measures and culturally and linguistically relevant information. 6. Traditional indigenous practices accepted and well integrated into the national health system. 7. Degree of participation of indigenous peoples in health-care management, disaggregated by sex. 8. Percentage of indigenous communities managing health care in their territories, disaggregated by sex. 9. Existence of health information systems capable of capturing morbidity and mortality profiles among indigenous peoples, including sexually transmitted infections, disaggregated by sex and age group.

Related instruments, forums and mechanisms

Permanent Forum on Indigenous Issues, Special Rapporteur on the rights of indigenous peoples and the Expert Mechanism on the Rights of Indigenous Peoples (see priority measure 85).

The World Conference on Indigenous Peoples and its outcome, which declares specifically: “12. We recognize the importance of indigenous peoples’ health practices and their traditional medicine and knowledge”, and “13. We commit ourselves to ensuring that indigenous individuals have equal access to the highest attainable standard of physical and mental health. We also commit ourselves to intensifying efforts to reduce rates of HIV and AIDS, malaria, tuberculosis and non-communicable diseases by focusing on prevention, including through appropriate programmes, policies and resources for indigenous individuals, and to ensure their access to sexual and reproductive health and reproductive rights in accordance with the Programme of Action of the International Conference on Population and Development, the Beijing Platform for Action and the outcome documents of their review conference.”

Monitoring of the Sustainable Development Goals must take into account the particular situation of indigenous persons, pursuant to Goal 3.

Comments

This priority measure is complementary to the targets and indicators included in priority measure 26 on bringing health policies into line with the epidemiological profile, and with chapter D (“Universal access to sexual and reproductive health services”), especially priority measures 37, 40, 44 and 45, in which the particular situation of indigenous women and peoples must be taken into account. Some of the indicators proposed need to be made operational and may entail developing instruments for their measurement.

Priority measure 88

Respect and guarantee the territorial rights of indigenous peoples, including those of peoples living in voluntary isolation and those in the initial phase of contact, with special attention to the challenges presented by extractive industries and other major global investments, mobility and forced displacements, and design policies that facilitate free, prior and informed consultation on matters that affect these peoples, pursuant to the provisions of the United Nations Declaration on the Rights of Indigenous Peoples.

Related instruments, forums and mechanisms

This measure implies a broad spectrum of actions that are key to the life and survival of indigenous peoples and that are highlighted in the United Nations Declaration on the Rights of Indigenous Peoples and in ILO Convention 169, and are monitored by the specific mechanisms described in priority measure 85. In addition, the World Conference on Indigenous Peoples established commitments and agreements that are being implemented in the Plan of Action. However, some dimensions of territorial rights are addressed in other chapters of the Montevideo Consensus on Population and Development. For that reason, it is essential to follow the international guidelines regarding the State’s duty of consultation and its obligation to guarantee procedures for free, prior and informed consent of indigenous peoples (see priority measure 85).

Comments

The priority measures included in chapter G on territory inequality, spatial mobility and vulnerability must give special attention to the particular situation of indigenous peoples, considering in particular: (i) the boundaries of indigenous territories, regardless of their status; (ii) the impact of extractive industries on indigenous population dynamics (forced displacement, violence in the territories, and migration driven by environmental deterioration, among others); and (iii) implementation of measures that transcend the urban-rural divide with respect to the collective rights of indigenous peoples, and in particular the situation of indigenous people living in cities.

The implementation of priority measure 83 on natural resources must take explicit account of the territorial rights of indigenous peoples, which encompass the land, the territory and control of natural resources. Indigenous peoples must also be explicitly included in priority measure 77 on development and well-being in all territories, priority measure 81 on territorial and urban planning, and priority measure 84 on the use of georeferenced information (which is complementary to priority measure 90).

With respect to international migration, fulfillment of priority measure 71 on dialogue and international cooperation requires special measures to establish agreements among adjacent countries for the free circulation of indigenous peoples through ancestral territories that were fragmented by the establishment of boundaries imposed by States.

All the above considerations regarding territorial rights (including land ownership and control of natural resources), migrations and displacements, demographic impacts of extractive industries and city-dwelling indigenous people, should capture the particular situation of indigenous women, children, young persons, older persons and persons with disabilities.

Priority measure 89

Adopt, in conjunction with indigenous peoples, the measures needed to ensure that indigenous women, boys, girls, adolescents and young people enjoy protection from and full guarantees against all forms of violence and discrimination, and take measures to ensure the restitution of rights.

Related instruments, forums and mechanisms

This matter is covered by the instruments on minimum standards of rights of indigenous peoples (United Nations Declaration on the Rights of Indigenous Peoples and ILO Convention 169), for which specialized mechanisms exist as described under priority measure 85.

In the outcome of the World Conference on Indigenous Peoples, States undertook to intensify their efforts, “in cooperation with indigenous peoples, to prevent and eliminate all forms of violence and discrimination against indigenous peoples and individuals, in particular women, children, youth, older persons and persons with disabilities, by strengthening legal, policy and institutional frameworks” (article 18), for which purpose a plan of action is being prepared.

At the national level, this topic is covered in part by the Regional Conference on Women in Latin America and the Caribbean: article 80 of the Santo Domingo Consensus makes explicit mention of indigenous women.

Notwithstanding the foregoing, the following priority measures explicitly include the particular situation of indigenous persons: priority measure 16 on guaranteeing a life free from violence for boys, girls, adolescents and young people; priority measures 22 and 23 (chapter C on ageing), the first calling for eradication of all forms of discrimination that affect older persons, including all forms of violence, and the second dealing with the establishment of programmes to tackle violence against older persons in the public and private spheres, and the priority measures of chapter E on gender equality —measures 56, 57, 58 and 65—, which call for various actions to eradicate all forms of violence against women.

Comments

The design of actions must take into account: (i) the conceptualization of violence from the perspective of indigenous women, including such concepts as structural violence, spiritual violence, violence against Mother Earth, and healing processes; (ii) the formulation of diagnostic studies and programmes defined by indigenous women and peoples, incorporating indigenous girls, boys and young people, and work with the ancestral and traditional community authorities; (iii) the processes of empowering indigenous women, who are central to addressing situations of violence, preserving practices and beliefs that they deem positive, and challenging those they consider harmful; and (vi) the intersection between individual rights and collective rights, and indigenous and State justice systems, and the construction of legal pluralism.

Priority measure 90

Guarantee indigenous peoples’ right to communication and information, ensuring that national statistics respect the principle of self-identification, as well as the generation of knowledge and reliable and timely information on indigenous peoples through participatory processes, with reference to their requirements and international recommendations relating to these issues.

Possible lines of action

1. Adapt national legislation for the inclusion of indigenous peoples in the entire national statistics system, including the institutional arrangements needed to guarantee indigenous full and effective participation throughout the process of generating information. 2. Include questions to identify indigenous peoples in statistical data sources, in a consistent and comparable manner, respecting the principle of self-identification and, to the extent possible, supplementing it with other variables such as language. 3. Enhance the integrity, quality and timeliness of sociodemographic information on indigenous peoples. In the case of surveys, revise the sampling schemes. 4. Move forward with the cultural adaptation of statistical instruments and procedures as required for each stage in the production of information. 5. Promote discussion sessions for defining a set of agreed well-being indicators that meet the requirements of indigenous peoples, accompanied by the design of tools for collecting and producing that information. 6. Strengthen the technical capacities of indigenous peoples to access and make active use of the available information and to assess its impact on policies, and broaden the knowledge of State officials regarding their duties with respect to producing information and the importance of participation and cultural relevance for improving data quality and validity. 7. Work jointly with indigenous peoples and statistics institutes to evaluate progress and obstacles in these matters, in order to define strategies consistent with the nature of each data source.

Targets

1. Have in place institutionalized legal frameworks and participatory mechanisms for producing information on indigenous peoples. 2. Include questions for identifying indigenous peoples in all data sources for the national statistics system, to be recorded fully and with standards of quality that support disaggregation of information on population and development. 3. Make available culturally relevant indicators, consistent with the requirements of indigenous peoples, together with the tools for collecting and producing information. 4. Disaggregate the sectoral information published by statistics offices by indigenous people, with a generational and gender focus, among others. 5. Guarantee indigenous women and peoples access to linguistically relevant information.

Tentative indicators

1. Percentage of relevant data sources that include indigenous identification, including censuses, surveys and administrative records in the different sectors (target 100%). 2. Coverage and response rates for the variables on indigenous peoples, by data source. 3. Degree of inclusion of indigenous peoples in the tabulation and analysis of public information. 4. Existence of mechanisms that guarantee full participation by indigenous peoples in statistics production. 5. Number of indigenous experts (male and female) working on information production and analysis in government offices. 6. Existence of culturally and linguistically relevant information systems. 7. Existence of information systems on indigenous peoples validated by the official system.

Related instruments, forums and mechanisms

The Permanent Forum on Indigenous Issues, the Special Rapporteur on the rights of indigenous peoples, the Expert Mechanism on the Rights of Indigenous Peoples, and the Statistical Conference of the Americas of ECLAC.

The implementation and follow-up mechanism of the World Conference on Indigenous Peoples states that: “We commit ourselves to working with indigenous peoples to disaggregate data, as appropriate, or conduct surveys and to utilizing holistic indicators of indigenous peoples’ well-being to address the situation and needs of indigenous peoples and individuals, in particular older persons, women, youth, children and persons with disabilities” (article 10).

Sustainable Development Goals, target 17.18 on the availability of timely data disaggregated by ethnicity, among other factors.

Comments

This priority measure complements priority measure 17 on the disaggregation of data for adolescents and young people, and priority measure 84 on the use of georeferenced information. Indicators should also be disaggregated by sex. The recommendations on data disaggregation made by the Permanent Forum on Indigenous Issues, the Latin American and Caribbean Demographic Centre (CELADE)-Population Division of ECLAC, and the United Nations human rights mechanisms should be reviewed in this regard.

The right to communication implies a series of differentiated actions with respect to the right of access to information and statistics systems, the monitoring of which for indigenous peoples should be explicitly integrated into the Conference on Science, Innovation and Information and Communications Technologies of ECLAC. It is also being monitored within the framework of the United Nations Declaration on the Rights of Indigenous Peoples.

Priority measure 91

Participate actively and at the highest possible level, with provision for the inclusion of indigenous peoples in national delegations, in the United Nations General Assembly high-level meeting entitled the World Conference on Indigenous Peoples, to be held in September 2014, as well as in other relevant international forums.

Comments

The World Conference on Indigenous Peoples was held in 2014; accordingly, this measure seeks to establish some guidelines to guarantee that the indigenous peoples of Latin America and the Caribbean participate in the official delegations to international and regional forums on population and development. From this perspective, some possible lines of action are: (i) create a participatory mechanism for indigenous peoples for implementing the Montevideo Consensus on Population and Development; (ii) encourage and ensure that indigenous peoples’ representatives participate in meetings of the Regional Conference on Population and Development in Latin America and the Caribbean; and (iii) promote and ensure the participation of indigenous peoples in the follow-up meetings to the International Conference on Population and Development.

I. AFRO-DESCENDANTS: RIGHTS AND COMBATING RACIAL DISCRIMINATION

Latin America has a sizeable population of African descent, estimated in 2010 at more than 120 million. That population exhibits a high degree of demographic and sociopolitical heterogeneity between and even within countries of the region. In addition to their shared origins, culture and identity, persons of African descent face a series of social problems, which have been characterized by historical situations of slavery, colonization, discrimination and exclusion, as was recognized at the Third World Conference against Racism, Racial Discrimination, Xenophobia and Related Intolerance, convened by the United Nations in Durban, South Africa, in 2001. Although the information is fragmentary, the inequalities observed in indicators of living conditions, to the disadvantage of Afro-descendent populations, constitute an expression of discrimination and structural racism, as does the lack of visibility of these persons in policies and programmes.

The United Nations General Assembly has proclaimed the years 2015-2024 as the International Decade for People of African Descent, citing the need to strengthen national, regional and international cooperation so as to engender the full enjoyment of economic, social and cultural rights as well as civil and political rights for persons of African descent, and their full and equal participation in all aspects of society. Hence the importance of their inclusion in the Montevideo Consensus on Population and Development. Although the Cairo Programme of Action did not explicitly include the situation of Afro-descendants, the regional five-year reviews of the Programme of Action have increasingly done so.

This chapter contains seven priority measures. Priority measure 92 calls for respecting and implementing the provisions of the Durban Declaration and Programme of Action, which covers all the dimensions of political, civil, economic, social and cultural rights of Afro-descendent persons. Priority measure 93, on addressing ethnic and racial inequalities in conjunction with other factors, entails a broad range of actions, and consequently this guide will deal with the more specific ones under priority measures 94, 95, 96, 97 and 98. It is also important that the remaining priority measures operationalized in this guide should be viewed in light of the particular situation of persons of African descent.

In addition to the specific mechanisms for follow-up and implementation of the rights of persons of African descent, action must be articulated with other forums and counterpart bodies such as UNFPA, PAHO and UNICEF. Priority measure 98 on generating knowledge and up-to-date disaggregated information is essential for the design and application of policies relating to population and development and to persons of African descent, as well as for promoting and monitoring the implementation of rights. In this respect, joint follow-up with the Statistical Conference of the Americas of ECLAC and the agencies of the United Nations system is essential.

Priority measure 92

Respect and implement the provisions of the Durban Declaration and Programme of Action adopted at the World Conference against Racism, Racial Discrimination, Xenophobia and Related Intolerance, by adapting the legal frameworks and formulating the policies necessary for their implementation, with the full participation of Afro-descendent persons.

Related instruments, forums and mechanisms

The main mechanisms of follow-up on these matters within the United Nations system are: (i) the Committee on the Elimination of Racial Discrimination; (ii) the Working Group of Experts on People of African Descent; (iii) the Special Rapporteur on contemporary forms of racism, racial discrimination, xenophobia and related intolerance.

Comments

This measure covers all the dimensions of political, civil, economic, social and cultural rights of persons of African descent, a diversity of spheres that transcends their monitoring under the mechanism of the Montevideo Consensus on Population and Development.

The Durban Declaration and Programme of Action call for concerted measures to combat racism in all its manifestations: these include strengthening education, ending poverty, guaranteeing development, improving the available means and resources for victims of racism, and fostering respect for human rights.

Some of the objectives contained in the Durban Programme of Action are addressed specifically in this chapter, and in a cross-cutting manner throughout this guide.

Priority measure 93

Address gender, racial, ethnic and intergenerational inequalities, bearing in mind the way these dimensions overlap in situations of discrimination affecting women, especially young Afro-descendent women.

Comments

This measure implies a broad range of actions. The race-specific inequalities that affect persons of African descent overlap with gender and generational inequalities, and these are explicitly incorporated into priority measures 94, 95, 96 and 98, as described below.

The remaining priority measures covered in this guide must also be viewed in light of the particular situation of persons of African descent. In particular, the overlapping of inequalities is explicitly included in: priority measure 17 on data disaggregation for adolescents and young people; priority measure 22 on eradicating the multiple forms of discrimination against older persons; and the priority measures of chapter E on gender equality, in particular priority measure 50 on promoting and ensuring the mainstreaming of the gender and racial perspectives; priority measure 54 on gender equality in employment and the elimination of discrimination; and priority measures 57 and 58, which call for actions to eradicate all forms of discrimination and violence, combining the gender, generational and ethnic perspectives.

Priority measure 94

Consider the special demographic and sociocultural dynamics of Afro-descendent populations in the design and implementation of public policies, ensuring their full participation and the development of disaggregated statistics.

Possible lines of action

1. Generate up-to-date knowledge on the demographic dynamics of the Afro-descendent population, taking into account social and territorial diversity, with a gender and generational perspective. 2. Integrate the demographic situation of persons of African descent in a cross-cutting manner into the design of policies. 3. Prioritize the allocation of resources in light of Afro-descendent demographic dynamics. 4. Strengthen the institutions responsible for Afro-descendent affairs so as to contribute to the mainstreaming of population issues in policies. 5. Strengthen national capacities (both of State agencies and of Afro-descendent organizations) in population analysis and its inter-relations with development. 6. Establish participatory mechanisms for Afro-descendent populations in the production and analysis of sociodemographic information, in particular within national statistics systems.

Targets

1. Formulate policies that explicitly include up-to-date knowledge of Afro-descendent population dynamics. 2. Create an institutional mechanism for mainstreaming Afro-descendent matters in policies, consistent with the standards of international law, and guaranteeing participation by persons of African descent. 3. Implement the Montevideo Consensus on Population and Development, taking explicit account of the situation of persons of African descent, and combating racism and discrimination.

Tentative indicators

1. Percentage of the public budget earmarked for affirmative action policies for persons of African descent, by sector. 2. Existence of a policy for integrating Afro-descendent issues into development plans (if there is a national population policy, it should explicitly include the situation of Afro-descendent persons). 3. Existence of mechanisms to guarantee full participation in this process for persons of African descent. 4. Existence of specialized diagnostic reviews on the demographic and socioeconomic situation of the Afro-descendent population.

Related instruments, forums and mechanisms

There is a need to establish coordination with the specific mechanisms for follow-up to implementation of the Durban Programme of Action (see priority measure 92).

Comments

This measure requires that the actions taken should be articulated with those set forth under priority measure 4.

Priority measure 95

Ensure that Afro-descendent persons, in particular Afro-descendent girls, adolescents and women, can exercise the right to health, especially the right to sexual health and reproductive health, taking into account the specific socioterritorial and cultural features and the structural factors, such as racism, that hinder the exercise of their rights.

Possible lines of action

1. Prepare laws, policies and programmes of affirmative action for furthering the exercise of sexual and reproductive rights for men and women of African descent. 2. Create and strengthen mechanisms for enforceability and evaluate the implementation of public policies and health standards that take account of the particular situation of persons of African descent. 3. Strengthen the generation of information and knowledge on problems that affect the health of persons of African descent, in particular their sexual and reproductive health, and upgrade the capacities of researchers to apply the rights, gender and generational perspectives. 4. Boost operational capacities for addressing the health of persons of African descent, in particular those relating to sexual and reproductive health. 5. Promote the empowerment of women of African descent, which is necessary for addressing sexual and reproductive health issues.

Targets

1. By 2030, end maternal morbidity and mortality from preventable causes among women of African descent, and ensure that the levels of maternal mortality among these women do not exceed those for other women (adapted from target 3.1 of the Sustainable Development Goals). 2. By 2030, guarantee universal access for women of African descent to timely and high-quality sexual and reproductive health services, with an intercultural perspective (adapted from target 3.7 of the Sustainable Development Goals). 3. By 2030, end preventable deaths of newborns and children under age five of African descent, and ensure that their levels of infant and child mortality do not exceed those for other boys and girls (adapted from target 3.2 of the Sustainable Development Goals). 4. Increase life expectancy at birth for persons of African descent, eliminating the gap with the rest of the population. 5. Ensure that health information systems are available for monitoring the right to health for persons of African descent, and support disaggregation by sex, age group and geographical area.

Tentative indicators

1. Maternal mortality rate for women of African descent. 2. Infant and child mortality rate for children of African descent. 3. Life expectancy at birth and healthy life expectancy at birth for the Afro-descendent population. 4. Percentage of women of African descent attended at delivery by skilled personnel. 5. Satisfied demand of persons of African descent for family planning services, by type of method (modern and traditional). 6. Existence of morbidity and mortality profiles for persons of African descent, disaggregated by sex and age group. 7. Existence of intercultural sexual and reproductive health services, including preventative measures and culturally relevant information, in accordance with the needs of men and women of African descent. 8. Existence of health information systems that that include the self-identification of persons of African descent, with timely and quality data.

Related instruments, forums and mechanisms

Specific mechanisms, at least to those mentioned in priority measure 92.

The follow-up to the Sustainable Development Goals must pay particular attention to the situation of persons of African descent, under Goal 3.

Comments

This priority measure complements the targets and indicators included in priority measure 26 on bringing health policies into line with epidemiological profiles, and those included in chapter D, which must be viewed in light of the particular situation of women of African descent, in particular priority measures 37, 40, 44 and 45.

Priority measure 96

Promote the development of Afro-descendent populations by implementing public policies, establishing standards and creating institutions to guide and carry forward affirmative action policies, plans and programmes at the sectoral level, whereby the principles of equality and non-discrimination can be incorporated into all levels of government, with organized civil society participating throughout the process of design, implementation and evaluation of those instruments.

Possible lines of action

1. Prepare laws, policies and programmes of affirmative action to further the exercise of the rights of persons of African descent, with an ethno-racial, gender and generational perspective. 2. Include the situation of persons of African descent explicitly in sectoral policies, particularly those directed towards ensuring the right to health care, employment and education. 3. Establish an institutional mechanism with specific responsibility for Afro-descendent affairs or, if one already exists, strengthen it, so as to articulate and coordinate implementation of the Montevideo Consensus on Population and Development together with that mechanism. 4. Create mechanisms to guarantee full and effective participation by Afro-descendent organizations in development policies and affirmative action. 5. Generate up-to-date knowledge on situations of discrimination and racism that affect persons of African descent. 6. Prepare and implement communication programmes and strategies to combat racism and ethno-racial discrimination. 7. Educate and train public officials, including judges and candidates for judicial positions, in ways and means to combat ethno-racial discrimination. 8. Establish accessible mechanisms through the courts, the administrative authorities, national human rights institutions and/or public defenders’ offices to handle complaints of racial discrimination.

Targets

1. Have in place affirmative action policies, with adequate financial resources, for the purpose of achieving equality and non-discrimination. 2. Significantly improve the living conditions of persons of African descent, and reduce their inequality with respect to the rest of the population. 3. End racial discrimination.

Tentative indicators

Multidimensional poverty index of persons of African descent and gap with respect to the rest of the population. 2. Percentage of the public budget earmarked for affirmative action policies for persons of African descent and percentage allocated to a governing institution on Afro-descendent affairs. 3. Percentage of persons of African descent who report having suffered racial discrimination. 4. Percentage of the population that considers that persons of African descent are discriminated against as a group. 5. Existence of policies to combat racism and ethnic and racial discrimination, designed with effective participation by the Afro-descendent population. 6. Inclusion of persons of African descent in sectoral policies, plans and programmes. 7. Existence of mechanisms for Afro-descendent participation in public policy design.

Related instruments, forums and mechanisms

Specific mechanisms, at least those mentioned in priority measure 92.

At the regional level, some aspects are covered by the Santo Domingo Consensus, which makes explicit reference to women, girls, young women and older women of African descent in numerous articles covering various aspects of their rights and their development (articles 7, 30, 34, 35, 38, 40, 42, 62, 73, 74, 98 and 106).

Comments

This measure involves a great number of fields of action, hence the importance of making persons of African descent visible throughout the guide, in the lines of action, targets and disaggregated indicators, and of recognizing the racism and structural discrimination that these persons suffer. In particular, it complements priority measure 77 (on development and well-being in all territories) and priority measure 81 (on territorial and urban planning).

Priority measure 97

Ensure that policies and programmes are in place to raise the living standards of Afro-descendent women, by fully enforcing their rights, in particular their sexual rights and reproductive rights.

Comments

This priority measure is addressed through priority measure 95 on the right to health, including sexual and reproductive health, and priority measure 96 on promoting the development of persons of African descent.

Priority measure 98

Generate knowledge and reliable and timely information with a gender perspective and disaggregated by sex, age and socioeconomic status, among other variables, on Afro-descendent populations through participatory processes, paying attention to the international requirements and recommendations relating to the issue.

Possible lines of action

1. Adapt national legislation for the inclusion of persons of African descent in the national statistics system as a whole, including the establishment of the institutional arrangements needed to guarantee this population’s full and effective participation throughout the process of generating information. 2. Include questions to identify persons of African descent in statistical data sources, in a consistent and comparable manner, respecting the principle of self-identification. 3. Promote discussion sessions for defining a set of agreed indicators that reveal the discrimination and racism suffered by these population groups. 4. Strengthen the technical capacities of persons of African descent to access and make active use of the available information and to assess its impact on policies, and broaden the knowledge of State officials regarding their duties with respect to producing information and the importance of participation and the inclusion of the ethno-racial perspective. 5. Work jointly with persons of African descent and statistics institutes to evaluate progress and obstacles in these matters, in order to define strategies consistent with the nature of each data source.

Targets

1. Have in place laws, policies and institutionalized, participatory mechanisms for producing information on persons of African descent. 2. Ensure that all data sources for the national statistics system include questions for ethno-racial self-identification, recorded fully and with standards of quality that allow disaggregation of the information. 3. Have available a set of indicators on racism and discrimination, consistent with the requirements of persons of African descent, together with the tools for collecting and producing information. 4. Disseminate the sectoral information published by statistics offices, disaggregated for persons of African descent, as well as for other relevant factors such as age and sex.

Tentative indicators

1. Percentage of relevant data sources that includes the self-identification of persons of African descent, including censuses, surveys and administrative records in the different sectors (target 100%). 2. Coverage and response rates for the ethno-racial variable, by data source. 3. Degree of inclusion of persons of African descent in the tabulation and analysis of public information. 4. Number of Afro-descendent experts (male and female) working on information production and analysis in government offices. 5. Existence of mechanisms that guarantee full participation by persons of African descent in official statistics production. 6. Availability of timely and good-quality information on population and development, disaggregated by racial descent.

Related instruments, forums and mechanisms

United Nations Working Group of Experts on People of African Descent; the follow-up mechanisms for the Durban Declaration and Programme of Action; the Statistical Conference of the Americas of ECLAC; and target 17.18 of the Sustainable Development Goals, concerning the availability, by 2020, of high-quality, timely and reliable data disaggregated by race and ethnicity.

Comments

This priority measure complements priority measure 17 on the disaggregation of data for adolescents and young people, and priority measure 84 on the use of georeferenced information. The recommendations on the inclusion of persons of African descent in the data sources of the Latin American and Caribbean Demographic Centre (CELADE)-Population Division of ECLAC and the recommendations of the United Nations human rights mechanisms should be reviewed in this regard.

[1] All references to the Sustainable Development Goals (SDGs) and their targets, and citations thereof, in this Operational guide correspond to the proposal contained in the Report of the Open Working Group of the General Assembly on Sustainable Development Goals.

[2] Strictly speaking, the international definition included in the Convention on the Rights of the Child defines children as persons under 18 years of age, but there are no projections by simple age available for constituting the groups 0-18.

[3] For further details, see [online] http://esa.un.org/unpd/wpp/Excel-Data/population.htm.

[4] Adopted by the General Assembly in resolution 44/25, of 20 November 1989; entered into effect on 2 September 1990.

[5] In particular, chapter VI. “Population growth and structure”, section B “Children and youth” and, in relation to reproductive rights and health, chapter VII, “Reproductive rights and reproductive health”, section E on adolescents.

[6] See ILO, “Ageing societies: The benefits, and the costs, of living longer”” [online] http://www.ilo.org/

global/publications/magazines-and-journals/world-of-work-magazine/articles/WCM_041965/lang--en/index.htm.

[7] See Council of the European Union [online] http://ec.europa.eu/health/ageing/docs/ev_20140618_co04_en.pdf.

[8] See Resolution AG/RES. 2455 (XXXIX-O/09) of the forty-fifth regular session of the General Assembly of OAS.

[9] The will and concern of governments to establish an international treaty on the protection of the human rights of older persons was first formally expressed in the Brasilia Declaration, adopted at the second Regional Intergovernmental Conference on Ageing in Latin America and the Caribbean, organized by ECLAC in 2007. Today, after three years of work, the region of the Americas is the first in the world to have enshrined the rights and freedoms of older persons in a single binding instrument.

[10] See chapter VI, “Population Growth and Structure”, section C on elderly people.

[11] See chapter II “Population and Development Concerns”, section B on changing age structure and ageing of the population.

[12] In this regard, priority measure 34 is to “Promote policies that enable persons to exercise their sexual rights, which embrace the right to a safe and full sex life, as well as the right to take free, informed, voluntary and responsible decisions on their sexuality, sexual orientation and gender identity, without coercion, discrimination or violence, and that guarantee the right to information and the means necessary for their sexual health and reproductive health”.

[13] Paragraph 7.3 in the basis for action on reproductive rights and reproductive health indicates that: “Reproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other consensus documents. These rights rest on the recognition of the basic right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes their right to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights documents. In the exercise of this right, they should take into account the needs of their living and future children and their responsibilities towards the community.”

[14] These instruments have a cumulative effect for the region, in that each new consensus recognizes the political and programmatic value of those adopted at earlier sessions of the Regional Conference on Women in Latin American and the Caribbean.

[15] For further details, see the document prepared by ECLAC, Guaranteeing indigenous peoples’ rights in Latin America: progress in the last decade and remaining challenges (LC/L.3902), Santiago, 2014, the regional contribution to the World Conference on Indigenous Peoples.

Table of Contents

Scope of the operational guide

I. Background

II. Frameworks for implementing the regional agenda on population and development

III. Making operational the priority measures of the montevideo consensus on population and development

A. Full integration of population dynamics into sustainable development with equality and respect for human rights

B. Rights, needs, responsibilities and requirements of girls, boys, adolescents and youth

C. Ageing, social protection and socioeconomic challenges

D. Universal access to sexual and reproductive health services

E. Gender equality

F. International migration and protection of the human rights of all migrants

G. Territorial inequality, spatial mobility and vulnerability

H. Indigenous peoples: interculturalism and rights

I. Afro-descendants: rights and combating racial discrimination