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Environmental Scan. Caribbean. Modalities of Delivery. Progress made on ICPD . Stabilization of Population growth – CPR varies Commitment to adult SRH - Unmet need for FP varies Maternal Mortality decreased Progress in Women’s education, participation - 2 female Prime Ministers

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Modalities of delivery
Modalities of Delivery

Progress made on ICPD

  • Stabilization of Population growth – CPR varies

  • Commitment to adult SRH - Unmet need for FP varies

  • Maternal Mortality decreased

  • Progress in Women’s education, participation - 2 female Prime Ministers

  • Census conducted in most countries

  • Signatories to conventions, proud of leadership in NCDs , gender, and youth.

Lags in achieving the PoA

  • Maternal Mortality:

  • Stagnated over past several years in several countries

  • Related to quality of care, scarce human resources (esp. midwives and nurses), NCDs, monitoring systems.

  • Cultural and social factors

Universal Access to Sexual and Reproductive Health

  • Legal and cultural barriers to access to SRH services for persons below the age of 18

  • Absence of youth-friendly services

  • Resistance to sexuality education in schools

  • High stigma, discrimination and even violence against LGBT community, and lack of access to services

  • HIV prevalence high


  • High proportion of births (about 20%) to teen mothers

  • Mis-match between laws on age of sexual consent (16 years) and maturity for access to contraception and HIV testing (18 years)

  • Pregnant girls and teen mothers drop out of education system – policy results in continuing cycle of lack of opportunity and exclusion

  • Little support from “baby fathers” , and family

  • Some good examples, but contradictions make effective implementation difficult

  • “Choice”? Planned?

  • Need for comprehensive policy

Gender Equality

  • Violence and citizen security major concerns

  • Violence against women, especially sexual violence, very high - between 3 and 8 times global average

  • Concerns around self-image, opportunities and mental health of young men, expressed as domestic violence/violence against women

  • Cultural norms see male violence as justified and “sign he cares”

Data and evidence

  • Limited national and sub-regional capacity for data collection, analysis, use

  • Insufficient inter-censal data collection

  • Lack of trust makes collection of data difficult

  • Lack of evidence –based planning

  • Insufficient attention to linking different sectors for a holistic understanding of issues, and the development of multi-sectoral solutions.

Favourable Trends

  • Reviews of legislation, policies in several countries

  • Willingness to draft new policies on population, SRH, gender, youth, migration

  • Debate and dialogues on difficult issues now in public space – eg MSM

  • Re-vitalisation of sub-regional mechanisms, CARICOM

  • Willingness to reach out to communities, young people, use social media,

Favourable Trends

  • Good examples of what does work, good practice (SRH and disability, teens , youth parliament and YAGs)

  • Effective engagement of key stake-holders –eg FB leaders, parliamentarians

  • Renewed emphasis on Family Planning - focus on sexual decision-making, especially for adolescents

  • Strong Political Commitment , including from highest levels, following visit of ED

Risk-factors to Progress

  • Legislative and policy barriers

  • Cultural , religious beliefs and leadership

  • Popular conceptions of sexuality

  • Capacity gaps – small size, migration

  • Planning gap – including cross-sectoral

  • Resource gaps – especially linked to Middle-Income status, HIV

  • Lack of investment in health, SRH

  • Lack of equity

Regional Contributions

Sound inputs to policy and legislation reform (analysis, convening inter-sectoral process, working with stakeholders to address religious and cultural factors)

Sound and sustainable resource-mobilization (human and $$)

Maximize impact of high-level commitment through review process, visibility, accountability related to ICPD +20