END DECADE ASSESSMENT OF
WORLD SUMMIT FOR CHILDREN
YEAR 2000 GOALS
NATIONAL REPORT
JAMAICA
Final Report
November, 2000
ACKNOWLEDGEMENTS
The contribution of all those who gave support to the preparation 0of the National Report on End Decade Assessment is gratefully acknowledged.
All organizations and individuals, from both Government and non-government agencies, that provided statistical data and other information, as input into the Report are hereby acknowledged. Of special mention in this regard are the representatives of organizations and interests, that participated in the End Decade Assessment National Review, held in November, 2000.
Special thanks to:
- The National Steering Committee on End Decade Assessment, chaired by Special Envoy for Children, Ambassador Marjorie Taylor;
- The Planning Institute of Jamaica, for technical input and guidance in preparation of the Report;
- The Statistical Institute of Jamaica, for date collection, cleaning and editing, with particular reference to the Multiple Indicators Cluster Survey, and the Jamaica Survey of Living Conditions;
- The United Nations Children’s Fund (UNICEF), for technical input and financial support to the process;
- Mrs. Collette Robinson, for compiling the Report.
NATIONAL REPORT
JAMAICA
END DECADE ASSESSMENT OF
WORLD SUMMIT FOR CHILDREN GOALS
TABLE OF CONTENTS
Acknowledgements1
Table of Contents2
List of Text Tables4
List of Figures4
List of Panels4
List of Acronyms5
THE REPORT:
EXECUTIVE SUMMARY7
SUMMARY OF GOAL ATTAINMENT 11
1.0Introduction and Background26
1.1Introduction
1.2National Context
2.0Process Established for End Decade Review of WSC Goals30
2.1Review Process
2.2Methodology and Data Sources for the Report
3.0Actions taken at Local and International Levels33
3.1Follow-Up Actions
3.2Institutional Framework for Goal Attainment
4.0Specific Actions for Child Survival, Protection
and Development 35
4.1 Health, Nutrition and Environment35
4.1.1Infant Mortality Rate
4.1.2Maternal Mortality Rate
4.1.3Malnutrition
4.1.4Safe water
4.1.5Sanitary excreta disposal
4.1.6Reproductive Health of Women and Girls
4.1.7Low Birth Weight
4.1.8Breastfeeding
4.1.9Growth Promotion
4.1.10Iron deficiency Anemia
4.1.11Food production and security
4.1.12Immunization
4.1.13Diarrhea
4.1.14Acute Respiratory Infection
4.1.15HIV/AIDS
4.1.16Home Management of Illness
4.1.17Care-seeking Knowledge
4.2 Education and Information 46
4.2.1Early Childhood Development
4.2.2Adult Literacy
4.2.3Primary Education
4.2.4Access to Parenting Programmes
4.2.5Increased Knowledge for Better Living
4.3 Child Protection and Rights48
4.3.1Birth Registration
4.3.2Children’s living arrangements
4.3.3Orphans
4.3.4Children with Disabilities
4.3.5Child Labour
4.3.6Other Children in Need of Special Protection:
Street Children
Children in Child Care Institutions
Foster Care
Child Abuse
Juvenile Offenders
Adolescents
4.3.7Women’s Rights
5.0 Lessons Learned59
6.0 Recommendations for Future Action62
7.0 Appendices67
- Statistical data
- National Steering Committee for End Decade Assessment
- National Plan of Action Coordinating Committee
- National Review – List of Participating Organizations
- Summary Indicator Definitions for WSC Goals
List of Text Tables
Table AInstitutional Framework
Table BMean Number of Children Ever Born and Proportion Dead, by Mother’s Age
Table CImmunization Coverage 0-11 Months, Jamaica 1990-1999
Table DSummary of HIV/AIDS Cases for Jamaica, 1990-1999
Table EChildren in Institutions, June 2000
Table FChildren in Foster Care
List of Figures
Figure 1Inflation Rate and Rate of Growth in Real GDP, 1990-1999
Figure 2Gross Domestic Product in Producers Values at Current prices, per capita, 1990-1999
Figure 3 Paediatric AIDS Cases as a Proportion of Total AIDS Cases, 1990-1999
List of Panels
Panel AThe Multiple Indicator Cluster Survey 2000
Panel BThe 3D Projects
Panel CRural Family Support Organization
Panel DWomen’s Centre of Jamaica Foundation
List of Acronyms
ACOSTRAD
/ Association for the Control of Sexually Transmitted DiseasesAIDS
/ - / Acquired Immune Deficiency SyndromeARI
/ / Acute Respiratory InfectionBCG
/ / Anti-tuberculosis VaccineBFHI / / Baby Friendly Hospital Initiative
BWA / / Bureau of Women’s Affairs
CBO / / Community-Based Organization
CBP / / Coalition for Better Parenting
CCA / / Common Country Assessment ( United Nations)
CEDAW / / Convention on the Elimination of all Forms of Discrimination Against Women
CEDC / / Children in Especially Difficult Circumstances
CFNI
CIDA / -
- / Caribbean Food and Nutrition Institute
Canadian International Development Agency
CSD / / Children’s Services Division (Ministry of Health)
CSU / / Child Support Unit (Ministry of Health)
DPT / / Diphtheria/Pertussis/Tetanus
ECD / / Early Childhood Development
ESSJ / / Economic and Social Survey of Jamaica
FAO / / Food and Agricultural Organization
GDP / / Gross Domestic Product
GOJ / / Government of Jamaica
HEART Trust / NTA / / Human Employment and Resource Training Trust /
National Training Agency
HIV / Human Immunodeficiency Virus
IDB / - / Inter American Development Bank
IMR / / Infant Mortality Rate
JAMAL / / Jamaica Movement for Adult Literacy
JCF / / Jamaica Constabulary Force
JCRC / / Jamaica Coalition on the Rights of the Child
JFC / / Jamaica Foundation for Children
JSLC / / Jamaica Survey of Living Conditions
KMA / / Kingston Metropolitan Area
LDUC / / Land Development Utilization Commission
LEAP / / Learning for Earning Activity Programme
MICS / / Multiple Indicator Cluster Survey
MNSJ / / Ministry of National Security & Justice
MOEC / / Ministry of Education and Culture
MOFP / - / Ministry of Finance and Planning
MOH / - / Ministry of Health
MOLGYCD / / Ministry of Local Government, Youth and Community Development
MOLSSS / / Ministry of Labour, Social Security and Sport
NBPP / / National Breastfeeding Promotion Programme
NEPA
NFPB / -
- / National Environment Planning Agency
National Family Planning Board
NGO / / Non-Governmental Organization
NISC / / National Initiative on Street Children
NPA / / National Plan of Action
NPACC / / National Plan of Action Coordinating Committee
NRCA / / National Resources Conservation Authority
NWC / - / National Water Commission
OPV
PAHO / -
- / Oral Poliomyelitis Vaccine
Pan American Health Organization
PALS / / Peace and Love in Schools
PIOJ / / Planning Institute of Jamaica
PVO / / Private Voluntary Organization
RGD / / Registrar General’s Department
RuFamSO / / Rural Family Support Organization
SAAC / / Situation Assessment and Analysis of Children
SDC / / Social Development Commission
STATIN / / The Statistical Institute of Jamaica
STD / / Sexually Transmitted Disease
STI / / Sexually Transmitted Infection
TPD / / Town Planning Department
UNDAF / / United Nations Development Assistance Framework
UNDP / / United Nations Development Programme
UNFPA / / United Nations Population Fund
UNICEF / / United Nations Children’s Fund
USAID / / United States Agency for International Development
UWI / / University of the West Indies
VIP Clinic / / Very Important Person Clinic
WCJF / / Women’s Centre of Jamaica Foundation
WHO / / World Health Organization
WSC / / World Summit for Children
1
EXECUTIVE SUMMARY
The Government of Jamaica presents to the United Nations General Assembly,
Special Session on Children,
the National Report on End Decade Assessment of World Summit for Children (WSC) Year 2000 Goals.
The Year 2000 Goals were developed within the context of urgent prioritization of health and survival challenges, in a world where the status of children across nations and regions, was diverse. Twenty-seven Goals, and several other monitoring indicators were adopted by the WSC; these would be used to assess progress at the end of the decade, and largely covered issues relating to health, nutrition, sanitation, education, knowledge of and access to services, care and protection of children in especially difficult circumstances, and child rights.
Jamaica signed the 1990 WSC Declaration and Plan of Action, and signaled further commitment when it ratified the International Convention on the Rights of the Child in 1991. The Convention recognizes that all children, regardless of circumstance, are born with fundamental freedoms and the rights afforded to all human beings, and gives priority and recognition to the protection of the rights of children across the globe. The right to survival, health, education, a caring environment, recreation, protection from exploitation and abuse, as well as the right to share their opinions and participate in civil society, were all enshrined in the Convention.
With the Convention as a focal point of reference, and within the parameters of the National Plan of Action for Children (NPA) developed in 1996, the Government of Jamaica has committed itself to ensuring that the welfare and development of children is given high priority. Despite amortization and debt service obligations on the National Budget, and the experience of a price/growth trade-off which has seen falling inflation rates but negative real growth rates in the last half of the decade, Government sought to ensure adequate budgetary allocations to basic social services, and the funding of poverty alleviation initiatives.
The NPA outlines specific lines of action agreed on by a participatory process involving government and non-government organizations. Issues dealing with child survival, protection and development, including health and education were considered. The implementation of the NPA has been monitored by an inter-sectoral National Plan of Action Coordinating Committee (NPACC). The NPACC reports to the Human Resources Council of Cabinet.
The National Policy on Children was developed in 1997, in response to the international and local initiatives. Through the development of a national policy statement, Government sought to ensure that its position on the importance of children, and the provision of effective, quality services to them, became the standard adopted by all the players in the field of children’s services. An important aspect of the Policy was the institutional arrangements providing for intersectoral collaboration on Policy implementation, to reduce fragmentation and duplication of effort, and provide for improved targeting and efficiency.
Jamaica has made significant progress towards the attainment of WSC Goals over the decade, and prospects for further achievements are good. Gains have been made in child survival, protection and development, with valuable alliances formed between government, non-government and private sector partners. The consultative approach to planning and programming of resources has been applied both locally, as well as in regional contexts, where the sharing of experiences and best practice, has enriched and enlightened the entire process.
Official estimates of Infant Mortality Rate and Maternal Mortality Rate have shown declines over the decade, though not of the magnitudes targetted by the WSC Goals. A fair evaluation of goal attainment for infant mortality is limited by the date of the last estimates. The improvements have largely been achieved through improved access and reach of public health services, expanded usage of antenatal and postnatal care and services, as well as increased attendance by trained health personnel at delivery. Challenges which remain include the need for improvements in the average number of antenatal visits per woman, earlier initiation of antenatal care and the relatively high mortality rate among adolescent mothers.
During the decade, Jamaica has achieved very high (above 90 per cent) immunization coverage for the pertinent antigens in the relevant target group, 0-59 months, but has experienced some amount of slippage over the past three years in the vulnerable 0-11 months category. Some of this slippage can be attributed to under-reporting from the private health system, shortage of human resources in the public sector, and shortage of health personnel authorized to give certain vaccines, particularly in rural areas, leading to some babies ‘slipping’ through the system in their early months. The challenge now is to address the gaps acknowledged, and to ensure the sustainability of high levels achieved in the mid-1990s, for the 0-11 months age group.
Measures of nutritional status in children indicate that the majority of children in Jamaica enjoy good nutrition. However, severe under-nutrition remains a concern in poor families, and in children at the weaning stages. Government surveillance and nutrition promotion programmes give continued monitoring to the growth of children. Over the decade there have been declines in the overall prevalence of moderate and severe malnutrition, with Year 2000 goals being met to a large extent. Progress is being made through the close monitoring of the anthropometric standards, and the provision of nutritional information and supplements through government safety net programmes, such as nutrition clinics in high-risk communities, and the Food Stamp Programme. In large measure, poor nutritional status is more evident in poorer consumption groups, for whom food security and quality are challenges. Issues of poverty alleviation therefore remain a priority in addressing nutritional status, as well as public information campaigns.
Jamaica has attained near universal access (enrolment) to primary level education, and increases in early childhood enrolment as well. Significant strides have been made during the decade with respect to the quality and offering of day care and early childhood educational services. There are ongoing efforts at greater integration of these services and moves towards establishing standards for service delivery by all partners involved. Current priorities include the upgrading of human resources in the early childhood system, and the placing of at least one trained teacher in each facility in the immediate future. High enrolment rates at the primary level are evident in both the male and female age cohorts; however, the translation of high enrolment into improved attendance rates at that level remains a challenge. Measures of achievement in adult literacy show an improvement in both male and female literacy levels over the decade. Government and non-government sponsored programmes continued to offer educational upgrading to school-leavers and adults.
Sanitation levels have improved over the decade, with the majority of the population having access to safe drinking water, and sanitary means of excreta disposal. Access to safe drinking water showed disparities across geographic regions, with the public standpipe being a significant source to rural populations. In the rural areas, access to safe water was well below the national average. With respect to sanitary excreta disposal, though rates were near universal, pit latrines were the major facility in rural areas. With the assistance of public information campaigns, continued attention to environmental health and infrastructure development, and technical and funding support from international development agencies, there are prospects for further improvement.
Special attention to the antenatal and postnatal delivery of services, including family planning information and services, has been provided through the Ministry of Health and the National Family Planning Board. There has been widened availability of these services and improvements in access and acceptance. The challenge to ensure wider accessibility to rural populations, and to groups such as adolescents, remains.
Throughout the decade, work was done on reviewing and updating legislation regarding children’s rights. The legal rights of children have, to date, been enshrined in several pieces of legislation, including the Juveniles Act, the Status of Children Act, the Matrimonial Clauses Act, the Maintenance Act, the Registration of Births and Deaths Act, the Education Act, the Incest (Punishment) Act, and the Family Court Act, to name a few. The Office of the Special Envoy for Children spearheaded the process of the drafting of a comprehensive Child Care and Protection Act, which would pull together legal provisions for protection of children eighteen years and under. The Draft Act was completed in 1999.
The status of children in especially difficult circumstances has been given priority attention over the decade, by Government, non-government and private sector interests. Within the private sector, financial institutions and commercial enterprises, as well as service clubs, have played integral roles in supporting investments in child care and development. Review of legislation, the establishment of the Child Support Unit, appointment of a Special Envoy for Children, and the drafting of the Child Care and Protection Act, were some of the major supporting achievements in this area.
Major concerns and gaps which have been acknowledged by partners in child development have included the shortage of trained human resources in the public health sector, the increasing challenges of dealing with HIV/AIDS in the population, the enforcement of legislation .for the protection of children, and the flow of quality information to children as target beneficiaries. The challenges of poverty alleviation and economic empowerment, continue to be primary areas of focus for government and counterpart resources. Social ills accompanying economic downturn, such as crime, violence and other deviant behaviour, impact on social development, and the prospects for foreign investment.
Consideration of gender equity and enhanced opportunities for women have continued to be priority issues for Government. The balance of power, decision-making and opportunities have historically been biased towards males. Government has over the decade instituted processes to promote gender awareness and consciousness at planning and implementation levels. Strides have been made in the promulgation of women’s rights, and in the expansion of opportunities for women; however, there are still remaining concerns regarding the access by women to positions of power and decision-making, the translation of high academic achievements in girls into comparative opportunities for economic empowerment, and the levels of violence against women and girls. Work in the area of gender equity and the development of women is supported by activities of several NGOs and international agencies, along with relevant government agencies.
Valuable lessons learned from the decade’s experience in child development include the importance of the collaborative, inter-sectoral approach to planning; the value of the enabling environment, involving not only policy development and legislative reviews, but also capacity building and the development of infrastructure; and of tremendous importance, the paradigm shift in the approach to sustainable human development, from a welfare/needs assessment to a rights-based approach.
Future actions for government and its partners in child development will demand continued efforts at poverty eradication and the pursuit of economic growth; the development of strategies and actions to provide wider access to health services for all population groups; close monitoring of immunization coverage and sustainability of gains made in health, and attention to issues such as the prevalence of HIV/AIDS in infants and adolescents. The further development of early childhood education and the improved access to quality care and education by all population groups will be top priority issues in education; while strengthened initiatives to support the protection of vulnerable groups of children and youth within the population will be required.