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Third Regional Intergovernmental Conference on Ageing in Latin America and the Caribbean San José, Costa Rica, May 8-11

Third Regional Intergovernmental Conference on Ageing in Latin America and the Caribbean San José, Costa Rica, May 8-11 2012. Inclusion and Strengthening of Social Services: The Case of Jamaica Presentation by Faith Innerarity. Outline of Presentation. Introduction and Background

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Third Regional Intergovernmental Conference on Ageing in Latin America and the Caribbean San José, Costa Rica, May 8-11

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  1. Third Regional Intergovernmental Conference on Ageing in Latin America and the CaribbeanSan José, Costa Rica, May 8-11 2012 Inclusion and Strengthening of Social Services: The Case of Jamaica Presentation by Faith Innerarity

  2. Outline of Presentation • Introduction and Background • Jamaica at a Glance • Historical context • Demographic profile • Socio-economic situation • Advances in implementation of Brasilia Declaration • Social policy framework • Coverage of older persons in the social protection system • Promoting participation • Gaps and Challenges • Conclusion and Recommendations

  3. Jamaica at a Glance • Jamaica is a mountainous island, which is comprised of 14 parishes and spans 11,242 sq. miles of land in the Caribbean Sea. • It is the largest English-speaking Island in the Caribbean. • The country is classified as Upper Middle Income in the World Bank’s World Development Indicators (GNI per capita of US$ 4,990 in 2009) • The level of human development has been ranked as medium range (100 out of 182 countries in 2009) by the UNDP in the Human Development Index (HDI). • The population has been growing at about 0.5 per cent per annum and was estimated at about 2.7 million in 2009. • While the country’s population is ageing 28 per cent is still under the age of 14.

  4. Historical Context • This year (August 6th) Jamaica celebrates 50 years as an independent nation. • Range of cultural and other events planned to mark this milestone. • Recent seminar (April 26, 2012) hosted by the Sir Arthur Lewis Institute (SALISES) of the University of the West Indies provided critical analysis of achievements in the area of social policy since independence.

  5. HAS SOCIAL POLICY ACHIEVED ANYTHING SINCE INDEPENDENCE? Presentation by Faith Innerarity

  6. Historical Evolution of the Social Protection System in Jamaica • As a post-colonial society, Jamaica’s social protection system had its genesis in British social policy and has evolved over time influenced by the political economy and international norms and trends. • Overall movement from residualism in social protection policy to the rights-based approach. • Paradigm shift from welfare to developmental model in the provision of social services.

  7. Residualism • Residual Model (Titmuss) - Proceeds from the premise that the market and the family are the two ‘natural’ or ‘socially given’ means of properly meeting the needs of the individual and that only when these fail should welfare institutions come into play and only on a temporary basis. - Seen as having its roots in the English Poor Laws dating back to the 14th Century

  8. Slavery, Colonialism and Influence of British Social Policy: Poor Law 1682 • The first attempt at providing formal social protection in the island was represented by the Poor Law introduced in 1682 that was similar in nature to that which existed in England at the time. • The law recognized three categories of poor persons, the ‘able-bodied poor’, ‘vagrants’ and the ‘aged sick’. • The ‘able-bodied’ persons were to be ‘rehabilitated’ so that they could work, the ‘vagrants’ were to be sent to houses of correction, while the ‘aged sick’ were to be cared for in their homes.

  9. Slavery, Colonialism and Influence of British Social

  10. Impact of Post-War International Developments

  11. Social Protection: Conceptual Framework

  12. Demographic Profile • Jamaica’s population is ageing rapidly. • In 2010, the estimated number of persons sixty years and over constituted 11.1 per cent of the total population (299,500 persons). • Between 2010 and 2050, the elderly is expected to double both in absolute numbers and as a percentage of the population.

  13. Demographic Profile Source: Statistical Institute of Jamaica (Demographic Statistics 2010, Projections 2010)

  14. Indicators of Ageing 2010, 2030 and 2050

  15. Demographic Profile • There is a predominance of females among older persons: • In 2010 the ratio was 55 per cent females (163,900) to 45 per cent males (135, 600) or 100 females to 82.7 males.

  16. Expectation of Life** At Specific Ages: Jamaica 1999-2001 Source: Demographic Statistics STATIN 2002. **Additional years

  17. Life Expectancy 2010 -2015 • Life expectancy at birth for the period 2010-2015, is estimated at 76.0 for females and 69.7 years  males.

  18. Prevalence of Poverty: Jamaica 2006-2009 (%) Source: Social Protection Diagnostic Study May 2011

  19. Regional Distribution of Poverty: Jamaica 2006-2009 (%)

  20. Percentage of population who are elderly by sex and area of residence: Jamaica 2009 • Source: STATIN. JSLC 2009

  21. Percentage of elderly and total population below the Poverty Line Jamaica 2007 – 2009 STATIN. JSLC, 2007, 2008, 2009

  22. Social Policy Framework: Pre Brasilia Declaration • National Policy for Senior Citizens adopted by Parliament in 1997: • Reflects Vienna Plan of Action on Ageing 1982 • Incorporates developmental and rights-based approach • National Policy for Persons with Disabilities adopted in 2000: • Based on UN Standard Rules for Equalization of Opportunities for Persons with Disabilities

  23. Social Policy Framework: Post Brasilia Declaration • Vision 2030 National Development Plan (2009-2030): • Crafted using participatory and consultative approach involving over 30 technical working groups from all spheres of society representatives of retired persons associations. • Stated goals include provisions to create secure future for vulnerable segments of the population, ensuring in particular, that older persons and persons with disabilities are fully integrated within society, have access to appropriate care and support services and are treated as valuable human resources. • Explicitly recognizes the importance of planning for the changing demographic landscape and that older persons are within the “most vulnerable” category of social groupings. • Clearly aligned with MIPAA and Brasilia Declaration

  24. Social Safety Reform and Adoption of CCT: 2002 • Factors central to the social protection reform process and the decision to adopt the conditional cash transfer (CCT) model: • Recognition of the need for a more systematic and equitable mechanism for the targeting of beneficiaries for non-contributory social assistance programmes. • Policy shift from a welfare to developmental mode for greater effectiveness. • Achieving greater administrative efficiencies.

  25. CCT Programme Of Advancement Through Health and Education (PATH) Target 2002: 236,000 2% 8% 14% Children 0-17 Pregnant & lactating Elderly (> 60yrs) 5% Persons with Disabilities Adult poor (18-59 yrs.) 71%

  26. Broadening of scope of CCT to include more older persons: 2008 • Constant lobbying by social workers and advocacy groups on behalf of older persons. • Dialogue on universalism versus means testing in social policy. • Global economic and financial crisis resulted in multilateral and bilateral assistance to broaden scope of social assistance to include older persons and persons with disabilities (additional 10,000).

  27. Redistributive Justice and Targeting Efficiency • From the standpoint of redistributive justice PATH has been fairly successful in redistributing benefits from higher consumption groups to the poor based on its targeting mechanism. • Confirmed by Targeting Assessment (Mathematica Policy Incorporated 2003) • Diagnostic Study Social Protection System 2011.

  28. Distribution of PATH Beneficiaries by Quintile

  29. Concentration Curve for PATH and Poor Relief

  30. Govern Health Insurance and Drug subsidy Programmes – Elderly Population: 2010

  31. Distribution of NHF Beneficiaries

  32. Gender and Access to Health Benefits

  33. Abolition of User Fees in Public Health Facilities: 2008 • General applicability but of particular value to the elderly. • Progress in realization of right to health care for older persons. • Increased access accompanied by range of resource constraints because of underfunding of the health services (shortage of drugs longer waiting time). • Strategy for financing of public health sector required to ensure accessible and quality health care for elderly.

  34. Persons that could not Afford Seeking Health Care: 2006-2009 (%)

  35. Abolition of User Fees in Public Health Facilities: Universalism versus Targeting Debate • No user fee policy for public hospitals has intensified debate on the merits of universalism versus the targeted approach in the delivery of social services.

  36. Abolition of User Fees in Public Health Facilities: Universalism versus Targeting Debate • Contending views have been particularly strong in terms of the Abolition of the User Fees in public health facilities; • Supporters of the policy point to the increased access for the poor and the inefficiency of the former system of fee collection; • Critics have highlighted the increased strain on the human and other resources in the public health system and the drain on the national budget.

  37. Concentration Indices of Selected Programmes

  38. Contributory Social Security: National Insurance Scheme (NIS) Annual Summary of Contributors 2006-2008

  39. Contributory Social Security: Distribution of NIS Pensioners by Age Cohort a/ Statistical Institute of Jamaica (STATIN), End of Year population 2009 b/Ministry of Labour and Social Security (MLSS) – No. NIS Pensioners as at March 2010

  40. Distribution of NIS Pensioners by Age Group and Sex (2010) • Source: a/ STATIN End of Year Population; b/ National Insurance Scheme, MLSS

  41. NIS Retirement Ages 2010-2015 Source: Ministry Paper 41/2010 Reform t the National Insurance Scheme

  42. Number and percentage of elderly employed by age group: Jamaica 2009 • aSurvey data raised to provide national estimates • Source: STATIN, 2009, unpublished data reported by Kristin Fox 2012

  43. Social Protection Coverage Gap in Income Support for Elderly (2010)

  44. Distribution of Social Protection Spending by Age Group: Jamaica (2010-2011)

  45. Sub-Regional Comparison of Social Protection • Public Spending (% of GDP) Source: World Bank ; Jamaica Social Protection Assessment Study 2011

  46. Enabling Environment: Promoting Participation and Advocacy • HelpAge International (HAI), global network that advocates for the rights of older persons. HelpAge has been very active in Jamaica monitoring and supporting the government’s commitment to the Madrid International Plan of Action on Ageing. • Between 2007 and 2012, HelpAge has implemented several projects in communities across Jamaica, including, Disaster Risk Management, HIV Surveys, Poverty Alleviation and the Older Citizens Monitoring Project.

  47. HAI Older Citizens Monitoring Project: Best Practice • Older Citizens Monitoring is essentially a process which promotes dialogue and interaction between older people, civil society organizations and governments in order to develop policies and practices that benefit disadvantaged older people. • Concept was developed by HelpAge International to ensure that signatories to the Madrid Plan of Action on Ageing institute policies and programmes to ensure implementation.

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