Sexual and Reproductive Health: Access to sexual and reproductive health services is crucial for both men and women of the region. While Latin America and the Caribbean as a whole have lower rates of maternal mortality than many other developing regions, the rates are not as low as they should or could be given the region's level of development. Meanwhile, pockets of high maternal mortality continue to exist in some countries and regions. Another challenge in this area is the non-participation of men in sexual and reproductive health services—a situation which results in negative health outcomes for both men and women, including high incidences of sexually transmitted diseases, including HIV/AIDS, and high rates of adolescent or unwanted pregnancies. Building stronger health care responses: reproductive health and intra-family violence
With support from the Dutch government, the World Bank is improving the effectiveness of healthcare services in Bolivia, Honduras and Nicaragua by addressing gender-related health issues. In particular, this technical assistance program focuses on the areas of reproductive health and intra-family violence by building the capacity: a) of health service providers (private companies, NGOs, and community-based health networks) to integrate men in sexual and reproductive health programs; and (b) of staff in health care centers and hospitals to effectively screen for intra-family violence and refer victims to appropriate services. The program supports capacity building activities for health sector personnel including: (a) development of a training module on male issues in reproductive health for local health personnel; (b) development of suitable health protocols for intra-family violence screening; (c) design and implementation of social marketing campaigns providing information and education to raise awareness of sexual and reproductive health and intra-family violence in communities.
Argentina Second Maternal and Child Health and Nutrition Project (PROMIN II)
The project seeks to help the Government of Argentina to: a) increase coverage of maternal and prenatal care services to 60 percent; b) increase pediatric coverage of children aged 0-6 to 60 percent; c) transform 40 percent of existing child feeding centers and kindergartens into early childhood development centers; and d) decentralize and strengthen social services management. The major component consists of subprojects including: a) maternal, child health and nutrition activities; b) early childhood development and nutrition activities; and c) institutional strengthening. The other components are: strengthening the Ministry of Health statistical system and project administration.
Bolivia Integrated Child Development Project
This project supports the Social Strategy Statement of the Government of Bolivia and its Ten-Year Action Plan for Children and Women. It contributes toward poverty alleviation and human capital development objectives by supporting the initiation of the Proyecto Integral de Desarrollo Infantil (PIDI), thus expanding coverage and improving quality of child development programs in poor urban and peri-urban areas of the 34 largest cities. The specific objectives of this project are to: (a) improve children's readiness to succeed in school and beyond by facilitating their physical, emotional, social and cognitive development; (b) enhance the status of women by increasing their employment opportunities, and expanding their knowledge of education, health and nutrition; and (c) increase community and private sector participation in the social development process. An associated objective of this project is to assist the GOB to strengthen its capacity to formulate and evaluate social policy. The project is comprised of three main components: (i) the sector policy development and management strengthening component enhances the public sector's capacity to formulate and evaluate social policy; (ii) the service delivery support component supports the delivery of integrated child development services to poor children; and (iii) close project performance monitoring and impact evaluation.
Brazil Second AIDS and STD Control Project
This project builds on a successful first phase that increased the proportion of males that always use a condom from 25% in 1993 to 37% in 1996. The project aims to: 1) reduce the incidence of HIV and STD infection and 2) expand and improve diagnosis, treatment, and care of persons with HIV, AIDS, and STD. The project components include: 1) AIDS and STD prevention, 2) diagnosis, treatment and care for HIV, AIDS, and STD patients, and 3) strengthening of public and private institutions for AIDS/STD control. The Government put in place a prevention program which now contains many of the features that international experience has shown to be highly successful in preventing the spread of HIV/AIDS. These include a focus on: behavior change; high-risk groups (homosexuals, drug users, commercial sex workers); community-based interventions executed to a large extent by non-governmental organizations; and counseling and testing.
Health Sector Modernization Project of Nicaragua- The Health Sector Modernization Program (HSMP), of which this project is the first phase, seeks to improve the efficiency, effectiveness and equity of the Nicaraguan health system by: (i) strengthening primary care and nutrition; (ii) modernizing the hospital network; (iii) developing the institutional capacity of the ministry of health; and (iv) supporting social security reform. To reach its goals, the program aims at implementing over a period of nine years (1998-2007) sector reforms and targeted investments through a phased approach, by expanding gradually and geographically some program activities to the whole country, and deepening and consolidating others. PROGENIAL's work in this project has focused on strengthening the maternal health centers, which have been key in reducing maternal mortality among its target populations. A key strategy in making the maternal health centers more effective has been promote outreach to the male partners of mothers to involve them in childcare, maternal health and family planning. Preliminary data in the municipality of San Carlos, indicates that the rate of births attended by health professional has increased by 48 percent since the maternal health centers have been in operation; and maternal mortality has decreased from 1000 per 6000 born alive to 374.
Health Sector Reform Pilot Project of Panama- The project supports the government of Panama's goal to improve the health status of the Panamanian population. To achieve this goal, the project has set up a pilot health sector reform program that increases overall efficiency and effectiveness of the health system, while achieving equity of access and utilization of health services for all population groups, particularly the poor. Specific activities include increasing access and facilitating the utilization of health services, particularly of the poor, through the: (i) development and implementation of a user identification system/card; (ii) development and implementation of new community participatory mechanisms; (iii) implementation of a cost compensation system between the Ministry of Health and the Social Security System (CSS); and (iv) development of a cost-recovery scheme that adjusts by family income. PROGENIAL's technical assistance has resulted in the completion of a gender-disaggregated analysis of the main health issues in the pilot region; greater outreach to men and attention to their health needs, such as sexual and reproductive health issues and domestic violence as a mental health issue; and training of healthcare providers to build their understanding of the need for a gender-differentiated approach to healthcare. |
