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[Introduction] [Approach]
[Population and Demography] [Poverty]
[Economic Activity] [Education]
[Health] [Citizen Participation]
[Conclusion] [References] The sustainable development context of Latin America and the Caribbean over the last half century is characterized by far-reaching changes in the environment and in society, over time and from one place to another. This paper summarizes these changes over the last several decades at several different scales, from local municipalities to states, and more broadly to the national-level and to the larger region. What are the major sustainable development trends over the last 50 years? How have these changes played themselves out among different social classes, between different age cohorts and in different places in the region? What is the context for future changes that will lead to improved livelihoods for Latin Americans? The W. K. Kellogg Foundation's (WKKF) Latin America and Caribbean program commissioned the development of this paper and accompanying database of sustainable development information for the region. Our analysis paid particular attention to the countries and local areas where WKKF has on-going projects and partners. Information for these project areas provided the local scale focus. Development indicators for these local places were considered in the context of larger geographic areas such as state, country and region. We acquired development indicators from censuses, the sustainable development literature, and other commonly available sources. One explicit feature of the paper is our analysis of how individual local areas compare to their larger department, country and regions in the context of sustainable development. Our intention was to link global and local processes such that stakeholders and actors can benefit from knowledge at different scales. For international organizations, a better understanding of the local context can help them make more informed decisions that will ultimately influence what happens in local areas. Local actors can benefit from knowing what the trends are in the global context, and by knowing what other actors in other localities are doing to address development problems. The paper focuses on the magnitudes of the differences in sustainable indicators. An important task for future development research will be to investigate in great detail why some areas are better or worse off than others with respect to sustainable development. The paper is organized according to six topic areas critical
for sustainable development - population and demography, poverty, economic
activity, education, health and citizen participation. A detailed analysis
of each of these six areas is beyond the scope of this paper. Instead
we identify one or two key indicators in each topic areas to get a sense
of development trends since the middle of the last century. Our approach has been to describe development trends in Latin America and the Caribbean based on secondary information from print and digital publications (Internet) and to look at the magnitude of these trends at local scales. This line of investigation follows the recommendations of a growing number of global change researchers advocating the linking of global and local processes (Gallopin, 1991; AAG, 2003; Wilbanks 1994). While national and international policies and directives impact local development, most change occurs due to efforts of local actors working in their communities. This concept was well developed in a study on greenhouse gas emissions carried out by geographers in the United States (AAG, 2003). Further developing the popular slogan think globally and act locally, the researchers showed how global knowledge alone overlooks important local trends and driving forces. But local knowledge and action is also insufficient since many of the decisions affecting local areas are made elsewhere. While this paper does not address the many reasons why some places are better or worse off than others, it does provide a backdrop for future comparisons of local areas with respect to sustainable development. Conditions today can be compared with the state of affairs in the future to monitor and evaluate progress towards sustainable development. If available, we gathered information for municipios
- the second level of administrative divisions after state or department
- where the Kellogg Foundation has on-going projects and partners (Figure
1, Figure
2 and Table
1). These groups of local areas are referred to as Conjuntos Integrados
de Proyectos (CIP). They are generally located in three priority geographical
areas (PGA). Haiti, the Dominican Republic, Central America and southern
Mexico comprise PGA number 1. PGA number 2 contains the Andean countries
of Peru and Bolivia. Northeast Brazil is PGA number 3. Our analysis focuses on indicators of population and demography, poverty, economic activity, education, health and citizen participation. While we could have chosen other indicators or an expanded list, this group of topic areas fits well with general themes of sustainable development. This group of topic areas was also chosen bearing in mind the limitations of what information can reasonably be collected. We were unable to find indicators that for all of the topic areas. The global Millennium Development Goals (MDG) initiative also influenced the indicators for discussion in this paper. Since a large number of development experts selected the MDG indicators after careful deliberation in a participatory consultative process, we have some confidence about the usefulness and availability of this information. But one drawback of the MDG effort is the lack of analysis of these indicators at local scales. Our analysis explicitly considers these indicators at the local, national and regional scale. Sustainable Development Forum In addition to data collection and analysis of the WKKF CIPs, an on-line forum was created to illustrate the potential of using indicators for evaluating and monitoring sustainable development. The forum is a web page that allows people to share information on sustainable development indicators from their local communities. The on-line forum also can be a useful tool in the development process itself. By fostering the sharing of problems, ideas, solutions and other information, the on-line forum can help local communities address sustainable development issues. The prototype forum can be viewed on the Web at http://gisweb.ciat.cgiar.org/Foro/index.html. The forum interface has also been loaded onto the compact disk that accompanies this paper. Using the on-line forum, five municipios in Cauca Valley department of Colombia were added to parts of the analysis in order to give the authors the chance to talk with local officials about how development indicators are measured in their communities. No field work was carried out in the CIPs because that type of detailed analysis was considered outside the scope of the paper. However, with the added municipios in Cauca Valley, Colombia, we were able to acquire a better understanding of the utility of the chosen indicators. Another advantage of the addition of the Colombian municipios was the opportunity to appreciate what the data means in one local area. Since the goal of the larger analysis was to put the WKKF municipios in context, this assessment lacks detailed information on reasons that the development indicators are at the level they are found. However, our brief field work in Colombia gave us some clues to help us understand differences in levels of development. This assessment of the Colombian municipios suggests what we may expect to find in future comparative analyses of development in the region. The on-line sustainable development forum could be used in future efforts by WKKF and others to improve our knowledge of baseline conditions, but more importantly to share information between community leaders working on similar problems in different areas. Data Sources Our data sources include information from international
organizations providing indicators, such as the World Bank and the United
Nations. For many indicators we relied on the World Development Indicators
annual series of data tables (World Bank Group, 2004). Another reliable
source of country level and international information is the Millennium
Indicators Database (United Nations Statistics Division, 2004). We used
the definitions supplied in this database for our indicators. For indicators at subnational levels that we could find over broad areas, we used a series of data sets developed by CIAT and our partners. Information on population and growth rates was derived from CIAT's Latin American and Caribbean Population Database (International Center for Tropical Agriculture, 2003). This data was part of a larger effort to map population world-wide (CIESIN and CIAT, 2004). Our partners at the Columbia University's Center for International Earth Science Information Network (CIESIN) developed sub-national data on underweight children and the infant mortality rate, information that has yet to be published. Sub-national poverty data for Latin America was supplied by the Economic Commission for Latin America and the Caribbean (Schuschny and Gallopin, 2004). For many of the indicators, we only have information for one or two countries. Much of this data came from national statistics and census institutes or government ministries. The compact disk and web page that accompanies this report holds links to these resources. We complemented our analysis with information acquired on the Internet. Some of this information is from on-line versions of newspapers throughout the region. Other sources include web pages of non-governmental organizations (NGO), national or regional research institutes and sites that are specific to certain themes. Readers of this report should note that local-level indicators of health, education, economic activity, poverty, demography and other topics are difficult to acquire without a visit to government agencies that manage this information or a visit to the local data provider. We included local level data where we were able to acquire it. Some of the topics we discuss in the following sections lack information at the level of CIPs. Our discussions of the sustainable development forum and web page show how this data might be collected in the future. Unfortunately, local level research for the WKKF CIPs was outside the scope of this paper. The following sections of the report discuss each one of the sustainable development themes chosen for analysis - population and demography, poverty, education, health, economic activity and citizen participation. We give an overview of the major trends for each theme, looking at a few key indicators. Where available we show how things are changing over time. Some anecdotal information is also included where possible. Throughout the paper we include some discussion of sustainable development conditions in Cauca Valley department in Colombia. Carrying out fieldwork in this local area guided our development of the indicators selected and their interpretation. Latin America and Caribbean population increased from 175 million in 1950 to 515 million people in 2000 (Figure 3). This tremendous growth influences virtually every aspect of sustainable development in the region. For example, the huge increases in economic activity have had little impact on per capita income since these increases are spread out over such a larger population. While the percentage of Latin Americans in extreme poverty has remained about the same between 1980 and 2000, the absolute number of extreme poor has risen in line with the overall population growth (CEPAL, 1998). Rural dwellers moved to cities in huge numbers over the last 50 years the LAC region (Figure 4; United Nations, 2003). In 1950 about 42% of the population or 70 million people were urban. Today, over 75% of the population representing about 400 million people is urban, placing substantial stress on cities to provide services to burgeoning population. Despite the large numbers leaving the countryside, aggregate population in rural areas has not declined. The Brazilian countryside lost millions to rural-to-urban migration, in large part accounting for the stability in the overall number of rural people in LAC. But rural population in other countries, like Guatemala, Mexico, Haiti and Bolivia, had significant increases in rural population. Fertility rates in LAC have dropped dramatically over the last decades - the so-called fertility transition (Guzman et al., 1996). As people have moved to cities, they are having fewer children. In urban areas, the population is ageing. However, many rural areas in the poorest LAC countries still have high fertility rates. In these areas the number of young people is very high and likely to exert continued pressure on employment. What population changes are occurring in the CIPs? Broad indicators of population change in Latin America and the Caribbean suggest that growth rates are going down, reducing the pressures on natural resources, infrastructure and social services. But the absolute number of people will continue to grow for many decades to come (Lutz et al., 2001). The reduction in growth rates will translate into lower overall population in the second half of this century. Therefore, the challenge for the region is to outlast the coming growth before population stabilizes sometime near the middle of the century. Population and demographic change differs geographically. The pace of change varies by country and many areas lag behind in the transition from very high growth rates to more sustainable population change (Appendix 1). Figure 5 shows a graphic depiction of the changes in population growth rates for all of Latin America, for individual countries and for the CIPs within each of these countries. These changes take into account the births, deaths and both in- and out-migration. Generally they show that these eight countries have growth rates equivalent to or slightly higher than the average for all of Latin America during the 1950's and 1960's, but increasing to higher rates in the last three decades of the century. The two exceptions to this trend are Brazil and Mexico, where population growth rates tapered off in the last two decades of the century. The lower growth rates for these two countries are likely due to increased urbanization and increased non-agricultural economic development. Compared to national-level growth rates and those of Latin America as a whole, population growth rates were higher in the decade of the 1950's for all the municipios making up the CIPs except in Bolivia. The Guatemalan municipios in this group especially stand out with a growth of 7.1 percent in the decade of the 1950's. The Peruvian, Brazilian and Salvadoran CIPs all had growth rates near five percent, indicating that these areas had clearly established the pattern of strong population growth after the middle of the last century. During the 1960's and 1970's the eight countries in Figure 5 generally showed continued high population growth rates, although trending toward lower rates. Bolivia, Peru, Brazil Mexico, El Salvador and Guatemala generally had lowering rates in these two decades, suggesting the influence of the fertility transition and rural to urban migration. The CIPs generally followed these trends in the 1960's and 1970's but lagged behind the overall average condition at the country level and the average for all of Latin America. During the last two decades of the last century, population growth rates declined further indicating the maturing of the fertility transition. Clearly much of the decline is related to the increasingly urban nature of Latin America and the Caribbean. With the exception of Brazil, the countries in Figure 5 all lagged behind the average for Latin America with respect to the decreasing trend in population growth rates. The CIPs lagged behind the average growth rates at the country level. The CIPs operating within the Kellogg Foundation's network of local places lag behind the aggregate population growth rate of Latin America as a whole. These areas remain as pockets of unsustainable population growth that puts substantial pressure on natural resources, physical infrastructure and the ability to provide social services. Rural to urban migration and the tremendous growth of cities is a key trend in population and demography in Latin America and the Caribbean. Many of the CIPs are located in urban settings. The pressures of migration and population growth in urban areas create difficult challenges and significant opportunities for urban development. In the cities the proximity of people to other people creates opportunities for sharing both physical and human resources, something much more difficult in rural areas. While urban populations increase, the overall rural population in Latin America has remained the same. But when we look at rural populations for individual countries, we can see that many rural areas in countries like Honduras and Bolivia have grown substantially. Rural population is not decreasing, and in many places is increasing. Because addressing development problems is rural areas is more difficult than urban areas, those rural areas with increasing population present a difficult challenge during the coming decades. Although population growth rates are declining in Latin America and the Caribbean countries, the continued high number of the base population means that population will continue to increase in the decades to come (Lutz et al., 2001). The region will continue to experience the effects of high population pressures on resources, services and infrastructure. In the latter of this century, population numbers will likely stabilize. Whether Latin American and Caribbean societies remain stable and livelihoods improve will depend on how the countries of the region respond to population pressures over the next decade. More than 40 percent of the population of Latin America
and the Caribbean live in conditions of poverty, and 18 percent live in
extreme poverty (Table
2, CEPAL 1998). The percentage of poor people increased during the
1980's during what many have called the "lost decade," a period
of fiscal crises and increased national debt. During the 1990's the percentage
of poor decreased, but still remained above the 1980 rate. However, since
population increased enormously, the absolute number of poor people expanded
from 135 million in 1980 to 221 million in 2000. But this picture is worse when inequality is considered. Latin America has the most unequal distribution of wealth of any region in the world. Unequal wealth distribution is usually one of the main topics of interest in any discussion of poverty in Latin America and the Caribbean. For example, in both Brazil and Guatemala, the 10 percent of the population with the highest incomes earn almost 50 percent of the national income. The bottom 20 percent of income earners receive less than 3 percent of the national income (Ferranti et al., 2003). However, recent studies have shown that inequality is not increasing as many people believe (Ferranti et al., 2003; Economist.com, 2003). Rather, Latin America shows signs of persistent inequality over many decades. Some observers cite historical reasons for persistent inequality (Ferranti et al., 2003). According to this view, the legacies of colonialism and slavery left us with a system in which the descendents of European colonists dominate indigenous groups and Latin Americans of African ancestry. Bellon et al. (2004) have shown that ethnicity is an important factor in food poverty in Mexico. (Figure 7). High levels of poverty coincide with areas where the majority of people speak an indigenous language. According to a recent World Bank report (Ferranti et al., 2003), addressing inequality will require "more equal sharing of political influence, broader access to education and health, and greater recognition for Afro-descendents and indigenous groups." Wealth inequality and income are among many dimensions of poverty that could be considered. In subsequent sections of this report aspects of poverty such as health and education are discussed. In these two topic areas, development indicators show substantial improvements over the last decades. In the context of increasing numbers of poor people in Latin America, population growth appears to be overwhelming improvements in health, in education and in other aspects of well-being. What are the poverty conditions in the priority geographical areas? In order to assess poverty for the local areas designated as CIPs, we used information from CEPAL's database of basic needs unmet in Latin America (Feres and Mancero, 2001; Schuschny and Gallopin, 2004) and a recent study of household expenditure for all of Mexico (Bellon et al., 2004). The basic needs data is the only poverty information available for most of the countries of Latin America. Based on national censuses, the basic needs indicators include information on house quality, number of persons per room in the house, availability of potable water, sewage system for the household, children's school attendance and probability of sufficient income for the household. The data set used in this paper contains two indicators. One is simply the density of population with at least one basic need unmet. The other indicator is an index that accounts for the number of basic needs unmet in a household. Higher index numbers show areas where the depth or intensity of poverty is high. We also look at the measures of household expenditure in the Mexican CIPs in comparison with the poverty line established by the Mexican government. The average poverty intensity figures show some countries and CIPs have higher index numbers while others are substantially lower (Appendix 2 and Figure 8). While no clear pattern appears in the intensity numbers (Appendix 2), some variation exists between poverty index numbers within countries (Figure 8). The index for Ceara state in Brazil is higher than the average index for the whole country. But the municipios making up this CIP have some measures higher and some lower than both the state and national averages. The same is true for El Paraiso department in Honduras, where the national and departmental indices are about the same. Many of the municipios within this CIP are lower than the national or departmental averages. In the case of Ourua department in Bolivia, the two municipios have higher index numbers compared to the departmental and national figures. The differences in these three examples shown in Figure 8 are small. More research would be needed to determine whether these disparities reflect true differences in levels of economic and social development. If the differences are real, a better understanding of the reasons for these differing levels of poverty could potentially aid stakeholders to devise interventions in these areas. Figure 9 shows the population density with basic needs unmet for Latin America as a whole, for the eight countries where CIPs are located, and for the municipios that make up the CIPs. The population density numbers suggest that the eight countries that we are focusing on generally have higher density of poor people. Only Brazil, Bolivia and Peru show figures below the average for Latin America. This result could be due to the large land area of these countries, which would tend to diminish the population density figure. The CIPs show even more striking differences, with the closest group of municipios having twice as high a population density with basic needs unmet compared to the average for Latin America. Many of the CIPs have substantially higher population densities with basic needs unmet. For example, El Salvador, Guatemala, Nicaragua, Brazil and Peru have densities of poor people of over 100 persons per kilometer squared. Some of these CIPs surely have urban municipios. Nevertheless the development programs in the CIPs are being conducted in areas with substantially higher numbers of poor people, as measured by basic needs unmet indicators. While the basic needs indicators are direct measures of
well-being (eg. whether a household has in-door plumbing or not), indirect
estimates such as household income and expenditure can also be useful
poverty measures. Unfortunately, indirect poverty measures that can be
compared across countries at detailed geographic resolution are difficult
or impossible to acquire. However, one study gives clues about poverty
levels in the municipios making up CIPs of southern Mexico (Figure
10; Bellon et al., 2004). Figure 10 also shows variable levels of household expenditure across the range of the 10 communities. The poorest community has almost one half of the average household expenditure of the least poorest. These differences raise the question of what accounts for the variability between levels of household expenditure in this region. This is an opportunity for sharing poverty reduction strategies among community leaders and others addressing these issues at the local level. The data reviewed above show the general and relative levels of poverty in the CIPs where development programs are being carried out. Economic and social development initiatives can use measures of relative poverty and comparisons with a poverty line to set baseline conditions against which future progress can be judged. The Latin America and the Caribbean region is transitioning from economies dominated by agriculture and natural resources extraction to those most heavily influenced by the services sector (Figure 11). This direction of change has been a well-known development pathway for many regions of the world. For example, in highly developed countries of Europe and North America agriculture captures a relatively small part of the gross national product (GNP). Generally the least developed countries of the world have high proportions of economic activity dedicated to agriculture, and less activity in the services sector (Ebener et al., 2005). Figure 11 shows that agricultural activity as a share of gross national product declined in Latin America from about 25 percent in 1960 to less than 10 percent in 2000. A related feature of economic activity is that those rural areas with more effort dedicated to non-agricultural activities tend to have higher levels of well-being (de Janvry and Sadoulet, 2000) It is important to note however that this picture changes when looking at individual countries or local areas within countries. In the least developed nations of Latin America and the Caribbean, agriculture and natural resources extraction still make up large proportions of the GNP. Agriculture also tends to be a source of employment for a large proportion of these countries' population. The effects of changing economic activities on unemployment in the region is not well known. Measuring unemployment has traditionally been very difficult in the region. Measures of urban unemployment in the region and in some countries during the 1990's show mixed results (Figure 12). For the region as a whole, urban unemployment increased by several percentage points. Argentina, which suffered from macro economic shocks in the 1990's experienced a large increase in unemployment. Even Chile, which often is cited as an economic success story in the region, endured increases in unemployment. Of the selected group of countries in Figure 12, only Mexico showed reduced unemployment during this period. Some of that small decline in Mexican unemployment could have been due to the North American Free Trade Agreement, in which case the beneficiaries would likely be the northern regions near the border with the United States. Economic activity and unemployment in Argentina was likely a broad based phenomenon affecting all areas of the country. Another indicator of economic activity is per capita gross national product (GNP). Brazil has experienced solid gains in GNP and is well above the average for all of Latin America (Figure 13). Most of the Brazilian states with CIPs are below the Latin American average. These departments grew more slowly than the Brazilian and Latin American averages. Bolivia shows an even more striking example of per capita GNP, with on average three to five times lower per capita GNP than Latin America as a whole (Figure 14). While on average GNP rose sharply in Latin America and the Caribbean between 1999 and 2003, Bolivia remained stagnant. A comparison of economic growth in Oaxaca state, and that of Mexico as a whole shows disparities over time between 1994 and 2002 (Figure 15). Growth in Oaxaca, a CIP location, occurred at one half the rate as that of Mexico as a whole. We would expect to find similar relationships between national growth rates and the CIPs in other countries as well. Detailed indicators of economic activity at local scales for the CIPs were mostly unavailable within the scope of this study. But future research on local economic trends would be useful for determining the scale at which processes affecting employment and overall economic activity are occurring. For example, a better understanding of whether local unemployment statistics reflect broader macro-economic processes (e.g. Argentina) or more local factors (e.g. Mexican-U.S border region) would be useful in designing development policies. In order to gauge how local factors might figure in to the larger economic processes, some information on economic activity was collected for the municipios in Cauca Valley department in Colombia. Figure 16 shows unemployment statistics for four municipios. The department as a whole has a slightly lower rate of unemployment compared to the national figure. But the four selected municipios all had higher rates of unemployment compared to the national total. One municipio, La Cumbre, had a rate twice as high as all the others. It is likely that the lower figure for the entire department is heavily influenced by Cali, Colombia's third largest city. Our informal interviews with community leaders in the Cauca Valley municipios suggested several different reasons for unemployment in these local areas. The municipio of Yumbo is mostly dedicated to industrial and manufacturing activities. Their employment situation is largely dictated by national economic health. When times are good, the Yumbo factories have more orders and need more workers. During depressed economic periods, orders go down and workers are laid off. In the communities of Candelaria and Pradera, the slightly higher unemployment rates are probably due to technological changes in the sugar industry, the most important economic activity in these two local areas. Over the last two decades, sugar cane growers are adopting more mechanized operations, including mechanical harvesting. This change has left many of the most economically disadvantaged in a vulnerable position. Unemployment is highest in La Cumbre, a community in the mountainous region between the flat Cauca Valley and the Pacific Ocean, where over 50 percent of the economically active population is unemployed. Local community leaders trace their economic difficulties to global coffee prices. Colombia's famous Eje Cafetero, or Coffee Axis, has experienced a serious decline in recent years in tandem with lower coffee prices. The lowering of prices reflects the emergence of new coffee growing regions in Asia and the growth of large producers such as Brazil. La Cumbre has suffered more than most places in Colombia because the area is marginal for coffee production compared to other areas in Colombia. When the coffee sector declines, La Cumbre is usually the first to feel the effects. When coffee prices improve, it is the last to reap the benefits. One lesson we can take from the situation of the Cauca Valley municipios is the need to diversify economic activities in order to reduce vulnerability to a single activity. La Cumbre is beginning to establish tourism activities targeting the large potential market of the city of Cali. They hope to attract city dwellers who want to spend weekends in the country. La Cumbre residents are also developing efforts in flower (heliconia) and pepper (habanero) production for the Cali market. Clearly a major challenge for local places in Latin America and the Caribbean is to adjust to rapid changes associated with globalization (Keeling, 2004). As economic structures change and the region is increasingly integrated through free trade agreements, local, national and international organizations will need to orient their development programs and policies accordingly. Adjusting to changing economic activity will require well educated citizens, the focus of the following discussion. Educational indicators for Latin America and the Caribbean show substantial progress in many areas. The percentage of people who could not read has declined over the last 20 years (Figure 17, Appendix 3). A notable aspect of literacy in Latin America and the Caribbean is the large difference between rates for males and those for females. Generally illiteracy rates are twice as high for females. Some notable examples of the decline in female illiteracy between 1980 and 2000 include Bolivia where the rate dropped from 41 to 20 percent and Ecuador which declined from 21 to less than 10 percent. Several countries have relatively low female illiteracy rates, including Uruguay, Cuba and Costa Rica. However the female illiteracy rate remains very high in many countries, such as Haiti (53%), Nicaragua (35%) and Guatemala (38%). While regional and national trends are encouraging, gender differences and geographic disparities in illiteracy rates are large. For example, in Bolivia, illiteracy is up to four times greater among women compared to men. Rural Bolivians have illiteracy rates up to four times greater compared to urban dwellers (Figure 18). One obstacle to well-educated youth populations is the need in many areas for young people to work. Figure 19 shows the percentage of adolescents that work in selected countries in the region. Argentina (not shown in Figure 19) lies at one extreme, where less than 3 percent of adolescents work. Since there is less pressure for Argentine youth to work, it is expected that they will be able to complete more years of education. This low percentage of working youth could also be reflected in the low illiteracy rate for Argentina. Uruguay is another country that has both a low percentage of adolescents working and low literacy rates. At the other extreme, more than one fifth of Bolivian youth between 5 and 14 years old work. These youths are less likely to receive formal education, and as they get older will be at a disadvantage in the labor market. The number of years of formal education that a student completes is another indicator of the level of education. Figure 20 shows the number of years of schooling completed for the PGA countries and for Latin America as a whole. The average number of years completed in Peru and Mexico is higher than the overall average for Latin America. Bolivia has the third highest completion average of the countries shown here, about five and a half years. The four Central American countries have the lowest number of years of schooling completed of the group here. Guatemala's completion figure is notably low, and more than half as low as that of Peru. More research is needed to understand the reasons for these disparities at the national level. The number of years of formal education completed in the La Libertad, Peru CIPs are higher than the national average and the average for the department (Figure 21). Youth in La Libertad department complete over 2 years more of schooling compared to the total for Peru as a whole. But for the CIP's the number of years completed is close to the national total. Since two years of schooling is a substantial period, finding the explanations for this difference could reveal ways to improve education in Peru and other countries of Latin America. The case of Bolivia provides a notable example of how national-level policy-making can improve the number of years of schooling completed (Bolivia.com, 2004). The Education Reform Law of 1994 created a series of incentives to keep children in school. In 1992, 55 percent of children completed school. In less than a decade, the completion rate rose to 72 percent. Could elements of the Bolivian reform law be carried out in other countries? For children to complete school, be good readers and do well within the educational system, good health is a prerequisite. The following section discusses health in Latin America and the Caribbean at different scales. Health in Latin America and the Caribbean While health conditions in Latin America and the Caribbean have improved in many respects over the last several decades, many persistent problems remain, and many local areas have not experienced the advances that we see across the larger region. Regarding improvements in health, some observers speak of an "epidemiological transition." As has occurred in more developed countries of North America and Europe, a transition is occurring where chronic and degenerative diseases are increasingly more important than infectious and parasitic diseases (Gribble and Preston, 1993). In years past, diseases like yellow fever, cholera, malaria, measles and others were the main threats to health. Advances in health technology, vaccinations and health science in general have reduced the prevalence of many of these diseases. International efforts to produce vaccines and efforts in health education have improved the outlook for many disease problems, especially for transmitted diseases like polio and measles. Increasingly the major health problems include heart disease, diabetes, hypertension and cancer. Problems associated with overweight and obese populations, especially in Latin America's urban areas are growing (Uauy et al., 2001) Many health indicators associated with infectious diseases
in Latin America are improving broadly throughout the region (Table
3). While infectious diseases like yellow fever, malaria and dengue
continue to be worrisome in many parts of the lowland tropics, substantial
advances have been made in past decades. Vaccinations for yellow fever
have largely controlled this disease. Deaths from malaria in Latin America
(1 per 100,000 inhabitants) are much less than the rates reported for
Africa (791 per 100,000 inhabitants). While the death rate from malaria
has gone down, it is unclear what the effect of the disease has on the
capacity for people to work. Latin America has been less affected by AIDS and HIV compared to Africa which accounts for 70 percent of the global deaths. But some countries like Haiti, where over five percent of the population is HIV positive and an estimated 22,000 people died from AIDS in 2001, have rates similar to those found in some African countries. The countries that make up the priority geographical areas generally have HIV prevalence rates below one percent. The enormous population growth over the last half century in Latin America and the Caribbean is surely putting burdens on health systems to treat larger numbers of people. For example, the number of hospital beds per person in many countries has decreased between 1980 and 2000 (Figure 22). Counter to the trend of less health infrastructure (there are less hospital beds per person), the number of people per doctor has decreased (Figure 23). More doctors per capita is a positive trend. However, we should expect this trend to be occurring mostly in urban areas, while rural doctors remain relatively scarce. Public health spending indicates the efforts of the governments of the region to address health problems. Time series information is only available for a few selected countries, and only as far back as 1980 (World Bank 2002). Figure 24 shows that in some countries like Nicaragua and Honduras health spending fluctuates from one to year to the next. Health professionals are also concerned about malnutrition problems in Latin America and the Caribbean. One of the more serious aspects of this problem is chronic malnutrition as measured by height for age in health survey. Many Latin Americans lack protein and micronutrients such as iron, zinc and Vitamin A in their diets. For example, in Ecuador one fourth of all children less than 5 years of age suffer from chronic malnutrition (Larrea et al., 2001). Resolving malnutrition problems could potentially solve other social problems as well because poor nutrition negatively affects education attainment and work performance (Fogel, 2001). In general the Latin America and Caribbean region has made important advances in health over the last several decades. The region is experiencing an epidemiological transition whereby infectious diseases are becoming rarer and problems such as cardiovascular disease and cancer are becoming more common. However, in the same manner that the region shows high inequality in wealth, health differences between the richest and the poorest segments of society are substantial (Carr, 2005). The following section suggests what might be the conditions in the less developed regions of the priority geographical areas where project groups (CIPs) carry out development programs. A key health indicator for CIPs in Mexico and Brazil Health professionals often look to the infant mortality rate as a key indicator of overall health conditions. Maternal nutrition, prenatal health care, health delivery systems in general and the home environment affect infant death rates. Infant mortality rates were acquired at the municipio level for two areas with CIPs - Oaxaca, Mexico and northeast Brazil (Figure 25). The graph shows the rates for these municipios in the context of the weighted average for Latin America, Africa, more developed countries and the world. Infant mortality rates are between two and 10 times higher in the Mexico and Brazil CIPs compared to the developed world average of 9 deaths per 1000 live births. Six of the 24 municipios have infant mortality rates less than the Latin American average of 32. Half of the 24 municipios have rates lower than the global average. Three municipios have rates higher than the average rate for African countries. Only one municipio in the Oaxaca CIP has a higher infant mortality rate than the lowest figure for municipios associated with the northeast Brazil CIPs. Within the Oaxaca group, the highest rates are twice as large as the lowest. Within the northeast Brazil group, the highest is three times the lowest. The considerable variability of the infant mortality rates for the Brazil and Mexico municipios associated with CIPs raises several interesting questions. Why is the Mexican group consistently lower than the Brazilian group? Within each group why are the highest rates two and three times larger than the lowest ones? What are the conditions that put the infant mortality rate of three northeast Brazilian municipios at levels similar to those found in Africa? What interventions could potentially have the most impact in bringing infant mortality rates down to levels below the Latin American average and closer to rates found in more developed countries? Solutions to health and nutrition problems in Latin
America Other solutions to health and nutrition problems include nutrition and education programs. Some observers have estimated that health problems could be reduced by as much as 30 percent by improving nutrition (Mason et al., 2003)). Malnourished populations suffer from weaker immune systems and other problems associated with poor diets. Improving health education for women is another strategy that can potentially bring positive results to overall heath. Education programs can help improve infant and child health as well as nutrition. Local solutions to health and nutrition problems may turn out to be the most effective. Solutions to child health problems may lie in unraveling the reasons for high variability in infant mortality rates in the Brazilian and Mexican municipios discussed earlier. Greater dialogue between local professionals could encourage problem solving in the health sector in other fields of sustainable development. Our dialogue in the sustainable development forum for Cauca Valley municipios demonstrated the need for better communication between communities in the search for local solutions to health problems. For example, La Cumbre municipio has developed a citizen support group focused on problems related to increased incidence of adult-onset diabetes. The results and materials developed by this group could be highly valuable to residents of other municipios in the department. Citizen Participation in Civic Life and Sustainable Development The topic of citizen participation was included in our assessment because most experts agree that sustainable development will not likely occur without broad participation from a cross section of people within countries. However, analysis is this topic is hampered by the difficulty of defining a framework to organize information related to citizen participation A political systems framework is one way to assess the level of citizen participation in society and the life of the nation. Although it is difficult to measure the degree of citizen participation under different forms of government, some political systems clearly allow more citizen participation in civic life than others. In general, political systems have evolved from authoritarian and military to representative democracies. For example, not too long ago the people of the following countries lived under authoritarian or military dictatorships (period of authoritarian government is noted next to country name; Wikipedia, 2005; Comision Andina de Juristas, 2005):
Other Latin American countries
A second framework for assessing citizen participation would be to analyze the extent that previously-excluded groups are involved in civic life and can exercise rights to participate. What are the trends with respect to citizen participation for women and minorities? Progress for women has been slow, but substantial. In 1928 in the Americas only women from Canada and the United States had the right to vote (Inter-American Commission of Women, 2004). Women in most of the countries that we have focused on in this paper secured the right to vote in the 1950's. Even with voting rights, participation of women in political life has progressed slowly. One example that shows this progress is in Peru, where between 1950 and 2001 the percentage of women in the Congress went from zero to 20 percent. These represent real gains. Less progress has been made for ethnic minorities in the region. Indigenous Latin Americans remain far behind economically and have been excluded from much of the political life the countries of the regions (Ruiz Murrieta, 2002). In the section above on poverty, a Mexico study showed a close correlation between areas with high levels of food insecurity and the location of indigenous communities (Bellon et al., 2004; Figure 7). The map discussed earlier shows the high indigenous population in the Oaxaca department, the site of the Mexican CIP. The CIPs in Guatemala, Peru and Bolivia likely have high proportions of indigenous groups among their population. Despite the historical exclusion of indigenous peoples from political and economic participation in Latin America, recent events suggest positive changes towards greater inclusion (Ruiz Murrieta, 2002). Part of this trend is due to greater democratization of Latin American countries. Indigenous people are increasingly courted for their voting power. For example, Alejandro Toledo in Peru and Lucio Gutierrez in Ecuador may not have won their elections without the support of indigenous groups. Ironically, both these presidents have lost much of the support they once had from indigenous peoples in their countries. The power of indigenous peoples has also recently been seen in Mexico and Bolivia, where the threat of rebellion has convinced political leaders of the need to address the concerns of these groups. A third context for analyzing citizen participation is the development of civic organizations (NGO). These might include farmer associations, political parties and non-governmental organizations. Quantitative information on the growth of these groups is not commonly available, as was the case for the WKKF CIPs. We acquired some information on the number of NGOs in Latin America and Bolivia (Figure 26). The data is normalized by population. Bolivia has six times the number of NGOs per capita compared to Latin America as a whole. This high number can probably be traced to the importance of development aid for Bolivia. Time series information on Bolivian NGOs shows an impressive increase in their number, from 17 in 1942 to 338 in 1999 (Table 4). Greater citizen participation in political life, less exclusion of minorities and the growth of citizen advocacy organizations are all positive trends in Latin America and the Caribbean. Yet, the region has much to do to improve the capacity of individuals and groups of citizens to effect positive changes leading to sustainable development. Clearly this topic needs further investigation in the local areas where development work is going forward. The principal objective of this analysis was to describe the context of sustainable development for Latin America and the Caribbean. The W.K. Kellogg Foundation CIPs are working among the less developed areas of the region (Table 5). The following observations from our assessment attest to the levels of development in the areas with WKKF programs:
These data are part of the baseline condition against
which future conditions should be measured. They could be compared with
the larger baseline survey of individuals involved in Kellogg projects
to better define the conditions on some key indicators of sustainable
development. Comparisons of the CIPs, departments, nations and the region as a whole provide insights into development processes operating at different scales. While Latin America and the Caribbean is well known for strong rural to urban migration, many areas in Honduras, Bolivia and other countries continue to have growing rural populations. Thus, ignoring rural areas in many countries would be to neglect an important population group. While improvements in per capita gross national product at regional and national levels have been positive, many areas, such as the CIPs in Bolivia, have remained stagnant or have experienced declining GNP per capita. While there is considerable variation in illiteracy at local scales in Bolivia, school attendance at the national scale appears to be improved through national-level policies. Our fieldwork in Cauca Valley department showed some interesting
examples of how development processes work at different scales. La Cumbre
municipio has been severely affected by the global coffee market.
Weather conditions in the coffee regions of Brazil or new areas cultivated
in Vietnam can change conditions in La Cumbre drastically. Industrial
production in Yumbo municipio is strongly affected by the overall
economic situation in Colombia. Cauca Valley residents call out for more help from the departmental and national governments, but at the same time recognize that much of their fate depends on local action. For example, La Cumbre residents have taken some substantial steps towards developing tourism. But they need better security offered by the federal government and marketing support from their departmental government. Many innovative solutions to local problems exist in neighboring areas or in other countries. Connecting communities to share technologies and ideas appears to have great promise. A first step is to look at the causes of the differences in development, and to identify solutions that are working. Our analysis shows how comparisons across scale give insights into global and local processes that affect sustainable development. These insights need to be conveyed to community leaders, national-level decision-makers and international organizations working in development. Information on the status of a local area in context of a millennium development goal indicator can be used to lobby the national government for more resources or apply for a development grant from international organizations. But more importantly, local citizens need information on local problems so that they can develop their own solutions.
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