sustainable development 20 years on from the ... - José Eli da Veiga

49
Lastly, mounting global uncertainty underlines the need for strategies to manage the risk inherent
in the traditional approach to food security, in order to mitigate the impacts of unforeseen shocks and
adapt to more permanent changes.
Target 1C of the Millennium Development Goals —to halve, between 1990 and <strong>20</strong>15, the
proportion of people who suffer from hunger— remains a pending issue in the region. This is
compounded by the challenge of reducing obesity and dealing better with the economic impacts of crises
and natural disasters due to extreme weather events or natural phenomena (FAO, <strong>20</strong>10a; <strong>20</strong>10b; <strong>20</strong>11).
5. Reproductive rights and sexual and reproductive health
According to the Programme of Action of the International Conference on Population and Development
(ICPD), reproductive rights derive from the basic right of all couples and individuals to decide freely and
responsibly the number, spacing and timing of their children and to have the information and means to do
so, and the right to attain the highest standard of sexual and reproductive health. It also includes their right to
make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in
human rights documents”. In this framework, among other matters the Programme of Action includes
objectives referring to education (especially for girls) and to greater reduction of infant, child and maternal
mortality, which requires measures to broaden and improve access to sexual and reproductive health care.
These objectives were further reinforced with the adoption of the Millennium Development Goals. In <strong>20</strong>07,
target 5B —to achieve, by <strong>20</strong>15, universal access to reproductive health— was included in Millennium
Development Goal 5.
Latin America and the Caribbean is the region which has made the most headway in signing
international accords on human rights, including those which refer to reproductive rights. A number of
countries have adopted national legislation expressly recognizing sexual and reproductive rights and the
great majority have adopted policies and programmes designed to promote the realization of reproductive
rights, broaden access to sexual and reproductive health services and improve their quality.
Several indicators relating to this field have shown improvements since the 1990s and particularly
since <strong>20</strong>04. In the latter period, unmet family planning needs fell, the coverage of prenatal care and
skilled birth attendance rose and infant mortality came down. Data from the Inter-Agency Group for
Child Mortality Estimation show a drop in infant mortality from 41 per 1,000 live births to 19 (figures
from CEPALSTAT).
Although maternal mortality declined in 1997-<strong>20</strong>05, the absolute number of maternal deaths
virtually stood still and many of these appear to have been from avoidable causes.
A particularly important area of concern for the region is reproductive health during adolescence.
As mentioned previously, early fertility is one of the factors involved in the intergenerational
reproduction of poverty, since it obliges households to distribute scarce resources more thinly and makes
it more difficult for mothers to participate in the labour market or continue with their education. Poor
children develop at a disadvantage in terms of health and access to education systems. This erodes their
human capital and contributes to the reproduction of poverty in the long run (ECLAC, <strong>20</strong>11a). Adolescent
fertility is high in Latin America and the Caribbean and, unlike in other regions, shows no sign of
systematically decreasing. The adult fertility rate has not decreased either and most of these pregnancies
are unplanned. The reduction in adolescent fertility since 1990 has been very slight and the high rates now
observed in the region are exceeded only by Sub-Saharan Africa (United Nations, <strong>20</strong>10b).