Consejo Nacional de
STATEMENT BY RODOLFO TUIRÁN, SECRETARY GENERAL OF THE NATIONAL POPULATION COUNCIL AND HEAD OF THE MEXICAN DELEGATION BEFORE THE THE HAGUE INTERNATIONAL FORUM IN THE PLENARY SESSION WHOSE OBJECTIVE IS TO ANALYZE THE EXPERIENCES: OF THE COUNTRIES IN THE EXECUTION OF ICPD'S ACTION PROGRAM THE HAGUE, FEBRUARY 9, 1999.
On behalf of the Mexican Government I would like to congratulate you for the well- deserved appointment and I would also like to express our confidence that under your sensible leadership the tasks of this International Forum will be successful. I am sure that transcendental proposals of actions to be taken will come out of this meeting. And, I would also like to show my appreciation to the people and the government of the Netherlands for their warm hospitality. Last, but not least, I would like to thank the United Nations Population Fund, and specifically its Executive Director, Dr. Nafis Sadik, for the invaluable contribution that made this important encounter possible. Mexico has always maintained a decisive presence in the various international forums on population and development. Our country hosted the 11 International Conference and had the honor of being present at the Bucharest and Cairo Conferences. More recently, Mexico participated in the regional forums held to draft the contribution of Latin America and the Caribbean to the review and evaluation process of Cairo + 5. During these forums, experiences and achievements were shared and our country actively participated in the identification of obstacles and priorities for the future. The commitment of the Government of Mexico to issues I inked to population and development is renewed by our presence in this International Forum at The Hague.
Within the framework of the National Development Plan, Mexico joined the consensus of Cairo and collected, under several national programs, the commitments made during that Conference, among which the National Population Program, the National Women's Program and the Reproductive Health and Family Planning Program should be noted. The National Development Plan recognizes that social progress and the ability to overcome the accumulated lag depend on economic development, education, health, the fight against poverty and an improvement in the social condition of women are top priority. It sets forth viable strategies for sustainable development progress; it also defines the population policy as being part of economic and social development strategies.In Mexico, the objective of regulating and guiding. population phenomena, in its complex interrelationship with the economic and social development processes, has been an affair of the State, a task of the government and the ambit in which society is participating. The population policy was set in motion and, in time, has perfected the institutions that make it up; during all these years, the population policy has become relevant and meaningful in family daily life, and its profound and lasting effects have affected-people's lives, and, at the same time, it has continuously and permanently contributed to outline a broader horizon for our country.
Had this respectful, responsible and realistic policy not been implemented, Mexico today would have over 134 million people, in lieu of around 96 million. This shows the strategic potential that the population policy has to make our Country's project viable and to potentialize the efforts to achieve social equity and sustainability. There are few public policies that maintain a high degree of continuity, that have an increasingly broader consensus and that can count with achievements that are as significant as this throughout so many years.
Mexico's population policy has been able to construct a sound institutional structure. In 1974 a multi-sectorial national body was created. This body is responsible for implementing the population policy. Since 1984, thanks to the drive to decentralize, more that 32 states have their own population planning body. More recently, the decentralization effort has expanded from the states to the municipalities through the creation of municipal population councils, a necessary step to make public administration more democratic when it deals with population issues. And, it is here where problems arise and demands are generated and, consequently, where the various government levels, closer to the communities' every day lives, must implement the relevant solutions.
As part of the decentralizing effort, by legal mandate, a new budgetary assessment was allocated to transfer federal resources to the states to improve the coverage and quality of educational services, health and social infrastructure. As a consequence, today for the first time in Mexico's history, local governments-are directly exercising more resources than the Federal Government. For every peso that the latter spends, state governments are spending 1.31 pesos, when in 1994 this ratio was one to 0.78. The participation of local authorities has contributed to provide a more efficient attention to the demands of the citizenry, to expand the spaces for social participation and to integrate the concerns and demands of an increasing number of institutional actors and of various nuclei of civil society.
In spite of what has been attained, there are still several obstacles and a lot to do. It is imperative to review the current national population legal framework to adapt it to the institutional, political and operational requirements of the new federalism; to strengthen the integrated orientation and the multi-sectorial character of the population policy; to efficiently focus its priorities and to allocate higher budgetary resources to break the vicious circle that goes between poverty and populational lags; to reinforce the positive synergism and the best use of those areas that require a reciprocal strengthening through the expansion and reinforcement of the mechanisms of coordination among the three orders of government; to strengthen the-institutional capabilities of the states and municipalities; and to reinforce the human resource training systems to be able to execute the complex exercise of incorporating populational considerations and criteria to the development policies and programs.
Health, Reproductive Rights and Reproductive Health
In the area of health, the Government of Mexico is carrying out one of the most important institutional reforms in this Administration. To expand and to make these services more efficient, to better use the available human and material resources and to promote the active participation of the population in health care, the Health Reform Program has encouraged the restructure of the institutions that make this sector up. Just to give you an idea of the scale of this operation, I should mention that every business day in the year public institutions give more than 750 thousand consultations and close to 15 thousand people are admitted to hospitals. This has gone up by 120 thousand consultations and one thousand admittances to hospitals as a result of a greater institutional capacity when you compare them to figures recorded in 1994. To achieve these, it has been necessary to open over 2,400 medical units in the last four years. Namely, two units per day as an average. This has included encouraging the permanent activities of mobile brigades, health centers and auxiliary community health networks in more that 33 thousand sites in the country, and defining a Basic Health Service Package, consisting of 14 irreducible interventions to which every individual is entitled.
The policies on health and population issues give a special importance to reproductive health attention. In our country, this mission was set forth in 1995 in an action program, elaborated with the participation of the civil society, and which rests on four essential pillars: family planning, perinatal health, adolescent health and women's health, including pre-conception risk, timely detection and handling of infertility and neoplasias in the female reproductive tract, attention to menopause and post-menopause, as well as the prevention, detection and management of sexually transmitted diseases, and VIH-AIDS. The objective of this program is to guarantee universal access to an increasingly wider range of reproductive health services, which are fully integrated and high quality, with a holistic vision that emphasizes free informed election and the incorporation of the gender perspective in standardization, education and communication activities, provision of services and evaluation.
As a result of the efforts made in recent years in the ambit of reproductive health, it is estimated that between 1994 and 1998, the population that has had access to the basic actions of reproductive health went up from 89 to 96 percent of the population; the prevalence of contraception rose from 65 to 69 percent during the same period; the average number of consultations for pre-natal control increased by,50 percent; and the number of deliveries made by medical personnel in the last decade went from 7 to 9 out of ten.
The adoption and implementation of the comprehensive approach to reproductive health implied profound changes in institutional, juridical and administrative structures of the health sector; it gave place to the creation of a body that has been constituted centrally and in the 32 states of the country, by government representatives as well as civil society organizations; and it has led to an enormous mobilization of human and material resources aimed at establishing the standardization frameworks to supply these services, encouraging training in reproductive health of thousands of health agents and promoting social participation. The effort that has been undertaken has also signified strengthening of the strategies to reduce maternal and perinatal morbi-mortality, a reorientation of preventive strategies and cervix-uterine cancer and breast cancer control; the integration of health measures for women; and the multiplication of information, education and communication so that people can perceive the reproductive health notions and practices as relevant and important, and that they have the knowledge and ability to make decisions with freedom, full information and responsibility in order to achieve an adequate and qualified demand of these services.
In spite of the undeniable achievement, it is fundamental to work harder on this issue. Among other tasks, we have to continue fostering institutional changes so that the various substantive contributions of the reproductive health approach can be fully integrated in the operation of these services; expand the ranges of reproductive health components that are being offered; guarantee the access of male and female adolescents to those services and customize them according to their demands and requirements; oversee full compliance of voluntary informed consent, with full respect for the dignity of individuals and the free decision of couples; intensify the efforts aimed at increasing the technical competencies of the medical and paramedical personnel; reinforce the content of interpersonal communication among all the institutional training programs; support reproductive health actions on participative schemes whose credibility has a broad reach; empower individuals to generate a qualified demand of services and motivate a greater commitment in their reproductive health care; stimulate greater participation of men in the decisions and practices linked to reproductive health; improve stock control and the mechanisms of distribution of inputs, equipment and instruments; to strengthen the articulation of reproductive health programs with the broadest strategies of social development and the fight against poverty; and consolidate the assessment and follow- up mechanisms of the quality of services, emphasizing full satisfaction of users, male as well as female.
Equality and Gender EqualityThe Government of Mexico in this International Forum reiterates its commitment to Mexican women. It is a question of the commitment that is based on recognizing their undeniable contribution to the promotion of economic and social development, democratic advancements and the dissemination of our culture and values. In order to promote the comprehensive regulation of actions that benefit women and the support of inter-institutional coordination, the President of Mexico presented in May, 1996 the National Women's Program and created an institutional entity that has a general, coordination responsible for implementing and following-up institutional programs, as well as a Consultative Council and a Social Comptrollership to favor social participation. The Program is a concrete response of the Mexican Government to the requirements and demands of Mexican women, and it is -also a response to an old aspiration of a society preoccupied in promoting full, free, equal and satisfactory participation of female population in the social, economic, political and cultural life. The Government of Mexico has decided that compliance with this Program must be an example of commitment, co-responsibility and collaboration. During the last few years, the Government of Mexico launched and implemented a wide range of strategies and a large number of actions to address lags, deficiencies and inequalities that affect women in our country. Among the efforts to incorporate gender perspective in planning, designing, execution and assessment of public policies, and specifically in recent actions against poverty should be noted. To carry out this task, it has been necessary to develop basic and derived statistics and a system of indicators to account for changes in the access to opportunities for men and women in different environments.
The latest information available indicates that there is a trend to attenuate inequalities based on gender. This has been a result, for example, of the unprecedented expansion of basic education opportunities through the operation of regular and compensatory educational programs. Today, close to 92 percent of girls and 93 percent of boys in the country, between 6 and 14, attend primary school or secondary school. To support the permanence of children, male and female, in school and to contribute to improve their performance in school, programs that offer economic aid to children of the poorest families in the country were reinforced or started. To mention just one of these programs, educational scholarships will be granted to close to 2.2 million students, boys and girls, starting this school cycle.
In the area of health, a prioritary program was launched, consisting in the distribution of the Women's National Health Carnet, which is a document that will enable following-up the services provided to women, to opportunely detect their major health problems and to provide adequate treatment. During all 1998, year in which this Program was launched, close to 22 million carnets were given at no cost. This type of action is a recognition that health is a fundamental right that potentializes the role of women in society and that is crucial for their life and well-being, as well as the capability that women have to control their own fertility.
The incorporation of women in the labor market, is supported through job training. More than one and a half million women have been benefited from this program. At the same time, several programs have been launched to finance and encourage the productive capabilities of women, specifically of those who are more vulnerable. In only one year, close to 173 thousand actions were taken to equip rural productive units headed by women; advice was also provided to constitute and consolidate 728 rural women's organizations; and, between 1995 and 1998, almost 15 thousand projects to strengthen and diversify the sources of income of women living in rural and urban-marginated areas were undertaken; and legal certainty and protection of land ownership was given to more than 400 thousand farmer women, which, as a whole, are usufructing close to 4.8 million hectares.
In the area of promoting and defending the rights of women, an exhaustive review has been made of secondary norms and, in consequence, a proposal to reform those that still contain discriminatory precepts has been drafted. Similarly, the electoral law has been modified to drive an affirmative action oriented to encourage political parties to establish a quota so that women may be represented among the nominees for popular-election charges. And, concerning violence against women, considerable progress has been made in the introduction of amendments to laws and codes that typify and punish, with greater rigor, crimes against their physical and moral integrity, in the formation of a sensitive and active public opinion, in the protection that is given to the victims, and in the provision of therapy to women who have been abused.Notwithstanding progress made, it is important to note, as-acknowledged by the National Women's Program, that there is still a long way before we can address the many and various lags that exist. For example, instruments and mechanisms to guarantee women's full exercise of their rights and to close the gap between equality of rights and the factual conditions must be strengthened; to go forward in the review of secondary federal laws and local norms so that they may be consistent with the constitutional principle of juridical equality for men and women; reinforce the institutional framework and the actions that foster the participation of women in all environments to decide and exercise power; consolidate measures aimed at guaranteeing equal opportunities between men and women at all levels in the educational system; to double efforts to ensure women have access to all health care services, sexual health and reproductive health, with quality and throughout all the stages of their life cycle; and multiply the actions oriented at strengthening the responsible practices of men as they relate to health and reproductive health; reinforce the mechanisms required to ensure full respect of working women's rights and access to productive labor, employment and training and education for the job, and to the technological and financial resources, under equal conditions and opportunities as men; and, finally, the implementation of measures aimed at eradicating ideas and attitudes that reproduce false images of the being and doings of women are increasingly important.
Collaboration and AlliancesMexico recognizes that the only guarantee that will lead to the achievement of the goals and objectives of the social and population programs depend on joining efforts between a government that represents community interests and an organized, demanding and propositive civil society. Today in face of democratic advancements, all initiatives require a broad and profound social participation. Today, the proliferation and active presence of a growing number of actors, whose agendas include local, state, regional and national scopes, is more visible than ever before and they have to be integrated in the elaboration, execution, follow-up and assessment of public policies
The association between government, institutions and non-government organizations (NGO'S) in Mexico has been showing significant strides for the fast few years as well as a rich and wide variety of beneficial experiences for both parties as well. Patterns of dialogue, interaction and transitory or permanent collaboration have been numerous, varied and changing. Political transformations that are taking place in our country contribute to facilitate this encounter, although we must accept that different reticences, doubts and mutual fears have to be frequently overcome. Government entities and NGO's, both, constitute complex and heterogeneous universes, for which reason it is only natural that the pattern of their mutual relationships tend to be differentiated, has multiple forms and is unstable. Government and society must together arrive at the formulas that will facilitate their inter-communication, interrelationship and mutual collaboration to eliminate reticence, doubts and fears in both parties.To multiply the successful experiences of collaboration, and to expand and reinforce the spaces for dialogue and participation that will enable confluence of various social and institutional actors, it will be required that measures are adopted to establish an environment that leans towards the construction of consensus and the formation of stable alliances; to set forth the principles that will rule their collaboration; to extend and root a culture that includes respect and tolerance; to reinforce the institutional sustainability and encourage the organizational and administrative capabilities of the organizations of the civil society and government institutions; to allocate resources to develop an effort suspended in time; to provide training actions to the human resources; to consolidate the mechanisms to achieve an inter-institutional coordination and develop an institutional framework that will regulate, balance and complement he relations between government activity and NGO'S, with a clear identification of their different roles, specific capabilities and responsibilities.
Mobilization of Resources and International CooperationDuring the last quarter of a century, our country was able to institutionalize population and development activities and assumed almost all their funding. This trend has been reinforced in recent years. Suffice to note that the Government of Mexico has allocated a great share of its human and material resources to social development and the fight against poverty. Today, the social expenditures of the country represent around 9 percent of the GNP (gross national product), while during the 1990-1995 period it totalled 7.8 percent. Traditionally, international cooperation has been an important asset for our social and populational policy: it has contributed to strengthen our links with other countries; it is an instrument of privilege that allows us to complement our internal development efforts; it has helped us to access and transfer knowledge, experiences and new technologies; and, it is one of the best tools to encourage higher levels of development and contribute to the welfare of the population. Because of our social and economic characteristics, our geographic location and our presence in various regions and forums, we are able to say that Mexico is an actor that can receive and offer cooperation and share the lessons that we have learned.
Even though the resources which are internally available have been used more efficiently and rationally, it is fundamental that we increase financial flows to be able to continue driving social development and address the accumulated social lags. These can only be generated if our economy has a sustained growth. However, the international economic situation and the dramatic drop in the international price of oil, among other factors, have imposed on Mexico the need to implement severe budgetary cutbacks. Within this context, multilateral and bilateral cooperation, and resources coming from international organizations and foundations are still imprescindible. We have, though, seen a reduction in these resources in the last few years. In this scenario, therefore, it is required that the international community of donors, considering the magnitude of the financial requirements that are related to population programs in developing countries, re-affirm their commitment to contribute with the funds that have been agreed. With due respect, we want to appeal to all governments and the international community to join in the effort to fully comply with the commitments of the International Conference on Population and Development.