Work-in-Progress

Update

Coverage of Population and Development Themes in Poverty Reduction

Strategy Papers (PRSPs)

Population and Development Branch (PDB)
Technical Support Division

17 April 2003

1 Introduction[1]

This note summarises a desk review of 19 full PRSPs adopted by governments between 2002 and early 2003. It updates an earlier study prepared in March 2002,which reviewed 36 Interim PRSPs and 8 full PRSPs completed before 2002[2] - for ease of reference the summary results of the earlier study for the 8 full PRSPs are also given here. These two reports may be read in conjunction with a survey of 21 Country Offices conducted by PDB at the end of 2002 on UNFPA’s engagement in, and technical support requirements for, PRSPs[3].

The objective here is to report on the extent of the coverage in PRSPs of six thematic population and development areas that are a primary focus of UNFPA, namely, (A) population dynamics and population and development linkages; (B) reproductive health; (C) HIV/AIDS; (D) girls’ education; (E) gender issues and (F) human rights. In addition, an account is given of the coverage of selective MDG targets and indicators.

The approach used to assess the extent to which PRSPs cover the six areas uses a three-fold rating: reasonable, minimal and no coverage – denoted A, B and C respectively. A theme within a PRSP is rated reasonable if there is substantive discussion and/or in-depth analysis. Coverage is categorized as minimal if the discussion is brief or superficial. Category C applies when there is no coverage at all, or simply a passing reference. The pattern of ratings should be taken as indicative only as the decision as to how to categorise a particular thematic area in a PRSP is necessarily sometimes rather arbitrary. Further, one factor in the extent of coverage of a particular theme is the availability of data which varies considerably across countries. Table 1 presents a summary of the results of the coverage assessment.

2 Results of Coverage Assessment

APopulation Dynamics and Population and Development Linkages

Eight[4] out of 19 PRSPs (13 out of 27) provide a reasonable description of the country’s national and in some cases sub-national population profiles and combine this with an analysis of population and development linkages at the macro and micro level.

Nearly all PRSPs provide a table with basic indicators, such as population numbers, life expectancy, infant, child and maternal mortality rate: some also provide trend and sex disaggregated data. Most PRSPs provide information on household size composition, dependency ratios and households headed by women in their analysis of the determinants

Table 1. Coverage of Population and Development Themes in 27 PRSPs to April 2003

Country and date PRSP posted by WB/IMF / Pop. dynamics & pop. & development linkages / RH
(CPR Y or N)* / HIV/
AIDS / Girls’ educ. / Gender / Human rights
Burkina Faso 05/00 / B / A (y) / A / A / A / C
Mozambique 10/00 / A / A (n) / A / A / A / C
Tanzania 10/00 / B / B (n) / A / B / B / C
Mauritania 12/00 / A / B (y) / A / A / C / A
Uganda 01/01 / B / C (n) / B / C / B / B
Bolivia 03/01 / A / A (n) / C / C / A / B
Nicaragua 09/01 / A / A (n) / C / B / A / B
Honduras 09/01 / A / B (n) / B / B / A / B
PRSPs listed above covered in earlier evaluation
Niger 01/02 / A / A (n) / A / B / A / C
Albania 02/02 / B / B (n) / C / C / C / C
Ghana 03/02 / A / A (y) / A / A / A / C
The Gambia 04/02 / A / A (y) / A / A / B / C
Malawi 04/02 / B / B (n) / A / A / A / A
Zambia 05/02 / B / A (n) / A / C / A / B
Viet Nam 05/02 / B / A (n) / B / C / A / B
Guyana 05/02 / B / B (n) / B / C / C / B
Mali 05/02 / B / B (y) / B / A / A / B
Kyrgyz Rep. 05/02 / B / B (y) / B / C / A / A
Yemen 05/02 / A / B (n) / C / A / B / B
Tajikistan 06/02 / B / B (y) / C / C / C / C
Rwanda 07/02 / A / A (y) / A / A / A / A
Ethiopia 10/02 / A / B (y) / A / B / A / C
Senegal 11/02 / A / B (n) / B / A / B / C
Sri Lanka 12/02 / B / B (y) / C / B / A / C
Cambodia 12/02 / A / A (y) / A / A / A / C
Guinea 01/03 / B / B (y) / A / A / A / C
Benin 03/03 / B / B (y) / A / A / A / C

* This denotes whether or not the PRSP includes discussion of contraceptive prevalence. Annex 1 gives information on CPR targets.

of poverty. A selection of PRSPs further shows poverty data by region displaying the often significantly higher rural poverty levels which may induce rural-to-urban migration. Ethiopia’s PRSP is a relatively good example of coverage of population variables acknowledging the significant impact of girls education and family planning services on population growth, also giving data on household size and dependency ratios by expenditure quintile. Yemen’s PRSP notes the young age structure and the problems related to internal migration and provides a sex-disaggregated table of basic population indicators. Niger’s PRSP analytically links population variables to poverty and illustrates the linkages with quotes of observations from the poor. Cambodia’s PRSP discusses the effect of high fertility and rapid population growth on individual families as well as its effect on the national economy.

Several PRSPs cover issues relating to population and development linkages, mostly in terms of urbanisation, environmental degradation and pressures on water supply and sanitation and the consequences for the poor. Notable is Rwanda’s PRSP which analyses the structural features of high population growth and density and states that although it reduces some of the costs of service provision it is a factor constraining development. At the same time it identifies the positive impact of nearby quality water sources on child and maternal health and the reduction of daily drudgery of women and girls.

B Reproductive Health

Out of the 19 PRSPs reviewed, 7 discuss RH reasonably well[5] (11 out of 27) and the 12 others provide some minimal coverage. All PRSPs include targets on maternal mortality (many also include targets on contraceptive prevalence, see section 3 below), but there is not necessarily discussion in these PRSPs of the policies and strategies required to reach these targets. So, when PRSPs are categorized as covering RH reasonably well, in addition to targets, there is generally also substantive discussion of the policies and strategies relating to access to family planning, maternal health, adolescent RH, and occasionally STIs, abortion, male involvement and gender-based violence.

Cambodia’sPRSP is a good example of coverage of RH issues and a pro-poor approach in targeting service delivery to poor people, including reallocating resources in favour of poorer geographical areas. It discusses reproductive health for women as an important development issue, citing high rates of abortion, unwanted and unplanned pregnancies as a problem. The Gambia’s PRSP provides an analytical discussion on maternal health, incorporating data on antenatal care, skilled birth attendance and CPR for different income quintiles. It highlights the problem of access to obstetric care for rural women who commonly utilise traditional birth attendants. It also includes in its health policy adolescent health as a programme targeting a reduction in STDs in this group.

Where family planning is covered in PRSPs, the discussion tends to address strengthening family planning programmes to increase choices, contraceptive prevalence rates and IEC campaigns to reduce high birth rates. Niger’sPRSP sets a clear population strategy along the lines of the ICPD and discusses the effects and persistence of harmful practices against women. Rwanda’PRSP discusses unwanted births being due to limited access, high costs of family planning services and the limited decision power of women.

Adolescent reproductive health issues are addressed in just a few PRSPs - often in relation to raising awareness of RH issues, sexuality and preventing teenage pregnancies. Zambia’sPRSPaddresses the lack of access to RH services by adolescents, and takes a fairly comprehensive approach to RH by including, among others, the issue of sexual violence against women and infertility.

C HIV/AIDS

Ten out of 19 PRSPs (14 out of 27) discuss the HIV/AIDS pandemic reasonably well[6] and a further 5 make at least some reference to it. The PRSPs in countries most affected, that is mainly sub-Saharan Africa, analyse the consequences of the epidemic from a wide perspective, such as its impact on demographic structure, poverty reduction, households and healthcare systems. Several PRSPs address the HIV/AIDS crisis as a cross-cutting issue while others cover the topic in the health section. Several PRSPs also present targets on sero-prevalence rates, and on containing and reversing the spread of the pandemic (see section 3).

Although several PRSPs cover HIV/AIDS well, two PRSPs, Cambodia and Ghana, stand out as relatively comprehensive. Cambodia’s section on HIV/AIDS describes the pandemic’s impact on poverty at a national level and on vulnerable sections of society, mentions the role of the National AIDS Authority and an array of strategies to be used against the disease. Ghana’s PRSP has a separate and detailed section discussing the problem and three-pronged strategy which involves preventing new transmissions, providing a continuum of care and laying an effective institutional foundation. It also sets out a target for reduction of new infection and an increase in condom use and service facilities.

Malawi’s PRSP makes HIV/AIDS a prominent cross-cutting issue by defining it in its “four-pillar” strategy against poverty. It presents an HIV/AIDS perspective in discussions of various sectors, such as agriculture, education, health and gender. Guinea’s PRSP in its discussion on poverty discusses the impact of the pandemic on the poor and most productive section society. Benin’s PRSP describes a National HIV/AIDS Control Strategic Framework with specific objectives to ensure a multi-sectoral approach to the problem. Niger uses the opportunity of the PRSP to develop an HIV/AIDS strategy.

D Girls’ Education

Education is identified in all PRSPs as one of the priority actions required for reducing poverty, promoting sustainable human development and creating a favourable environment for broad-based economic growth. Increasing access to basic education for girls is covered reasonably well in ten out of 19 PRSPs[7] (13 out of 27), while 6 have no coverage at all, or treat boys and girls education in the aggregate.

Coverage of girls’ education consists mainly of data and related policy analysis on school enrollment, drop-out rates, and sex-disaggregated illiteracy rates where available. A recurring theme in the discussion and action plans is providing universal primary education and closing the gender gap at both primary and secondary school levels consistent with MDG targets on education and gender (see section 3). Proposed actions for increasing the proportion of girls attending school include training more female teachers, waiving school fees for girls and constructing special girls schools.

The Gambia’s PRSP states its plan to set up a trust funds and scholarships and increase school enrolment for girls. Benin’s PRSP aims to reduce gender disparities in primary and secondary education by continuing subsidies and free enrolment centers for young girls, and sets targets for reducing illiteracy among girls and women. Ghana’s PRSP plans to improve infrastructure in deprived areas and enhance community participation in education: it further mentions that providing access to safe water will induce greater school enrolment for poor girls. Cambodia’s PRSP presents an analysis of the linkages between the lack of education and skills and poverty, giving the results of a survey of reasons for dropping out of school. It plans to increase government spending, reduce parental contribution and make available scholarships for poor children, especially girls to increase enrollment and ensure availability of trained and motivated teachers.

E Gender Issues

Thirteen of the 19 PRSPs[8] (18 out of 27) cover gender issues reasonably well. In several, gender is taken as a cross-cutting issue, or is discussed in depth in a separate section on gender. Many PRSPs recognise gender differences in access and outcomes and some develop fairly comprehensive policies and strategies to address gender inequalities and inequities. Important topics covered through a gender lense include access to basic social services, women’s rights, employment discrimination, lack of decision-making power, ownership and land rights issues, trafficking of women and domestic violence.

Several PRSPs describe targeted policies and strategies to reduce gender inequalities, such as Rwanda’s Gender Action Plan, Benin’s Policy for the Promotion of Women (PNPF) and Ghana’s micro financing fund for women. Mali is implementing a policy for the promotion of women, including in decision making processes, acknowledging women’s rights and strengthening these rights that encompasses their role in, and valuing their contribution to, economic development, and ensuring their access to basic social services and promoting women’s participation in political and family decision making. The Kyrgyz Republic’s PRSP describes the how poverty affects women asymmetrically and therefore places importance on gender equity in its development policy, using a rights based approach in line with outcomes of international conference.

Sri Lanka’s PRSP notes that Sri Lankan women are well-off compared to their South Asian counterparts but that women tend to be trapped in low-skilled, low-paid jobs and gender discrimination persists - the government plans to support the protection of women’s rights in line with the UN Convention on the Elimination of All Forms of Discrimination Against Women, promoting their employment and income opportunities, provide support for victims of violence against women and female headed households and embark on gender sensitisation programmes. Ghana’s PRSP notes the importance of gender by recognising that poor women are more disadvantaged due to lack of access and control of productive assets that would enable them to escape poverty. Cambodia’s PRSP acknowledges the impact of gender disparities on development in health, education and employment and discusses how a negative interpretation of traditional can perpetuating them.

F Human Rights

Just three of the 19 PRSPs (4 out of 27) contain a reasonable discussion of poverty in a human rights framework[9] and a further 6 make some minimal mention. In addition to civil and political rights, human rights are understood here as a rights based approach to development. Reasonable coverage should include, for example, reference to Declarations of UN Conventions, and the promotion and protection of the rights to education and healthcare and the rights for women, children and other excluded groups. Although several PRSPs mention the importance of enforcing property rights for both men and women, the rights of people living with HIV/AIDS, and refer to rights in the context of the judicial system, they do not use a rights-based approach to development - one which sees poverty as an infringement of basic human rights.

The Kyrgyz Republic’s commitment to human rights is underlined by its title “Kyrgyzstan – A Country of Human Rights” and the document discusses women’s rights, gender rights, child’s rights and several UN Conventions. The PRSP further refers to UNFPA in combination with others as making important contributions to human development and human rights. Rwanda’s PRSP also has good coverage of human rights, particularly in relation to the aftermath of the genocide and asserts that in the post-conflict situation the promotion and protection of human rights in essential. Rwanda is committed to support the integration of human rights issues in all its programmes and further notes that the link between human rights and poverty needs to be stressed.

Malawi’s PRSP deserves mention in that it states that respect and exercising human rights are fundamental for poverty reduction and includes guarantees of access for the poor to basic social services. Although the importance of human rights is recognised, the PRSP provides an explanation of why human rights issues have not taken center stage. In this light efforts will be made to train all public servants in human rights issues and raise awareness among citizens about their constitutional rights and obligations.

3 Use of MDG Targets and Indicators

The inclusion of MDG targets implies that budgetary support will be given to programmes that help achieve them. An assessment was made of the inclusion of selected MDG targets and indicators in PRSPs (Annex 1). All 27 PRSPs include targets for maternal mortality reduction, even though in some countries the incidence is relatively low and the number of maternal deaths is small. Some PRSPs set their own targets. Thus, Niger’s PRSP states that the target of reducing MMR by three-quarters is too ambitious and adapts the target to its own setting. Eight PRSPs have explicit CPR targets in relation to the ICPD goal of achieving universal access to RH services by 2015. Several PRSPs set targets for decreasing unsatisfied demand for family planning, or increasing access to reproductive health services. Fifteen PRSPs include targets to reduce HIV/AIDS prevalence rates with some having specific targets for adolescents. All 27 PRSPs include targets on increasing primary enrolment, with 10 accompanied by specific targets for girls.

Increasingly there is a sharper interface between the MDGs and PRSPs, with several of the latter making reference to the Millennium Declaration. A good example is Cambodia’s PRSP which includes a short section and an annex on the MDGs and mentions how the targets and indicators set for the medium term in the PRSP will help realise the MDGs. Ethiopia’s PRSP includes a section entitled: Millennium Development Goals and Ethiopia’s Prospects.

4 Conclusion

The findings of this desk review of 19 full PRSPs completed since early 2002 show that there is increasing coverage of social sector issues in PRSPs, including MDG targets and pro-poor budgeting. The early experience with I-PRSPs is unrepresentative of the quality, depth and content of full PRSPs. One particularly encouraging finding of this review, as compared with the March 2002 review, is a stronger focus on gender - both as a cross cutting issue and as a substantive policy area in its own right. Conversely, it is still the case that only a few of the PRSPs make an attempt to address poverty concerns within a rights-based framework.

In terms of coverage of the themes of highest priority to UNFPA, the best examples are those of Ghana, Rwanda, Cambodia, Niger and The Gambia. With the PRSP increasingly evolving into the national plan in many countries, from which the sector budget is determined, it is strategic for UNFPA to further strengthen its engagement.

In order to help UNFPA Country Offices achieve better coverage of population and development themes in PRSPs, including in relation to increased pro-poor social sector expenditures, PDB/TSD in partnership with others, is preparing a Technical Guidance Note and related tools. These will help strengthen UNFPA participation in the PRSP process, including policy dialogue, as well as provide further guidance on population, RH, gender and poverty linkages within a rights-based framework.