Health and Education
Serious health problems still greatly affect the
Western Hemisphere. Issues such as the high infant-mortality rate in
Latin American and the Caribbean, the effect of communicable
diseases on morbidity and mortality, and other problems caused by
new and resurgent infectious diseases, environmental hazards and an
increase in violence must all be considered in the future as real
threats to the region's long-term and overall health. Moreover, much
is lacking in the areas of education and social awareness. These
problems must also be addressed if the region's commitment to
sustainable development is to be reinforced in the area of health.
The Bolivian Summit, in addressing these issues, took into account
the topics below, which are related to health and education:
Among others, the following actions have been
taken to improve access to safe drinking water:
- A regional meeting took place in Peru, 1996, on drinking water
quality. The Pan-American Health Organization (PAHO) also
formulated baseline data on access to water disinfection levels
and water quality and incorporated it into its mid-decade
- Several Latin American countries have elaborated projects on
cholera prevention which promote social mobilization within
communities and the development of basic technologies and small
enterprises to improve water sanitation. Along with this,
indigenous populations have worked towards the improvement of
basic sanitation in an effort to address water supply problems.
- A working group, consisting of PAHO, the United Nation's
Children Fund (UNICEF), the World Bank, the U.S. Agency for
International Development (USAID), the Canadian International
Development Agency (CIDA), the OAS, the IDB, the National
Sanitation Foundation and the U.S. Environmental Protection
Agency (USEPA), was formed by the Inter-American Task Force for
Bolivia Summit Follow-Up to address coordination of technical
cooperation for improving access to and the quality of potable
In order to reduce the effects of environmental
problems on children's health, the following efforts are underway:
- Countries in the region and PAHO have worked together to
strengthen the framework of the "Care of the Sick Child
Strategy," which supports the integral development and
growth of the child.
- Several countries are in the process of revising their laws on
infants' and children's rights, access to and coverage of health
and nutrition services and educational opportunities.
- Several regional meetings have taken place which serve as fora
for the exchange of information and experience on health
- Countries in the region have also undertaken mass-media
campaigns for health promotion and protection and education on
the abuse of alcohol, drugs and tobacco.
Governments are working to improve health
coverage and the quality of health services available. In doing
this, they are focusing on preventive and educational issues and
offering access to family planning information and services.
- Several countries are formulating a basic health care package
to be guaranteed to all citizens. Venezuela has focused on
providing medications to outpatients, paying special attention
to vulnerable groups such as pregnant women, children and the
elderly. Nicaragua has developed a basic services package to
vulnerable groups that emphasizes preventive health to reduce
- Non-governmental organizations (NGOs) and women's groups have
been active in implementing national health policies with a
particular emphasis on reproductive health services and pre- and
- PAHO has supported countries that are working to build their
capacity to analyze and formulate health policy plans and to
strengthen cooperation between them. PAHO has also distributed a
document that establishes parameters for health sector reform;
its emphasis lies in universal coverage with equity.
Emerging and Infectious/Contagious Diseases
The following steps have been taken in addressing
- In Latin America and the Caribbean, a survey was done on
countries' capacity for surveillance of emerging and re-emerging
infectious diseases. The results will be used as the base for
setting technical cooperation priorities.
- Countries continue to review their national and health sector
plans in the areas of response to disease outbreaks and disaster
planning, preparedness and mitigation.
- The United Nations Development Program (UNDP), the Caribbean
Disaster Emergency Response Agency, the International Federation
of Red Cross and Red Crescent Societies and PAHO have
collaborated to help strengthen response mechanisms in the
Caribbean. The Safety System of the Caribbean and CARICOM work
together in training programs for health administration in the
event of disaster as well.
- The United Nations Commission on Latin America and the
Caribbean (ECLAC) and the International Decade for Natural
Disaster Reduction jointly prepared a series of technical
training modules directed to professionals in structural
engineering and the design of hospitals.
- PAHO prepared a guide on the vulnerability of water systems
when exposed to disasters. Technical documents have also been
prepared as a result of case studies on the damage caused by
earthquakes in the urban water-supply systems in Costa Rica and
Ecuador, by the volcanic eruption in Montserrat, and by
landslides and floods in Brazil and other countries.
Education for Sustainable Development
Educational and communications policy changes
reflect the different needs and realities of the hemisphere
regarding instruction in sustainable development. The following
activities mark progress made in this effort:
- Countries have developed multi-sectoral plans for health
promotion efforts, and as a follow-up to international accords
regarding this subject, different groups of civil society have
been involved in these efforts.
- Several countries' health sectors have initiated studies and
training for the improvement of indigenous people's living
conditions. In order to reach diverse communities, alternative
models of communications and service delivery are being
researched with the help of the media itself in order to
effectively transmit information to target populations.
- Training models are also being developed for quality of care,
preparation of human resources, and adolescent health. These
models are based on an initial assessment and knowledge of what
target populations see as their needs.
- In seeking sustainable development, countries have formed
partnerships with NGOs and the private sector which have led to
greater efficiency and increased accountability in their
ministries of health. An example of this occurred in Nicaragua,
where a National Committee for Environmental Education was
founded in 1994, with the participation of the ministries of
education and health, other government agencies and
representatives of civil society. This institution analyzes,
prepares, proposes and implements national policies in the areas
of environmental protection and health.
- USAID and PAHO are working in coordination to support a
project, entitled "Equitable Access to Basic Health
Services," which will foster regional or inter-country
activities aimed at developing tools, providing support and to
designing, implementing and monitoring reform processes.
- The United Nations Educational, Scientific, and Cultural
Organizations (UNESCO) and the OAS will assist in the training
of teachers on the topic of sustainable development.
- Countries have encountered difficulties in assessing their
health sectors, especially with the need to clarify the functions
of different actors involved in regulation, financing, and the
provision of services.
- Along with this, there is a general lack of medical and
non-medical supplies, inadequate infrastructure, and insufficient
and poorly kept equipment. Furthermore, access to services by
underprivileged groups, such as indigenous and rural populations,
is very limited in several countries.
- Education is poorly funded in public schools serving low-income
groups. A lack of awareness of the harm being done by polluting
habits is widespread, and educational efforts to increase public
knowledge of this issue are inadequate.