Social and health situation in Latin America and the Caribbean
Since the early 2000s, Latin American and Caribbean countries have been experiencing rapid population ageing. While 12% of the population was aged 60 years or over in 2017, this rate is expected to reach 25% by 2040. In its “Economic and Social Overview of Latin America and Caribbean”, the Economic Commission for Latin America and the Caribbean (ECLAC) states that the region will have 87 million elderly people by this date.
In addition, due to the increase in life expectancy, elderly people will account for a growing proportion of the population. According to the Inter-American Development Bank (IDB), the over 80s will account for 26% of the over 60s by 2050, with an increase differing depending on the country, ranging between about 20% in Bolivia to over 30% in Chile, for example.
Ageing also comes with increased dependence. This results in a difficulty in carrying out the main daily tasks and the need for care, particularly to treat long-term illnesses. According to the OECD, only 0.5% of the Latin American population aged 60 and over currently benefits from healthcare assistance.
Furthermore, the Covid-19 pandemic has primarily affected the elderly and/or chronically ill population. Adapting public policies to population ageing poses a major challenge for weakened health systems, in terms of developing robust social protection systems and increasing citizen participation.
Operational strategy of the VITAL programme
In a context where the provision of informal services is declining due to an increased participation of women in the labour market, growing urbanisation and smaller households, in March 2020, Agence Française de Développement (AFD) launched VITAL, a technical assistance programme for five countries in the region (Bolivia, Colombia, Costa Rica, Cuba and the Dominican Republic).
This “Facility on Ageing in Latin America and the Caribbean” has two specific objectives:
1. Help countries acquire detailed knowledge of the needs of the elderly and be capable of identifying the institutional, legal and operational challenges.
2. Support and strengthen healthcare systems and care for the elderly suited to their needs, taking people’s social situations into account.
To this end, three thematic areas of operation have been identified:
● The development of quality medical and social services suited to elderly and/or dependent persons
● The adaptation of health systems to the needs of the elderly, in particular to treat chronic illnesses
● The introduction of financial support mechanisms to cover the basic needs of the elderly, including minimum pensions, care allowances and non-contributory transfers
Several identification missions conducted by the Inter-American Development Bank and Expertise France, together with discussions with local institutions, will lead to the development of annual national action plans for each of the five partner countries and the subsequent implementation of priority activities identified at the national and regional levels. At the same time, financing and co-financing operations by AFD and the PIB will be prepared in the context of policies on ageing and dependence in the region.
Gender mainstreaming through the Gender Help Desk
The activities of the VITAL programme are governed by the principle of an “on-demand” mobilisation. The national governments of partner countries must first formulate their needs for strategic assistance for their public policies, then IBD and Expertise France implement various technical assistance activities which include, for example:
- The organisation of study trips in France and Europe to learn about the care systems for elderly and/or dependent persons
- The organisation of technical workshops and national and regional seminars with the presence of French and European experts
- The preparation of comparative studies and national diagnostics on care systems in France and Europe
- Support for national technical assistance, with the mobilisation of French and Latin American experts
- Training for officials and technicians by French and Latin American experts
The technical assistance planned under VITAL ensures that the gender perspective is taken into account in the development of these policies. The project includes an innovative initiative to ensure the mainstreaming of gender issues: the Gender Help Desk.
It involves mainstreaming gender issues by producing the tools required to evaluate the activities ex ante and ex post, to ensure that they take gender inequalities into account.
What prospects for VITAL in 2023?
2023 is the year of the full implementation of the project, with more than 20 activities to organise. To improve its implementation, VITAL has benefited from a mid-term review which has identified the future challenges and opportunities, while making recommendations for the preparation of the annual action plans.
During the first 19 months, the project mobilised 14 experts for a total of 206 person-days of work. These experts have conducted analyses on ageing, gender and climate change at the regional and national levels.
VITAL is working towards the commitments of the Santiago Declaration of 2022, which promotes sustainable and resilient social protection systems, as well as the adoption of effective measures against age discrimination and the elimination of persistent difficulties which undermine the participation of elderly people in the political, social, economic and cultural life of countries in the region.
