Institucionalidad de la equidad de género en el Estado: un diagnóstico para América Latina = The institutionality of gender equity in the State: a diagnosis for Latin America and the Caribbean

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Infrastructure, integration and equity: The social impact of the health and public transportation infrastructure.

Academicians and practitioners generally agree that there is a positive correlation between more and better infrastructure and economic growth. From the broader perspective of development, attempts have been made in the literature to identify the different theoretical connections and the empirical patterns that link infrastructure to productivity, on the one hand, and those that link it to social inclusion and equity, on the other hand. Infrastructure contributes to development in different ways. The capital involved is not homogeneous, nor is its effect on the distributive aspects. Water and sanitation have a particularly strong association with the health of the general population and with infant mortality, early childhood health, learning abilities and the acquisition of labour skills. With respect to transportation, the reduction of costs and travel times has a direct economic impact on economic activities of production and domestic and international distribution. That infrastructure also has a social and distributive role to play by reducing the number of fatal accidents and serious injuries in the sectors that are naturally most susceptible to them, namely, the poor. Under the broad umbrella of infrastructure, we can include a number of facilities that make possible the provision of certain services. Some of these facilities require very significant fixed capital investments; some of them are residential, while others are not necessarily. What they all have in common is the existence of networks (transportation, wiring, pipelines) and a strong convergence of physical capital and/or technology, as well as the need for major investments in periodic maintenance.

Capital flows to Latin America: recent developments

The external environment has deteriorated sharply as a result of the spiraling financial turmoil, and has led to a weakening in commodity prices and fears of a worldwide recession. Latin America and the Caribbean's fastest expansion in 40 years may be threatened as the global credit crunch makes financing scarce and squeezes demand for the region's commodities. This time around the region is better positioned to weather the crisis than in the past, given improvements in macroeconomic and financial policies as well as a reduced net dependency on external capital inflows. However, Latin American markets are feeling the effects of the crisis through a slowdown in capital inflows, large declines in stock price indexes, significant currency adjustments and an increase in debt spreads. Volatility has soared, with the closely watched Chicago Board Options Exchange Volatility Index moving to an all-time high of 70.33 on October 17, indicating that fear (rather than greed) has been ruling the markets.After reaching record lows in May 2007, emerging markets bond spreads are now above pre-Asian crisis levels. The JPMorgan EMBI+ Latin American composite widened by 146 basis points in the third quarter, with spreads reaching 448 basis points at the end of September. Spreads have widened sharply in recent weeks as foreign investors cut back regional exposure for the safety of U.S. Treasuries. The ongoing lack of liquidity and subsequent liquidation of assets is leading to a collapse in asset prices and a sharp widening in spreads. Daily spreads in October have risen to levels not seen since December 2002, making it much more difficult for governments that need financing to get it. Risk premiums for Latin corporates and sovereigns have risen substantially, but have remained well below U.S. junk (high-yield) bonds. Latin corporates are facing a steep rise in foreign exchange borrowing costs (although less than firms in other emerging markets), which raises concerns that refinancing risks will climb.So far, emerging markets vulnerabilities have been more focused on corporates, as sovereigns have improved public debt dynamics and countries' financing needs are under control. Market performance has been driven by the rapid deterioration of emerging markets bank and corporate market, as well as ongoing losses in emerging markets equities. From January to September 2008, the Morgan Stanley Capital International (MSCI) Latin American Index lost almost 28%, while the Emerging Markets Index lost 37% and the G-7 Index lost 24%. While in 2007 the Latin America component gained 47%, almost nine times as much as the MSCI-G7 index for developed markets, since mid-September 2008 stocks in Latin America have been doing worse than stocks in developed countries, as concerns about access to credit and the adverse impact of sharp falls in commodity prices and in local currencies contribute to increased risk aversion and to outflows of capital. Many governments in the region have used revenue from the commodity boom to pay down debt and build reserves. Now, facing a global financial crisis and the threat of recession in developed countries, the biggest question for Latin America is how long and deep this cyclical downturn will be, and how much it is going to reduce commodity prices. Prices for commodities such as soy, gold, copper and oil, which helped fund the region's boom, have fallen 28% since their July 2 high, according to the RJ/CRB Commodity Price Index. According to Morgan Stanley (in a September 29 report), should prices return to their 10-year average, Latin America's balanced budgets would quickly revert to a deficit of 4.1% of GDP. As risk aversion increases, investors are rapidly pulling out massive amounts of money, creating problems for local markets and banks. There is an ongoing shortage of dollars (as investors liquidate assets in Latin American markets), and as currencies depreciate, inflation concerns increase despite the global slowdown. In Brazil and Mexico, central banks deployed billions of dollars of reserves to stem steep currency declines, as companies in these countries, believing their local currencies would continue to strengthen against the U.S. dollar, took debts in dollars. Some companies also made bets using currency derivatives that have led to losses in the billions of dollars. Dramatic currency swings have caused heavy losses for many companies, from Mexico's cement giant Cemex SAB to the Brazilian conglomerate Grupo Votorantim. Mexico's third-largest retailer, Controladora Comercial Mexicana, declared bankruptcy recently after reporting huge losses related to exchange rate bets. As concerns about corporate exposure to dollar-denominated derivatives increases, yields on bonds issued by many of Brazil's and Mexico's leading companies have started to rise, sharply raising the cost of issuing new debt. Latin American external debt issuance came to a halt in the third quarter of 2008, totaling only US$ 690 million. The cost of obtaining loans for capital expenditures, M&A and debt refinancing is also rising substantially for Latin American corporates amid contagion from the U.S. financial crisis. According to bankers, a protracted trend of shortening tenors and widening spreads has intensified in the past few weeks, indicating that bank lending is quickly following the way of bonds and equity. Finally, money transfers from Latin American migrants are expected to decline for the first time this decade, as a result of economic downturns in the U.S. and Spain, inflation and a weaker dollar. The Mexican Central Bank announced that money transfers from Mexicans living in the U.S. dropped a record 12.2% in August. In 2008, migrants from the region will send some 1.7% less in remittances year-on-year when adjusted for inflation, according to the IADB, compounding the adverse effects of the deepening financial turmoil.

Work, family and public policy changes in Latin America: Equity, maternalism and co-responsibility

Taking account of the substantial increase in female labour market participation that has occurred throughout the Latin American region, this article describes policies adopted with the aim of reconciling work and family responsibilities between 2003 and 2013, and the implications of their design for socioeconomic and gender equity. We look at the cases of Argentina, Brazil, Chile, Costa Rica and Uruguay, five countries which, on the basis of their track records, are the best placed to implement policies to reorganize time, income and services. The empirical analysis indicates, first, that these changes have contributed to socioeconomic equity more consistently than to gender equity. Second, the scale and type of change was found to vary significantly from one country to another. The article concludes by raising a number of substantive questions about the measures, their implementation and effectiveness, and the variations between countries.

The equity gap: Latin America, the Caribbean and the Social Summit

The World Summit for Social Development, held in Copenhagen, Denmark, from 6 to 12 March 1995, brought together a large number of heads of State and Government and official representatives from States Members of the United Nations and culminated in the adoption of the Copenhagen Declaration on Social Development and the Programme of Action of the World Summit for Social Development. These two documents —the first containing policy statements, the other dealing with their practical application— imply commitments at the national, regional and international levels. Barely two years have passed since this summit was held, too short a period to permit an evaluation of the impact of the actions that the Latin American and Caribbean Governments set out to undertake. On the other hand, most of the countries were already implementing a variety of official policies related to the great objectives of the World Summit for Social Development. Al reunirse ahora los países miembros de la CEPAL para examinar, por vez primera, los avances hacia la aplicación de los resultados de la Cumbre,1 la Secretaría ha centrado su estudio en tres aspectos. Primero, en examinar, desde la óptica latinoamericana y del Caribe, la situación actual en materia de pobreza, empleo e integración social, los principales temas de la Cumbre. Segundo, en el ámbito de las políticas, en reseñar las tendencias que resultan más relevantes para el cumplimiento de los compromisos antes mencionados. Tercero, en proponer algunas orientaciones adicionales sobre el contenido y alcance de las políticas tendientes a facilitar el pleno cumplimiento futuro de dichos compromisos. Se procura con ello orientar el debate de los gobiernos y de la sociedad civil en América Latina y el Caribe acerca de cómo se están instrumentando en la región los compromisos de la Cumbre de Copenhague.

Social equity and changing production patterns: an integrated approach

In accordance with the mandate it received at the twenty-third session, in this document the secretariat has attempted to delve further into the links among technical progress, international competitiveness and social equity, although it does not, certainly, purport to have exhausted these subjects. Two qualifying remarks are called for here. First, the secretariat is deliberately abstaining from becoming embfoiled in the theoretical aspects of a controversy which has raged for centuries, and particularly since the French revolution, i.e., the debate surrounding the cause-and-effect relationships and possible areas of incompatibility among democratic governance, economic stability, growth and well-being. Rather than concerning itself with doctrine, the secretariat prefers to deal with the realities confronting virtually all the Governments of the region. These realities include the need to resume a sustained (and environmentally sustainable) growth process within the framework of the consolidation of pluralistic, democratic societies -societies that are faced with very real demands to address the many ways in which the majority of the population has been bypassed by development. Secondly, no attempt has been made in this document to provide a list of suitable policies for changing production patterns or for attaining greater social equity. Instead, the focus is on how certain pivotal analytical and policy aspects can be linked within an integrated approach so as to reinforce any existing areas of complementarity between efforts to achieve greater growth and efforts to seek greater social equity. This approach highlights the central tenet of the document: that growth, social equity and democracy can be compatible. What is more, there are significant but as yet largely unexplored areas in which social equity and changing production patterns complement and reinforce one another.

Measuring the Performance of Cooperative Equity Redemption Plans

Cooperatives differ from other businesses in that they are owned by their patrons and net margins are distributed to patrons on the basis of use instead of capital investment. For financing, cooperatives often rely on allocated equities from retained patronage refunds. Retained patronage refunds are noncash allocations of net margins reinvested in a cooperative by patrons. Under an ideal program of equity formation, equity is held by patrons in proportion to patronage. Each patron’s share of financing the cooperative is equal to the share of benefits received. Equities of former patrons are retired as active patrons take on more of the responsibility of financing the organization.

Precautionary principle, economic and energy systems and social equity

In this paper the precautionary principle is reviewed alongside the process of international implementation. Adoption of the precautionary principle is advocated to deal with energy choices as a mechanism to account for potential climate change impacts, notwithstanding the debate on scientific uncertainty on the links between solar activity, greenhouse gas concentration and climate. However, it is also recognized that the widespread application of the precautionary principle to energy choices does not seem to be taking place in the real world. Relevant concrete barriers are identified stemming from the intrinsic logic governing the hegemonic economic system, driving the energy choices by economic surplus and rent generation potential, the existence of social asymmetries inside and among societies as well as by the absence of democratic global governance mechanisms, capable of dealing with climate change issues. Such perception seems to have been reinforced by the outcome of the United Nations Climate Change Conference, held in Copenhagen in December 2009. (c) 2010 Elsevier Ltd. All rights reserved.

Equity in health: tuberculosis in the Bolivian immigrant community of Sao Paulo, Brazil

Objectives To analyse the profile of tuberculosis (TB) among Bolivian immigrants, investigate the impact that this population has on the trends of TB and assess equity in access to TB treatment, in the city of Sao Paulo, Brazil. Methods Descriptive study of the epidemiological profile of TB in four city districts with large Bolivian populations, comparing cases among Brazilians and Bolivians, during the 19982008 period was carried out. We used logistic regression to adjust the treatment outcome for potential confounders. Results We identified 2056 new TB cases: 65.7% in Brazilians, 32.1% in Bolivians and 2.2% among other nationalities. Although TB incidence remained stable (high) over the study period, the annual proportion of cases among Bolivians increased from 15.0% to 53.0%. In comparison with the Brazilians, the Bolivians were younger (median age, 24 vs. 40 years; P < 0.0001) and presented a lower unemployment rate (3.1%vs. 11.6%; P < 0.0001), a lower rate of HIV co-infection (1.5%vs. 28.5%; P < 0.001), a higher proportion of individuals receiving supervised treatment (81.5%vs. 62.0%; P < 0.0001) and a higher proportion of cures (71.6%vs. 63.2%; P < 0.0001). After having been adjusted for potential confounder, cure after treatment was not associated with nationality. Conclusions Bolivian immigrants influenced the incidence but not the trends of TB among Brazilians in the study area. We found no significant differences between Bolivians and Brazilians regarding healthcare access or treatment outcome. Guaranteed universal health care access for all, including undocumented individuals, contributes to health equity. Specific intervention strategies are warranted for immigrants with tuberculosis.

Equity and women's health services for contraception, abortion and childbirth in Brazil

This paper addresses equity in health and health care in Brazil, examining unjust disparities between women and men, and between women from different social strata, with a focus on services for contraception, abortion and pregnancy. In 2010 women's life expectancy was 77.6 years, men's was 69.7 years. Women are two-thirds of public hospital services users and assess their health status less positively than men. The total fertility rate was 1.8 in 2011, and contraceptive prevalence has been high among women at all income levels. The proportion of sterilizations has decreased; lower-income women are more frequently sterilized. Abortions are mostly illegal; women with more money have better access to safe abortions in private clinics. Poorer women generally self-induce abortion with misoprostol, seeking treatment of complications from public clinics. Institutional violence on the part of health professionals is reported by half of women receiving abortion care and a quarter of women during childbirth. Maternity care is virtually universal. The public sector has fewer caesarean sections, fewer low birth weight babies, and more rooming-in, but excessive episiotomies and inductions. Privacy, continuity of care and companionship during birth are more common in the private sector. To achieve equity, the health system must go beyond universal, unregulated access to technology, and move towards safe, effective and transparent care. (C) 2012 Reproductive Health Matters

Are prescribing doctors sensitive to the price that their patients have to pay in the Spanish National Health System?

[EN] Background This study aims to design an empirical test on the sensitivity of the prescribing doctors to the price afforded for the patient, and to apply it to the population data of primary care dispensations for cardiovascular disease and mental illness in the Spanish National Health System (NHS). Implications for drug policies are discussed. Methods We used population data of 17 therapeutic groups of cardiovascular and mental illness drugs aggregated by health areas to obtain 1424 observations ((8 cardiovascular groups * 70 areas) + (9 psychotropics groups * 96 areas)). All drugs are free for pensioners. For non-pensioner patients 10 of the 17 therapeutic groups have a reduced copayment (RC) status of only 10% of the price with a ceiling of €2.64 per pack, while the remaining 7 groups have a full copayment (FC) rate of 40%. Differences in the average price among dispensations for pensioners and non-pensioners were modelled with multilevel regression models to test the following hypothesis: 1) in FC drugs there is a significant positive difference between the average prices of drugs prescribed to pensioners and non-pensioners; 2) in RC drugs there is no significant price differential between pensioner and non-pensioner patients; 3) the price differential of FC drugs prescribed to pensioners and non-pensioners is greater the higher the price of the drugs. Results The average monthly price of dispensations to pensioners and non-pensioners does not differ for RC drugs, but for FC drugs pensioners get more expensive dispensations than non-pensioners (estimated difference of €9.74 by DDD and month). There is a positive and significant effect of the drug price on the differential price between pensioners and non-pensioners. For FC drugs, each additional euro of the drug price increases the differential by nearly half a euro (0.492). We did not find any significant differences in the intensity of the price effect among FC therapeutic groups. Conclusions Doctors working in the Spanish NHS seem to be sensitive to the price that can be afforded by patients when they fill in prescriptions, although alternative hypothesis could also explain the results found.