Country Report Mexico STUDY ON POVERTY AND DISPARITIES IN CHILDHOOD

Transcription

1 Country Report Mexico STUDY ON POVERTY AND DISPARITIES IN CHILDHOOD

2 The cover design of this report was inspired by the Global Study on Child Poverty and Disparities, a multi-country initiative to leverage evidence, analysis, policy and partnerships in support of child rights. The overlapping, multi-coloured frames symbolize the national, regional and global contributions to the Global Study, which form the basis for exchanging experiences and sharing knowledge on child poverty. The design encapsulates three central tenets of the Global Study: ownership, multidimensionality and interconnectedness. Ownership: Although children s rights are universal, every country participating in the study has its own history, culture and sense of responsibility for its citizens. The analyses aim to stimulate discussion and provide evidence on how best to realize child rights in each country. Multidimensionality: No single measure can fully reflect the poverty that children experience. A multidimensional approach is therefore imperative to effectively understand and measure children s wellbeing and the various forms of poverty that they experience. Interconnectedness: Today s world is increasingly interconnected through economic, social, technological, environmental, epidemiological, cultural and knowledge exchanges. These exchanges have important implications for child poverty and can also help provide avenues for its reduction.

3 Acknowledgement The present Country Report is an input for the elaboration of a Global Study on Poverty and Disparities in Childhood performed by UNICEF in 40 countries of located in 7 regions (Central and East Europe and the Commonwealth of Independent States; east Asia and the Pacific; east and south Africa; Latin America and the Caribbean, Middle East and North Africa, South Asia and West and Central Africa.) The purpose of the global study is to place boys and girls at the center of public policies, and to influence the assignment of resources and the design and execution of economic and social policy, as well as anti-poverty programs. The team commissioned for the elaboration of the Global Study at UNICEF headquarters will use the information contained in the reports of each country and the statistical and policies tables to perform a comparative analysis and generate recommendations oriented towards development strategies, social and sectorial protection in order to respond in a more integral and effective manner to the problems derived from poverty and disparity that obstruct the complete fulfillment of the rights of boys, girls and youth. The team will analyze and pinpoint good practices and successful experiences in matter of multidimensional measurement of poverty and programs and policies aimed at the overcoming of poverty and disparity in Mexico. We are grateful for the collaboration of the Social Development Department, of the National System for Integral Family Development, the Health Department, the National Commission for Evaluation of Social Development Policies and the National Coordination of the Opportunities Human Development Program for the fulfillment of this Project.

4 Table of contents Executive Summary... 1 Section One: Children and Development Children, poverty and disparities... 5 What does this survey on children in Mexico show? Political, economic and institutional context Macroeconomic strategies and resources allocation Chapter s Conclusions...19 Section Two: Poverty and Childhood Income poverty and deprivations that affect children Child survival and equity Causal analysis: which factors explain the levels and trends of poverty? Conclusions Section Three: The Pillars of Childhood Wellbeing Nutrition Health Child Protection Education Social Protection Conclusions Section Four: Addressing Child Poverty and Disparities a Strategy for Results What must be done? How to make this happen Conclusions Acronyms List References Annex 1. Policy and Statistics Tables Appendix 2. National Mexican Family Life Survey Appendix 3. Construction of variables of deprivation through ENIGH and ENNViH

5 Table of figures Section One: Children and Development... 5 Table Estimated numbers of children affected by deprivations targeted by the MDG's... 9 Table Population and economic growth since Table Fertility...11 Table 1.3.4: Financing from abroad Table 1.2.4: Income inequality Table 1.2.5: Introducing sub-national dimensions of development...14 Table 2. Public spending and development supports Table 3. Data related to childhood regarding Household Income Key Budget Allocation Table 4. Data related to childhood regarding Nutrition Key Budget Allocations Table 5. Data related to childhood regarding Health Key Budget Allocations Table 6. Data related to childhood regarding Infancy Protection Key Budget Allocations Table 7. Data related to childhood regarding Children Education Key Budget Allocations...19 Section Two: Poverty and Childhood Table Trends in income/consumption poverty since Table Correlates of income/consumption poverty among households with children Table Households with children younger than 17 years old Table All households Table Child poverty as multiple deprivations Table Change in the incidence/prevalence of severe deprivations over the last decade among children.. 27 Table Correlates of severe child deprivations Table Prevalence of seven severe deprivations by region and residence Table Correlation between different indicators for child poverty/disparity Table Combined child poverty incidence Table Children in public care or adopted Table Change in U5MR by wealth quintile and gender Table Under 5 and infant mortality rates and their correlates Table 2.2.3: Relationship between U5MR and income/consumption poverty at sub-national level Table Odds ratios for the probability of income/consumption poverty by individual, household and geographic dimensions Table Odd ratios for the probability that children will or will not experience deprivations Section Three: The Pillars of Childhood Wellbeing Table A Individuals under 15 years old by expense per capita group in Table B Health indicators for children age five or less, by region Table Child nutrition outcome and its correlates Table C Health indicators for children between 5 and 11 years old Table Child nutrition: supply side and uptake variables by region Table Young child health outcomes, related care and correlates... 51

6 Table Adolescent health outcomes, care and correlates Table Child and youth health: supply side and uptake variables by region Table Birth registration and its correlates Table Orphanhood, child vulnerability and their correlates Table A Child labor and its correlates Table Child labor and its correlates Table Early marriage and its correlates Table Child protection: supply side and uptake variables by region Table School attendance and correlates Table C Individuals between 6 and 14 years old by age groups and expenditures per capita Table D Information about the school where children between 6 and 14 years old assist to Table Child education: supply side and uptake variables by region Table Access to social protection and its correlates by individual, households and geographic dimensions.78 Table Social Protection: supply side and uptake variables by region Annex 1. Policy and Statistics Tables Table Table 2. Public Spending and Development Supports Table 3. Household Income Key and Relevant Budget Allocation Table 4. Childhood Results in Nutrition Key Budget Allocations Table 5. Childhood Results in Health Key Budget Allocations Table 6. Childhood Results in Infancy Protection Key Budget Allocations Table 7. Childhood Results in Education Key Budget Allocations Table Estimated numbers of children affected by deprivations targeted by the MDG's Table Females by age in household surveys Table Males in the survey Table 1.2.4: Income inequality Table 1.2.5: Introducing sub-national dimensions of development Table Total and private social expenditures Table 1.3.4: Financing from abroad (million pesos of 2002) Table Trends in income/consumption poverty since Table Correlates of income/consumption poverty among Table Odds ratios for the probability of income/consumption poverty by individual, household and geographic dimensions Table Child poverty as multiple deprivations Table Change in the incidence/prevalence of severe deprivations over the last decade among children.113 Table Percentages of severe child deprivations Table Odds ratios for the probability that children will or will not experience deprivations Table Percentage of prevalence of seven severe deprivations by region and residence Table Correlation between different indicators for child poverty/disparity Table Combined child poverty incidence Table Children in public care or adopted

7 Table Change in U5MR by wealth quintile and gender Table Under 5 and infant mortality rates and their correlates Table 2.2.3: Relationship between U5MR and income/consumption poverty at sub-national level Table Child nutrition outcome and its correlates Table B Health indicators for children age five or less, by region Table C Health indicators for children between 5 and 11 years old in Table Child nutrition: supply side and uptake variables by region Table Young child health outcomes, related care and correlates Table Adolescent health outcomes, care and correlates Alternative of Table Adolescent health outcomes, care and correlates Table Child and youth health: supply side and uptake variables by region Table Birth registration and its correlates (individual, HH and geog. Dimensions) Table Orphanhood, child vulnerability and their correlates Table Child labor and its correlates Table Early marriage and its correlates Table Child protection: supply side and uptake variables by region Alternative of Table Child protection: Number of shelters for children and teenager migrants unaccompanied (2007) Table School attendance and correlates (by individual, households and geographic dimensions) Table D Individuals between 6 and 14 years old by age groups and expenses per capita Table E Information about the school were children between 6 and 14 years old assist to Table Child education: supply side and uptake variables by region Table Access to social protection and its correlates by individual, households and geographic dimensions.144 Table Social Protection: supply side and uptake variables by region Table Correlation between child outcomes and indicators of child poverty National inventory of programs Oportunidades Nursery and children houses program Program for the Development of Marginalized Zones Food Assistance Program, DICONSA Social - Milk Supply Program, LICONSA Compensatory Actions to Fight the Lag in Initial and Basic Education Quality Schools Program (PEC) Scholarship Program for young mothers and young pregnant women Support program for Preschool and Primary Education for boys and girls form families of migrant agricultural workers (PRONIM) Popular Insurance Medical Insurance for a new generation Urban marginal child work School Breakfast Program National Net of Childhood Rights Diffusion Program for Girls, Boys and Adolescents in Frontier Zones...176

8 STUDY ON POVERTY AND DISPARITIES IN CHILDHOOD: THE CASE OF MEXICO Executive Summary Overview/ Executive Summary Mexico is considered by the World Bank (WB) to be a middle-high income country (World Bank, 2008); with a relatively high Gross National Income (GNI) of $12,580 dollars in 2007 (World Bank 2009) and a GDP per capita of $14,400 USD in 2008 (The world Factbook, CIA). However- and despite the progress achieved in social development in the nineties- Mexico still has high levels of poverty and inequality that directly affect children (for example 2006 Gini index in Mexico was 49.6, CONEVAL - National Commission for Evaluation 2008). In this Report we study different aspects of child poverty, inequality and wellbeing in Mexico, using the Mexican Family Life Survey (ENNViH in Spanish) as well as other Mexican surveys including the National Survey of Household Incomes and Expenditures (ENIGH). This Report consists of Policy Tables and Statistical Tables. The first one comprises the main documents, programs, laws and strategies that are currently in place that relate to child poverty, while the second one comprises detailed statistical al analysis on childhood, poverty, disparities; deprivations and wellbeing of the children. In the Report we demonstrate a number of areas in which Mexican boys and girls suffer disadvantages. Regarding poverty measures based on monetary income, about 25% of Mexican children (10 million approximately) lived in conditions of food poverty in 2005; in other words, they lived in homes where income was insufficient to purchase the basic food basket. (Chart ENIGH). According to international standards, 8% of the children in the country (3.3 millions) were in families who had less than one dollar per capita expenditure in 2005 (chart ENIGH). According to the analysis of deprivations, 1 we have found that close to 9% of children lived with at least two less severe deprivations in 2005 (chart 2.1.5, ENIGH). In that year, 24% of children experienced severe deprivations of housing (children who live in homes with 5 or more people per room or with dirt floors); 5% had no access to any kind of sanitation services and 7% experienced severe deprivations of information (children between 3 and 17 years old without access to Television, Internet or who do not read). By gender, however, few significant differences can be seen between deprivations of boys and girls. For example, analysis of the ENIGH demonstrates that in 2005, 24.3% of the boys and 24.5% of the girls experienced a severe housing deprivation; 6.3% of the boys and 6.9% of the girls had deprivations on information; 12.4% of boys and 13.9% of girls had deprivations in the area of education. About 9.0% of the boys experienced at 1 The deprivations analysis consists of a series of indicators regarding housing, sanitation, water, information, education, health and nutrition that enables analyzing poverty incidence from a different perspective than poverty measured by the income/expenditures of the households. Each deprivation can arise in a severe or less severe way. For example, a severe deprivation in matter of housing refers to a household with five or more habitants per room or with dirt floors and a less severe deprivation refers to a household with four or more habitants per room, with dirt floor or a ceiling with an inappropriate material (for example, laminated roof). 1

9 least two severe deprivations in 2005, versus 9.7% of girls. Over time there has been large reductions in the percentage of children experiencing severe deprivations overall in sanitation, water and information. While 23% of the children had a severe deprivation insanitation in 1994, this percentage had fallen to 5% in 2005 (ENIGH); the percentage of children with water deprivations fell from 18% to 2% during the same years and children with information deprivations fell from 15% to 7% during the same period. There are great differences in disparities between urban and rural areas; children in rural areas face more disadvantages than those in urban areas and indigenous children are generally the most vulnerable group of children in Mexico (for example, 33% of indigenous children under 5 years old were stunted in 2006, in comparison to the 12% of all the children with this age, CONEVAL 2008). This is an important result due to the fact that Mexico has one of the largest ethnical diversity in the world (with approximately 68 indigenous languages, INALI, 2005) and in general indigenous population, both adults and children, live in very precarious conditions, have low schooling levels,, high rate of grade failure and school desertion and generally have access to lower quality health and education services than the nonindigenous population. With respect to education, there are still an important number of children between 5 and 17 years of age who do not attend school (ENOE 2007 (National Survey of Occupation and Employment) (about 1.6 million boys and 1.4 million girls), and who do not finish basic education on time 2 (about 62% of girls and boys completed basic education on time). (EN- NViH 2002 Mexican Family Life Survey). In spite of the fact that elementary and junior high school are mandatory, 40% of youth fifteen years old and above cannot read and write, 9.5% of the population aged 5 to 17 years does not attend school (2005 CONTEO survey), and close to 12.5% of the children and youth work, which corresponds to approximately 3.6 million children (INEGI, 2008 National Institute for Statistics and Geography). In spite of the existing disparities, it is important to emphasize that some social indicators indicator for boys and girls have progressed. The mortality rate of children under five years old declined from 33.7 in 1995 to 18.4 in 2007 and the mortality rate of children under one year old decreased from 27.7 in 1995 to 16.8 in 2005 (CONAPO National Population Council); the proportion of boys and girls over one year old vaccinated against measles increased from 90% in 1995 to 96.4% in 2006 and the coverage of full scheme vaccination in one year old children increased from 87.9% to 95.2% (MDO's, 2006). While in % of the children under 5 were underweight, in 2006 only 5% were underweight. Similarly, while in 1992 almost 23% of the children under five were stunted, only 12.5% were stunted in 2006 (CONEVAL 2006). Only 1.6% of the children were underweight for their size in 2006 (ENSANUT). Additionally, government social expenditures have consistently increased. While in the seventies government social expenditure represented close to 4.5% of the GDP, in 2005 it represented 11% (Scott, 2008). The Federal Government has made some recent notable efforts which include the Opportunities Program- to improve the targeting of government expenditures to poorer groups. Nevertheless, there are still notorious inequalities in certain aspects of government expenditures, such as subsidies to certain goods and services, such as gasoline. Even though there adequate data sources to learn about the situation of childhood in areas such as socio-economic variables and health., there are important shortcomings in the availability and quality of the available information in areas such as child protection. In spite of the fact that there has been progress in some information areas, for instance through data presented by indicator CONEVAL), adequate information is lacking on child shelters, children employed as day farmers, adoptions, child violence, as well as unregistered boys and girls, among others. In general, these children are among the most vulnerable and are more prone to living in poverty and exclusion conditions, so that this lack of information represents an obstacle to fulfilling and respecting their rights and helping to overcome their poverty situation. In summary, this Report shows that Mexico has made important progress in the reduction of poverty and the improvement of child wellbeing in several dimensions. However, the Report also demonstrates that there is still a long way to go and that a high proportion of children in Mexico still live in unacceptable conditions. 2

10 We now turn to some conclusions and recommendations generated from the findings of this report. 1. There are a number of groups that suffer substantially higher deprivations and disadvantages in Mexico. In spite of being a country with a relatively high per capita level of income, high inequalities in a number areas have led to important population groups that live in a high level of social exclusion and deprivation, as has been broadly documented in this report. In particular, lower income groups, the indigenous and those who live in rural areas suffer more deprivations than other groups. These differences and inequalities make it clear that the government s policies must continue to focus on correcting these inequalities. Historically, in the areas of education and health, the government s expenditures shows evidence of being regressive, which can be seen, for example, in the fact that poorer children have access to worse education and health services than those children in families with a higher income. A basic principle of public expenditures is that it should be progressive rather than regressive. Health and education services offered to poor boys and girls must have the same quality than those offered to boys and girls of medium and high levels, which implies that the budget in matter of education and health destined to poor children should be larger than the budget assigned to higher income children in order to reverse historical inequalities. In this regard, a main recommendation of this report is that the government should guarantee similar education, nutrition and health services across Mexico, and particularly that a significant effort should be made to improve the quality of the services in indigenous and rural areas. This may require a larger allocation of expenditures towards investment in the areas with a lower level of services. 2. Emphasis has been placed on this report not only on monetary poverty indicator, but also on other indicators of wellbeing and fulfillment of the rights of boys, girls and youth, including health and nutrition. There are still significant populations above all rural and indigenous- where children suffer malnutrition. indicator However, it is important to note that an issue that now affects a larger proportion of the child population is obesity. Though this is not a specific topic in the Report s guidelines, we consider it important to mention that obesity has become a major public health concern, not only because of the high proportion of children who are overweight or obese in Mexico, but because of the rhythm with which this prevalence has increased among all groups of income, including the poorest. In spite of the fact that there is still a considerable proportion of boys and girls with stunting, wasting and underweight (Chart 1.1.3, ENNViH), overweight and obesity are rapidly growing among children. For example, in the group aged 5 to 11 years old, the combined prevalence of overweight and obesity increased 33% between 1999 and 2006 (ENSANUT, 2006). Parker, Rubalcava and Teruel, 2007 report that in 2005 close to 16% of the individuals under fifteen were overweight and almost 12% were obese. It is very probable that the high rates of obesity will lead to an increase on chronic diseases among children such as high blood pressure and diabetes-, which is likely to affect their life expectancy. This is currently one of the most important public health topics that affect childhood in Mexico and that require the implementation of immediate policies to reduce and prevent child obesity, in addition to addressing the consequences of the current obesity epidemic. 3. The role performed by the main social programs oriented to childhood in Mexico should be highlighted, including Oportunidades (Opportunities), the renowned social program of conditional cash transfers, that provides monetary benefits in exchange for children regularly attending school and the family attending periodical health check-ups. Oportunidades has been a revolutionary program in terms of its design, targeting mechanisms, multidimensional perspective and evaluation. However, the program still has areas where coverage could be improved, particularly urban areas, where coverage is notably less than in rural areas. Furthermore, while the impact of Oportunidades on school attendance to secondary or middle school is well documented, few significant results have been found on the cognitive development and nutritional development of children, so that it might be necessary to redesign some components of the program that could improve its impact in those areas. Additionally there are a significant number of families that are not eligible to receive Oportunidades because they live in areas where there are no close schools or health centers. In view of this situation, specific programs have been designed to service this population, such as the Program of Alimentary Support of Diconsa, which seeks to improve alimentation and nutrition of the population that does not receive the Oportunidades Program because they are located in faraway areas from schools and health centers. 4. It is worth highlighting the outstanding role of the Federal Government through the National Commis- 3

11 sion for Evaluation (CONEVAL), an new institution that is in charge of the definition, measurement and publication of the poverty rates of the population, being the official source for these statistics. We note that, based on the Social Development Act, the CONEVAL is obligated to include in the measurement of poverty variables such as income per capita, average education deficit at home, access to health services and to social security, the quality of housing and the availability of the basic services, in addition to access to alimentation and the degree of social cohesion (LGDS, 2004). The CONEVAL is also in charge of monitoring that all social programs with Rules of Operation carry out external and independent evaluations and regulates that the recommendations derived from these external and independent evaluations be followed. Furthermore, since 2007 CONEVAL is collaborating with SHCP (Treasury Department) and the Public Office Department to implement the Performance Evaluation System, which seeks to measure and evaluate the results of the programs and of the social policy to systematically improve its performance. To be able to achieve this, it is proposed that there are follow up of results through an Indicators Matrix, in which the budget of the programs is planned and conformed in a manner so as to clearly define the objective to which they were created; and also to advance in the efforts to the full instrumentation of the budget based on results. The preceding reflects a notable effort from the Federal Government and an important step towards the development of a social policy based on the integration of programs, encouraging those program that work well and removing those that do not. The success of the Oportunidades Program represents an excellent example of a social program where rigorous external evaluations that have been carried out ever since its initial phases have allowed to distinguish positive results, and that have also put in evidence some of its weaknesses or negative aspects of the program. Thus it is recommended to continue the implementation begun CONEVAL of carrying out rigorous external evaluations of social programs; and also to continue using the results of the evaluations to improve and/or expand programs with positive outcomes and reduce or even eliminate programs with few positive impacts on the beneficiary population. In summary, This Report has made two important contributions in matters of findings and in methodological terms. First, it has shown that, in spite of the advances in matter of social development, the disparity in social expenditures persists. Education and health services continue to have a differential quality between the poor and non poor population, quality is much higher in urban populations and for those of higher income. To eradicate these gaps in access to health and education services of equal quality, progressive government expenditures is necessary with a general emphasis on increasing services for those boys and girls who live in rural, indigenous, or marginalized 2 receives priority. Secondly, this report takes advantage on the multidimensional character of the Mexican Family Life Survey (ENNViH) to study poverty not only in monetary terms but also in terms of deprivations and other indicators indicator (such as wealth, mother s education and indigenous condition) which allow to crossing diverse information and thus elaborate on the poverty of children in Mexico, which could not be made with any other poll in Mexico. This Report adds to a very advanced trajectory of social policy in Mexico that seeks to deepen the multidimensional analysis of poverty and, strengthen the actions that have been carried out in Mexico to improve social development, such as the creation of the Social Development Act, the CONEVAL and the Oportunidades Human Development Program. Finally, it is important to point out that this Report establishes a conceptual link between the multidimensional approach of poverty and the integrality of human rights (specifically the rights of children and youth). That is, the multidimensional measurement of poverty strengthens the analysis of the causes that prevent the fulfillment of rights and the effect of such non-fulfillment, by encompassing all the dimensions under which boys, girls and teenagers may face situations of poverty, exclusion or deprivations. 2 For more information and data to this regard, see Parker, Susan (2008). Poverty and Education in Mexico. UNDP. Parker, Susan (2008). Health and Nutrition in Mexico. UNDP. Parker, Susan; Rubalcava, Luis y Teruel, Graciela (2007). Quality of Education in Latin America and the Caribbean Region: The Mexican Case. Banco Interamericano de Desarrollo (BID - The Inter American Bank for Development). 4

12 STUDY ON POVERTY AND DISPARITIES IN CHILDHOOD: THE CASE OF MEXICO Section One: Children and Development In this chapter we present the objectives of the research, synthesize the main results and describe the precedents and the analysis of the characteristics of Mexico that are relevant to the survey of childhood poverty. 1.1 Children, poverty and disparities Mexico is a Latin American country classified by the World Bank as of medium-high income, with a GDP per capita of $14,400 USD in 2008 (The World Factbook, 2009). The main language is Spanish, though there are approximately 68 indigenous languages (INALI, 2005) spoken by over six million people above five years of age (COUNT, 2005). In 2005, the population of Mexico was close to 103 million people (CONAPO, 2005), of which 41 million were between 0 to 17 years old (ENIGH, 2005). Close to 10 million of people lived in conditions of alimentary poverty, this is, they lived in households with insufficient means to purchase a basic food basket. This Report presents the situation of Childhood in Mexico from a perspective of poverty, disparity and deprivations. The survey uses a variety of sources of nationally representative information to provide an up to date panorama on the wellbeing of children in Mexico. The Report provides statistics and analysis in three levels: country, home and individual. At the country level, an analysis on the general economic and social conditions that affect the situation of childhood is presented, as well as the social policies aimed at improving childhood wellbeing. Surveys are also used to construct aggregate indicators on childhood wellbeing in Mexico, both at home level and individually. In matter of deprivations, indicators of housing, sanitation, water, information, alimentation, health and education are used. In the first place, poverty indicators based on income (for example, total income or expense) were constructed with information on home level, while the indicators such as malnutrition were constructed based on individual information. One of the main purposes of this report survey is to present multidimensional information, which allows measuring poverty and deprivation from several different dimensions, (including income, nutrition, education and household dwelling characteristics). The Report shows that, while there are significant correlations between the different indicators of poverty and disparities, there are also important differences in the incidence of different deprivations. This Report is based on, in great extent, the Mexican Family Life Survey (ENNViH), and the National Survey of Household Income and Expenses (ENIGH), on Government reports and on other surveys such as the National Survey of Youth s, among other data sources. One of the main advantages of the ENNViH is that it brings together in one sole source information on income, health and nutrition, among other topics, which enables to present an integral analysis of all the deprivations using a single source. 5

13 ENNViH Main Purpose: collect within one instrument information on socioeconomic, demographic, crime, health and community indicators pertaining to the Mexican population. Multi-thematic data base and of longitudinal nature. It started in 2002 with a follow-up round in 2005; two more rounds will be carried out in 2009 and It collects information at individual, home and community level about: o Expendituresse and consumption patterns, savings decisions, ownership of assets and family wealth. o Social programs. o Level of schooling, attendance and permanence at school. o Types of employment, mobility and work participation. o Use of time. o State of health: self perception and expectations, habits; anthropometric measurements (weight and size), biological markerss (blood pressure, hemoglobin,glucose. o Reproductive health. o Crime and victimization. o Quantitative and qualitative information about schools, health centers and small health suppliers. o Home equipping, services, vehicles, appliances and items. ENIGH* Main Purpose: provide information on the distribution, amount and structure of income and expenditures of households. Cross section data base. Provides some socio-demographic characteristics, activity condition and occupational characteristics of the family members of 12 and older, in addition to household dwelling characteristics. Statistics are available for years: , 1989, 1992, 1994, 1996, 1998, 2000, 2002, 2004, 2005 and It collects information on: o Dwelling characteristics. o Residents and home identification at the dwelling. o Socio-demographic characteristics. o Activity condition and occupational characteristics of the family members of 12 and older. o Household services, vehicles, appliances and items. o Total expenditures of the homes. o Current non monetary expenditures. Total income of the household, both monetary and non monetary. o Current total money and nonmonetary income of the homes. In particularly, ENNViH was used to present the main analysis on monetary poverty, deprivations and the pillars of information wellbeing, due to the wealth of information it provides in a solo survey. (for example, ENNViH allows to analyze health, child work and education indicators according to the wealth levels of households, parental level of schooling, by indigenous status and by region) 3, which is not possible to do with any alternative survey in Mexico. * During 2008 CONEVAL and INEGI designed a module of Socio-economic Condition inside ENIGH, which incorporated data on health, income, education, social security, quality and dwelling s spaces, basic services, alimentation and social cohesion, to fulfill provisions in articles 36 and 37 of the LGDS. What does this survey on children in Mexico show? (Main conclusions) In spite of the fact that Mexico is a country with medium high income that has had important progress in matter of social development during the nineties 4 a large proportion of the population still lives under poverty and disparity conditions. Disparity among urban and rural areas, as well as among indigenous and non-indigenous locations is evident. Almost one fourth of the population lives in communities with less than 2,500 individuals. Due to their general isolation, rural areas tend to have lower access to basic health and education services, an important correlate to its high levels of poverty. 3 It is important to mention that, due to the fact that the weights for the second round of the ENNViH corresponding to 2005 were not ready at the time the analysis was made, the analysis in this report uses the first round of data, that is Specifically, Mexico has had an increase in the coverage of basic services, especially for the population of lower income; the expectation of life at birth has increased and poverty has reduced in an important form since 1996 (CONEVAL, 2008). 6

14 This research has shown that Mexican children suffer disadvantages in several areas. With regard to monetary income measures, close to 25% of the children lived in conditions of alimentary poverty in 2005 (Chart ENIGH). As per international standards, 8% of the children in Mexico lived in households with less than one dollar per capita per day to survive (Chart 2.1.1, ENIGH) With regard to the deprivations analysis, we have found that 9% of the children in Mexico lived with at least two severe deprivations in About 5% of children had no access to any type of sanitation (close to 2 million). Close to 2% of children used rivers or wells to get water. With regard to information, 17% of children had no access to Internet (2.2 million), to televisions or to books (ENIGH 2005). With regard to education, there are still an important number of children that do not attend school (as per ENNViH 2002, more than a million and a half between 6 and 15 years old, a number that increases to 3.2 million if we consider those between 6 and 17 years old). There are also an important number who do not finish primary education on time. That is, on time implies that for children between 6 and 15 years, the difference between their age and their education plus six is equal to or less than one. Close to 2.1 million children and 2.4 million girls, in conjunct little more than 20% of the total population between 6 and 15 years old, ENNViH 2002 do not finish primary school on time). This is associated with the high degree of repetition and dropout existing in Mexico. To this regard, at the beginning of school term 2006/2007 the group of boys and girls from 12 to 14 years old was the one that represented the highest fallback rate (persons who are enrolled two grades or more below what would otherwise normally correspond as per their age) of 9.3%. When differentiated by state we find that while in the Federal District this rate was 3.8% and in Nuevo Leon 3%, in Chiapas it was 20.2% and in Oaxaca 21.3% (INEE 2007). With respect to repetition, close to 5% of the children repeated first grade during the term and 1.2% repeated first grade of secondary or middle school in the same term (INEE 2008). Furthermore, in spite of the fact that basic education, which includes preschool, primary and secondary are mandatory, 40% of fifteen years old and older had not finished junior high in 2005, close to 10% of the five year and older population did not read and write, and close to 9.5% of the population 5 to 17 years old did not attend school (Mexican Conteo Survey 2005). With respect to deprivations in the area of health, approximately 25% of children (9.9 million) in 2002 reported either not having received vaccination or not having seen a doctor to treat a respiratory disease, or both. 5 Almost 40% of the children (15.7 million) had not received additional vaccines after the age of two (ENNViH 2002). In spite of the fact that there are an important proportion of l children who are mal nourished (Chart 1.1.3, ENNViH), currently the proportion of children overweight and obese are rapidly growing. For example, Parker, Rubalcava and Teruel, 2007 show that in 2005, close to 16% of individual under fifteen were overweight and almost 12% were obese. In turn, the ENSANUT 2006 shows that 16.5% of boys between 5 and 11 years old were overweight in 2006 and 9.4 suffered obesity, while 18.1% of the girls within the same range of age were overweight and 8.7% obese. The high rates of obesity are likely to cause an increase in chronic diseases among children, such as hypertension and diabetes, which would threaten to reduce their life expectancies. In spite of the existing disparities, it is important to emphasize that there has been important progress in some of the social indicators for children. For instance, while in % of the children lived in conditions of alimentary poverty, in 2005 this percentage had fallen slightly to 25% (close to 10 million of children). In terms of poverty of capacities, in % of the children suffered this type of poverty, while for 2005 this percentage had fallen to 33% (13 million children). In as much as patrimonial poverty, in % of the children lived in these conditions, while in 2005 this percentage had fallen to 57% - approximately 23 million children- (ENIGH 1992, 2005). 6 The proportion of children who have no access to a sanitary service of any kind has greatly diminished over time (from 23% in 1994 to 5% in 2005); those who use rivers, wells, or walk 30 minutes or longer to get water (from 18% to 2% in the 5 That is not inconsistent with the high rates of coverage of vaccination with full scheme reported on children one year old, because the definition of severe deprivation by UNICEF applies only to children from 0 to 18 years old and furthermore, the definition is not only based on vaccination but also on clinic visits with regard to respiratory diseases. 6 In 2002, under the supervision of the Technical Committee for Measurement of Poverty (CTMP), three official lines of poverty were created in Mexico used by the Federal Government to monitor the changes in poverty as per the income of the homes and using the ENIGH as reference base. The first line corresponds to alimentary poverty, the second one to poverty of capacities, and the third one to patrimonial poverty. Alimentary poverty refers to the incapacity to obtain the basic food basket, even using the whole of the available income at home purchasing only the goods of the said basket. Poverty of capacities refers to the insufficiency of the available income to purchase the value of the food basket and make the necessary pay the necessary expenses on health and education, even assigning the total income of the household for nothing more than these purposes. Patrimonial poverty refers to insufficiency of the income available to purchase the alimentary basket, and also to perform the necessary expenses for health, education, clothing, housing and transportation, though the total income of the household were used exclusively for the acquisition of these goods and services. 7

15 same years), and who have no access to television, Internet or to reading materials(from 15% in 1994 to just 7% in 2005, ENIGH). In education, during the past three decades the average of schooling of the Mexican population more than doubled, from 3.4 in 1970 to 7.6 years in 2000 (Census). In 2005 the inhabitants 15 years old and older had on average 8.1 grades of schooling (about 2 years of secondary school). By state, there are significant differences, for instance while in 2005 in the Federal District the population s average years of schooling was and in Nuevo Leon 9.7, in Chiapas these were 5.6 and in Oaxaca 6.1 (INEE, 2006). Additionally, it is important to remark that, government social expenditures has increased importantly in real terms. While in the decade of the seventies the social expenditures represented close to 4.5% of the GDP, in 2005 it represented 11% of the GDP (Scott, 2008). This clearly reflects a greater effort of the Federal Government to improve both expenditures and the targeting of these expenditures (including the Oportunidades Program)- to improve the focalization towards the poorest groups; although some regressive expenditures persist. Additionally, recently the Mexican Government has implemented a careful system of evaluation and monitoring to measure poverty and the impacts of of the social development programs it has created. The Social Development Act (LGDS) of 2004 brought with it the creation of the National Commission for Evaluation of Social Development Policy (CONEVAL) in 2006, an institution in charge of monitoring and regulating that the government s main social programs be evaluated. Currently CONEVAL is working on the measurement and follow-up of poverty in Mexico based on a multidimensional approach of poverty. These innovations represent an important step forward for Mexico to improve the effectiveness and impacts of its social policy. In addition to this, in matter of equity of gender, in Mexico has followed diverse strategies that seek to reduce disparities between men and women. Among these, the ratification of the Inter American Convention on the Elimination of all Forms of Discrimination against Women in 1981 exists, and the Inter American Convention to Prevent, Sanction and Eradicate Violence against Women (Convention of Belem do Para) in 1998, which seeks to guarantee women the full enjoyment of their rights in conditions of equality with men; and also the approval of several laws, national and state to prevent and sanction violence and discrimination based on gender. It is also worth mentioning the implementation of the Woman s National Program in 1996, which sought to incorporate the perspective of gender into the planning, design and execution of public policies, and the creation of the National Institute for Institute (INMUJERES), in 2001, as a federal government s organization, the institution in charge of directing the national policy to achieve equality of opportunities among men and women. These efforts have contributed to a better legal and institutional platform for the promotion and fulfillment of women s rights, which are now beginning to show positive results through the indicators such as the Index for Development Related to Gender (IDG), which adjusts the level of IDH (Human Development Index) according to gender disparity and the Index for Development of Gender (IPG), which measures women s participation in : legislative power, managing posts and labor income, both elaborated by the UNDP (United Nations Program for Development). With regard to the IPG, defined between 0 and 1, where zero means no participation of women in the public sphere and one implies total parity in the components of the indicator, in 2000, 19 of the 32 federal entities in this country had a value of IPG less than 0.5, 11 entities had values between 0.51 and 0.60, and two entities obtained a IPG over 0.61 (only the Federal District had a value over 0.70); by 2005, 9 federal entities registered a IPG less than 0.5 (half with regard to that observed five years before), 12 reached values between 0.51 and 0.6 and 11 entities reached values over 0.61 (again the Federal District had the highest value, this time with a IPG slightly over 0.80) 7. Finally, it is important to mention that this Report establishes a conceptual link between the multidimensional approach of poverty and the integrality of the human rights (specifically the rights of childhood and adolescence). This is, the multidimensional measurement of poverty strengthens the analysis of the causes that prevent the fulfillment of children s rights. Childhood and the MDO's (Millennium s Development Objectives): progress and disparity Mexico has carried out social policies and strategies that have allowed significant progress towards the fulfillment of the MDO's. Furthermore, Mexico has committed itself to fulfilling a series of additional 7 Indexes of Human Development and Gender in Mexico , UNDP Mexico, 2009, p

16 Table Estimated numbers of children affected by deprivations targeted by the MDG's Percentage of Mexico, Mexican Family Life Survey, 2002 hholds with such children or youth girls or women of this age in this category boys or men of this age girls or women of this age not in this category A. Nutrition poor 1. Underweight children under five years of age (MDG 1 Indicator 4) B. Education poor 2. Enrolled in primary education (MDG 2 and 3 Indicator 6 and 9, between 5 and 14 years old) 3. Completing the final year of primary education in proper age (MDG 2, Indicator 7 proxy) 4. Attending primary and secondary school in proper age (MDG 3, Indicator 9) C. Health poor 7. Number of 1 year-olds immunized against measles 9. Households and/or children with sustainable access to an improved water source (MDG Goal 7 Indicator 30) 10. Households and/or children with access to improved sanitation (MDG Goal 7 Indicator 31) REFERENCE/SOURCE: Mexican Family Life Survey 2002 (MxFLS-1) goals called beyond the millennium, among which them are:: to reduce in half the proportion of persons with less than the minimum recommended level of consumption of proteins by the year 2015; insure that 90% of youth 12 years and older who enroll in secondary or middle school finish within the official term (three years), and achieve that students of primary level and secondary education reach satisfactory levels in Spanish and Math as per the exams established by an independent evaluation organism. (Millennium s Objectives, 2000). Prior to the current financial crisis, the country had advanced somewhat in the reduction of extreme poverty, between 2000 and 2005, it has reduced in over half the percentage of persons with income under one dollar a day, going from 8.6% in 2000 to 3.5% in 2005 (MDO's, 2006). The preceding can be explained in part due by economic growth and low inflation, as well as targeted conditional transfers by the Federal Government such as the Oportunidades Program- 8, 8 The governmental transfers of Oportunidades have contributed to increase the total net income per capita of alimentary poor families in rural areas in almost 58% between 1992 and 2006 (Coneval, 2008). and by the effect of remittances. In countries such as Mexico, the remittances are a key tool for the reduction of poverty, 57% of remittances are used to pay for essential expenses such as clothes, food and lodging and the remainder is generally saved or invested in small businesses, properties or education, (BID 2008). The progress to achieve the Millennium s Development Objectives in matter of health has been significant. Child mortality for children under five fell from 33.7 in 1995 to 18.4 in 2007 (CONAPO); the proportion of boys and girls one year old vaccinated against measles increased from 90% in 1995 to 96.4% in 2005 and the coverage of full scheme vaccination of one year old children increased from 87.9% to 95.2% (MDO's, 2006). However, there still are several challenges for the fulfillment of the MDO's, above all in education. In 2002, only 65% of the girls and 63% of the boys had completed the last year of primary level at an adequate age (Chart 1.1.3, ENNViH, 2002). Likewise, 80% of the girls and 77% of the boys attended 9

17 primary and secondary school at the proper age. Both indicators reflect the existence of high grade repetition in Mexico. Interestingly, however, the differences between genders in these two indicators show that currently, girls have a better performance than boys (Chart 1.1.3, ENNViH, 2002). With regard to child health, Chart shows that 82% of one year old girls (approximately 4 million) and 84% of one year old boys (3.6 million) were vaccinated against measles in % of homes with children have access to a sanitation service (12.9 million), and also only 82% of the homes (13.8 million) has access to sources of improved water, this is, that they have access to treated or untreated water, but not contaminated alternatively in urban areas they receive water from a public source or a well located no more than 200 meters away or that in rural areas the members of a house do not have to spend a large portion of the day carrying water (Chart 1.1.3, ENNViH, 2002) Political, economic and institutional context We now present a general panorama of the country s structure, population and economic indicators and budget allocation. Political, geographical and institutional background Mexico is a democratic republic, representative and federal formed by 31 federal entities (states) and one Federal District, seat of the federation s powers (executive, legislative, and judicial). Geographically, Mexico has a surface of almost 2 million Km2 and shares borders with the United States, Guatemala, and Belize. For its territorial extension it has the 12th place worldwide and the 5th within the American Continent (INEGI, 2006). The official language is Spanish, though there are also 68 indigenous languages and multiple variable dialects. Mexico is considered the 13th world economy. The Mexican political system is dominated by three main parties: the Institutional Revolutionary Party (PRI), the National Action Party (PAN), and the Democratic Revolution Party (PRD). Both presidential elections and state executives elections are every 9 Through the ENNViH it was not possible to construct indicator number 4 of the MDO's (mortality of children under one year or between one year and five). six years. In 2000 an important time was lived inside the process of democratic transition of the country, with the presidential electoral victory of PAN, which represented the first party change at the federal level after over seventy years of governance by the PRI. Mexico generally has an open economic and political system. In 1994 it signed the North America Free Trade Agreement with United States and Canada, and has also signed free trade treaties with the European Union, the majority of Latin American countries, Japan and Israel, and also with the Free Trade European Association, formed by Iceland, Norway, Lichtenstein and Switzerland. Furthermore, it is a member of the Organization for Economic Co-operation and Development (OECD) since In legislative terms, Mexico is ruled through the Political Constitution of the United Mexican States, signed in 1917 and with numerous reforms up to the present. From a macro-economic point of view, after different periods of crisis and recoveries during the decade of the eighties and the nineties, Mexico has been relatively stable during the last ten years back with low growth rates but also with low inflation and a relatively stable currency. However, currently Mexico is again amid a period of economic complications as a consequence of the world financial crisis and due to its high interrelation with the economy of the United States. The Finance Ministry estimated that during the first quarter of 2009 the real value of GDP fell at a yearly rate close to 7.0%, (SHCP, 2009), since September of 2008 the currency has devaluated close to 32.8% with regard to the dollar, which has significantly increased the price of imported goods. Furthermore, between December of 2008 and March of 2009 a decrease of 1.3% on formal employment was recorded, equivalent to 181,675 persons. (SHCP, 2009). Banco de Mexico, for its part, stated at the end of April that Mexico s GDP in 2009 is expected to register a contraction of between 3.8 and 4.8% of GDP annually. (Banxico, 2009). The National Development Plan (PND) , developed by the Federal Executive Power, through the President s office, establishes the national objectives of the current administration around five main topics that are: 1) state of law and security; 2) competitive economy and generator of employment; 3) equality of opportunities; 4) environmental sustainability; and 5) effective democracy and responsible external policy. There are currently close to 45 social programs that are defined as programs for overcoming of poverty 10

18 Table Population and economic growth since 1990 Mexico Population (1000s) 91,725 98,439 99, , , , , ,874 GDP 1990=100 millions of pesos) 749, , , , ,282 1,058,096 1,094,615 1,158,263 GDPppp (billion US$) REFERENCE/SOURCE: Consejo Nacional de Poblacion (CONAPO), Banxico (INPC), Instituto Nacional de Estadistica y Geografia (INEGI) (GDP), OECD Factbook 2008: Economic, Environmental and Social Statistics Table Fertility (children per woman) Mexico TFR REFERENCE/SOURCE: Consejo Nacional de Poblacion (CONAPO) Graph A. GDP Growth in Mexico % Growth Source: CepalStat, Latin America and the Caribbean Statistics (SHCP, 2008). 10 Some of the main programs are: Oportunidades, which delivers monetary benefits to families in situation of extreme poverty to improve their health, education and nutrition, serving 5 million families in Procampo, which through transfer mechanisms compensates the national producers for the subsidies of their foreign competitors, in 2007 having 2, 800,000 farm producers throughout the country beneficiaries that cultivate a surface of 13.9 million hectares in all the country; Seguro Popular, a health Insurance, which offers financial and health protection to the population without social security, and which at the end of 2007 had 5 393,541 affiliated families; and the Attention to Senior Adults over 70 and older in rural areas, which gives the elderly an economic support, which in 2007 benefited 1 031,005 senior adults. The majority of the remaining programs have relatively few beneficiaries compared to the coverage of those just mentioned. 10 As considered by the Quarterly Reports about the Economic Situation, the Public Finances and the Public Debt, of SHCP. Graph B GDP per capita in Mexico USD (2000) Source: CepalStat, Latin America and the Caribbean Statistics Population and economic growth In 2005, close to 103 million people inhabited Mexico, of which approximately 41 million are individuals 0 to 17 years old (CONAPO, 2005). The growth rate of the Mexican population has been diminishing overtime. In 2005 this rate was 15% for women and 12% for men and it is expected that for 2015 it will reach 8% for women and 9% for men. Mexico is experiencing an aging of its population. It is expected that for 2015 the age group with the highest group are those between 50 and 69 years old, followed by individuals between 24 and 49 years old (National Population Conteo Census, 1995, CONAPO). The noticeable decrease of the population of Mexico can also be observed through the rate of fertility. While in 1990 the fertility rate was 3.4 children per woman, in 2005 it was 2.2 (CONAPO). The demographic structure of Mexico in recent years shows that individuals under 18 represent a decreasing proportion of the population, so that Mexico has been in a position of being able to take advantage of the demographic bonus or window, 11

19 Graph The Structure of the economy in 2005 (Table ) Agriculture Mining, Manufacturing Services Other eletricity, water, gas and construction Share (%) in total GDP Share (%) in total employment Source: Instituto Nacional de Estadística y Geografía (INEGI). Primer Informe FCH, 2007 Graph 1.3.1a: Total public revenues and expeditures in Mexico as % of GDP (Table ) Total Public revenues Total public expenditures Source: Sexto informe de Gobierno Secretaria de Hacienda y Crédito Público this is, the idea of being able to stimulate economic growth, as a consequence of the larger proportion of workers, and of the reduction of the expenditures on dependent persons. According to Mexico s National Population Council Board (2004), this window of opportunities generated by the demographical bonus may last for about the three next decades ; afterwards, the aging of the population will bring again a larger proportion of dependent persons. The macro-economic panorama in Mexico for the past 20 years has been marked by several economic crises and periods of recovery (Graph A and B). As can be seen, there have been recessions or crisis in the years 1994 and 2000 and recoveries in the following years. Poverty levels are highly related to the economic growth of Mexico. The several crises through which the country has gone through have caused important increases in poverty. For example, as a result of the economic crisis of 1994, the alimentary poverty increased from 21.2% in 2004 to 37.4% in 1996, that of capacities increased from 30% to 46% and the patrimonial poverty increased from 52.4% to 69%. (CONEVAL, 2006). Note that poverty levels in Mexico have generally taken a long time to recover, it wasn t until 2002 that the levels of poverty returned to the pre crisis levels in The economic growth of Mexico is highly linked to the services sector, as it represents close to 56% of the GDP of Mexico and approximately 57% of the total employment of the country (Graph 1.2.3, INEGI). The next sector with larger participation in the economic growth is the manufacturing sector, with 18% and with a participation in total employment of 16%. Mexico is very connected to the economic conditions of the United States, its main commercial partner (over 80% of the Mexican exportations are directed to this country, INEGI 2008). The crisis, which began in the residential real estate market of the United States, has had repercussions in Mexico s production activity and in the labor market. During the past few years, Mexico s GDP has been growing at a lower pace, in 2006 the real annual growth was 4.8 per cent, while in 2007 it was 3.3% and in % (Banxico, 2008). The most recent forecasts for 2009 indicate that the GDP will fall between 3.8 and 4.8% (Banxico, 2009). The analysis of inflation in Mexico indicates that in the last years it has had relatively small fluctuations. In 2006 inflation was 4.05% and in %. The recent inflationary pressures associated to the increase of the international prices of raw materials (such as food, energy and metal) provoked that in December of 2008 the annual inflation rate was 6.53%, while in the first quarter of 2009 at 6.18% (Banxico, 2009). The growth of prices of goods and the increase of inflation of course lead to immediate on the real income of households, which can provoke, among other effects, a shift to less nutritional but cheaper food purchases. Regarding foreign exchange rates, from 2007 to date the exchange rate of peso vs. dollar has been relatively stable at near 11 pesos per dollar, nevertheless toward the end of 2008, there was a devaluation of the currency and in January 2009, the exchange rate was pesos per dollar, and in March was (Banxico, 2009). 12

20 Table 1.3.4: Financing from abroad (millions of pesos) Mexico Balance of payments Trade balance 46, , , , , , , ,990.9 Debt service 19, , , , , , , ,669.2 Remittances 24, , , , , , , ,327.6 Foreign Direct Investment 62, , , , , , , ,150.2 REFERENCE/SOURCE: Primer Informe de Gobierno, Anexo estadistico. Pagina 49. Banco de Mexico. BID. Banco Mundial (Basic Education Development Project in Support of the Third Phase of the Basic Education Development Program). United Nations Table 1.2.4: Income inequality Country Gini index of household income/consumption Ratio between last and first decile Ratio between last and first decile Ratio between last and first decile REFERENCE/SOURCE: CONEVAL, Informe de Evaluacion de la Politica de Desarrollo Social en Mexico, In matters of public finances, Mexico has had a public surplus since 1995, in other words, the public income has surpassed that of expenditures, although again in 2009 and 2010 that is likely to reverse itself because of the economic crisis. (Graph 1.3.1a, SHCP). With respect to external financing, Mexico does not have a high dependence on the financing of international institutions. It is characterized for having a high level of private remittances sent in mainly from the United States (in 2006 the amount of remittances was close to 2,193 million pesos). At a second level, Direct Foreign Investment (IED) represents an important source of income in 2006 it was 1,786 real million pesos)- (Chart 1.3.4). Challenges to human development and equity In addition to existing poverty in Mexico, the country is characterized by high levels of disparity between the population with greater and lesser resources, with few large changes over time. While in 1992 the Gini Index was of 52.9, in 2000 it increased to 53.5; (Chart 1.2.4, CONEVAL). For 2006, inequality dropped somewhat, the Gini coefficient placing itself at 49.6 (CONEVAL 2008). While the ratio between total income of the tenth and the first decile was 31.3 in 1992, in 2000 it was 36.1 and in By state and according to the Human Development Index (IDH) 11, we can observe that there are great disparities within the country (Chart 1.2.5, UNDP). For instance, while the Federal District had an IDH of 0.88 in 2004, that of Chiapas was However most states have showed improvement over time (between 1990 and 2004) with the exceptions of Baja California, Baja California Sur, Chihuahua, Federal District, State of Mexico, Nuevo Leon and Sonora. As previously stated, the high inequalities to the inside of the country show that, while there are municipalities with Indexes of Human Development similar to those in the United States or that of countries with the OECD, there are also municipalities that have similar indexes or lesser to countries in the Sub Saharan Africa. 12 These profound economic and social disparities reflect a combination of several complex factors. Ethnicity is a clear factor that affects inequality, as the indigenous are much more likely to have lesser income, less schooling and worse levels of health than the non-indigenous population. For example, while 26% of the indigenous households are located in the lowest income quintile, only 6% are located in the highest quintile (ENNViH, 2002). 11 The Human Development Index (IDH) is prepared by the United Nations Program for Development (UNDP), and is based on three parameters: i) health (measured as per the life expectation at birth; ii) education (measured by the rate of alphabetizing of adults and the combined gross rate of enrollment to primary, secondary and high school education, as well as the years of duration of mandatory education); and iii) income (measured by the GDP per capita PPA in dollars). 12 To have a wider perspective on the history of inequality in Latin America, see World Bank (2003). 13

21 Table 1.2.5: Introducing sub-national dimensions of development Mexico 2005 Population, 1,000s Change over 1990 HDI scores (or similar socioeconomic indicator) 2004 Change over 1990 States Aguascalientes 1, % % Baja California 2, % % Baja California Sur % % Campeche % % Coahuila % % Colima % % Chiapas % % Chihuahua % % Distrito Federal % % Durango % % Guanajuato % % Guerrero % % Hidalgo % % Jalisco % % Mexico % % Michoacan % % Morelos % % Nayarit % % Nuevo Leon % % Oaxaca % % Puebla % % Queretaro % % Quintana Ro % % San Luis Potosi % % Sinaloa % % Sonora % % Tabasco % % Tamaulipas % % Tlaxcala % % Veracruz % % Yucatan % % Zacatecas % % REFERENCE/SOURCE: Esquivel Hernandez Gerardo, Lopez Calva Luis F. & Velez Grajales Roberto (2003). Crecimiento economico, desarrollo humano y desigualdad regional en Mexico Sexto Informe de Gobierno, Informe sobre Desarrollo Humano Mexico , Migracion y desarrollo humano. UNDP. INEGI 14

22 Table 2. Public spending and development supports Millions of Pesos as of Information Source Total Public Spending (Millions of Pesos) Public spending in cash transfers and household income generation programs (Millions of pesos) Public spending in child nutrition (Millions of pesos)*** Public spending in health (Millions of pesos) Public spending in education (Millions of pesos) 17,127 19,077 20, ,960 2,091 1,732 2,813 3,020 3,148 SHCP. Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005 and 2006 Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and Federal Spending Budget 2005, 2006 and Second State to the Nation Report Statistic Appendix. Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and First State to the Nation Report Statistic Appendix. Page 204 First State to the Nation Report Page 56 Second State to the Nation Report Page 104 First State to the Nation Report Page 56 Second State to the Nation Report Page 104 **Budgeted expenditures *** Oportunidades educational component was not included in this row in order to avoid duplications of amounts. Public spending in cash transfers and income generation programs refers to the budget of Oportunidades and Senior Adults program Public spending in child nutrition refers to Diconsa, Liconsa and Scholar Breakfasts budget. Public spending in health and education refers to programmable spending of the Public Sector Budget Additional inequalities exist with respect to access to basic services because of the complexity to offer basic services such as electricity and sanitation to small rural isolated communities, of which there are over 100,000 in Mexico Additionally, urban infrastructure in schools and health clinics tends to be much superior to that in rural areas, perhaps reflecting historical inequalities in government expenditure. (Parker, 2008). The government s expenditures in the sections of education and health represent one of the main variables for attempting to reduce existing disparities of the population. However, historically, the federal expenditures have been regressive in the areas of education and health. Scott (2008) shows the high inequality that exists in the federal expenditure on high school and university. Likewise, there is are a number of subsidies which are regressive (for example, the subsidy to energy is absorbed by almost 35% of the population of the top income decile, Scott, 2008). Additionally, Parker (2008) shows that the characteristics of the schools to which children of lesser resources go are significantly worse than those of children in wealthier households. As will be demonstrated throughout this Report, in addition to the low income, there are other dimensions of poverty that affect children, including the lack of education and the lack of access to health services. This not only affects the situation of poverty in which the children currently live, but also increases the probability that the children continue being poor when they become adults. 1.3 Macroeconomic strategies and resources allocation Public budgets and partnerships as evidence of commitment In Mexico public spending has been increasing in real terms during the last decades. (although its growth has been interrupted by economic crises). While in the decade of the seventies social spending represented around 4.5% of GDP, at the beginning of the eighties it represented almost 9% of GDP, as a product of large increases in the expansion of public education, health and social security systems. After its collapse in 1982 and in 1994 public spending recovered to almost 11% of GDP in 2005 (Scott, 2008). During 2008 social spending of the budgetary public sector ascended to 2 billion 865 thousand 298 million pesos, this amount was 9.8% higher in real terms compared to the budget of the previous year. (SHCP, 2008). The highlights are the real increases in budget allocated to 1) urbanization, housing and regional development, 2) social assistance and 3) potable water and sewage (20.3, 14.6 and 13.0%, respectively, SHCP 2008). 15

23 Table 3. Data related to childhood regarding Household Income Key Budget Allocation Millions of pesos as of 2002 Total spending in 2005 Total spending as % of government spending in 2005 Total spending in 2006 Total spending as % of government spending in 2006 Total spending in 2007 Total spending as % of government spending in 2007 Data Source Cash for human development programs Cash for labor programs Price subsidies, tax exemptions Social pensions (seniority and disability ) , , , , , , Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and Second State to the Nation Report Statistic Appendix. Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and 2007 Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and 2007 Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and 2007 Other support programs for senior adults Federal Expenditure Budget 2005, 2006 and 2007 Note: Information on social programs refers to budgeted spending, while subsidies, pension, motherhood and fatherhood benefits and child and families allocations information refers to the actual exercised spending. Public spending for human development programs refers to Oportunidades Program budget. Public spending for labor programs in 2005 includes: Program for Temporary Employment, Priority Groups and Regions, Productive Re-conversion Program, National Support Fund for Companies in Solidaridad (Solidarity) (FONAES), and Productive Options. For 2006 and 2007 it includes Agri-Food and Fishing Chains, Priority Groups and Regions, Productive Re-conversion, FONAES and Productive Options Subsidies of prices and tax exemptions are targeted to social development, economic growth and government actions. They include gasoline subsidies; Luz y Fuerza (light) to support electric energy costs; decentralization and relocation agreements in federal entities encompassed in the Alliance for the Countryside Program; subsidies to the States destined to support education at medium high, high school and superior levels; Scholarship Program and CONAFE Financing; highly specialized hospitals equipment for the health sector, between others. Social pensions (seniority and disability) include those granted by IMSS, ISSSTE, CFE, LFC and PEMEX. Others: in 2005 and 2006 refers to the Senior Adult Program in Rural Areas; in 2007 it refers to the Attention Program for Adults of 70 years and on in Rural Areas. In 2007 the fractions of the spending in education and health occupied approximately 24% of the total public spending in Mexico (Table 2, SHCP). From the social development spending, the percentage dedicated to anti poverty programs. was approximately 47%. Specifically, Oportunidades (which is categorized as public spending in cash transfers and income generation to combat extreme poverty), is the social program with the highest budget, using approximately 26% of the spending destined to anti poverty programs. The increase of the social spending in real terms, and specifically of the expenditures destined to combat poverty, reflects that the Mexican government has been seeking to improve the living conditions of those in poverty. Additional efforts however should include not only increasing generally social spending on education and health but engaging in progressive expenditures in order to ensure that those in poorer areas have similar health and education services than those in wealthier areas. Table 3 (SHCP) shows that 1.5% of the public spending is destined to human development programs (Oportunidades) and that 1.02% is destined to programs to support and promote jobs (including the Temporary Employment Program, the National Fund of Supports for Companies in Solidaridad). It is important to highlight that close to 12% of government spending is composed of price subsides (mainly destined to gasoline, electric energy and Procampo). 9% of government spending is destined to pensions of the systems of social security. Regarding the resources dedicated to nutrition, it can be seen that they are very low (Table 4, SHCP). 16

24 Table 4. Data related to childhood regarding Nutrition Key Budget Allocations Millions of pesos as of 2002 Total spending in 2005 Total spending as % of government spending in 2005 Total spending in 2006 Total spending as % of government spending in 2006 Total spending in 2007 Total spending as % of government spending in 2007 Data Source Communitarian services targeted to nutrition and health (growth promotion, supplementary food) Nutrition services at institutions (severe undernourishment treatment) Procurement of micronutrients supplements First State to the Nation Report 2007, page 204. Statistic Appendix (Public Expenditure on Poverty Reduction Programs). Second State to the Nation Report Statistic Appendix (Food Support Programs, page 245). Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and 2007 First State to the Nation Report 2007, page 204. Statistic Appendix. Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and Sixth State to the Nation Report 2006, page 37 Federal Finance Ministry Account Public Spending Policy. Selective food assistance Communitarian services targeted to nutrition and health (growth promotion, supplementary food) refers to Liconsa Program Nutrition services at institutions (severe undernourishment treatment) refers to Scholar Breakfasts Program Procurement of micronutrients supplements refers to the food component of Oportunidades Selective food assistance refers to Rural Supply Program and Food Support Program Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and Second State to the Nation Report Statistic Appendix Food Support Programs, page 245). Programs like Liconsa, School Breakfasts, Nutrition Supports receive less than 1% of social spending (specifically the nutritional component of Oportunidades represented 0.57% of total government spending focused on micronutrients supply). Health spending on the population in poverty conditions (like immunization programs, prenatal and neonatal programs and reproductive health) has been relatively constant at a very low level (Table 5, PEF). Regarding childhood protection, it is important to mention that in the last few years an important effort has been performed to increase the budget on child care, specifically through the Child Care Center 17

25 Table 5. Data related to childhood regarding Health Key Budget Allocations Millions of pesos as of 2002 Total spending in 2005 Total spending as % of government spending in 2005 Total spending in 2006 Total spending as % of government spending in 2006 Total spending in 2007 Total spending as % of government spending in 2007 Data Source Immunization programs Prenatal attention programs Neonatal attention programs Reproductive health and support for mothers Federal Expenditure Budget, Subdivision , 2006 and 2007 Federal Expenditure Budget, Subdivision , 2006 and 2007 Federal Expenditure Budget, Subdivision , 2006 and 2007 Federal Expenditure Budget, Subdivision , 2006 and 2007 Expenditure in immunization programs includes the budgeted expenditure in vaccines programs and the procurement of consumables for those programs. Expenditure in prenatal attention programs correspond to the budgeted expenditure of the National Institute of Perinatology Isidro Espinosa de los Reyes each year. Expenditure in neonatal attention includes both the budgeted expenditure of the National Institute of Perinatology Isidro Espinosa de los Reyes and the National Pediatrics Institute. Expenditure in reproductive health and support for mothers corresponds to the budgeted expenditure of the National Center of Gender Equity and Reproductive Health. Table 6. Data related to childhood regarding Infancy Protection Key Budget Allocations Millions of pesos as of 2002 Total spending in 2007 Total spending as % of government spending in 2007 Data Source Family Support Services * Second State of the Nation Report Statistic Appendix (Expenditure in the main programs for poverty reduction, page 243). * Family support services refers to the Nursery And Children Houses Program Program created in This program grants a cash monthly support to mothers and single fathers that live in poverty condition to register their children in a child care facility. Also, the Program grants up to $35,000 to individuals or groups that desire to establish or operate a child care facility. The budget of this program increased from 731 million pesos in 2007 to 1,500 million pesos in 2008 (Table 6, State to the Nation Report 2008). This program allows those mothers with an income of maximum 6 minimum salaries, to have available time to look for and obtain a stable job. Education receives significant resources from the government (Table 7, State of the Nation Reports). In % of government spending was allocated to preschool education, 6% to primary education, almost 4% to secondary education (junior high) and 2% to high secondary education (high school general and technological). Mexico has registered increases in its investment in education, not only in absolute terms, but also in relation to national income: during the period, spending in educational institutions in Mexico increased from 5.6 to 6.5% of GDP, this level is actually above OECD s mean of 5.8%. Nevertheless because of Mexico s relatively lower GDP than other OECD countries, spending per student at all academic levels (excluding preschool education) in Mexico is US$2,405, that is, lower that OECD s mean of US$7,527. In addition, the largest part of the spending is absorbed by teachers remuneration. In primary only 2.3% of the spending is destined to capital expenditures (long term assets, as installations and equipment), compared to OECD s average of 8.9%. In secondary that spending is 2.7% compared to OECD s average 7.8%; and at college level it is of 4.5%, compared to OECD s average of 9.5%. (OECD, 2008). In general, the outlook presented by OECD on Mexico indicates that, despite the important increase experienced in education investment over time, this has not translated into a significant improvement of school performance. 18

26 Table 7. Data related to childhood regarding Children Education Key Budget Allocations Millions of pesos as of 2002 Total spending in 2005 Total spending as % of government spending in 2005 Total spending in 2006 Total spending as % of government spending in 2006 Total spending in 2007 Total spending as % of government spending in 2007 Data Source Pre-school teaching Elementary teaching Lower secondary teaching Higher secondary teaching (general and technological high school) Note: Real expenditure , , , First State to the Nation Report 2007, page 276. Statistic Appendix, page 16 First State to the Nation Report 2007, page 276. Statistic Appendix, page 16 First State to the Nation Report 2007, page 276. Statistic Appendix, page 16 First State to the Nation Report 2007, page 276. Statistic Appendix, page 16 In summary, despite the elevated expenditure levels in relation to GDP and also in relation to public resources, the expenditure per student remains low in absolute terms. Practically all the spending in education is linked to salaries. Compared to other countries, Mexico dedicates a much smaller part of the spending to schools infrastructures and teaching material. Growth in favor of the poor and results in favor of children Growth in favor of the poor can be defined in different ways (see Ravallion, 2005), but it generally implies economic growth that causes the reduction of the percentage of people living in poverty conditions. Nevertheless, as pointed by Ravallion (2005), there are few factors that can predict which countries with economic growth have a higher reduction of their poverty levels. In his research, Ravallion shows that it is less probable that the countries with constant inequalities and inequities have growth in favor of the poor. Given the general lack of a formula to ensure and promote this type of growth, the government should have policies aimed at a better distribution of the gains derived from growth towards the poor. In general, in the case of Mexico, GDP s increases per capita have provoked the reduction of the proportion of the population that lives in monetary poverty conditions. Specifically, Programs like Oportunidades have also favored the social development of the poor. The transfers of Oportunidades represent a secure income for beneficiaries. Whereas macroeconomic fluctuations might affect the labor income of the beneficiaries, transfers from Oportunidades are guaranteed and updated each year for inflation according to the price of the basic basket), reducing with this the impact of negative macroeconomic downturns. Other programs oriented to the poor and to children include Child Care Centers, Seguro Popular insurance program and the Health Insurance for the New Generation (SMNG). Chapter s Conclusions In matter of social development, it is important to mention the important advance of Mexico with the creation of the General Social Development Act (LGDS) in 2004, whose law formalizes the evaluation of social policy and creates the CONEVAL. The Law also establishes that the federal budget destined to social spending cannot be inferior, in real terms, to the one of the previous fiscal year. 19

27 Currently all social programs in Mexico that have published Operating Rules have to be evaluated and monitored. Additionally, there is now official poverty lines for the definition and measurement of poverty (there are three official poverty lines: alimentary, capacities and wealth), that allows to perform comparative analysis on the evolution of poverty in the country. Also the LGDS orders CONEVAL to establish the methodology and criteria to initiate a multidimensional measurement of poverty. The guidelines and criteria that CONEVAL establishes to define, measure and identify poverty will use information on indicators about current income per capita, educative lag, and the access to health and social security services, characteristics of the dwelling, alimentation and social cohesion (LGDS, 2005). Mexico has a relatively high per capita GDP and is classified as a medium high income country. Nevertheless, a high percentage of its population still lives in poverty conditions. Particular groups, including the indigenous, and those living in rural areas, have greater degrees of poverty and deprivations compared with other populations. Unfortunately, in addition to higher poverty, these groups generally have access to worse health and education services than other groups. Mexico is undergoing a number of transitions; the life expectancy at birth has increased and contagious illnesses have ceased to be the main causes of death. However, chronic diseases, and the proportion of the population who are overweight or obese have increased significantly in Mexico. In educational terms, the average schooling of the Mexicans has increased, on average currently about 7 years of schooling, but there continue to be a population who cannot read or write. A significant percentage of children do not attend school; there are high rates of grade failure, and the indigenous have much worse education indicators than the rest of the population. Also, there are great disparities between the performance of children between states. While in Chiapas 30.4% of the children failed a year during primary in 2006, in the Federal District only 7.4% did so. 20

28 STUDY ON POVERTY AND DISPARITIES IN CHILDHOOD: THE CASE OF MEXICO Section Two: Poverty and Childhood Introduction In this chapter the topic of child poverty is analyzed using a number of different indicators (including income/consumption, deprivations and child mortality). Each one of these concepts is examined through micro level disaggregated data, with the purpose of analyzing how the individual s, household s and community s characteristics influence children s poverty conditions. 2.1 Income poverty and deprivations that affect children Findings of the income/consumption approach There are three poverty lines which are used to make official measurements of poverty in Mexico. These lines are: poverty of alimentation, of capacities and of patrimony. In the Report we emphasize those statistics based on the strictest version, poverty of alimentation, which defines itself as the lack of sufficient income to purchase a basic food basket. Using this definition, the levels of poverty have been slightly decreasing within the period of 1992 to 2005 (though the 1995 financial crisis temporarily increased the poverty rates up to 29%). In % of households lived in conditions of alimentary poverty (close to 3 million homes), and in % of the households lived in these conditions, which represents approximately 3.6 million households. (Table 2.1.1, ENIGH) As per international standards (less than one dollar per day per capita), 3.8% of households found themselves in conditions of extreme poverty in 2005, which corresponds to approximately 974 thousand households. (Table 2.1.1, ENIGH) In 2005 there were close to 17.7 million households with children between 0 and 17 years. Almost 25% of the children in Mexico lived in conditions of alimentary poverty (close to ten million children) in that year. 33% lived in conditions of poverty of capacities (close to 13.4 million children), and 57% lived in conditions of poverty of patrimony (23.5 million children). As per the international standard of less than one dollar per day per capita, this proportion is 8%, which corresponds to approximately 3.3 million children (Table 2.1.1, ENIGH) The analysis of the correlation of income/consumption poverty in households with children (Table 2.1.2, ENNViH 2002) shows that close to 40% of the households with children lived in conditions of alimentation poverty in There are few differ- 13 This chart emphasizes the differences on the percentage of households with children that live in alimentation poverty conditions as per the ENNViH (40%) and the ENIGH (19%). In general, the EN- NViH reports larger incomes at both extremes of the income distribution than the ENIGH. One reason why the difference is so large may be because of the elimination by ENIGH of those households that delivered incomplete questionnaires. However, in spite of the identification of this difference between both sources, the pattern of eliminated households in the ENIGH is not clear (see Rascon and Rubalcava 2008 for more information on this subject). 21

29 Table Trends in income/consumption poverty since Poverty headcount among households with children 0-17 (%) - by national poverty line 1 (food poverty) by national poverty line 2 (poverty of capacities) by national poverty line 3 (poverty of patrimony) by international poverty line Poverty headcount among all households (%) - by national poverty line 1 (food poverty) by national poverty line 2 (poverty of capacities) by national poverty line 3 (poverty of patrimony) by international poverty line Number of children in poverty (%) - by national poverty line 1 (food poverty) by national poverty line 2 (poverty of capacities) by national poverty line 3 (poverty of patrimony) by international poverty line National poverty 1 refers to the alimentation poverty threshold of the household (incapacity of acquiring a basic food basket even though all income available was used for that purpose). National poverty line 2 refers to those households that have less income per capita than the necessary for acquiring basic alimentation, health and education. National poverty line 3 refers to those households that have less income per capita than the necessary for acquiring basic alimentation, clothing, dwelling, health, education and transportation. REFERENCE/SOURCE: Encuesta Nacional de Ingresos y Gastos de los Hogares 2002,2005, CONEVAL. ence by gender when poverty is analyzed at the individual level. Poverty rates at the individual level are highest for children aged 0 to 14 and for the elderly. (Table 2.1.2, ENNViH). At the household level it is found that households with children and that have a larger number of members live in worse conditions (54% of those in households with over seven members lived in conditions of poverty compared to the 36% of households with less than 3 members). Similarly, when the head of the household does not have a primary level education, or has no secondary level education, the household probability of being in poverty is higher (53% lived in poverty when the head has no studies and 48% when he/she has studied only primary level). When the head of the house is a woman, or when he or she is of indigenous origin, in rural areas, within lower level quintiles, or when living in the South-Southeast region of the country, poverty conditions are greater. For example, 53% of households with children within the lowest quintile of wealth lived in poverty conditions compared to 19% of households with children in the last quintile (Table 2.1.2, ENNViH 2002). When the levels of poverty are calculated according to the labor force participation of the parents, it is also observed that when neither of them works poverty worsens (47% in households with children where neither of the parents works lived in conditions of poverty, while 24% of the households with children where both worked lived with this condition). Likewise, households with single parents have very high poverty levels (48%). (Table 2.1.2, ENNViH 2002). 22

30 Table Correlates of income/consumption poverty among households with children Mexico, 2002 Poverty headcount rate (%) Poverty gap ratio (income/consumption shortfall as proportion of poverty line) All households with children (0-17) Individual dimension Sex and age Male Age group 1 (0-14) Age group 2 (15-24) Age group 3 (25-44) Age group 4 (45-64) Age group 5 (65- ) Female Age group 1 (0-14) Age group 2 (15-24) Age group 3 (25-44) Age group 4 (45-64) Age group 5 (65- ) Household dimension Household size Less than members members Education of the head of the household None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion Group 1: Indigenous

31 (Continued from previous page) Mexico, 2002 Poverty headcount rate (%) Poverty gap ratio (income/consumption shortfall as proportion of poverty line) Group 2: Not Indigenous Work (not mutually exclusive categories) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Access to land in rural areas Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural Exchange rate using at day October 14th. $12.00 Poverty gap ratio is the mean distance separating the population from the poverty line (with the non-poor being given a distance of zero), expressed as a percentage of the poverty line. National poverty line is in rural areas $ and in urban areas $ Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household The poverty gap ratio is the sum of the income gap ratios for the population below the poverty line, divided by the total population REFERENCE/SOURCE: Mexican Family Life Survey, MXFLS 2002 (ENNVIH) Definitions and sources: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2). DHS asks also on foster status which is not available from MICS. A vulnerable child is defined as a child who lives in a household where parents have been chronically ill or adult death after a chronic illness or any adult household member has been sick for 3 of 12 months preceding the survey. Children with disability are available from the MICS for 2-9 year olds only (if Mexico has elected to have a disability module). 24

32 Table Households with children younger than 17 years old Income quintile Source: Mexican Family Life Survey 2002 Table All households % of indigenous Income quintile Source: Mexican Family Life Survey 2002 % of indigenous Summarizing, the above table shows that there is a high level of poverty within households with children and that these conditions intensify when dealing with households with which are larger, in rural or indigenous areas. The indigenous population in Mexico usually lives in very precarious conditions, without access to quality basic services. Close to 28% of indigenous households with children under the age of 17 are in the lowest income quintile, versus only 6% are in the highest income quintile. Findings of the deprivation approach In this section the concept of childhood poverty is analyzed as per the deprivations of dwelling, sanitation, water, information, nutrition, health and education, and as per the degree of severity of these, making a distinction between each deprivation as of less severe and severe. In general, there is a high percentage of children who experiment severe conditions of dwelling deprivation almost 27%, which corresponds to 10.6 million children- and less severe -41.3%, which corresponds to 16.5 million children- in 2002 (Table 2.1.4, ENNViH). In this case, severe deprivation refers to children who live in homes with five or more persons, with dirt floors and the lesser deprivation refers to children in homes with four or more persons living in houses with an inappropriate roof or dirt floors. With regard to sanitation, the overview is more encouraging since only close to 7% (3 million) children experimented severe deprivations in 2002 (they do not have access to sanitary premises of any kind); though there are still 20% of children with this deprivation (close to 8 million) in a less severe degree (they use latrines). In terms of lack of water, 9.6% of the children (3.8 million) have severe deprivations (they use rivers, wells or walk 30 minutes or more to get water), and 1% (4.4 million) experienced a less severe privation (they take water from a tap or walk 30 minutes or more to get it (Table 2.1.4, ENNViH). With regard to nutritional issues, only 3% of children (1.2 million) surpassed three standard deviations under the international reference for their BMI (Body Mass Index) to their age in Close to 12% of the children (5.1 million) lived this deprivation in a less severe manner, namely, over two standard deviations under the international reference (Table 2.1.4, ENNViH 2002). With respect to access to information, 11% of the children (3.9 million) suffered this deprivation in a severe manner (children between 3 and 17 years who have no access to television, Internet or do not read) and close to 30% (9.9 million) suffered it in a less severe manner (children between 3 and 17 years of age and adults without access to television or Internet). On education, there are important severe deprivations, 12% of children between 7 and 17 years old have never attended school or did not currently attend school), which corresponds to 3.1 million children (Table 2.1.4, ENNViH 2002). Finally, with respect to deprivations on access to health, close to 25% of the children (9.9 million) reported to not have received vaccination or to have visited the doctor due to a recent disease related to a respiratory infection or diarrhea, or both (severe deprivation). Close to 40% of the children (15.7 million) had not been vaccinated since age two (Table 2.1.4, ENNViH 2002). It is interesting to analyze the trends on the incidence of poverty with respect to the different deprivations (Table 2.1.5, ENIGH). Here we show results with the ENIGH in order to make compari- 25

33 Table Child poverty as multiple deprivations Mexico, 2002 a) Incidence (prevalence) of deprivation Of which experiencing severe deprivation, % Of which experiencing less severe deprivation, % 1. Shelter Sanitation Water Information Food Education Health Total b) The incidence of the most frequent combinations of deprivations The most frequent case of any deprivation: Shelter Two most frequent combinations Shelter & health Two second most frequent combinations Health & Information Three most frequent combinations: Shelter, Health & Information Three second most frequent combinations: Health, Information & Education The most frequent associate of food: Food & Shelter The most frequent associate of education: Education & Shelter The most frequent associate of health: Health & Shelter c) The incidence of multiple deprivations Only one (any) deprivation Two of any deprivations Three of any deprivations Four of any deprivations Five of any deprivations Six of any deprivations Seven of any deprivations REFERENCE/SOURCE: Mexican Family Life Survey 2002 sons in time, although for two specific deprivations it was not possible to construct deprivation indexes (nourishment and health only) due to the lack of information from ENIGH to construct these indicators. The results show that there has been a significant reduction in the proportion of children who experience severe deprivations in sanitation, going from 23% (9 million) in 1994 to 5% (1.9 million) in 2005; in water, from 18% (7 million children) to 2% (almost 800 thousand children) in the same years; and in the area of information, going from 15% (5 million) in 1994 to just 6% (2.2 million) in However, the advance in education has not been as encouraging, in % of 26

34 Table Change in the incidence/prevalence of severe deprivations over the last decade among children Mexico Number of children in relevant age cohort, (estimates in 1,000s) Of which experiencing severe deprivation, % Number of children in relevant age cohort, (estimates in 1,000s) Of which experiencing severe deprivation, % 1. Shelter 38, , Sanitation 38, , Water 38, , Information 33, , Food* N/I N/I N/I N/I 6. Education 24, , Health* N/I N/I N/I N/I Total N/A N/A N/A N/A Two severe deprivations* N/A: not applicable. N/I: no information obtained. * Note: Information is not available in the ENIGH REFERENCE/SOURCE: Encuesta Nacional de Ingresos y Gastos de los Hogares 1994, , , the children (4.5 million) did not go to school or had never gone to school and in 2005 this proportion was 13% (3.2 million) 14. It is important to point out that while in 1994 almost 22% of the children experienced at least two severe deprivations, only 9% did so in Within the same analysis, the table (ENNViH 2002) shows the variables associated to having at least one or two severe deprivations. Nation-wide, close to 55% of the children lived with some kind of deprivation in 2002 and 22% with at least two deprivations. When making the differentiation by gender there are slightly more women who experience at least one severe deprivation (56%), versus 54% of men. As was the case for monetary poverty, for the case of deprivations, households where the head of family is a woman or the mother has no education, they find themselves in worse conditions with regard to the deprivations they experience. Similarly, when the household finds itself within the lowest wealth quintile, 70% of the children suffered at least one severe deprivation, compared to 38% of the wealthiest quintile (Table 2.1.6, ENNViH 2002). With respect to the indigenous population, 75% experienced at least one severe deprivation and 48% experienced at least two severe deprivations, while 51% of the non-indigenous households experienced at least one severe deprivation and 17% at least two severe deprivations. If living in rural areas or in the South-Southeast of the country, the percentage of households that experience at least one or two severe deprivations increases considerably with regard to urban areas or other geographical areas in this country (Table 2.1.6, ENNViH 2002). Furthermore, when there is a high rate of dependency (more than four children per adult) the proportion of children who live with at least one severe deprivation is greater. When analyzing by region and residence condition (Table 2.1.8, ENNViH 2002) it is found that the South-Southeast 15 region, is the one that has the highest levels of deprivations, measured by the level of deprivation in practically all of the deprivations (including dwelling, sanitation, water, information, alimentation and health). In each one of these indicators this region has the largest poverty deprivations, while the Northeast region (Coahuila, Durango and Nuevo Leon) presents the lowest 14 It is very important to mention that, in general, the level of deprivation in children with ENNViH and ENIGH are very similar, except for the deprivation of water. Probably, this last item is due to the fact that with ENNViH there are questions about the characteristics of the dwelling that have different options to those in ENIGH and it is not possible to fully compare them, which affects the form in which the variable was accrued to measure this deprivation. For more information about the creation of the indexes on deprivations of ENNViH and ENIGH see Exhibit It is appropriate to keep in mind that the ENNViH is representative nation-wide, urbanely, rurally, and it divides the Mexican Republic into 5 regions as per the National Development Plan, thus the outcome of the polled states by region (in the case of the South-Southeast region, the states of: Oaxaca, Veracruz and Yucatan) are representative of the whole region (in the case of the South-Southeast region, the states of Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz) 27

35 Table Correlates of severe child deprivations (by individual, households and geographic dimensions) Mexico, 2002 At least one severe deprivation At least two severe deprivations Total Individual dimension Sex and age Male Age group 1 (0-2) Age group 2 (3-4) Age group 3 (5-9) Age group 4 (10-14) Age group 5 (15-17) Female Age group 1 (0-2) Age group 2 (3-4) Age group 3 (5-9) Age group 4 (10-14) Age group 5 (15-17) Household dimension Household size Less than members members Women s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q

36 (Continued from previous page) Ethnicity/language/religion Group 1: Indigenous Group 2: Not Indigenous Work (among hholds with children) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural The variable women s education contain the education of the children s mother Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) N/I: no information or Data REFERENCE/SOURCE: Mexican Family Life Survey 2002 prevalence of deprivations in dwelling, sanitation, water, and health. The only case in which the South-Southeast region does not have the greatest deprivations is in that of education, this indicator being worse in the Central West Region (Michoacan, Jalisco and Guanajuato). In this region close to 10% of the children did not go to or does not go to school (while in the south region this indicator is 6%). It is also important to remark that, in the case of nutrition, the Northeast area (Baja California Sur, Sinaloa and Sonora) has the lowest prevalence of poverty (0.73% compared to 6% in the South- 29

37 Table Prevalence of seven severe deprivations by region and residence Region Mexico Shelter Sanitation Water Information Food Education Health Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural REFERENCE/SOURCE: Mexican Family Life Survey 2002 Southeast area). This analysis also implies that there is certain correlation between the incidences of the deprivations, since it is likely that areas that have high prevalence of one deprivation also have high prevalence of the other deprivations (Table 2.1.8, ENNViH). Table also shows very clearly the numerous disadvantages of the population living in rural areas. In these areas there are larger levels of deprivations in the categories related to dwelling, sanitation, water, information, food, education and health. Furthermore, the differences between zones is quite large. For example, 48% of the homes in rural areas suffered shelter deprivations while this indicator is of 19% in urban areas. Correlation among poverty measures and combined poverty incidence In this section, an analysis on the correlation existing between the different measures of poverty is presented, using disaggregated data on gender, age group, household size, education of the mother, wealth quintiles, ethnicity, geographical area, etc. Table (ENNViH 2002) shows the correlations among the different deprivations and monetary income. In general, there is a high and significant correlation between the monetary income and the deprivations on dwelling, sanitation, water and information, with correlations of about However, the correlation between income and deprivations on education and health is much smaller through positive and significant-, with a correlation coefficient of and 0.007, respectively. Table (ENNViH 2002) examines the variables related to the probability that a household with children lives with less than one dollar per day per capita. Close to 22% of the children lived in households with less than one dollar per day per capita in Furthermore, close to 16% of the children who did not live under this situation of extreme poverty continued to experience at least one severe deprivation. Close to 33% of the children who live in households with over seven inhabitants lived with less than one dollar per day per capita, compared to the 12% of households with less than three members. Similarly, almost 38% of the children whose mothers have no schooling lived in households with less than one dollar per capita per day, in comparison to the 11% of the children whose mothers have secondary education or more (Table , ENNViH 2002). There is also large differences in the proportion of children who live in 30

38 Table Correlation between different indicators for child poverty/disparity Mexico Household income (1.08$ a day per person in ppps) Bottom asset quintile (Q1) Two deprivations First four deprivations Last three deprivations (Sh, S, W, I) (F,E, H) Shelter Sanitation Water Information Food Education Health Hh. inc [0.01]*** [0.01]*** [0.001]*** [0.001]*** [0.008]*** [0.005]*** [0.005]*** [0.006]*** [0.003]*** [0.007] [0.008] Asset Q [0.01]*** [0.01]*** [0.001]*** [0.001] [0.009]*** [0.006]*** [0.006]*** [0.007]*** [0.004]*** [0.009]*** [0.009]** Two depr [0.01]*** [0.01]*** [0.001]*** [0.001]*** [0.007]*** [0.005]*** [0.005]*** [0.006]*** [0.003]*** [0.008]*** [0.008]*** First four [0.08]*** [0.06]*** [0.06]*** [0.007]*** [0.071]*** [0.041]*** [0.046]*** [0.052]*** [0.025] [0.066]*** [0.069]*** Last three [0.14]*** [0.11] [0.12]*** [0.015]*** [0.126]*** [0.073]*** [0.084] [0.095]*** [0.042]*** [0.096]*** [0.123]*** Shelter [0.01]*** [0.01]*** [0.01]*** [0.001]*** [0.001]*** [0.005]*** [0.005]*** [0.007]*** [0.003]*** [0.008]*** [0.008]*** Sanitation [0.01]*** [0.01]*** [0.01]*** [0.002]*** [0.001]*** [0.014]*** [0.009]*** [0.011]*** [0.005]*** [0.014]*** [0.014]*** Water [0.01]*** [0.01]*** [0.01]*** [0.002]*** [0.001] [0.013]*** [0.008]*** [0.010]*** [0.005]*** [0.012]*** [0.013]*** Inform [0.01]*** [0.01]*** [0.01]*** [0.002]*** [0.001]*** [0.012]*** [0.007]*** [0.008]*** [0.004]*** [0.011]*** [0.012]*** Food [0.02]*** [0.02]*** [0.02]*** [0.003] [0.002]*** [0.022]*** [0.013]*** [0.014]*** [0.019]*** [0.023]*** [0.022]*** Education [0.01] [0.01]*** [0.01]*** [0.002]*** [0.001]*** [0.014]*** [0.008]*** [0.009]*** [0.010]*** [0.005]*** [0.013] Health [0.01] [0.01]** [0.01]*** [0.001]*** [0.001]*** [0.009]*** [0.005]*** [0.006]*** [0.007]*** [0.003]*** [0.008] Correlation is significant at 10% level (*), 5% level **, or 1% level***. REFERENCE/SOURCE: Mexican Family Life Survey

39 Table Combined child poverty incidence Mexico, 2002 Who live in households under the 1$ day/person ppp-s threshold % of children in relevant category who are experiencing severe deprivation of human need who are experiencing less severe deprivation of human need while their households live above the 1$ day/person ppp-s threshold All children (0-17) Individual dimension Sex and age Male Age group 1 (0-2) Age group 2 (3-4) Age group 3 (5-9) Age group 4 (10-14) Age group 5 (15-17) Female Age group 1 (0-2) Age group 2 (3-4) Age group 3 (5-9) Age group 4 (10-14) Age group 5 (15-17) Household dimension Household size Less than members members Women s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q

40 (Continued from previous page) Q Q Ethnicity/language/religion Group Group Work (among hholds with children) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region Region Region Region Region Residence Urban Rural N/I: No information or Data. N/A: Not Applicable The sub-national regions are: region 1: South-Southeast (Oaxaca, Veracruz, Yucatan). Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-Western (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Groups of ethnicity: Group 1: Indigenous. Group 2: Not Indigenous Exchange rate using at second quarter of $9.25 National poverty line is in rural areas $ and in urban areas $ Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household See definition for severe and less severe under Table Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) REFERENCE/SOURCE: Mexican Family Life Survey

41 extreme poverty as per their indigenous status, since 39% of children in indigenous households lived with one dollar per day per capita, versus 19% of non-indigenous children. The proportion of households with children who live with less than one dollar per day per capita also increases when there is a high ratio of children to adults in the households, when a child is disabled or when they living in rural areas. Children deprived of a family upbringing missing from household surveys All the analyses made to this point refer to children who appear in household surveys because they belong to a household or family. However, in Mexico there are many children who live outside households and thus do not appear in these kind of surveys. (such as ENIGH or the ENNViH). It is evident that those children who live in public care institutions or shelters of any type would likely be very susceptible to live with high levels of deprivation. Unfortunately, due to the shortage of available information, it has not been possible to obtain historical information on the total number of children in foster care. It has also not been possible to obtain information on the total number of adopted children who come from international adoptions. However, through the SNDIF we were able to obtain information on the number of adoptions performed in Mexico in 2007 (Table ). Here it can be seen that there were 2,200 regular adoption trials and 973 adoption trials through judgment. 2.2 Child survival and equity In the following section, results on infant and child mortality rates are presented by gender and geographic area of residence. Furthermore, a regional comparison on these indicators is provided. Change in U5MR and differentials over time The child mortality rate for five year olds and under has been decreasing during the last years (Table 2.2.1, CONAPO). While in 2005 this rate was 19.6 deaths per thousand children born alive, in 2007 it was Table Children in public care or adopted Mexico Total number adoptions N/I: No information obtained. By income decile, the lower income deciles have a disproportionate share of child mortality, with the first decile having 21% of all the child deaths in 2000, while the last decile of income has only 6% of child mortality (Table 2.2.1, alternative). U5MR by main social stratifiers N/I N/I N/I 3101 REFERENCE/SOURCE: Sistema Nacional para el Desarrollo Integral de la Familia, 2008 Table Change in U5MR by wealth quintile and gender Mexico Total Total Total Total Total Total U5MR REFERENCE/SOURCE: CONAPO Alternative of Table Proportion of infant deaths by decile 2000 Decile Infant deaths (%) % REFERENCE/SOURCE: Scott, J. 2006, Desigualdad de la Salud y de la Atencion de la Salud en Mexico, Serie de Documentos de Trabajo 4, Innovacion en el Financiamiento de la Salud, Funsalud- INSP. By geographic dimensions (Table 2.2.2, SSA and INEGI), in 2006 it can be seen that the infant mortality rate was larger for the South and Southeast area (almost 19 deaths per every one thousand born alive), while the Northeast area was the one that presented the lowest indicator of child deaths (13.6 per each 1000 born alive). The rate of child mortality for under five years old shows very similar trends, though the values are somewhat larger than in the case of the child mor- 34

42 Table Under 5 and infant mortality rates and their correlates Mexico 2007 Infant mortality rate Under 5 mortality rate Total Individual dimension Sex and age Male Female Household dimension Geographic dimension Region Northeast (includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila) Northwest (Baja California, Baja California Sur, Sonora and Sinaloa) Center (Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico) Center West (Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato) South and South East (Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz) REFERENCE/SOURCE: Total infant mortality rate and under five mortality rate come from CONAPO Infant mortality rate and under five mortality rate according to gender and to region come from Situacion de la Salud en Mexico 2006, Indicadores Basicos, Secretaria de Salud Table 2.2.3: Relationship between U5MR and income/consumption poverty at sub-national level Mexico 2005 U5MR Number of individuals under the hhold income/ consumption poverty threshold Proportion of poor individuals Region Northeast ,313, Northwest , Center ,499, Center West ,766, South and South East ,170, Note: Poverty Threshold refers to alimentation poverty Northeast region includes Tamaulipas, Nuevo Leon and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora, Sinaloa, Chihuahua and Durango. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Puebla, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz. REFERENCE/SOURCE: Encuesta Nacional de Ingresos y Gastos de los Hogares 2005, Situacion de Salud en Mexico 2005, Indicadores Basicos, Secretaria de Salud tality rate. This indicator continues to be larger in the case of males and for the South-Southeast zone of the country. It is also useful to note that the 100 municipalities with lowest Human Development index in Mexico had a child mortality rate of 32.5 in 2007, a much larger rate than the national average. To this regard, one of the goals of the Health Sector Program is to reduce by 40% this rate for 2012 (PROSESA). Links between child mortality and poverty Table shows that the South-Southeast area is the one that presents a largest child mortality rate n 2005, in addition to the fact that the proportion of persons who live in conditions of alimentary poverty was also larger in this area (46% of the individuals who live in this region lived under these conditions of poverty in 2005). On the other hand, the Northeast area presented both the lowest rate of child mortality and the lowest proportion of individ- 35

43 uals who lived in conditions of alimentary poverty (7.5%, that corresponds to 1.3 million individuals). Hence, it can be seen that the regions with a higher level of child mortality tend to be the regions with greater child poverty. 2.3 Causal analysis: which factors explain the levels and trends of poverty? In this chapter we analyze the variables affecting the probability of living under the poverty line, using the alimentary poverty line, including individual, household and geographic levels. (Table 2.1.3, EN- NViH 2002). Families in extreme poverty tend to have a greater number of household members. Low levels of schooling of the head of the household increase the probability that the household lives in conditions of alimentary poverty. If the head of the household is male, the probability that the household lives in these conditions decreases. If the household is indigenous, this probability increases (Table 2.1.3, ENNViH 2002). Finally, if both parents work, the probability of living in conditions of extreme poverty decreases. This finding may provide an additional justification to the recently created Program of Day Care Centers previously mentioned, which aims at providing child care services to families with mothers who work or single parents. Thus the program may facilitate the search and obtaining of a job. Finally, it is observed that if the household lives in rural areas, in the South-Southeast area or if it has a high dependence rate, then the probability of being poor increases (Table 2.1.3, ENNViH 2002). larger than 7 persons. The gender of the head of the family does also not affect the probability of suffering at least two types of deprivation. 16 In both regressions, the schooling of the woman has a high negative relationship to the probability of suffering deprivations, with less schooling increasing the probability of suffering at least 2 deprivations and reducing the probability of not experiencing deprivations. Furthermore, the level of wealth is highly and negatively related to the probability of suffering deprivations. Being indigenous status has a positive impact on this probability. When both parents do not work the probability of not suffering any deprivation is reduced, while children working under the age of 15 in the household increases the probability of suffering severe deprivations (Table 2.1.7, ENNViH 2002). A high dependency ratio increases the possibility of suffering at least two severe deprivations, though it does not affect the probability of not suffering any deprivation. Residents in the South region have the highest probability of suffering deprivations relative to other regions, followed by the Central and Northwest regions. Finally, residents of rural areas have a much higher probability of suffering deprivations than residents of urban areas. The variables related to which children live in households with deprivations are analyzed in Table (ENNViH 2002). In the first column variables affecting households that have no deprivations are shown, while the second column analyzes the variables related to having two or more severe deprivations. In general, small children have a higher probability of having two severe deprivations than older children. It is interesting to point out that, controlling for by other demographic and social variables the size of the household does not tend to affect the probability of suffering deprivations unless households are 16 There is a long and important debate on the causality between the number of children in the family and the level of poverty, namely if poverty affects the number of children born or if the number of children affects whether the family is poor or not. In this survey we only report the relationship as per the format of the established tables, this is, the association among the size of the household and the probability of suffering deprivations. 36

44 Table Odds ratios for the probability of income/consumption poverty by individual, household and geographic dimensions Odds ratio of living under the poverty line Mexico, 2002 among households with among all households children Individual dimension Sex and age Male Age group 2 (15-24) Age group 3 (25-44) Age group 4 (45-64) Age group 5 (65- ) Female Age group 2 (15-24) Age group 3 (25-44) Age group 4 (45-64) Age group 5 (65- ) Household dimension Household size 3-4 members 5-6 members 7+ Education of the head of the household None Primary [0.059]** [0.059]** [0.048]** [0.048]** [0.080]* [0.080]* [0.137] [0.137] [0.052]** [0.052]** [0.047]* [0.047]* [0.066]** [0.066]** [0.170] [0.170] [0.533] [0.533] [0.735]** [0.735]** [1.075]** [1.075]** [0.099]** [0.099]** [0.059]** [0.059]** Secondary+ dropped Dropped Gender of the head of the household Male Wealth index quintiles Q1 (poorest) Q2 Q [0.048]** [0.048]** [0.349]** [0.349]** [0.219]** [0.219]** [0.164]** [0.164]** 37

45 (Continued from previous page) Mexico, 2002 Odds ratio of living under the poverty line among households with children among all households Q4 Ethnicity/language/religion Group 2: Not Indigenous Work (not mutually exclusive categories) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Access to land in rural areas Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) [0.098]** [0.098]** [0.033]** [0.033]** [0.026]** [0.026]** [0.156]* [0.156]* [0.941] [0.941] [0.063] [0.063] [0.078]** [0.078]** [0.026]** [0.026]** [0.186] [0.186] Orphan child in household N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Residence Rural [0.201]** [0.201]** [0.089]** [0.089]** [0.101]** [0.101]** [0.046]** [0.046]** [0.084]** [0.084]** [0.075]** [0.075]** [0.070]** [0.070]** Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) * significant at 5%; ** significant at 1% REFERENCE/SOURCE: Mexican Family Life Survey

46 Table Odd ratios for the probability that children will or will not experience deprivations Odds ratio of children having Mexico, 2002 not even less severe deprivations at least two severe deprivations Total (average) Individual dimension Sex and age Male Age group 1 (0-2) [0.142] [0.081]** Age group 2 (3-4) [0.165] [0.102]* Age group 3 (5-9) [0.128] [0.063]** Age group (10-14) [0.150] [0.062]** Female Age group 1 (0-2) [0.206] [0.086]** Age group 2 (3-4) [0.159] [0.081]** Age group 3 (5-9) [0.122] [0.060]** Age group (10-14) [0.153] [0.071]** Household dimension Household size 3-4 members [0.249] [1.074] 5-6 members [0.249] [3.068] Women s education [0.156]* [3.836] None [0.102]** [0.170]** Secondary Gender of the head of the household [0.140]** [0.040]** Male Wealth index quintiles [0.127] [0.092] Q1 (poorest) [0.033]** [0.445]** Q [0.038]** [0.353]** 39

47 (Continued from previous page) Mexico, 2002 not even less severe deprivations Odds ratio of children having at least two severe deprivations Q [0.053]** [0.198]** Q Ethnicity/language/religion [0.073]** [0.144] Group 1: Indigenous Work (among hholds with children) [0.089]** [0.138]** Both parents working [0.078] [0.076] None of the parents are working [0.165]* [0.263] At least one child under 15 working Illness and disability in the household [0.116] [0.130]** Adult(s) with chronic illness [0.079]* [0.051]** Child/children with disability Family vulnerability (not mutually exclusive categories) [0.244] [0.342] Orphan child in household N/I N/I High dependency ratio (4+children per adult) [0.166] [0.271]** Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Residence [0.130] [0.112] [0.070]** [0.371]** [0.080]* [0.162]** [0.089] [0.175]** [0.067]** [0.151]* Urban The variable women s education contain the education of the children s mother Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) N/I: no information or Data REFERENCE/SOURCE: Mexican Family Life Survey 2002 [0.199]** [0.025]** 40

48 Conclusions In this chapter we have shown that, using the traditional indicators of child poverty based on the household per capita income, an important percentage of Mexican children live in conditions of monetary poverty. In 2005, 25% of the children lived in alimentary poverty (close to 10 million children). Variables such as the low schooling of adults in the household, being indigenous and household size (a larger household size increases the probability of being poor) are highly related to the probability of a household living in poverty conditions. Furthermore, individuals who live in rural areas also have a higher probability of being poor than the residents of urban areas. When measuring poverty based on the prevalence of deprivations, there is a high percentage of households that have dwelling, information and health deprivations. On the other hand, the deprivations on sanitation are somewhat lower. Overtime there has been a significant reduction in the proportion of homes that experience sanitation deprivations (from 23% in 1994 to 5% in 2005) and of water (from 18% to 2% in the same years, ENIGH). The advances in education have been slower, in % of the children had never attended or were currently not enrolled in school and in 2005 this percentage was 13% (ENIGH). The analysis also shows that child mortality has been decreasing from 1995 to this date (from 27.7 deaths per one thousand children born alive in 1995 to 15.7 in 2007, CONAPO). There are however substantial variations by region, the South-Southeast region presents larger mortality rates than other regions in the country. Our analysis has shown relatively high rates of poverty and deprivations in childhood in Mexico, given the level of the GDP per capita in Mexico (of approximately US$14,400 in 2008). Households that suffer monetary poverty also tend to suffer deprivations in other areas;, there are important correlations between monetary poverty in Mexico and the prevalence of deprivations. In particular, there are strong correlations between shelter, sanitation facilities, water and information deprivations and poverty measured by household income. 41

49 STUDY ON POVERTY AND DISPARITIES IN CHILDHOOD: THE CASE OF MEXICO Section Three: The Pillars of Childhood Wellbeing Introduction In this chapter the five pillars of childhood wellbeing are analyzed; nutrition, health, child protection, education and social protection. Each pillar analyzes the concept of childhood poverty taking in consideration the laws, policies, strategies and national programs set to improve outcomes in favor of children. As well as the results, the access and use of services related to these pillars are analyzed. The legal reference frame for this chapter are based on The Mexican Constitution, The Convention on the Rights of the Child, and Law for the Protection of the Rights of the Boys, Girls and Adolescents. 3.1 Nutrition National laws, policies and key programmes The main legislations regarding childhood nutrition in Mexico are the Constitution of the United Mexican States, The Convention on the Rights of the Child, the 1984 Health Act, Mexican Official Norm (NOM) for the Health Attention of the Child (1999), and the Law for the Protection of the Rights of the Boys, Girls, and Adolescents(2000). The first establishes that the nutrition of the children and youth from indigenous and immigrant families should be supported by nutrition programs. As well, the Convention on the Rights of the Child establishes the need to take measures to fight against diseases and malnutrition through the use of available technologies and with the supply of suitable nutritious foods and safe drinking water. The Health Act does not distinguish nutrition from health. This Act lays down the objectives of the National Health System, which aims to provide health services to all the population and improve the quality of services. The Law for Protection of the Rights of Boys, Girls and Adolescents establishes the importance of fighting against malnutrition by promoting a balanced diet. Regarding policies and strategies in childhood nutrition, the PND (The National Development Plan), with the Social Development Sectorial Program (PROSESA) stand out. In addition, the Action Program , that emerged from the United Nation s Special Session for Children has committed in accordance with the Millennium Development Objectives to decrease malnutrition in children under 5 years of age. Institutions such as DIF; SSA and SEDESOL, in coordination with federal entities, are the main agents in charge of implementing and developing policies and social programs related to the improvement of childhood nutrition. Specifically, DIF implements a variety of national food programs in coordination with the DIF State Systems. An example of these programs is the School Breakfast Program, which 42

50 provides breakfasts to children from low income families aimed at improving nutrition. In 2007 this program had a coverage of nearly 5.5 million children. Under the coordination of SEDESOL, the Oportunidades Program has an important nutritional component; providing nutritional supplements to women during pregnancy, as well as during the first two years of life of the child and up to 5 years of age in case of malnutrition. The mother of the family is required to attend monthly talks on family health, good nutrition and good hygiene practices. An evaluation from the National Institute of Public Health (INSP) on the impact of the program on nutrition in urban areas (INSP, 2005) shows that beneficiary children younger than 6 months of age when the program began (2002), measured on average 1cm more and weighed an average of 0.5kg more than non beneficiary children, after one year of receiving the benefits from Oportunidades. In turn, Liconsa, a company with majority state ownership that industrializes and distributes milk coordinates the Milk Supply Program, that distributes fortified milk with vitamins and minerals at a subsidized price to families that live in patrimony poverty conditions. In order to distribute the milk, Liconsa has a diverse number of community stores that sell the milk to the beneficiary population. At the end of 2007, Liconsa benefited nearly 5.6 millions of people (2007 Liconsa Program Consistency Evaluation) In turn, the Nutrition Support Program (PAL), run by Diconsa 17 promotes actions to improve the nutrition of households that live in poverty conditions and do not receive help from other programs of the Federal Government, in particular Oportunidades. This program grants: i) bimonthly an alimentary support of $530 in 2009 in cash or/and in kind ii) a bimonthly support in cash of $240 to compensate families from the international rise of food prices iii) bimonthly visits to the communities in order to provide counseling in matters such as: hygiene practices and health prevention, good eating habits, obesity and overweight prevention, iv) food complements for the families with children under five years and/or with lactating mothers; v) nutritional monitoring of the families that receive this food comple- 17 Diconsa is a company with a majority of state participation that belongs to the Social Development Sector. With the purpose to contribute the overcoming of nourishment poverty, through the supply of basic and complementary products to rural areas with high and very high marginalization, based on the organization and participation of the community. ments. In 2007, the PAL benefitted 143,423 thousand households (2007 Public Account). Considering the similarities with the Alimentary Program on Areas of Priority Attention (PAZAP), in 2009 these 2 programs were merged into one program. The Action Program from the Report A Suitable Mexico for Childhood and Youth, derived from the Special Session of the General Assembly of the United Nations in favor of Childhood, has set the goal to decrease, at least by one third, the malnutrition of children under 5 years old; to keep the number of newborns with low weight at birth below the 10% percentage and to reduce at least by one third the gap between states by Currently the tendency of low weight for age in children younger than 5 years has decreased from a 7.6 in 2000 to a 5% in 2006 (fulfilling one of the indicators of Goal 2 of the MDO's ); the low height for age prevalence in children younger than 5 has decreased from 17.8 in 2000 to 12.5% in 2006; the prevalence of underweight children younger than 5 years has fallen from 2.1 to 1.6% in the same years and the low height for age prevalence in children younger than 5 years in the indigenous population has decreased from 44.3 in 2000 to a 33.2 % in 2006 (CONEVAL,2008) There are few evaluations of the impact of the aforementioned programs, which would allow us to know which of the improvements in the nutritional indicators are a result of the government programs and which are due to other factors, such as the economic growth. The main social program that has proven impacts in the malnutrition indicators of children using a rigorous methodology is the Oportunidades Program. As well it is very important to emphasize the evaluation studies of the Social Supply of Milk Program by Liconsa (the studies of the impacts done through the INSP in 2006 show that the intake of Liconsa fortified milk decreased anemia in 44% of the children between 12 and 24 months of age that consumed the milk for six months under controlled conditions, that is, supervising the intake). In the same manner, the PAL has developed external evaluations which show an increase in the total consumption of beneficiaries between 14 and 16%. Regarding the quality of the diet, children and women that received the in kind food basket increased their intake of bioavailable iron and zinc significantly more that those who received benefits in cash (who only improved the consumption of bioavailable iron marginally but not that of zinc). Both groups improved the intake of vitamin C, reflecting 43

51 an increase in the consumption of fruits and vegetables. The improvements in the consumption of food from animals were not reflected in reductions in anemia. The evaluation expresses concern about the potential increase of calories consumed by the benefited population many of whom already have weight problems. However, there was no significant impact on anthropometric measures. As well, the educational component had a positive impact in the indicators of pre-scholars diet and alimentary safety of households 18. Besides economic growth, other factors that could have helped to fight malnutrition are: i) systematic growth of social expenditures from 1996 (Scott, 2008); ii) Better targeting of social programs; iii) improvements in progressivity of social expenditures; iii) the decentralization of federal resources towards the states, among other aspects (CONEVAL 2008). Child outcomes, disparities and gender inequality In the following section an analysis on childhood nutrition is shown according to the different disaggregations available in the ENNViH. About 11.5% of the children nationwide suffered stunting (approximately 978 thousand children), almost 2% with wasting (around 142 thousand children) and 2 % (254 thousand children) underweight weight in 2002 (ENNViH 2002 table 3.1.1). Boys have higher stunting rates than girls (12% versus 10%), while girls suffer higher under weight problems (3% versus 1.6% of the boys).by age and sex, two years old boys have the highest rates of stunting, although in the girls case the most vulnerable group is between four and five years old. Regarding wasting, one year old girls as well as boys have the highest levels of this childhood malnutrition problem. Likewise, one year old boys have the highest underweight problems (4% of the boys of this group suffered this in 2002), while two years old girls are the group of girls with the highest rate. (5.7%). As household size increases the percentage of children with malnutrition measured by stunting, wasting and underweight increases (while a household with less than three members had no children with this problem, at a household of seven or more 18 National Institute for Public Health Research Center on Nutrition and Health; Evaluation on the nutritional conditions of children younger than 5 and their mothers, and the food expense of families in marginalized communities in Mexico. Comparative Analysis of the delivery of food and cash transferences ;2006 Table A Individuals under 15 years old by expense per capita group in 2002 Expenses per capita by group % overweight % obese Group 1(poorer) Group Group Group Group Source: Mexican Family Life Survey (MXFLS-1) Table B Health indicators for children age five or less, by region Stunting Overweight North 7.0% 5.0% Center 11.0% 5.5% Mexico City 12.0% 4.9% South 18.0% 5.4% National 12.7% 5.40% Source: National Survey of Health and Nutrition (ENSANUT 2006) members the percentage of children with stunting was 19%, with wasting 1.4% and underweight 3%). When the mother has no schooling, is more likely that her children will be stunted (21%), have low height for weight (35%) and low weight (4.6%), than when the mother has studied at least junior high (in this case the proportion of children with stunting is 7%, with wasting 0.75% and underweight 0.9%) Similarly, according to different levels of wealth, children from lower wealth quintiles show a higher incidence rates of malnutrition, than others located in higher quintiles (for example, the 5% of the children in the first wealth quintile were underweight compared with the 0.2% of the children in the last quintile) Finally, indigenous children with non-working parents, who live in households with high dependency ratios (more than 4 children per adult), who live in the South-Southeast region of the country or in rural areas, showed higher levels of stunting, wasting and underweight. Table A provides information on the percentage of children younger than fifteen years old that are overweight or obese by expenditures per capita. Table A shows that in the higher income quintile there are a higher percentage of obese children 44

52 Table Child nutrition outcome and its correlates (by individual, households and geographic dimensions in 2005 or most recent year) Individual dimension Sex and age Mexico Stunting Wasting Underweight Total incidence/prevalence Male Age group 1 (0) Age group 2 (1) Age group 3 (2) Age group 4 (3) Age group 5 (4-5) Female Age group 1 (0) Age group 2 (1) Age group 3 (2) Age group 4 (3) Age group 5 (4-5) Household dimension Household size Less than members members Women s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion Group 1: Indigenous Group 2: not indigenous Work (among hholds with children) Both parents working None of the parents are working

53 (Continued from previous page) Mexico Stunting Wasting Underweight Total incidence/prevalence No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region Region Region Region Region Residence Urban Rural The sub-national regions are: region 1: South-Southeast (Oaxaca, Veracruz, Yucatan). Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Wealth index quintile defined as the cost of the assets that have the household Single parent defined as a woman that is the head of the household Stunting defined as children who are under -2sd and -3sd from height for age Wasting defined as children who are under -2sd and -3sd from weight for height underweight defined as children who are under -2sd and -3sd from weight for age Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) REFERENCE/SOURCE: Mexican Family Life Survey 2002 (13% versus 6% from the first expenditures quintile). Likewise, while only 13% of the poorest children are overweight, 24% of the wealthier children are overweight. Besides the ENNViH, the National Survey on Health and Nutrition (ENSANUT) allows analyzing health indicators of children age five or less and children between 5 and 11 years old in Table B shows the percentage of children less than five years old that were stunted and the proportion overweight by region. While in the South of the country 18% of the children were stunted, in the North only 7% had this problem. Nationally 12.7 % of the children with less than five years of age were stunted. On the other Table C Health indicators for children between 5 and 11 years old in 2006 Age Stunting Overweight Obesity Men Women Men Women Men Women Total Source: National Survey of Health and Nutrition (ENSANUT 2006) 46

54 Table Child nutrition: supply side and uptake variables by region Number of children in nutritional control per thousand children with malnutrition between 1-4 years old 2006 Total Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 605 By region Region 1: Northeast Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 319 Region 2: Northwest Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 163 Region 3: Center Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 529 Region 4: Center-West Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 608 Region 5: South-Southeast Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 825 Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Ro, Tabasco, Guerrero and Veracruz. REFERENCE/SOURCE: Base de datos de Oportunidades, Encuesta Nacional de Salud y Nutricion (ENSANUT 2006) hand, the number of overweight (without considering obesity) children under five is more similar between regions, even though in the South of the country rates are higher than in the North. By gender, five years old boys are more likely to be stunted than girls (15% against 13%), and girls from this age had higher obesity levels than boys (8.6% against 5%). In general, 10.4% of boys and 9.5% of girls between 5 and 11 years old were stunted in 2006; 16.5% of boys and 18% of girls were overweight and 9.4% of boys and 8.7% of girls were obese. Now we present some statistics from the Oportunidades program about children being treated for malnutrition. Table shows that, in general, Oportunidades has covered with health and nutrition services more than half of the children from 1 to 4 years of age diagnosed with malnutrition. There are however differences in the geographical regions coverage (Table ENSANUT 2006 Oportunidades 2006). For example, in the South- Southeast region, in 2006 the program served 825 children for every 1,000 that had malnutrition problems, while in the Northeast of the country only served 163. This may reflect the existence of more social programs in areas with higher numbers of cases with malnutrition. Causalities and correlates analysis Table (ENNViH 2002) analyzes the correlation between the main indicators of childhood nutrition (stunting, wasting and underweight) and childhood poverty. In general, it shows that when children live in households with an income less than a dollar a day per capita, are in the lowest wealth quintile or have at least one deprivation (whether it is shelter, water, hygiene, health or education) it is more likely that they suffer stunting. In the same manner, there is a positive correlation between child labor and the probability that they suffer stunting. There are also correlations between stunting, and being underweight. In general, the results show that the worst off children in matters of nutrition (measured in accordance with the indicators of low height for age, 47

55 low height for weight and underweight) are those who are younger, who live in households with many members (between 5 and 6 or more than seven), whose mother has low levels of education, and who live in households with less wealth, that are indigenous or that live in the south of the country. All the indicators of malnutrition show more pronounced differences when comparing indigenous and non indigenous (being the formers the ones with the worst conditions)., when comparing the first quintile (the poorest) and the last wealth quintile (the wealthiest), and according to mother s education levels. By gender, there are few relevant differences in the percentage of girls and boys with low height for weight. Nevertheless, the percentage of boys who are stunted is higher than girls, while there are more girls who are underweight than boys. In this section it is also important to analyze the emerging difficulties in matter of nutrition and the health risks that come with it. In particular, there has been an alarming increase in obesity in Mexico which is also evident in the case of children. The 1999 National Survey on Nutrition (ENN) and the National Survey on Health and Nutrition (2006), show that between 1999 and 2006 the proportion of children who were overweight increased from 12.9 to 21.2% in boys from five to eleven years of age and from 12.6 to 21.8% in girls. Obesity increased from 4.8 to 11.3% in boys from this age range and from 7 to 10% in girls. Between the ages of 12 and 19, the proportions are even larger. The 2006 ENSANUT show that one in every three Mexican adolescents are overweight or obese. These statistics are alarming given that they imply that this population is likely to suffer risks related to obesity problems, including cardiovascular problems (such as arterial hypertension, high cholesterol and diabetes), among others. Basic elements and alliances for a strategy Concerning childhood nutrition, the situation in Mexico is complex. There is an elevated proportion of people who live in poverty conditions, which implies that there are still an important percentage of boys and girls with malnutrition according to international standards (for example, as measured by stunting). While these traditional measures of malnutrition have shown reductions overtime in Mexico in recent years, there continue to be an important percentage of children that suffer malnutrition, mainly in rural, poor or indigenous areas. Whereas obesity indicators are not part of the guidelines of this study, it is important to observe that in Mexico a much higher fraction of children suffer obesity or are overweight than the children that have malnutrition. Additionally, not only the middle or upper class children show high percentages of overweight, but the percentages of poor children that suffer from weight problems is increasing significantly as well (Parker, 2008). The reasons for the rapid increase of obesity in Mexico are complicated and require more research. It is important to investigate the elements that explain the changes in food consumption and/or the physical activity patterns, as well as the environmental elements that have promote these trends. For example, Mexico is the top consumer of soft drinks at international level (measured by soft drinks consumed per capita Reuters, 2005). The aforementioned implies that there could be many children with overweight as well as malnourished 19, in the sense that the intake of vitamins and minerals is not sufficient for a healthy development. These characteristics of the Mexican context show the need for a strategy that ensures that poor children receive enough healthy food and that their families have the capacity to buy or produce a diet with a variety of foods. In addition, Mexico must turn to the problem of obesity, an important problem for children and young people that, if it follows current trends, will become a heavy burden for health and social protection systems due to its relation with the prevalence of chronic-degenerative illnesses and disabilities. Specifically, in the framework of Equality of Opportunities the PND sets forth a series of strategies connected with this problem. For example, the PND looks to strength the protection against health risks associated with unhealthy lifestyles. In order to achieve its goals, it strengthens the actions of fomenting, promoting, communal work, fiscal policies and other not regulated policies. Another strategy consists in promoting physical activities 19 The specialists recognize this phenomenon as excess malnutrition. 48

56 at schools and sports at all levels of the education system, to prevent obesity and a sedentary life style. Therefore, a national strategy which promotes healthy nutrition and an exercise or sports culture should be developed; considering measures such as information programs at schools, banning junk food at schools, revising and strengthening regulations regarding production and commercialization of food, and taxing certain food and processed beverages, like soft drinks. In regard to this last aspect, Rivera (2008), from the National Institute of Public Health, has presented a series of recommendations related to the intake of beverages for a healthy life. Rivera classifies beverages in six categories according to its energetic content, nutritious value and health risks in a scale that classifies beverages from 1 to 6, being one the healthiest. In level 1 is drinking water; level 2 low fat milk, and sugar free soya drinks; level 3 sugar free coffee and tea; level 4 non caloric beverages with artificial sweeteners; level 5 beverages with high caloric value and limited health benefits (fruit juice, whole milk, fruit drinks with sugar, alcoholic beverages and sport drinks); and level 6 beverages with sugar and low nutritive content (soft drinks). In these beverages the water intake is documented in first place, followed by beverages without or with low energetic contribution and skim milk. Besides this study recommends schools to: i) offer drinking water for the all the community; ii) to get involved with school cooperatives with the purpose of amending the rules and to create awareness among the Public Education Ministry (SEP), directors and teachers about the need to limit the accessibility of sweetened beverages; iii) suggest the use of skimmed milk, without flavor and without sugar in the breakfasts offered by DIF to schools; iv) suggest incentives for schools certified as free from sweetened beverages at their premises. In the matter of regulations, subsidies and taxes it is recommended: i) that the SSA works with Congress to tax the content of saturated fat in milk and subside skim milk; charge taxes for every gram of sugar added to all the commercial bottled beverages such as coffee, tea, soft drinks, energetic beverages, and juices; ii) regulate radio, television and internet commercials of drinks with calories targeted to children; iii) label all the beverages that need to be diminished; and iv) advice parents and the general population. 3.2 Health Laws, policies and fundamental national programs The Health System of Mexico is conformed by different systems that operate in parallel. In 2005, approximately 40% of women and 33% of men were covered by at least one type of social security (measured according to the possession of a medical insurance from IMSS, ISSTE, Sedena, Pemex, Secmar or from any private institution); however it is important to mention that there is a lot of mobility in and out of these organisms, since many individuals with social security benefits in a determined moment in time do not have them a few years later because of job changes (Parker, Rubalcava and Teruel, 2008). In general, in the National Health System there are social security institutions that cover workers from the social sector and their families. These institutions are divided in two different systems that cover workers from the private sector (IMSS) or workers from the public sector (ISSSTE, Pemex, Secmar and Sedena). In turn, there are the medical services for the uninsured, which are provided by the federal government and state governments through the Ministry of Health (Parker and Scott, 2008). Broadly speaking, an individual with social security enjoys the benefits such as: workplace risk insurance; illnesses and maternity; disability and life; retirement, old age unemployment insurance; daycare and social assistances, among other services (1995, Social Security Act). The Sectorial Health Program (PROSESA ), in accordance with PND, defines the actions of the agencies and of the federal organisms that belong to the National Health Program. The General Health Act is the document that regulates the right for health protection that all Mexican people have and sets forth the main agents related to it. In addition, the Law for protection of the Rights of Boys, Girls and Youth (2000) establishes that all boys, girls and youth have the right to health and that the government official should coordinate strategies in order to reduce childhood mortality, promote immunizations, promote breastfeeding, prevent early pregnancies and help children and adolescents victims of domestic violence, among other things. Likewise, the Action Program of the Special Session of the United Nations in favor of 49

57 childhood set forth a number of obligations to reduce childhood and maternal mortality and increase the access to reproductive health services and youth health programs. There are different governmental programs dedicated to improve the level of health of the poor population with or without insurance. The Seguro Popular offers a public insurance option for informal workers, who do not have social security. According to this definition, the informal sector represents approximately the 58% of the economically active population (PEA), while the formal sector represents 38% and the unemployed 4% (Levy, 2007). In the Seguro Popular operating rules, payments for services depend on the decile -in the income distributionbeing exempted of payment the first two deciles. The Seguro Popular covers the expenses incurred according to a manual of health procedures that catalogs the illnesses and medicines covered. In turn, the SMNG grants free Health attention in matter of prevention, diagnosis, treatment and rehabilitation to Mexican children born from December 1 st 2006, that are not social security beneficiaries, until they reach five years of age. In 2007 the Seguro Popular covered 5 million 100 thousand families around the country, 255 medical interventions and 285 medicines (2008 Seguro Popular). In turn, the SMNG covered 108 interventions related to infectious and parasitic illnesses (such as tuberculosis), tumors, endocrine, nutritional and metabolic illnesses, from the nervous system, circulatory system and respiratory system, among others. The children affiliated to the SMNG are granted, the right to receive preventive medicine services and medical attention, without any payment for the service. The general components of these services are: i) a preventive actions package; ii) Laboratory tests and specialized exams; iii) medical attention, medicines and health inputs, and iv) certain types of interventions (as the aforementioned). Possibly since they have been operating for a relatively short time, there are few evaluations of the impacts of these health programs, however the most recent studies do not reveal important impacts on health with the exception of the indicator of household expenditures on health. (see Barros 2007 and Parker and Scott 2007). In turn, Oportunidades contributes to improving the health of households in extreme poverty conditions through a basic health package to all the beneficiaries. The program conditions its monetary transfers to the regular attendance of the families to health clinics and to informative sessions where they review basic preventive health topics. The Program has shown to have significant impacts, including increasing by 35% the use of health services and decreasing by 20% decrease the number of sick days in children younger than 6 and adults between 16 and 49 years, among other results (INSP, 2005) Hoddinott and Skoufias (2004) have found positive impacts, as a result of Oportunidades, in the consumption of calories (a 6.4% increase on the average intake), with greater impacts on fruits, animal and vegetable products, which shows that the families are not only consuming more but are also consuming a better quality diet. In matters of health, Riviera et al (2004) found that when comparing the children that had received the benefits of the program for 2 years opposed to those that only received them for one year, the first ones had an increase in height of 1cm approximately (for children 12 months and under in 1998). In the same context, Cattaneo et al (2009) have shown that the Piso Firme program, which consists in replacing dirt floors with concrete floors, improves significantly the health of young children (measured according to the incidence of parasitic illnesses, diarrhea and the prevalence of anemia) besides improving the cognitive development of children. It is important to mention that there are about 279 thousand households, located in very small and disperse areas, that are not incorporated in the existing social programs, in particular Oportunidades, because of lacking basic health and education services (Development Program for Marginalized Zones 20 ) Diconsa s Nutrition Support Program looks to improve the nutrition of the population who does not receive the assistance of the Oportunidades Program. To achieve this, the program grants bimonthly monetary supports of $530 and organizes bimonthly visits to provide counseling on hygiene practices and health prevention, among other things. 20 It is important to mention, due to the similarities in their components and objectives, in 2009 the nourishment component from the prior Alimentary Program on Areas of Priority Attention merged with the Nutrition Support Program from Diconsa and the infrastructure component merged with the Regional Development Program (Micro regions), taking the name of Development Program on Priority Areas. 50

58 Table Young child health outcomes, related care and correlates (by individual, households and geographic dimensions) Mexico, 2002 Child diarrhea* % children aged 0-4 Received ORT or increased fluids, and continued feeding (MICS Indicator No. 35) Child fever** %children aged 0-4 Antibiotic treatment of suspected pneumonia (MICS Indicator No 22) Total incidence Individual dimension Sex and age Male Age group 1 (0) Age group 2 (1) Age group 3 (2) Age group 4 (3) Age group 5 (4) Female Age group 1 (0) Age group 2 (1) Age group 3 (2) Age group 4 (3) Age group 5 (4) Household dimension Household size Less than members members Women s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion Group 1: Indigenous Group 2: Not Indigenous Work (among hholds with children) 51

59 (Continued from previous page) Mexico, 2002 Child diarrhea* % children aged 0-4 Received ORT or increased fluids, and continued feeding (MICS Indicator No. 35) Child fever** %children aged 0-4 Antibiotic treatment of suspected pneumonia (MICS Indicator No 22) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural * Child had diarrhea in the last 4 weeks ** Child had fever in the last 4 weeks Wealth index quintile defined as the total value of the assets that have the household Single parent define as a woman that is the head of the household Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) Note: The values in column 3rd. & 6 th are the children that visited to the doctor & received some medications. REFERENCE/SOURCE: Mexican Family Life Survey 2002 Results in favor of the children, disparities and inequality between genders In this section the main results on childhood health are presented according to the prevalence of illnesses such as diarrhea or fever, and the provision for oral re-hydration or antibiotic treatments for the prevention of pneumonia. Around 12% of the children (1.2 million) had diarrhea and 18% fever in the last month (1.8 million), with about 43% receiving re-hydration treatment (around 535 thousand children) and nearly 49% of children (877 thousand) were given antibiotics to prevent pneumonia (table 3.2.1, ENNViH ) By gender, it can be seen that a higher percentage of boys than girls suffered these illnesses, and also a higher percentage of boys received oral treatment 21 We follow the guidelines from this study, although with respect to treatment, we consider that a child with fever can evolve in many other illnesses than pneumonia. 52

60 Table Adolescent health outcomes, care and correlates (by individual, households and geographic dimensions) Mexico Currently uses any contraceptive method Comprehensive knowledge about any contraceptive method Comprehensive knowledge about any Sexual Transmission Disease (STDs) Comprehensive knowledge about contraceptive methods that prevent STDs Total incidence 64.2% 91.2% 86.9% 73.4% Individual dimension Sex and age Male 69.9% 97.2% 91.1% 74.7% Age group 1: years old 55.1% 99.6% 65.4% 97.6% Age group 2: years old 70.4% 87.8% 87.0% 98.6% Age group 3: years old 66.2% 97.6% 92.9% 98.5% Age group 4: years old 65.0% 96.3% 88.5% 97.7% Female 55.4% 83.4% 83.2% 72.3% Age group % 53.0% 69.0% 98.3% Age group % 74.1% 80.7% 98.2% Age group % 91.5% 87.2% 96.7% Age group % 92.7% 88.4% 97.8% Household dimension Household size Less than % 66.2% 66.8% 61.3% 3-4 members 68.1% 92.9% 90.6% 76.8% 5-6 members 70.4% 97.1% 95.9% 79.4% % 98.4% 71.0% 60.0% Women s education None 35.6% 4.4% 3.3% 0.4% Primary 41.0% 82.9% 73.6% 15.6% Secondary+ 68.3% 97.0% 89.8% 31.3% Gender of the head of the household Male 85.1% 77.2% 75.5% 75.5% Female 14.9% 22.8% 24.5% 24.5% Socio-economic level Medium-high 78.2% 96.6% 75.5% 75.9% Medium 62.0% 94.0% 92.7% 90.6% Medium-low 71.9% 95.9% 92.1% 89.1% Low 47.6% 80.6% 76.4% 75.4% Very low 41.9% 89.4% 92.9% 90.4% Geographic dimension Region Region 1: Northeast 58.3% 95.8% 91.5% 70.9% Region 2: Northwest 77.3% 77.4% 86.1% 69.0% Region 3: Center 63.2% 90.5% 83.8% 71.6% Region 4: Center-West 73.4% 94.2% 88.6% 81.3% Region 5: South-Southeast 50.1% 90.5% 88.7% 69.5% Residence Urban 64.4% 92.6% 87.3% 74.0% Semi-urban 61.0% 74.0% 77.0% 63.3% Rural 83.6% 100.0% 97.3% 84.9% REFERENCE/SOURCE: National Youth Poll 2005 Note: Weighted results 53

61 Table Child and youth health: supply side and uptake variables by region Major health supply indicator: Number of doctors per 1,000 habitants Total number of doctors per 1,000 habitants By region Region 1: Northeast - number of doctors per 1,000 habitants Region 2: Northwest - number of doctors per 1,000 habitants Region 3: Center - number of doctors per 1,000 habitants Region 4: Central West - number of doctors per 1,000 habitants Region 5: South-South East - number of doctors per 1,000 habitants Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz. Source: First State to the Nation Report 2007 for dehydration. The analysis by age groups allows seeing that boys and girls of one year of age were the ones with more cases of diarrhea. Nearly 21% of boys with one year of age (207 thousand) had fever, while almost 26% of girls age years had fever in the last month (270 thousand), according to the 2002 ENIGH. On the other hand, the percentages for pneumonia treatment allows to see that all the age groups had this kind of attention, however it was more prevalent for boys than for girls (Table 3.2.1ENNViH 2002) This analysis also shows that as household size increases, the proportion of children with diarrhea and fever also increases (for example, 15% of children in households of seven or more members had diarrhea during the past four weeks versus 3% of the children in household with less than three members). (Table 3.2.1ENNViH 2002). Furthermore, children in households from the lowest wealth quintile, who are indigenous, from the South-Southeast area or rural areas are more likely to become ill and when ill, less likely to receive treatment. (Table ENNViH 2002). By comparing the previous table with the outcomes from ENSANUT 2006, this survey reveals that 12.9 of the children had diarrhea in the last two weeks. This survey shows clearly the regional differences in matters of health, while 6.4% of the children younger than five years had diarrhea in the state of Nuevo Leon, 21% of the children in Chiapas had diarrhea. The health analysis on the youth in reference to the use and knowledge of contraceptive methods, sexually transmitted diseases (ETS) and the use of contraceptive methods to prevent these (Table National Youth Survey, 2005) shows that, even though teenagers are very well informed on these topics (92% admit to knowledge of at least one contraceptive method), the percentage of teenagers who in fact currently use a contraceptive method is high (64%). Only 83% of teenagers in 2005 had knowledge of any sexually transmitted disease. On the use of contraceptive methods, table shows that there are few differences between the proportion of men (66%) and women (61%) that use contraceptives. In the case of men, those who are between years old report to have a higher percentage use of them (70%) while in the women s case the age group from 25 to 29 (63%). Regarding the socioeconomic level, the percentage of youth that uses contraceptive methods is higher as the socio economic level increases generally speaking. There are also large differences in the percentage of youth that used them according to urban (63%) and rural areas (42%). 54

62 By gender, men are generally better informed than women, about contraceptive methods as well as sexually transmitted diseases. Younger men (12-14) had more knowledge on contraceptive methods (99%), versus only 53% of women in this range. The higher the educational level of the mother, the higher the proportion of teenagers that are knowledgeable on contraceptive methods and ETS. By geographic areas, in the north and the center of the country youth are better informed on contraceptives that in other areas, as well as when living in urban areas (Table 3.2.2, National Youth Survey, 2005). Regarding medical coverage, from the perspective of supply (number of doctors for every 1,000 inhabitants), we can observe a relatively slow progress in increasing medical coverage by regions, -measured by the number of doctors for every thousand inhabitant-, in 1990 there was almost one doctor for every 1,000 inhabitant, in 2007 this number was about 1.5 (table 3.2.3, State of the Nation Report 2007). The differences by geographical areas clearly show the disparities in the interior of the country: while in the Northeast area there were approximately 1.72 doctors for every 1,000 inhabitants, in the South- Southeast area the number was 1.43 (Table State of the Nation Report 2007). Analysis on causality and correlation This study shows that Mexico, in matters of childhood health, has made important progress towards achieving the MDO's (Millennium Development Objectives). For example, childhood mortality rate was reduced in children younger than five years old, from 33.7 deaths for every thousand born alive in 1995 to 18.4 in 2007 (CONAPO, 2007). Notwithstanding, there are still many challenges. In matter of health deprivations, around 25% of children (9.9 million) neither received immunization nor visited the doctor for a recent illness related to a respiratory infection or diarrhea, or both, which represents the definition of a severe deprivation. In addition to this, nearly 40% of the children (15.7 millions) did not receive immunizations after two years of age. (Table ENNViH 2002) In general, only half of the children receive antibiotic treatment to prevent pneumonia, a percentage that decreases considerably as the size of the household increases (44%); if the mother of the household has no formal education, (38%); if the household is located in the lowest wealth quintile (44%); if the children are indigenous (34%); or from rural areas (38% Table 3.2.1, ENNViH 2002). At a descriptive level (Table 3.2.1), the outcomes on childhood health presented in the previous section show that children who live in rural areas, are indigenous or in households where the mother has a low schooling level usually have a higher incidence of illnesses such as diarrhea and fever; besides when ill they have less probability of receiving the proper treatment. For example, 24% of the children between 0 and 4 years of age whose mother does not have formal education, had fever the month before the survey, and only 38% of these children received an antibiotic treatment to prevent pneumonia; while 17% of children whose mother has a junior high education level or more, had fever and almost 58% of these children received antibiotic treatment. The area with more illnesses incidences in the childhood population is the South-Southeast of the country. In general, only 40% of the children that had diarrhea received oral re-hydration treatment, and there are important differences in the probability of receiving this treatment according to gender, being more probable that boys receive treatment than girls, however in the case of antibiotic treatment to prevent pneumonia the differences are not as large. It is evident, as well, that the probability of having received treatment is lower for children living in rural areas and when the mother has a low schooling level or when the household has a lower wealth level. These outcomes suggest that children from low income families get ill more frequently, and also when they do they tend to receive treatment less frequently than children in better economic conditions that get sick as well. An important potential explanation of the high incidence of illnesses and the lower probability of being treated in the poorest population is related to the access to health services and their insurance conditions. Parker (2008) explores the conditions of the supply of services using the ENNViH which has a module with information about the general characteristics of schools and health clinics situated in the locality. In this document Parker (2008) shows that the provision of medical services in Mexico is far from being equitable according to the socioeconomic level of 55

63 the population. The analysis shows that, for example, 26% of the clinics that cover the households from the lowest quintile per capita have ambulances, while this percentage is 57% for the highest quintile. Likewise, the clinics that cover people from the highest quintiles have higher salaries for health personal for instance directors from clinics treating the population in the highest quintile earn $18 thousand pesos versus $9 thousand paid for the lowest quintile. (Parker, 2008). Building blocks and partners for a strategy The epidemiologic profile of the county is dominated by chronic-degenerative illnesses and injuries related with the ageing of the population; inequity of opportunities and the growth of risks related to less healthy lifestyles. There are high levels of individuals who are overweight and obese in children and young people, as well as high incidences of high blood pressure and diabetes. Data from the National System for Health Information (SINAIS) show that, in 2007, the main causes of mortality in girls and boys from 1 to 4 years of age were infectious intestinal illnesses, respiratory and congenital malformations. In the case of teenagers (15 to 19 years of age), the main causes of mortality in men were traffic accidents, aggressions (homicides) and self-inflicted injuries. In the case of women were traffic accidents, self-inflicted injuries, nephritis and nephritic syndrome and leukemia. There remain great challenges in Mexico in matters of health attention and prevention of intestinal and respiratory illnesses, particularly for infants. In view of this, it is necessary to intensify the efforts to reduce the incidence of infectious illnesses which are still an important cause of childhood mortality in poor areas of Mexico. Certain evaluations of Oportunidades have shown that the program is useful to improve childhood health. Likewise, programs like the Seguro Popular and the SMNG could be useful in this aspect as well and should have strict evaluations to assure their impacts. As mentioned before, there is an important segment of the population that is not benefited by Oportunidades or by any social security system. therefore it is necessary to continue promoting universal access to quality health services. Related to this, there is a need for a country level strategy to face the problem of obesity and the illnesses related to obesity. First, it is necessary to fight against obesity to avoid further increases and to encourage the obese population to lose weight. This implies the consideration and/or implementation of policies that promote exercising, campaigns to improve nutrition and improve regulations and environmental conditions. 3.3 Child Protection National laws, policies and key programmes Childhood protection refers to all actions and strategies that are carried out to safeguard the physical, mental and emotional state of children, especially those who live in marginalized conditions, abandonment, abuse, violence or any other situation that puts in risk their integrity and fulfillment of their rights. The protection of childhood rights is foreseen in the Politic Constitution of the United Mexican States, in general, as an element of the individual guarantees, acknowledged in favor of all individuals and in particular in article 4 (reforma )) and 18 (reforma ). It is recognized as well in different international treaties ratified by Mexico, among which stand out the Convention on the Rights of the Child (1989) and its Facultative Protocols 24, the Committee on the Elimination of Discrimination Against Women (1979) and The International Convention on the Protection of the Rights of Immigrant Workers and their Families (1990) that, according to article 133 of the constitution, are supreme law of the Union. This legal framework is integrated as well, by different national laws including the Law for protection of the Rights of Boys, Girls and Youth (2000); the General Health Act (1984); the Social Assistance Law (2004), The law to Prevent and Sanction Human Trafficking (2007) and the General Population Law (1974) the law of General Access of Women to a Life Free of 22 On December of 1999, the Congress of the Union amended the 4th article of the Constitution, in order to incorporate in its context the notion of boys and girls as subject of rights. Through this amendment it was recognized that the boys and girls are entitled of the right on the satisfaction of their nourishment needs, health, education and leisure for their integral development. It was established that the ascendants, tutors and guardians have the obligation to preserve these rights and that the State will provide the necessary to propitiate respect and dignity to childhood and the full exercise of their rights. Likewise, it was stated that the State would grant facilities to the individuals to contribute with the fulfillment of the childhood rights. 23 In 2005 there was another amendment to the 18th article of the Constitution, through which the Juvenile system for minor offenders was transformed and the bases for the creation of an Integral system of justice for adolescents in conflict with the criminal law were set, according with the Convention on the Childhood Rights. With this reform, the Federation as well as the States was complied to adapt their own legislation in the matter and implement a new integral system of justice for the adolescent. The federal law in this matter is not approved yet. 24 For a description of the approach on right developed by the United Nations, see org/org/spanish/crc/index_framework.html 56

64 Violence (2007) and the Federal Law to Prevent and Eliminate Discrimination (2003), Federal Civil Code and the Federal Penal Code among others, as well as state laws of health, education, social assistance and childhood rights protection, justice for youth and local civil and penal codes. Specifically, the Law for Protection of the Rights of Boys, Girls and Adolescents strives to assure the full and integral development, which entails the chance to develop physically, mentally, emotionally, socially and morally. This law states, as well, that boys, girls and adolescents cannot be imposed a regime of life, study, work or discipline rules that would make them renounce their rights to rest and leisure. It is very important to emphasize that this Law states, in its 14 th article, that all the boys, girls and adolescents are assured the right to the fulfillment of all their rights. The Social Assistance Law establishes a National Social Assistance System to promote and coordinate the rendering of public and private social assistance services and to stimulate the participation of the society. This law stipulates that all boys, girls and adolescents- especially those in risky situations due to malnutrition, physical or mental development deficiencies, mistreatment, abandonment, etc., are eligible for social assistance. Likewise the General Health Act states the importance of providing social assistance services that promote wellbeing and integration to society. As for strategies and national programs, the PND, the National Health Program and the State Development Plans integrate the main documents governing child protection. The PND sets forth objectives related to child protection policies. Specifically, the Program Oportunidades emphasizes the importance of developing a public policy aimed to the family, with the purpose of reducing social vulnerability. In addition it seeks for the sane and integral development of Mexican childhood warranting total respect to their rights, health attention, nourishment, education and housing. The Vivir Mejor (Better living) strategy has two parts related to childhood protection in Mexico. The first one is, the Action Program, derived from the Special Session in Favor of Childhood of the General Assembly of the United Nations celebrated in 2002, which comprises the federal Government strategies to improve educational, health conditions and the protection of rights for boys, girls and adolescents. The second one refers to the National Board for Children and Teenagers (COIA), formed by presidential decree on July 2001, as a permanent inter-secretarial commission, with the purpose to coordinate and define policies, strategies and actions that guarantee the total and integral development of boys, girls and adolescents. This board is formed by representatives from SSA, SEDSOL, STPS, as well as the main directors of IMSS, ISSSTE and SNDIF. Nevertheless, there have been no recent reports, the last report on the Action Program , was carried out in 2006, and the COIA currently does not appear to be active. The main institutions that have powers in matter of protection of childhood rights are the DIF, the Attorney s General Office (PGR), Human Rights National Board (CNDH), Mexican Board for Aid to Refugees (COMAR), the STPS; SEDESOL, the National Board for Development of Indigenous People (CDI), Public Security Ministry (SSP); Health Ministry (which is in charge for the NOM 190 against domestic violence); Judicial Power of the Federation and judicial state power and the Civil Registry Office. DIF is specifically the public organism in charge of implementing and applying public policies in matter of social assistance that promote the integral development of the family and the community. Part of the DIF includes the Proctorships on Defense of the Minor and the Family, which are in charge of rendering free orientation, protection, defense and legal counseling to all people in vulnerable conditions. They receive and orient affairs related to childhood mistreatment, domestic violence, divorces, food allowances, search for missing boys and girls and adoptions. DIF has several programs in matters of protection and childhood rights, such as the Program for Prevention, Attention, Discouragement and Eradication of Urban Marginal Child Work (PROPADETIUM), which composes actions to prevent the incorporation of boys, girls and adolescents in labor activities and to encourage their enrollment in school (in case they are working). Among these actions are: help the DIF state systems distribute academic and training scholarships; provide training and counseling to those in charge of coordinating and carrying out the program; counseling and monitoring visits to the DIF state systems. In 2007 the program attended to 74,446 working girls, boys and adolescents, as well as 99,943 boys and girls in risk of entering the labor market. (DIF, 2007), Similarly, the Program on Promotion and Diffusion of Childhood Rights, distributes information on 57

65 rights and guarantees of the laws to children and and adolescents. It is estimated that, through this program, in 2008 nearly 30,258 girls and 30,557 boys were informed and 7 thousand girls and around 6 thousand boys have been trained, and spread and promote the knowledge of their rights to their families, schools and communities. As an additional effort complementary to this program, the Human Rights National Board coordinates the Program on Women, Child and Family affairs, founded in 1993 with the purpose of disseminating knowledge on the human rights of women, children and family. On the other side, in the Inter-institutional DIF Program for Attention to Minors in the Border, the Strategy for Prevention and Attention to Migrant Girls, Boys and Adolescents Repatriated strives to attend the necessities of migrant boys, girls and adolescents and repatriates that travel alone and the associated problems which they are exposed to, as well as promoting coordinated actions to protect and contain families and communities. In 2007 this program served 21,366 girls, boys and adolescents unaccompanied migrants and repatriates without companion in the network of transit shelters (DIF/ UNICEF, 2009). In addition, during 2008 the DIF aids the vulnerable population through integral attention rendered in the Support Centers Attention, Research and Training Modules. These centers serve girls and adolescents between 6 and 19 years of age that require social assistance, physical and mental protection to guarantee their rehabilitation (medical, physiological, pedagogical), security, and survival by providing opportunities for their education and integral development. For example, are subject of attention those children and adolescents that present degenerative illnesses, any kind of incapacity or terminal illness. There are new centers that provide services such as medical attention, immunizations, civic events, social attention, pedagogical and formative counseling, rehabilitation therapy, everyday life activities and legal attention. (Second State to the Nation Report, 2008). Another important aspect in terms of protection of rights of childhood is the National Coordination to Prevent, Attend and Eradicate Commercial Sexual Childhood Exploitation, which is headed by DIF, and formed by diverse public institutions, civil society organizations and international organisms, including SSA, SEP, SRE, SEGOB, STPS, SSP, PGR, CNDH, UNICEF, Casa Alianza among others. The purpose of this coordination is to promote policies and systematic actions for the prevention, attention and protection of girls, boys and adolescents who are victims of sexual exploitation. Finally in matter of childhood protection, it stands out the creation of the Inter-institutional Committee on Dialogue on Unaccompanied Girls, Boys and Adolescent in 2007, whose objective is to open a discussion forum about policies and responsibilities on migrant boys and girls including mechanism to protect their rights. This committee is integrated by the Secretary of State, The Ministry of Foreign Affairs, SEDESOL, SEP, SSA, DIF, INM, OIM, ACNUR, The Mexican Board for the Help of Refugees (COMAR) and UNICEF, among other institutions. It is important to mention as well, that through the creation of a task force of Officers of Protection to Childhood (OPI), an important step to strength the protection of the childrens rights was made. The OPIs, forming part of the National Immigration Institute have been trained to operate a repatriation model for unaccompanied boys, girls and adolescents that guarantees the complete protection of their rights. Its purpose is to identify and attend the most urgent necessities of the migrant boys and girls; to have the necessary tools to intervene in crisis situations; handle protection requests and cases of human trafficking, as well as to inform boys, girls and adolescents in appropriate terms, about their rights as well as answering questions on the immigration procedure. In the same manner, the OPIs are in charge of bringing children to DIF shelters and, in the case of foreigners, accompanying them during the repatriation process to their countries of origin. Child outcomes, disparities and gender inequality. In this section we analyze diverse indicators regarding childhood rights and protection. Among the indicators that are analyzed in this section are the ones related with the birth registry, child labor, teenage marriage and adoptions in Mexico. We now analyze the indicator of registration of children at birth. Specifically we analyze the percentage of children with late registry (between one and eight years after being born) in It is worth noting that the analysis is done on children with 58

66 Table Birth registration and its correlates (individual, HH and geog. Dimensions) Mexico % of children registered late/total number of children registered in 2005 Of which: due to high cost, travel or not want to pay late fee Number children aged 0-59 months (2002) Total incidence/prevalence N/I 9,766,615 Individual dimension Sex and age Male N/I 4,841,875 Female N/I 4,924,740 Women s education None ,863 Incomplete primary ,032,884 Complete primary ,032,884 Secondary N/I 4,847,723 High school N/I 4,847,723 Professional N/I 4,847,723 Geographic dimension Region Region 1: Northeast N/I 1,311,618 Region 2: Northwest N/I 684,496 Region 3: Center N/I 3,189,840 Region 4: Center-West ,309,960 Region 5: South-Southeast ,270,701 Note: due to the lack of information regarding the number of children whose birth is not registered, this table displays information about the number of children that were registered late (from one to eight years late) according to the total number of children registered. Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) N/I: No information available REFERENCE/SOURCE: INEGI, Mexican Family Life Survey 2005 late registration instead of children not registered because for the latter information is not available. Table (INEGI, 2005) shows that approximately 42% of children in 2005 were registered late (around 4 million), which can be as a result of diverse causes such as: lack of money to go to the civil registry, the absence of civil registry offices in their community, the remoteness of these offices, the charge for late expedition of the certificates, as well as lack of knowledge of the importance of timely registration. By gender, there are slightly more girls registered late. According to the mother s schooling, around the 77% of the boys were registered late when the mother has no schooling, while this percentage was only 20% when the mother has a professional career. As for the analysis according to geographical areas, the proportion of the children registered late was higher in the South-Southeast of the country and lower in the Center-West (Table ENEGI 2005) Another indicator of child protection is related to the level of childhood vulnerability according to diverse characteristics of the individuals and the household, taking as reference the vulnerability definition from the Global Study on Poverty and Disparities of Childhood, which indicates that a boy or a girl is vulnerable if he or she lives in a household where parents suffer some chronic illness. In the Table (ENNVIH 2002) shows that about 42% of the children were considered vulnerable in 2002 (around the 16.4 million). When the analysis is done according to the size of the household, it is found that in households with 5 and 6 or seven members or more children were more vulnerable (43% in the first case and 42 % in the second). When the head of the family is a man, the children were more vulnerable, - 42% versus 39% in cases of households headed by a woman. (Table 3.3.2, ENNViH 2002). 59

67 Table Orphanhood, child vulnerability and their correlates (by individual, households and geographic dimensions) Mexico, 2002 % Vulnerable children Number of children aged 0-17 years Total incidence/prevalence ,961,034 Individual dimension Sex and age Male ,526,898 Age group 1(0-2) ,949,916 Age group 2(3-4) ,001,231 Age group 3(5-9) ,610,310 Age group 4(10-14) ,893,468 Age group 5(15-17) ,071,973 Female ,434,136 Age group 1(0-2) ,929,701 Age group 2(3-4) ,078,426 Age group 3(5-9) ,842,239 Age group 4(10-14) ,233,066 Age group 5(15-17) ,350,704 Household dimension Household size Less than , members ,753, members ,958, ,776,966 Women s education None ,768,184 Primary ,808,063 Secondary ,666,506 Gender of the head of the household Male ,299,187 Female ,661,847 Wealth index quintiles Q1 (poorest) ,186,066 Q ,137,545 Q ,332,664 Q ,528,072 Q ,221,163 Ethnicity/language/religion Group 1: Indigenous ,336,662 Group 2: Not Indigenous ,624,372 Work (among hholds with children) 60

68 (Continued from previous page) Mexico, 2002 % Vulnerable children Number of children aged 0-17 years Both parents working ,982,113 None of the parents are working ,325 No adult in primary working age (18-54) ,418 At least one child under 15 working ,350,766 Illness and disability in the household Adult(s) with chronic illness ,490,875 Child/children with disability ,532,442 Family vulnerability (not mutually exclusive categories) Single parent ,661,847 Orphan or fostered child in household N/I High dependency ratio (4+children per adult) ,340,274 Elder (70+) person in household ,702,967 Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) ,503, ,672, ,614, ,983, ,185,913 Residence Urban ,836,014 Rural ,125,020 Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) Vulnerable child is define as a child who lives in a household where parents or some adult has a chronically illness Chronically ill define as diabetes, hypertension, heart disease, cancer, rheumatism, gastric ulcer or migraine. REFERENCE/SOURCE: Mexican Family Life Survey 2002 It is important to mention that the topic of orphan hood was not considered here because of lack of information on this variable in the ENNViH. From the available e information on this subject, in Mexico there are around 1.6 million orphans from newborns to 18 years of age Words of the deputy Gabriela Molina Aguilar, president of the Commission of Vulnerable Groups, Equity and Gender, in the announcement of the realization of the Adoption Forum: Juridical and Social Problematic, of April 1, March 26, By household wealth level, the results show that the children who live in households from the highest wealth quintile (the wealthiest) are in more vulnerable conditions than the poorest children, which contrasts with the previous results. These results can likely be explained because of the fact that the questions from the ENNViH concerning chronic illnesses are self-reported. And it may be that those with higher wealth have more 61

69 Table A Child labor and its correlates (by individual, households and geographic dimensions) Mexico, 2002 Total child labor (MICS indicator 71, children aged 5-14 years) of which: paid work outside the household Number of children aged 5-14 years Total incidence/prevalence ,579,083 Individual dimension Sex and age Male ,503,778 Age group 1(5-6) ,196,779 Age group 2(7-8) ,278,401 Age group 3(9-10) ,306,887 Age group 4(11-12) ,379,763 Age group 5(13-14) ,341,948 Female ,075,305 Age group 1(5-6) ,189,161 Age group 2(7-8) ,362,266 Age group 3(9-10) ,601,665 Age group 4(11-12) ,516,316 Age group 5(13-14) ,405,897 School participation Yes ,659,559 No ,401,026 Household dimension Household size Less than , members ,578, members ,782, ,025,328 Women s education None ,341,498 Primary ,525,041 Secondary ,208,350 Gender of the head of the household Male ,567,822 Female ,011,261 Wealth index quintiles Q1 (poorest) ,249,195 Q ,677,688 Q ,413,742 Q ,918,714 Q ,770,167 62

70 (Continued from previous page) Mexico, 2002 Total child labor (MICS indicator 71, children aged 5-14 years) of which: paid work outside the household Number of children aged 5-14 years Ethnicity/language/religion Group ,388,896 Group ,190,187 Work (among hholds with children) Both parents working ,027,265 None of the parents are working ,614 No adult in primary working age (18-54) ,072 At least one child under 15 working ,174,803 Illness and disability in the household Adult(s) with chronic illness ,752,604 Child/children with disability ,055 Family vulnerability (not mutually exclusive categories) Single parent ,011,261 Orphan child in household N/I N/I N/I High dependency ratio (4+children per adult) ,998 Elder (70+) person in household ,617,007 Geographic dimension Region Region ,750,350 Region ,306,115 Region ,728,871 Region ,734,862 Region ,058,885 Residence Urban ,834,768 Rural ,744,315 The sub-national regions are: region 1: South-Southeast (Oaxaca, Veracruz, Yucatan). Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Groups of ethnicity: Group 1: Indigenous. Group 2: Not Indigenous Exchange rate using at day October 14th. $12.00 National poverty line is in rural areas $ and in urban areas $ Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household REFERENCE/SOURCE: Mexican Family Life Survey

71 knowledge about their true health conditions. Similar patterns exist with respect to indigenous status, almost 42% of non indigenous children lived in a vulnerable situation in (13.6 million), compared with 38% of the indigenous (around 2.8 million). When analyzing childhood protection according to the percentage of children who work 26, Table (ENNViH 2002) shows that nearly 5% of children from 5 to 14 years of age worked in 2002, and of those working, almost 92% had a paying job 27. Distinguishing by gender, a higher proportion of males worked than of females (6% versus 4%). Only 5% of children who worked went to school (approximately 951 thousand). Mother s schooling has an important negative relation with the probability that her children will work. When she has never attended school, nearly 8 % of children worked, whereas when the mother went to Junior High only 3% of children worked. The Center area of Mexico is where there is a higher proportion of children who work, (about 8%) (Table EN- NViH 2002) According to the National Survey on Occupation and Employment 2007, which had a module on childhood labor, the labor force participation rate was 12.5% (16.6% for boys and 8.3% for girls) in other words, near 3.6 million children from 5 to 17 years of age performed some kind of economic activity. Of all working boys and girls, approximately 1.5 million did not attend school (41.5%), from which 70.7% were boys and 29.5% girls. By household size, the labor force participation rate of children rises as the size of the household increases. In households with one to three members there were 14.1% households with working children while in households with eight or more members this rate was 36.7%. When the head of the household has less schooling, the percentage of the households with children with labor activities was higher (29.8% of the households where the head of the family had no formal studies versus 9.8% of the households where the head of the family had at least some high school education. The labor force participation rate in more urbanized areas was 8.6% and in areas with less than Childhood labor refers in this case when the child developed any economical activity the week before, paid or not. 27 Table Child labor and its correlates (additional table) Mexico thousand habitants was 15.6%. Occupation rate of children age 5-17 Total incidence/prevalence 12.5 Individual dimension Male 16.6 Female 8.3 School participation Yes 58.5 No 41.5 Household dimension Household size 1-3 members Education of the head of the family None 29.8 High school Geographic dimension State Estado de Mexico 8.6 Jalisco 7.9 Puebla 7.9 Distrito Federal 3.2 Baja California Sur 0.3 Residence Urban (+ 100 thousand habitants) 8.6 Rural 15.6 Source: Encuesta de Ocupacion y Empleo. Modulo de Trabajo Infantil 2007 By state, the State of Mexico concentrated 8.6% of the total number of children with a labor activity in the country (312 thousand children), followed by Jalisco and Puebla with 7.9% each (228 thousand children). The Federal District has 3.2% of total childhood labor (115 thousand children). Baja California Sur reported a lower number of children working (0.3% of the total, which corresponds to nearly 12 thousand children.) In addition to these indicators, the ENOE shows interesting numbers on the labor conditions of children between 5 and 17 years of age. About 3.6% of these children worked in places considered not to be suitable or prohibited for minors, (for examples mines, places without ventilation or light, streets or avenues, bars). Likewise, 20.7% boys and girls 64

72 Table Early marriage and its correlates (by individual, household and geographic dimensions) Mexico, 2002 Percentage of women aged married before age 15 Percentage of women aged married before age 18 Number of women aged Total incidence/prevalence ,529,952 Individual dimension Female Age group 1(15-20) ,573,528 Age group 2(21-25) ,947,756 Age group 3(26-30) ,469,577 Age group 4(31-40) ,343,479 Age group 5(41 +) ,195,612 Household dimension Household size Less than ,652, members ,487, members ,442, ,948,466 Women s education None ,967,909 Primary ,643,228 Secondary ,176,438 Gender of the head of the household Male ,095,546 Female ,434,406 Wealth index quintiles Q1 (poorest) ,446,582 Q ,975,966 Q ,635,969 Q ,763,976 Q ,727,110 Ethnicity/language/religion Group 1: Indigenous ,178,127 Group 2: Not Indigenous ,351,825 Work (among hholds with children) Both parents working ,482 None of the parents are working ,235 No adult in primary working age (18-54) ,919 At least one child under 15 working ,497,867 Illness and disability in the household Adult(s) with chronic illness ,514,757 Child/children with disability ,855 Family vulnerability (not mutually exclusive categories) Single parent ,434,406 High dependency ratio (4+children per adult) ,492 65

73 (Continued from previous page) Mexico, 2002 Percentage of women aged married before age 15 Percentage of women aged married before age 18 Number of women aged Elder (70+) person in household ,153,280 Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) ,111,100 Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos) ,162,361 Region 3: Center-West (Michoacan, Jalisco, Guanajuato) ,180,699 Region 4: Northwest (Baja California Sur, Sinaloa, Sonora) ,310,480 Region 5: Northeast (Coahuila, Durango, Nuevo Leon) ,765,312 Residence Urban ,338,483 Rural ,191,469 Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household REFERENCE/SOURCE: Mexican Family Life Survey 2002 in labor activities were exposed to some kind of workplace risk, meaning they worked in places with excessive noise, humidity, dangerous tools, chemical products, etc. Regarding early marriages, the Table (ENNViH, 2002) shows the percentage of women between 15 and 49 years of age that married before 15 and 18 years of age in Nearly 3% of women in this age range married before the age of 15 and almost 17% did before 18 years of age. There is a significant difference between the percentages of indigenous women that married before 15 years of age (almost 5%) compared with non indigenous women (2%). Likewise nearly 24% of indigenous women married before 18 years of age, versus 15% of non indigenous women. In matter of adoptions, Table (DIF, 2008) shows the number of trials performed in Mexico in 2007 for an adoption to be granted. Here the number of trials for regular adoptions and the number of trials by sentence is reported, according to the geographical area. In general it shows that the number of adoption is very low (2,200 for the case of regular adoptions and 973 due to a sentence), being higher the number of regular adoptions in the Northeast region (574) and in the Center-West (550). The adoptions due to a sentence are higher in the Center-West (430) and almost minimal (48) in the Center area. Table Child protection: supply side and uptake variables by region Total 2007 Number of trials for adoptions Number of trials for adoptions due to a sentence - number of trials By region Region 1: Northeast - number of trials Region 2: Northwest - number of trials Region 3: Center - number of trials Region 4: Center-West - number of trials Region 5: South- Southeast - number of trials Urban - number of trials N/I N/I Rural - number of trials N/I N/I Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz. Source: 66

74 Since Mexico is a country with high levels of population migration (in particular to the United States), it is important to analyze the situation of the migrants and mainly boys, girls and adolescents who travel alone or with their parents on their way to the United States. Due to their vulnerable situation, there is a high probability that they will suffer violations of their rights. According to the National System for Integral Family Development, in 2007 there were 27 shelters in the country, for immigrant boys, girls and adolescents who are not accompanied by their parents (DIF/UNICEF, 2009). From these shelters, there is only one in the Southern region of the country, the remainder are at the north border. Causalities and correlates analysis There are a number of different situations that put in risk the fulfillment of childhood rights in Mexico. Child labor, unaccompanied migration of boys, girls and adolescents without companion, sexual exploitation, violence, lack of registration at birth and the case of boys and girls that live with VIH/SIDA are some examples (UNICEF, 2008). About 3.6 million Mexican children between 5 and 17 years of age, worked in 2007 (ENOE, 2007), from which 66.9% are boys and 33.1% are girls. Approximately 30.5% were between the ages of 5 and 13 and the remaining 69.5% were between 14 and 17 years of age. At the interior of the Republic Guerrero reported the highest child labor activity rate (20%) and the Federal District the lowest (6.1%). There is a significant and negative correlation between the household income and the probability that a child works. In other words, as the household income decreases the probability that a child works increases. Furthermore, if the child works there is an increase in the probability of living with between one and four deprivations. Furthermore, there is also a strong and negative correlation between child work and school attendance. The situation of vulnerability and lack of protection that unaccompanied migrant boys and girls suffer is evident. (North Border Child Immigrants: Legislation and Processes, Unicef-DIF 2004). Statistics from the National Immigration Institute (INM, 2008) show that, in 2008 around 32 thousand boys and girls younger than 18 years of age immigrated to the United States and were repatriated to Mexico. In the same manner, childhood sexual exploitation represents a serious violation to the rights of boys and girls. Regarding this subject, the Infancia Robada (Stolen Childhood) study from the Unicef, DIF and CIESAS estimates that in 2000 around 16,000 girls were victims of this type of exploitation. The absence of birth certificates from the childhood population that live in marginalized conditions also represents a serious lack of protection to their rights, since by not having a legal identity, the children face an obstacle to attending school and having access to the basic services such as health, and to exercise their rights in general. This is particularly common in indigenous communities It should be mentioned that the prevalence of VIH/ SIDA among the children and adolescents, even though it is currently relatively low, requires attention and constant monitoring to avoid the spreading of new infections at increasingly early ages. The proportion of people younger than 14 years of age living with VIH represented 2.4% of the total of the accumulated cases between 1983 and 2008, corresponding to 2831 cases, according to statistics from CENSIDA (UNICEF, 2008). In regards to violence, in Mexico social inequities, poverty and other factors have contributed to the increase of violence in many areas, (households, schools, communities, and in workplaces), besides school violence, which has been linked to high rates of school desertion (Pinheiro, 2006). In the last years, violence and insecurity in Mexico have increased and, and many victims are boys, girls and adolescents. According to the National Report on Violence and Health, 2006, 2 children under 14 years of age die each day as a result of violence in Mexico. The impact of violence on the population is multiple. Violence is associated with situations of posttraumatic or chronic stress, with cardiovascular, digestive disorders as well as mental health disorders such as depression, anxiety or insomnia, among others. Whether it is at work, home at school or at social and public life, the impact of violence generates diverse social expenditures; with respect to only the work aspect, The World Health Organization distinguishes direct, indirect and intangible 67

75 costs from violence that include the healthy years of life lost by a incapacity or death related with violent events, labor absenteeism, school truancy, accidents, diverse illnesses, and the reduction in creativity and productivity from individuals that live situations of violence (SSA, 2006). According to the Health Ministry, in 2006 there were 223 specialized services of attention to victims of violence in this institution. For the cases of extreme violence where the lives of women, and/or her children are in danger, they have established agreements for providing shelter services with 25 organizations from the civil society and public institutions that offer these services. The numbers related to violence show that the mortality rate for homicides in boys from 0 to 4 years of age is 1.6 for every 100,000 inhabitants, while in boys from 5 to 14 it is 1.1. In the case of girls from 0 to 4 years of age it is also 1.6 and in girls from 5 to 14 it is 0.7. The mortality rate for homicides is 0.9 in boys from 5 to 14 years and 9.4 in men from 15 to 29. In the case of women, this rate is 0.5 for girls between 5 and 14 years of age and 2.2 for women between 15 and 29 years (SSA, 2006). Even though statistics are scarce on the magnitude of this problem, in Mexico there is also violence carried out by teachers and school personnel (for example, the 2006 National Report on Violence and Health show that in % of children between 6 and 9 years said that they were beaten at school). Regarding domestic violence, the National Report on Violence and Health show that in % of boys between 6 and 9 years old had been beaten at home. In regards to institutional violence (defined as the violence practiced by State institutions, their organisms and their agents), in Mexico there were 3,975 cases of boys and girls institutionalized due to protection reasons in 2004, but there is no available information of violence in such institutions. Likewise, nearly boys, girls and adolescents were deprived of their liberty by a conflict with the criminal law (United Nations, 2006). Basic elements and alliances for a strategy The topics that have been reviewed in the previous sections show that although Mexico has ratified many international instruments in matter of human rights and specifically in matter of childhood rights, and that the country has a national legal framework for protection of children s rights, currently the integral protection mechanisms which allow to fully guarantee these rights to all the boys, girls and adolescent in the country are still insufficient. A first step towards making recommendations and developing a strategy to improve the fulfillment of the rights of the children would be the development of more statistical information that allows determining the current state of the children s rights. During the elaboration of this report it was evident that, there is insufficient information available on many subjects that are essential to contextualize childhood poverty. As an example, according to the last observations done in Mexico by the Committee on Children Rights, there is little information violence against children of any kind, physical, psychological, sexual or negligence, and in any field, at home, at school, at the community, at the institutions- the number of adoptions nationally and internationally; the number of children in public institutions; the number of children not registered nationally and by state as well as the reasons for not being registered according to the different disaggregations: the number of orphan children and street children, and the number of children living in vulnerable conditions from which one or both parents have died. In addition, to strength the protection of the childhood rights it is necessary to have further collaboration of the different agencies and institutions in charge of monitoring the main principles (education, health, nourishment ) of human development. In light of this situation it is clear the necessity to keep working in the generation of better laws and policies that monitor the integral and universal fulfillment of the rights of boys, girls and adolescents in Mexico, in particular those that are unprotected due to their labor situation, sexual exploitation, presence of VIH/SIDA, lack of identity documents or any other circumstance that risks their full development. 3.4 Education Fundamental laws, policies and programs The Mexican Education System is structured pursuant to provisions in the Political Constitution of the Mexican United States and the Law of Education. Within the first one, the 3 rd Article establishes the State s obligation to provide basic, non religious and free and mandatory education to all the individuals. In the second one it is further specified that the 68

76 State is obligated to supply sufficient education services so that all of the people may go through preschool, primary and secondary (junior high) education, which correspond to the basic mandatory education in Mexico. Throughout the past fifteen years, the country has been through a series of reforms in matter of education. In 1992 a National Agreement for Modernization of Basic Education (ANMEBN) was signed, which among its purposes was to decentralize education services. To this effect, the Federal level transferred onto the 31 States the means and responsibility to operate the basic education systems (preschool, primary and secondary), being it the Federal level s responsibility to train teachers, develop the curriculum and carry out evaluations. 28 In 1993 compulsory schooling was extended to secondary education. Later on, in 2002, a constitutional reform was approved making preschool education mandatory for all children from 3 to 5 years old and establishing time-frames to fulfill this provision: for five year olds during schoolterm , four year olds during school-term and three year olds during school-term The Education Act divides education into three areas: basic education, high school, and university. Basic education consists of three levels, which includes 3 years of preschool education, 6 years of primary education and 3 years of secondary school or junior high. High school includes senior high school level (general or technical), and is carried out in two or three years (between 15 and 17 years old). Finally, university consists of college or university and postgraduate degrees. The establishment of mandatory preschool education resulted in a rapid growth of enrollment in this level. In 2005, 98% of the 5 years old children, 81% of four years old children and 25% of three years old children were enrolled into preschool. Each level of education has different types of provision; furthermore there are several types of primary, secondary, high schools, and colleges. The largest 28 The Federal District (D.F.) is different from the rest of the States because it is the sole Federal Entity where education services continue to be federal. In this frame, the D.F. has created its own education services and offers free benefits to education centers and students: books, school lunches, uniforms, improvements to infrastructure. In this manner, not only federal education services coexist in the D.F. with some local services within the entity, but from the government it has been sought to gradually generate an education option for all of its territory. Source: Descentralizacion y Reforma Educativa en la Ciudad de Mexico (Decentralization and Education Reform in Mexico City) (2008). Federal District Government s Education Department. 29 It is important to mention that in 2008 it was determined to grant a larger term to make preschool education compulsory as of the age of three. proportion of the population attending basic education school (preschool and primary and secondary school) is undertaken by the general modality. There is also the modality of indigenous education and the communitarian courses developed by the National Council for Education (CONAFE). 30 One out of each three general primary schools is multi-grade, while two out of every three indigenous schools are multigrade, that is, their teachers serve more than one grade simultaneously(inee, 2007). 31 For its part, secondary schools include general schools, technical schools and tele secondary schools. One out of each five telesecondary schools is multi-grade. This modality began in 1968 as an effort to elevate the educational coverage in isolated rural communities and marginalized communities. Telesecondary schools have a teacher per grade and are characterized for using differentiated didactical resources for each one of the three grades which include, mainly, television programs that are broadcast through a satellite net on a determined schedule and learning guidelines for the students. Telesecondary schools represent 20% of total secondary schools and the number of these schools significantly varies among the states. Technical schools, in turn, respond to the need of the students to acquire specific knowledge (with more emphasis on technological skills) that allows them to rapidly incorporate to the labor force. With respect to high school education, there is the modality of technical professional and baccalaureate, within which general, technological or telehigh schools can be found. The majority of schools in Mexico are public, though private institutions do cover close to 9% of children in primary and secondary schools. Close to 75% of senior high schools are financed with public funds (Reimers and Knaul, 2007). The Education Law also establishes that education authorities are responsible for encouraging more equal education and also the achievement of equality in the opportunities of access and permanence within the education services. In 2005, the Law was reformed and established that the annual amount which the State-Federation, federal entities and mu- 30 Communitarian courses offer preschool and primary education to children who live in rural communities. These are multi-grade and are serviced not by teachers but by communitarian instructors. 31 In principle, multi-grade schools were created due to the low rates of enrollment, the small size of the communities and their high level of isolation. 69

77 nicipalities- must assign to expenditures in public education cannot be less than eight percent of the country s gross domestic product. The Sectorial Education Plan (PSE) drafted based on the PND-, establishes the objectives and goals in matter of education in Mexico. Among these objectives are: 1) to elevate the quality of education, 2) extend education opportunities to reduce disparities among social groups and promote equity, 3) offer an integral education that forms good citizens, 4) offer quality education services to educate persons with a high sense of social responsibility, and 5) encourage a school and institutional operation that strengthens participation of school centers in the process of making decisions, that makes the different agents co-responsible, promotes security, transparency, and accountability. Furthermore, it is important to point out that since 2006 a National Evaluation of Academic Achievement in School Centers (ENLACE) has been applied, which is a test that the Public Education Ministry applies to public and private schools throughout the country. It is applied to all girls and boys enrolled in school from first to sixth grade at the primary level and youths of first, second and third grades of secondary school (junior high) as per the official study plans and programs on subjects of Spanish, Mathematics and Civic and Ethical Formation. It is also applied to twelfth graders to evaluate knowledge and basic skills acquired in reading comprehension and math (Enlace 2009). The results are delivered to parents and also to the schools (and at the school level can also be consulted by Internet). The Public Education Ministry has also proposed a new strategy called Alliance for Quality on Education, in which Federal Government, SEP, SHCP, SEDESOL, SSA and the National Union of Education Workers (SNTE) participate. Among the main actions promoted, there are: modernizing of the school centers, professionalizing of teachers and education authorities (in this item, the intention is that the access and promotion of all new teachers be granted through a national teacher evaluation), integral wellbeing and development of the students and the evaluation of all the participants within the educational process. It is further intended to grant incentives to teachers and students based on the results of standardized achievement tests. This last item has turned out to be a controversial aspect of the reform that has resulted in its rejection by some states and delays in its implementation. We now address some of the main education programs that seek to improve the quality and access to education for the population in poverty. In the first place, within this Report some of the education scholarships to basic and high school education are mentioned, being the Oportunidades Program the most important. In addition to the education grants provided, other notable programs include the School Quality Program and that the most outstanding programs, because of the effort they represent to improve educational offer and a program which allows pregnant adolescent girls- to continue studying (Program of Scholarship Award for Youths and Pregnant Mothers). First the Oportunidades Program, in coordination with the Public Education Ministry, grants scholarships to 2.5 million children in primary level (1.27 million boys and 1.23 million girls), 1.7 million youths in junior high and 789 thousand youths in senior high that live in extreme poverty (Oportunidades bimonthly indicators, November-December 2008). This Program gives out monthly grants beginning in third grade and all the way to the last grade of senior high school education, with slightly higher grants for girls than boys being in junior high. This design feature is due to the fact that at this level women begin to have higher levels of dropout than men, though other evidences show that men tend to repeat more grades than women and as a consequence the levels of schooling between men and women in the Program are not significantly different. It is important to mention that to be able to participate in the program, the community must have a health center and a school close by. The program has numerous evaluation studies that have shown that the program increases school attendance, reduces repeat of grades and in general causes children and youth to achieve a higher level of education (Parker, Rubalcava and Teruel, 2008). On the other hand, the National Scholarships Program for Retention of High School Students, begun in 2007, delivers grants to students in conditions of patrimonial poverty and with an academic merit, located in rural and/or urban areas with a very high margination in order to promote continuing their education at this level. The Quality Schools Program (PEC) seeks to improve the quality of the education through actions 70

78 Table School attendance and correlates (by individual, households and geographic dimensions) Mexico, 2002 Net primary school attendance rate* (MICS Indicator No. 55) Total Individual dimension Sex and age Male Age group Age group Age group Age group Age group Female Age group Age group Age group Age group Age group Household dimension Household size Less than members members Women s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion* Group 1: Indigenous Group 2: Not Indigenous Work (among hholds with children) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness

79 (Continued from previous page) Mexico, 2002 Net primary school attendance rate* (MICS Indicator No. 55) Total Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos) Region 3: Center-West (Michoacan, Jalisco, Guanajuato) Region 4: Northwest (Baja California Sur, Sinaloa, Sonora) Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural * Net primary school attendance rate define as children between 6 to 15 years that attending the school Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) REFERENCE/SOURCE: Mexican Family Life Survey 2002 that give more responsibility and capacity for decision making to school principals, teachers and parents. Evaluations of this program have found that the failure rates of students of beneficiary schools is 0.31% less than those students of not beneficiary schools (CIDE, 2006). Furthermore, the Program of Compensatory Actions to Reduce Education Delays operated by National Board for Education (CONAFE) forms part of the programs of this institution aimed at the poor population that were created in 1993, both in Mexico and other Latin American countries, financed by World Bank until Specifically this program seeks to improve access to education and the remaining in school of children and youths of vulnerable and socially displaced sectors. To achieve this, the program carries out actions such as: providing education and administrative infrastructure; supply of didactic materials; training and counseling to mothers, fathers and teachers; economic support to Parent Associations to strengthen school operation, incentives to teachers and principals, and institutional strengthening. The Program of Scholarships for Youths and Pregnant Mothers supports young mothers and pregnant youth to continue and conclude their basic education in the modalities of regular schooling system, adult education or in any other modality available in Mexico. In 2007 there were 2 thousand women with scholarships in this program. More recent programs that have been implemented include the Program of Full Time Schools and the Program of Safe Schools. The Full Time Schools Program began its operation in 2008 and extends the school day (until reaching 1,200 hours of classes per year). It is aimed at basic education public schools, preferably those that serve populations in urban marginalized, indigenous or migrating, areas; and those which present low education results. On the other hand, the Safe School Program (PES), created in 2007, gives economic support to schools to improve the security of the students, teachers, principals, parents and the community. In matter of public expenditures, it is important to note that the financing in the education sector has been consistently increasing for the past fifteen years, in 1990 it represented 3.7% of the GDP and in 2005 it represented 5.5% (Reimers and Knaul, 2007). In 2007 this percentage was of 7.05% (Government Report). None withstanding, it is important to mention that the assignment of the expenditures does 72

80 Table C Individuals between 6 and 14 years old by age group and expenditures per capita Age group and Expense per capita group Years of schooling MXFLS-1 (ENNViH) % that repeated a school year Cognitive test % Enrolled in school Group Group years old Group Group Group Group Group to 14 years old Group Cognitive test is based on Ravens matrix. Source: Mexican Family Life Survey (MXFLS-1) Group Group Table D Information about the school where children between 6 and 14 years old assist to. Age group and Expenditures per capita group School has electricity School has toilets School has computers Proportion of computers per student School has clean floors School has a library Proportion of books per student # classrooms 6 7 years old years old TOTAL Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Source: Mexican Family Life Survey (MXFLS-1) 2002 not historically appear to have been equal. (Scott, 2008). The analysis that will be later on presented shows disparities in the quality and supply of education services available to children by household income levels. Child outcomes, disparities and gender inequality In this section an analysis on school enrollment is presented. Specifically, the proportion of children who attend primary and secondary school is analyzed according to different individual and home characteristics (Table 3.4.1, ENNViH 2002). Close to 87% of the children between 6 and 15 years old attend school, this percentage being practically equal among boys and girls. With regard to the mother s schooling, close to 82% of the children whose mothers have no schooling were enrolled in school in 2002; 87% 73

81 Table Child education: supply side and uptake variables by region Major child education indicator: number of teachers per 1,000 students Total Major education supply indicator* number of teachers per 1,000 students By region Region 1: Northeast Major education supply indicator* - number of teachers per 1,000 students Region 2: Northwest Major education supply indicator* - number of teachers per 1,000 students Region 3: Center Major education supply indicator* - number of teachers per 1,000 students Region 4: Center-West Major education supply indicator* - number of teachers per 1,000 students Region 5: South-Southeast Major education supply indicator* - number of teachers per 1,000 students Northeast region includes Tamaulipas, Nuevo Leon and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora, Sinaloa, Chihuahua and Durango. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Puebla, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz. REFERENCE/SOURCE: Primer Informe de Gobierno 2007 of the children whose mothers have only primary education went to school, and 91% of the children whose mothers have secondary education or more went to school. The children of households located within the highest wealth quintile are those who had the largest percentage of school attendance (91% of the last quintile, compared to the 86% of the first ). We now summarize some more detailed analysis on education derived from Parker (2008). By income/ poverty groups it is found that, for each age group, the poorest children present lower percentages of enrollment to school. A notorious difference is found in the group of 12 to 14 years old in 2002, in which the poorest had a rate of enrollment of 84% compared to a rate of 95% for children of higher income demonstrating differences overtime in school enrollment by wealth categories increase. (Table C). We now turn to an analysis of the characteristics of schools to which students have access. In Table D we present an analysis on the information of the school to which children between 6 and 14 years attend per age group and expenditures per capita in With respect to school infrastructure, indicators such as having electricity, schools with lavatories, computers, clean floors and libraries, the in all cases the results show that the poorest children have access to schools in the worst conditions. For example, the proportion of computers per student is far from being equitable among the levels of income/poverty. The poorest children attend schools where there is a fewer number of computers per child. Additionally, while in the highest quintiles there are almost four books per student in the library(3.7), in the first income/poverty quintile the relationship of books per students is of 2.4. The preceding statistics are suggestive that government resources to education services have not tended to favor the neediest groups. As another indicator to analyze children s education from the point of view of the supply (number of 74

82 teachers per 1,000 students) and by geographical region, Table 3.4.2, dated on the First State of the Nation Report 2007, shows that throughout the years the coverage of teachers has been increasing considerably in all the country, though this has been occurring in an uneven manner. For example, while in the Central-West area of the country there are 54 teachers per every 1,000 students (numbers 2007), in the South-Southeast there are 48. Analysis on causality and correlation In general, in this Report we have been able to see that, in spite of the fact that Mexico has made important advances in matter of education, there are still an important number of children between 5 and 14 years old who do not finish primary education at the appropriate age (close to 3.1 million boys and 3.5 million girls in 2002, Table 1.1.3, ENNViH). The rate of coverage in 2007 was almost universal at the primary level, though in secondary level it was of approximately 80% (78% for men and 82% for women) and in preschool of 73% (72% for boys and 74% for girls, INEE 2007). While 81% of the girls attended primary and secondary school at the right age, 77% of the boys did so. Furthermore, 65% of girls finished last grade of primary school at an appropriate age, versus 63% of the boys. In general terms, according to data from the ENNViH, 87% of the children between 6 and 15 years old attended primary and secondary school. The analysis of education from the supply and quality side also demonstrates that there are great disparities in the quality of the public services available to children by the wealth of their household. According to a number of indicators, (such as computers, libraries and number of classrooms among other characteristics), it can be seen that the children of lower income quintiles attend schools that are in worse condition and worse equipped. In general, these households are in rural areas of the country, in the South-Southeast and in indigenous communities. It is also important to mention that there are great disparities in the school performance of children and teenagers when differentiating by type of school. For example, in 2008, while 50% of the students in private primary schools were graded as having a good performance at the ENLACE test in Spanish, this percentage was 25% for general primary schools, 7.7% for CONAFE schools and 7.3% for indigenous primary schools. In Mathematics, 42% of the students in private schools had a good performance, followed by 22% in general primary schools, 8.5% in indigenous schools and 6.9% in CONAFE schools (ENLACE, comparison ). In third grade secondary school, 47% of the student in private schools had a good performance in Spanish, followed by 16.7% in general schools, 16.5% in technical schools and 7% in telehigh schools. The results in the math test are very similar. The above section supports the hypothesis that in matters of education, the most disfavored children (measured by attendance to school) are those who live in rural areas or in households where the mother has no schooling degree (for example, while 83% of the children whose mothers have no education attend primary school, 91% of the children whose mothers have secondary education or more do). Likewise, in households with lower wealth levels, children s attendance to school is also lower (while 87% of the children in the lowest wealth quintile go to school, 92% of the children in the last quintile of wealth do so). With respect to households where the woman is head of the family or are supported by a single parent, the children have lower school attendance; similarly in households with high dependency ratios. A correlation analysis (Table of the Statistical Appendix) shows that when a household lives in extreme conditions of poverty, the probability that the child never attends school or drops out in any given time increases. Likewise, there is a positive correlation between the fact that a child lives with at least one deprivation and does not attend school or has never attended school. By gender, it is important to note that there are now few differences in educational achievements by gender. This is, there are practically no differences in schooling levels between men and women. Though previously there were important differences in the schooling per gender, the differences have reduced during the past thirty years (Parker and Pederzini, 2001). From the supply side, there are important disparities in the access to education. For example, the student teacher ratio (proxy of the resources destined at school level) for children in the lowest income quintile is of 23 students per classroom versus 19 for students in the higher income quintile. There are also 75

83 notorious differences between schools in terms of characteristics such as bathrooms, computers, clean floors or library according to the expenditure group per capita of the child s household. (Parker, 2008). To face these and other differences, the Sectorial Plan of Education has established a series of goals for 2012, among which are to increase: i) PISA scores on tests of math and reading comprehension from an average of 392 points (2006) to 435; ii) to increase the proportion finishing secondary or junior high school studies from 75.5% (2006) to 86.7%; iii) to increase the percentage of indigenous boys and girls with schooling that finish their primary education at indigenous education schools from 85.1% in 2006 to 88.1%; iv) to increase education scholarships for students of the Oportunidades basic education from 4 602,403 in 2006 to 5 000,000; and v) to increase scholarships granted to young mothers and young pregnant women to conclude their basic education from 1,975 scholarships in 2006 to 49,460, among others. It is important to remark that SEP has recently introduced standardized tests applied annually to all the school population (ENLACE). In particular, in year 2007 tests were applied to children from third grade to sixth grade at the primary level and to third grade at the secondary level (ninth grade), in the areas of mathematics and Spanish. In year 2008, tests were applied to the same grades and a standardized test was also applied to twelfth grade and also a science test was introduced (natural sciences in the case of primary level and biology, physics and chemistry to secondary level). This third subject (sciences) will be rotated each year to allow an integral evaluation (in 2009 civic and ethical education will be evaluated, in 2010 history, in 2011 geography and in 2012 sciences). In 2009 the coverage of the ENLACE test was expanded to cover all grades of primary and secondary levels. Basic elements and alliances for a strategy It is evident that there are a series of disparities in education in Mexico and that the improvement of the access to and the quality of education in the country is a primordial aspect towards achieving a higher levels of development and wellbeing. The country s performance in international tests has shown that Mexico lags behind in school performance. For example, in countries took part in the PISA test and Mexico had position 48 in Math, 48 in sciences and 42 in writing (INEE, 2007). The annual implementation of the ENLACE tests represents an important advance in the measurement and developing a general diagnostic on school performance in Mexico. Such information will allow a broad vision of school achievement in the country and monitoring school performance throughout time, both at a school level and individually. With regard to other policies, scholarship programs such as Oportunidades and the National Scholarship Program for the Retention of Middle High School Education Students are useful tools to reduce disparities that exist in the rates of school enrollment by household income, There are however obvious remaining disparities with respect to school quality by place of residence (rural/urban) and as by levels of income. The poorest children attend schools of lower quality in several dimensions, which probably reflects some historical disparities that exist in public expenditures on education. Thus, a basic principle of distribution of public expenditures is that they should at least not be regressive and preferably be progressively allocated. It is also important to mention that in certain cases it may be more costly to supply rural areas with schools with the same quality than in urban areas because it is common that teachers prefers to teach in an urban environment rather than a rural one. Therefore, larger incentives should be given (besides higher salaries such as in the cases where SEP gives bonuses to the permanence of teachers and the help the CONAFE schools give to teachers who work at focused schools) to the teachers who work in rural areas to encourage them to go teach to these areas. In this sense, it is likely to not be sufficient to equalize expenditures on rural and urban students, but that public expenditures may need to be larger in rural areas than urban areas to attain the same quality of services. In Mexico, the enrollment rate for indigenous population tends to be considerably lower than that of the urban medium class or non-indigenous groups (Yoshikawa et al, 2007). In rural areas, Parker, Rubalcava and Teruel (2004) have shown that when indigenous children speak Spanish (as first or second language), they obtain schooling levels similar to those of their non-indigenous mates. In fact, in Mexico there are primary level schools that teach part of the classes in the native language of the region, though there is little information or evaluations on the impacts of indigenous education in Mexico. Further research is needed on indigenous education in Mexico. 76

84 3.5 Social Protection National laws, policies and key programmes There are three basic social security systems in Mexico; the institutions in charge of them are: the Mexican Institute of Social Security (IMSS) attending workers from the private sector -; the State Employees Social Security and Social Services Institute (ISSSTE), attending workers from the public sector and the Popular Social Security System - attending workers, generally working on their own, who are not affiliated to any of the other systems mentioned above. There are other social security systems that benefit smaller sectors of the population like Pemex (that attends the workers from this state company), from the Ministry of Navy (Secmar), and from the Ministry of National Defense (Sedena). The IMSS is the main social security institution in Mexico (in 2005 it had more than 47 millions of affiliates). The ISSSTE had in that same year a total of 20.5 millions of affiliates. In both institutions, affiliates and their families receive benefits for illness and maternity; job accidents; retirement; severance due to age or time working; disability; death; unemployment in late life; as well as services like preventive medicine; physical and mental rehabilitation; and attention for the wellbeing and development of children. In turn, the Popular Social Security System attends the population working on their own and excluded from social security institutions, basically individuals working in agriculture, small businesses, non-salary workers and workers paid on a honorary basis; it offers the beneficiary population a system of retirement savings, subsidies for housing and medical services. In 1997, the Mexican pension system made an important change, switching from a universal system to a funded system ( individual accounts), in which individuals choose their own retirement fund administrator (AFORES) (most of the AFORES are related to the banks that manage the retirement accounts). The workers must have had jobs affiliated to the IMSS for at least 24 years to have access to the minimum pension guaranteed. The self-employed can affiliate to the IMMS in order to obtain a health insurance and to open a retirement account. The benefits from the health insurance cover all the levels. The system is financed by payroll contributions from the individuals and from companies, and the Federal Government gives some subsidies that stem from general taxes (Parker y Scott, 2008). Despite the fact that the social security system in Mexico has many different options, the proportion of the population that currently has a health insurance (including IMSS; ISSSTE; Pemex, Sedena, Secmar or from a private institution) is only 27% (Parker, 2008). Child outcomes, disparities and gender inequality We now turn to an analysis of social protection and its correlation with individual indicators, as well as household and geographic indicators. (Table 3.5.1, ENNViH 2002). This table allows us to see that approximately 27% of the women were covered by a health insurance in 2002 (from the IMSS; ISSSTE, Pemex, Sedena or from a private institution), while close to 13% of the individuals were covered by Oportunidades, the most important program, in Mexico, for the human development of the population in extreme poverty. In total, close to 58% of the population enjoyed a type of social protection (any type of social security, cash or in-kind transfers, or government transfers) 32. By gender, coverage is very similar. As the level of schooling of the mother increases, the percentage of individuals covered by Oportunidades decreases (31% of the individuals from households where the mother has no schooling where covered against 4% of the individuals from households where the mother has a secondary education o more). While the mother s level of schooling increases the degree of health coverage from the members of the household also increases (46% of the households where the mother has a secondary education had a health insurance). By wealth levels of the households, it could be seen that 42% of the households from the last wealth index quintile had health insurance while only 20% of the households from the first wealth index quintile were covered. In turn, the poorest households (from the first and second quintile) where the ones more likely to have benefits from Oportunidades, 18% from the first wealth index quintile versus 4% from the last quintile (Table 3.5.1, ENNViH 2002). As it is expected, this table shows that a high percentage of the indigenous population (39%) is covered by Oportunidades. With respect to the not indigenous population, only 9% are Oportuni- 32 While only 27% of the population has medical insurance, 58% has social protection as this heading includes the supports of the Government trough different social programs, such as Oportunidades. 77

85 Table Access to social protection and its correlates by individual, households and geographic dimensions Mexico, 2002 % of respondent women covered by health insurance* (age 15 and above) % of households or population covered by program Oportunidades % of households or population covered by any form of social protection (social insurance and/or cash transfers, inkind transfers from public authorities, employers, or charities)*** Total incidence/prevalence Individual dimension Sex and age Male Age group 1(0-14) N. A Age group 2(15-24) N. A Age group 3(25-44) N. A Age group 4(45.64) N. A Age group 5(65 +) N. A Female Age group 1(0-14) N. A Age group 2(15-24) Age group 3(25-44) Age group 4(45.64) Age group 5(65 +) Household dimension Household size Less than members members Women s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion Group

86 (Continued from previous page) Mexico, 2002 % of respondent women covered by health insurance* (age 15 and above) % of households or population covered by program Oportunidades % of households or population covered by any form of social protection (social insurance and/or cash transfers, inkind transfers from public authorities, employers, or charities)*** Group Work (among hholds with children) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region Region Region Region Region Residence Urban Rural N/I: Not information or Data. N/A: Not Applicable *Health Insurance defined as a member of the household that had any type of health insurance (IMSS, ISSSTE, PEMEX, SEDENA, SECMAR or private) The sub-national regions are: region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Groups of ethnicity: Group 1: Indigenous. Group 2: Not Indigenous Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household REFERENCE/SOURCE: Mexican Family Life Survey 2002 dades beneficiaries. On the other hand, only 17% of the indigenous women are covered by a health insurance. By region, 39% from the women in the Northeast region were covered by a health insurance, compared with 21% from the South-Southeast region. However, the population from this region has the highest coverage by the program Oportunidades (almost 28% of the inhabitants from the South-Southeast region are attended by Oportunidades compared with 5% from the Northeast region). 79

87 Table Social Protection: supply side and uptake variables by region Major Social Protection indicator: number of medical offices per potential 1,000 habitants Total number of medical offices per 1,000 habitants By region Region 1: Northeast - number of medical offices per 1,000 habitants Region 2: Northwest - number of medical offices per 1,000 habitants Region 3: Center - number of medical offices per 1,000 habitants Region 4: Center-West - number of medical offices per 1,000 habitants Region 5: South-Southeast - number of medical offices per 1,000 habitants Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz. Medical offices include those from SSA, IMSS-Oportunidades, State offices, IMSS, ISSSTE, PEMEX, SEDENA and SECMAR (it does not include private medical offices) Source: Primer Informe de Gobierno Using as a social protection indicator the number of medical offices per 1,000 inhabitants, the Table shows that, while in 1995 there were approximately 0.4 medical offices per inhabitants, in 2007 this number change to 0.5. By geographical region, we find that there are not large differences in the number of medical offices per 1,000 inhabitants, even though this proportion is slightly higher in the Center region (0.55 in 2007) than in the Northeast region (0.53). It is important to highlight that, in this case, the medical offices referred to the ones from the Health Secretariat (rather than social security institutions), IMSS-Oportunidades, universities, state owned, IMSS, PEMEX, SEDENA and SECMAR, and private ones are excluded. Analysis on causality and correlation Social security coverage in Mexico is a major challenge for the government given that the informal sector represents approximately 58% of the economically active population (EAP), while the formal sector represents 38.4% and the unemployed represents 4% (Levy, 2007). The analysis presented here in the report tables shows that, in general, the percentage of women with health insurance increases with age. Similarly, this percentage varies considerably (is higher) if the mother has primary or secondary education versus if the mother does not have any schooling. As expected, women living in the highest wealth index quintile are more likely to have health insurance, and at the same time, less likely to be beneficiaries of the program Oportunidades. The indigenous population has a much lower probability of being covered by social security than the non indigenous population. On the other hand, the percentage of households covered by any form of social protection (social insurance, cash and/or in-kind transfers) is very different depending on the socio-economic characteristics of the households. For example, households with many members (more than seven), living in the lowest wealth index quintile or that are indigenous are more likely to receive social assistance (as expected). In the same way, the households with a high dependency rate, living in the South-Southeast region of the country or in rural areas are more likely to be covered by some type of social program o receive a subsidy that benefits them directly). Building blocks and partners for a strategy In this section we have demonstrated that the social security systems in Mexico cover only a fraction of the population, leaving the rest without insurance and with the only real alternative to use services offered by the Ministry of Health. It is evident that a series of duplicities exist in the social security sys- 80

88 tem in Mexico and that Mexico would greatly benefit from a universal system than from a fragmented social security system that excludes a large proportion of the population. Furthermore, the formal sector is not constant in time, rather workers go in and out of formal jobs, providing further motivation for the creation of a universal coverage system. The Seguro Popular program was created to fill the gap between the population with benefits from the social security and the population without them, and to offer a health insurance to this population. However, there is evidence that, at least, in rural areas (where at the beginning the degree of coverage was higher), the program has discouraged the creation of jobs with formal benefits because the Seguro Popular is essentially costless for workers and firms, whereas IMSS has high payroll taxes associated with coverage. (Parker y Scott, 2008). However, this does not mean that the Seguro Popular, which extends coverage and public financing of the public health services for individuals without a health insurance is not desirable. Rather that given the fractured system of social security in Mexico, such negative incentives effects described above might be expected and perhaps should be compared to the large health and equity benefits that the program likely has. And the overall objective should be a universal health and social security system independent of the type of sector of employment and largely financed by general taxes. Conclusions Despite the important advances achieved in child nutrition issues, there are many remaining challenges. An important percentage of children have small size for their age (8%), being boys who present higher stunting rates compared with girls. Children are more likely to suffer nutrition problems when the household has many members, has low wealth, or when the mother has no schooling. Also, indigenous households or with parents that do not work, have a higher number of children that suffer stunting, wasting and are underweight. In matters of health, there remain important percentages of children that suffer illnesses like diarrhea and fever and that did not received adequate treatment for these ills. Overall, households with many members, with low wealth, in rural areas or in the South have children who are more likely to suffer these illnesses and the proportion of children treated for these illnesses are lower. This report has also analyze youth knowledge on sexually transmitted diseases, contraceptives and the use of those contraceptives. Although youth overall are fairly well informed; there are differences by gender, with women having lower knowledge in general in these areas. The percentage of children that are registered late according to the total number of registered children in 2005 was used to measure, indirectly, the degree of child protection in Mexico. The late registration of boys and girls can be related, to the lack of money to pay for the procedure or to go to the civil register or to the lack of civil register offices in the community where they live. The results also show that schooling is an important factor, because when the mother has no schooling the percentage of children that are registered late is very high. Also, several indicators related to the education of the children have shown that those who live in rural areas, are indigenous or whose mothers have no schooling are in less favorable conditions than those who live in urban areas, are not indigenous or live in wealthier households. A small but important percentage of children age 6 to 14 work in Mexico and they are at much higher risk for dropping out of school than those who do not work. In conclusion, it has been observed that the children with most disadvantages in matters of nutrition, health, education and child protection are those who live in rural areas, are indigenous, live in the South zone of the country, or live in households whose parents have no schooling or do not work. We have noted that access of these groups to quality services in the areas of education and health is much inferior for lower income children than higher income children. Thus, a clear recommendation derived from this analysis is that social spending should be progressive in order to better equalize services available to the population. Another important conclusion relates to the lack of information in the area of protection. There is no historical information available by state that is pubic and can be accessed on violence, orphan hood (number of orphan children or number of orphanages), child shelters or, number of adoptions (both national and international). This represents a major limitation in order to describe fully the situation of children in Mexico with respect to child protection. 81

89 STUDY ON POVERTY AND DISPARITIES IN CHILDHOOD: THE CASE OF MEXICO Section Four: Addressing Child Poverty and Disparities A Strategy for Results Introduction An important proportion of Mexican population is young (in 2007 there were 38.1 million boys and girls aged 0 to 17 years old, representing 36% of the total population CONAPO), consequently the policies and strategies to be implemented during the coming years to improve the country s development will be highly related to this population. Mexican youth in many areas show improvements to their measured well being overtime. However, there are still important challenges that must be faced. For example, a high percentage (25%) of children lived in alimentation poverty in 2005 (close to 10 million children ENIGH 2005). The fact that a household lives in poverty conditions implies that the children who live within the household will generally have less access to education, health, or good nutrition. These deficiencies become greater when referring to rural areas (for example, ENIGH 2005 shows that there were 2.3 million households living in conditions of alimentation poverty in rural areas, while this number is 1.2 million in urban areas) or indigenous communities. Current policies must pay special attention to these communities. In general, this report has shown that families with a larger number of members have a greater probability of living in conditions of extreme poverty. Low levels of schooling of the head of the family increase the probability a households lives in conditions of alimentary poverty. 4.1 What must be done? (Which pillars and policies are in process, which gaps persist) Being Mexico a country with a medium-high income and with a relatively high GDP per capita (14,400 US in 2008), it is alarming that still 8% of Mexican children live in households with one dollar or less per day per capita (approximately 3.3 million children) and that close to 9% of boys and girls still experience some type of severe deprivation (approximately 3.6 million boys and girls). Furthermore, the differences in the level of poverty between urban and rural areas make clear that Mexico is a country with a high degree of inequality inasmuch as opportunities and provision of basic services for development. In spite of the fact that there have been important advances in the eradication of extreme poverty, there still are millions of persons who live in poverty conditions and children who do not go to school, who have no medical attention and thus cannot fully develop their capacities. Furthermore, the households that suffer monetary 82

90 poverty tend to suffer deprivations in other areas; namely, there is an important correlation between monetary poverty in Mexico and the prevalence of deprivations. Particularly, there are strong correlations between deprivations of shelter, sanitation, water and information and poverty measures with the monetary income of households. During the past years there has been a reduction in the percentage of children who live with one or two deprivations, and there has been important progress in matters of access to water and sanitation (specifically, the severe deprivation in sanitation fell from 23% in 1994 to 5% in 2005, and that of water from 18% to 2% in the same period, ENIGH). Nevertheless, currently almost half the children still live with at least one deprivation and almost 22% with two deprivations (ENIGH, 2005). In addition to this, it is important to remark that, in general, it is small children who have a larger probability of living with two or more severe deprivations than older children. In matter of public resources allocation, this research has shown evidence that education services are of higher quality for wealthier children. Children in lower income quintiles go to schools with the worst conditions, and are often found in rural areas of the country, in the South-Southeast area and in indigenous communities. As a result, it is necessary to improve the quality and coverage of the education system to reduce the existing gaps between those who have greater resources and those who, because of living in marginalized areas, because of being indigenous, or because of being located in rural communities, have lower access to quality education services. The supply of quality health services also faces tough challenges due to the high level of disparity that exists between the services received by wealthier households and poorer households. The supply of services does not cover all of the population, particularly the population living in more marginalized areas. This research has shown that children in poorer families get sick more often and are less likely to receive adequate treatment than wealthier households. On the other hand, to attend to the emerging health issues, there is a great need for strategies directed at the current epidemic of obesity in Mexico, all groups including childhood have shown great increases in the proportion of those overweight or obese and this has also lead to a higher incidence of cardiovascular illnesses, among other diseases. In terms of public policies, based on this report we suggest two main recommendations. The first one deals with the topic of the impact and distribution of government expenditures. Here, there are several suggestions. One the government should consider the regressive effect of energetic subsidies, which tend to benefit the higher income deciles and represent an important percentage of the federal budget. This recommendation is also applicable to the case of college education, which is highly regressive. Even in lower levels such as primary and junior high (or secondary education) there are great differences in quality of education available for children of higher resources versus poorer children. This implies the need to exert a progressive expenditures in favor of disadvantaged groups (rural, poor and indigenous), with the purpose of reducing the disparities in these levels in terms of access to education and health services (Scott, 2008). The second recommendation to reduce existing disparities is to continue with the enforcement of social programs specifically focused on the poor population. Oportunidades has been an excellent example that has had clear positive impacts on its beneficiary population. There remain however areas of potential improvement, for example, the coverage in urban areas is relatively low. In addition, there is a need for specific analysis on the extent to which families escape poverty with this program and are able to maintain themselves out of poverty. It is also important to implement impact evaluations of other important social programs such as Popular Health Insurance, Liconsa and of Diconsa, to verify that the resources indeed get to the poorest population and to analyze their impact on the population. In as much as the pillars of childhood wellbeing there are many challenges to confront. In education and health matter, great advances have been made in the coverage and the increase of schooling years of children and youth, though there remain strong inequalities in education and health. On the other hand, in matters of child protection and social protection there are also many challenges, arising from violence, child work, the lack of identity right and other aspects remain an obstacle for children to adequately fully exert their rights. In this area we recommend the implementation of a much more complete information system to that which already 83

91 exists so as to enable a much more detailed diagnosis on the situation of the rights of the children. 4.2 How to make this happen (proposals, synergies, associates) Building blocks and partnerships for a strategy for children and development In the next paragraphs we summarize our recommendations on each one of the five main topics. Within the area of child nutrition, there is currently a situation of dual nutritional problems, in which an important population of children continue to suffer malnutrition according to indicators of stunting, wasting and being underweight. On the other hand, today Mexico is one of the countries with the highest rates of obesity, and obesity among children is growing at a very fast pace. Thus, we recommend a strategy that ensures that the children who live in poor homes have sufficient resources to purchase a sufficient, balanced and nutritious diet. On the other hand, we also recommend implementing an integral strategy to combat the tendencies of the growing child obesity problem. These strategies could include promoting exercise and implementing taxes on processed food and/or with high levels of sugar, besides other regulatory measures for the production and commercialization of food. The health area also faces a dual situation where infectious diseases continue to be important causes of child mortality in poor areas, though the incidence of chronic diseases is also rapidly growing. The former implies that a strategy is needed that takes care of the needs of the poor population and that a national strategy is also implemented to reduce obesity as well as better prepare the health system to confront a growing number of chronic diseases associated with obesity. Furthermore, in this research it has been shown that the under five child mortality and also the proportion of persons who live in alimentary poverty conditions is larger in the South-Southeast area of the country and lesser in the Northeast area. These results imply that, due to the fact that there is an important correlation between these two variables, better focused strategies are needed to the areas that require better services (both in matter of coverage and of quality) to confront child mortality and alimentation poverty. In the area of social security, the separation between the formal population with access to medical services and the informal sector population that is attended by the Secretariat of Health is notorious. This demonstrates that, evidently, it is quite inefficient to have several health systems simultaneously in operation. In spite of the fact the Popular Insurance seeks to provide health insurance to the population without social security, there is evidence that it promotes informality (Parker and Scott, 2008). This point also supports the idea of constructing a universal system of health services. In the education area, we have shown that there are important inequalities in education achievements and in access to education services by region and income group. A main priority is to reverse historical inequalities in the assignment of resources and ensure that the schools to which the poor population has access to are of similar quality as the rest of the population. Finally, the area of child protection is still a little developed area in Mexico. Hence the first step to develop a strategy in this area is to have a more complete information system that allows analyzing in depth the current situation on child protection and the violation of the rights of the children. Conclusions This research offers a diagnostic on the different dimensions of child poverty in Mexico. The research has demonstrated that while social indicators in the majority of t areas have continued improving throughout time, there is still a relatively high rate of child poverty, as measured by deprivations studied, and in particular likely higher than would have been expected given Mexico s GDP. In addition, there is evidence that the government s expenditures in some in some areas is not particularly oriented to the poorest sectors of population, so that some areas of government expenditure may even exacerbate inequality. An example is the subsidy in gasoline, which in the year of 2007 was 48,304 million pesos, an amount 1.15 times larger than the expense of the Oportunidades Program, which constitutes the main strategy in matter of social development and combat to poverty. While only 1.5% of the benefit of the subsidy of gasoline is received by the population of the lowest wealth quintile, the highest wealth decile (Scott, 2008) receives 35% of this benefit. 84

92 Although this report documents an important advance on the levels of schooling over time, there are many children and youths who do not finish basic compulsory education. Some of this deficit likely reflects low quality of schooling as well as high poverty conditions of the population in these areas. (Parker et al. 2007). As a consequence of this, the low quality of schools not only may increase school desertion but promote early incorporation into the labor force. Although child work is illegal for those under the age of 14, laws are not enforced with respect to child labor. Additionally, in certain areas of child wellbeing, the availability of information is quite limited or inexistent. For example, the number of children who live on the streets, the number of children who live in public care institutions, homes or foster homes and the number of children who are victims of violence, are areas on which there is very little available information. An additional example is related to the dimension of the VHI/AIDS epidemics among teenagers and youths in Mexico, where there are no good available statistics. The implementation of a much more complete information system than the existing one would be a clear advancement with respect to promoting children s rights in Mexico. Finally, in the following paragraphs we revisit the main recommendations in matter of public policies derived from this Report: Due to the high inequalities that exists in Mexico in matter of income, expenditures, health and education, a basic principle is that the government s expenditures should at a minimum not worsen the existing disparities. Hence a first recommendation is that, both the government s expenditures as well as taxes are oriented towards the benefit of the poor or at least, are not regressive, such as the case of the current subsidies to gasoline. In second place, the social programs that are well designed and seek to reduce intergenerational poverty such as the case of Oportunidades- should enter a new stage that explicitly seeks the improvement of the quality of the services beneficiaries receive, mainly in terms of health and education; and also continued design of actions oriented towards families that are not beneficiaries of Oportunidades or other social programs to encourage the further reduction of poverty. Another large and important program, is the Popular Health Insurance, which seeks to expand the medical insurance among the population that has no social security. Currently there are few evaluations over its impacts on health. However, this should be an important future research topic, especially because of the size of the informal economy in the country. There remain a significant percentage of children who suffer malnutrition measured according to traditional measures (stunting, wasting, underweight). Nevertheless, the problem of obesity now affects a much larger proportion of children and evidence show that the proportion of children with overweight or obesity is significantly increasing, particularly among the poor population. Clearly, the high rates of obesity are sure to lead to an increase on chronic diseases among children, such as high blood pressure and diabetes, which would reduce life expectancy for children and implies considerable financial challenges in terms of public health. Thus, it is urgent that a national strategy is developed to combat both child and adults obesity, as well as its main causes. 85

93 Acronyms List ANMEB BM National Agreement for the Modernization of Education (Acuerdo Nacional para la Modernizacion de la Educacion Basica) World Bank (Banco Mundial) ENN ENNViH National Poll on Nutrition (Encuesta Nacional de Nutricion) Poll on Home s Standard of Living (Encuesta Sobre el Nivel de Vida de los Hogares) DOF CAIC CAUSES CEPAL CDI CFE Official Gazette of the Federation (Diario Oficial de la Federacion) Program for the attention of minors of early age: through communitarian centers for child assistance. (Programa de atencion a menores de edad temprana: a traves de centros de asistencia infantil comunitarios) Universal Health Services Catalogue (Catalogo Universal de Servicios de Salud) Economic Commission for Latin America and the Caribbean, ECLAC (Comision Economica para America Latina y el Caribe) National Board for Development of Indigenous People (Comision Nacional para el Desarrollo de los Pueblos Indigenas) Federal Energy Company (Comision Federal de Electricidad) FONAES FPGC IDH IIN IED IETU IFPRI National Fund of Supports for Companies in Solidaridad (Solidarity) (Fondo Nacional de Apoyos para Empresas en Solidaridad) Fund of Protection against Catastrophic Expenses (Fondo de Proteccion contra Gastos Catastroficos) Human Development Index (Indice de Desarrollo Humano) Inter-American Children s Institute (Instituto Interamericano del Niño, la Niña y Adolescentes) Foreign Direct Investment (Inversion Extranjera Directa) Sole Rate Business Tax (Impuesto Empresarial a Tasa Unica) International Food Policy Research Institute COIA COMAR CONAFE National Board for Childhood and Teenagers (Consejo Nacional para la Infancia y la Adolescencia) Mexican Board for Help to Refugees (Comision Mexicana de Ayuda a Refugiados) National Board for Education Support (Consejo Nacional de Fomento Educativo) IMSS INALI INEE Mexican Social Security Institute (Instituto Mexicano del Seguro Social) National Institute of Indigenous Languages (Instituto Nacional de Lenguas Indigenas) National Institute of Education Evaluation (Instituto Nacional de Evaluacion de la Educacion CONASIDA Control of AIDS (Control del Sindrome de la Inmunodeficiencia Adquirida) CONEVAL National Commission for Evaluation (Consejo Nacional de Evaluacion de la Politica de Desarrollo Social) INEGI INM National Institute for Statistics and Geography (Instituto Nacional de Estadistica y Geografia) National Migration Institute (Instituto Nacional de Migracion) CNDH Human Rights National Board (Comision Nacional de Derechos Humanos) INMUJERES National Women Institute (Instituto Nacional de las Mujeres) EIASA ENIGH Integral Strategy of Social Alimentary Assistance (Estrategia Integral de Asistencia Social Alimentaria) National Poll on Household Income and Expenses (Encuesta Nacional de Ingresos y Gastos de los Hogares) ISSSTE LFC State Employees Social Security and Social Services Institute (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado) Electricity Company, Light and Force of the Center (Luz y Fuerza del Centro) ENSANUT National Poll on Health and Nutrition (Encuesta Nacional de Salud y Nutricion) LFPRH Federal Act of Budget and Fiscal Responsibility (Ley Federal de Presupuesto y Responsabilidad Hacendaria) 86

94 LGE LGDS LGS Education Act (Ley General de Educacion) Social Development Act (Ley General de Desarrollo Social) Health Act (Ley General de Salud) PROPADETIUM Program for Prevention, Attention, Discouragement and Eradication of Urban Marginal Child Work (Programa para la prevencion, atencion, desaliento y erradicacion del trabajo infantil urbano marginal) NOM Mexican Official Norm (Norma Oficial Mexicana) PND National Development Plan (Plan Nacional de Desarrollo) OCDE MDO's OPI OPEP Organization for Economic Co-operation and Development, OCDE (Organizacion para la Cooperacion y Desarrollo Economico) Millennium s Development Objectives (Objetivos de Desarrollo del Milenio) Officers of Protection to Childhood (Oficiales de Proteccion a la Infancia) Organization of the Petroleum Exporting Countries (Organizacion de Paises Exportadores de Petroleo) PRONAFIDE Nacional Program for Development Financing (Programa Nacional de Financiamiento del Desarrollo ) PROSESA Health Sectorial Program (Programa Sectorial de Salud ) PSDS PSE ROP Social Development Sectorial Program (Programa Sectorial de Desarrollo Social) Education Sectorial Program (Programa Sectorial de Educacion ) Operating Rules (Reglas de Operacion) DIF PAIDEA National System for Integral Family Development (Sistema Nacional para el Desarrollo Integral de la Familia) Program for the Prevention and Integral Attention of Pregnancy in Teenagers (Programa para la Prevencion y Atencion Integral del Embarazo en Adolescentes) SEDENA SEDESOL SEP National Defense Ministry (Secretaria de la Defensa Nacional) Social Development Ministry (Secretaria de Desarrollo Social) Public Education Ministry (Secretaria de Educacion Publica) PAL PAZAP PAZM PEC PEMEX PGR Nourishment Support Program (Programa de Apoyo Alimentario) Alimentary Program on Areas of Priority Attention (Programa de Apoyo a Zonas Prioritarias) Alimentary Program for Marginalized Zones (Programa Alimentario para Zonas Marginadas) Quality Schools Program (Programa Escuelas de Calidad) Mexican Oil Company (Petroleos Mexicanos) Republic s General Proctorship (Procuraduria General de la Republica) SEMAR SHCP SINAIS SNDIF SNS SNTE Navy Ministry (Secretaria de Marina) Finance Ministry (Secretaria de Hacienda y Credito Publico) National System for Health Information (Sistema Nacional de Informacion en Salud) National System for Integral Family Development (Sistema Nacional para el Desarrollo Integral de la Familia) National Health System (Sistema Nacional de Salud) National Union of Education Workers (Sindicato Nacional de Trabajadores de la Educacion) PIB Gross Domestic Product (Producto Interno Bruto) STPS Labor Ministry (Secretaria de Trabajo y Prevision Social) PISA PREVERP International Project for the Production of Students Performance Indicators (Proyecto Internacional para la Produccion de Indicadores de Rendimiento de los Alumnos) Psychosocial risk prevention Program (Programa de prevencion de riesgos psicosociales ) SSA SSP SMNG WTI Health Ministry (Secretaria de Salud) Public Security Ministry (Secretaria de Seguridad Publica) Medical Insurance for A New Generation (Seguro Medico para una Nueva Generacion) West Texas International 87

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97 Petroleos Mexicanos (PEMEX). Plan Nacional de Desarrollo Politica Social del Gobierno Federal. Vivir Mejor. Presidencia, 31 de marzo de gob.mx/programas/?contenido=34623 Primer Informe de Gobierno 2007, pagina 204. Anexo estadistico (Gasto federal de los principales programas para la superacion de la pobreza). Primer Informe de Gobierno 2007, pagina 276. Anexo estadistico, pagina 16. Programa Sectorial de Educacion Programa Sectorial de Salud Secretaria de Salud. PRONAFIDE Prueba ENLACE Ravallion, Martin (2005). Pro-Poor Growth. Development Research Group. World Bank. Reglas de Operacion Programa de Desarrollo Humano Oportunidades. Rivera, Juan A., Muñoz-Hernandez, Onofre, Rosas Peralta, Martin, Aguilar Salinas, Carlos, Popkin, Barry, Willet, Walter. (2008) Consumo de bebidas para una vida saludable: recomendaciones para la poblacion mexicana Rubalcava, Luis y Teruel, Graciela (2006). Guia de Usuario de la Encuesta Nacional sobre Niveles de Vida de los Hogares Primera Ronda. Rubalcava, Luis y Teruel, Graciela (2008). Guia de Usuario de la Encuesta Nacional sobre Niveles de Vida de los Hogares Segunda Ronda. Schultz, Paul T. (2004). School subsidies for the poor: evaluating the Mexican Progresa poverty program. Journal of Development Economics. Scott, John (2008). Redistributive Constraints under High Inequality: The Case of Mexico. Scott, John (2008). Gasto Publico y Desarrollo Humano en Mexico: Analisis de Incidencia y Equidad. UNDP. Secretaria de Educacion del Gobierno del Distrito Federal. (2008). Descentralizacion y Reforma Educativa en la Ciudad de Mexico. Secretaria de Salud (2006). Indicadores Demograficos y Socioeconomicos. Secretaria de Salud (2006). Informe Nacional sobre Violencia y Salud. Segundo Informe de Gobierno Anexo Estadistico. Paginas 243, 245, 363. Senado de la Republica (2006). La Seguridad Social en Mexico. SHCP, Informe sobre la Situacion Economica, las Finanzas Publicas y la Deuda Publica, Cuarto Trimestre 2005, 2006 y SHCP. Enero Informes sobre la Situacion Economica, las Finanzas Publicas y la Deuda Publica, Segundo, Tercer y Cuarto Trimestre SHCP. Abril Informes sobre la Situacion Economica, las Finanzas Publicas y la Deuda Publica. Acciones y Resultados al Primer Trimestre de Sistema Integral para el Desarrollo Integral de la Familia. Subsecretaria de Educacion Media Superior, SEP (2008). Construye-T: Programa de Apoyo a las y los Jovenes de Educacion Media Superior para el Desarrollo de su Proyecto de Vida y la Prevencion en Situaciones de riesgo. The Economist Newspaper: Profile Books, The Economist pocket word in figures London. UNDP, Human Development Report 2007/2008. UNICEF, DIF, CIESAS (2001). Infancia Robada: Niñas y Niños Victimas de Explotacion Sexual en Mexico. UNICEF (2008). La infancia y el VIH/SIDA. Colocando a la niñez y la adolescencia en el centro de la respuesta al VIH/ SIDA. Mexico. UNICEF (Fondo de las Naciones Unidas para la Infancia). UNICEF, DIF (2004). Niñez Migrante en la Frontera Norte: Legislacion y Procesos. UNICEF (2007). Global Study on Child Poverty and Disparities , Guide. Yoshikawa, Hirokazu; McCartney, Kathleen; Myers, Roberts; Bub, Kristen L.; Lugo-Gil, Julieta; Ramos, Maria A.; Knaul, Felicia (2007). Early childhood education in Mexico: expansion, quality improvement and curricular reform. Unicef. Innocenti Research Center. World Bank List of economies (Julio, 2008). World Bank (2003). Inequality in America Latina and the Caribbean: breaking with history? World Bank (2004). World Development Report 2004: Making Services Work for Poor People. World Bank (2006). World Development Report 2006: Equity and Development. Sedesol. Programa Sectorial de Desarrollo Social

98 Annex 1. Policy and Statistics Tables Table Which is the national key document/plan that establishes the purposes and strategy in this sphere? 2. What is the name of the national key policy, law, ministerial decree or direction in this sphere? 3. Objectives of Policies. What is exactly the purpose of achievement of the policy/law with regard to the dimension of child poverty? Household Income 1) National Development Plan ) Sector Program for Social Development ) Operation Rules 2008, Opportunities (Oportunidades) Human Development Program 1) Strategy Live Better. 2) Opportunities (Oportunidades) Human Development Program. 3) Boys, Girls and Adolescents Protection Act. 4) Action Program The PND, in line with the strategy Live Better, represents all of the Federal Government actions that seek to create conditions of economical growth and of prosperity for all Mexicans in such a manner that a sustainable human development may be achieved. One of the main actions of this strategy seeks to continue developing the capacities of the Mexican people, especially that of girls and boys, by guaranteeing access to education, health, nourishment and a worthy dwelling. The Sector Program of Social Development (PSDS) has four main objectives that are in line to the PND and the population s and childhood s wellbeing. These are: 1) Develop the basic capacities of persons in poverty conditions; 2) abate the backdrop faced by vulnerable social groups through the strategies of social assistance that allows them to develop; 3) reduce the regional disparities through territorial ordainment and social infrastructure that allows the integration of socially excluded areas; and 4) improve the quality of life in the cities, emphasizing on social groups in poverty conditions, through the provision of the social infrastructure and worthy dwelling, and also to consolidate efficient cities, safe and competitive. The PSDS establishes as one of its main goals the reduction of nourishment poverty in 30% for 2012 (in million people lived in these conditions and it is a wish that by 2012 only 10.1 million are burdened by it). For its part, Oportunidades seeks to support families who live in extreme poverty conditions, so as to increase the capacities of their members and widen up their alternatives to achieve better levels of wellbeing, through the improvement of the options in education, health, nourishment, besides contributing to the bonding of new services and development programs that propitiate the improvement of their socio-economical conditions and of quality of life. 4. How does this policy objective fit in with the purposes of other sectors or with the National Development Strategy in general? Live Better is a strategy that takes into consideration the current social programs and complements them with new actions which, overall, seek to reach the goals proposed by the PND, the Sector Programs and the MDO's. In line with PND s axis on equality of opportunities, the purposes of Live Better and the PDN are centered on: significantly reducing the number of Mexicans in poverty conditions with policies that overcome an assistance focus, so that the persons may acquire capacities and generate work opportunities; support the poorest population to increase their income and improve their quality of life, encouraging and supporting the generation of productive projects. In like manner, Oportunidades, in line with the goals of the PND, seeks to break the intergenerational cycle of poverty in such a manner that present generations may have a better quality of life than that of those who preceded them. On the other hand, the PSDS takes as point of reference the Vision Mexico 2030 and it includes the objectives, strategies and lines of actions of the government offices and federal organisms that belong to this sector. 5. Which is the State organism in charge of the execution phase? SEDESOL / National Coordination of the Oportunidades Human Development Program 91

99 (Continued from previous page) 1. Which is the national key document/plan that establishes the purposes and strategy in this sphere? 2. What is the name of the national key policy, law, ministerial decree or direction in this sphere? 3. Objectives of Policies. What is exactly the purpose of achievement of the policy/law with regard to the dimension of child poverty? 4. How does this policy objective fit in with the purposes of other sectors or with the National Development Strategy in general? 5. Which is the State organism in charge of the execution phase? Child Nutrition 1) National Development Plan ) Health Sectorial Program Even though the Health Act does not have a chapter on nutrition, this law represents the most Within its axis of equality of opportunities, the important decree in matter of health and thus on PND establishes several objectives that seek to nutrition. In it are established the objectives of the increase the wellbeing of the Mexican people. In Health National System, which seeks to supply this line, the PND establishes as main objectives health services to all the people and improve to reduce extreme poverty and secure equality of 1) Health Act the quality of the same, so that the wellbeing opportunities and the enlargement of capacities Last and development of families is impelled (and so that all Mexicans significantly improve their modification on hence that of childhood) and thus the incidence quality of life and have nourishment, health, July 4, on poverty is prevented. On the other hand, the education, worthy housing guaranteed, and an 2) Mexican objectives, strategies and lines of action in matter appropriate environment for their development Official Norm of health and children s health are expressed in as provided by the Constitution. Inasmuch as NOM-031- the Sectorial (PROSESA), which is in the nourishment subject, PDN establishes the SSA2-1999, for charge of defining taking as starting point the SSA, DIF importance of bringing to the communities child s health Vision Mexico 2030 and the PND- the performance more actions on education, health, and nutrition attention, of the government offices and the federal among other things- to socially excluded 3) Boys, Girls organisms that pertain to the National Health villages. Social programs such as Oportunidades and Adolescents System, such as the SSA, IMSS, ISSSTE, DIF, (within its nourishment component) and Protection Act. 4) SEDENA, SEMAR and PEMEX. In like manner, the School Breakfasts, have contributed to reduce Action Program NOM for attention to child s health establishes the malnutrition indexes of the poorest population so criteria, strategies, activities and procedures that that, within the PND , the importance give attention to children in this country, such as: to continue consolidating these type of programs vaccination, prevention, treatment and control of has been established, so that special attention diarrheic diseases, and acute breathing infections, is given to socially excluded towns and social as well as actions for the vigilance of the state of breaches continue to be reduced. nutrition, growth and development of children under five years old. 92

100 (Continued from previous page) 1. Which is the national key document/plan that establishes the purposes and strategy in this sphere? 2. What is the name of the national key policy, law, ministerial decree or direction in this sphere? 3. Objectives of Policies. What is exactly the purpose of achievement of the policy/law with regard to the dimension of child poverty? 4. How does this policy objective fit in with the purposes of other sectors or with the National Development Strategy in general? Children s Health 1) National Development Plan ) Health Sectorial Program ) Health Act Last modification on July 4, ) Boys, Girls and Adolescents Protection Act. 3) Action Program PROSESA, on line with PND is in charge of defining the performance of the government offices and federal organisms that pertain to the National Health System. Each one of its objectives is integrally related to the ten national objectives of PND. The National Health Act is presented as a document that regulates the right to protection of health had by all Mexicans and establishes the purposes and main agents related to protection of health. Each one of PROSESA s purposes is integrally related to the 10 national objectives of PND. Some of these are: i) improve health conditions of the people (for example, increase the expectations of life at birth 1.5 years); ii) reduce health breaches or inequalities with focused interventions on vulnerable groups and socially excluded communities (reduce to half the rate of maternal mortality in the 100 municipalities with less index of human development); iii) supply quality and safe health services (for example, certify 100% of the health units that provide services to the Health Social Protection System); iv) avoid impoverishment of the people due to health reasons; and v) guarantee that health contributes to the combat of poverty and the country s social development (the main goal is to reduce 20% the prevalence of malnutrition on children under 5 years at the 100 municipalities with less human development index). The advance on these objectives has been possible thanks to programs such as Oportunidades, the Popular Insurance and SMNG, among others. Child Protection 1) National Development Plan ) An Appropriate Mexico for Childhood and Adolescence Action Program ) The Boys, Girls and Teenagers Rights Protection Act. May 29, ) Health Act. February 7, ) Social Assistance Act. September 2, 2004 The Boys, Girls and Teenagers Rights Protection Act (2000), along with several statements and other State and federal instruments, forms part of the national policy in favor of child protection. Its main purpose resides in securing a full and integral development, which implies the opportunity to have a physical, mental, emotional, and social formation, and morally in conditions of equality. Hence, it is the labor of the Federation, the Federal District, the States, the municipalities and the private and social sector, to seek to and implement policies and strategies that guarantee the improvement of the social condition of girls, boys and teenagers and which impel a culture of protection of childhood s rights, based on the contents of the Convention on the rights of the child. The PND delimitates objectives with a high entailment to child protection policies. Specifically, the axis of equality of opportunities establishes the importance of developing a public policy aimed at the family, with the purpose of reducing social vulnerability. Furthermore, it seeks to promote healthy and integral development of Mexican childhood guaranteeing full respect to their rights, the attention to their needs for health, nourishment, education and housing, and promoting full development of their capacities. The strategy Live Better establishes two branches under which child protection in Mexico takes its guidance. The first one, the Action Program , which summarizes the strategy of Federal government to improve educational conditions, of health and protection of children s rights, and the second one, the COIA, formed by the Ministries of SSA, SEDESOL, STPS, as well as ISSSTE and SNDIF. Inasmuch as social programs that promote childhood protection, the most important are the Program From Street to Life, the PROPADETIUM, the PAIDEA and the Program for Diffusion of Childhood s Rights, among others. However, currently COIA is practically inactive and the last report on the Action Program was made in Which is the State organism in charge of the execution phase? SSA DIF, SSA 93

101 (Continued from previous page) 1. Which is the national key document/plan that establishes the purposes and strategy in this sphere? 2. What is the name of the national key policy, law, ministerial decree or direction in this sphere? 3. Objectives of Policies. What is exactly the purpose of 4. How does this policy objective fit in with the purposes of other achievement of the policy/law with sectors or with the National Development Strategy in general? regard to the dimension of child poverty? 5. Which is the State organism in charge of the execution phase? 1) National Development Plan Children s 2) Sectorial Education Education Program ) Education Act, July 13, 1993 (last modifications in July, 2008). 2) Boys, Girls and Adolescents Protection Act. 3) Action Program So that childhood poverty can be faced, the Education Act establishes that the education authorities are responsible for promoting a major educational equity, as well as the achievement of equality of opportunities of access and permanence in educational services. The said measures are aimed, preferably, at those groups and regions with most educational backdrop or that face economical and social conditions of disadvantage. In turn, the Sectorial Education Plan, formulated based on the PND and the Vision 2030, establishes the main objectives and goals in matter of education of the Mexican people. The Sectorial Education Plan establishes six objectives with regard to the reduction of child poverty, which are: 1) increase the quality of education, 2) Extend education opportunities to reduce disparities among social groups and impel equity, 3) offer an integral education that equilibrates formation in citizen values and development of competences, 4) offer quality education services to form persons with a high sense of social responsibility, and 5) promote school and institutional operation that strengthens the participation of school centers in the process of decisions taking, makes the several agent co-responsible, promotes security, transparency, and the rendering of accounts. Furthermore, among the main goals proposed by PSE for 2012 there are to increase: i) grading of PISA tests on mathematics and reading comprehension from 392 (2006) to 435; ii) percentage of public school updated teachers from 17.8 in 2006 to 87.9%; iii) junior high school termination rate of 75.5% (2006) to 86.7%; iv) percentage of native boys and girls that conclude their primary education in indigenous education schools from 85.1% in 2006 to 88.1%; v) education scholarships for students in the Oportunidades basic education from 4 602,403 in 2006 to 5 000,000; and vi) scholarships granted to young mothers and young pregnant women to conclude their basic education from 1,975 grants in 2006 to 49,460 among others. To achieve this, there are programs being carried out such as Oportunidades, Quality Schools, Scholarships for youths and Pregnant Mothers and the Preschool and Primary Education Program for Boys and Girls of Migrating Agricultural Workers Families SEP 94

102 Table 2. Public Spending and Development Supports Millions of Pesos as of Information Source Total Public Spending (Millions of Pesos) Public spending in cash transfers and household income generation programs (Millions of pesos) Public spending in child nutrition (Millions of pesos)*** Public spending in health (Millions of pesos) Public spending in education (Millions of pesos) Gross Official Assistance for Development (OAD) (Millions of pesos) Support from General Budget (Millions of pesos) OAD in cash transfers and household income generation programs (Millions of pesos) OAD in child nutrition (Millions of pesos) OAD in health (Millions of pesos) 17,127 19,077 20, ,960 2,091 1,732 2,813 3,020 3,148 NA NA NA NA NA NA NA NA NA 10 8 NA SHCP. Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005 and 2006 Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and Federal Spending Budget 2005, 2006 and Second State to the Nation Report Statistic Appendix. Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and First State to the Nation Report Statistic Appendix. Page 204 First State to the Nation Report Page 56 Second State to the Nation Report Page 104 First State to the Nation Report Page 56 Second State to the Nation Report Page 104 Third Basic Health Care Project: proposed amendment to loan. World Bank OAD in education (Millions of pesos) NA **Budgeted expenditures *** Oportunidades educational component was not included in this row in order to avoid duplications of amounts. NA: Not available Public spending in cash transfers and income generation programs refers to the budget of Oportunidades and Senior Adults program s Public spending in child nutrition refers to Diconsa, Liconsa and Scholar Breakfasts budget. Public spending in health and education refers to programmable spending of the Public Sector Budget Basic Education Development Project in Support of the Third Phase of the Basic Education Development Program. World Bank 2005,

103 Table 3. Household Income Key and Relevant Budget Allocation Millions of pesos as of 2002 Total spending in 2005 Total spending as % of government spending in 2005 Total spending in 2006 Total spending as % of government spending in 2006 Total spending in 2007 Total spending as % of government spending in 2007 Data Source Cash for human development programs Cash for labor programs Price subsidies, tax exemptions Social pensions (seniority and disability ) Motherhood and fatherhood benefits Child and families allocations , , , , , , NA NA NA NA NA NA NA NA NA NA Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and Second State to the Nation Report Statistic Appendix. Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and 2007 Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and 2007 Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and 2007 Accounts on reproductive health and gender equity Estimation and spending evolution , INSP. Page 34 Other support programs for senior adults Federal Expenditure Budget 2005, 2006 and 2007 Note: Information on social programs refers to budgeted spending, while subsidies, pension, motherhood and fatherhood benefits and child and families allocations information refers to the actual exercised spending. Public spending for human development programs refers to Oportunidades Program budget. Public spending for labor programs in 2005 includes: Program for Temporary Employment, Priority Groups and Regions, Productive Re-conversion Program, National Support Fund for Companies in Solidaridad (Solidarity) (FONAES), and Productive Options. For 2006 and 2007 it includes Agri-Food and Fishing Chains, Priority Groups and Regions, Productive Re-conversion, FONAES and Productive Options Subsidies of prices and tax exemptions are targeted to social development, economic growth and government actions. They include gasoline subsidies; Luz y Fuerza (light) to support electric energy costs; decentralization and relocation agreements in federal entities encompassed in the Alliance for the Countryside Program; subsidies to the States destined to support education at medium high, high school and superior levels; Scholarship Program and CONAFE Financing; highly specialized hospitals equipment for the health sector, between others. Social pensions (seniority and disability) include those granted by IMSS, ISSSTE, CFE, LFC and PEMEX. Motherhood and fatherhood benefits include hospital and ambulatory assistance from public and private sector. Others: in 2005 and 2006 refers to the Senior Adult Program in Rural Areas; in 2007 it refers to the Attention Program for Adults of 70 years and on in Rural Areas. NA: No information available 96

104 Table 4. Childhood Results in Nutrition Key Budget Allocations Millions of pesos as of 2002 Total spending in 2005 Total spending as % of government spending in 2005 Total spending in 2006 Current Total spending as % of government spending in 2006 Total spending in 2007 Total spending as % of government spending in 2007 Data Source Communitarian services targeted to nutrition and health (growth promotion, supplementary food) Consultancy on breast feeding Nutrition services at institutions (severe undernourishment treatment) Procurement of micronutrients supplements Selective food assistance NA NA NA NA NA NA First State to the Nation Report 2007, page 204. Statistic Appendix (Public Expenditure on Poverty Reduction Programs). Second State to the Nation Report Statistic Appendix (Food Support Programs, page 245). Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and First State to the Nation Report 2007, page 204. Statistic Appendix. Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and Sixth State to the Nation Report 2006, page 37 Federal Finance Ministry Account Public Spending Policy. Report on Economic Situation, Public Finances and Public Debt, Fourth Quarter 2005, 2006 and Second State to the Nation Report Statistic Appendix Food Support Programs, page 245). Others Enumerate NA NA NA NA NA NA NA: No information available Communitarian services targeted to nutrition and health (growth promotion, supplementary food) refers to Liconsa Program Nutrition services at institutions (severe undernourishment treatment) refers to Scholar Breakfasts Program Procurement of micronutrients supplements refers to the food component of Oportunidades Selective food assistance refers to Rural Supply Program and Food Support Program 97

105 Table 5. Childhood Results in Health Key Budget Allocations Millions of pesos as of 2002 Total spending in 2005 Total spending as % of government spending in 2005 Total spending in 2006 Total spending as % of government spending in 2006 Total spending in 2007 Total spending as % of government spending in 2007 Data Source Primary facilities for health care Immunization programs Prenatal attention programs Neonatal attention programs Reproductive health and support for mothers Others Enumerate NA NA NA NA NA NA NA NA NA NA NA NA Expenditure in immunization programs includes the budgeted expenditure in vaccines programs and the procurement of consumables for those programs. Expenditure in prenatal attention programs correspond to the budgeted expenditure of the National Institute of Perinatology Isidro Espinosa de los Reyes each year. Expenditure in neonatal attention includes both the budgeted expenditure of the National Institute of Perinatology Isidro Espinosa de los Reyes and the National Pediatrics Institute. Expenditure in reproductive health and support for mothers corresponds to the budgeted expenditure of the National Center of Gender Equity and Reproductive Health. Federal Expenditure Budget, Subdivision , 2006 and 2007 Federal Expenditure Budget, Subdivision , 2006 and 2007 Federal Expenditure Budget, Subdivision , 2006 and 2007 Federal Expenditure Budget, Subdivision , 2006 and 2007 Table 6. Childhood Results in Infancy Protection Key Budget Allocations Millions of pesos as of 2002 Total spending in 2005 Total spending as % of government spending in 2005 Total spending in 2006 Total spending as % of government spending in 2006 Total spending in 2007 Total spending as % of government spending in 2007 Data Source Birth inscription NA NA NA NA NA NA Alternative Care (daycare, adoption services, child care in institutions) NA NA NA NA Second State to the Nation Report Statistic Appendix (Expenditure in the main programs for poverty reduction, page 243). Family Support Services * Child Protection Services Justice for minors Others Enumerate NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA NA Second State to the Nation Report Statistic Appendix (Expenditure in the main programs for poverty reduction, page 243). * Family support services might include social assistance services, nurseries, education in first childhood and extracurricular activities, advisory and related services, education for fatherhood and motherhood. Note: Real expenditure. NA: No information available Family support services refer to the Daycare and Child Houses Program. Alternative Care refers to the Daycare and Chile Houses Program 98

106 Table 7. Childhood Results in Education Key Budget Allocations Millions of pesos as of 2002 Total spending in 2005 Total spending as % of government spending in 2005 Total spending in 2006 Total spending as % of government spending in 2006 Total spending in 2007 Total spending as % of government spending in 2007 Data Source Pre-school teaching Elementary teaching Lower secondary teaching Higher secondary teaching (general and technological high school) Others Enumerate , , , NA NA NA NA NA NA First State to the Nation Report 2007, page 276. Statistic Appendix, page 16 First State to the Nation Report 2007, page 276. Statistic Appendix, page 16 First State to the Nation Report 2007, page 276. Statistic Appendix, page 16 First State to the Nation Report 2007, page 276. Statistic Appendix, page 16 Note: Real expenditure. NA: No information available Graph 1.1.1a: The Population Pyramid in 2005 (Table ) 70+ Graph 1.1.1b: Population change (Table 1.1.1) Male Female Age Group % 30% 20% 10% 0 10% 20% 30% 40% Male Female Age Source: INEGI I y II Conteo de Población y Vivienda, 1995, Source: INEGI I y II Conteo de Población y Vivienda, 1995, Graph 1.1.1c: Projected population change (Table 1.1.1) Male Female Age Source: INEGI I y II Conteo de Población y Vivienda, 1995,

107 Table Estimated numbers of children affected by deprivations targeted by the MDG's Percentage of Percentage of Total number of Mexico, 2002 hholds with such children or youth girls or women of this age boys or men of this age girls or women of this age boys or men of this age girls aged 0-17 boys aged 0-17 Households girls aged 0-17 boys aged 0-17 i. ii. iii. iv. v. vi. vii. viii. ix. x. in this category not in this category in these households in the sample or national estimate A. Nutrition poor 1. Underweight children under five years of age (MDG 1 Indicator 4) ,629,027 12,233,536 11,483,349 B. Education poor 2. Enrolled in primary education (MDG 2 and 3 Indicator 6 and 9) ,617,823 17,814,041 17,198, Completing the final year of primary education in proper age (MDG 2, Indicator 7 proxy) ,049,835 12,582,482 12,079, Attending primary and secondary school in proper age (MDG 3, Indicator 9) ,782,147 16,345,095 15,791,770 C. Health poor 5. Children died under age one (MDG 4, Indicator 12) N/I N/I N/I N/I N/I N/I N/I N/I N/I N/I 6. Children died between ages one and five (MDG 4, Indicator 13 proxy) N/I N/I N/I N/I N/I N/I N/I N/I N/I N/I 7. Number of 1 year-olds immunized against measles ,220,172 4,981,002 4,352, years with comprehensive correct knowledge of HIV/AIDS (MDG Goal 7 Indicator 30) N/I N/I N/I N/I N/I N/I N/I N/I N/I N/I 9. Households and/or children with sustainable access to an improved water source (MDG Goal 7 Indicator 30) ,759,458 20,434,136 19,526, Households and/or children with access to improved sanitation (MDG Goal 7 Indicator 31) N/I: No information or Data. Enrolled in primary education define as a child that attending primary school between 5 and 14 years old.. Completing the year of primary education in proper age define as a child between years old that finished the primary school at 12 years old. Attending primary and secondary school in proper age define as a child between 6-15 years old that the difference between their age and their education + 6 is equal or less than 1 Improved water source define as children using water from an improved source. Improved sanitation define as child living with access to a toilet facility REFERENCE/SOURCE: Mexican Family Life Survey 2002 (MxFLS-1) ,759,458 20,434,136 19,526,

108 Table Females by age in household surveys Mexico, 2002 Percentage distribution of females in the survey Total Household dimension Household size Less than members members Women s education* None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion Group 1: Indigenous Group 2: Not Indigenous Work (among hholds with children) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I N/I N/I N/I N/I N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora) Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural N/I: no information or Data. Groups of ethnicity: Group 1: Indigenous. Group 2: Not Indigenous *The variable women s education contain the education from the partner or the household head when is women. REFERENCE/SOURCE: Mexican Family Life Survey

109 Table Males in the survey Mexico, 2002 Percentage distribution of males in the survey Total Household dimension Household size Less than members members Mother s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion Group 1: Indigenous Group 2: Not Indigenous Work (among hholds with children) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I N/I N/I N/I N/I N/I N/I Elder (70+) person in household High dependency ratio (4+children per adult) Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos) Region 3: Center-West (Michoacan, Jalisco, Guanajuato) Region 4: Northwest (Baja California Sur, Sinaloa, Sonora) Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural N/I: no information or Data. *The variable women s education contain the education from the partner or the household head when is women. REFERENCE/SOURCE: Mexican Family Life Survey

110 Graph 1.2.1a: Population growth (Table 1.2.1) 3.0 Argentina Millions of individuals Bolivia Brasil Chile Colombia Ecuador Guatemala Jamaica México Nicaragua Source: CepalStat, Estadísticas de América Latina y el Caribe Graph 1.2.1b: GDP per capita (Table 1.2.1) Dollars at 2000 prices Argentina Bolivia Brasil Chile Colombia Ecuador Guatemala Jamaica México Nicaragua Source: CepalStat, Estadísticas de América Latina y el Caribe Graph 1.2.1c: GDP per capita (Table 1.2.1) Growth % Argentina Bolivia Brasil Chile Colombia Ecuador Guatemala Jamaica México Nicaragua Source: CepalStat, Estadísticas de América Latina y el Caribe 103

111 Graph 1.2.1d: GDP of Mexico (Table 1.2.1) 1,400,000 1,200,000 1,000, , , , , Source: Banxico, INEGI GDP 1990=100 (millions of pesos) Graph 1.2.2: Total Fertility Rate (Table 1.2.2) Children per woman Source: CepalStat, Estadísticas de América Latina y el Caribe Argentina Bolivia Brasil Chile Colombia Ecuador Guatemala Jamaica México Nicaragua Graph 1.2.3: The structure of the economy in 2005 (Table ) Agriculture Mining, electricity, water, gas and construction Manufacturing Services Other Share (%) in total GDP Share (%) in total employment Source: Instituto Nacional de Estadística y Geografía (INEGI), Primer Informe FCH,

112 Table 1.2.4: Income inequality Country Gini index of household income/consumption Ratio between last and first decile Ratio between last and first decile Ratio between last and first decile Note: Show actual year(s) if different from indicated. REFERENCE/SOURCE: CONEVAL, Informe de Evaluacion de la Politica de Desarrollo Social en Mexico, Table 1.2.5: Introducing sub-national dimensions of development Population, 1,000s Country Change over HDI scores (or similar socioeconomic indicator) Change over States Aguascalientes 1, % % Baja California 2,845 1, % % Baja California Sur % % Campeche % % Coahuila % % Colima % % Chiapas % % Chihuahua % % Distrito Federal % % Durango % % Guanajuato % % Guerrero % % Hidalgo % % Jalisco % % Mexico % % Michoacan % % Morelos % % Nayarit % % Nuevo Leon % % Oaxaca % % Puebla % % Queretaro % % Quintana Roo % % San Luis Potosi % % Sinaloa % % Sonora % % Tabasco % % Tamaulipas % % Tlaxcala % % Veracruz % % Yucatan % % Zacatecas % % HDI is defined by three basic variables 1) life expectancy, 2) proportion of adults literate and 3) per capita income. REFERENCE/SOURCE: Esquivel Hernandez Gerardo, Lopez Calva Luis F. & Velez Grajales Roberto (2003). Crecimiento economico, desarrollo humano y desigualdad regional en Mexico Sexto Informe de Gobierno, Informe sobre Desarrollo Humano Mexico , Migracion y desarrollo humano. UNDP. 105

113 Table Total and private social expenditures Mexico Social expenditures in 2005 (millions of pesos of 2002) Total health expenditures 1,646.9 of which private 5.63 Total education expenditures 2,953.2 of which private Total primary and lower secondary education expenditures - of which private - Total water and sanitation expenditures 87.7 Of which private Note: Actual (disbursed) data presented. N/I: no information available at that desegregation level. REFERENCE/SOURCE: Sexto Informe de Gobierno Fox 2006, pagina 7. Mexican Family Life Survey (for private expenditures), N/I Graph 1.3.1a: Total public revenues and expenditures in Mexico as % of GDP (Table 1.3.1) 25.0 Graph 1.3.1b: Public revenues and expenditures in Mexico as % of GDP (Table 131) % Total public revenues Revenues from taxes on international trade Health public expediture Health currente expenditures Source: Sexto Informe de Gobierno 2006, Secretaría de Hacienda y Crédito Público Source: Sexto Informe de Gobierno 2006, Secretaría de Hacienda y Crédito Público Graph 1.3.2: Expenditures per child (pesos) (Table ) Program of the South-South East Region (and Plan Puebla Panamá) Program of the Center-West Region Program of the Northeast Region Program of the Center Region Source: Informe sobre la Situación Económica, las Finanzas Públicas y la Deuda Pública, ENIGH

114 Table 1.3.4: Financing from abroad (million pesos of 2002) Mexico Balance of payments Trade balance 1, Debt service Remittances , , , , Foreign Direct Investment 1, , , , , , , , Aid disbursed (ODA/OA) of which (millions of dollars) for general budget support N/I N/I N/I N/I N/I N/I N/I N/I for health (less HIV/AIDS) N/I N/I N/I for HIV/AIDS N/I N/I N/I N/I N/I N/I N/I N/I for education N/I N/I N/I for water and sanitation N/I N/I N/I 0.62 N/I N/I Aid allocated but not disbursed/used (ODA/OA) of which (millions of dollars) for general budget support N/I N/I N/I N/I N/I N/I N/I N/I for health (less HIV/AIDS) N/I N/I N/I N/I N/I N/I N/I N/I for HIV/AIDS N/I N/I N/I N/I N/I N/I N/I N/I for education 1.04 N/I N/I N/I N/I N/I N/I N/I for water and sanitation N/I N/I N/I N/I N/I N/I 0.96 N/I Memorandum items: GDP* (millions of pesos 1990=100) 20, , , , , , , , Total government revenue (current millions of pesos) 7, , , , , , , , Net aid allocated (ODA/OA) N/I: no information available. Note: Actual (disbursed) data. REFERENCE/SOURCE: Primer Informe de Gobierno, Anexo estadistico. Pagina 49. Banco de Mexico. BID. Banco Mundial (Basic Education Development Project in Support of the Third Phase of the Basic Education Development Program). United Nations Table Trends in income/consumption poverty since 1990 Poverty headcount among households with children 0-17 (%) by national poverty line 1 (food poverty) by national poverty line 2 (poverty of capacities) by national poverty line 3 (poverty of patrimony) by international poverty line Poverty headcount among all households (%) - by national poverty line 1 (food poverty) by national poverty line 2 (poverty of capacities) by national poverty line 3 (poverty of patrimony) by international poverty line Number of children in poverty (%) - by national poverty line 1 (food poverty) by national poverty line 2 (poverty of capacities) by national poverty line 3 (poverty of patrimony) by international poverty line National poverty line 1 (local currency) Urban 167,955.3* Rural 124,750.5* Number of households with children (million) Total number of households (million) Total number of children (million) Average household size Average household size among families with children National poverty 1 refers to the alimentation poverty threshold of the household (incapacity of acquiring a basic food basket even though all income available was used for that purpose). National poverty line 2 refers to those households that have less income per capita than the necessary for acquiring basic alimentation, health and education. National poverty line 3 refers to those households that have less income per capita than the necessary for acquiring basic alimentation, clothing, dwelling, health, education and transportation. REFERENCE/SOURCE: Encuesta Nacional de Ingresos y Gastos de los Hogares 2002,2005, CONEVAL. 107

115 Table Correlates of income/consumption poverty among households with children (most recent survey, national or international measure) Mexico, 2002 Poverty headcount rate (%) Poverty gap (income/consumption shortfall as % of poverty line) All households with children (0-17) Individual dimension Sex and age Male Age group 1 (0-14) Age group 2 (15-24) Age group 3 (25-44) Age group 4 (45-64) Age group 5 (65- ) Female Age group 1 (0-14) Age group 2 (15-24) Age group 3 (25-44) Age group 4 (45-64) Age group 5 (65- ) Household dimension Household size Less than members members Education of the head of the household None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion Group 1: Indigenous Group 2: Not Indigenous

116 (Continued from previous page) Mexico, 2002 Work (not mutually exclusive categories) Poverty headcount rate (%) Poverty gap (income/consumption shortfall as % of poverty line) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Access to land in rural areas Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos) Region 3: Center-West (Michoacan, Jalisco, Guanajuato) Region 4: Northwest (Baja California Sur, Sinaloa, Sonora) Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural National poverty line is in rural areas $ and in urban areas $ Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household The poverty gap ratio is the sum of the income gap ratios for the population below the poverty line, divided by the total population where z is the poverty line, y i is the income of individual i, q is the number of poor people and n is the size of the population REFERENCE/SOURCE: Mexican Family Life Survey 2002 Definitions and sources: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2). DHS asks also on foster status which is not available from MICS. A vulnerable child is defined as a child who lives in a household where parents have been chronically ill or adult death after a chronic illness or any adult household member has been sick for 3 of 12 months preceding the survey. Children with disability are available from the MICS for 2-9 year olds only (if Mexico has elected to have a disability module). 109

117 Table Odds ratios for the probability of income/consumption poverty by individual, household and geographic dimensions Mexico, 2002 Odds ratio of living under the poverty line among households with children among all households Individual dimension Sex and age Male Age group 1 (0-14) dropped dropped Age group 2 (15-24) [0.059]** [0.059]** Age group 3 (25-44) [0.048]** [0.048]** Age group 4 (45-64) [0.080]* [0.080]* Age group 5 (65- ) [0.137] [0.137] Female Age group 1 (0-14) dropped dropped Age group 2 (15-24) [0.052]** [0.052]** Age group 3 (25-44) [0.047]* [0.047]* Age group 4 (45-64) [0.066]** [0.066]** Age group 5 (65- ) [0.170] [0.170] Household dimension Household size Less than 3 dropped dropped 3-4 members [0.533] [0.533] 5-6 members [0.735]** [0.735]** [1.075]** [1.075]** Education of the head of the household None [0.099]** [0.099]** Primary [0.059]** [0.059]** Secondary+ dropped dropped Gender of the head of the household Male [0.048]** [0.048]** Female dropped dropped Wealth index quintiles Q1 (poorest) [0.349]** [0.349]** Q [0.219]** [0.219]** 110

118 (Continued from previous page) Q3 Q [0.164]** [0.164]** [0.098]** [0.098]** Q5 dropped dropped Ethnicity/language/religion Group 1: Indigenous dropped dropped Group 2: Not Indigenous Work (not mutually exclusive categories) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Access to land in rural areas Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) [0.033]** [0.033]** [0.026]** [0.026]** [0.156]* [0.156]* [0.941] [0.941] [0.063] [0.063] [0.078]** [0.078]** [0.026]** [0.026]** [0.186] [0.186] Single parent dropped dropped Orphan child in household N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora) [0.201]** [0.201]** [0.089]** [0.089]** [0.101]** [0.101]** [0.046]** [0.046]** [0.084]** [0.084]** [0.075]** [0.075]** Region 5: Northeast (Coahuila, Durango, Nuevo Leon) dropped dropped Residence Urban dropped dropped Rural N/I: no information or Data Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) * significant at 5%; ** significant at 1% REFERENCE/SOURCE: Mexican Family Life Survey [0.070]** [0.070]** 111

119 Table Child poverty as multiple deprivations Mexico Number of children in relevant age cohort, (estimates in 1,000s) Of which experiencing severe deprivation, % Of which experiencing less severe deprivation, % a) Incidence (prevalence) of deprivation 1. Shelter 39, Sanitation 39, Water 39, Information 34, Food 39, Education 25, Health 39, Total b) The incidence of the most frequent combinations of deprivations The most frequent case of any deprivation: Shelter 39, Two most frequent combinations Shelter & health Two second most frequent combinations Health & Information Three most frequent combinations: Shelter, Health & Information Three second most frequent combinations: Health, Information & Education The most frequent associate of food: Food & Shelter The most frequent associate of education: Education & Shelter 39, , , , , , The most frequent associate of health: Health & Shelter c) The incidence of multiple deprivations 39, Only one (any) deprivation 39, Two of any deprivations 39, Three of any deprivations 39, Four of any deprivations 39, Five of any deprivations 39, Six of any deprivations 39, Seven of any deprivations 39, Note: Severe deprivations as per original Bristol measures; less severe deprivations use standards which reflect upon those in the official MDG indicators as in italics per below. 1. Shelter Severe: Children living in a dwelling with 5 or more people per room or with no floor material (mud floor or other. Less severe: Children living in dwellings with 4 or more people per room or living in a house with no flooring (mud floor) or inadequate roofing 2. Sanitation facilities Severe: Children with no access to a toilet facility of any kind. Less severe: Children using unimproved sanitation facilities. Unimproved sanitation facilities are: pour flush latrines; covered pit latrines; open pit latrines; and buckets. 4. Information Severe: Children (aged 3-17 years) with no access to a television or internet or don t read. Less severe: Children (aged 3-17 years) and adults with no access to television or internet. 5. Food Severe: Children who are more than three standard deviations below the international reference population for stunting (height for age) or bmi for age Less severe: Children who are more than two standard deviations below the international reference population for stunting (height for age) or bmi for age. 6. Education Severe: Children (aged 7-17) of schooling age who have never been to school or who are not currently attending school. Less severe: Children (aged 7-17) of schooling age not currently attending school or who did not complete their primary education. 7. Health Severe: Children who did not receive immunization against any diseases or who did not visit to the doctor for a recent illness involving an acute respiratory infection or diarrhea. Less severe: Children who have not been immunized by two years of age. If the child has not received eight of the following vaccinations they are defined as deprived: bcg, dpt1, dpt2, dpt3, polio0, polio1, polio2, polio3, measles or who did not visit to a doctor for a recent illness involving an acute respiratory infection or diarrhea. N/I: no information or Data - REFERENCE/SOURCE: Mexican Family Life Survey

120 Table Change in the incidence/prevalence of severe deprivations over the last decade among children Mexico Number of children in relevant age cohort, (estimates in 1,000s) Of which experiencing severe deprivation, % Number of children in relevant age cohort, (estimates in 1,000s) Of which experiencing severe deprivation, % 1. Shelter 38, , Sanitation 38, , Water 38, , Information 33, , Food* N/I N/I N/I N/I 6. Education 24, , Health* N/I N/I N/I N/I Total N/A N/A N/A N/A Two severe deprivations* 38, , N/A: not applicable. N/I: no information obtained. * Note: Information is not available in the ENIGH REFERENCE/SOURCE: Encuesta Nacional de Ingresos y Gastos de los Hogares 1994, Table Percentages of severe child deprivations (by individual, households and geographic dimensions) Mexico, 2002 At least one severe deprivation (%) At least two severe deprivations (%) Total Individual dimension Sex and age Male Age group 1 (0-2) Age group 2 (3-4) Age group 3 (5-9) Age group 4 (10-14) Age group 5 (15-17) Female Age group 1 (0-2) Age group 2 (3-4) Age group 3 (5-9) Age group 4 (10-14) Age group 5 (15-17) Household dimension Household size Less than members members Women s education None

121 (Continued from previous page) Mexico, 2002 At least one severe deprivation (%) At least two severe deprivations (%) Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion Group 1: Indigenous Group 2: Not Indigenous Work (among hholds with children) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos) Region 3: Center-West (Michoacan, Jalisco, Guanajuato) Region 4: Northwest (Baja California Sur, Sinaloa, Sonora) Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural The variable women s education contain the education of the children s mother Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) N/I: no information or Data REFERENCE/SOURCE: Mexican Family Life Survey

122 Table Odds ratios for the probability that children will or will not experience deprivations Mexico, 2002 Odds ratio of children having not even less severe deprivations at least two severe deprivations Total (average) Individual dimension Sex and age Male Age group 1 (0-2) [0.142] [0.081]** Age group 2 (3-4) [0.165] [0.102]* Age group 3 (5-9) [0.128] [0.063]** Age group (10-14) [0.150] [0.062]** Age group 5(15-17) dropped dropped Female Age group 1 (0-2) [0.206] [0.086]** Age group 2 (3-4) [0.159] [0.081]** Age group 3 (5-9) [0.122] [0.060]** Age group (10-14) [0.153] [0.071]** Age group 5(15-17) dropped dropped Household dimension Household size Less than 3 dropped dropped 3-4 members [0.249] [1.074] 5-6 members [0.249] [3.068] Women s education [0.156]* [3.836] None [0.102]** [0.170]** Primary dropped dropped Secondary Gender of the head of the household [0.140]** [0.040]** Male [0.127] [0.092] Female dropped dropped Wealth index quintiles Q1 (poorest) [0.033]** [0.445]** 115

123 (Continued from previous page) Q [0.038]** [0.353]** Q [0.053]** [0.198]** Q [0.073]** [0.144] Q5 dropped dropped Ethnicity/language/religion Group 1: Indigenous [0.089]** [0.138]** Group 2: Not Indigenous dropped dropped Work (among hholds with children) Both parents working [0.078] [0.076] None of the parents are working [0.165]* [0.263] No adult in primary working age (18-54) dropped dropped At least one child under 15 working Illness and disability in the household [0.116] [0.130]** Adult(s) with chronic illness [0.079]* [0.051]** Child/children with disability Family vulnerability (not mutually exclusive categories) [0.244] [0.342] Single parent dropped dropped Orphan child in household N/I N/I High dependency ratio (4+children per adult) [0.166] [0.271]** Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). [0.130] [0.112] [0.070]** [0.371]** [0.080]* [0.162]** [0.089] [0.175]** [0.067]** [0.151]* Region 5: Northeast (Coahuila, Durango, Nuevo Leon) dropped dropped Residence Urban [0.199]** [0.025]** Rural dropped dropped The variable women s education contain the education of the children s mother Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) N/I: no information or Data0 REFERENCE/SOURCE: Mexican Family Life Survey

124 Table Percentage of prevalence of seven severe deprivations by region and residence Region Mexico Shelter Sanitation Water Information Food Education Health Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural REFERENCE/SOURCE: Mexican Family Life Survey

125 Table Correlation between different indicators for child poverty/disparity Mexico Household income (1.08$ a day per person in ppps) Bottom asset quintile (Q1) Two deprivations First four deprivations Last three deprivations (Sh, S, W, I) (F,E, H) Shelter Sanitation Water Information Food Education Health Hh. inc [0.008]*** [0.008]*** [0.001]*** [0.001]*** [0.008]*** [0.005]*** [0.006]*** [0.007]*** [0.003]*** [0.008] [0.009] Asset Q [0.009]*** [0.009]*** [0.001]*** [0.001] [0.009]*** [0.006]*** [0.006]*** [0.007]*** [0.004]*** [0.009]*** [0.009]** Two depr [0.008]*** [0.008]*** [0.001]*** [0.001]*** [0.007]*** [0.005]*** [0.005]*** [0.006]*** [0.003]*** [0.008]*** [0.008]*** First four [0.068]*** [0.068]*** [0.068]*** [0.007]*** [0.071]*** [0.041]*** [0.046]*** [0.052]*** [0.025] [0.066]*** [0.069]*** Last three [0.122]*** [0.119] [0.124]*** [0.015]*** [0.126]*** [0.073]*** [0.084] [0.095]*** [0.042]*** [0.096]*** [0.123]*** Shelter [0.008]*** [0.008]*** [0.007]*** [0.001]*** [0.001]*** [0.005]*** [0.005]*** [0.007]*** [0.003]*** [0.008]*** [0.008]*** Sanitation [0.014]*** [0.013]*** [0.012]*** [0.002]*** [0.001]*** [0.014]*** [0.009]*** [0.011]*** [0.005]*** [0.014]*** [0.014]*** Water [0.012]*** [0.012]*** [0.011]*** [0.002]*** [0.001] [0.013]*** [0.008]*** [0.010]*** [0.005]*** [0.012]*** [0.013]*** Inform [0.012]*** [0.011]*** [0.010]*** [0.002]*** [0.001]*** [0.012]*** [0.007]*** [0.008]*** [0.004]*** [0.011]*** [0.012]*** Food [0.021]*** [0.021]*** [0.021]*** [0.003] [0.002]*** [0.022]*** [0.013]*** [0.014]*** [0.019]*** [0.023]*** [0.022]*** Education [0.013] [0.013]*** [0.013]*** [0.002]*** [0.001]*** [0.014]*** [0.008]*** [0.009]*** [0.010]*** [0.005]*** [0.013] Health [0.008] [0.008]** [0.008]*** [0.001]*** [0.001]*** [0.009]*** [0.005]*** [0.006]*** [0.007]*** [0.003]*** [0.008] Correlation is significant at 10% level (*), 5% level **, or 1% level***. Correlation obtain with OLS regressions REFERENCE/SOURCE: Mexican Family Life Survey

126 Table Combined child poverty incidence Mexico, 2002 Who live in households under the 1$ day/person ppp-s threshold % of children in relevant category who are experiencing severe deprivation of human need who are experiencing less severe deprivation of human need while their households live above the 1$ day/person ppp-s threshold All children (0-17) Individual dimension Sex and age Male Age group 1 (0-2) Age group 2 (3-4) Age group 3 (5-9) Age group 4 (10-14) Age group 5 (15-17) Female Age group 1 (0-2) Age group 2 (3-4) Age group 3 (5-9) Age group 4 (10-14) Age group 5 (15-17) Household dimension Household size Less than members members Women s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion 119

127 (Continued from previous page) Mexico, 2002 Who live in households under the 1$ day/person ppp-s threshold % of children in relevant category who are experiencing severe deprivation of human need who are experiencing less severe deprivation of human need while their households live above the 1$ day/person ppp-s threshold Group Group Work (among hholds with children) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region Region Region Region Region Residence Urban Rural N/I: Not information or Data. N/A: Not Applicable The sub-national regions are: region 1: South-Southeast (Oaxaca, Veracruz, Yucatan). Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-Western (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Groups of ethnicity: Group 1: Indigenous. Group 2: Not Indigenous Exchange rate using at second quarter of $9.25 National poverty line is in rural areas $ and in urban areas $ Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household See definition for severe and less severe under Table Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) REFERENCE/SOURCE: Mexican Family Life Survey

128 Table Children in public care or adopted Mexico Total number adoptions N/I N/I N/I 3101 N/I: No information obtained. REFERENCE/SOURCE: Sistema Nacional para el Desarrollo Integral de la Familia, 2008 Table Change in U5MR by wealth quintile and gender Mexico Total Total Total Total Total Total U5MR REFERENCE/SOURCE: CONAPO Alternative of Table Proportion of infant deaths by decile 2000 Decile Infant deaths (%) REFERENCE/SOURCE: Scott, J. 2006, Desigualdad de la Salud y de la Atencion de la Salud en Mexico, Serie de Documentos de Trabajo 4, Innovacion en el Financiamiento de la Salud, Funsalud-INSP. 121

129 Table Under 5 and infant mortality rates and their correlates Mexico 2006 Infant mortality rate Under 5 mortality rate Total (2007) Individual dimension Sex and age Male Age group 1 N/I N/I Age group 2 N/I N/I Age group 3 N/I N/I Age group 4 N/I N/I Age group 5 N/I N/I Female Age group 1 N/I N/I Age group 2 N/I N/I Age group 3 N/I N/I Age group 4 N/I N/I Age group 5 N/I N/I Household dimension Household size N/I N/I Less than 3 N/I N/I 3-4 members N/I N/I 5-6 members N/I N/I 7+ N/I N/I Women s education* None N/I N/I Primary N/I N/I Secondary+ N/I N/I Gender of the head of the household Male N/I N/I Female N/I N/I Wealth index quintiles N/I N/I Q1 (poorest) N/I N/I Q2 N/I N/I Q3 N/I N/I Q4 N/I N/I Q5 N/I N/I Ethnicity/language/religion Group 1 N/I N/I Group 2 N/I N/I Group 3 N/I N/I 122

130 (Continued from previous page) Work (among hholds with children) N/I N/I Both parents working N/I N/I None of the parents are working N/I N/I No adult in primary working age (18-54) N/I N/I At least one child under 15 working N/I N/I Illness and disability in the household N/I N/I Adult(s) with chronic illness N/I N/I Child/children with disability N/I N/I Family vulnerability (not mutually exclusive categories) N/I N/I Single parent N/I N/I Orphan child in household N/I N/I High dependency ratio (4+children per adult) N/I N/I Elder (70+) person in household N/I N/I Geographic dimension Region Northeast Northwest Center Center West South and South East Residence N/I N/I Urban N/I N/I Rural N/I N/I N/I: no information available. Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz. Mortality rate according to mother s education cannot be constructed because information regarding the education of the mother according to the number of deaths of children younger than one year old is not available. REFERENCE/SOURCE: Total infant mortality rate and under five mortality rate come from CONAPO Infant mortality rate and under five mortality rate according to gender and to region come from Situacion de Salud en Mexico 2006, Indicadores Basicos, Secretaria de Salud Table 2.2.3: Relationship between U5MR and income/consumption poverty at sub-national level Mexico 2005 U5MR (Table 24.a) Number of people under the hhold income/consumption poverty threshold Proportion Northeast ,313, Northwest , Center ,499, Center West ,766, South and South East ,170, Note: Poverty Threshold refers to alimentation poverty Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz. REFERENCE/SOURCE: Encuesta Nacional de Ingresos y Gastos de los Hogares 2005, Situacion de Salud en Mexico 2005, Indicadores Basicos, Secretaria de Salud 123

131 Table Child nutrition outcome and its correlates (by individual, households and geographic dimensions in 2005 or most recent year) Mexico Stunting Wasting Underweight Total incidence/prevalence Individual dimension Sex and age Male Age group 1 (0) Age group 2 (1) Age group 3 (2) Age group 4 (3) Age group 5 (4-5) Female Age group 1 (0) Age group 2 (1) Age group 3 (2) Age group 4 (3) Age group 5 (4-5) Household dimension Household size Less than members members Women s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion Group 1: Indigenous Group 2: not indigenous Work (among hholds with children) 124

132 (Continued from previous page) Mexico Stunting Wasting Underweight Total incidence/prevalence Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region Region Region Region Region Residence Urban Rural The sub-national regions are: region 1: South-Southeast (Oaxaca, Veracruz, Yucatan). Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household Stunting define as children who are under -2sd and -3sd from height for age wasting define as children who are under -2sd and -3sd from weight for height underweight define as children who are under -2sd and -3sd from weight for age Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) REFERENCE/SOURCE: Mexican Family Life Survey

133 Table B Health indicators for children age five or less, by region Stunting North 7.0% 5.0% Center 11.0% 5.5% Mexico City 12.0% 4.9% South 18.0% 5.4% National 12.7% 5.40% Source: National Survey of Health and Nutrition (ENSANUT 2006) Overweight Table C Age Health indicators for children between 5 and 11 years old in 2006 Stunting Overweight Obesity Men Women Men Women Men Women Total Table Child nutrition: supply side and uptake variables by region Source: National Survey of Health and Nutrition (ENSANUT 2006) Number of children in nutritional control with Oportunidades per thousand children with malnutrition between 1-4 years old 2006 Total Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 605 By region Region 1: Northeast Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 319 Region 2: Northwest Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 163 Region 3: Center Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 529 Region 4: Center-West Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 608 Region 5: South-Southeast Major nutrition supply indicator* - supply/delivery indicator* (e.g. unit number/per capita) 825 N/A: not applicable because Oportunidades did not exist in those years. N/I: no information obtained Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz. Source: Primer Informe de Gobierno 2007 Note: Table has not been created for every year because information regarding the number of children that have malnutrition in 1995, 2000 and 2005 has not been obtained yet. *Here countries will need to propose/select some context-specific direct interventions e.g. - Community based nutrition and health services (growth promotion, supplementary feeding) - Breastfeeding counseling - Facility-based nutrition services (treatment of severe malnutrition, antenatal care) - Micronutrient supplementation and fortification - Targeted food aid - IEC/nutrition education/behavior change programmes - Advocacy on nutrition - Women s nutrition interventions - Nutritional surveillance This table might be constructed by using nutritional indicators from Oportunidades program for each state of Mexico. Information is still being gathered REFERENCE/SOURCE: Base de datos de Oportunidades, Encuesta Nacional de Salud y Nutricion (ENSANUT 2006) 126

134 Table Young child health outcomes, related care and correlates (by individual, households and geographic dimensions) Mexico, 2002 Child diarrhea* % children aged 0-4 % Received ORT or increased fluids, and continued feeding (MICS Indicator No. 35) Child fever** %children aged 0-4 % Antibiotic treatment of suspected pneumonia (MICS Indicator No 22) Total incidence Individual dimension Sex and age Male Age group 1 (0) Age group 2 (1) Age group 3 (2) Age group 4 (3) Age group 5 (4) Female Age group 1 (0) Age group 2 (1) Age group 3 (2) Age group 4 (3) Age group 5 (4) Household dimension Household size Less than members members Women s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion Group 1: Indigenous

135 (Continued from previous page) Mexico, 2002 Child diarrhea* % children aged 0-4 % Received ORT or increased fluids, and continued feeding (MICS Indicator No. 35) Child fever** %children aged 0-4 % Antibiotic treatment of suspected pneumonia (MICS Indicator No 22) Group 2: Not Indigenous Work (among hholds with children) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household N/I N/I N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural Notes: N/I: Not information or Data N/A: Not Applicable * Child had diarrhea in the last 4 weeks ** Child had fever in the last 4 weeks Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) Note: The values in column 3rd & 6th are the children that visited to the doctor & received some medications. REFERENCE/SOURCE: Mexican Family Life Survey

136 Table Adolescent health outcomes, care and correlates (by individual, households and geographic dimensions) Mexico, 2005 Currently uses any contraceptive method Comprehensive knowledge about any contraceptive method Comprehensive knowledge about any Sexual Transmission Disease (STDs) Comprehensive knowledge about contraceptive methods that prevent STDs Total incidence 64.2% 91.2% 86.9% 73.4% Individual dimension Sex and age Male 69.9% 97.2% 91.1% 74.7% Age group 1: years old 55.1% 99.6% 65.4% 97.6% Age group 2: years old 70.4% 87.8% 87.0% 98.6% Age group 3: years old 66.2% 97.6% 92.9% 98.5% Age group 4: years old 65.0% 96.3% 88.5% 97.7% Female 55.4% 83.4% 83.2% 72.3% Age group % 53.0% 69.0% 98.3% Age group % 74.1% 80.7% 98.2% Age group % 91.5% 87.2% 96.7% Age group % 92.7% 88.4% 97.8% Household dimension Household size Less than % 66.2% 66.8% 61.3% 3-4 members 68.1% 92.9% 90.6% 76.8% 5-6 members 70.4% 97.1% 95.9% 79.4% % 98.4% 71.0% 60.0% Women s education None 35.6% 4.4% 3.3% 0.4% Primary 41.0% 82.9% 73.6% 15.6% Secondary+ 68.3% 97.0% 89.8% 31.3% Gender of the head of the household Male 85.1% 77.2% 75.5% 75.5% Female 14.9% 22.8% 24.5% 24.5% Socio-economic level Medium-high 78.2% 96.6% 75.5% 75.9% Medium 62.0% 94.0% 92.7% 90.6% Medium-low 71.9% 95.9% 92.1% 89.1% Low 47.6% 80.6% 76.4% 75.4% Very low 41.9% 89.4% 92.9% 90.4% Geographic dimension Region Region 1: Northeast 58.3% 95.8% 91.5% 70.9% Region 2: Northwest 77.3% 77.4% 86.1% 69.0% Region 3: Center 63.2% 90.5% 83.8% 71.6% Region 4: Center-West 73.4% 94.2% 88.6% 81.3% Region 5: South-Southeast 50.1% 90.5% 88.7% 69.5% Residence Urban 64.4% 92.6% 87.3% 74.0% Semi-urban 61.0% 74.0% 77.0% 63.3% Rural 83.6% 100.0% 97.3% 84.9% REFERENCE/SOURCE: Encuesta Nacional de la Juventud 2005 Note: Weighted results 129

137 Alternative of Table Adolescent health outcomes, care and correlates (by individual, households and geographic dimensions in 2005 or most recent year) Mexico New detected cases of HIV among individuals from 25 to 44 years old Year Total Men Women ,719 3, ,533 4, ,510 7,006 1, ,357 6,823 1, ,172 6,626 1, ,513 7,107 1, ,439 7,045 1, ,255 6,891 1, ,969 6,598 1, ,592 6,287 1,305 REFERENCE/SOURCE: Primer Informe de Gobierno Table Child and youth health: supply side and uptake variables by region Major health supply indicator: Number of doctors per 1,000 habitants Total number of doctors per 1,000 habitants By region Region 1: Northeast - number of doctors per 1,000 habitants Region 2: Northwest - number of doctors per 1,000 habitants Region 3: Center - number of doctors per 1,000 habitants Region 4: Central West - number of doctors per 1,000 habitants Region 5: South-South East - number of doctors per 1,000 habitants Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz. Source: Primer Informe de Gobierno

138 Table Birth registration and its correlates (individual, HH and geog. Dimensions) Mexico, 2005 % of children registered late/total number of children registered in 2005 Of which: due to high cost, travel or not want to pay late fee Number children aged 0-59 months (2002) Total incidence/prevalence N/I 9,766,615 Individual dimension Sex and age Male N/I 4,841,875 Female N/I 4,924,740 Household dimension Household size Less than 3 N/I N/I 68, members N/I N/I 3,448, members N/I N/I 3,541, N/I N/I 2,708,280 Women s education None ,863 Incomplete primary ,032,884 Complete primary ,032,884 Secondary N/I 4,847,723 High school N/I 4,847,723 Professional N/I 4,847,723 Gender of the head of the household Male N/I N/I 8,307,530 Female N/I N/I 1,459,085 Wealth index quintiles Q1 (poorest) N/I N/I 2,550,762 Q2 N/I N/I 2,222,020 Q3 N/I N/I 1,793,050 Q4 N/I N/I 1,488,218 Q5 N/I N/I 1,186,788 Ethnicity/language/religion Group 1 N/I N/I 1,634,030 Group 2 N/I N/I 8,132,585 Work (among hholds with children) Both parents working N/I N/I 1,661,783 None of the parents are working N/I N/I 100,077 No adult in primary working age (18-54) N/I N/I 23,887 At least one child under 15 working N/I N/I 447,509 Illness and disability in the household Adult(s) with chronic illness N/I N/I 3,715,

139 (Continued from previous page) Mexico, 2005 % of children registered late/total number of children registered in 2005 Of which: due to high cost, travel or not want to pay late fee Number children aged 0-59 months (2002) Child/children with disability N/I N/I 93,908 Family vulnerability (not mutually exclusive categories) Single parent N/I N/I 1,459,085 Orphan child in household N/I N/I N/I High dependency ratio (4+children per adult) N/I N/I 261,825 Elder (70+) person in household 558,990 Geographic dimension Region Region 1: Northeast N/I 1,311,618 Region 2: Northwest N/I 684,496 Region 3: Center N/I 3,189,840 Region 4: Center-West ,309,960 Region 5: South-Southeast ,270,701 Residence Urban N/I N/I 7,276,842 Rural N/I N/I 2,489,773 Note: due to the lack of information regarding the number of children whose birth is not registered, this table displays information about the number of children that were registered late (from one to eight years late) according to the total number of children registered. Countries could add further rows on sub-national regions and ethnic/language/religion groups. A somewhat different version of this table is included in the MICS Guide tabulations (Table CP.1) which could be used alternatively here. The breakdowns are for a standard table on child outcome correlates. Not all categories will be applicable for all outcome measures from all types of surveys. For example, data on age and gender may not be applicable to IMR and U5MR from MICS. Age groups will change according to outcome or process measure (e.g. malnutrition to children under 5 (0-3 months, 4-6 months, 7-12 months, months, 24 months-35 months, 36 months+) and national legislation (e.g. on school attendance, use relevant ages for primary and secondary schooling). Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) N/I: No information available REFERENCE/SOURCE: INEGI, Mexican Family Life Survey

140 Table Orphanhood, child vulnerability and their correlates (by individual, households and geographic dimensions) Mexico % Vulnerable children of which: one or both parents dead (orphans) Number of children aged 0-17 years Total incidence/prevalence N/I 39,961,034 Individual dimension Sex and age Male N/I 19,526,898 Age group 1(0-2) N/I 2,949,916 Age group 2(3-4) N/I 2,001,231 Age group 3(5-9) N/I 5,610,310 Age group 4(10-14) N/I 5,893,468 Age group 5(15-17) N/I 3,071,973 Female N/I 20,434,136 Age group 1(0-2) N/I 2,929,701 Age group 2(3-4) N/I 2,078,426 Age group 3(5-9) N/I 5,842,239 Age group 4(10-14) N/I 6,233,066 Age group 5(15-17) N/I 3,350,704 Household dimension Household size Less than N/I 471, members N/I 11,753, members N/I 15,958, N/I 11,776,966 Women s education None N/I 3,768,184 Primary N/I 17,808,063 Secondary N/I 15,666,506 Gender of the head of the household Male N/I 33,299,187 Female N/I 6,661,847 Wealth index quintiles Q1 (poorest) N/I 9,186,066 Q N/I 8,137,545 Q N/I 7,332,664 Q N/I 6,528,072 Q N/I 6,221,163 Ethnicity/language/religion Group 1: Indigenous N/I 7,336,662 Group 2: Not Indigenous N/I 32,624,

141 (Continued from previous page) Mexico % Vulnerable children of which: one or both parents dead (orphans) Number of children aged 0-17 years Work (among hholds with children) Both parents working N/I 7,982,113 None of the parents are working N/I 625,325 No adult in primary working age (18-54) N/I 386,418 At least one child under 15 working N/I 3,350,766 Illness and disability in the household Adult(s) with chronic illness N/I 16,490,875 Child/children with disability 6.47 N/I 1,532,442 Family vulnerability (not mutually exclusive categories) Single parent N/I 6,661,847 Orphan or fostered child in household N/I N/I High dependency ratio (4+children per adult) N/I 1,340,274 Elder (70+) person in household N/I 2,702,967 Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) N/I 9,503,953 Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos) N/I 12,672,714 Region 3: Center-West (Michoacan, Jalisco, Guanajuato) N/I 9,614,657 Region 4: Northwest (Baja California Sur, Sinaloa, Sonora) N/I 2,983,797 Region 5: Northeast (Coahuila, Durango, Nuevo Leon) N/I 5,185,913 Residence Urban N/I 28,836,014 Rural N/I 11,125,020 Notes: N/I: Not information or Data N/A: Not Applicable Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) Vulnerable child is define as a child who lives in a household where parents or some adult has a chronic disease Chronic disease is defined as diabetes, hypertension, heart disease, cancer, rheumatism, gastric ulcer or migraine. REFERENCE/SOURCE: Mexican Family Life Survey

142 Table Child labor and its correlates (by individual, households and geographic dimensions) Mexico, 2002 Total child labor (MICS indicator 71, children aged 5-14 years) of which: paid work outside the household Number of children aged 5-14 years Total incidence/prevalence ,579,083 Individual dimension Sex and age Male ,503,778 Age group 1(5-6) ,196,779 Age group 2(7-8) ,278,401 Age group 3(9-10) ,306,887 Age group 4(11-12) ,379,763 Age group 5(13-14) ,341,948 Female ,075,305 Age group 1(5-6) ,189,161 Age group 2(7-8) ,362,266 Age group 3(9-10) ,601,665 Age group 4(11-12) ,516,316 Age group 5(13-14) ,405,897 School participation Yes ,659,559 No ,401,026 Household dimension Household size Less than , members ,578, members ,782, ,025,328 Women s education None ,341,498 Primary ,525,041 Secondary ,208,350 Gender of the head of the household Male ,567,822 Female ,011,261 Wealth index quintiles Q1 (poorest) ,249,195 Q ,677,688 Q ,413,742 Q ,918,714 Q ,770,

143 (Continued from previous page) Mexico, 2002 Total child labor (MICS indicator 71, children aged 5-14 years) of which: paid work outside the household Number of children aged 5-14 years Ethnicity/language/religion Group ,388,896 Group ,190,187 Work (among hholds with children) Both parents working ,027,265 None of the parents are working ,614 No adult in primary working age (18-54) ,072 At least one child under 15 working ,174,803 Illness and disability in the household Adult(s) with chronic illness ,752,604 Child/children with disability ,055 Family vulnerability (not mutually exclusive categories) Single parent ,011,261 Orphan child in household N/I N/I N/I High dependency ratio (4+children per adult) ,998 Elder (70+) person in household ,617,007 Geographic dimension Region Region ,750,350 Region ,306,115 Region ,728,871 Region ,734,862 Region ,058,885 Residence Urban ,834,768 Rural ,744,315 Notes: N/I: Not information or Data N/A: Not Applicable The sub-national regions are: region 1: South-Southeast (Oaxaca, Veracruz, Yucatan). Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Groups of ethnicity: Group 1: Indigenous. Group 2: Not Indigenous Exchange rate using at day October 14th. $12.00 National poverty line is in rural areas $ and in urban areas $ Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household REFERENCE/SOURCE: Mexican Family Life Survey

144 Table Early marriage and its correlates (by individual, household and geographic dimensions) Mexico, 2002 Percentage of women aged married before age 15 Percentage of women aged married before age 18 Number of women aged Total incidence/prevalence ,529,952 Individual dimension Sex and age Male Age group 1 N/A N/A N/A Age group 2 N/A N/A N/A Age group 3 N/A N/A N/A Age group 4 N/A N/A N/A Age group 5 N/A N/A N/A Female Age group 1(15-20) ,573,528 Age group 2(21-25) ,947,756 Age group 3(26-30) ,469,577 Age group 4(31-40) ,343,479 Age group 5(41 +) ,195,612 Household dimension Household size Less than ,652, members ,487, members ,442, ,948,466 Women s education None ,967,909 Primary ,643,228 Secondary ,176,438 Gender of the head of the household Male ,095,546 Female ,434,406 Wealth index quintiles Q1 (poorest) ,446,582 Q ,975,966 Q ,635,969 Q ,763,976 Q ,727,110 Ethnicity/language/religion Group 1: Indigenous ,178,127 Group 2: Not Indigenous ,351,

145 (Continued from previous page) Mexico, 2002 Percentage of women aged married before age 15 Percentage of women aged married before age 18 Number of women aged Work (among hholds with children) Both parents working ,482 None of the parents are working ,235 No adult in primary working age (18-54) ,919 At least one child under 15 working ,497,867 Illness and disability in the household Adult(s) with chronic illness ,514,757 Child/children with disability ,855 Family vulnerability (not mutually exclusive categories) Single parent ,434,406 Orphan child in household N/I N/I N/I High dependency ratio (4+children per adult) ,492 Elder (70+) person in household ,153,280 Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) ,111, ,162, ,180, ,310, ,765,312 Residence Urban ,338,483 Rural ,191,469 Notes: N/I: Not information or Data N/A: Not Applicable Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household REFERENCE/SOURCE: Mexican Family Life Survey

146 Table Child protection: supply side and uptake variables by region 2007 Number of trials for adoptions Number of trials for adoptions due to a sentence Total - number of trials By region Region 1: Northeast - number of trials Region 2: Northwest - number of trials Region 3: Center - number of trials Region 4: Center-West - number of trials Region 5: South-Southeast - number of trials Urban - number of trials N/I N/I Rural - number of trials N/I N/I Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Ro, Tabasco, Guerrero and Veracruz. Source: DIF, 2008 Alternative of Table Child protection: Number of shelters for children and teenager migrants unaccompanied (2007) State Municipality Number of shelters Number of Modules Baja California Tijuana 2 1 Mexicali 1 1 Sonora San Luis Rio Colorado 0 1 Nogales 1 1 Aguaprieta 1 1 Chihuahua Ojinaga 1 0 Ciudad Juarez 4 1 Coahuila Cd. Acuña 1 1 Piedras Negras 0 1 Nuevo Leon Monterrey 1 0 Tamaulipas Nuevo Laredo 1 1 Reynosa 1 1 Matamoros 1 1 Chiapas Tapachula 1 1 Tabasco Tenosique 0 1 Veracruz Acayucan 0 1 Source: Sistema Nacional para el Desarrollo Integral de la Familia 139

147 Table School attendance and correlates (by individual, households and geographic dimensions) Mexico, 2002 Net primary school attendance rate* (MICS Indicator No. 55) Total Individual dimension Sex and age Male Age group Age group Age group Age group Age group Female Age group Age group Age group Age group Age group Household dimension Household size Less than members members Women s education None Primary Secondary Gender of the head of the household Male Female Wealth index quintiles Q1 (poorest) Q Q Q Q Ethnicity/language/religion* Group 1: Indigenous Group 2: Not Indigenous Work (among hholds with children) Both parents working None of the parents are working No adult in primary working age (18-54) At least one child under 15 working Illness and disability in the household Adult(s) with chronic illness

148 (Continued from previous page) Mexico, 2002 Net primary school attendance rate* (MICS Indicator No. 55) Total Child/children with disability Family vulnerability (not mutually exclusive categories) Single parent Orphan child in household High dependency ratio (4+children per adult) Elder (70+) person in household Geographic dimension Region Region 1: South-Southeast (Oaxaca, Veracruz, Yucatan) Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos) Region 3: Center-West (Michoacan, Jalisco, Guanajuato) Region 4: Northwest (Baja California Sur, Sinaloa, Sonora) Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Residence Urban Rural * Net primary school attendance rate define as children between 6 to 15 years that attending the school Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household Definitions: Orphan children are considered those for whom one or both biological parents are dead (MICS HL9=2 or HL11=2) REFERENCE/SOURCE: Mexican Family Life Survey

149 Table D Individuals between 6 and 14 years old by age group and expenses per capita Age group and Expense per capita group Years of schooling MXFLS-1 (ENNViH) % that repeated a school year Cognitive test % Inscribed at school Group Group years old Group Group Group Group Group years old Group Group Group Group Group years old Group Group Group Group Group years old Group Group Group Group Group TOTAL Group Group Group Cognitive test is based on Ravens matrix. La prueba estandarizada fue hecha con respecto a la media de la poblacion. Source: Mexican Family Life Survey (MXFLS-1) 142

150 Table E Age group and Expense per capita group 6 7 years old 8 9 years old years old years old TOTAL Information about the school were children between 6 and 14 years old assist to. School School Proportion of School School School has has has computers has clean has a computers electricity toilets per student floors library Proportion of books per student # classrooms Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Group Source: Mexican Family Life Survey (MXFLS-1) Table Child education: supply side and uptake variables by region Major child education indicator: number of teachers per 1,000 students Total - number of teachers per 1,000 students By region Region 1: Northeast - number of teachers per 1,000 students Region 2: Northwest - number of teachers per 1,000 students Region 3: Center - number of teachers per 1,000 students Region 4: Center-West - number of teachers per 1,000 students Region 5: South-Southeast - number of teachers per 1,000 students Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Roo, Tabasco, Guerrero and Veracruz. Students are from every school level REFERENCE/SOURCE: Primer Informe de Gobierno

151 Table Access to social protection and its correlates by individual, households and geographic dimensions Mexico, 2002 % of respondent women covered by health insurance* (age 15 and above) % of children receiving free medical supplies (e.g. antimalarials, antibiotics, oral rehydration salts) of the total purchased and distributed - of the total in need of medication ** % of households or population covered by program Oportunidades % of households or population covered by any form of social protection (social insurance and/ or cash transfers, in-kind transfers from public authorities, employers, or charities)*** Total incidence/prevalence N/I Individual dimension Sex and age Male Age group 1(0-14) N. A. N/I Age group 2(15-24) N. A. N/I Age group 3(25-44) N. A. N/I Age group 4(45.64) N. A. N/I Age group 5(65 +) N. A. N/I Female Age group 1(0-14) N. A. N/I Age group 2(15-24) N/I Age group 3(25-44) N/I Age group 4(45.64) N/I Age group 5(65 +) N/I Household dimension Household size Less than N/I members N/I members N/I N/I Women s education None 8.81 N/I Primary N/I Secondary N/I Gender of the head of the household Male N/I Female N/I Wealth index quintiles Q1 (poorest) N/I Q N/I Q N/I Q N/I Q N/I

152 (Continued from previous page) Mexico, 2002 % of respondent women covered by health insurance* (age 15 and above) % of children receiving free medical supplies (e.g. antimalarials, antibiotics, oral rehydration salts) of the total purchased and distributed - of the total in need of medication ** % of households or population covered by program Oportunidades % of households or population covered by any form of social protection (social insurance and/ or cash transfers, in-kind transfers from public authorities, employers, or charities)*** Ethnicity/language/religion Group N/I Group N/I Work (among hholds with children) Both parents working 8.94 N/I None of the parents are working No adult in primary working age (18-54) At least one child under 15 working 8.17 N/I N/I N/I Illness and disability in the household Adult(s) with chronic illness N/I Child/children with disability N/I Family vulnerability (not mutually exclusive categories) Single parent N/I Orphan child in household N/I N/I N/I N/I High dependency ratio (4+children per adult) Elder (70+) person in household 7.08 N/I N/I Geographic dimension Region Region N/I Region N/I Region N/I Region N/I Region N/I Residence Urban N/I Rural N/I N/I: Not information or Data. N/A: Not Applicable *Health Insurance defined as a member of the household that had any type of health insurance (IMSS, ISSSTE, PEMEX, SEDENA, SECMAR or private) **Households or population covered by any form of social protection define as a household that received Oportunidades The sub-national regions are: region 1: Region 2: Center (Distrito Federal, Mexico, Puebla, Morelos). Region 3: Center-West (Michoacan, Jalisco, Guanajuato). Region 4: Northwest (Baja California Sur, Sinaloa, Sonora). Region 5: Northeast (Coahuila, Durango, Nuevo Leon) Groups of ethnicity: Group 1: Indigenous. Group 2: Not Indigenous Wealth index quintile define as the cost of the assets that have the household Single parent define as a woman that is the head of the household REFERENCE/SOURCE: Mexican Family Life Survey

153 Table Social Protection: supply side and uptake variables by region Major Social Protection indicator: number of medical offices per potential 1,000 habitants Total number of medical offices per 1,000 habitants By region Region 1: Northeast - number of medical offices per 1,000 habitants Region 2: Northwest - number of medical offices per 1,000 habitants Region 3: Center - number of medical offices per 1,000 habitants Region 4: Center-West - number of medical offices per 1,000 habitants Region 5: South-Southeast - number of medical offices per 1,000 habitants Urban - number of medical offices per 1,000 habitants N/I N/I N/I N/I N/I N/I Rural - number of medical offices per 1,000 habitants N/I N/I N/I N/I N/I N/I Northeast region includes Tamaulipas, Nuevo Leon, Chihuahua and Durango and Coahuila; Northwest includes Baja California, Baja California Sur, Sonora and Sinaloa. Center includes Distrito Federal, Queretaro, Hidalgo, Tlaxcala, Morelos and Estado de Mexico. Center West includes Jalisco, Michoacan, Colima, Aguascalientes, Nayarit, Zacatecas, San Luis Potosi and Guanajuato; and South-Southeast includes Puebla, Campeche, Yucatan, Chiapas, Oaxaca, Quintana Ro, Tabasco, Guerrero and Veracruz. Medical offices include those from SSA, IMSS-Oportunidades, State offices, IMSS, ISSSTE, PEMEX, SEDENA and SECMAR (it does not include private medical offices) Source: Primer Informe de Gobierno

154 Table Correlation between child outcomes and indicators of child poverty Mexico Household income (1.08$ a day per person in ppps) Bottom asset quintile (Q1) At least one deprivation (Bristol) Two deprivations First four deprivations Last three deprivations (Sh, S, W, I) (F,E, H) CHILD OUTCOME 1 (CO1) CHILD OUTCOME 2. (CO2) CHILD OUTCOME 3 (etc.) CHILD OUTCOME 4 CHILD OUTCOME 5 CHILD OUTCOME 6 Income [0.008]*** [0.010]*** [0.008]*** [0.001]*** [0.001]*** [0.008]*** [0.004]*** [0.015]*** [0.010]*** [0.004]** [0.005]** Asset Q [0.009]*** [0.010]*** [0.009]*** [0.001]*** [0.001] [0.009]*** [0.004] [0.016]*** [0.010]*** [0.004] [0.005]*** One depr [0.007]*** [0.007]*** [0.006]*** [0.001]*** [0.001]*** [0.007]*** [0.004]*** [0.014]*** [0.009]*** [0.004] [0.005]*** Two depr [0.008]*** [0.008]*** [0.009]*** [0.001]*** [0.001]*** [0.008]*** [0.004]*** [0.013]*** [0.011]*** [0.004] [0.006]*** First four [0.068]*** [0.068]*** [0.079]*** [0.068]*** [0.007]*** [0.063]*** [0.036]*** [0.084]*** [0.091] [0.033] [0.044] Last three N/A N/A N/A CO 1 Not attended school CO 2 Child Working CO 3 never attended school [0.122]*** [0.119] [0.143]*** [0.124]*** [0.015]*** [0.098]*** [0.122]*** [0.056] [0.012]*** [0.012]*** [0.013]*** [0.012]*** [0.002]*** [0.001]*** [0.010]*** [0.011]*** [0.023]** [0.003] [0.003] [0.021]*** [0.021] [0.025]*** [0.021]*** [0.003]*** [0.001]*** [0.013]*** [0.054]*** [0.287]*** [0.119] [0.152] [0.024]*** [0.024]*** [0.026]*** [0.028]*** [0.004]*** [0.007] [0.029]*** [0.029]*** [0.087] [0.000] [0.000] CO 4 stunting N/A [0.023]*** [0.024]*** [0.027]*** [0.022]*** [0.005] [0.063]** [0.001]*** [0.057] [0.006] [0.008]*** CO 5 wasting N/A CO 6 underweight [0.057]** [0.057] [0.066] [0.053] [0.014] [0.455] [0.002] [0.000] [0.037] [0.019]*** N/A [0.045]** [0.045]*** [0.052]*** [0.041]*** [0.010] [0.455] [0.002] [0.000] [0.029]*** [0.012]*** N/I: Not information or Data. N/A: Not Applicable. Correlations obtained with OLS regressions. Correlation is significant at 10% level (*), 5% level **, or 1% level***. REFERENCE/SOURCE: Mexican Family Life Survey

155 National inventory of programs 1 Concept Description Name of the Program Oportunidades (Opportunities) Objectives To support families living in extreme poverty, so that their members are able to increase their capabilities and extend their possibilities of improving their wellbeing conditions. Type of Program For the household income; conditioned cash transfers Inclusion argument The Program has shown significant impacts on : i) the children s overall size, ii) families consumption, iii) permanence of the children in the school, iv) decrease in sick days and v) child and mother mortality rates. Financing cost 2008 Budget 41,361 millions of Mexican pesos nationwide SEDESOL 20,513.2 MILLIONS OF MEXICAN PESOS (42.22% from the total) SEP SALUD 17,639 MILLIONS OF MEXICAN PESOS (50.36% from the total) 3,209 MILLIONS OF MEXICAN PESOS (7.4% from the total) Budget per State (%): Aguascalientes Baja California Baja California Sur Campeche Coahuila Colima Chiapas Chihuahua Distrito Federal Durango Guanajuato Guerrero Hidalgo Jalisco Mexico Michoacan Morelos Nayarit Nuevo Leon Oaxaca Puebla Queretaro Quintana Roo San Luis Potosi Sinaloa Sonora Tabasco Tamaulipas Tlaxcala Veracruz Yucatan Zacatecas Captured in Section A If yes: proportion to total Participating Agencies Agency s role Mechanism and Beneficiaries What is delivered? Who are the beneficiaries, who aren t? No N/A SEDESOL, SEP (Ministry of Public Education), SALUD (Ministry of Health) SEDESOL is responsible for the general coordination of the Program through Coordinacion Nacional (National Coordination), a decentralized organism of that agency. SEDESOL, SEP, SALUD and IMSS (Mexican Institute of Social Security) participate in the programs operations. SEP and SALUD, together with the IMSS, and in coordination with the state authorities, are in charge of providing adequate education and health services, personnel training, and the certification of the families co-responsibilities. On the other hand, Coordinacion Nacional is responsible for the coordination and follow up of the entire program. SALUD; SEP; IMSS; Coordinacion Nacional, as well as the public health and education services (of each State) are in charge of strengthening the development of the personnel involved in the execution of the Program, through training sessions. SEP is also responsible of integrating the budget of the Programs with the requirements for scholarships and the support to acquire or replace school supplies. Bi-monthly delivery of the following supports: -Nutritional support: $210 Mexican pesos monthly per family, plus nutritional supplements -Education: between $140 until $890 Mexican pesos monthly per youth, depending on its school grade and gender. -Energy: $55 Mexican pesos monthly per family -Senior adults: $295 Mexican pesos monthly per senior person. -Support for better living (Vivir Mejor): $120 Mexican pesos monthly per family (this was created to offset the decrease in the purchasing power of the poor people due to the increase in food prices in the international market. Valid from June to December, 2008 with the possibility of extending the support period according with the PEF 2009). -Health: Basic health package guaranteed. - Jovenes con Oportunidades (Youth with Opportunities): Up to $3,598 Mexican pesos in one installment when graduating from high school before the age of 22. The amount depends on the points that each student accumulates when finishing every school year. -The average amount per family is $655 Mexican pesos monthly. Families living in extreme poverty. 148

156 Focus Target Population Method The families are selected based on a socio-economic analysis that considers the following: 1) schooling (level of education) of the head of household, 2) household access to social security, 3) overcrowding index, 4) type of floor in the house, 5) bathroom at home, 6) demographic dependency ratio, 7) gender of the head of household, 8) number of children, 9) age of the head of household, 10) type of area (rural/urban), 11) type of region where the family lives, 12) indexes of household items ownership. In order to choose the beneficiaries, socio-economic information is gathered from potential eligible families both in urban and rural areas. Later, this information is analyzed and the beneficiary households are identified. Finally, the households are incorporated to the census for the posterior delivery of the supports. Potential disparities Coverage Geographic Number of covered people 32 States; 2,444 municipalities; 92,961 locations; Beneficiaries families per State in 2008: Aguascalientes 25,572; Baja California 16,758; Baja California Sur 11,198; Campeche 55,221; Coahuila 36,920; Colima 17,240; Chiapas 559,382; Chihuahua 60,124; Distrito Federal 18,430; Durango 73,971; Guanajuato 230,583; Guerrero 323,898; Hidalgo 198,672; Jalisco 149,754; Mexico 378,924; Michoacan 269,563; Morelos 70,570; Nayarit 45,304; Nuevo Leon 46,030; Oaxaca 406,131; Puebla 390,161; Queretaro 74,512; Quintana Roo 48,110; San Luis Potosi 192,571; Sinaloa 120,791; Sonora 60,630; Tabasco 154,544; Tamaulipas 83,692; Tlaxcala 52,347; Veracruz 584,798; Yucatan 135,651 y Zacatecas 107,948. 5,000,000 families (15 millions of beneficiaries) Quality of the coverage N/A Most vulnerable children N/A Monitoring and Evaluation Yes/No By whom Impact of the results Implementation challenges Yes. The Program is evaluated by an external organization. EVALUATION OF CONSISTENCY AND RESULTS 2007, Tecnologico de Monterrey, Center for Strategic Studies. -The Program offers the children a higher probability of enrolling in school at an earlier age -An 85% increase in the enrollment of the first year of high school in rural areas. -An increase in the possibility of attending junior high in rural areas (an increase of 42% in boys and 33% in girls) -An increase of one additional school grade in the expected schooling of young people between 15 and 18 years old, in rural areas. -An increase in preventive health clinic visits: 35% in rural areas and 20% in urban areas -In rural areas, the average sick days per families decreased (by 20% for the group from 0 to 5 equal to two days per year and by 11% for the group from 16 to 49 equal to 6 days per year) -An 11% decrease in maternal mortality and 2% in infant mortality -An increase in the overall size of children. Children under 24, 12 and 6 months of age that entered the Program before 6 months of age are, on average, 1.42 cm taller (urban areas). -Less prevalence of a small overall size in children from rural areas that are incorporated to the Program, compared with the ones that are not in the Program (a difference of 12.4%). -Higher total consumption of the families: 22% in rural areas and 16% in urban areas. Oportunidades could have important complementarities and synergies with the Social Milk Supply Program (Liconsa), in terms of nutritional support, cognitive development and learning. However, the operating rules of the Program establish that households in areas that receive nutritional support from other government programs could not be beneficiaries of this Program. Therefore, we suggest Sedesol and Liconsa to think in the convenience and possibility of changing the operating rules of the Social Milk Supply Program to eliminate the mutual exclusion with the beneficiary households from both programs. Currently, Oportunidades does not have a component or activity that could be directly linked to the quality of education to guarantee that the impact on the level of education could turn into skills that can be useful in the labor market. Therefore, the creation a complementary source of support that invests resources that could act directly on the quality of the education, is recommended: i.e., to give economic incentives to the teachers; to help the academic performance of the students with scholarships, and to support the transitions of school grades by providing financial assistance for remedial courses in reading and mathematics. 149

157 2 Concept Description Name of the Program Nursery and Children Houses Program Objectives Type of Program Inclusion argument To make available for working mothers from households with an income up to 6 minimum wages, with children between 1 and 3 years of age, to have enough time to enter the job market, to continue on it or to study. For infant protection and household income: Nursery schools The Program promotes equal opportunities in the labor market, eliminating two important types of barriers that working mothers and single parents face: insufficient number of nursery schools and children houses, and the high cost of them. Financing cost 2008 Budget 1,711 MILLIONS OF MEXICAN PESOS for 2008 (subsidies, fees and indirect expenses) Budget per State (%) Aguascalientes Baja California Baja California Sur Campeche Coahuila Colima Chiapas Chihuahua Distrito Federal Durango Guanajuato Guerrero Hidalgo Jalisco Mexico Michoacan Morelos Nayarit Nuevo Leon Oaxaca Puebla Queretaro Quintana Roo San Luis Potosi Sinaloa Sonora Tabasco Tlaxcala Veracruz Yucatan Zacatecas Captured in Section A: No If yes: proportion to total N/A Participating Agencies SEDESOL, DIF, private citizens in charge of the Services for Child Care and Attention (Servicios de Cuidado y Atencion Infantil). Agency s role Mechanism and Beneficiaries Cash Contributions. The agencies responsible of this Program are Sedesol and its Delegations, DIF National System, and the beneficiaries of this branch of the Program to Boost the Services of Child Care and Attention and Incorporation to the Child Care Centers Network, that have prepared places to offer services of child care, nutrition, and leisure activities for children between 1 to 3 years 11 months of age and in the case of disabled children they must be between 1 to 5 years 11 months of age, and are incorporated to the Child Care Centers Network. DIF National System is in charge of training the personnel of the Child Care Centers that receive support from that branch of the Program to Boost The Services of Child Care and Attention and the Incorporation to the Child Care Centers Network of this Program. In the other hand, Sedesol is in charge of verifying the existence of at least one Child Care Center in the area pointed out by the applicant, as well as the accomplishment of the eligibility criteria (principles) and requirements established in the Operating Rules of the Program, and if there is a budget available to give an answer to the applicant in a time frame of no more than 30 working days. Also, Sedesol must request DIF National System to validate the property to determinate the feasibility of it, the number of children that could be attended in it, and if needed, suggest the adjustments required to offer the service of Child Care and Attention. What is delivered? Who are the beneficiaries, who aren t? Focus Target Population -To create a Child Care Center: up to $35 thousand Mexican pesos (one time support) -To cover the expenditures of child care: up to $700 Mexican pesos per child every month Beneficiaries: working mothers and single parents Working Mothers and single parents 150

158 Method The people or group of people wishing to establish and operate a new Child Care Center for a minimum period of one calendar year could receive a maximum support of $35,000 Mexican pesos for the adaptation and equipment of the place, and also for the acquisition or elaboration of the materials needed to work with the children. Up to 20% of these resources could be used to cover the operating expenditures of the first two months, once the Child Center had been incorporated to the Child Care Centers Network. It could also be given a second and final economic support of a maximum of $20,000 Mexican pesos to those Child Care Centers supported by this Program that after having been in operation uninterruptedly for at least 12 months, want to increase their capacity to attend the target population of the Program; this could happen only if there is a high demand, a lack of infrastructure an equipment, and all the criteria (principles) and requirements established had been accomplished during the year before. They must fill out the corresponding application to obtain the support and accomplish the following requirements: i) fill out the application for support, present the official documents (official identification, the deeds of the property ). In order to obtain the support for child care, the following requirements should be accomplished: i) to have at least one child between 1 and 3 years 11 months of age and in the case of disabled children they must be between 1 to 5 years 11 months of age; ii) to be studying, working or looking for a job; iii) not having an income above 6 minimum wages per month in the household; iv) not having access to the service of nursery schools or child care through the public institutions of social security or other organisms; v) in the case of being a single parent, he or she must be the only person responsible of taking care of their children. Potential disparities N/A Coverage Geographic Number of people covered Quality of the coverage Has 8,161 Child Care Centers. 244,387 children are attended, this means that the objective for 2008 of 200,000 children had been exceeded, which had allowed to benefit 199,106 entitled ones. The objective for 2008 was exceeded. Most vulnerable children Monitoring and Evaluation There are 921 Child Care Centers caring for 1,284 disabled children. There are Child Care Centers caring for disabled children in every State. Yes/No By whom Impact of the results Yes. The Program is evaluated by an external organism. DESING EVALUATION 2007, National Institute of Public Health - The Program promotes equal opportunities in the labor market, eliminating two important types of barriers that working mothers and single parents face: insufficient number of nursery schools and children houses, and the high cost of them. - The evaluation of the impact of the Program is currently ongoing. - Preliminary results of the surveys made in June, 2008 show the following data (which aren t exclusively the result of the Program) - An average increase of 35% in the mother s income - Before enrolling in the Program, 34% of the mothers didn t have a job. From them, 85% already have one. - 27% of the beneficiaries are working for the first time. From them, 72% mentioned that they didn t work before because they didn t have a place to leave their children. Lack of coordination between State governments and Municipalities Implementation challenges -The Program shows inefficiency in the allocation of resources. This could be due to the following reasons: there are inadequate criteria to focus the target population; the possibility of a duplicity in the payment from the federal government to the holder of the right from the social security institutions that enrolls to one of the Child Care Centers of the Program; and the overlapping of the Child Care Centers in the same localities. - There is a risk that the Program could not cover marginalized rural and urban areas given to the requirements that the Child Care Centers must fulfill to be incorporated to the Child Care Centers Network. - Lack of coordination with DIF to guarantee the safety and qualified attention in child caring services, which is key for the success of the Program. -There is the risk that Child Care Centers could not be sustainable as business in the future. 151

159 3 Concept Description Name of the Program Program for the Development of Marginalized Zones (was created from the merge of the Support Program for Micro-regions and Support Program for Priority Attention Areas, PAZAP) Objectives Type of Program Inclusion argument Help reduce the disparities between regions through the strengthening of physical capital and the development of actions that allow the integration of marginal, lagged, or in poverty regions into the processes of development. For the household income Pursuit the attention in the laggards related with the basic social infrastructure and the lack of basic services for the houses. Financing cost 2008 Budget Captured in Section A If yes: proportion to total Participating agencies Agency s role Mechanism and Beneficiaries 299 MILLIONS OF MEXICAN PESOS No N/A SEDESOL SEDESOL is in charge of: i) establishing the coordination mechanisms required to guarantee that its programs and actions do not oppose, affect or present some duplicities with other programs or with actions of the federal government; ii) guarantee the best use of the resources; iii) strengthen the coverage of the actions; and v) reduce the administrative expenses. Support for the construction and actions of the following: What is delivered? a) Social and Services infrastructure: providing drinking water, sanitation works, including sewerage, drainage, storm drain system and waste water treatment plants, landfills or similar, electricity, education infrastructure; health centers o similar; infrastructure for the productivity of the community (greenhouses, silos, cattle infrastructure, among other); communication systems and community centers. b) Housing improvement: concrete floors (remove dirt floors); restroom services (bathrooms, latrines, septic tank, absorption pit, o similar); stoves above the floor, rustic stoves o something similar, reinforced walls and roofs. The maximum federal support is up to $4,500,000 Mexican pesos to build the waste water treatment plants and electricity, the rest of the programs, constructions or actions will have a maximum federal support of $2,500,000. Who are the beneficiaries, who aren t? Focus Target Population Method Households located in areas with a high level and a very high level of marginalization and municipalities included in the priority attention zones. Inhabitants of the areas defined as Priority Attention Zones in the 32 states, this means: the municipalities with a high level and a very high level of marginalization; municipalities with a highly indigenous population, areas with a high level and a very high level of marginalization located in municipalities with a medium, low and very low level of marginalization, independently of the territorial coverage, only if the proposed actions do not duplicate with the activities of the Habitat Program. The areas that fulfill the requirements of eligibility should present an investment proposal related with one of the different types of supports given by the Program or in the case of infrastructure investments, there must be a technical study or an executive project, there should also be a commitment from all the organisms involved in giving the service and a maintenance and conservation program. SEDESOL could decline the investment proposals from an organism that has failed accomplishing the commitments of maintenance and operation or that had a problem in proofing documentation. Regarding the actions for housing, all the inhabitants living in households presenting poverty conditions, social lag or marginalization could be part of the Program, independently of the territorial coverage, as long as the proposed actions do not duplicate with other Programs actions. Potential disparities N/A Coverage 152

160 Geographic Number of people covered Quality of the coverage Most vulnerable children Monitoring and Evaluation Yes/No By whom Impact of the results Implementation challenges 32 States Its objective is to attend the 125 municipalities with the highest poverty and marginalization of the country. The Program seeks to reach the highly dispersed localities Not Available Yes, the Programs is evaluated by an external organism 2008 CIDE; 2007 FAO PAZAP (Priority Attention Areas): The focus is appropriate and would allow the turnaround unbalanced processes of development in the medium term. Complementary provision of private goods (housing conditions) and public goods (package of basic infrastructure) at housing and locality level, that guarantees synergies to reach a better quality of live and opportunities for the development of the inhabitants of the localities participating in the Program. External Design Evaluation 2008 from the Support Program for Priority Attention Areas (PAZAP). CIDE, December PDL: There has been an impulse in the coordination of inter-institutional actions, from the three separate branches of the government, different sectors and overall society, to target and concentrate the efforts and resources on local development of the regions in most need from the country. Evaluation of Consistency and Results 2007, FAO, March Impact from the actions of concrete floor (Firm Floor): Replacing dirt floors with concrete floor reduces parasitic infestations by 78%, anemia by 80% and diarrhea by 49% in children less than 5 years of age. This actions have a positive effect on the cognitive development of children and teenagers (between 36% and 96% depending on the age range) Cattaneo et al, Housing, Health and Happiness;World Bank Policy Research Working Paper 4214, April households provided of concrete floor, located in any part of the country - 13,500 households provided with tap water - 13,400 households provided with bathrooms - 11,050 households provided with electricity public computer centers sanitation works 153

161 4 Concept Description Name of the Program DICONSA Food Assistance Program (In 2008 known as Food Assistance and Rural Procurement Program but in 2009 its Operation Regulations were modified) Objectives Type of Program Inclusion argument Contribute with the development of nutritional abilities granting the supply of quality basic and complementary products, in rural areas with high marginalization, that lack of sufficient and appropriate supply sources, and do not receive help from the Human Development Program Oportunidades. For childhood health, nutrition and home income. Savings transferring through the prices of main and complementary products ( savings margin), is an efficient transfer mechanism, the saving margin increased to a 6% Financing cost 2008 Budget 335 million pesos Budget of each State (%) Aguascalientes Baja California Baja California Campeche Coahuila Colima Chiapas Chihuahua Distrito Federal Durango Guanajuato Guerrero Hidalgo Jalisco Mexico Michoacan Morelos Nayarit Nuevo Leon Oaxaca Puebla Queretaro Quintana Roo San Luis Potosi Sinaloa Sonora Tabasco Tamaulipas Tlaxcala Veracruz Yucatan Zacatecas Captured in Section A If yes: proportion to total Participating agencies No N/A Diconsa S.A de C.V, SEDESOL, Diconsa Stores (committees) Agency s role Mechanism and Beneficiaries What is delivered? In the operation there is a co-responsibility system with the beneficiary communities. Each store has a Rural Procurement Committee who is responsible for the management of the store and for designating the person in charge of the same. The Rural Procurement Committees of the stores that depend of each warehouse integrate the Community Procurement Councils which participate in the operation of the warehouses through the community personnel designated by them. The groups of these organizations of communitarian participation integrate an important social organization with national coverage, which promotes direct relationships between company s employees and the representatives of the beneficiaries of the Diconsa Stores. All the families benefited are granted a bi-monthly financial support and/or in kind of $530mxp. Besides, they receive bi-monthly a financial support ( Vivir mejor ) for an amount of $240mxp. Likewise, they receive guidance and social promotion for the development of the family (training on the improvement of hygiene, health, good eating and nutritional habits, overweight and obesity prevention, access to other social programs). Additionally, the program delivers food complements to the families with children under five years of age and or lactating mothers (10 packets of Liconsa milk for each children over 2 years of age and under five, 10 packets of nutritional complements for each pregnant or lactating woman) and provides nutritional follow up, in other words, monitors the evolutions of benefits concerning nutrition in families who received food complements. Who are the Families in poverty conditions that are not considered by Oportunidades. beneficiaries, who aren t? Focus Target Population Method Families in poverty conditions according to the CONEVAL criteria who do not receive the food assistance from the Human Development Program Oportunidades The rural communities participating are selected by the Sedesol based on marginalization criteria and on the analysis of the existence of any food assistance program of Sedesol or other federal entities. In order to be eligible, the communities mustn t have any food assistance program from the Federal Government. In order to participate in this modality the families from the chosen community should be: i) located in a highly marginal area according to the CONAPO, ii) to be located in areas with a population up to 2,500 habitants, iii) to have a patrimonial poverty condition. Diconsa in coordination with Sedesol, visits the eligible communities, gathers the necessary information for the completion of the Socioeconomic Informative Statement through personal interviews with the head of the family. The members of the families interviewed will provide the information for the completion of the Socioeconomic Informative Statement. The Sub-Ministry of Research, Planning and Assessment of Sedesol will examine the socioeconomic information of the interviewed families according to the poverty criteria stated by the CONEVAL, in order to determine if the families are susceptible to receive this type of assistance. 154

162 Potential disparities Coverage Geographic Number of people covered Nation-wide In ,881 households. In ,190 households. Quality of the coverage Most vulnerable children It is by beneficiary household without making distinctions among people. Monitoring and Evaluation Yes/No Yes. The program has external evaluation EVALUATION OF CONSISTENCY AND RESULTS RURAL PROCUREMENT PROGRAM: Colegio Nacional de Economistas, AC (National College of Economists, AC) By whom 2007 EVALUATION OF CONSISTENCY AND RESULTS FOOD ASSISTANCE PROGRAM: Centro de Estudios para un Proyecto Nacional Alternativo( Research Centre for an alternative National Project.) (CEPNA) THE RURAL PROCUREMENT PROGRAM: -The beneficiary households save a 10% in their monthly expenses in basic products. -Diconsa sales increased % from December 2007 to July Till August 2008 there were 22,490 stores. Impact of the results -Diconsa launched for sale the fortified and enriched cornmeal flour Mi masa (Sedesol Diconsa brand) which provides additional proteins, minerals and vitamins to the conventional cornmeal flour. FOOD ASSISTANCE PROGRAM -Program beneficiaries obtained a final consume value 14% higher than the non beneficiaries, which was mostly food. -In average the beneficiary household members improved the quality of their diet concerning Iron, Zinc and Vitamin C. -The children ages 3 and 4 beneficiaries of the Program had an increase of 0.5 cm in size more than the non beneficiaries form the same age. RURAL PROCUREMENT PROGRAM: The program has a geographic focalization problem: - From the 22,490 stores, only 9,137 are located in targeted areas. - Only the 43% of the areas covered by the program are rural with high marginalization. - There are 11 thousand target areas that are not being covered. - It lacks of medium and long term planning, as the intervention of the program, in the covered areas, is revised annually, according to the coverage of Liconsa and Oportunidades. Implementation challenges - It will be important to register the results concerning nutrition and the efficient supply of basic and quality products. - There is a problem to establish the appropriate procedure to assess the regular potential population; the coverage strategy depends in the appropriate assessment. -The programs don t have an appropriate diagnosis to calculate the shortage of main and complementary products in communities with high marginalization. FOOD ASSISTANCE PROGRAM: -The program shows an increase in calories intake but not in physical activity, which can result in an overweight problem. 155

163 5 Concept Description Name of the Program Social Milk Supply Program (LICONSA) Objectives Type of Program Inclusion argument Contribute with the improvement of nutritional levels of households in poverty conditions, offering fortified milk at reasonable prices. For children nutrition, food supplement (milk) It has been shown that fortified milk is an efficient instrument to improve nutrition of the beneficiary children. Financing cost 2008 Budget 2,7421million of Mexican pesos. State Budget (%) Aguascalientes Baja California Baja California Sur Campeche Coahuila Colima Chiapas Chihuahua Distrito Federal Durango Guanajuato Guerrero Hidalgo Jalisco Mexico Michoacan Morelos Nayarit Nuevo Leon Oaxaca Puebla Queretaro Quintana Roo San Luis Potosi Sinaloa Sonora Tabasco Tamaulipas Tlaxcala Veracruz Yucatan Zacatecas Captured in Section A If yes: proportion to total Participating agencies No N/A Liconsa S.A de C.V., Sedesol, government agencies, and nongovernmental organizations and other institutions participating. Agency s role Mechanism and Beneficiaries What is delivered? Who are the beneficiaries, who aren t? Focus Target Population Method Distribution of fortified milk at a reasonable Price. Each beneficiary household can acquire between 4 to 24 liters a week, depending on the number of members that qualify for the assistance. Population groups of certain ages from household in poverty conditions. Are qualified to receive the aid: i) children from 6 months to 12 years of age; ii) women from 13 to 15 years; iii) pregnant or lactating women; iv) women between 45 and 59 years; v) elderly 60 years and more; vi) people with chronic diseases or physical impaired older than 12. In order to integrate the members of the household in the beneficiaries register is necessary that the head of the family submits the following documents at the sale point: i) birth certificates of the possible beneficiaries; ii) Immunizations Record for children under 5 years. iii) The Unique Code Population Register (CURP) from the head of the family or his spouse, if there is one; iv) Official Identification from the head of the family (voter registration card or military record); v) Proof of Address. In addition, pregnant or lactating women should: i) Hand in the medical certificate that states her pregnancy. ii) Present birth certificate or childbirth proof. People with a chronic disease or physically impaired should present the medical certificate which recommends milk ingestion. Potential disparities N/A Coverage Geographic Number of people covered Nation-wide 6,030,725 beneficiaries Quality of the coverage N/A Most vulnerable children N/A Monitoring and Evaluation Yes/No By whom Yes, The program has external evaluation EVALUATION OF CONSISTENCY AND RESULTS: BetaKorosi Consultores S.C 156

164 Impact of the results Implementation challenges -In 2007, the program distributed around one thousand millions litters of fortified milk in 5,006 localities of 1,810 municipalities, almost the 74 % of the municipalities in the country, of the 31 federal entities and the Federal District. -In comparison with last year, there is an increase in coverage, since 19 more municipalities were served. - Children who consumed fortified milk present lower anemia than the ones that consumed unfortified milk (10.7% vs.15.6%) - All the beneficiaries around 4.3 millions live in urban areas and 1.2 in semi urban-rural areas. By attention groups, 3.6 millions were boys and girls between six months to 12 years of age, 64.3% of the total census register; women between 13 to 15 years of age were more than 368 thousand (6.5%); 63.6 thousand (1.1%) were pregnant or lactating mothers; (7.9%) were women between 45 and 59 years of age; thousand (5.4%) were people with chronic diseases or physical impaired; as well elderly citizens (60 or more) were 843 thousand (14.9% of the beneficiaries census) -The sale price of 4 pesos for litter has been kept below the price of similar commercial milk in the market, which has allowed, the beneficiaries of the program, to save 6.26 pesos for litter. - The milk that the Program produces is appropriate to fight malnutrition. - In 2007 the coverage of the program represents 9.3% of the goal of 5,900,014 beneficiaries. - The program lacks of strategic medium and long term planning, which limits its ability to obtain the results desired concerning nutrition and development. -The program has mistakes of inclusion and exclusion. - The program lacks of strategic medium and long term coverage. - The program is centered in urban areas and not in localities with high levels of malnutrition. 157

165 6 Concept Description Name of the Program Compensatory Actions to Fight the Lag in Initial and Basic Education Objectives Type of Program Inclusion argument Contribute to the improvement of the quality of education of children and youth in vulnerable areas with access and permanency to initial not schooled education and basic education (preschool, elementary and Junior high in the modality of televised education), through Compensatory Actions such as: educational and administrative infrastructure; didactic material distribution; training and support for parents and teachers; financial assistance to Parents Associations (APF), teachers and directors, and institutional strength. For initial education not schooled and basic education (preschool, elementary and Junior High in the modality of televised education) The erratic development of the country has prevented the educational benefits from reaching the population. The situation is more serious in entities and regions with high marginalization and among more vulnerable groups. Therefore, coverage and equity is the main challenge of the National Education Program. The program started in 1994 with the purpose of improving the quality of initial education not schooled and basic education by compensatory actions in infrastructure, didactic materials, training and support for parents and teachers, as well as financial assistance to Parents Associations and for institutional strength. In the last fifteen years five Compensatory Programs have been launched in order to inverse the consequences of the educational lag in basic education in rural and native settings. Currently the compensatory actions manage initial not schooled education services and support the basic education (preschool, elementary and Junior High in the modality of televised education). Financing cost 2009 Budget Captured in Section A If yes: proportion to total Participating agencies Agency s role 3,124 Million pesos N/A N/A National Council for Education Development (CONAFE) The CONAFE is in charge of: i) establish foundations to carry out Compensatory Actions. ii) Establish communication mechanisms to promote parental participation in a permanent and organized manner at schools assisted by compensatory actions, performing activities of social involvement, with the purpose of verifying that the aid gets to the beneficiaries. iii) Management of financial resources to operate the Compensatory Actions. iv) Require the subscription to the Compensatory Actions Execution Coordination Agreement in each Federal Entity. v) Establish and implement monitoring and tracking systems that allow observing and corroborating the fulfillment of the regulation issued by the Compensatory Actions. 158

166 Mechanism and Beneficiaries What is delivered? The type of assistance to the program are: i) Goods and Services: didactic material for students, teachers, consultants, parents associations: and for educational activities en each operative chain of initial education not schooled, as well as infrastructural support, and furniture and equipment. Students from 1 st to 6 th grade of elementary school receive a basic package of school supplies for the school year. The schools also receive a package of didactic materials for the school year. ii) Training in Initial not schooled education for educational promoters, supervisors: during the training period the representatives of the community education chain, who have an Agreement with the CONAFE are provided with lodging, food and travel expenses, as well as those who render service to the program on behalf of the State Government. Each member of the State Technical Team receives monthly $554mxp for food and $800mxp for travel expenses, during one year. iii) CONAFE provides monthly financial assistance to people who participate in strengthen initial education. The enlace coordinator receives monthly $4,341mxp during 12 months, the zone inspector receives $3,341mxp, the module supervisor $2,952mxp, educational promoter $884mxp. iv) Equipment and educational infrastructure : construction or restoration of classrooms, workshops, laboratories, playgrounds, bathrooms, latrines, civic-sports areas. v) Assistance and Training for Parents Association. The preschools with 10 to 60 students receive $3,000.00mxp; from students, 4,000.00, and those with 121 students or more, $5, mxp; the unitaria and bidocente elementary schools receive $5, mxp; tridocente and tetradoente organizations $6, mxp and pentadocentes or full organization, $7,000.00mxp; and televised middle schools with 5 to 45 students receive $10,000.00mxp. from 46 to 90 students $11,000.00mxp and those with 91 students or more, $12,000.00mxp. All these aids will be received through the parents associations. vi) Incentives on performance to elementary teachers. All the teachers identified in the elementary schools selected to receive the incentive are granted a set amount of $1, during the months of the school year, including the school break. vii) Help school supervision. School supervisions that oversee the elementary schools selected integrate the Universe of Compensatory attention, they receive financial support quarterly for $2, during three quarters of the school year. Sector headquarters who serve the elementary selected schools in the Universe of Compensatory attention, receive a quarterly financial support for $1, mxp during three quarters of the school year. Who are the beneficiaries, who aren t? Focus Target Population Method Potential disparities Boys and girls in vulnerable areas with access and permanency to initial not school and basic education. Population in rural and native areas preferably, susceptible of being benefited en the following educational levels: i) initial education not schooled (mothers, fathers and persons that participate in taking care of boys and girls between 0 and 4 years of age). ii) preschool education (students, parents association, schools). iii) elementary education: students, teachers, directors, zone supervisors, chiefs of sectors, parents associations and schools) iv) middle school education: students, parents association and schools with televised middle school.) Zone coordinators, module supervisors, educational promoters and enlace coordinators should present certain documentation and comply with some requirements (as to live in the community where they teach, to have legal age, traveling availability, team work ability and communicate ideas in an oral and written manner). Once documentation has been accepted, the authority has a period of 30 calendar days to communicate the approval of the applications to the Zone Coordinator and Module Supervisor. In the case of educational promoters the response time is two months. In order to be eligible, preschools should: i) Be located in the main municipalities for the strategy 100x100 determined by the Federal Government. ii) Be a part of the schools situated in the main municipalities in the Agendas for Equity in Initial and Basic Education. iii) To be in the 50% of native-rural schools with more disadvantages. iv) To be in the 25% of the general-rural schools with more disadvantages. Elementary schools should: i) Be located in the main municipalities for the strategy 100x100 determined by the Federal Government. ii) Be a part of the schools situated in the main municipalities in the Agendas for Equity in Initial and Basic Education. iii) Be a part of native schools of the rest of the 31 states in the country. iv) To be in the 62.5% rural schools with more disadvantages. v) To be in the 12.5% of the urban schools with more disadvantages. The televised middle schools should: i) Be a part of the Middle School System in the modality of televised education registered in the 31 states of the country. N/A 159

167 Coverage Geographic Number of people covered Quality of the coverage Most vulnerable children 31 states, excepting the Federal District In 2007 the Program covered 367,986 parents concerning initial education not schooled, 409,871 children between 0 and 4 years of age; 75,342 people related with basic education support and 5,104 concerning the institutional strengthen. The program has enough coverage and has been able to reach the target population. N/I Monitoring and Evaluation Yes/No By whom Impact of the results Implementation challenges Yes 2008 EVALUATION OF CONSISTENCY AND RESULTS: Centro de Investigacion y Docencias Economicas A:C (Research and Economic Teachings Center A.C) Compensatory actions contribute to decrease the educational lag, by taking care of the first childhood and basic education services. -The program has an efficient improvement in coverage and has achieved to cover the target population. - The program has contributed to decrease the failing rates, repetition and desertion and increase the terminal efficiency of covered schools. Lacks of long term strategic planning that allows establishing goals and indicators, define strategies and develop detailed execution programs. - There is no evidence of the follow up of the suggestions generated from external evaluations. - Performance indicators lack of base guidelines. - Focalization criteria is based on information not updated (INEGI 1995 and CONAPO 1998) - The program has a limited number of indicators oriented to the measuring of results. 160

168 Name of the Program 7 Concept Description Quality Schools Program (PEC) Objectives Type of Program Inclusion argument i) Increase the quality of basic education provided by the public schools. Ii) Establish, in the beneficiaries basic public schools of PEC, a model of academic management with a strategic focus on strengthening its organizational culture and operation, oriented towards the improvement of the learning processes of the students and the quality of teaching practices that responds to diversity with fairness, based on a social participation scheme of co-financing, transparency and accountability. For the education of children: preschool, primary and secondary. Given that one of the main responsibilities of the Mexican Government is to ensure the right of receiving quality education, this Program is part of the national policies aimed at the transformation of the institutional and educative process that is seeking to overcome the different obstacles that education is facing such as : the lack of a culture of planning, the absence of external evaluations to improve their performance, the excess of administrative requirements that take time from teaches and principals, among others. Financing cost 2008 Budget Captured in Section A If yes: proportion to total Participating agencies 1,258 MILLIONS OF MEXICAN PESOS No N/A SEP (Ministry of Public Education) Agency s role Mechanism and Beneficiaries SEP and local governments (states and municipalities) are in charge of promoting responsible actions for the proper execution of the PEC in each State and they also must promote actions that change the institutional management for the benefit of the school. SEP, through the Subsecretaria de Educacion Basica y la Direccion General de Desarrollo de la Gestion e Innovacion Educativa (Sub-Ministry of Basic Education and the General Direction of Development of Educational Management and Innovation), is the organism that interprets and defines any financial or operating aspect of the program. SEP and the Ministries of Public Education or its equivalent from each state should spread the information about budget allocations and beneficiaries in accordance with the Federal Law of Transparency and Access to Public Government Information. On the other hand, the National Coordination for the Quality Schools Program and the States General Coordination of the Quality Schools Program are in charge of promoting in the mass media and in social and cultural spaces the philosophy, institutional objectives and achievements of PEC. What is delivered? Who are the beneficiaries, who aren t? The resources of PEC are in addition and complementary to the ones given by the federal, state and municipalities programs aimed to the improvement of the infrastructure and operation of the educational establishments. These resources are managed by SEP through the National Fund for Quality Schools. In order to participate in the program, the States must assure their wish and commitment to matching the resources given to them. SEP transfers the amounts corresponding to each State in proportion to its population (4 to 14 years of age); this should be in accordance with the statistical information from the II Population and Housing Counting (INEGI 2005). For each peso invested by the State Government, SEP matches three more pesos. The allocation of the resources to the schools works in the following way: i) The Technical Committee for the Quality Schools State Trust will authorize the transfer of one initial contribution to each school participating in the PEC, per school year, up to $50,000 mxp based on the socio-economic conditions established in the basic geostatistical area (AGEB) and on the educational needs of the community where the beneficiary school is. Ii) As an exception; this Committee will authorize the transfer of an initial grant up to $70,000 mxp to new schools or to those that have at least accomplished four years in the PEC and are also located in urban areas with high levels or very high levels of marginalization. Iii) The Committee could give simultaneous resources, in addition to the transfers mentioned above, up to one peso per each peso that the school can collect from the municipal contributions, parents, or donations given by social or private organizations,. These simultaneous resources can not exceed $50,000 mxp per school year per school. Basic Public Schools, including all its levels and modalities, that voluntarily decide to participate in the program and fulfill the requisites published in the official announcements per State. 161

169 Focus Target Population Method Potential disparities Coverage Geographic Number of people covered Basic Public Schools, including all its levels and modalities. Each State must present their willingness to participate in the Program. Initially, the schools that have not been participating for more than 5 years in PEC will be beneficiated. ii) For urban schools applying for the first time, an index of urban marginalization from medium to high marginalization as defined by the AGEB and established by the CONAPO (The National Population Council) and/or its counterpart at the state level, should be proven. Iii) In addition, it should be considered as a target population: a) educational places located at agricultural workers' camp sites that attend migrants students; b) schools that attend indigenous students; c) multigrade schools; d) multiple attention centers for students with special education necessities related to a disability and/or development disorders, as well as, e) community centers from the CONAFE (National Council for Educational Development); iv) For the beneficiaries schools that have been participating for five years or more, the state will define the support strategy and according with the maximum amounts of the financial resources, v) If all the possibilities mentioned above are exhausted, the rest of the different types of basic public schools could be beneficiated by the PEC. Nation-wide During the school year , the Program benefited 14,310 schools, from a target population of 35,249 schools. Quality of the coverage Most vulnerable children Monitoring and Evaluation Yes/No By whom Yes, the Program is evaluated by an external organism 2008 EVALUATION OF CONSISTENCY AND RESULTS. Centro de Investigacion y Docencias Economicas A:C (Research and Economic Teachings Center A.C) - The Program seeks to increase the quality of education and encourages an institutional and academic management that strengthens the participation of the academic centers into the decisions taking process, promotes a joint responsibility among the different social and educative players, and the students and teachers safety as well as transparency and accountability information disclosure. Impact of the results - The Program has monitored the results and followed the suggestions made by the external evaluations to improve their performance. - The fact that the schools participate in the Program, improves the ability of cooperative and participative work especially inside the Schools Technical Council, the ability to make participative auto-diagnostics in the schools; and the ability of the principals to participate with leadership. - The Program has result in a 6% decrease in desertion rates taking as a base the year 2000, compared with the schools not participating in the PEC with similar characteristics. - Attention to marginal urban schools is a wise move, since this population had not been benefited by any other educational programs. PEC could be a complement or achieve synergies with most of the programs for basic education especially with the ones focused on education equality. It is not possible to gather accurate information about the operation of the program in the schools (resources allocation, accomplishment of objectives, ) Implementation challenges There is a lack of a database that identifies the characteristics of the target population, and of an information system that offers accurate information about what is happening in the schools participating in the Program. There hasn t been any improvements related to the regulations, therefore procedures have not been simplified and the costs have not decreased It does not have an accurate specific diagnostic of the problems that the marginal urban schools face. The improvement in flunking and desertion rates is modest. 162

170 8 Concept Description Name of the Program Scholarship Program for Young Mothers and Young Pregnant Women Objectives Type of Program Inclusion argument To support teenage mothers and pregnant teenagers, regardless their civil status, so they can continue and finish their basic education in the regular school system, in an adult education school or in any other type of public education available in each State. In addition, the Program seeks to promote a higher equity and no discrimination for teenagers facing motherhood at an early age, creating or increasing their opportunities of enrollment and continuation in the programs of basic public education and therefore improving their living conditions. For the household income: scholarships for pregnant teenagers and young mothers The National Development Plan has established the importance of not only aiming for the highest coverage and expansion of the educational services but also for their equality and quality. Therefore, such importance is given to the equality of educational services and the implementation of programs attending those groups that given their vulnerable situation are in risk of dropping-out from their basic education, like the Scholarship Program for Young Mothers and Young Pregnant Women. Financing cost 2008 Budget Captured in Section A If yes: proportion to total Participating agencies 30 MILLIONS OF MEXICAN PESOS No N/A Sub-Ministry of Basic Education. the education authorities of each State, the scholarships committees of each State Agency s role Mechanism and Beneficiaries The responsibilities of the States, through their education authorities, are: i) to lead the operation of the Program in its State, according with the established operating rules, the current regulations and the agreements subscribed with SEP; ii) formalize agreements with SEP required for the operation of the Program; iii) to celebrate collaboration and/or coordination agreements for the participation of other public organisms of basic education (not schooled), like the State Institutes for Adults Education and the National Institute for Adults Education, through their states delegacies, as well as informing SEP of these agreements, v) to establish the Scholarships Committee, among other responsibilities. What is delivered? Who are the beneficiaries, who aren t? Focus Target Population Method The scholarships consist in a monthly stipend of $650 mxp during the 10 months of the school year. Teenage mothers or pregnant teenagers with just one child, between 12 and 18 years of age. Teenage mothers, regardless their civil status with just one child or that are pregnant for the first time, between 12 and 18 years of age wishing to start, restart, continue and finish their basic education, studying in the regular public system or in any type of public education available in their States. Any woman wishing to participate in the program must present documents such as: her birth certificate and her child birth certificate, a signed registration form, the grades from her last year at school and an income statement. All women presenting their registration form that meet all the requirements are considered as potential candidates. The program gives priority to the candidates from indigenous or excluded communities that have an income less that four minimum wages and that are about to finish primary school or that are starting secondary school. Besides, women must: i) be Mexican, ii) be between 12 and 18 years of age at the moment of applying for a scholarship (once the teenagers are admitted in the program, they can stay in it longer even if they surpass the age limit, if and when they finish their basic education and continue to accomplish all the requirements), iii) to have just one child or being pregnant for the first time, iv) they must not have another economic support for their studies and, v) they must be enrolled in a public education institute. The operation of the program has six general stages: i) the promotion of the program and the establishment of the Scholarship Committee by the local authorities of each State, public schools and SEP, ii) distribution and reception of the scholarship applications, iii) validation of the records, iv) selecting of the beneficiaries, v) the delivery of the information to SEP and, vi) the process of giving the scholarship. 163

171 Potential disparities N/A Coverage Geographic Number of people covered Quality of the coverage The coverage of the Scholarship Program for Young Mothers and Young Pregnant Women has a nationwide coverage; the resources will be given to the 31 States and the Federal District to the teenage mothers or pregnant teenagers. 2 thousand young women (2207) N/A Most vulnerable children N/A Monitoring and Evaluation Yes/No By whom Yes, the Program is evaluated by an external institution CONSISTENCY EVALUATION Latin American Faculty of Social Sciences (FLACSO) Impact of the results -Currently, the Program does not have mechanism for the documentation of final results. -The Program has not achieved an acceptable level of cooperation between the different levels of the government (federal, state and municipality) that participate in its design and operation. -The Program does not have a coverage strategy for the short, medium and long term. -The Program s stipends are delivered with a delay to the beneficiaries. Implementation challenges -To precise the criteria to be used for the allocation of the resources between the States in order to promote a more efficient execution of the resources. -To precise the criteria and the role that the principals of the schools play in the pre-selection of the candidates to avoid discrimination and/or favoritism. -To develop a diagnosis that allows to establish the potential demand by State and that weighs the percentage of the target population with the poverty index of abilities of each State, so this can be the base for the distribution of the resources. -To establish a budget including the operating expenses and the creation of campaigns. 164

172 9 Concept Description Name of the Program Support Program for Preschool and Primary Education for Boys and Girls from Families of Migrant Agricultural Workers (PRONIM) Objectives Type of Program Inclusion argument To promote intercultural basic education, for girls and boys from families of migrant agricultural workers through the coordination of inter-institutional efforts. In addition, the Program seeks: i) to develop and implement an integral model of basic education according to the living conditions of the infant population from families of migrant agricultural workers, ii) to design and implement a national proposal of an intercultural teaching training program involving migration concepts, iii) to establish a national system of socio-educational information of the infant population from families of migrant agricultural workers, and v) to strengthen the inter-institutional coordination mechanisms at different levels (federal, state and municipalities) that enhance politics and actions to offer a quality educational service targeted to the infant population from families of migrant agricultural workers. For infant education: preschool and primary The migratory dynamic of the agricultural workers from Mexico, about 2 millions of Mexicans (Operating Rules of the Program, 2008), including entire families, obliges the country to make an additional effort to offer this population the required guarantees for their girls and boys to access the basic education. It is estimated that about 400 thousand children in Mexico live in this situation, and only 5% of them have access to education. Financing cost 2008 Budget 11.4 MILLIONS OF MEXICAN PESOS Captured in Section A No If yes: proportion to total Participating agencies N/A Sub-Ministry of Basic Education. Local and State governments. Agency s role Mechanism and Beneficiaries The National Coordination of PRONIM and the Educational Organisms of each State, through the Sub-Ministry or Direction of Basic Education, will promote the implementation of mechanisms that contribute to the diffusion of PRONIM s actions and results, as well as mechanisms for consulting and information in order to boost transparency and accountability disclosure of information. The Ministry of Public Education will transfer the resources to those States having families of migrant agricultural workers according with the Census of the Assistance Program for the Agricultural Workers. What is delivered? Who are the beneficiaries, who aren t? Focus Target Population Method PRONIM resources are transferred to each State in just one installment. The education authority of each State opens a bank account, in which the resources are deposited, theses resources will be exclusively used for the development of PRONIM activities. The bank account is supervised by the financial area of the educational organisms of each State and by the General Direction of Development of Educational Management and Innovation of the Sub-secretariat of Basic Education. The allocation of resources for the States participating in the PRONIM is different, based on the coverage of girls and boys attended by each State and on the complement of the Human Development Index of the same State. Sons and Daughters of migrant agricultural workers. The States are the ones that get, in the first place, the federal funds of the Program, which are used to complete the expenses of operation, development, tracking, teachers training, schools counselors, technique-pedagogic advisers, supervisors with migrant school centers, and state coordinators. As well as for infrastructure and academic equipment expenses. The Ministry of Public Education transfers the resources to those States with families of migrant agricultural workers. Then, each State designs their own criteria to chose the target population according with the diagnosed information that they have, the Strategic Plan of Educational Assistance for Girls and Boys from Families of Migrant Agricultural Workers made by each State and according with the target coverage, besides the principles establish in the Operating Rules. The State benefited by PRONIM must: i) Show their willingness to participate in the program either written or via ; ii) present a Strategic Plan of Educational Assistance for Girls and Boys from Families of Migrant Agricultural Workers that includes an annual working Program according with the technical specifications that the national coordination of the Program establish with the Program coordinations from each State, and iii) subscribe a coordination agreement with the Ministry of Public Education. 165

173 Potential disparities N/A Coverage Geographic Number of people covered Quality of the coverage Coverage: Nation-wide. In 2008, the Program covered 21 States (Baja California, Baja California Sur, Chiapas, Chihuahua, Colima, Coahuila, Durango, Guerrero, Hidalgo, Jalisco, Michoacan, Morelos, Nayarit, Nuevo Leon, Oaxaca, Puebla, San Luis Potosi, Sinaloa, Sonora, Tamaulipas and Veracruz). N/I The Program seeks to ensure more equity in the quality of the educational services for boys and girls between 3 and 14 years of age, children of migrant agricultural workers. Most vulnerable children Monitoring and Evaluation This program supports boys and girls living in a vulnerable situation due to the fact, that in most of the cases, they work, and because of this they don t attend school. Besides, the ongoing migration of their families puts them under an unstable and full of risks situation. Yes/No By whom Yes, the Program is evaluated by an external institution. CONSISTENCY EVALUATION Institute for Social Investigations, UNAM -Very low enrollment rate related to the eligible population. Impact of the results -The program has not had a big effect in the overall enrollment rate. -There are very little personnel in the Coordination of the Program to promote the stipulated services. -The Program does not present jet any mechanisms for the registration of the final results. -The Program does not have a strategic plan for the medium and long term. -The coverage progress of the Program has been very slow. Implementation challenges -The extension of the Program towards preschool and secondary school education could scatter the efforts. -The Program does not have any documents that accurately determine the educational requirements of the population settled in the camp sites of the agricultural workers. -Ensure that the children from migrant agricultural workers could stop working and attend school, so they can have higher development opportunities. 166

174 10 Concept Description Name of the program Popular Insurance Objectives Type of Program Inclusion argument Offer financial protection to all Mexicans, presenting a public securing option in matter of health to families and citizens who due to their labor and socioeconomic condition are not beneficiaries of the social security institutions. To face this task implies to adopt the following specific objectives: i) reduce private pocket expense that puts at risk the impoverishment of the most vulnerable families, because of their state of health and their socioeconomic level, ii) encourage timely attention to health of Mexican families, avoiding delay and consequent aggravation of diseases due to economical reasons, iii) fortify the public system of health to reduce the breach between beneficiary families of social security and those who do not have this benefit in matter of health, and iv) contribute to the overcoming of inequalities and backdrops in the distribution of expense among the federal entities with different levels of development in matter of health. For household income and child health: supply of health services and medical insurance Population that does not enjoy any type of insurance represents an important proportion of the total population, since the housing and Population Census 2000 reports up to 57.8% of not insured population. These people is not affiliated to social security due to their labor situation and/or because their low capacity of acquisition does not allow them to pay for the IMSS familiar health insurance, or purchase a private insurance. The high costs of medical attention frequently cause families to postpone or give up the attention, and if they pay for the costs, these make the whole family face tough financial situations. Financing cost 2008 Budget 37,000 MILLIONS OF MEXICANPESOS Captured in Section A No If yes: proportion to total Participating Agencies N/A Health Ministry. Federal and State Governments. Agency s role Mechanism and Beneficiaries The Health Ministry is the instance that guarantees coherence and coordination between Popular Health Insurance and its other programs, as well as to other institutions of health sector. Furthermore, it identifies the priorities with regard to geographical areas, population groups, and available infrastructure for the execution of Popular Health Insurance and coordinates the performance of surveys and investigations necessary for their implementation. It is the Federal Government s task to formulate the strategic development plan of the Popular Health Insurance and to channel to the participating federal entities the resources to instrument the Popular Health Insurance, among other actions. What is delivered? Who are the beneficiaries, who aren t? Focus Target Population Method The Popular Insurance covers close to 255 interventions and medical services and the supply of 285 medicines associated to the services package. The coverage of services that the suppliers shall grant the beneficiaries of the Health Popular Insurance includes the majority of interventions performed in the health centers and general hospitals of the public health net of state services. Mexicans without social security Beneficiaries of Health Popular Insurance are Mexican families that have no benefits from social security in matter of health and have satisfied the affiliation requirements. In order to be selected, individuals must: i) reside within the regions of coverage of the Health Popular Insurance, ii) Not be beneficiary of social security, iii) freely choose to become affiliated, and iv) pay the appropriate affiliation fee. Potential disparities N/A Coverage Geographic Number of covered people Nation-wide In 2007 the program covered around 5 100,000 families throughout the country. 167

175 Quality of the coverage Most vulnerable children Monitoring and Evaluation The goal is that all children without social security to be covered by the Popular Insurance Yes/No By whom Yes. The program has an external evaluation CONSISTENCY EVALUATION AND RESULTS 2007: Investigacion en Salud y Demografia S.C. (Health and Demography Investigation) - The level of coverage reached is satisfactory; it is deemed that with the registered tendency 98% of the established goal will be covered by Impact of the results - When comparing results of 2007 with those of 2006, progress was seen in the performance of Activities and the delivery of the Components to the beneficiaries. - In matter of financial protection, a reduction of 2% in catastrophic expenses was reported between 2005 and The affiliates have a larger probability of use based on need perceived (62%) than those not affiliated (54%). - The Program does not formally have a strategic plan that takes into consideration the scenarios in the short, medium and long term and that includes the indicators and strategic goals. - The fulfillment of the coverage presents wide variations in each federal entity. Implementation challenges - The Program faces weaknesses and threats such as: diversity of areas responsible for the operation; the lack of information to measure the impact; the lack of strategic plans with indicators and goals with scenarios of medium and long term and an infrastructure with deficiencies and low quality. - Continue with the goal of expanding the coverage of the population that does not have social security. 168

176 11 Concept Description Name of the program Medical Insurance for a New Generation (SMNG) Objectives Type of Program Inclusion argument Promote, attend and conserve a better state of health of Mexican children under five years old, born as of December 1 of 2006, who not being beneficiaries of social security are affiliated to the System, through the free granting of high quality health care in matter of prevention, diagnosis, treatment and rehabilitation. The benefits of SMNG shall be additional top and complementary to those currently offered by the System described in the Universal Health Services Catalogue (CAUSES) and in the Fund of Protection against Catastrophic Expenses (FPGC). Furthermore, this program seeks: i) reduce incidence of diseases, damages to health and incapacities to the people among the newborns, ii) reduce mortality and neonatal, infantile and in preschool age morbidity, iii) impel healthy growth and development of the beneficiary people; iv) secure access of the targeted people to health services; v) grant a package of health actions and its medicaments and related products, that take care of the epidemiologic profile, and also to the demand of health services and needs of this sector of the people; and vi) avoid impoverishment. For Child Health: health program for children from 1-4 years old. The level of health of the Mexican people has substantially improved during the past decades as a result of a larger coverage of health services, the improvement on hygiene and sanitation, and the advance on medical technology. However, the achievements on health and the epidemiologic transition have been reached unequally throughout the country and among the several strata of income. Particularly worrisome are the backdrops in matter of health still observed on minors under 5 years. The child mortality indicators stand out, of infectious diseases and malnutrition. The prevalence of anemia on 30% of minors under one puts at risk the development of new generations (ROP of Program, 2008). It is important to highlight that the health conditions during the first years of life impact in a decisive manner and on some occasions permanently, the growth and development of the person up to advanced ages. Financing cost 2008 Budget Captured in Section A If yes: proportion to total 2,641 MILLIONS OF PESOS No N/A Participating Agencies Agency s role Mechanism and Beneficiaries Health Ministry. National Board of Health Social Protection. Under Department of Prevention and Health Promotion. IMSS and ISSSTE What is delivered? Who are the beneficiaries, who aren t? Focus Target Population Method Children affiliated to SMNG are guaranteed, during the term of validity of their rights, the right to receive services of prevention medicine, and medical attention at the first, second and third levels, without any disbursement whatsoever for the service. The components that integrate these services are: i) a prevention actions set and of attention with line of life, ii) lab and cabinet tests and that allow early diagnosis; iii) medical attention, medicaments and related products for the diseases that affect children under 5 years; and v) certain type of interventions. Mexican children who were born as of December 1st of 2006, who are not beneficiaries of social security. Beneficiaries of the SMNG are Mexican children born as of December 1 st of 2006, who are not beneficiaries of social security or do not have any other mechanism of social prevention on health and that are affiliated to the System. On perspective, beneficiary population of the Program shall be taken care of until they reach the age of five years old. The program operates in all towns within national territory where there are families with Mexican children that were born as for December 1 st of 2006, who are not beneficiaries of the social security system and have the possibility of access to the health services from any institution within the Health National System with capacity to provide the benefits of this Program. Eligible as beneficiaries of SMNG are Mexican children that belong to families affiliated to the system and who further proof: i) to be Mexicans residents within Mexican territory, ii) to have been born on December 1 st of 2006 or after, iii) not to be beneficiaries of social security or have some other mechanism of social prevention on health; and iv) their rights to be current within the System. 169

177 Potential disparities N/A Coverage Geographic Number of covered people Quality of the coverage The Program operates within all of the localities in National Territory. In 2008, close to de 830,000 children were affiliated to the Program, the Federal District, Nuevo Leon and Veracruz with larger coverage N/A Most vulnerable children N/A Monitoring and Evaluation Yes/No By whom Impact of the results Implementation challenges Not available Not Available Not available There is no evidence but it is believed that it stimulates informality. 170

178 12 Concept Description Name of the Program Urban Marginal Child Work Objectives Type of Program Inclusion argument Keep or reinsert into and education environment girls, boys and teenagers, so as to break the circle of poverty. For child protection: social assistance Because it contributes to the attention to causes that generate children s work, such as: lack of education, cultural aspects that determine whether the girls or boy will go to school, insufficiency of resources to go to school, among others. Financing cost 2008 Budget MILLIONS OF MEXICAN PESOS Budget per State (%) Aguascalientes Baja California Baja California Sur Campeche Coahuila Colima Chiapas Chihuahua Durango Guanajuato Guerrero Hidalgo Jalisco Mexico Michoacan Morelos Nayarit Nuevo Leon Oaxaca Puebla Queretaro Quintana Roo San Luis Potosi Sinaloa Sonora Tamaulipas Tlaxcala Veracruz Yucatan Zacatecas Captured in Section A If yes: proportion to total Participating Agencies No N/A DIF National System (Normative Instance) and 31 State DIF Systems (Executing Instances): Aguascalientes, Baja California, Baja California Sur, Campeche, Coahuila, Colima, Chiapas, Chihuahua Durango, Guanajuato, Guerrero, Hidalgo, Jalisco, Mexico, Michoacan, Morelos, Nayarit, Nuevo Leon, Oaxaca, Puebla, Queretaro, Quintana Roo, San Luis Potosi, Sinaloa, Sonora, Tabasco, Tamaulipas, Tlaxcala, Veracruz, Yucatan, Zacatecas Agency s role Mechanism and Beneficiaries Administrate the financial resources, Design and execution of the Annual Work Plans, Offer Counseling and Training, Follow-up on the execution of the Programmed Actions and Evaluate the Impact of the Actions. What is delivered? Who are the beneficiaries, who aren t? Focus Target Population Method Potential disparities Coverage Actions of family and community intervention are performed (informal model of education) so as to encourage social co-responsibility in the prevention of risks associated to urban marginal children s work, and scholarships are given to girls and boys, who due to their precarious situation do not have the economic means to attend or remain within an education environment. Working girls, boys and teenagers who live in socially excluded urban areas, and their families. Girls, boys and teenagers who work in urban areas and live in conditions of social exclusion, and also their families. As part of the strategies against children s work, the participation of Communitarian Children s Promoters is expected, who identify girls, boys and teenagers who work in urban areas within their own work ambiance, and invite them to participate with actions that discourage this social phenomenon. In case the family of the boy or the girl does not have sufficient resources for him/ her to remain or be introduced to the school environment, they are then considered as candidate to receive a scholarship, as per budgeted availability. N/A Geographic 31 Federal Entities: Aguascalientes, Baja California, Baja California Sur, Campeche, Coahuila, Colima, Chiapas, Chihuahua Durango, Guanajuato, Guerrero, Hidalgo, Jalisco, Mexico, Michoacan, Morelos, Nayarit, Nuevo Leon, Oaxaca, Puebla, Queretaro, Quintana Roo, San Luis Potosi, Sinaloa, Sonora, Tabasco, Tamaulipas, Tlaxcala, Veracruz, Yucatan, Zacatecas 171

179 Number of covered people Quality of the coverage During Fiscal Exercise 2007 the following coverage was reached: - Attention to a 73,446 working girls and boys, and also to 99,943 girls and boys at risk of incorporating into work activities ,441 attended Families The actions implemented to discourage child work, include the municipalities considered in the survey of 100 Cities of working girls, boys and teenagers performed by the DIF National System and UNICEF Most vulnerable children Monitoring and Evaluation Working girls and boys subject to attention may be: natives, teenagers, pregnant women, with drug problems, in state of abandonment, among others. This is, there is no discrimination for any one particular reason. Yes/No By whom Yes. The Program has external evaluation EVALUATION OF RESULTS 2006: el Colegio Mexiquense EVALUATION OF RESULTS 2007: UAM Impact of the Results Implementation challenges - Reduction of 17.2% of total urban marginal working girls, boys and teenagers, as per the results achieved by the First study on one hundred cities of working girls, boys and teenagers performed in 1997 by the National System for the Integral Development of Family DIF and the United Nations Children s Fund UNICEF, which registered 114,497 working girls and boys who worked in the main urban centers of the country, in the second survey made in ,795 were identified. - Termination efficiency of girls and boys with scholarship of 93% (girls and boys with grants that approved the school term), during fiscal exercise Increase termination efficiency of girls, boys and teenagers within school environment and promote social participation. 172

180 13 Concept Description Name of the Program School Breakfast Program Objectives Type of Program Inclusion argument To promote an adequate nutrition in the vulnerable population with the intention of impacting their nutritional condition through a breakfast or lunch with nutritional quality and through strategies of nutritional orientation and community development. For the nutrition and protection of children: Social Assistance School Nutrition The Program has been operating for 60 years and actuality has become strategic due to the risk of obesity and malnutrition that the Mexican scholar child population faces, in addition to a complex problem of low levels of education, lack of information and poverty. Financing cost 2007 Budget Captured in Section A If yes: proportion to total Participating Agencies 3,030.8 MILLIONS OF MEXICAN PESOS No N/A -National System for Integral Family Development (DIF) -DIF National System. -DIF from each State -DIF State System Agency s role Mechanism and Beneficiaries 1. Coordination of the Program; 2. Operation of the Program What is delivered? Who are the beneficiaries, who aren t? Focus Target Population Method Hot or Cold Breakfast (milk, cookies or cereal bars, juice, fruit, vegetables, leguminous, meat, chicken, eggs) Students from public schools after a targeting exercise aiming at detecting vulnerability conditions. Preschool and elementary school children from public schools Targeting by the level of marginalization and poverty Potential disparities N/A Coverage Geographic The entire Mexican Republic Number of covered people 5,510,187 children with federal resource. Quality of the coverage It is necessary to reorganize and redefine the targeting strategy Most vulnerable children N/A Monitoring and Evaluation Yes/No By whom Impact of the Results Implementation challenges Yes. The Program is evaluated by an external organism. CONSISTENCY AND RESULTS EVALUATION Instituto Tecnologico y de Estudios Superiores de Monterrey -The Program correctly identifies the problem that wishes to solve (infant malnutrition and the performance of children at school) -The variety in the composition of the school breakfasts given by each of the 32 States causes that the nutritional components of these breakfasts might be significantly different from one State to another, from a population group to another, as well from a type of breakfast to another. -At national level, the Program hasn t been able to consolidate the mechanisms for a systematic gathering of information that allows the global analysis of the -performance and results of the Program. -To improve the quality and nutritional contents of the school breakfasts given around the country so that the breakfasts could help to achieve a healthier diet according to the needs of the different groups served. -To plan and implement actions to guarantee that in every single breakfast the three big groups of food are included; to encourage eating vegetables, fruits, leguminous and integral cereals; to include, preferably, regional and seasonal food from local producers, as well as to consider the fat, sugar and sodium contents in order to prevent issues like child obesity. 173

181 14 Concept Description Name of the Program National Net of Childhood Rights Diffusion Objectives Type of Program Inclusion argument Financing cost Budget Captured in Section A To create a space for girls, boys and teenagers to promote the knowledge, analysis and reflection of their rights and motivate them to freely and voluntarily participate in their family, school and community, in order to build up a social culture where children rights are practiced and respected. For child protection: a precautionary strategy that promotes the knowledge of children s rights and the education of the citizens. Innovative since the knowledge, reflection and practice of their rights will help the girls, boys and teenagers, especially the most vulnerable ones, to actively participate in building up a better social environment for them, promoting equal opportunities, as in the extent that this population group exercise its citizenship it will make itself more visible to the adult s world. During this process, adults that interact with the boys and girls that participate in the Program are also involved in building up a social culture of daily practice of children s rights. The National System for Integral Family Development (DIF National System) (SNDIF) does not disburse resources for the operation of the strategy. The States and municipalities use their own resources for the implementation of the Program and the expenses required for it. That is why the budget and the activities are different in each case. N/A If yes: proportion to total N/A Participating Agencies State governments, Electoral Institutes from each State, The Human Rights Commission from each State and municipalities, The Ministry of Public Education from each State and local areas, Indigenous Towns Commission, Municipal Councils Agency s role Mechanism and Beneficiaries i) Facilitate spaces in the mass media, they allocate budget for the operation of the strategy, ii) support and/or create the election of diffusing groups and its training, iii) facilitate the promotion of the strategy in the schools, iv) implement the strategy in the shelters/schools in indigenous areas and train the personnel that works with children on children s rights (Yucatan); v) support the local activities of the diffusing groups of girls and boys. What is delivered? Who are the beneficiaries, who aren t? Focus Target Population Advice and support for the diffusion of the children s rights. Girls, boys and teenagers attended by the DIF and the overall population Mainly girls, boys, teenagers and their families participating in the different programs implemented by the DIF of the States and municipalities, by government workers of the System, local (municipality) authorities and the overall population. Method N/I Potential disparities N/A Coverage Geographic 32 States reported and 30 operating with the participation of 1276 municipalities During 2008 (January-June) Informed girls 30,258, trained girls 7,073 Number of covered people Informed boys 30,577; trained boys 6,372 Informed adults 10,697; trained adults 3,964 Total informed 71,532; trained 17, DIFfusers and state representatives and 1276 municipalities Quality of the coverage The strategy has contributed to the knowledge of the children s rights by the children and to the diffusion of them among the community, especially among the local authorities. 174

182 Most vulnerable children The most vulnerable children are attended by DIF. The participation of girls and boys in the strategy is almost the same. The difference is 1.02% more girls than boys. Monitoring and Evaluation Yes/No By whom Impact of the Results Implementation challenges Due to the lack of resources there isn t an evaluation that indicates the progress and impact of the strategy, although the Inter-American Children s Institute (IIN) considers it a novelty strategy. No N/A The National System for Integral Family Development (SNDIF) has been making sure that the results from the annual workshops made with the diffusers groups of girls and boys from the federal entities are analyzed and taken into account to have a more active and genuine participation of children so that this can contribute to their integral formation and citizens formation. -Lack of a budget to create national campaigns. -Lack of knowledge from the authorities at all levels of the government about the commitments taken by our country when ratifying at the Child s Rights Convention. -Resistance of adults to recognize that girls and boys have rights (culture). -Lack of knowledge from adults (teachers, parents, Civil Society Organizations (CSOs) and community authorities) about the implementation and interpretation of the Child s Rights Convention. -Lack of a budget at all levels to promote and diffuse the knowledge and implementation of the children s rights. -Lack of knowledge about the promotion and motivation of child population. 175

183 15 Concept Description Name of the Program Program for Girls, Boys and Adolescents in Frontier Zones Strategy for the Prevention and Attention of migrant and repatriated children and adolescents Objectives Type of Program Inclusion argument To join efforts and actions between the three instances of the government order, public and private institutions, and national and international organisms from the civil society to prevent and attend the needs of migrant and repatriate boys, girls and teenagers traveling by themselves and the collateral problems which they are exposed to, as well as to promote coordinated actions of familiar and communitarian protection and contention. At the same time, with the strategy implementation, in both, the north and south borders the physical and metal integrity of the migrant and repatriated boys, girls and teenagers are protected until their return to their families and their return to their places of origin. For the infant protection: Social Assistance The search for better living conditions has made migration one of the big global phenomena. In this case, Mexico becomes the place of origin, traffic and destination of many men, women, girls, boys and teenagers wishing to enter the United States searching for better life conditions, sometimes leaving behind, unprotected and in a vulnerable condition, their wives, children and relatives. Financing cost 2008 Budget MILLIONS OF MEXICAN PESOS Budget per State (%) Aguascalientes Baja California Coahuila Chiapas Chihuahua Guanajuato Guerrero Jalisco Mexico Michoacan Nuevo Leon Puebla Sinaloa Sonora Tabasco Tamaulipas Veracruz Captured in Section A If yes: proportion to total Participating Agencies No N/A The National System for Integral Family Development (SNDIF) and 17 State DIF Systems (Executorial Instances): Aguascalientes, Baja California, Coahuila, Chiapas, Chihuahua, Guanajuato, Guerrero, Jalisco, Mexico, Michoacan, Nuevo Leon, Puebla, Sinaloa, Sonora, Tabasco, Tamaulipas, Veracruz. At the same time, the Program is in coordination with the following public and private institutions: Secretary of Government, Ministry of Foreign Affairs, Ministry of Health, National Institute of Migration, Mexican Commission for Refugee Assistance, UNICEF, National Institute of Women, UNHCR (The UN Refugee Agency), IOM (International Organization for Migration), Secretariat of Social Development, Juvenile Integration Centers, Organizations from the civil society, National Human Rights Commission, YMCA, and AEROMEXICO (airline). Agency s role Mechanism and Beneficiaries i) Manage the financial resources, design and execution of the annual work plans; ii) give advise and training; iii) follow up the execution of programmed actions; iv) evaluate the impact of such actions. What is delivered? Who are the beneficiaries, who aren t? Focus Target Population Through this strategy, financial resources are given to the State DIF Systems which use them to transfer the girls, boys and teenagers from the north and south borders of Mexico to their place of origin, they also get support for food and ground transportation, and for the strengthening of the shelters or places where the girls, boys and teenagers are guarded. Migrant and repatriated girls, boys and teenagers (nationals and foreigners) Migrant or repatriated girls, boys and teenagers (nationals and foreigners) travelling by themselves, this means without an adult relative. From new born up to 17 years 11 months of age getting temporary shelter to protect their physical and mental integrity during the time of their journey to their place of origin or until being reunited with their family. 176

184 Method Potential disparities Coverage Geographic Number of covered people In the case of Mexican citizens, the program attends all the girls, boys and teenagers traveling by themselves and that are repatriated by the United States authorities or that have migrated from their place of origin with the intention of crossing the northern border with the United States but are unable to do so and are left abandoned in the border cities. Regarding, foreign girls, boys and teenagers, the program attends all the cases referred by the National Institute of Migration inside the frame and agreements established for that purpose. N/A 17 States: North border: Baja California, Coahuila, Chihuahua, Nuevo Leon, Sonora y Tamaulipas South border: Chiapas, Tabasco, and Veracruz Place of origin: Aguascalientes, Guanajuato, Guerrero, Jalisco, Mexico, Michoacan, Puebla and Sinaloa During the 2007 fiscal year, the program reached the following coverage: Assistance to 21,366 migrants and repatriate girls, boys and teenagers (national or foreign) traveling by themselves. Regarding the year 2008 (up to September), the program had assisted 15,256 migrants and repatriate girls, boys and teenagers (national or foreign) traveling by themselves. Quality of the coverage Most vulnerable children Monitoring and Evaluation The working girls and boys that are attended by the program can be indigenous, pregnant teenagers, with addiction problems, abandoned, among others. This means, that the program doesn t discriminate against any special condition and it aims to give attention to every boy, girl and teenager living under these vulnerable conditions. Yes/No By whom Impact of the Results Implementation challenges Yes. The Program is evaluated by an external organism. RESULTS EVALUATION 2006: Colegio Mexiquense RESULTS EVALUATION 2007: Universidad Autonoma Metropolitana The shelters net have the ability of making boys, girls and teenagers aware of the dangers of the informal migration. The intervention methodology influences the patterns of behavior of the target population by guaranteeing the respect and protection of their rights. To establish the operation of an information system that allows the intercommunication of all the organisms involved in the attention of migrant and repatriate girls, boys and teenagers, in order to make it easier and faster for them to return to their places of origin. 177

185 Appendix 2. National Mexican Family Life Survey The Mexican Family Life Survey (ENNViH or MxFLS) is a multi-thematic and longitudinal database which collects, with a single scientific tool, a wide range of information on socioeconomic indicators, demographics and health indicators on the Mexican population. ENNViH is the first Mexican survey with national representation departing from a longitudinal design, tracking the Mexican population for long periods of time regardless of migration decisions with the objective of studying the dynamics of economy, demographics, epidemiology, and population migration throughout this panel study of at least, a 10-year span. The base-line sampling design was undertaken by the National Institute of Geography Statistics and Information (INEGI acronym in Spanish). This base-line is a probabilistic, stratified, multi-staged, and independent sample at every phase of the study. The scope of the study consists of private households in Mexico during the year Primary sampling units were selected under criterions of national, urban-rural and regional representations on pre-established demographic and economic variables. Regional definitions are in accordance with the National Development Plan The approximate sampling size is 8,440 households with approximately 35,000 individual interviews in 150 communities throughout the Mexican Republic. The base-line was conducted during The second wave of field work was conducted during with a 90 per cent re-contacting rate at household levels. The 3rd and 4th waves of the survey are programmed for the years 2009 and 2012, respectively. The multidimensional characteristics of the ENNViH facilitate the inter-relational study of different demographic and socioeconomic phenomenons present in population welfare dynamics. Surveys ENNViH 1 and 2 provide detailed information on the individual, household and community levels: Household and Individual Information Expenditure and consumer models, decisions regarding savings, family owned assets and wealth, as well as information about total and transfer mechanisms of resources between non-resident family members. Information regarding the impact of social programs in the community, as well as at the household and individual levels. Levels of education and school attendance decisions and permanent schooling for all household members, including information on school performance, grade repetition, as well as the highest level of education attained by parents and siblings who do not reside within the household, regardless of weather or not they are deceased. Type of employment, participation and mobility within the workforce of all household members who are over the age of 5, along with retrospective information about the individual s employment activities in a formal and informal sector during the past two years, as well as general information about his/her first job. Time allocation information on an individual level concerning household activities, child education, recreational and leisure time in general. Measurement and interpretation of health status: self-perception and expectations of the individuals own health status, everyday habits relating to the care or negligence of individual health (sports, alcohol drinking, tobacco, etc.); functional indicators for elderly adults; tendencies and reports of chronic illnesses; anthropometric measures (weight and size) relating to nutritional and overweight problems; and samples of biological indicators such as blood pressure and hemoglobin levels that are found to be related to arterial hypertension and anemia complications, respectively. MxFLS 1 and 2 includes information on the demand and use of health services, public as well as private, and self-medication. 178

186 Retrospective information on reproductive health, pregnancy history, births and abortions pertaining to women of fertile age within the household (ages 14-45); the practice and use of contraceptives and information about the use of health services during pregnancy, during labor and postnatal services. Crime and victimization information on a household and an individual level theft, assault, burglary and kidnapping and their relation on individual welfare; as well as individual conduct modifications that function on levels of perception pertaining to community safety, such as a change of residence, investments in modes of security, general modifications of everyday habits. Information on the use of, and managing of agricultural lands and family businesses. Individual, historical information on marriage, domestic partnership and migration (permanent and rotating ) of adult women and men who comprise the household. The second wave also includes a module to measure risk preferences, inter-temporary and altruistic preferences; a module about individual expectations, and information on paternity and daycare centers. There are also additional biomarkers such as: total levels of cholesterol and a total count of glucose levels while fasting. Community Information Similar to the fieldwork conducted on households, ENNViH-1 carried out a community operative with the purpose of collecting quantitative and qualitative data on schools, health centers and small health care providers; on social programs, and economic and physical infrastructures; and information on the level of local prices by means of visiting medical dispensaries, pharmacies, markets, flea markets, miscellaneous and/or supermarkets within the community. Discussion We consider that the ENNViH represents an excellent source to perform the statistical analysis of the Study on Poverty and Disparities during Childhood. In fact, this is the only source that allows in great extent the elaboration of most of the charts in the Statistical Template. A main advantage is that, thanks to the great quantity and diversity of information in this survey, practically all the charts proposed in the Statistical Tables can be made using this data base, which avoids the use of different bases for all the topics that are analyzed in this study, thus avoiding compatibility issues. It is important to mention that, due to the fact that the population weights for the second round of ENNViH were not ready at the time of performing the analysis, the tables here were carried out using the first round of the ENNViH, thas is, data of In this study, statistical information is made according to the regions where the ENNViH is representative These regions are: Central-Northeast (Coahuila, Durango and Nuevo Leon), Central West (Guanajuato, Jalisco and Michoacan), Central-Country (Federal District, State of Mexico, Morelos and Puebla), and Northwest (Baja California Sur, Sinaloa and Sonora) and South-Southwest (Oaxaca, Veracruz and Yucatan). Possibly the sole limitation of EN- NViH for this study is that this data base only covers the periods of 2002 to 2005 Therefore, we shall complement our analysis using alternate sources of information with a longer period of time coverage. These data bases are: National Survey of Household Incoem and Expenditures (performed since beginning of the eighties to this date) Census of Households and Population 2005, 2000, 1995 National Survey on Occupation and Employment (ENOE) National Survey on Demographic Dynamics (ENADID) National Survey on Health and Nutrition (ENSANUT) 179

187 Appendix 3. Construction of variables of deprivation through ENIGH and ENNViH ENIGH (National Survey on Household Income and Expenditures) For the categorization of the variables on deprivations, the following questions of the 1994 and 2005 ENIGH questionnaire were taken into consideration: 1. Shelter Severe deprivation: home with five or more dwellers per room with dirt floor Less severe deprivation: home with four or more dwellers per room or with dirt floor or with discarded materials, roof of cardboard sheets, metallic or asbestos sheets, reeds, bamboo or palm, rope or shake, or earth with beams 2. Sanitation Severe deprivation: the dwelling has no bathroom 3. Water Severe Deprivation: the dwelling gets water from a river, creek or lake or other source Less severe deprivation: the dwelling gets water from a well, a pipe or a public tap. 4. Information Severe deprivation: the dwelling has no television, neither black-and-white nor color, and has no computer Less severe deprivation: children and adults in the house have a television set, black-and-white or color, and have no computer 5. Education Severe deprivation: when the child between 7 and 17 does not go to school Less severe deprivation: children between 7 and 17 years old who do not go to school or did not finish primary education 6. Health does not apply because there is no information on which to construct the indicator 7. Alimentation does not apply because there is no information with which to construct the indicator ENNViH (Mexican Famiy Life Survey) For the categorization of the variables on deprivations, the following questions from the ENNViH 2002 and 2005 were taken into consideration: 1. Shelter Severe deprivation: home with five or more dwellers per room or with dirt floor Less severe deprivation: home with four or more dwellers per room or with dirt floor or reed, bamboo, earthen or discarded materials 2. Sanitation Severe deprivation: the dwelling has no bathroom Less severe deprivation: the dwelling has a latrine, black hole or well 180

188 3. Water Severe deprivation: the dwelling gets water to wash or drink from a river, creek or lake (carried) or other source Less severe deprivation: the dwelling has water to drink or wash from a pipe or public tap 4. Information Severe deprivation: children at the house did not watch television, did not read or use the Internet during last week Less severe deprivation: children and adults at the house did not watch television or use the Internet during the past week 5. Education Severe deprivation: children between 7 and 17 years who do not go to school or never did. Less severe deprivation: children between 7 and 17 years old who do not go to school or did not finish primary education 6. Health: Severe deprivation: children who were not vaccinated against measles, diphtheria, tuberculosis or polio. Less severe deprivation: children who did not get vaccinated against measles, diphtheria tuberculosis or polio at age two 7. Alimentation: Severe deprivation: children who find themselves over three standard deviations below the international reference of impairment (height per age) or the BMI per age Less severe deprivation: children who find themselves over two standard deviations below the international reference of impairment (height per age) or the BMI per age 181

189 For further information on the Study on Poverty and Disparities in Childhood: the Case of Mexico please contact: Paseo de la Reforma 645 Col. Lomas de Chapultepec Mexico, D.F Mexico UNICEF Mexico/ Mauricio Ramos July, 2009